Ghrelin Modifies the Impact of Life Stress on Suicidality in Patients With Acute Coronary Syndrome

Objective@#This study investigated associations of life stressors and serum ghrelin levels with suicidal ideation (SI), and evaluated the potential mediating effect of ghrelin on associations between life stressors and SI in patients with acute coronary syndrome (ACS). @*Methods@#In total, 969 ACS patients recruited from a tertiary university hospital in Korea within 2 weeks of disease onset were evaluated in terms of life stressors (using the List of Threatening Events Questionnaire), serum ghrelin levels, and SI (using the “suicidal thoughts” item of the Montgomery–Asberg Depression Rating Scale). Covariates included sociodemographics, depression, vascular risk factors, and disease severity. After 1 year, 711 patients were re-evaluated in terms of SI; logistic regression was performed with adjustment for covariates. @*Results@#Life stressors were significantly associated with SI at baseline and follow-up. Serum ghrelin showed no such associations, but high levels thereof mediated associations of life stressors with SI; significant interaction terms were also observed after adjustment for covariates. @*Conclusion@#By evaluating life stressors and serum ghrelin levels, clinical prediction of SI in the acute and chronic phases of ACS could be improved.

Dopamine and serotonin alterations by Hizikia fusiformis extracts under in vitro cortical primary neuronal cell cultures

BACKGROUND/OBJECTIVES@#Hizikia fusiformis (HF) is a class of brown seaweeds whose active ingredients exert central nervous system protective effects, such as neuroprotection;however, the underlying mechanisms remain unknown. Given that dopamine (DA) and serotonin (5HT) are two major neurotransmitters involved in various psychiatric disorders and neuronal growth in early neurodevelopmental processes, we investigated whether HF extract could modulate the molecular expression associated with DA and 5HT transmission as well as the structural formation of neurons.MATERIALS/METHODS: in vitro cell cultures were prepared from cerebral cortical neurons obtained from CD-1 mice on embryonic day 14. Cultured cells were treated with 0.1, 1.0, or 10.0 μg/mL of HT extract for 24 h, followed by fluorescence immunostaining for DA and 5HT-related receptors and transporters and some neuronal structural formation-associated molecules. @*RESULTS@#HF extract dose-dependently upregulated the expression levels of selective DA and 5HT receptors, and downregulated the levels of DA and 5HT transporters. Moreover, HF extract increased the neurofilament light chain expression. @*CONCLUSION@#These results suggest that HF may modulate DA and 5HT transmission, thereby affecting neurodevelopment.

Obesity Is Associated With Higher Risk of Adverse Maternal and Neonatal Outcomes Than Supervised Gestational Diabetes

Background@#Unlike gestational diabetic mellitus (GDM), which is strictly managed by most patients and physicians, obesity does not have proper management guidelines, and the importance of its management during pregnancy is often ignored. The aim of this study was to compare maternal and neonatal outcomes according to obesity and GDM, alone or in combination. @*Methods@#This was a retrospective cohort study of 3,078 consecutive pregnant women who experienced prenatal care and delivery of a live singleton neonate between January 2016 and December 2020 at our institution. Study participants were categorized into 4 mutually exclusive groups, as follows: group 1, no GDM without obesity; group 2, GDM without obesity; group 3, no GDM with obesity; and group 4, GDM with obesity. @*Results@#Compared to group 2, group 3 had higher rates of pre-eclampsia, cesarean section including emergent cesarean section rate. Also, neonates in group 3 were heavier and had lower glucose levels compared to those in group 2. Of note, there was no significant difference in maternal or neonatal outcomes except the rate of large-for-gestational-age (LGA) between group 1 and group 2. Among the GDM groups, group 4 had higher risks for pre-eclampsia, cesarean section, and LGA infant status than group 2. @*Conclusion@#Our data showed that obese women without GDM face higher risk of adverse pregnancy outcomes than women with supervised GDM and non-obese women. We also confirmed that adverse pregnancy outcomes associated with GDM were mainly attributable to obesity among women receiving GDM education.

