Sarcopenia and Muscle Aging: A Brief Overview

The world is facing the new challenges of an aging population, and understanding the process of aging has therefore become one of the most important global concerns. Sarcopenia is a condition which is defined by the gradual loss of skeletal muscle mass and function with age. In research and clinical practice, sarcopenia is recognized as a component of geriatric disease and is a current target for drug development. In this review we define this condition and provide an overview of current therapeutic approaches. We further highlight recent findings that describe key pathophysiological phenotypes of this condition, including alterations in muscle fiber types, mitochondrial function, nicotinamide adenine dinucleotide (NAD+) metabolism, myokines, and gut microbiota, in aged muscle compared to young muscle or healthy aged muscle. The last part of this review examines new therapeutic avenues for promising treatment targets. There is still no accepted therapy for sarcopenia in humans. Here we provide a brief review of the current state of research derived from various mouse models or human samples that provide novel routes for the development of effective therapeutics to maintain muscle health during aging.

Sarcopenia and Muscle Aging: A Brief Overview

The world is facing the new challenges of an aging population, and understanding the process of aging has therefore become one of the most important global concerns. Sarcopenia is a condition which is defined by the gradual loss of skeletal muscle mass and function with age. In research and clinical practice, sarcopenia is recognized as a component of geriatric disease and is a current target for drug development. In this review we define this condition and provide an overview of current therapeutic approaches. We further highlight recent findings that describe key pathophysiological phenotypes of this condition, including alterations in muscle fiber types, mitochondrial function, nicotinamide adenine dinucleotide (NAD+) metabolism, myokines, and gut microbiota, in aged muscle compared to young muscle or healthy aged muscle. The last part of this review examines new therapeutic avenues for promising treatment targets. There is still no accepted therapy for sarcopenia in humans. Here we provide a brief review of the current state of research derived from various mouse models or human samples that provide novel routes for the development of effective therapeutics to maintain muscle health during aging.

Clinicopathologic Significance of Survivin Expression in Relation to CD133 Expression in Surgically Resected Stage II or III Colorectal Cancer

BACKGROUND: Cancer stem cells have been investigated as new targets for colorectal cancer (CRC) treatment. We recently reported that CD133+ colon cancer cells showed chemoresistance to 5-fluorouracil through increased survivin expression and proposed the survivin inhibitor YM155 as an effective therapy for colon cancer in an in vitro study. Here, we investigate the relationship between survivin and CD133 expression in surgically resected CRC to identify whether the results obtained in our in vitro study are applicable to clinical samples. METHODS: We performed immunohistochemical staining for survivin and CD133 in surgically resected tissue from 187 stage II or III CRC patients. We also comparatively analyzed apoptosis according to survivin and CD133 expression using terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling. RESULTS: The results of the Mantel-Haenszel test established a linear association between nuclear survivin and CD133 expression (p = .018), although neither had prognostic significance, according to immunohistochemical expression level. No correlation was found between survivin expression and the following pathological parameters: invasion depth, lymph node metastasis, or histologic differentiation (p > .05). The mean apoptotic index in survivin+ and CD133+ tumors was higher than that in negative tumors: 5.116 ± 4.894 in survivin+ versus 4.103 ± 3.691 in survivin– (p = .044); 5.165 ± 4.961 in CD133+ versus 4.231 ± 3.812 in CD133– (p = .034). CONCLUSIONS: As observed in our in vitro study, survivin expression is significantly related to CD133 expression. Survivin may be considered as a new therapeutic target for chemoresistant CRC.

