Historical Review and Future of Cardiac Xenotransplantation

Along with the development of immunosuppressive drugs, major advances on xenotransplantation were achieved by understanding the immunobiology of xenograft rejection. Most importantly, three predominant carbohydrate antigens on porcine endothelial cells were key elements provoking hyperacute rejection: α1,3-galactose, SDa blood group antigen, and N-glycolylneuraminic acid. Preformed antibodies binding to the porcine major xenoantigen causes complement activation and endothelial cell activation, leading to xenograft injury and intravascular thrombosis. Recent advances in genetic engineering enabled knock-outs of these major xenoantigens, thus producing xenografts with less hyperacute rejection rates. Another milestone in the history of xenotransplantation was the development of co-stimulation blockaded strategy. Unlike allotransplantation, xenotransplantation requires blockade of CD40-CD40L pathway to prevent T-cell dependent B-cell activation and antibody production. In 2010s, advanced genetic engineering of xenograft by inducing the expression of multiple human transgenes became available.So-called ‘multi-gene’ xenografts expressing human transgenes such as thrombomodulin and endothelial protein C receptor were introduced, which resulted in the reduction of thrombotic events and improvement of xenograft survival. Still, there are many limitations to clinical translation of cardiac xenotransplantation. Along with technical challenges, zoonotic infection and physiological discordances are major obstacles. Social barriers including healthcare costs also need to be addressed. Although there are several remaining obstacles to overcome, xenotransplantation would surely become the novel option for millions of patients with end-stage heart failure who have limited options to traditional therapeutics.

Blood Transfusion Status Based on the Literature of the 1920s in Korea / 대한수혈학회지

The ABO blood type was discovered by Karl Landsteiner in 1901. The frequency of occurrence of the ABO blood type in Korea was reported in the journal of the Joseon Medical Association in 1922. The status of 54 transfusions at one medical clinic in 1924 was reported at a medical congress in 1925. Many direct transfusion cases in Korea were identified by a literature search for articles published during the 1920s.

Giant Cardiac Rhabdomyoma with Mixed Atrial Tachycardia and Nonsustained Ventricular Tachycardia in a Newborn with Tuberous Sclerosis / 이화의대지

Cardiac rhabdomyomas are typically presented in the tuberous sclerosis. Although benign and often associated with spontaneous regression, in rare circumstances huge mass size and critical location can lead to heart failure, ventricular outflow tract obstruction and refractory tachyarrhythmias. An 1-day-old girl was diagnosed as cardiac tumor during perinatal period. At birth, transthoracic echocardiography revealed huge cardiac mass located in septal area of both ventricle measuring 34×30 mm. It protruded into the left ventricular (LV) outflow tract, potentially obstructing it. A surface ECG revealed atrial tachycardia with nonsustained ventricular tachycardia with heart rate of 217 beats per min. The tachyarrhythmias were controlled with intravenous amiodarone. Reduction of the giant cardiac mass was treated with mammalian target of rapamycin pathway inhibitor sirolimus. However, she unfortunately died at 10 days-old because of sudden cardiac arrest maybe due to LV outflow tract obstruction during therapy. Gene analysis revealed TSC2 mutation after death. (Ewha Med J 2022;45(3):e5)

The Changes in Obesity Prevalence and Dietary Habits in Korean Adults by Residential Area during the Last 10 Years – Based on the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Survey Data / 대한지역사회영양학회지

