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We investigated the role of mortalin (HSPA9) and its interaction with other mitochondria-related genes (parkin, PINK1, DJ1, and COQ2) as a risk factor for Parkinson's disease (PD) and Alzheimer's disease (AD) in 500 PD, 400 AD, and 500 control subjects. The HSPA9 variants identified by direct sequencing or its interaction with other genes assessed by genetic risk scores did not show a significant association with PD or AD risk. Our findings did not provide a strong evidence for the role of HAPA9 and its interaction with other mitochondria-related genes as a genetic risk factor for PD or AD.

Objectives This article describes new longitudinal data on older adults' egocentric social networks collected by the National Social Life, Health, and Aging Project (NSHAP). We describe a novel survey technique that was used to record specific personnel changes that occurred within respondents' networks during the 5-year study period, and we make recommendations regarding usage of the resulting data. Method Descriptive statistics are presented for measures of network size, composition, and structure at both waves, respondent-level summary measures of change in these characteristics between waves, as well as measures that distinguish between changes associated with losses of Wave 1 network members, additions of new ones, and changes in relationships with network members who were present at both waves. Results The NSHAP network change module was successful in providing reliable information about specific changes that occurred within respondents' confidant networks. Most respondents lost at least one confidant from W1 and added at least one new confidant between waves as well. Network growth was more common than network shrinkage. Both lost and new ties were weaker than ties that persisted throughout the study period. Discussion These data provide new insight into the dynamic nature of networks in later life, revealing norms of network turnover, expansion, and weakening. Data limitations are discussed.

This paper introduces scales on shared activity and relationship quality for married and partnered older adults using multiple indicators from the second wave of National Social Life, Health, and Aging Project.We assessed the reliability of the scales using Cronbach's alpha and the item-total correlation. We conducted exploratory factor analysis to explore the structure of the items and compared the distribution of each scale means by age group and gender.We found that the relational quality scale has a 2-factor structure, including a positive and negative dimension. The shared activity scale has a 1-factor structure. We found that partnered men show both higher positive and higher negative relationship quality than do partnered women, suggesting that more older men than women experience ambivalent feelings toward their spouse or partner and more women than men have relationships of indifferent quality, with relatively low costs and relatively low benefits.The separate conceptualization of shared activity and relationship quality provides one way to examine the dynamic nature of marital quality in later life such as the extent to which shared activities among couples promote or detract from relationships' quality. Analyses for individuals and for dyads are discussed.

Despite the importance of airway surface liquid pH in the lung's defenses against infection, the mechanism of airway HCO3− secretion remains unclear. Our aim was to assess the contribution of apical and basolateral Cl−/HCO3− exchangers to Cl− and HCO3− transport in the Calu-3 cell line, derived from human airway submucosal glands. Changes in intracellular pH (pHi) were measured following substitution of Cl− with gluconate. Apical Cl− substitution led to an alkalinization in forskolin-stimulated cells, indicative of Cl−/HCO3− exchange. This was unaffected by the anion exchange inhibitor DIDS but inhibited by the CFTR blocker CFTRinh-172, suggesting that the HCO3− influx might occur via CFTR, rather than a solute carrier family 26 (SLC26) exchanger, as recently proposed. The anion selectivity of the recovery process more closely resembled that of CFTR than an SLC26 exchanger, and quantitative RT-PCR showed only low levels of SLC26 exchanger transcripts relative to CFTR and anion exchanger 2 (AE2). For pHi to rise to observed values (∼7.8) through HCO3− entry via CFTR, the apical membrane potential must reverse to at least +20 mV following Cl− substitution; this was confirmed by perforated-patch recordings. Substitution of basolateral Cl− evoked a DIDS-sensitive alkalinization, attributed to Cl−/HCO3− exchange via AE2. This appeared to be abolished in forskolin-stimulated cells but was unmasked by blocking apical efflux of HCO3− via CFTR. We conclude that Calu-3 cells secrete HCO3− predominantly via CFTR, and, contrary to previous reports, the basolateral anion exchanger AE2 remains active during stimulation, providing an important pathway for basolateral Cl− uptake.

The mother-infant relationship is an instinctive phenomenon, and loss of maternal care in early life influences neonatal development, behavior and physiologic responses.(1,2) Furthermore, the early loss may affect the vulnerability of the infant to neuropsychiatric disorders, such as childhood anxiety disorders, personality disorders and depression, over its lifespan.(3,4) Fluoxetine is prescribed worldwide for depression and is often used in the treatment of childhood mental problems related to maternal separation or loss of maternal care.(5,6) In the present study, fluoxetine was administrated to rats with maternal separation to determine its effects on neuronal development, in particular with respect to cell proliferation and apoptosis in the dentate gyrus of the hippocampus. Rat pups were separated from their mothers and socially isolated on postnatal day 14 and were treated with fluoxetine (5 mg kg(-1)) and 5-bromo-2'-deoxyuridine (BrdU) (50 mg kg(-1)) for 7 days, after which immunohistochemistry and a terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining were carried out. In the pups with maternal separation treated with fluoxetine, the number of BrdU-positive cells was significantly increased and that of TUNEL-positive cells was significantly decreased in the dentate gyrus compared to pups with maternal separation that did not receive fluoxetine treatment. These findings indicate that fluoxetine affects new cell proliferation and apoptosis, and we propose that fluoxetine may be useful in the treatment of maternal separation-related diseases.