Orai1 Expression Is Closely Related with Favorable Prognostic Factors in Clear Cell Renal Cell Carcinoma

Store-operated calcium (Ca2+) entry (SOCE) is the principal Ca2+ entry route in non-excitable cells, including cancer cells. We previously demonstrated that Orai1 and STIM1, the molecular components of SOCE, are involved in tumorigenesis of clear cell renal cell carcinoma (CCRCC). However, a clinical relevance of Orai1 and STIM1 expression in CCRCC has been ill-defined. Here, we investigated the expression of Orai1 and STIM1 in CCRCC, and compared their expression with clinico-pathological parameters of CCRCC and the patients' outcome. Immunohistochemical staining for Orai1 and STIM1 was performed on 126 formalin fixed paraffin embedded tissue of CCRCC and western blot analysis for Orai1 was performed on the available fresh tissue. The results were compared with generally well-established clinicopathologic prognostic factors in CCRCC and patient survival. Membrane protein Orai1 is expressed in the nuclei in CCRCC, whereas STIM1 shows the cytosolic expression pattern in immunohistochemical staining. Orai1 expression level is inversely correlated with CCRCC tumor grade, whereas STIM1 expression level is not associated with tumor grade. The higher Orai1 expression is significantly associated with lower Fuhrman nuclear grade, pathologic T stage, and TNM stage and with favorable prognosis. The expression level of STIM1 is not correlated with CCRCC grade and clinical outcomes. Orai1 expression in CCRCC is associated with tumor progression and with favorable prognostic factors. These results suggest that Orai1 is an attractive prognostic marker and therapeutic target for CCRCC.

Influenza Vaccination Coverage Rate according to the Pulmonary Function of Korean Adults Aged 40 Years and Over: Analysis of the Fifth Korean National Health and Nutrition Examination Survey

Influenza vaccination is an effective strategy to reduce morbidity and mortality, particularly for those who have decreased lung functions. This study was to identify the factors that affect vaccination coverage according to the results of pulmonary function tests depending on the age. In this cross-sectional study, data were obtained from 3,224 adults over the age of 40 who participated in the fifth National Health and Nutrition Examination Survey and underwent pulmonary function testing in 2012. To identify the factors that affect vaccination rate, logistic regression analysis was conducted after dividing the subjects into two groups based on the age of 65. Influenza vaccination coverage of the entire subjects was 45.2%, and 76.8% for those aged 65 and over. The group with abnormal pulmonary function had a higher vaccination rate than the normal group, but any pulmonary dysfunction or history of COPD did not affect the vaccination coverage in the multivariate analysis. The subjects who were 40-64 years-old had higher vaccination coverage when they were less educated or with restricted activity level, received health screenings, and had chronic diseases. Those aged 65 and over had significantly higher vaccination coverage only when they received regular health screenings. Any pulmonary dysfunction or having COPD showed no significant correlation with the vaccination coverage in the Korean adult population.

Insulin Receptor Expression in Clear Cell Renal Cell Carcinoma and Its Relation to Prognosis

PURPOSE: Both insulin and insulin-like growth factor (IGF)-1 signaling are key regulators of energy metabolism, cellular growth, proliferation, and survival. The IGF-1 receptor (IGF-1R) is overexpressed in most types of human cancers including renal cell carcinoma (RCC) with poor prognosis. Insulin receptor (IR) shares downstream effectors with IGF-1R; however, the expression and function of IR in the tumorigenesis of renal cancer remains elusive. Therefore, we examined the expression of IR and its prognostic significance in clear cell RCC (CCRCC). MATERIALS AND METHODS: Immunohistochemical staining for IR was performed on 126 formalin-fixed paraffin-embedded CCRCC tissue samples. Eight of these cases were utilized for western blot analysis. The results were compared with various clinico-pathologic parameters of CCRCC and patient survival. RESULTS: IR was expressed in the nuclei of CCRCC tumor cells in 109 cases (87.9%). Higher IR expression was significantly correlated with the presence of cystic change, lower Fuhrman nuclear grade, lower pathologic T stage, and lower TNM stage, although it wasn't significantly related to diabetes status and patient survival. Western blot analyses supported the results of the immunohistochemistry studies. CONCLUSION: IR expression in CCRCC may be associated with favorable prognostic factors.

