Initial Experience with Left Bundle Branch Area Pacing in Patients with Atrioventricular Block and Impaired LV Function / 전남의대학술지

Chronic right ventricular (RV) pacing can exacerbate heart failure in patients with a low left ventricular ejection fraction (LVEF). Left bundle branch area pacing (LBBAP) has emerged as a novel physiological pacing technique; however, information remains limited on its use among patients with a low EF. This study investigated the safety and short-term clinical outcomes of LBBAP among patients with impaired left ventricular (LV) function. This retrospective analysis of pacemakers at Chosun University Hospital, South Korea, included all patients with impaired LV function (EF＜50%) who underwent pacemaker implantation for atrioventricular blockage from 2019-2022. Clinical characteristics, 12-lead electrocardiography findings, echocardiography findings, and laboratory parameters were evaluated. Composite outcomes were defined as all-cause mortality, cardiac death, and hospitalization due to heart failure during the 6-month follow-up. Altogether 57 patients (25 men; mean age, 77.4±10.8 y; LVEF, 41.5±3.8%) were divided into LBBAP (n=16), biventricular pacing (BVP; n=16), and conventional RV pacing (RVP; n=25) groups. In the LBBAP group, the mean paced QRS duration (pQRSd) was narrower (119.5±14.7 vs. 140.2±14.3 vs. 163.2±13.9; p＜0.001) and cardiac troponin I level was elevated post-pacing (1.14±1.29 vs. 0.20±0.29 vs.0.24±0.51, p=0.001). Lead parameters were stable. One patient was hospitalized, and four died (one patient each from heart failure admission, myocardial infarction, unexplained death, and pneumonia in RVP vs. one from intracerebral hemorrhage in BVP) during the follow-up period. In conclusion, LBBAP is feasible in patients with impaired LV function without acute or significant complications and provides a remarkably narrower pQRSd with a stable pacing threshold.

Peripheral Neuron-Organoid Interaction Induces Colonic Epithelial Differentiation via Non-Synaptic Substance P Secretion

Background and Objectives@#The colonic epithelial layer is a complex structure consisting of multiple cell types that regulate various aspects of colonic physiology, yet the mechanisms underlying epithelial cell differentiation during development remain unclear. Organoids have emerged as a promising model for investigating organogenesis, but achieving organ-like cell configurations within colonic organoids is challenging. Here, we investigated the biological significance of peripheral neurons in the formation of colonic organoids. @*Methods@#and Results: Colonic organoids were co-cultured with human embryonic stem cell (hESC)-derived peripheralneurons, resulting in the morphological maturation of columnar epithelial cells, as well as the presence of enterochromaffin cells. Substance P released from immature peripheral neurons played a critical role in the development of colonic epithelial cells. These findings highlight the vital role of inter-organ interactions in organoid development and provide insights into colonic epithelial cell differentiation mechanisms. @*Conclusions@#Our results suggest that the peripheral nervous system may have a significant role in the development ofcolonic epithelial cells, which could have important implications for future studies of organogenesis and disease modeling.

Kordyana commelinae Associated with White Smut-like Disease on Commelina communis and C. minor in Korea

A fungus of the genus Kordyana, found on leaves of Commelina communis and C. minor exhibiting white smut-like symptoms, was identified as Kordyana commelinae based on morphological characteristics and two rDNA sequence analyses. We report the novel occurrence of the genus Kordyana in Korea and the association of K. commelinae with the host plant species. As well, we provide the necessary mycological information to resolve species delimitation and taxonomic problems of Kordyana.

Kordyana commelinae Associated with White Smut-like Disease on Commelina communis and C. minor in Korea

A fungus of the genus Kordyana, found on leaves of Commelina communis and C. minor exhibiting white smut-like symptoms, was identified as Kordyana commelinae based on morphological characteristics and two rDNA sequence analyses. We report the novel occurrence of the genus Kordyana in Korea and the association of K. commelinae with the host plant species. As well, we provide the necessary mycological information to resolve species delimitation and taxonomic problems of Kordyana.