Objectives To evaluate the characteristics of ischemic stroke in Korean young adults. Material and methods We prospectively studied 149 consecutive patients with acute ischemic stroke aged between 15 to 44 years who were admitted to Asan Medical Center. All patients underwent brain CT/MRI and the majority of them underwent cerebral anglogram, echocardiography and laboratory studies for coagulopathy and vasculitis. Stroke subtypes were classified according to TOAST criteria. Results In our study, men (75.2%) significantly outnumbered women. Stroke subtypes were: large artery atherosclerosis 20.8%), small artery occlusive disease 17.4%), cardioembolism 18.1%, undetermined causes 16.8%, and other determined etiologies 26.8%. The prevalence of hypertension, cigarette smoking and habitual alcohol consumption was significantly higher in men than in women. Conclusions Compared to the western studies, the deviation of sex ratio and the relative proportion of large artery atherosclerosis/small artery occlusion was higher. Heavy exposure to risk factors such as hypertension and cigarette smoking in Korean young men may explain these differences.

Self-organized In0.6Ga0.4As/GaAs/AlGaAs quantum dot (QD) heterostructures were grown by metalorganic chemical vapor deposition using the Stranski–Krastanow growth mode. The atomic force microscopy image shows that the quantum dot structures are formed. The room-temperature photoluminescence (PL) measurement was employed to establish the optimized growth condition for QD structures. A strong PL emission was obtained at room temperature. Blueshifts in the PL emission from InGaAs QDs are observed as a results of postgrowth annealing and also when raising the upper cladding layer growth temperatures. Also, the strong electroluminescence at room temperature shows the possibility of QD optical device. Using the optimized growth condition, a full laser structure was fabricated by selective oxidation.

High-quality GaAs layers were grown on Si substrates by low-pressure metalorganic chemical vapor deposition. Double crystal X-ray diffraction measurement shows that the structural properties of GaAs layers are so much improved by 5 μm thick Ge buffer layer and InGaAsGaAs strained-layer superlattice. The X-ray full-width at half-maximum of the (4 0 0) reflection obtained from 2 μm thick GaAs is 98 arcsec, one of the smallest value ever reported. The surface dislocation density of the GaAs layer estimated by molten KOH study is as low as 4 × 105cm−2. Photoluminescence and Raman measurements confirm the good optical quality of the heteroepitaxial GaAs epilayer.

Background The genetic factors that determine the heterogeneity of cognitive impairment in Alzheimer's disease (AD) patients have been rarely reported. We aimed to investigate the association between top hits of genome-wide association studies (GWAS) and specific cognitive domains in AD patients. Methods We investigated 86 single nucleotide polymorphisms (SNPs) selected from 12 genes ( ABCA7 , APOE , BIN1 , CD2AP , CD33 , CLU , CR1 , EPHA1 , LRAT , MS4A6A , PCDH11X , and PICALM ) based on results of the recent GWAS and genotyped in 211 AD cases. We also analyzed results of comprehensive neuropsychological evaluations in all cases. We performed multiple regression analyses. Results There were four significant associations between genotypes and phenotypes of AD patients: CR1 SNP rs11803956 correlated with Mini-Mental State Examination (MMSE) score (β=1.718, P corrected =0.002); ABCA7 SNP rs3752232 correlated with Rey Complex Figure Test (RCFT) copy score (β=−6.861, P corrected =0.013); APOE SNP rs2075650 correlated with the percentile of RCFT copy score (β=14.005, P corrected =0.021) and the percentile of total score in phonemic fluency (β=11.052, P corrected =0.035). Conclusion Our results suggest that CR1 , ABCA7 , and APOE correlate with specific aspects of cognitive impairments in AD patients.

Background and purpose The progression pattern of brain structural changes in patients with isolated cerebrovascular disease (CVD) remains unclear. To investigate the role of isolated CVD in cognitive impairment patients, patterns of cortical thinning and hippocampal atrophy in pure subcortical vascular mild cognitive impairment (svMCI) and pure subcortical vascular dementia (SVaD) patients were characterized. Methods Forty-five patients with svMCI and 46 patients with SVaD who were negative on Pittsburgh compound B (PiB) positron emission tomography imaging and 75 individuals with normal cognition (NC) were recruited. Results Compared with NC, patients with PiB(-) svMCI exhibited frontal, language and retrieval type memory dysfunctions, which in patients with PiB(-) SVaD were further impaired and accompanied by visuospatial and recognition memory dysfunctions. Compared with NC, patients with PiB(-) svMCI exhibited cortical thinning in the frontal, perisylvian, basal temporal and posterior cingulate regions. This atrophy was more prominent and extended further toward the lateral parietal and medial temporal regions in patients with PiB(-) SVaD. Compared with NC subjects, patients with PiB(-) svMCI exhibited hippocampal shape deformities in the lateral body, whilst patients with PiB(-) SVaD exhibited additional deformities within the lateral head and inferior body. Conclusions Our findings suggest that patients with CVD in the absence of Alzheimer's disease pathology can be demented, showing cognitive impairment in multiple domains, which is consistent with the topography of cortical thinning and hippocampal shape deformity.