Changes in body composition, body balance, metabolic parameters and eating behavior among overweight and obese women due to adherence to the Pilates exercise program / 한국영양학회지

Purpose@#We examined the effects of the 8-week moderate-intensity Pilates exercise program on body composition, balance ability, metabolic parameters, arterial condition, and eating habits among overweight and obese women. @*Methods@#From the general sample of overweight or obese Korean women (body mass index ≥ 23 kg/m2 ), those who had not been diagnosed with any chronic degenerative diseases were enrolled in the study (n = 39). After 8 weeks of the Pilates exercise program, the participants were subdivided into adherence and non-adherence groups. Among the study participants, 24 women were matched for age and menopausal status to reduce the bias, and then finally included for the comparison (Pilates-adherence, n = 12; Pilates-non-adherence, n = 12). @*Results@#The body balance measured by the Y-balance test, body mass index, and subcutaneous fat areas were significantly improved in both groups. However, the Pilatesadherence group showed more positive changes in body balance and had significant improvement in body composition parameters such as waist size, visceral fat area, systolic blood pressure, arterial aging index, fasting blood glucose, and glycated hemoglobin than the Pilates-non-adherence group. In addition, the nutrition quotient for Korean adults (balance,moderation, and behavior except diversity) were significantly improved in both groups after dietary education. However, the participants did not show dramatic improvement in the metabolic parameters, because all the study subjects were in relatively good health and did not have any diagnosed diseases. @*Conclusion@#This study demonstrated that higher adherence to the Pilates exercise program together with a modification of eating habits may effectively improve body balance, body composition, and obesity-related parameters among overweight and obese women.

Response to growth hormone according to provocation test results in idiopathic short stature and idiopathic growth hormone deficiency

Purpose@#To investigate growth response in children with either idiopathic short stature (ISS) or growth hormone (GH) deficiency (GHD). @*Methods@#The data of prepubertal GHD or ISS children treated using recombinant human GH were obtained from the LG Growth Study database. GHD children were further divided into partial and complete GHD groups. Growth response and factors predicting growth response after 1 and 2 years of GH treatment were investigated. @*Results@#This study included 692 children (98 with ISS, 443 partial GHD, and 151 complete GHD). After 1 year, changes in height standard deviation score (ΔHt-SDS) were 0.78, 0.83, and 0.96 in ISS, partial GHD, and complete GHD, respectively. Height velocity (HV) was 8.72, 9.04, and 9.52 cm/yr in ISS, partial GHD, and complete GHD, respectively. ΔHt-SDS and HV did not differ among the 3 groups. Higher initial body mass index standard deviation score (BMI-SDS) and midparental height standard deviation score (MPH-SDS) were predictors for better growth response after 1 year in ISS and the partial GHD group, respectively. In the complete GHD group, higher Ht-SDS and BMI-SDS predicted better growth response after 1 year. After 2 years of GH treatment, higher BMI-SDS and MPH-SDS predicted a better growth outcome in the partial GHD group, and higher MPH-SDS was a predictor of good growth response in complete GHD. @*Conclusion@#Clinical characteristics and growth response did not differ among groups. Predictors of growth response differed among the 3 groups, and even in the same group, a higher GH dose would be required when poor response is predicted.

Prosthetic rehabilitation of an oligodontia patient with atrophic maxilla / 대한치과보철학회지

Congenital tooth agenesis is the most common developmental dental anomaly, of which oligodontia is defined as the absence of six or more permanent teeth, except the third molars. Tooth agenesis causes malocclusion, alveolar atrophy, aesthetic and psychosocial problems. This clinical report describes a multidisciplinary treatment for a patient diagnosed as oligodontia, who exhibited absence of 14 permanent teeth, atrophy of maxillary alveolar bone, and mandibular protrusion. Restoration space was secured and tooth axis was improved by the extraction of deciduous teeth and orthodontic treatment. However, edge-to-edge bite of posterior teeth and arch dimension discrepancy due to atrophic maxilla was remained. To restore the aesthetics and functionality, implant retained prosthesis was planned. Considering minimal bone grafts, location and number of dental implants and prostheses design were determined. Through the gradual adjustment of provisional restoration, the appropriate centric and eccentric occlusion was reflected into a definitive prosthesis. Currently, stable functional results were attained, however, regular follow up and maintenance care over lifetimes should be performed.