Insulin Receptor Expression in Clear Cell Renal Cell Carcinoma and Its Relation to Prognosis

PURPOSE: Both insulin and insulin-like growth factor (IGF)-1 signaling are key regulators of energy metabolism, cellular growth, proliferation, and survival. The IGF-1 receptor (IGF-1R) is overexpressed in most types of human cancers including renal cell carcinoma (RCC) with poor prognosis. Insulin receptor (IR) shares downstream effectors with IGF-1R; however, the expression and function of IR in the tumorigenesis of renal cancer remains elusive. Therefore, we examined the expression of IR and its prognostic significance in clear cell RCC (CCRCC). MATERIALS AND METHODS: Immunohistochemical staining for IR was performed on 126 formalin-fixed paraffin-embedded CCRCC tissue samples. Eight of these cases were utilized for western blot analysis. The results were compared with various clinico-pathologic parameters of CCRCC and patient survival. RESULTS: IR was expressed in the nuclei of CCRCC tumor cells in 109 cases (87.9%). Higher IR expression was significantly correlated with the presence of cystic change, lower Fuhrman nuclear grade, lower pathologic T stage, and lower TNM stage, although it wasn't significantly related to diabetes status and patient survival. Western blot analyses supported the results of the immunohistochemistry studies. CONCLUSION: IR expression in CCRCC may be associated with favorable prognostic factors.

The Role of CTGF in Osteosarcoma Progression / 대한골관절종양학회지

PURPOSE: To examine the expression of Connective Tissue Growth Factor (CTGF) in osteosarcoma and to evaluate its role in osteosarcoma invasion and proliferation. MATERIALS AND METHODS: The mRNA expression of CTGF from 23 patient-derived osteosarcoma cell lines was examined, and the role of CTGF in cell invasion and proliferation was examined using siRNA transfection. RESULTS: The over-expression of CTGF mRNA was observed in 17 cell lines (74%). CTGF-specific siRNA transfection into SaOS-2 and MG63 cell lines resulted in efficient knockdown of CTGF expression on Western blot analysis. siRNA transfected cells showed decreased migration on Matrigel invasion assay and decreased cell proliferation on WST-1 assay. CONCLUSION: These results indicated that the CTGF expression may play an important role in osteosarcoma progression, and may be a therapeutic target of osteosarcoma.

Influence of Malnutrition and Social Network on Health-related Quality of Life in Elders / 기본간호학회지

PURPOSE: This study was done to identify the relationship of malnutrition, social network and health-related quality of life and to investigate the main factors influencing health-related quality of life in elders. METHODS: The research design was a descriptive survey design using a convenience sampling. Data were collected by self-report questionnaires from 196 elders. Data analysis was done using SPSS 18.0 pc+ program for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. RESULTS: The average score for health related quality of life was 3.33 (SD=0.86). Differences in health-related quality of life were statistically significant according to age, gender, occupation, presence of spouse, monthly income, source of income, economic status, medicine, and existence of chronic disease. Health-related quality of life was significantly correlated with malnutrition and social network. Major factors affecting health related quality of life for elders were malnutrition, occupation, age, social network, and economic status which explained 52.0% of the variance in health related quality of life. CONCLUSION: Findings provide a basis for developing nursing interventions to improve health-related quality of life. Future studies are needed a wide variety of variables that might influence health-related quality of life in elders.

Influence of Occupational Stress and Burnout on Turnover Intention of Caregivers in Geriatric Hospitals / 한국직업건강간호학회지

PURPOSE: The purpose of this study was identify the influences of occupational stress and burnout on turnover intention of caregivers in geriatric hospitals. METHODS: The data were collected from 176 caregivers working at three geriatric hospitals located in Gyeonggi province. A self-reported questionnaires was used to assess the level of occupational stress, burnout and turnover intention. The data were analyzed with descriptive statistics, t-test, ANOVA and Pearson correlation coefficients and multiple regression by SPSS/WIN 18.0 program. RESULTS: The turnover intention was positively correlated with occupational stress(r=.438, p<.01) and burnout(r=.418, p<.01). The influencing factors of turnover intention were occupational stress(beta=.290, p<.001), burnout(beta=.253, p=.001) and education level(beta=.182, p=.006). CONCLUSION: The results of this study indicate that it is necessary to develop stress management program so that caregivers in geriatric hospitals can reduce occupational stress and burnout.

