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1.
Opt Express ; 31(10): 15301-15315, 2023 May 08.
Article in English | MEDLINE | ID: mdl-37157634

ABSTRACT

We demonstrate interleaved sampling by multiplexing conical subshells within the tomosynthesis and raster scanning a phantom through a 150 kV shell X-ray beam. Each view comprises pixels sampled on a regular 1 mm grid, which is then upscaled by padding with null pixels before tomosynthesis. We show that upscaled views comprising 1% sample pixels and 99% null pixels increase the contrast transfer function (CTF) computed from constructed optical sections from approximately 0.6 line pairs/mm to 3 line pairs/mm. The driver of our method is to complement work concerning the application of conical shell beams to the measurement of diffracted photons for materials identification. Our approach is relevant to time-critical, and dose-sensitive analytical scanning applications in security screening, process control and medical imaging.

5.
J Eur Acad Dermatol Venereol ; 34(5): 1004-1009, 2020 May.
Article in English | MEDLINE | ID: mdl-31733082

ABSTRACT

BACKGROUND: The dermoscopic patterns of acral melanocytic nevi (AMNs) are crucial in differentiating them from acral melanoma. Several studies have reported the dermoscopic patterns of acquired acral melanocytic nevi (AAMNs). However, few have investigated the dermoscopic patterns of congenital acral melanocytic nevi (CAMNs). OBJECTIVE: To compare the clinical and dermoscopic features of CAMNs and AAMNs. METHODS: The present study included 43 patients with CAMNs and 40 with AAMNs. We reviewed their medical records as well as their clinical and dermoscopic findings. RESULTS: Congenital acral melanocytic nevis were more asymmetrical than AAMNs (P = 0.002) and presented more frequently as comma-shaped (P = 0.005). Regarding dermoscopic findings, globular pattern (55.8%) was the most common feature of CAMNs, while parallel furrow pattern (37.5%) was the most common feature of AAMNs. The presence of fibrillar, globular, and parallel ridge patterns, and diffuse multi-component pigmentation differed significantly between the groups (P < 0.05). Furthermore, CAMNs showed melanoma-specific dermoscopic patterns, such as parallel ridge (18.6%) and diffuse multi-component pigmentation (25.6%). CONCLUSION: The dermoscopic patterns of CAMNs and AAMNs differed markedly. In terms of dermoscopic patterns, CAMNs resembled acral melanoma more often than AAMNs did.


Subject(s)
Melanoma , Nevus, Pigmented , Skin Neoplasms , Dermoscopy , Humans , Nevus, Pigmented/diagnostic imaging , Republic of Korea , Skin Neoplasms/diagnostic imaging
6.
East Asian Arch Psychiatry ; 29(3): 75-80, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31566182

ABSTRACT

OBJECTIVE: To review the first 8-month outcome of the Common Mental Disorder Clinic model in Hong Kong in terms of patient exit status and improvement in depressive and anxiety symptoms. METHODS: During the first appointment, patients were interviewed by a multidisciplinary team comprising a psychiatrist, a psychiatric nurse, and an occupational therapist. A multidisciplinary case conference was conducted to discuss clinical observations, diagnosis, issues of concern, and the optimal individualised treatment plan. Low-intensity interventions by nurses and/or occupational therapists were provided, as were optional, time-limited, protocol-based interventions by clinical psychologists for those with mild to moderate depressive and anxiety symptoms. Pharmacological intervention may be used when indicated. Upon completion of the treatment plan, patients were reassessed by the treating psychiatrist. Discharge options included discharge without psychiatric follow-up, step-up to psychiatric outpatient clinics, and step-down services. The self-administered Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder 7-item scale (GAD-7) were used to assess the past 2 weeks' depressive and anxiety symptoms, respectively, at baseline and at each session. RESULTS: From July 2015 to February 2016, 1325 Chinese patients received the new service. Of them, 170 men and 363 women (mean age, 52.6 years) completed the treatment plan. After treatment, their mean PHQ-9 score decreased from 11.06 to 7.55 (p < 0.001), and the mean GAD-7 score decreased from 9.94 to 6.54 (p < 0.001). After treatment, 42.4% and 48.2% of the patients were within the normal range of PHQ-9 and GAD-7 scores, respectively, compared with 16.9% and 20.8% before treatment. The mean time to implementation of the individualised treatment plan was 82.33 days. Of the patients, 54.4% were discharged without any need for medical or psychiatric follow-up; 28% were stepped up to psychiatric outpatient clinics; and 17.3% were stepped down. The predictors of exit status were whether psychiatric medication was prescribed during initial intake (p = 0.011), whether psychiatric medication was prescribed at last follow-up (p < 0.001), the service period (p = 0.010), and the GAD-7 final score (p = 0.005). CONCLUSIONS: The first 8-month outcome of the new service model was encouraging, with shortened waiting time, reduced severity of symptoms, and better exit status (high recovery and step-down rates).