Meeting clock skew constraint is one of the most important tasks in the synthesis of clock trees. Moreover, the problem becomes much hard to tackle as the delay of clock signals varies dynamically during execution. Recently, it is shown that adjustable delay buffer (ADB) whose delay can be adjusted dynamically can solve the clock skew variation problem effectively. However, inserting ADBs requires non-negligible area and control overhead. Thus, all previous works have invariably aimed at minimizing the number of ADBs to be inserted, particularly under the environment of multiple power modes in which the operating voltage applied to some modules varies as the power mode changes. In this work, unlike the previous works which have solved the ADB minimization problem heuristically or locally optimally, we propose an elegant and easily adoptable solution to overcome the limitation of the previous works. Precisely, we propose an O(n log n) time (bottom-up traversal) algorithm that (1) optimally solves the problem of minimizing the number of ADBs to be inserted with continuous delay of ADBs and (2) enables solving the ADB insertion problem with discrete delay of ADBs to be greatly simple and predictable. In addition, we propose (3) a systematic solution to an important extension to the problem of buffer sizing combined with the ADB insertion to further reduce the ADBs to be used.

Background Xerostomia, a subjective sense of dry mouth, is not generally regarded a disease despite its high prevalence among the elderly, and therefore continues to impair affected patients’ quality of life. In traditional Korean medicine, ‘Yin-Deficiency’ has been implicated in the pathogenesis of xerostomia among the elderly. Yukmijihwang-tang is a famous herbal prescription used to relieve ‘Yin-Deficiency’, and reportedly has antioxidant effects; therefore, it is postulated that Yukmijihwang-tang can be used to treat xerostomia in the elderly. However, to our knowledge, no clinical trial has been conducted on the effects of Yukmijihwang-tang on xerostomia. Thus, we designed a randomized clinical trial to investigate the effects and safety of Yukmijihwang-tang on xerostomia in the elderly. In addition, we will clarify the aforementioned assumption that ‘Yin-Deficiency’ is the major cause of xerostomia in the elderly by identifying a correlation between xerostomia and ‘Yin-Deficiency’. Methods/Design This randomized, double-blind, placebo-controlled trial will be carried out at two centers: Kyung Hee University Korean Medicine Hospital and Kyung Hee University Hospital at Gangdong. We will recruit 96 subjects aged 60-80 years who have experienced xerostomia for 3 months prior to participation. Subjects who present with score >40 on the visual analogue scale for xerostomia and unstimulated salivary flow rate under 0.3mL/min will be included and the randomization will be carried out by an independent statistician by using a random number creation program. The subjects and all researchers except the statistician will be blinded to the group assignment. Yukmijihwang-tang or placebo will be administered to each group for 8 weeks. The primary outcome is change in the scores for the visual analogue scale for xerostomia and the dry mouth symptom questionnaire from 0 to 8 weeks. Discussion It will be assessed whether Yukmijihwang-tang can be used as a new herbal treatment for xerostomia in the elderly by demonstrating its therapeutic effects in a well-designed clinical trial. Trial registration ClinicalTrials.gov Identifier:NCT01579877

Alzheimer's disease (AD) and Parkinson's disease (PD) have overlapping clinical and pathological features, suggesting a common pathway for these 2 neurodegenerative disorders. Here we investigated the association of both AD and PD GWAS top hits with PD susceptibility. We selected 25 single nucleotide polymorphisms (SNPs) in 9 genes (ABCA7, APOE, BST1, CLU, CR1, LRRK2, PARK16, PICALM, and SNCA) that were genotyped in 1036 PD case patients and 1208 controls. Case patients and controls were all ethnic Koreans. Logistic regression analysis was performed to calculate age- and sex-adjusted odds ratios. None of the AD-susceptibility loci (ABCA7, APOE, CLU, CR1, and PICALM) showed statistically significant association with PD susceptibility. In contrast, we replicated associations of SNCA, LRRK2, BST1, and PARK16 with PD susceptibility in Koreans. Of those, the SNCA SNP rs11931074 showed the most significant association with PD susceptibility (adjusted odds ratio = 1.48; 95% confidence interval = 1.31-1.67; p = 2.20E-10). In a logistic regression analysis with SNPs coded under an additive model, there was no significant genetic interaction between the LRRK2 and the PARK16 locus gene RAB7L1 in PD risk. Our results confirm the associations of SNCA, LRRK2, BST1, and PARK16 with PD susceptibility and fail to show significant associations of AD genome-wide association study (GWAS) top hits with PD susceptibility in a Korean population.