Objectives@#The purpose of this study was to discover the changes in obesity prevalence and dietary habits in Korean adults residing in various residential areas during the last 10 years. @*Methods@#Data on Korean adults aged 19 years and above was obtained from the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Survey. The subjects were classified into metropolitan 4th : n=5,977, 7th : n=6,651), urban (4th : n=4,511, 7th : n=5,512) and rural (4th : n=3,566, 7th : n=2,570) based on their residence. The general characteristics, nutrient intake, intake amount, food groups, and healthy dietary factors were analyzed. The association between residential areas and obesity prevalence were analyzed by multiple logistic regression. @*Results@#In urban and rural areas, the obesity rate increased in the 7thsurvey compared to the 4th survey, excluding the metropolitan area. The carbohydrate intake decreased, and lipid intake increased in the 7thsurvey compared to the 4thsurvey. Over the same period, the intake of cereals and vegetables decreased, and the intake of meat and processed foods increased. Rural residents had a higher intake of cereals and vegetables, and a lower intake of milk and processed foods than those in metropolitan areas and urban residents. The proportion of subjects who practiced a healthy diet increased in the 7th survey compared to the 4thsurvey. In the 4th survey, there was no relationship seen between the prevalence of obesity and the subject’s residential area, but in the 7thsurvey, the odds ratio of obesity was higher in rural areas than in the metropolitan areas, confirming the regional gap (OR: 1.16, 95% CI=1.00-1.36, p=0.044). @*Conclusions@#This study showed that the obesity prevalence increased in rural residents compared to metropolitan residents, indicating a gap between the regions. The nutrient intake and intake of food groups changed in the 10 years under consideration, and there were differences seen between regions. Therefore, it is necessary to formulate a policy that will reduce obesity prevalence and health inequalities between regions.

Genetics of Cardiomyopathy: Clinical and Mechanistic Implications for Heart Failure

Genetics has played an important role in the understanding of different cardiomyopathies, and the field of heart failure (HF) genetics is progressing rapidly. Much research has also focused on distinguishing markers of risk in patients with cardiomyopathy using genetic testing. While these efforts currently remain incomplete, new genomic technologies and analytical strategies provide promising opportunities to further explore the genetic architecture of cardiomyopathies, afford insight into the early manifestations of cardiomyopathy, and help define the molecular pathophysiological basis for cardiac remodeling. Cardiovascular physicians should be fully aware of the utility and potential pitfalls of incorporating genetic test results into pre-emptive treatment strategies for patients in the preliminary stages of HF. Future work will need to be directed towards elucidating the biological mechanisms of both rare and common gene variants and environmental determinants of plasticity in the genotype-phenotype relationship. This future research should aim to further our ability to identify, diagnose, and treat disorders that cause HF and sudden cardiac death in young patients, as well as prioritize improving our ability to stratify the risk for these patients prior to the onset of the more severe consequences of their disease.

Does Demineralized Bone Matrix Enhance Tendon-to-Bone Healing after Rotator Cuff Repair in a Rabbit Model?

Background@#The purpose of this study was to compare the histologic outcomes of rotator cuff (RC) repair with demineralized bone matrix (DBM) augmentation and those without DBM augmentation and to evaluate the role of DBM for tendon-to-bone (TB) healing in a rabbit model. @*Methods@#Twenty-six adult male New Zealand white rabbits were randomly allocated to the control group (n = 13) or the DBM group (n = 13). Repair was performed 8 weeks after complete transection of the right supraspinatus tendon of all rabbits. In the control group, RC repair was achieved by a standard transosseous technique. In the DBM group, RC repair was achieved using the same technique, and DBM was interposed between the cuff and bone. After 8 weeks, the RC tendon entheses from all rabbits were processed for gross and histologic examination. @*Results@#On gross TB healing, 2 of 11 specimens in the control group were unhealed and no specimen was grossly unhealed in the DBM group (p = 0.421). In the control group, the tendon midsubstance was disorganized with randomly and loosely arranged collagen fibers and rounded fibroblastic nuclei. The TB interface was predominantly fibrous with small regions of fibrocartilage, especially mineralized fibrocartilage. In the DBM group, the tendon midsubstance appeared normal and comprised densely arranged collagen fibers, with orientated crimped collagen fibers running in the longitudinal direction of the tendon. These fibers were interspersed with elongated fibroblast nuclei. The TB interface consisted of organized collagen fibers with large quantities of fibrocartilage and mineralized fibrocartilage. @*Conclusions@#The use of DBM for TB interface healing in rabbit experiments showed good results in gross and histologic analysis. However, it is difficult to draw a solid conclusion because the sample size is small. Further evaluation in the in vivo setting is necessary to determine clinical recommendations.