“Reading the Mind in the Eyes Test”: Translated and Korean Versions

Objective@#The Reading the Mind in the Eyes Test (RMET) was developed by using Caucasian eyes, which may not be appropriate to be used in Korean. The aims of the present study were 1) to develop a Korean version of the RMET (K-RMET) by using Korean eye stimuli and 2) to examine the psychometric properties of the Korean-translated version of the RMET and the K-RMET. @*Methods@#Thirty-six photographs of Korean eyes were selected. A total of 196 (101 females) healthy subjects were asked to take the Korean-translated version of the RMET and K-RMET. To assess internal consistency reliability, Cronbach’s alpha coefficients were computed, and test–retest reliability was assessed by the intraclass correlation coefficient (ICC) and Bland-Altman plots. Confirmatory factor analysis (CFA) and item analysis were also conducted. @*Results@#Internal consistency, measured by Cronbach’s alpha, was 0.542 for the Korean-translated version of the RMET, and 0.540 for the K-RMET. Test–retest reliability (n=25), measured by the ICC, was 0.787 for the Korean-translated version of the RMET, and 0.758 for the K-RMET. In CFA, the assumed single and 3-factor model fit indices were not good in the both types of RMETs. There was difficulty in discrimination in nine items of the Korean-translated version of the RMET and 10 items of the K-RMET. @*Conclusion@#The psychometric properties of both the Korean-translated version of the RMET and the K-RMET are acceptable. Both tests are applicable to the clinical population, as well as the general population in Korea.

Prosthetic rehabilitation of an oligodontia patient with atrophic maxilla / 대한치과보철학회지

Congenital tooth agenesis is the most common developmental dental anomaly, of which oligodontia is defined as the absence of six or more permanent teeth, except the third molars. Tooth agenesis causes malocclusion, alveolar atrophy, aesthetic and psychosocial problems. This clinical report describes a multidisciplinary treatment for a patient diagnosed as oligodontia, who exhibited absence of 14 permanent teeth, atrophy of maxillary alveolar bone, and mandibular protrusion. Restoration space was secured and tooth axis was improved by the extraction of deciduous teeth and orthodontic treatment. However, edge-to-edge bite of posterior teeth and arch dimension discrepancy due to atrophic maxilla was remained. To restore the aesthetics and functionality, implant retained prosthesis was planned. Considering minimal bone grafts, location and number of dental implants and prostheses design were determined. Through the gradual adjustment of provisional restoration, the appropriate centric and eccentric occlusion was reflected into a definitive prosthesis. Currently, stable functional results were attained, however, regular follow up and maintenance care over lifetimes should be performed.

“Reading the Mind in the Eyes Test”: Translated and Korean Versions

Objective@#The Reading the Mind in the Eyes Test (RMET) was developed by using Caucasian eyes, which may not be appropriate to be used in Korean. The aims of the present study were 1) to develop a Korean version of the RMET (K-RMET) by using Korean eye stimuli and 2) to examine the psychometric properties of the Korean-translated version of the RMET and the K-RMET. @*Methods@#Thirty-six photographs of Korean eyes were selected. A total of 196 (101 females) healthy subjects were asked to take the Korean-translated version of the RMET and K-RMET. To assess internal consistency reliability, Cronbach’s alpha coefficients were computed, and test–retest reliability was assessed by the intraclass correlation coefficient (ICC) and Bland-Altman plots. Confirmatory factor analysis (CFA) and item analysis were also conducted. @*Results@#Internal consistency, measured by Cronbach’s alpha, was 0.542 for the Korean-translated version of the RMET, and 0.540 for the K-RMET. Test–retest reliability (n=25), measured by the ICC, was 0.787 for the Korean-translated version of the RMET, and 0.758 for the K-RMET. In CFA, the assumed single and 3-factor model fit indices were not good in the both types of RMETs. There was difficulty in discrimination in nine items of the Korean-translated version of the RMET and 10 items of the K-RMET. @*Conclusion@#The psychometric properties of both the Korean-translated version of the RMET and the K-RMET are acceptable. Both tests are applicable to the clinical population, as well as the general population in Korea.