Tongue diagnosis is an important procedure in traditional Korean medicine (TKM). In particular, tongue coating thickness (TCT) is deemed to show the progression of the disease. However, conventional tongue diagnosis has limitations because of various external factors. Therefore, it is necessary to investigate the availability of tongue diagnosis system (TDS) in the assessment of TCT. This study has been designed as a prospective clinical trial involving 60 patients with functional dyspepsia. Tongue images will be obtained by TDS twice with a 30 min interval. The system will measure the percentage of TCT and classify it as either no coating, thin coating, or thick coating according to the existing diagnostic criteria. After finishing the collection of 60 patients' tongue images, TCT on the images will be simultaneously evaluated by the conventional method to establish the gold standard for assessing TCT by 5 well-trained clinicians. The evaluation will be repeated by the same clinicians after 2 weeks, but the order of the images will be changed. This trial is expected to provide clinical evidence for the availability of TDS as a diagnostic tool and to contribute to the standardization of the diagnosis system used in TKM. This trial is registered with ClinicalTrials.govNCT01864837.

Background and purpose Factors related to post- stroke anger proneness (PSAP) are poorly studied. The aim of the present study was to determine the frequency of, and the factors related to, PSAP in the acute stage of stroke. Serotonin transporter protein genes and monoamine oxidase A (MAO-A) gene polymorphisms were also examined. Methods A total of 508 patients with acute IS were screened for PSAP at admission after stroke, using the modified Spielberger Trait Anger Scale. Blood samples were collected from each participant for DNA extraction and genotyping. The promoter of serotonin transporter protein (5-HTTLPR), the variable number of tandem repeat polymorphisms within intron 2 (VNTR STin2), and the 30-bp functional VNTR polymorphism in the promoter region of the MAO-A gene (MAOA-uVNTR) were genotyped. Results Post- stroke anger proneness was present in 15.1% of patients at admission. The factors related to PSAP were diabetes mellitus (P