Does Demineralized Bone Matrix Enhance Tendon-to-Bone Healing after Rotator Cuff Repair in a Rabbit Model?

Background@#The purpose of this study was to compare the histologic outcomes of rotator cuff (RC) repair with demineralized bone matrix (DBM) augmentation and those without DBM augmentation and to evaluate the role of DBM for tendon-to-bone (TB) healing in a rabbit model. @*Methods@#Twenty-six adult male New Zealand white rabbits were randomly allocated to the control group (n = 13) or the DBM group (n = 13). Repair was performed 8 weeks after complete transection of the right supraspinatus tendon of all rabbits. In the control group, RC repair was achieved by a standard transosseous technique. In the DBM group, RC repair was achieved using the same technique, and DBM was interposed between the cuff and bone. After 8 weeks, the RC tendon entheses from all rabbits were processed for gross and histologic examination. @*Results@#On gross TB healing, 2 of 11 specimens in the control group were unhealed and no specimen was grossly unhealed in the DBM group (p = 0.421). In the control group, the tendon midsubstance was disorganized with randomly and loosely arranged collagen fibers and rounded fibroblastic nuclei. The TB interface was predominantly fibrous with small regions of fibrocartilage, especially mineralized fibrocartilage. In the DBM group, the tendon midsubstance appeared normal and comprised densely arranged collagen fibers, with orientated crimped collagen fibers running in the longitudinal direction of the tendon. These fibers were interspersed with elongated fibroblast nuclei. The TB interface consisted of organized collagen fibers with large quantities of fibrocartilage and mineralized fibrocartilage. @*Conclusions@#The use of DBM for TB interface healing in rabbit experiments showed good results in gross and histologic analysis. However, it is difficult to draw a solid conclusion because the sample size is small. Further evaluation in the in vivo setting is necessary to determine clinical recommendations.

Perceived Stress, Positive Resources and Their Interactions as Possible Related Factors for Depressive Symptoms

Objective@#The present study aimed to explore how the patterns of interaction between stress and positive resources differ according to the severity of depression and which resources play the most important role among the various positive resources. @*Methods@#The study included 1,806 people who had visited a health screening center for a mental health check-up to evaluate the levels of perceived stress, positive resources, and depressive symptoms. The participants were divided into a depressive group (n=1,642, mean age 50.60, female 68%) and a non-depressive group (n=164, mean age 48.42, female 66.6%). We conducted hierarchical regression analyses and simple slope analyses to examine the interaction between perceived stress and positive resources. @*Results@#The interaction between perceived stress and optimism was significantly associated with depression in non-depressive groups. In depressive groups, the interactions between five types of positive resources (optimism, purpose in life, self-control, social support and care) and perceived stress were all significantly related to depression. @*Conclusion@#Interventions that promote optimism can be helpful for preventing inevitable stress from leading to depression. A deficiency in positive resources may be a factor in aggravating depression in stressful situations for people reporting moderate to severe depressive symptoms.

The Changes in Obesity Prevalence and Dietary Habits in Korean Adults by Residential Area during the Last 10 Years – Based on the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Survey Data / 대한지역사회영양학회지