Predictors of Acculturative Stress among Chinese Students in Korea / 성인간호학회지

PURPOSE: The purpose of this study was to identify the predictors of acculturative stress among Chinese students in Korea. METHODS: Between October and December 2009, two hundred one Chinese students from three universities located in Cungnam province, were included in the current study using a questionnaire survey. Data analysis was done using SPSS/WIN 17.0 program. RESULTS: The average score of acculturative stress was 38.50+/-6.97. There were significant differences in acculturative stress according to educational level, economic status, type of residence, speaking skill in Korean, listening skill in Korean, grade point average, satisfaction for studying abroad, and perceived health status. The acculturative stress was significantly correlated with depression, resilience and social support. The strongest predictor of acculturative stress among Chinese students was depression. CONCLUSIONS: The findings suggest that developing programs to improve psychological health may provide a buffer against acculturative stress experienced by migrating Chinese students. Furthermore, more studies are needed to explore variables that influence on the international students' acculturation in Korea.

Health Status and Resilience according to Acculturation Types among Chinese Students in Korea / 성인간호학회지

PURPOSE: This study was to identify the health status and reported resilience according to acculturation type among Chinese students in Korea. METHODS: The subjects were 386 Chinese students studying in three universities in Chungnam province. The data were collected by standardized questionnaires and SPSS/WIN 15.0 program was used to analyze the data with descriptive statistics, Chi-square, t-test, and ANOVA. RESULTS: Subjects reported the following Acculturation type: integration (26.7%), assimilation (28.5%), separation (32.4%), and marginalization (12.4%). The reported resilience was significantly different according to economic status. The health status was significantly different according to religion and economic status. Acculturation type was significantly different according to age, educational level, length of stay, type of residency and economic status working style. The health status and resilience were significantly different according to acculturation type. CONCLUSION: The findings suggest that integration of acculturation type is most useful to health status and resilience among Chinese students in Korea. Future studies need to examine acculturation type as coping strategy for foreign students' adaptation.

Aberrant CpG Island Hypermethylation of the RUNX3 Gene in Osteosarcoma / 대한정형외과학회잡지

PURPOSE: Transcriptional silencing of tumor suppressor genes by aberrant methylation of CpG islands plays a crucial role in the development of human cancers. We comprehensively examined the methylation status of several tumor suppressor genes in osteosarcoma with a special focus on the RUNX3 gene. MATERIALS AND METHODS: Methylation-specific polymerase chain reaction (MSP) was performed for osteosarcoma tissues and their cell lines. MSP and RT-PCR for the RUNX3 gene were performed in the tumor-derived cell lines and the immortalized cell lines. The demethylating agent 5-aza-2' deoxycytidine was used in the SaOS-2 cell line to reverse the methylation status. RESULTS: Hypermethylation of the RUNX3 gene was observed in 60% (24 of 40) of the osteosarcoma tissues, whereas other tumor suppressor genes showed very low methylation. Thirteen of 30 (43%) tumor-derived cell lines, and U-2OS and SaOS-2 showed hypermethylation of the RUNX3 gene on MSPCR. However, RUNX3 was expressed in the SaOS-2 cell line, as determined by RT-PCR, and the expression was augmented by treatment with 5-aza-2' deoxycytidine. CONCLUSION: Our study suggests that aberrant methylation is an important mechanism of RUNX3 down-regulation in osteosarcoma. This data may have potential significance in developing a potential therapeutic target for osteosarcoma.