s / Parkinsonism and Related Disorders 22 (2016) e149ee192 e171 Objectives: PD is an emerging class of autosomal mitochondrial diseases account for a rapidly growing clinical group. Until recently, it was thought that primary mtDNA mutations were the major cause of mitochondrial disease in humans, particularly those presenting in adult life. The proposed research work would plan to analyze the genetics and molecular basis in the POLG mutations in the gene encoding for mtDNA in PD patients. Methods: The PD patient group comprised of 30 individuals and equal numbers of control groups were selected. We collected risk factor information by in-person interview personally with informed concern form. POLG gene polymorphisms were detected using a PCReRFLP technique. Odds ratios were estimated using logistic regression Results: We observed the increased risk of PD among carriers of the homozygous variant genotype of POLG (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.10-4.03) and the homozygous variant genotype of (OR, 1.3; 95% CI, 0.50-6.53). Conclusion: In conclusion my work would involve indicating the neurological diseases which share some common clinical and etiological features with different molecular mechanisms underlie in the observed PD patients. Furthermore, biochemical studies will also help to unravel the mechanisms of pathogenesis, and patterns to emerge relating genotype to phenotype. Therefore, new treatments with the therapeutic target of improving mitochondrial function may prove to be promising. P 5.019. ASSOCIATION OF MORTALIN (HSPA9) AND OTHER MITOCHONDRIARELATED GENES WITH THE RISK OF PARKINSON'S DISEASE AND ALZHEIMER'S DISEASE Sun Ju Chung , Mi-Jung Kim , Ho-Sung Ryu , Juyeon Kim , Young Jin Kim , Kiju Kim , Sooyeoun You , Seong Yoon Kim , Jae-Hong Lee . Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Department of Neurology, Bobath Memorial Hospital, Seongnam, Republic of Korea; Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; Department of Neurology, Dongsan Medical Center, Keimyung University, Daegu, Republic of Korea; Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea Objectives: To investigate the role of genetic variants of the HSPA9 (mortalin gene) in the risk of Parkinson's disease (PD) and Alzheimer's disease (AD) as well as their genetic interactions with other mitochondriarelated genes. Methods: The mortalin (HSPA9), parkin, PINK1, DJ1, and COQ2 genes were selected. For HSPA9, direct sequencing was performed in 24 AD patients, 24 PD patients, and 24 controls. Common and low-frequency genetic variants were also selected using the HapMap and 1000 Genomes Project JPT and CHB samples to select variants in the HSPA9, parkin, PINK1, DJ1, and COQ2 genes. We genotyped genetic variants (8 in HSPA9, 10 in parkin, 4 in PINK1, 6 in DJ1, and 2 in COQ2) in 400 AD cases, 500 PD cases, and 500 controls, using the Fluidigm high-throughput platform. Results: The high-risk group carrying more than 4 risk alleles in the HSPA9 SNP rs41295739, parkin SNP rs9356040, PINK1 SNP rs76795760, DJ1 SNP rs2235733, and COQ2 variant M128V had significantly increased risk of PD compared with the low-risk group carrying 0-2 risk alleles (c2 1⁄4 0.01). The high-risk group carrying more than 3 risk alleles in the HSPA9 SNP rs41295739, parkin SNP rs1784590, PINK1 SNP rs1043424, DJ1 SNP rs34124834, and COQ2 SNP rs148156462 had significantly increased risk of AD comparedwith the low-risk group carrying 0-2 risk alleles (c21⁄4 0.039). Conclusions: Our results suggest that genetic interaction among mitochondria-linked genes may play a role in the development of PD and AD. P 5.020. SCREENING OF SPONTANEOUS GENOMIC ALTERATIONS AND P53 GENE POLYMORPHISM IN NEW ONSET OF PARKINSON DISEASE Jayalakshmi Ramalingam , Iyer mahalaxmi , Mohanadevi Subramaniam , Lokesh Thangamani , Arun Meyyazhagan , Balachandar Vellingiri . Department of Human Genetics and Molecular Biology, School of Life Sciences, Bharathiar University, 641046, Tamil Nadu, South India, Coimbatore, India; Human Genetics Laboratory, School of Life Sciences, Bharathiar University, 641046, Tamil Nadu, South India, Coimbatore, India; BHMG Research and Diagnostic Laboratory, Kovaipudur, Coimbatore, 641042, Tamil Nadu, South India, Coimbatore, India Objectives: Parkinson's disease (PD) is a progressive neurological disorder characterised by a large number of motor and non-motor features that can impact on function to a variable degree. To evaluate the presence of spontaneous chromosomal alterations, Micronucleus, and p53 polymorphism at codon 72 in peripheral blood leukocytes in newly diagnosed Parkinson patients. Methods: Patients with Parkinson disease (35) and control subjects (35), was recruited and matched for age, sex, and smoking habits. Cytogenetic analysis was performed using the human lymphocyte for finding Chromosomal alterations and micronucleus assay. Restriction Fragment Length Polymorphism was done for genotype analysis of P53 gene. Results: Patients with Parkinson disease showed an increase in the incidence of spontaneous Chromosomal alterations (p < 0.05); micronuclei (p < 0.05) compared to controls. Moreover, there was no statistically significant between p53 gene was found in Parkinson Disease. Conclusions: Understanding of the broad spectrum of clinical manifestations of Parkinson Disease is essential to the proper diagnosis of the disease. Genetic mutations or variants, chromosomal abnormalities are potential biomarkers that may improve diagnosis and allow the identification of persons at risk and better treatment options. P 5.021. IDENTIFICATION AND VERIFICATION OF NOVEL FBXO7 INTERACTING PROTEINS Wim Mandemakers , Roy Masius , Michelle Minneboo , Dick Dekkers , Jeroen Demmers , Max Kros , Vincenzo Bonifati . 1 Erasmus MC, Dept. of Clinial Genetics, Rotterdam, Netherlands; 2 Erasmus MC, Proteomics Center, Rotterdam, Netherlands; 3 Easmus MC, Dept. of Patholgy, Rotterdam, Netherlands Objectives: Parkinson disease-15 (PARK15), or parkinsonian-pyramidal syndrome, is caused by mutations in the FBXO7 gene. Although FBXO7 function is implicated in various cellular processes (i.e. cell cycle regulation and mitophagy), mechanistic insight into FBXO7 signaling pathways and consequences of PARK15 mutations is limited. The goal of our study is identification of novel FBXO7 interacting proteins and investigate the effect of PARK15 mutations on the detected interactions and related cellular processes. Methods: TAP-tag and GST-tag proteins of wildtype and mutated (R378G) FBXO7 were generated. DNA expression constructs of TAP-tagged FBXO7 proteins were transfected into human neuroblastoma cell lines (SH-SY5Y) and FBXO7 interacting protein were isolated by sequential pull down using FLAG and Streptactin peptide coated beads. GST-tagged proteins were used to pull down FBXO7 protein interactors from brain extracts. Various experimental paradigms were tested (i.e. investigation of cytoplasmic vs. nuclear interaction, phosphorylation dependent interactions, mitophagy dependent interactions). After pull down, eluates were fractionated by PAGE, Coomassie stained and processed for Mass Spec analysis. Candidate interactors were further validated in relevant follow up experiments. Results: Several FBXO7 protein interaction networks have been identified. Our data confirm previously identified interactions of FBXO7 with proteins from the SCF E3 ubiquitin ligase complex (CUL1, SKP1) and proteasome (PSMF1). In addition, novel FBXO7 interacting proteins involved in various functional pathways (i.e. mitochondrial and nuclear function) have been identified and are currently validated. Conclusions: Identification of novel FBXO7 protein interactors implicates SCF complex-dependent and -independent roles for FBXO7 function in various subcellular compartments (i.e. nucleus, mitochondria, cytoplasm). P 5.022. DEFECTIVE GLUCOCEREBROSIDASE IN GBA1 MUTANT PARKINSON'S DISEASE FIBROBLASTS IS RESCUED BY CHEMICAL CHAPERONE AMBROXOL THROUGH MODULATION OF LYSOSOMAL FACTORS

This paper proposes a graph-based algorithm for solving the adjustable delay buffer (ADB) allocation problem optimally under useful clock skew scheduling. Our algorithm supports additional features: extending the optimality to the allocation of ADBs with quantized delay values , extending the optimality to the allocation of ADBs with delay upper bound , and extending to the consideration of the delay variability of clock buffers . In addition, we propose two acceleration techniques for speeding up the computation. The first one is speeding up the graph traversal of our optimal solver without sacrificing the optimality while the second one, supplementing our algorithm, is to deal with the extremely large designs at the expense of the allocation quality. The experiments with benchmark circuits show that our algorithm reduces the number of ADBs by 23.3% on average over the results produced by the conventional ADB allocation under useful clock skew scheduling and reduces the number of ADBs by 86.3% on average over that produced by the previous optimal ADB allocation under bounded clock skew constraint. In addition, our optimal algorithm runs 30–460 times faster than the prior work.