Objectives@#The purpose of this study was to discover the changes in obesity prevalence and dietary habits in Korean adults residing in various residential areas during the last 10 years. @*Methods@#Data on Korean adults aged 19 years and above was obtained from the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Survey. The subjects were classified into metropolitan 4th : n=5,977, 7th : n=6,651), urban (4th : n=4,511, 7th : n=5,512) and rural (4th : n=3,566, 7th : n=2,570) based on their residence. The general characteristics, nutrient intake, intake amount, food groups, and healthy dietary factors were analyzed. The association between residential areas and obesity prevalence were analyzed by multiple logistic regression. @*Results@#In urban and rural areas, the obesity rate increased in the 7thsurvey compared to the 4th survey, excluding the metropolitan area. The carbohydrate intake decreased, and lipid intake increased in the 7thsurvey compared to the 4thsurvey. Over the same period, the intake of cereals and vegetables decreased, and the intake of meat and processed foods increased. Rural residents had a higher intake of cereals and vegetables, and a lower intake of milk and processed foods than those in metropolitan areas and urban residents. The proportion of subjects who practiced a healthy diet increased in the 7th survey compared to the 4thsurvey. In the 4th survey, there was no relationship seen between the prevalence of obesity and the subject’s residential area, but in the 7thsurvey, the odds ratio of obesity was higher in rural areas than in the metropolitan areas, confirming the regional gap (OR: 1.16, 95% CI=1.00-1.36, p=0.044). @*Conclusions@#This study showed that the obesity prevalence increased in rural residents compared to metropolitan residents, indicating a gap between the regions. The nutrient intake and intake of food groups changed in the 10 years under consideration, and there were differences seen between regions. Therefore, it is necessary to formulate a policy that will reduce obesity prevalence and health inequalities between regions.

Genetics of Cardiomyopathy: Clinical and Mechanistic Implications for Heart Failure

Genetics has played an important role in the understanding of different cardiomyopathies, and the field of heart failure (HF) genetics is progressing rapidly. Much research has also focused on distinguishing markers of risk in patients with cardiomyopathy using genetic testing. While these efforts currently remain incomplete, new genomic technologies and analytical strategies provide promising opportunities to further explore the genetic architecture of cardiomyopathies, afford insight into the early manifestations of cardiomyopathy, and help define the molecular pathophysiological basis for cardiac remodeling. Cardiovascular physicians should be fully aware of the utility and potential pitfalls of incorporating genetic test results into pre-emptive treatment strategies for patients in the preliminary stages of HF. Future work will need to be directed towards elucidating the biological mechanisms of both rare and common gene variants and environmental determinants of plasticity in the genotype-phenotype relationship. This future research should aim to further our ability to identify, diagnose, and treat disorders that cause HF and sudden cardiac death in young patients, as well as prioritize improving our ability to stratify the risk for these patients prior to the onset of the more severe consequences of their disease.

Performance of Copeptin for Early Diagnosis of Acute Myocardial Infarction in an Emergency Department Setting

BACKGROUND: Rapid and accurate diagnosis of acute myocardial infarction (AMI) is critical for initiating effective treatment and achieving better prognosis. We investigated the performance of copeptin for early diagnosis of AMI, in comparison with creatine kinase myocardial band (CK-MB) and troponin I (TnI). METHODS: We prospectively enrolled 271 patients presenting with chest pain (within six hours of onset), suggestive of acute coronary syndrome, at an emergency department (ED). Serum CK-MB, TnI, and copeptin levels were measured. The diagnostic performance of CK-MB, TnI, and copeptin, alone and in combination, for AMI was assessed by ROC curve analysis by comparing the area under the curve (AUC). Sensitivity, specificity, negative predictive value, and positive predictive value of each marker were obtained, and the characteristics of each marker were analyzed. RESULTS: The patients were diagnosed as having ST elevation myocardial infarction (STEMI; N=43), non-ST elevation myocardial infarction (NSTEMI; N=25), unstable angina (N=78), or other diseases (N=125). AUC comparisons showed copeptin had significantly better diagnostic performance than TnI in patients with chest pain within two hours of onset (AMI: P=0.022, ≤1 hour; STEMI: P=0.017, ≤1 hour and P=0.010, ≤2 hours). In addition, TnI and copeptin in combination exhibited significantly better diagnostic performance than CK-MB plus TnI in AMI and STEMI patients. CONCLUSIONS: The combination of TnI and copeptin improves AMI diagnostic performance in patients with early-onset chest pain in an ED setting.