Reading the Mind in the Eyes Test: Relationship with Neurocognition and Facial Emotion Recognition in Non-Clinical Youths

Objective@#The Reading the Mind in the Eyes Test (RMET) is a common measure of the Theory of Mind. Previous studies found a correlation between RMET performance and neurocognition, especially reasoning by analogy; however, the nature of this relationship remains unclear. Additionally, neurocognition was shown to play a significant role in facial emotion recognition. This study is planned to examine the nature of relationship between neurocognition and RMET performance, as well as the mediating role of facial emotion recognition. @*Methods@#One hundred fifty non-clinical youths performed the RMET. Reasoning by analogy was tested by Raven’s Standard Progressive Matrices (SPM) and facial emotion recognition was assessed by the Korean Facial Expressions of Emotion (KOFEE) test. The percentile bootstrap method was used to calculate the parameters of the mediating effects of facial emotion recognition on the relationship between SPM and RMET scores. @*Results@#SPM scores and KOFEE scores were both statistically significant predictors of RMET scores. KOFEE scores were found to partially mediate the impact of SPM scores on RMET scores. @*Conclusion@#These findings suggested that facial emotion recognition partially mediated the relationship between reasoning by analogy and social cognition. This study highlights the need for further research for individuals with serious mental illnesses.

Executive Summary of Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society / 대한뇌졸중학회지

Despite the great socioeconomic burden of stroke, there have been few reports of stroke statistics in Korea. In this scenario, the Epidemiologic Research Council of the Korean Stroke Society launched the “Stroke Statistics in Korea” project, aimed at writing a contemporary, comprehensive, and representative report on stroke epidemiology in Korea. This report contains general statistics of stroke, prevalence of behavioral and vascular risk factors, stroke characteristics, pre-hospital system of care, hospital management, quality of stroke care, and outcomes. In this report, we analyzed the most up-to-date and nationally representative databases, rather than performing a systematic review of existing evidence. In summary, one in 40 adults are patients with stroke and 232 subjects per 100,000 experience a stroke event every year. Among the 100 patients with stroke in 2014, 76 had ischemic stroke, 15 had intracerebral hemorrhage, and nine had subarachnoid hemorrhage. Stroke mortality is gradually declining, but it remains as high as 30 deaths per 100,000 individuals, with regional disparities. As for stroke risk factors, the prevalence of smoking is decreasing in men but not in women, and the prevalence of alcohol drinking is increasing in women but not in men. Population-attributable risk factors vary with age. Smoking plays a role in young-aged individuals, hypertension and diabetes in middle-aged individuals, and atrial fibrillation in the elderly. About four out of 10 hospitalized patients with stroke are visiting an emergency room within 3 hours of symptom onset, and only half use an ambulance. Regarding acute management, the proportion of patients with ischemic stroke receiving intravenous thrombolysis and endovascular treatment was 10.7% and 3.6%, respectively. Decompressive surgery was performed in 1.4% of patients with ischemic stroke and in 28.1% of those with intracerebral hemorrhage. The cumulative incidence of bleeding and fracture at 1 year after stroke was 8.9% and 4.7%, respectively. The direct costs of stroke were about ₩1.68 trillion (KRW), of which ₩1.11 trillion were for ischemic stroke and ₩540 billion for hemorrhagic stroke. The great burden of stroke in Korea can be reduced through more concentrated efforts to control major attributable risk factors for age and sex, reorganize emergency medical service systems to give patients with stroke more opportunities for reperfusion therapy, disseminate stroke unit care, and reduce regional disparities. We hope that this report can contribute to achieving these tasks.

Erratum: Validation of Dietary Reference Intakes for predicting energy requirements in elementary school-age children

No abstract available.