Subject(s)
Outcome Assessment, Health Care , Patient Care Team , Anxiety/therapy , Asian People , Depression/therapy , Female , Hong Kong , Humans , Male , Middle Aged , Psychotherapy , Retrospective Studies , Time Factors
7.
Cell Commun Signal ; 16(1): 74, 2018 11 07.
Article in English | MEDLINE | ID: mdl-30404645

ABSTRACT

BACKGROUND: We have previously evidenced apical expression of the 24p3/NGAL/lipocalin-2 receptor (Lcn2-R; SLC22A17) in inner medullary collecting duct (IMCD) cells, which are present in vivo in a hyperosmotic/-tonic environment that activates canonical Wnt/ß-catenin signaling. The localization of Lcn2-R in the inner medulla is intriguing considering local bacterial infections trigger toll-like receptor-4 (TLR-4)-mediated secretion of the bacteriostatic Fe3+-free (apo-)Lcn2. AIM: To determine the effects of osmolarity/tonicity changes, Wnt/ß-catenin and TLR-4 activation on Lcn2-R and Lcn2 expression and cell viability in rat primary IMCD and mouse (m)IMCD3 cells. METHODS: Normosmolarity/-tonicity was 300 mosmol/l whereas hyperosmolarity/-tonicity was induced by adding 100 mmol/l NaCl + 100 mmol/l urea (600 mosmol/l, 1-7 days). Lcn2-R and Lcn2 expression were determined by qPCR, immunoblotting, flow cytometry and immunofluorescence microscopy. ß-catenin was silenced by RNAi. Cell viability/death was determined with MTT and LDH release assays. TLR-4 was activated by bacterial lipopolysaccharides (LPS). RESULTS: Hyperosmotic/-tonic media upregulated Lcn2-R by ~4-fold and decreased Lcn2 expression/secretion, along with Wnt/ß-catenin activation, in IMCD cells. These effects of hyperosmotic/-tonic media on Lcn2-R/Lcn2 expression were reverted by normosmolarity/-tonicity, ß-catenin silencing and/or LPS. Exposure of cells with endogenous or stably overexpressing Lcn2-R to apo-Lcn2 or LPS decreased cell viability. CONCLUSIONS: Lcn2-R upregulation and Lcn2 downregulation via Wnt/ß-catenin may promote adaptive osmotolerant survival of IMCD cells in response to hyperosmolarity/-tonicity whereas Lcn2 upregulation and Lcn2-R downregulation via TLR-4 and/or normosmolarity/-tonicity may protect IMCD cells against bacterial infections and prevent autocrine death induction by Lcn2.


Subject(s)
Bacterial Infections/pathology , Gene Expression Regulation , Kidney Medulla/cytology , Kidney Medulla/microbiology , Lipocalin-2/metabolism , Organic Cation Transport Proteins/metabolism , Wnt Signaling Pathway , Animals , Bacterial Infections/metabolism , Mice , Osmolar Concentration , Rats
8.
Br J Anaesth ; 121(5): 1034-1040, 2018 Nov.
Article in English | MEDLINE | ID: mdl-30336847