Objectives: Patients undergoing hemodialysis suffer from a variety of complications related to end-stage renal disease. This prospective, observational pilot study aims to determine the fe...

To investigate the characteristics and prevalence of poststroke depression (PSD) and poststroke emotional incontinence (PSEI) and the factors related to these conditions at admission and 3 months after stroke.We evaluated 508 consecutive patients with acute ischemic stroke for PSD and PSEI at admission and 3 months later. PSD was evaluated using the Beck Depression Inventory, and PSEI was evaluated using Kim's criteria. Blood samples were collected and genotyped for the promoter region of the serotonin transporter protein (5-HTTLPR) and the number of tandem repeats within intron 2 (STin2 VNTR). Perceived social support (the ENRICHD Social Support Inventory) was also measured.PSD and PSEI were present in 13.7% and 9.4% of patients, respectively, at admission and in 17.7% and 11.7%, respectively, at 3 months after stroke. Multivariate analyses showed that PSD at admission was associated with the NIH Stroke Scale score at admission (p0.001), whereas PSD at 3 months was associated with the presence of microbleeds (p0.01) and perceived low social support (p0.001). In contrast, only lesion location (p = 0.022) was associated with PSEI at admission, whereas modified Rankin Scale score (p = 0.019), STin2 VNTR (p = 0.040), and low social support (p = 0.042) were related to PSEI 3 months after stroke.Diverse factors such as neurologic dysfunction, lesion location, microbleeds, genetic traits, and social support are differently related to acute and subacute emotional disturbances. Strategies to prevent or manage these problems should consider these differences.

Using the 10-item Spielberger Trait Anger Scale, the authors interviewed 145 patients with stroke regarding inability to control anger or aggression (ICAA). Poststroke depression and emotional incontinence were also assessed. ICAA was present in 47 patients (32%) and was closely related to motor dysfunction, dysarthria, emotional incontinence, and lesions affecting frontal-lenticulocapsular-pontine base areas. ICAA seems to be one of the major behavioral symptoms in patients with stroke.

Previously, we have shown that green tea extract (GTE) lowers the intestinal absorption of lipids and lipophilic compounds in rats. This study was conducted to investigate whether GTE inhibits the intestinal absorption and biliary secretion of benzo[ a ]pyrene (BaP), an extremely lipophilic potent carcinogen, present in foods as a contaminant. Male rats with lymph or bile duct cannula were infused at 3.0 ml/h for 8 h via a duodenal catheter with lipid emulsion containing 14 C-BaP with or without GTE in PBS buffer. Lymph and bile were collected hourly for 8 h. The 14 C-radioactivities in lymph, bile and intestine were determined and expressed as % dose infused. Results showed that GTE drastically lowered the lymphatic absorption of 14 C-BaP (7.6±3.2% in GTE-infused vs. 14.4±2.7% dose/8 h in control rats), with a significantly higher amount of 14 C-radioactivity present in the small intestinal lumen and cecum in rats infused with GTE. GTE also markedly increased the hourly rate (3.9±0.1% dose/h in GTE-infused vs. 3.0±0.1% dose/h in control rats) and the total biliary secretion of 14 C-BaP (31.5±0.8% dose/8 h in GTE-infused vs. 24.3±0.4% dose/8 h in control rats). The findings provide first direct evidence that GTE has a profound inhibitory effect on the intestinal absorption of BaP and promotes the excretion of absorbed BaP via the biliary route. Further studies are warranted to investigate whether green tea could be recommended as a dietary means of ameliorating the toxicity and carcinogenic effect of BaP.

Purpose To evaluate the technical and clinical safety and the efficacy of Amplatzer Vascular Plug (AVP)-assisted retrograde transvenous obliteration (PARTO) for the treatment of gastric varices (GV) and hepatic encephalopathy (HE). Materials and Methods From April 2009 to December 2011, we evaluated 20 patients (16 men and four women; mean age, 58 years; range, 47-79 years) who had undergone PARTO, 13 of whom had GV and seven who had HE. After retrograde transvenous placement of an AVP into the left adrenal vein, subsequent gelfoam embolization of both the gastrorenal shunt and the GV was performed. Results Placement of the AVP and subsequent gelfoam embolization were technically successful in all 20 patients. There were no procedure-related complications. Follow-up computed tomography (CT) obtained within one week after PARTO showed complete thrombosis of the GV and gastrorenal shunts in all patients. The clinical symptoms of HE were completely resolved in all seven patients with HE and the mean serum NH3 level, which was 127.4 umol/l ± 58 before PARTO, decreased significantly, to 28.1 umol/l ± 9.8, within one week after PARTO (p = 0.002). The clinical success rate was 100%. Improvement in the Child-Pugh score was observed in 12 of 18 patients (66.7%) at one month after PARTO. The mean follow-up period after PARTO was 422 days (range, 170-1168 days). Eighteen patients who had more than a two-month follow-up period, showed complete obliteration of the GV as well as the gastrorenal shunts on both CT and endoscopy. In these 18 patients, four (22.2%) experienced worsening of their esophageal varices at a mean of 9.4 months (range; 1-25 months) after PARTO. There were no cases of variceal bleeding or HE during a mean follow-up period of 422 days (range, 170-1168 days). Conclusion Our preliminary results suggest that PARTO is technically simple and safe and seems to be clinically effective for the treatment of GV and HE. We therefore believe that PARTO results in complete blockage of the gastrorenal shunt with a very high success rate. PARTO also has the potential to become a standard treatment for GV associated with a gastrorenal shunt either in patients with GV or in patients with HE.