Evaluation of Patients with Sensory Disturbance after Dental Treatment / 대한법의학회지

The Korean Dental Association recommends a disability rate (DR) of 1%-3% in the judgment of physical disability owing to sensory disturbance (SD) after dental treatment; however, criteria for deciding the exact percentage have not been suggested. Therefore, this study aims to provide practical criteria in the application of forensic physical disability evaluation by comparing the results of SD using the current perception threshold (CPT) test. A total of 324 patients with SD who visited the Department of Oral Medicine at Pusan National University Dental Hospital between January 2013 and August 2020, underwent the test. The eight stages, as a result of the CPT value, were reorganized as follows: profound sensory loss, very severe and severe as “severe group”, advanced and moderate as “moderate group”, mild and very mild as “mild group”, and normal as “normal group” The analysis of variance (ANOVA) test was used to calculate the statistical difference in the CPT values at 2000 Hz, 250 Hz, and 5 Hz among the four groups. There were significant statistical differences in the average values of CPT among the four groups (P<0.001). Additionally, a significant statistical difference in the CPT value between the affected and nonaffected sides of the patients was observed among the four groups (P<0.001).Therefore, based on the results of this study, the rationale for applying DR from 1%-3% was in accordance with the severity of the mandibular nerve injury.

Transfusion in RhD Mismatch Hematopoietic Stem Cell Transplantation / 대한수혈학회지

In some cases, hematopoietic stem cell transplants (HSCT) show differences in the D antigen. In previous studies, there have been few cases of de novo anti-D alloimmunization, and even rarer cases of serious side effects or the outcomes. De novo anti-D alloimmunization has been reported to occur more frequently in minor D mismatch than in major D mismatch. For the RhD type of blood components, RhD-negative type is recommended in transfusion in RhD mismatch HSCT without anti-D in donors and recipients. But in situations of insufficient RhD-negative blood supply, this study suggests that the RhD type of blood components depends on the patients’ RhD type before transplantation, and it depends on the donors’ RhD type after transplantation, and an RhD-positive platelet transfusion may be available.

Satisfaction Survey of the Regional Networks for Blood Transfusion Management Project / 대한수혈학회지

Background@#The Korean Blood Safety Commission established the Regional Networks for Blood Transfusion Management (RNBTM) Project which has operated in 14 regions across the country since 2017 to help blood transfusion management in small and medium-sized medical institutions. Since implementation of the RNBTM, participant’s satisfaction has not been evaluated, therefore in order to evaluate participant’s satisfaction and assist in future planning a survey was conducted. @*Methods@#Fourteen facilitators participated in an anonymous on-line survey (5 questions). Laboratory Medicine (LM) doctors from small and medium-sized medical institutions from 14 regions also participated in a separate anonymous on-line survey (15 questions). @*Results@#14/14 (100%) facilitators responded to the survey. In addition to the RNBTM they were also in favor of establishing a Network of University Hospitals. 135 LM doctors responded to the survey. Of the RNBTM participants, 94.1% (111/118) replied that RNBTM was helpful in providing and exchanging blood transfusion information. Respondents indicated that they wished to remain part of RNBTM into the future because they felt that RNBTM not only helped improve quality of blood transfusions but also other aspects in the laboratory. In 70.4% (95/135) of participating medical institutions, LM doctors have been the Chairperson of the Hospital Transfusion Committee. @*Conclusion@#Extremely positive survey results were received from LM doctors. These survey results from LM doctors and facilitators will be helpful in developing and planning future projects related to RNBTM.