Prosthetic rehabilitation of a patient with tongue cancer using palatal augmentation prosthesis and mandibular implant-retained overdenture: A case report / 대한치과보철학회지

The tongue, especially its lateral part, is the most common site of oral tumors. Patients who undergo glossectomy for the treatment of tongue cancer may experience difficulty in proper functioning for pronunciation, chewing, swallowing, and oral hygiene maintenance; therefore, a palatal augmentation prosthesis can be used to restore function of the tongue. In this case, an implant overdenture was used in a patient who had residual ridge resorption and obliteration of alveololingual sulcus after undergoing glossectomy for tongue cancer treatment. In addition, a palatal augmentation prosthesis with a metal framework, support, and retention part was fabricated. The palatal vault was reduced, so that even with limited tongue movement, adequate tongue-palate contact could be achieved. After placement of the definitive prostheses, the patient showed improvement in the functions of chewing, swallowing, and pronunciation.

Validation of Dietary Reference Intakes for predicting energy requirements in elementary school-age children

BACKGROUND/OBJECTIVES: Dietary Reference Intakes (DRI) for energy are derived from total energy expenditure (TEE) measured using the doubly labelled water (DLW) method. The objective of this study was to assess the validity of DRI for predicting the energy requirements of elementary school-age children. SUBJECTS/METHODS: The present study involved 25 elementary school-age children aged between 9 and 11 years. TEE was assessed by the DLW method, and the results were compared with the TEE predicted by the DRI equations in order to evaluate accuracy. RESULTS: The subjects' TEE measured by the DLW method was 1,925.2 ± 380.9 kcal/day in boys and 1,930.0 ± 279.4 kcal/day in girls, whereas resting energy expenditure was 1,220.2 ± 176.9 kcal/day in boys and 1,245.9 ± 171.3 kcal/day for girls. The physical activity level was 1.58 ± 0.20 in boys and 1.55 ± 0.13 in girls. The mean bias between the predicted and measured TEE was 12.6% in boys and −1.6% in girls, and the percentage of accurate predictions was 28.6% and 63.6%, respectively. In boys, the equation resulted in underprediction of TEE among the subjects having low TEE values, whereas there was overprediction among subjects having high TEE values as shown by the Bland-Altman plot. On the contrary, this proportional bias was not observed in girls. CONCLUSIONS: The findings of this study suggest that the DRI equation for energy could result in the overestimation of energy requirements in elementary school-age boys. In the case of girls, the equations could be accurate at the group level. However, the DRI appears to be invalid for individual girls, as more than one third of girls had their TEE inaccurately predicted. We recommend more studies for confirmation of these results.

A boy with 46,X,+mar presenting gynecomastia and short stature

A 15-year-old boy was referred due to gynecomastia and short stature. He was overweight and showed the knuckle-dimple sign on the left hand, a short fourth toe on the left foot, and male external genitalia with a small phallus. His levels of estradiol and follicle-stimulating hormone were increased, and his testosterone concentration was normal. Other hormonal tests were within the normal range. Radiographs showed short fourth and fifth metacarpals and fourth metatarsal bones. The karyotype was reported as 46,X,+mar, and the marker chromosome was shown to originate from the Y chromosome, which was identified by fluorescence in situ hybridization. Polymerase chain reaction and direct sequencing were used to clarify the deleted loci of the Y chromosome by making use of Y-specific sequence-tagged sites (STSs). The sex-determining region Y and centromere were verified, and there were microdeletions on the long arm of the Y chromosome. The azoospermia factor (AZF) b region was partially deleted, and AZFa and AZFc were completely deleted. Two STS probes of sY143 and the Y chromosome RNA recognition motif in AZFb showed positive signals corresponding to Yq11.223. The karyotype of the patient was interpreted as 46,X,der(Y)del(Y)(q11.21q11.222)del(Y)(q11.23qter). Herein, we report a rare case of a boy presenting with gynecomastia and short stature with 46, X, +mar, which originated from the Y chromosome, which was identified to have Yq microdeletions.