Lethality-Associated Factors in Deliberate Self-Poisoning

Objectives@#Deliberate self-poisoning (DSP) is the most common suicide method and can be life-threatening. The purpose of this study was to investigate the factors related to the lethality of DSP and the characteristics of the adolescent group. @*Methods@#A retrospective study was conducted on patients who had visited an academic hospital’s regional emergency medical center between 2015 and 2018. The data reviewed through their medical records included sociodemographic factors, clinical variables, and psychiatric treatment. Four groups (Q1–Q4) were categorized by descriptive analysis using the risk-rescue rating scale. @*Results@#A total of 491 patients were enrolled in this study. This study showed that high lethality had statistically significant associations with male sex, older age, admitting suicidal intentions, and the use of herbicides for suicide. Logistic regression analyses showed a significant association between high-lethality and female [odds ratio (OR)=0.50, 95% confidence interval (CI)=0.30–0.81, p=0.01], non-psychiatric drugs (over-the-counter drug: OR=2.49, 95% CI=1.08–5.74, p=0.03; herbicide: OR=8.65, 95% CI=3.91–19.13, p<0.01), and denial of suicide intent (OR=0.28, 95% CI=0.15–0.55, p<0.01). @*Conclusion@#This study showed the clinical factors associated with the high lethality of DSP and suggested that efforts were needed to care for and thoroughly examine patients with DSP.

Status of serving labeling of home meal replacement-soups and stews, and evaluation of their energy and nutrient content per serving / 한국영양학회지

Purpose@#In this study, the serving size of home meal replacement (HMR)-soups (Guk, Tang) and stews (Jjigae) available in the Korean market was investigated, and an evaluation of the nutrition per serving was conducted based on the nutrition labeling. @*Methods@#The market research was conducted from March to August 2021 on products sold on the internet, convenience stores, supermarkets, and hypermarkets. A total of 370 products were investigated and classified into 3 types: Guk (n = 129), Tang (n = 132), and Jjigae (n = 109). @*Results@#An analysis of the survey revealed that 72.9% of Guk, 71.2% of Tang, and 79.8% of Jjigae had labels with servings per container, and 89.2% of Guk, 91.7% of Tang, and 99.1% of Jjigae had labels with nutrition facts. The nutritional evaluation per serving of Guk, Tang, and Jjigae was conducted for 259 products (87 Guk, 86 Tang, and 86 Jjigae) having labels containing both the servings per container and nutrition facts. The average serving size of Tang was 367.6 g, which was significantly higher than Guk (325.3 g) and Jjigae (305.1 g) (p < 0.001). The calorie content of Jjigae (171.4 kcal) and Tang (162.3 kcal) was significantly higher than Guk (90.8 kcal) (p < 0.001), and the protein content was the highest in Tang (16.3 g) (p < 0.001). The sodium content per serving of Jjigae (1,479.0 mg) was significantly higher than Guk (1,073.3 mg) and Tang (959.8 mg) (p < 0.001). The percent daily value per serving of all three types was less than 10% on average for calories and 15–30% for protein, whereas for sodium showed an average of around 50% (48–74%). @*Conclusion@#The serving size and nutritional value per serving of the HMR-soups and stews found in this study can be used as basic data to establish the reference serving size.

Occurrence and Characterization of Leaf Spot Caused by Septoria melissae on Lemon Balm in Korea

Leaf spot on lemon balm is frequently observed in Korea, causing considerable damage to crops. In 2014 and 2015, the occurrence of leaf spot was observed in several production greenhouses at Suwon, Gongju, and Namwon in Korea. Symptoms on lower leaves initially developed as small, distinct, discolored lesions, which enlarged progressively turning into dark brown, angular spots surrounded by purplish-brown margins. Based on the morphological characteristics and sequence analysis of actin (ACT), translation elongation factor 1-alpha (EF-1α), internal transcribed spacer (ITS), 28S nrDNA (LSU), and RNA polymerase II second largest subunit (RPB2), the fungus associated with the lemon balm leaf spot was determined as Septoria melissae. To the best of our knowledge, this is the first report of lemon balm leaf spot caused by S. melissae in Asia as well as in Korea.

