Associations between obesity parameters and the risk of incident atrial fibrillation and ischaemic stroke in the different age groups.

Objective: Obesity and aging are important predisposing factors to atrial fibrillation (AF) and ischaemic stroke (IS). However, limited data comprehensively evaluated the relationships between obesity measurements and AF and IS in different ages. Methods: A total of 9,432,332 adults from the Korean National Health Insurance Service Database were included. The study population was categorized into the six age subgroups by an increase every decade from the twenties. We evaluated AF and IS risk according to body mass index (BMI) and waist circumference (WC) in the different age groups. Results: During a mean follow-up of 8.2 ± 1.0 years, BMI-AF presented a J-shaped association across ages. The highest hazard ratio (HR) of the BMI ≥ 30 kg/m2 group was observed in subjects aged 30-39 years [HR 1.80, 95% CI 1.63-1.98, p < 0.001]. Underweight adults over 60 years also presented an increased AF risk. Incident IS risk increased in those with BMI over the normal range in early and midlife, but the association became obscured in adults aged > 60 years. Among the BMI ≥ 30 kg/m2 groups, subjects aged 20-29 years presented the highest risk of IS [HR 3.00, 95% CI (2.34-3.84), p < 0.001]. Overall, WC-AF and WC-IS showed positive linear correlations, but the WC-IS association was weak in subjects aged ≥ 40 years. Conclusion: The higher risks of AF and IS according to an increment of BMI and WC were most apparent among the young ages. The association between obesity measurements and IS was not significantly above the midlife. Weight management in the young and integrated risk factor management in the elderly are warranted.

Clinical profiles of adverse drug reactions spontaneously reported at a single Korean hospital dedicated to children with complex chronic conditions.

Children with complex chronic conditions (CCC) are presumed to be vulnerable to adverse drug reactions (ADRs). The clinical profiles of ADRs in CCC are not well known. Herein, we aim to describe the ADR profiles in CCC with regard to typical presentations and vulnerable groups. We accessed the ADR yearly reports at a tertiary children's hospital whose practice is mainly dedicated to CCC and descriptively analyzed their clinical profiles according to the presence of a complex chronic condition, ADR severity, and age groups. A total of 1841 cases were analyzed, among which 1258 (68.3%) were mild, 493 (26.8%) moderate, and 90 (4.9%) cases were severe. A total of 1581 (85.9%) cases of complex chronic condition were reported. The proportion of CCC in each severity group increased as the ADR becomes more severe. In CCC, ADRs were most frequently reported by nurses in the adolescent group and in cases where the symptoms involved the gastrointestinal system. The class of antineoplastic and immunomodulating drugs was the most commonly suspected of causing an ADR, followed by one of the antibiotics. When we focus on the trend across the age groups, the ratio of severe-to-total ADRs decreased with older age. Among severe cases, the ratio of off-label prescription-related cases was the highest in the infant/toddler group and decreased as the groups aged. In conclusion, ADRs of CCCs admitted to a tertiary children's hospital have a unique profile. These groups are vulnerable to ADRs and thus they should be monitored closely, especially when they are infants or toddlers, so that severe ADRs can be identified and treated immediately.

A multivariate receptor modeling study of air-borne particulate PAHs: Regional contributions in a roadside environment.

Understanding the geographic source contributions by particulate polycyclic aromatic hydrocarbons (PAHs) is important for the Korean peninsula due to its downwind location from source areas. Regional influence of particulate PAHs was previously identified using diagnostic ratios applied to mobile source dominated roadside sampling data (Kim et al., 2012b). However, no study has yet been conducted to quantify the regional source contributions. We applied a multivariate receptor modeling tool to identify and quantify the regional source contributions to particulate PAHs in Seoul. Sampling of roadside particulate PAHs was conducted in Seoul, Korea for four years between May 2005 and April 2009, and data analysis was performed with a new multivariate receptor model, Solver for Mixture Problem (SMP). The SMP model identified two sources, local mobile source and transported regional source, and quantified their source contributions. Analysis of the particulate PAHs data reveals three types of episodic periods: a high regional source contribution period with one case, a high mobile source contribution period with three cases, and a normal contribution period with eight cases. Four-year average particulate PAHs source contributions from the two sources are 4.6 ng m(-3) and 10.7 ng m(-3) for regional and mobile sources, respectively and equivalent to 30% and 70% of the total estimated contribution from each of these sources.

Soluble CD93 induces differentiation of monocytes and enhances TLR responses.

The cell surface protein CD93 is known to be involved in the regulation of phagocytosis and cell adhesion. Although typically membrane-bound, a soluble form of CD93 (sCD93) has recently been identified. Currently, however, the role of sCD93 in monocyte function is unknown. In the current study, we analyzed the functional effects of sCD93 on THP-1 monocytic cells and human primary monocytes. Various forms of recombinant human sCD93 were used to investigate the effects of this molecule on both human primary monocytes and a monocytic cell line, THP-1. We found that sCD93 induced differentiation of monocytes to macrophage-like cells, as evidenced by activated cell adhesion and increased phagocytic activities. In addition, this differentiation resulted in an enhanced response to TLR stimulation in terms of differentiation marker expression and proinflammatory cytokine production. Furthermore, sCD93 enhanced LPS-stimulated TNF-α production even prior to monocyte differentiation. To investigate a possible role for sCD93 in the pathogenesis of chronic inflammatory diseases, we assessed the concentration of sCD93 in synovial fluid from patients with rheumatoid arthritis and found it to be significantly increased compared with synovial fluid from patients with osteoarthritis. Together, these data revealed a function for sCD93 that may have implications in inflammation and inflammatory diseases including rheumatoid arthritis.

[Fatigue, depression and sleep in young adult and middle-aged].

PURPOSE: The purpose of the study was to investigate fatigue, depression and sleep in young adult and middle-aged. METHOD: The convenient sample consisted of 415 subjects from 20 to 59 years old. Data were collected using a self-report questionnaire from July to October, 2001. The VAS-F and CES-D were utilized to measure the level of fatigue and depression. Sleep duration and sleep satisfaction were measured based on the subject's self-report. RESULT: The result of the study revealed that the level of fatigue and depression was higher among young adult than middle-aged. Considering age and gender, the level of fatigue and depression was higher among young adult women and middle-aged men. Depression and sleep satisfaction influenced on the fatigue. CONCLUSION: Health care providers need to concern about fatigue and depression in young adult women and middle-aged men. Especially, more concern and intervention programs are needed for young adult women and middle-aged men.