Accuracy of dietary reference intake predictive equation for estimated energy requirements in female tennis athletes and non-athlete college students: comparison with the doubly labeled water method

BACKGROUND/OBJECTIVES: The purpose of this study was to assess the accuracy of a dietary reference intake (DRI) predictive equation for estimated energy requirements (EER) in female college tennis athletes and non-athlete students using doubly labeled water (DLW) as a reference method. MATERIALS/METHODS: Fifteen female college students, including eight tennis athletes and seven non-athlete subjects (aged between 19 to 24 years), were involved in the study. Subjects' total energy expenditure (TEE) was measured by the DLW method, and EER were calculated using the DRI predictive equation. The accuracy of this equation was assessed by comparing the EER calculated using the DRI predictive equation (EER(DRI)) and TEE measured by the DLW method (TEE(DLW)) based on calculation of percentage difference mean and percentage of accurate prediction. The agreement between the two methods was assessed by the Bland-Altman method. RESULTS: The percentage difference mean between the methods was -1.1% in athletes and 1.8% in non-athlete subjects, whereas the percentage of accurate prediction was 37.5% and 85.7%, respectively. In the case of athletic subjects, the DRI predictive equation showed a clear bias negatively proportional to the subjects' TEE. CONCLUSIONS: The results from this study suggest that the DRI predictive equation could be used to obtain EER in non-athlete female college students at a group level. However, this equation would be difficult to use in the case of athletes at the group and individual levels. The development of a new and more appropriate equation for the prediction of energy expenditure in athletes is proposed.

Energy Expenditure of Eight Walking Activities in Normal Weight and Obese High School Students: Using an Indirect Calorimeter and Accelerometers Worn on Ankle and Waist

The purposes of this study were to assess energy expenditure of eight walking activities in normal weight and overweight or obese high school students and to evaluate the accuracy of two accelerometers worn on the ankle and waist. Thirty-five (male 17, female 18) healthy high school students participated in this study. They were classified into normal weight (n=21) and overweight or obese (n=14) groups. The subjects completed five treadmill walking activities (TW2.4, TW3.2, TW4.0, TW4.8, TW5.6), followed by three self-selected hallway walking activities (walk as if walking and talking with a friend: HWL, walk as if hurrying across the street at a cross-walk: HWB, walk as fast as you can but do not run: HWF). Energy expenditure and metabolic equivalents (METs) were measured using a portable indirect calorimeter, and predicted energy expenditures and METs were derived from two accelerometers placed on the ankle and waist. Measured energy expenditures per body weight (kg) of eight walking activities were significantly higher in the normal weight group than in the obese group and significantly higher in female than male. The ankle accelerometer overestimated energy expenditures and METs (bias 49.4~105.5%), whereas the waist accelerometer underestimated energy expenditures and METs (bias −30.3~−85.8). Except for HWF (fast) activity, METs of seven activities were moderate intensity based on Compendium METs intensity categories. HWF (fast) activity was vigorous intensity. METs from the ankle accelerometer were vigorous intensity except TW2.4 activity (moderate intensity). METs from the waist accelerometer were low intensity (TW2.4, TW3.2, TW4.0, TW4.8, HWL) and moderate intensity (TW5.6, HWB, HWF). Physical activity guidelines were developed based on measured physical activity level of high school students. Further studies should investigate the effects of body composition in larger subjects.

Rhabdomyolysis in a patient taking nebivolol

β Blockers such as propranolol and labetalol are known to induce toxic myopathy because of their partial β₂ adrenoceptor agonistic effect. Nebivolol has the highest β1 receptor affinity among β blockers, and it has never been reported to induce rhabdomyolysis until now. We report a patient who developed rhabdomyolysis after changing medication to nebivolol. A 75-year-old woman was admitted to our hospital because of generalized weakness originating 2 weeks before visiting. Approximately 1 month before her admission, her medication was changed from carvedilol 12.5 mg to nebivolol 5 mg. Over this time span, she had no other lifestyle changes causing rhabdomyolysis. Her blood chemistry and whole body bone scan indicated rhabdomyolysis. We considered newly prescribed nebivolol as a causal agent. She was prescribed carvedilol 12.5 mg, which she was previously taking, instead of nebivolol. She was treated by hydration and urine alkalization. She had fully recovered and was discharged.