Occurrence and Characterization of Leaf Spot Caused by Septoria melissae on Lemon Balm in Korea

Leaf spot on lemon balm is frequently observed in Korea, causing considerable damage to crops. In 2014 and 2015, the occurrence of leaf spot was observed in several production greenhouses at Suwon, Gongju, and Namwon in Korea. Symptoms on lower leaves initially developed as small, distinct, discolored lesions, which enlarged progressively turning into dark brown, angular spots surrounded by purplish-brown margins. Based on the morphological characteristics and sequence analysis of actin (ACT), translation elongation factor 1-alpha (EF-1α), internal transcribed spacer (ITS), 28S nrDNA (LSU), and RNA polymerase II second largest subunit (RPB2), the fungus associated with the lemon balm leaf spot was determined as Septoria melissae. To the best of our knowledge, this is the first report of lemon balm leaf spot caused by S. melissae in Asia as well as in Korea.

Impediment in Activity of Daily Living and Social Support for Rural Elderly Farmers Undergoing Nerve Block due to Low Back Pain

PURPOSE: This study is to investigate the low back pain, social support, impediment in daily living activities and to identify factors affecting impediment in elderly farmer' daily living activities. METHODS: The participants were 128 elderly farmers who had received nerve block. Data were collected using a structured questionnaire from February to March, 2018. They were analyzed using t-test, ANOVA, pearson's correlation coefficient, and linear multiple regression. RESULTS: The score of low back pain was 6.27±1.69 (10 points), that of social support 2.92±0.76 (1~5 points), and that of impediment in activity of daily living 2.01±0.82 (0~5 points). Factors affecting impediment in activity of daily living were found to include age (p=.017), daily hours of farm work (p<.001), fear for the nerve block (p<.001), low back pain (p<.001), and social support (p<.001); the explanatory power of these variables was 58.8%. CONCLUSION: This study has found the controllable factors affecting impediment in activity of daily living among the rural elderly engaging in farm work include low back pain, social support, and daily farming hours. Therefore, to reduce impediment in activity of daily living among them, it is necessary to develop nursing interventions that can improve impediment in activity of daily living through reduction of daily farming hours using local resources. It is also desirable to improve their health status by reducing low back pain, and develop and apply social supports with health education programs that fit the local resources and the needs of the rural elderly.

Angiopoietin-1 and -2 and vascular endothelial growth factor expression in ovarian grafts after cryopreservation using two methods / 대한생식의학회지

OBJECTIVE: The favored method of preserving fertility in young female cancer survivors is cryopreservation and autotransplantation of ovarian tissue. Reducing hypoxia until angiogenesis takes place is essential for the survival of transplanted ovarian tissue. The aim of this study was to investigate the role of angiopoietin-1 (Angpt-1), angiopoietin-2 (Angpt-2), and vascular endothelial growth factor (VEGF) in ovarian tissue grafts that were cryopreserved using two methods. METHODS: Ovarian tissues harvested from ICR mice were divided into three groups: group I (control), no cryopreservation; group II, vitrification in EFS (ethylene-glycol, ficoll, and sucrose solution)-40; and group III, slow freezing in dimethyl sulfoxide. We extracted mRNA for VEGF, Angpt-1, and Angpt-2 from ovarian tissue 1 week following cryopreservation and again 2 weeks after autotransplantation. We used reverse transcriptase-polymerase chain reaction to quantify the levels of VEGF, Angpt-1, and Angpt-2 in the tissue. RESULTS: Angpt-1 and Angpt-2 expression decreased after cryopreservation in groups II and III. After autotransplantation, Angpt-1 and Angpt-2 expression in ovarian tissue showed different trends. Angpt-1 expression in groups II and III was lower than in group I, but Angpt-2 in groups II and III showed no significant difference from group I. The vitrified ovarian tissues had higher expression of VEGF and Angpt-2 than the slowfrozen ovarian tissues, but the difference was not statistically significant. CONCLUSION: Our results indicate that Angpt-2 may play an important role in ovarian tissue transplantation after cryopreservation although further studies are needed to understand its exact function.

