Relationships of Antidepressant Medication With Its Various Factors Including Nitrogen Dioxides Seasonality: Machine Learning Analysis Using National Health Insurance Data

Objective@#This study employs machine learning and population-based data to examine major factors of antidepressant medication including nitrogen dioxides (NO2) seasonality. @*Methods@#Retrospective cohort data came from Korea National Health Insurance Service claims data for 43,251 participants with the age of 15–79 years, residence in the same districts of Seoul and no history of antidepressant medication during 2002–2012. The dependent variable was antidepressant-free months during 2013–2015 and the 103 independent variables for 2012 or 2015 were considered, e.g., particulate matter less than 2.5 micrometer in diameter (PM2.5), PM10, NO2, ozone (O3), sulphur dioxide (SO2) and carbon monoxide (CO) in each of 12 months in 2015. @*Results@#It was found that the Cox hazard ratios of NO2 were statistically significant and registered values larger than 10 for every three months: March, June–July, October, and December. Based on random forest variable importance and Cox hazard ratios in brackets, indeed, the top 20 factors of antidepressant medication included age (0.0041 [1.69–2.25]), migraine and sleep disorder (0.0029 [1.82]), liver disease (0.0017 [1.33–1.34]), exercise (0.0014), thyroid disease (0.0013), cardiovascular disease (0.0013 [1.20]), asthma (0.0008 [1.19–1.20]), September NO2 (0.0008 [0.01]), alcohol consumption (0.0008 [1.31–1.32]), gender - woman (0.0007 [1.80–1.81]), July NO2 (0.0007 [14.93]), July PM10 (0.0007), the proportion of the married (0.0005), January PM2.5 (0.0004), September PM2.5 (0.0004), chronic obstructive pulmonary disease (0.0004), economic satisfaction (0.0004), January PM10 (0.0003), residents in welfare facilities per 1,000 (0.0003 [0.97]), and October NO2 (0.0003). @*Conclusion@#Antidepressant medication has strong associations with neighborhood conditions including NO2 seasonality and welfare support.

Recurrent Pancreatitis Caused by Afferent Loop Syndrome with Pathologic Features of Type II Autoimmune Pancreatitis / 대한내과학회지

Afferent loop syndrome (ALS) is a rare cause of recurrent pancreatitis. Recurrent pancreatitis in association with ALS can develop due to impaired outflow of pancreatic juice or reflux of enteric secretions caused by increased intraluminal duodenal pressure. Here, we report a case of ALS presenting as recurrent acute pancreatitis due to chronic intermittent partial obstruction of the third portion of the duodenum caused by postoperative adhesion. Interestingly, pancreatic histology showed a granulocytic epithelial lesion, which is a diagnostic feature of type 2 autoimmune pancreatitis (AIP, idiopathic duct centric chronic pancreatitis [IDCP]). From this case we learned that the diagnosis of type 2 AIP should be made in the appropriate clinical setting.

Recurrent Pancreatitis Caused by Afferent Loop Syndrome with Pathologic Features of Type II Autoimmune Pancreatitis / 대한내과학회지

Afferent loop syndrome (ALS) is a rare cause of recurrent pancreatitis. Recurrent pancreatitis in association with ALS can develop due to impaired outflow of pancreatic juice or reflux of enteric secretions caused by increased intraluminal duodenal pressure. Here, we report a case of ALS presenting as recurrent acute pancreatitis due to chronic intermittent partial obstruction of the third portion of the duodenum caused by postoperative adhesion. Interestingly, pancreatic histology showed a granulocytic epithelial lesion, which is a diagnostic feature of type 2 autoimmune pancreatitis (AIP, idiopathic duct centric chronic pancreatitis [IDCP]). From this case we learned that the diagnosis of type 2 AIP should be made in the appropriate clinical setting.

Sex Differences in Cancer: Epidemiology, Genetics and Therapy

The incidence and mortality of various cancers are associated with sex-specific disparities. Sex differences in cancer epidemiology are one of the most significant findings. Men are more prone to die from cancer, particularly hematological malignancies. Sex difference in cancer incidence is attributed to regulation at the genetic/molecular level and sex hormones such as estrogen. At the genetic/molecular level, gene polymorphism and altered enzymes involving drug metabolism generate differences in cancer incidence between men and women. Sex hormones modulate gene expression in various cancers. Genetic or hormonal differences between men and women determine the effect of chemotherapy. Until today, animal studies and clinical trials investigating chemotherapy showed sex imbalance. Chemotherapy has been used without consideration of sex differences, resulting in disparity of efficacy and toxicity between sexes. Based on accumulating evidence supporting sex differences in chemotherapy, all clinical trials in cancer must incorporate sex differences for a better understanding of biological differences between men and women. In the present review, we summarized the sex differences in (1) incidence and mortality of cancer, (2) genetic and molecular basis of cancer, (3) sex hormones in cancer incidence, and (4) efficacy and toxicity of chemotherapy. This review provides useful information for sex-based chemotherapy and development of personalized therapeutic strategies against cancer.

Association of the RORA Gene Polymorphism and Seasonal Variations in Mood and Behavior / 수면정신생리

OBJECTIVES: Several evidence has been suggested that the circadian gene variants contribute to the pathogenesis of seasonal affective disorder. In this study, we aimed to investigate the polymorphism in RORA (Retinoid-related orphan receptor A) gene in relation to seasonal variations among healthy young adults in Seoul, Korea. METHODS: A total of 507 young healthy adult subjects were recruited by advertisement. Seasonal variations were assessed by the Seasonality Pattern Assessment Questionnaire (SPAQ). Single-nucleotide polymorphism in the RORA rs11071547 gene was genotyped by PCR in 507 individuals. Considering summer type as confounding factor, we conducted analysis 478 subjects except 29 subjects of summer type. The Chi-square test was conducted to compare differences between groups of seasonals and non-seasonals. Association between genotypes and Global Seasonality Score (GSS) were tested using ANCOVA (Analysis of covariance). RESULTS: In this sample, the prevalence of SAD was 12.1% (winter type 9.3%, summer type 2.8%). There is no significant difference in genotyping distribution of RORA rs11071547 between groups of seasonals and non-seasonals. Global seasonality score (GSS) and scores of all subscales except body weight and appetite were not significantly different between the group with C allele homozygote and the group with T allele homozygote and heterozygote (p-value 0.138). Scores of body weight and appetite were significantly higher in group with C allele homozygotes. CONCLUSION: These results suggest that RORA gene polymorphism play a role in seasonal variations in appetite and body weight and is associated with susceptibility to seasonal affective disorder in some degree in the population studied.