We reviewed the results of a selective à la carte soft-tissue release operation for recurrent or residual deformity after initial conservative treatment for idiopathic clubfoot by the Ponseti method. Recurrent or residual deformity occurred in 13 (19 feet) of 33 patients (48 feet; 40%). The mean age at surgery was 2.3 years (1.3 to 4) and the mean follow-up was 3.6 years (2 to 5.3). The mean Pirani score had improved from 2.8 to 1.1 points, and the clinical and radiological results were satisfactory in all patients. However, six of the 13 patients (9 of 19 feet) had required further surgery in the form of tibial derotation osteotomy, split anterior tibialis tendon transfer, split posterior tibialis transfer or a combination of these for recurrent deformity. We concluded that selective soft-tissue release can provide satisfactory early results after failure of initial treatment of clubfoot by the Ponseti method, but long-term follow-up to skeletal maturity will be necessary.

The hepatopulmonary syndrome occurs when an intrapulmonary shunt (IPS) causes hypoxemia in patients with cirrhosis. Because IPS has not been clearly defined in children, we investigated the prevalence, clinical characteristics, and outcomes of IPS in children undergoing liver transplantation (OLT). Of the 107 pediatric OLT recipients between December 1994 and March 2005, 18 (16.8%) had IPS, as evaluated by contrast-enhanced echocardiography (CEE) at 9 months to 16 years of age. The degree of IPS was classified into five grades according to the extent of microbubbles in the left ventricle, with significant IPS defined as grade II or higher. Baseline characteristics, including serum total bilirubin, albumin, aminotransferase, and prothrombin time, did not differ in patients with or without IPS. The patients with IPS had significantly lower Pao2 and Sao2, longer duration of mechanical ventilation and hospital stay, and higher postoperative morbidity and mortality than patients without IPS (P < .05 each), but there were no other significant differences between the groups. The six patients with significant IPS (one grade II, three grade III, and two grade IV) showed a significantly greater morbidity and mortality than patients with grade I IPS (P < .05). Most of the positive CEE findings of IPS regressed within 6 months after OLT. These findings indicated that IPS is not uncommon among children undergoing OLT, but is reversible. Because severe IPS may increase patient morbidity and mortality, early assessment of IPS status using CEE is essential for pediatric OLT candidates.

Accurate information regarding the maximum available pulse current can help to determine the power capability of the battery and allow the battery to be operated within the safe operating voltage range. However, although estimation methods of the maximum available pulse current have been developed, they have the drawback of variation in the resistance inside the batteries. In this paper, the state of charge (SOC) and resistance of the battery are estimated from the dual extended Kalman filter (dual EKF). Furthermore, the lumped resistance, which represents the impedance inside the battery during the predefined time, is calculated using an easy numerical calculation based on the estimated values.

We present architecture for implementing independent, extensible, and interoperable clinical decision support service in perspective of EHR. In this architecture, components for implementing independent knowledge service and interface mechanism with EHR service or existing hospital information system are identified. In our architecture knowledge engine is critical component for implementing knowledge service. In this paper, we suggested interoperable CDSS(clinical decision support system) architecture and knowledge engine architecture.

Periodic alternating nystagmus (PAN) is characterized by periodic reversal of horizontal jerky nystagmus with a null period of several seconds. Damage to the uvulonodulus or to their connections with the brainstem vestibular nuclei has been suggested as a mechanism of PAN.1,2 However, PAN has rarely been reported in circumscribed cerebellar lesion.3 We report a patient with isolated nodular infarction who developed PAN without fixation in association with perverted head-shaking nystagmus (HSN) and loss of tilt suppression of the postrotatory nystagmus. This is the first report of PAN in circumscribed cerebellar infarction, and provides further evidence that PAN occurs due to dysfunction of cerebellar nodulus. A 69-year-old man with a history of hypertension developed acute vertigo with nausea/vomiting and postural imbalance. On examination, we observed spontaneous horizontal nystagmus in the primary position which reversed its direction with a cycle of approximately 2 minutes and a transition period of several seconds by using video Frenzel goggles (SLMED, Seoul, Korea) (see the video on the Neurology Web site at www.neurology.org). The …