Prevalence Risk of Metabolic Syndrome Associated with Alcohol Use Behavior in Korean Women

OBJECTIVE: Considerable research has been conducted on the relationship between alcohol consumption and metabolic syndrome. Although various standards for the amount and frequency of alcohol consumption have been suggested, a tool to measure individual alcohol use behavior against a consistent standard is required. Moreover, the association of alcohol use behavior with health should be examined on the basis of such a standard. In this study, we examined the relationships between alcohol use behavior according to the Alcohol Use Disorders Identification Test (AUDIT) and metabolic syndrome and its components in Korean women. METHODS: This study utilized data from the fifth Korean National Health and Nutrition Examination Survey, which was administered from 2010 through 2012. We investigated the relationships between alcohol use behavior and metabolic syndrome and its components in a sample of 2,906 women by using analysis of covariance and logistic regression analysis. RESULTS: After adjusting for confounding variables, alcohol use behavior was significantly associated with metabolic syndrome [odds ratio (OR) 2.877; 95% confidence interval (CI) 1.523–5.435 in the problem use group]. AUDIT score also was significantly related to abdominal obesity (OR 2.263; 95% CI 1.704–4.459 in the problem use group), hypertension (OR 3.377; 95% CI 1.871–6.095 in the problem use group), hypertriglyceridemia (OR 3.204; 95% CI 1.800–5.702 in the problem use group), and impaired fasting glucose (OR 3.034; 95% CI 1.721–5.348 in the problem use group). CONCLUSION: In this study, positive associations were observed between AUDIT score and risk of metabolic syndrome and its components.

Physician-Directed Diabetes Education without a Medication Change and Associated Patient Outcomes

BACKGROUND: When patients with diabetes mellitus (DM) are first referred to a hospital from primary health care clinics, physicians have to decide whether to administer an oral hypoglycemic agent (OHA) immediately or postpone a medication change in favor of diabetes education regarding diet or exercise. The aim of this study was to determine the effect of diabetes education alone (without alterations in diabetes medication) on blood glucose levels. METHODS: The study was conducted between January 2009 and December 2013 and included patients with DM. The glycosylated hemoglobin (HbA1c) levels were evaluated at the first visit and after 3 months. During the first medical examination, a designated doctor also conducted a diabetes education session that mainly covered dietary management. RESULTS: Patients were divided into those who received no diabetic medications (n=66) and those who received an OHA (n=124). Education resulted in a marked decrease in HbA1c levels in the OHA group among patients who had DM for 10 years showed a slightly lower HbA1c target achievement rate of <6.5% (odds ratio, 0.089; P=0.0024). CONCLUSION: For patients who had DM for more than 5 years, higher doses or changes in medication were more effective than intensive active education. Therefore, individualized and customized education are needed for these patients. For patients with a shorter duration of DM, it may be more effective to provide initial intensive education for diabetes before prescribing medicines, such as OHAs.

CT Enterography for Surveillance of Anastomotic Recurrence within 12 Months of Bowel Resection in Patients with Crohn's Disease: An Observational Study Using an 8-Year Registry