Concept Development of Grief-Focusing on the Process of Spousal Bereavement / 간호학회지

PURPOSE: This study was done to develop the concept of grief focusing on the process of spousal bereavement in Korea. METHODS: The Hybrid model was used for analysis according to the 3 phases. An extensive literature review was done for the Theoretical phase. In-depth interviews were conducted with 15 participants whose spouses died within the past 3 years in the Field phase. In the Final analytic phase, the results in the Theoretical and the Field phases were compared, analyzed, and integrated according to the process of grief. RESULTS: The antecedent of the concept of spousal grief was spousal death. The dimensions of grief were classified to inner dimensions related to oneself, relational dimensions related to family and others, and existential dimensions related to the meaning of being. The attributes of grief were physical suffering, decline of cognitive ability, heartbreaking sorrow, expectations and conflicts of a new life, social stigma, dependence on or resentment towards God, etc. The empirical referent of grief was physical, psychological, social, and spiritual health status. The grieving progressed through 3 phasesshock-emancipation, suffering, and integration. CONCLUSION: Nurses should recognize the importance of their unique position as supporters for grievers, and try to assess individual characteristics and to provide tailored nursing interventions.

Expression and Clinical Significance of Heparanasein Osteosarcoma / 대한정형외과학회잡지

PURPOSE: This study examined the expression of heparanase in osteosarcomas and evaluated its prognostic value. MATERIALS AND METHODS: The immunohistochemical expression of heparanase from 51 osteosarcoma tissues was examined, and the correlations between the heparanase expression level and the clinicopathological factors were evaluated. RESULTS: Heparanase over-expression was observed in 37 tissue samples. There was a correlation between the heparanase expression level and a poor chemotherapeutic response, metastasis and poor survival rate. Multivariate analyses revealed that heparanase over-expression was a significant independent risk factor for a distant metastasis of an osteosarcoma. Among the 46 patients who underwent an adequate wide resection, there was a correlation between the heparanase expression level and recurrence. The 5-year survival rate was 83.8% for patients with heparanase negative tumors, and 46.9% for those with heparanase over-expression. Multivariate analysis using the Cox regression model revealed the heparanase expression level to be an independent prognostic indicator. CONCLUSION: These results indicate that heparanase expression might play an important role in local recurrence and metastasis, and might be a biological marker of the prognostic significance in osteosarcoma patients.

The Effects of Brisk Walking versus Brisk Walking Plus Diet on Triglycerides and Apolipoprotein B Levels in Middle-aged Overweight/obese Women with High Triglyceride Levels / 간호학회지

PURPOSE: The purpose of this study were to investigate the effects of a 12-week brisk walking program on triglycerides (TG) and apolipoprotein B (Apo B) and to compare these effects to those of a brisk walking plus diet program in middle-aged overweight/obese (BMI> or =23) Korean women with hypertriglyceridemia. METHOD: This analysis was done with nineteen middle-aged overweight/obese Korean women who completed either the brisk walking program (9 women) or the brisk walking plus diet program (10 women) for 12 weeks. The brisk walking consisted of walking for 20 to 50 minutes/day at an intensity of 40 to 70% of heart rate reserve (HRR) for 3 to 6 days/week. The diet consisted of 60 minutes of group education and 20 to 30 minutes of individual counseling every week. TG and Apo B were assessed pre- and post-intervention. RESULTS: TG and Apo B decreased significantly after the brisk walking program (Z = -2.31, p = 0.021; Z = -2.59, p = 0.009). TG and Apo B lowering effects of the brisk walking program were not significantly different from those of the brisk walking plus diet program (U = 37.0, p = 0.549; U = 42.0, p = 0.842). CONCLUSION: Brisk walking can be an effective intervention for overweight/obese middle-aged women with hypertriglyceridemia in reducing cardiovascular risk by lowering TG and Apo B levels. Adding diet to brisk walking may have no additional significant effects on changes in TG and Apo B.