Measurement of Energy Expenditure Through Treadmill-based Walking and Self-selected Hallway Walking of College Students - Using Indirect Calorimeter and Accelerometer / 대한지역사회영양학회지

OBJECTIVES: The objective of this study was to assess energy expenditure and metabolic cost (METs) of walking activities of college students and to compare treadmill based walking with self-selected hallway walking. METHODS: Thirty subjects (mean age 23.4 ± 1.6 years) completed eight walking activities. Five treadmill walking activities (TW2.4, TW3.2, TW4.0, TW4.8, TW5.6) were followed by three self-selected hallway walking activities, namely, walk as if you were walking and talking with a friend: HWL (leisurely), walk as if you were hurrying across the street at a cross-walk: HWB (brisk) and walk as fast as you can but do not run: HWF (fast) were performed by each subject. Energy expenditure was measured using a portable metabolic system and accelerometers. RESULTS: Except for HWF (fast) activity, energy expenditures of all other walking activities measured were higher in male than in female subjects. The lowest energy expenditure and METs were observed in TW2.4 (3.65 ± 0.84 kcal/min and 2.88 ± 0.26 METs in male), HWL (leisurely) (2.85 ± 0.70 kcal/min and 3.20 ± 0.57 METs in female), and the highest rates were observed in HWF (fast) (7.72 ± 2.81 kcal/min, 5.84 ± 1.84 METs in male, 6.65 ± 1.57 kcal/min, 7.13 ± 0.68 METs in female). Regarding the comparison of treadmill-based walking activities and self-selected walking, the energy expenditure of HWL (leisurely) was not significantly different from that of TW2.4. In case of male, no significant difference was observed between energy costs of HWB (brisk), HWF (fast) and TW5.6 activities, whereas in female, energy expenditures during HWB (brisk) and HWF (fast) were significantly different from that of TW5.6. CONCLUSIONS: In this study, we observed that energy expenditure from self-selected walking activities of college students was comparable with treadmill-based activities at specific speeds. Our results suggested that a practicing leisurely or brisk walking for a minimum of 150 minutes per week by both male and female college students enable them to meet recommendations from the Physical activity guide for Koreans.

Comparison of treatment delay associated with tunneled hemodialysis catheter placement between interventionists

BACKGROUND/AIMS: Fragmented care in nephrology can cause treatment delays. Nephrologists are qualified to perform vascular access-related procedures because they understand the pathophysiology of renal disease and perform physical examination for vascular access. We compared treatment delays associated with tunneled hemodialysis catheter (TDC) placement between interventional radiologists and nephrologists. METHODS: We collected data by radiologists from January 1, 2011 through December 31, 2011 and by nephrologists from since July 1, 2012 through June 30, 2013. We compared the duration from the hemodialysis decision to TDC placement (D-P duration) and hemodialysis initiation (D-H duration), catheter success and the complication rate, and the frequency and the usage time of non-tunneled hemodialysis catheters (NDCs) before TDC placement. RESULTS: The study analyzed 483 placed TDCs: 280 TDCs placed by radiologists and 203 by nephrologists. The D-P durations were 319 minutes (interquartile range [IQR], 180 to 1,057) in the radiologist group and 140 minutes (IQR, 0 to 792) in the nephrologist group. Additionally, the D-H durations were 415 minutes (IQR,260 to 1,091) and 275 minutes (IQR, 123 to 598), respectively. These differences were statistically significant (p = 0.00). The TDC success rate (95.3% vs. 94.5%, respectively; p = 0.32) and complication rate (16.2% vs. 11%, respectively; p = 0.11) did not differ between the groups. The frequency (24.5 vs. 26%, respectively; p = 0.72) and the usage time of NDC (8,451 vs. 8,416 minutes, respectively; p = 0.91) before TDC placement were not statistically significant. CONCLUSIONS: Trained interventional nephrologists could perform TDC placement safely, minimizing treatment delays.