Continuous quality improvement program and its results of Korean Society for Cytopathology

Since 1995, the Korean Society for Cytopathology has overseen the Continuous Quality Improvement program for cytopathology laboratories. The Committee of Quality Improvement has carried out an annual survey of cytology data for each laboratory and set standards for proficiency tests. Methods: Evaluations were conducted four times per year from 2008 to 2018 and comprised statistics regarding cytology diagnoses of previous years, proficiency tests using cytology slides provided by the committee, assessment of adequacy of gynecology (GYN) cytology slides, and submission of cytology slides for proficiency tests. Results: A total of 206 institutes participated in 2017, and the results were as follows. The number of cytology tests increased from year to year. The ratio of liquid-based cytology in GYN gradually decreased, as most of the GYN cytology had been performed at commercial laboratories. The distribution of GYN diagnoses demonstrated nearly 3.0% as atypical squamous cells. The rate for squamous cell carcinoma was less than 0.02%. The atypical squamous cell/squamous intraepithelial lesion ratio was about 3:1 and showed an upward trend. The major discordant rate of cytology-histology in GYN cytology was less than 1%. The proficiency test maintained a major discordant rate less than 2%. The rate of inappropriate specimens for GYN cytology slides gradually decreased. Conclusions: The Continuous Quality Improvement program should be included in quality assurance programs. Moreover, these data can contribute to development of national cancer examination guidelines and facilitate cancer prevention and treatment.

Attachment Style, Complicated Grief and Post-Traumatic Growth in Traumatic Loss: The Role of Intrusive and Deliberate Rumination

Objective@#The present study examines the effects of attachment styles on the grief response and the indirect effect of rumination in parents who lost a child in the Sewol Ferry accident. @*Methods@#Bereaved parents (n=81) completed self-report questionnaires evaluating their attachment style (Experience in Close Relationship-Short form), traumatic loss related rumination (Event-Related Rumination Inventory), degree of complicated grief (Inventory of Complicated Grief), and post-traumatic growth (Post-Traumatic Growth Inventory). Data were analyzed using correlation analysis, structural equation modeling, and bootstrapping. @*Results@#The indirect effect of event-related intrusive rumination was significant in the relationship between attachment avoidance and complicated grief. The path from attachment avoidance to post-traumatic growth via deliberate rumination was not significant. With respect toattachment anxiety and post-traumatic growth, the indirect effect of deliberate rumination was significant. But the indirect effect of intrusive rumination was not significant in the relationships among attachment anxiety, complicated grief, and post-traumatic growth. @*Conclusion@#Individuals with attachment anxiety could obtain post-traumatic growth via deliberate rumination. By contrast, attachment avoidance was associated with the risk of maladaptive grief. Grief interventions should account for individual differences in attachment styles through interventions that manage intrusive rumination and strengthen deliberate rumination.

Isolation of Carnobacterium divergens from Blood Culture in Korea : A Case Report and Literature Review / 대한임상미생물학회지

Carnobacterium is a genus of gram-positive bacilli belonging to the family Lactobacillaceae.Generally, Carnobacterium species are considered nonpathogenic to humans and are mostly found in the natural environment, food, and food packaging. Furthermore, some Carnobacterium species play a bioprotective role in the food industry. Isolation of Carnobacterium from human blood or other sites, such as skin or abscess, has rarely been reported—there are only four published case reports worldwide, and none of them is from Korea. In all the reported cases, the patients reported contact with an aqueous environment or were administered nutrition via a parenteral route. Herein, we report the detection of Carnobacterium divergens bacteremia in an immunocompromised patient by using mass spectrometry in Korea.

Current Status of Our Journal, The Korean Journal of Blood Transfusion / 대한수혈학회지

The Korean Journal of Blood Transfusion (KJBT) is a representative journal in the field of transfusion medicine and has contributed to the development of the national blood business and clinical research. The KJBT was selected as a candidate journal registered in the Korea Citation Index (KCI) in 2009 and was selected as a KCI-registered journal in 2016. The KJBT has published 796 articles, including 601 original articles and 144 case reports from the first issue to volume 31, number 2. The KJBT has continuously introduced new tools for improving journals but was assessed as having a high self-citation rate because of the characteristics of the journal. Nevertheless, it is necessary to increase the number of papers to improve the value of the KJBT. To accomplish this, continuous efforts of the editorial committee will be needed to provide better services to authors and readers and to promote journals.