A Case of Reactive Arthritis after Trichomonas vaginalis Infestation / 대한류마티스학회지

Reactive arthritis occurs after a preceding infection such as urogenital or gastroenteral tract infection. Trichomoniasis, due to Trichomonas vasinalis infection, is one of the most common causes of vaginitis. Reactive arthritis associated with trichomoniasis is uncommon and there has been no report in Korea. We present a 28 year-old woman who had oligoarthritis after Trichomonas vaginalis infection. The arthritis subsided with treatment of the Trichomoniasis with metronidazole and non-steroidal anti-inflammatory drug.

Effects of Brisk Walking and Brisk Walking Plus Diet on C-reactive Protein in Obese Women with Hypertriglycemia / 성인간호학회지

PURPOSE: The purpose of this study was to investigate the effects of 12-week brisk walking and brisk walking plus diet program on C-Reactive Protein(CRP) in middle-aged obese hypertriglycemic(triglyceride > or =150 mg/dl) Korean women. METHOD: The subjects were 16 obese (BMI > or =25) hypertriglycemic middle-aged women (7 for brisk walking group, 9 for brisk walking plus diet group) who participated in a health promotion program at one public health center. Initially the brisk walking intervention consisted of walking for 20 minutes/day at an intensity of 40 to 50% of heart rate reserve(HRR) for 3 days/week and progressed to 50 minutes/day, 60 to 70% of their HRR, and 6 days/week. The diet intervention consisted of 60 minutes of group education and 20 to 30 minutes of individual counseling with a nutritionist every week. Data were analyzed with SPSS PC program. RESULTS: There was no significant reduction in CRP levels in both brisk walking (Z=-1.70, p=0.088) and brisk walking plus diet group(Z=-0.31, p=0.752). In brisk walking only group, CRP levels were increased after the intervention. CONCLUSION: Brisk walking could increase the level of CRP when it is in the course of progression and diet could decrease the acute phase inflammatory response.

A Case of Colon Obstruction Developed during the Recovery Period of Acute Pancreatitis / 대한소화기학회지

Complications of acute pancreatitis usually occur in pancreas and its contiguous organs. The prevalence of colonic invasion is rare, however, the consequence is fatal, with mortality above 50%. The initial symptoms and onset times are variable and major affected sites are transverse colon and splenic flexure. The spread of inflammatory exudates into the colon is the main mechanism of colonic invasion. If the colonic stenosis develops, it is necessary to manage it surgically. We report a case who arrived at the hospital with watery diarrhea and abdominal distension in the recovery period of acute alcoholic pancreatitis and was diagnosed as a colonic obstruction in the splenic flexure. The patient underwent loop ileostomy instead of the resection of the lesion because of severe adhesion around the splenic flexure. The patient died due to sepsis 5 days after the operation.

Determinants of Nurses' Handwashing Practice / 성인간호학회지

PURPOSE: The purpose of this study was to determine handwashing-related factors in nurses. Specific purposes of this study were to examine 1) the applicability of the hypothetical model constructed for this study, on the basis of Theory of Planned Behavior(TPB), and 2) relationships between handwashing practice and other variables such as age, career, level of education, and level of recognition about handwashing. METHOD: Data were collected from 187 nurses in one university hospital in Kyung-Ki province. RESULT: The hypothetical model based on TPB was revealed applicable, but the degree of the variance explaining handwashing practice was small(26%). Perceived behavioral control(PBC) was the most strong variable explaining handwashing practice, and intention didn't have a significant effect on handwashing practice. Norm and PBC had significant effects on intention, but attitude was not a significant factor of intention. Age, career, and the level of awareness of handwashing practice were significantly related to handwashing practice. CONCLUSION: The result of this study suggests that we should focus on perceived behavioral control, awareness of handwashing practice and subjective norm about handwashing practice to increase the level of nurses' handwashing practice.