18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been reported to be superior to computed tomography (CT)/magnetic resonance imaging (MRI) in the evaluation of head and neck cancers, but little is known about its usefulness in oropharyngeal squamous cell carcinoma (SCC). We therefore compared FDG PET and CT/MRI in the preoperative staging of previously untreated oropharyngeal SCC.Thirty-two consecutive patients with oropharyngeal SCC underwent FDG PET and CT/MRI before surgery. Each method was interpreted separately to assess primary tumor and cervical node status. Their sensitivity and specificity were compared relative to histopathologic analysis.Histopathology revealed metastases in 29 of 39 dissected neck sides and in 47 of 163 dissected cervical levels. FDG PET had higher sensitivities than CT/MRI for primary tumor detection (25/32 vs. 30/32, P=0.063) and for identification of cervical metastases on neck side (22/29 vs. 28/29, P0.05) and level-by-level (37/47 vs. 45/47, P0.05) bases. In contrast, the specificity of the two methods did not differ significantly (P0.5). FDG PET correctly interpreted the false-negative results of CT/MRI in 6 of 7 primary tumors and 8 of 10 cervical levels.The improved preoperative staging of FDG PET may help in planning treatment, but its accuracy is insufficient to replace pathologic staging based on neck dissection.

The open circuit voltage (OCV) is widely used to estimate the state of charge (SOC) in many SOC estimation algorithms. But the relationship between the OCV and SOC can not be exactly same for all batteries. Because the conventional OCV-SOC differs between batteries, there is a problem in that the OCV-SOC data should be measured to accurately estimate the SOC in different batteries. Therefore, the conventional OCV- SOC should be modified. In this paper, a new OCV-SOC that is independent of the battery conditions is proposed. Thus, problems resulting from the defects of the EKF can be avoided by preventing the OCV-SOC data from varying. In this paper, the SOC and battery capacity are estimated using the dual EKF with the proposed OCV-SOC.

문해력이란 글을 읽고 이해하는 능력을 말한다. 건강문해력이 란 “개인이 적절한 건강 결정을 내리는데 필요한 기본적인 건강 정보와 의료 서비스를 얻고, 처리하고, 이해하는 능력”이다. 이 정의는 Institute of Medicine (IOM) 보고서와 미국 연방 보건국의 ‘Health people 2010’인 건강증진 프로그램에서 사용하는 정의로 현재 가장 널리 사용되고 있다. 구강건강문해력은 관련 연구영역 에서 최근에 정의되었다. Bridges 등은 구강건강문해력의 정의가 일반적인 건강문해력 정의와 일치한다고 하였다. 국외에서 구강건강문해력에 대한 연구는 활발히 이루어지 고 있다. 반면 국내에서 구강건강문해력에 대한 연구는 매우 드물 다. Ju 등은 Richman 등이 개발한 REALD-99 (The Rapid Estimate of Adult Literacy in Dentistry)를 번안하여 수정 보완한 도

우리는 주변에서 치과에 가는 것이 가장 무섭다고 하는 사람 들을 흔히 볼 수 있다. 또한 치과에 가는 것이 두렵고 무서워서 치 료를 연기하거나 진통제를 먹으며 참아보려고 하는 사람도 어렵 지 않게 찾아 볼 수 있다. 치과공포란 구강 진료 시 여러 자극에 대 해 환자가 주관적으로 느끼는 불안이나 두려움의 정도를 말하며, 특히 과거의 좋지 않은 치료경험이 주된 원인으로 알려져 있다. 또한, 일반적으로 주변사람의 부정적인 경험에 의하여 간접적으 로 치과에 대한 부정적인 반응을 형성하기도 한다. Jun은 과거 에 치과치료를 받을 때 통증을 느꼈던 직접경험과 가족이나 친구 의 치과치료 과정에서 있었던 통증경험을 듣게 되는 간접경험 모 두 치과에 대한 공포에 영향을 미친다고 하였다. 또한 Hong 등도 과거 치과치료시 통증경험 및 횟수가 증가할수록, 통증 정도가 강 할수록 치과치료에 대한 공포감이 증가한다고 하였다. 치과의료 서비스 이용횟수의 경우 치과공포 수준이 높아질수록 지난 1년 동 안의 치과의료서비스 이용횟수가 감소하고, 과거에 치과통증 경 험이 많을수록 치과공포의 수준이 높다는 연구가 있다. Choi 등 은 치과공포나 불안감이 비교적 크지 않은 교정치료를 경험한 사 람이 그렇지 않은 사람에 비해 치과치료에 대하여 통계적으로 유 의하게 낮은 공포심을 갖고 있다고 보고한 바 있다. Cohen 등은 학생과 아이들의 경우 치과공포의 정도가 높을수록 치과 재진율

Sung-Suk Chung, Jong-Bae Kim, Young-Sam Kim, Young-Ran Jung, Jin-Sil Hong, Ju-Yeon Kim, Kee-Wan Chang 2 Department of Statistics Institute of Applied Statistics, College of Natural Science, Chonbuk National University, Department of Preventive and Community Dentistry, Institute of Oral-bio Science, School of Dentistry, Chonbuk National University, Jeonju, Department of Dental Hygiene, Daegu Health College, Daegu, Korea

A 54-year-old man developed sudden left-sided headache and diplopia. There was complete left ophthalmoplegia and decreased sensation in the ophthalmic and maxillary divisions of the trigeminal nerve. CT angiography showed an aneurysm in the supraclinoid portion of the left internal carotid artery (figure). An emergent …