Evaluation of the dietary quality and nutritional status of elderly people using the Nutrition Quotient for Elderly (NQ-E) in Seoul / 한국영양학회지

PURPOSE: This study evaluated the dietary quality and nutritional status of elderly people using the Nutrition Quotient for Elderly (NQ-E).METHODS: The participants were 204 elderly people over 65 years of age (38 men and, 166 women) in Seoul. The dietary information was analyzed using a questionnaire of NQ-E, which consisted of 19 checklist items, and 24-recall test data. The NQ-E scores and its four factors, including ‘balance’, ‘moderation’, ‘diversity’, and ‘dietary behavior’ factors, were calculated according to general characteristics of the subjects. The subjects were divided into the ‘monitoring needed group’ (62 > NQ-E score) and the ‘good group’ (62 ≤ NQ-E score) according to their NQ-E score.RESULTS: The mean NQ-E score of the total subjects was 61.9, which was within the medium-high grade. The scores of balance, moderation, and dietary behavior factors were within the medium-high grade, while the score of the diversity factor was within the medium-low grade. The NQ-E score was 54.8 in the monitoring needed group and 69.3 in the good group. For the score of the diversity factor, the elderly living alone had a significantly lower score than the score for the elderly living with a spouse. The female subjects showed significantly higher scores of moderation and dietary behavior factors than did the male subjects. The daily intakes of vitamin A, thiamin, riboflavin, vitamin C and calcium in the monitoring needed group were significantly lower than those in the good group. The nutrient adequacy ratios (NAR) of vitamin A, thiamin, riboflavin, vitamin C and calcium in the monitoring needed group were significantly lower compared to the scores of the good group. The indexes of nutritional quality (INQ) of vitamin A, thiamin, riboflavin, vitamin C, calcium and potassium were less than 1 for all the subjects. The monitoring needed group had a significantly lower consumption of total foods, vegetables and mushrooms than the good group. As a result, the nutritional status of the monitoring needed group was significantly lower than that of the good group.CONCLUSION: The results of this study show that NQ-E would be a useful tool for assessing the dietary quality of the elderly. In conclusion, a focused-nutrition education program and a useful guideline are needed for promoting the health and nutritional status in elderly people.

Local Injection of Growth Hormone for Temporomandibular Joint Osteoarthritis

PURPOSE: Osteoarthritis (OA) of the temporomandibular joint (TMJ) elicits cartilage and subchondral bone defects. Growth hormone (GH) promotes chondrocyte growth. The aim of this study was to evaluate the efficacy of intra-articular injections of GH to treat TMJ-OA.MATERIALS AND METHODS: Monosodium iodoacetate (MIA) was used to induce OA in the TMJs of rats. After confirming the induction of OA, recombinant human GH was injected into the articular cavities of rats. Concentrations of GH and IGF-1 were measured in the blood and synovial fluid, and OA grades of cartilage and subchondral bone degradation were recorded by histological examination and micro-computed tomography.RESULTS: MIA-induced OA in the rat TMJ upregulated insulin-like growth factor-1 (IGF-1) rather than GH levels. GH and IGF-1 concentrations were increased after local injection of GH, compared with controls. Locally injected GH lowered osteoarthritic scores in the cartilage and subchondral bone of the TMJ.CONCLUSION: Intra-articular injection of GH improved OA scores in rat TMJs in both cartilage and subchondral bone of the condyles without affecting condylar bone growth. These results suggest that intra-articular injection of human GH could be a suitable treatment option for TMJ-OA patients in the future.