OBJECTIVE: To investigate the diagnostic yield and accuracy of CT enterography (CTE) for early (< 12 postoperative months) surveillance of anastomotic recurrence after bowel resection for Crohn's disease (CD). MATERIALS AND METHODS: We analyzed 88 adults (60 males and 28 females; mean age, 31.4 ± 9.6 years) who underwent bowel surgery for CD that created ileocolic anastomosis without enteric stoma, and underwent CTE for surveillance of CD recurrence/aggravation within 12 post-operative months. The CD activity index (CDAI) at the time of CTE was < 150 (i.e., clinically silent) in 51 patients, and ≥ 150 in 37 patients. Diagnostic yields of CTE regarding CD recurrence in the ileocolic anastomosis and extraluminal penetrating complications were determined. CTE-related step-up therapy was recorded. These outcomes were compared between the two CDAI groups after accounting for major risk factors for CD recurrence. In a subgroup of 31 patients who underwent both CTE and ileocolonoscopy within 1 month, CTE accuracy for anastomotic recurrence was assessed using the Rutgeerts scoring as the reference standard. RESULTS: CTE diagnostic yield was 35.2% (31/88) for the anastomotic recurrence and 9.1% (8/88) for penetrating complications. 20.5% (18/88) of the patients underwent step-up therapy after CTE detection of anastomotic recurrence. These outcomes were not significantly different between CDAI < 150 and CDAI ≥ 150, except that CTE yield for extraluminal penetrating complications was significantly higher in CDAI ≥ 150 (16.2% [6/37] vs. 3.9% [2/51]; multivariable-adjusted p = 0.029). CTE showed 92.3% (12/13) sensitivity and 83.3% (15/18) specificity for anastomotic recurrence. CONCLUSION: CTE may be a viable option for the early postsurgical surveillance of recurred disease in CD patients.

Pilot Algorithm Designed to Help Early Detection of HMG-CoA Reductase Inhibitor-Induced Hepatotoxicity / 대한의료정보학회지

OBJECTIVES: To enable early detection of adverse drug reactions (ADRs) in patients using HMG-CoA reductase inhibitors (statins), we developed an algorithm that automatically detects liver injury caused by statins from Electronic Medical Record (EMR) data. We verified the performance of our algorithm through manual ADR assessment and a direct chart review. METHODS: The subjects in this study were patients who had been prescribed a statin for the first time among outpatients in Seoul St. Mary's Hospital in Korea between January 2009 and December 2012. We extracted basic information about the patients, including laboratory information, underlying disease, diagnosis information, prescription information, and concomitant drugs. We developed an automatic ADR detection algorithm by using EMR data. We validated the results of the algorithm through a chart review. RESULTS: We developed the algorithm to assess ADR occurrences based on alanine transaminase (ALT) and alkaline phosphatase (ALP) levels. According to the proposed algorithm, any of these result options could be attained: ADR-free, little association, strong association, and weak association or indeterminable. The results of the ADR assessments obtained using the proposed algorithm showed that the data of 126 patients (1.4% of all 9,241 patients) included suspicious figures, thus indicating the possibility of an ADR. In the EMR chart review for verifying the algorithm, ADRs of 33 patients were not associated with statin use; therefore, the ADR occurrence rate was found to be 1.0% (93/9,241). Therefore, the positive predictive value was calculated to be 73.8% (93/126; 95% confidence interval, 69.2%–77.6%). No differences were observed between statin types (p = 0.472). CONCLUSIONS: For early detection of statin-induced liver injury, we developed an automatic ADR assessment algorithm. We expect that algorithms that are more reliable can be developed if we conduct supplement clinical studies with a focus on adverse drug effects.

Identification and Characterization of Pseudocercospora pyricola Causing Leaf Spots on Aronia melanocarpa

Leaf spot disease on black chokeberry (Aronia melanocarpa) was observed at several locations in Korea during 2014–2015. Leaf spots were distinct, scattered over the leaf surface and along the leaf border, subcircular to irregular and brown surrounded by a distinct dark color, and were expanded and coalesced into irregularly shaped lesions. Severely infected leaves became dry and fell off eventually. The causative agent was identified as Pseudocercospora pyricola. Morphological observations and phylogenetic analyses of multiple genes, including internal transcribed spacer, translation elongation factor 1-alpha, actin, and the large subunit ribosomal DNA were conducted. The pathogenicity test was conducted twice yielding similar results, fulfilling Koch's postulates. To our knowledge, this is the first report on P. pyricola infection of A. melanocarpa globally.

Identification and Characterization of Cercospora malayensis Causing Leaf Spot on Kenaf

In September 2013 and 2014, a significant number of kenaf plants showing symptoms of leaf spots with approximately 50% incidence were found in experimental plots in Iksan and Namwon, Korea. Leaf spots were circular to irregular, more or less vein-limited, reaching to 10 mm in diameter. The spots were initially uniformly brown to reddish brown, turning pale brown with a purplish margin and showing grayish patches on the lesion due to heavy fructification. The causative agent of the leaf spot disease was identified as Cercospora malayensis. The pathogenicity test was conducted with similar results, which fulfilled Koch's postulates. This is the first report of C. malayensis infection of kenaf in Korea.

Russian Inpatients' Nursing Service Expectations, Satisfaction and Intention to Revisit Hospital / 기본간호학회지

PURPOSE: The aim of this study was to identify Russian inpatients' expectation and satisfaction with nursing service, and further, to analyze the relationship between these variables. METHODS: A structured questionnaire was used to survey for 81 Russian inpatients. The survey was conducted from January to June, 2014. RESULTS: Empathy and assurance significantly influenced nursing service expectation and satisfaction. Nursing service expectation was statistically significant for the number of visit to Korea, and nursing service satisfaction was statistically significant for gender, monthly income and primary care giver during hospitalization. Revisit intention was significantly different according to religion, medical department and primary care giver during hospitalization. There were positive correlations between nursing service expectation and satisfaction, and between nursing service satisfaction and intention to revisit the hospital. CONCLUSION: The results of this study show that the level satisfaction with nursing service influences Russian inpatients' intention continue using the hospital. Therefore, in order to increase the intention to revisit the hospital Korea hospital employees, especially nurses, need to develop nursing service strategies according to general characteristics, culture and nationality of foreign patients.

Development of Clinical Data Mart of HMG-CoA Reductase Inhibitor for Varied Clinical Research

BACKGROUND: The increasing use of electronic medical record (EMR) systems for documenting clinical medical data has led to EMR data being increasingly accessed for clinical trials. In this study, a database of patients who were prescribed statins for the first time was developed using EMR data. A clinical data mart (CDM) was developed for cohort study researchers. METHODS: Seoul St. Mary's Hospital implemented a clinical data warehouse (CDW) of data for ~2.8 million patients, 47 million prescription events, and laboratory results for 150 million cases. We developed a research database from a subset of the data on the basis of a study protocol. Data for patients who were prescribed a statin for the first time (between the period from January 1, 2009 to December 31, 2015), including personal data, laboratory data, diagnoses, and medications, were extracted. RESULTS: We extracted initial clinical data of statin from a CDW that was established to support clinical studies; the data was refined through a data quality management process. Data for 21,368 patients who were prescribed statins for the first time were extracted. We extracted data every 3 months for a period of 1 year. A total of 17 different statins were extracted. It was found that statins were first prescribed by the endocrinology department in most cases (69%, 14,865/21,368). CONCLUSION: Study researchers can use our CDM for statins. Our EMR data for statins is useful for investigating the effectiveness of treatments and exploring new information on statins. Using EMR is advantageous for compiling an adequate study cohort in a short period.

The OAuth 2.0 Web Authorization Protocol for the Internet Addiction Bioinformatics (IABio) Database

Internet addiction (IA) has become a widespread and problematic phenomenon as smart devices pervade society. Moreover, internet gaming disorder leads to increases in social expenditures for both individuals and nations alike. Although the prevention and treatment of IA are getting more important, the diagnosis of IA remains problematic. Understanding the neurobiological mechanism of behavioral addictions is essential for the development of specific and effective treatments. Although there are many databases related to other addictions, a database for IA has not been developed yet. In addition, bioinformatics databases, especially genetic databases, require a high level of security and should be designed based on medical information standards. In this respect, our study proposes the OAuth standard protocol for database access authorization. The proposed IA Bioinformatics (IABio) database system is based on internet user authentication, which is a guideline for medical information standards, and uses OAuth 2.0 for access control technology. This study designed and developed the system requirements and configuration. The OAuth 2.0 protocol is expected to establish the security of personal medical information and be applied to genomic research on IA.

Churg-Strauss syndrome that presented with mediastinal lymphadenopathy and calculous cholecystitis

No abstract available.