ABSTRACT

BACKGROUND: Repeated remote ischaemic conditioning (RIC) during weaning from cardiopulmonary bypass and in the early postoperative period may confer protection against acute kidney injury (AKI). We evaluated the effect of repeated RIC on the incidence of AKI in patients undergoing valvular heart surgery. METHODS: Patients were randomised into either the RIC (n=120) or control (n=124) group. A pneumatic tourniquet was placed on each patient's thigh. Upon removal of the aortic cross-clamp, three cycles of inflation for 5 min at 250 mm Hg (with 5 min intervals) were applied in the RIC group. Additionally, three cycles of RIC were repeated at postoperative 12 and 24 h. AKI was diagnosed based on the Kidney Disease: Improving Global Outcomes guideline. The incidences of renal replacement therapy, permanent stroke, sternal wound infection, newly developed atrial fibrillation, mechanical ventilation >24 h, and reoperation for bleeding during hospitalisation were recorded. RESULTS: The incidences of AKI were not significantly different between the control (19.4%) and RIC (15.8%) groups (a difference of 3.5 percentage points; 95% confidence interval: -6.8%-13.9%; P=0.470). Perioperative serum creatinine concentrations were similar in the control and RIC groups (P=0.494). Fluid balance, urine output, blood loss, transfusion, and vasopressor/inotropic requirements were not significantly different between the groups (all P>0.05). The occurrences of a composite of morbidity and mortality endpoints were not significantly different between the control (46.0%) and RIC (39.2%) groups (a difference of 6.8 percentage points; 95% confidence interval: -6.4%-20.0%; P=0.283). CONCLUSIONS: The results of our study do not support repeated RIC to decrease the incidence of AKI after valvular heart surgery. CLINICAL TRIAL REGISTRATION: NCT02720549.


Subject(s)
Acute Kidney Injury/prevention & control , Cardiac Surgical Procedures/methods , Heart Valves/surgery , Ischemic Preconditioning/methods , Postoperative Complications/prevention & control , Acute Kidney Injury/epidemiology , Adult , Aged , Aged, 80 and over , Female , Humans , Incidence , Kidney Function Tests , Male , Middle Aged , Postoperative Complications/epidemiology , Remote Consultation , Reoperation/statistics & numerical data , Young Adult
10.
Soft Matter ; 13(34): 5665-5675, 2017 Aug 30.
Article in English | MEDLINE | ID: mdl-28737182

ABSTRACT

We show that submicron-sized patterns can be imprinted into soft, recombinant-engineered protein hydrogels (here elastin-like proteins, ELP) by transferring wavy patterns from polydimethylsiloxane (PDMS) molds. The high-precision topographical tunability of the relatively stiff PDMS is translated to a bio-responsive, soft material, enabling topographical cell response studies at elastic moduli matching those of tissues. Aligned and unaligned wavy patterns with mold periodicities of 0.24-4.54 µm were imprinted and characterized by coherent anti-Stokes Raman scattering and atomic force microscopy. The pattern was successfully transferred down to 0.37 µm periodicity (width in ELP: 250 ± 50 nm, height: 70 ± 40 nm). The limit was set by inherent protein assemblies (diameter: 124-180 nm) that formed due to lower critical solution temperature behavior of the ELP during molding. The width/height of the ELP ridges depended on the degree of hydration; from complete dehydration to full hydration, ELP ridge width ranged from 79 ± 9% to 150 ± 40% of the mold width. The surface of the ridged ELP featured densely packed protein aggregates that were larger in size than those observed in bulk/flat ELP. Adipose-derived stem cells (ADSCs) oriented along hydrated aligned patterns with periodicities ≥0.60 µm (height ≥170 ± 100 nm), while random orientation was observed for smaller distances/amplitudes, as well as flat and unaligned wavy ELP surfaces. Hence, micro-molding of ELP is a promising approach to create tissue-mimicking, hierarchical architectures composed of tunable micron-sized structures with nano-sized protein aggregates, which opens the way for orthogonal screening of cell responses to topography and cell-adhesion ligands at relevant elastic moduli.


Subject(s)
Elastin/chemistry , Hydrogels/chemistry , Hydrogels/pharmacology , Nanostructures/chemistry , Peptides/chemistry , Stem Cells/cytology , Stem Cells/drug effects , Animals , Cell Adhesion/drug effects , Cell Culture Techniques , Dimethylpolysiloxanes/chemistry , Rats
11.
Phys Rev Lett ; 118(22): 221102, 2017 Jun 02.
Article in English | MEDLINE | ID: mdl-28621983

ABSTRACT

Phase compensated optical fiber links enable high accuracy atomic clocks separated by thousands of kilometers to be compared with unprecedented statistical resolution. By searching for a daily variation of the frequency difference between four strontium optical lattice clocks in different locations throughout Europe connected by such links, we improve upon previous tests of time dilation predicted by special relativity. We obtain a constraint on the Robertson-Mansouri-Sexl parameter |α|≲1.1×10^{-8}, quantifying a violation of time dilation, thus improving by a factor of around 2 the best known constraint obtained with Ives-Stilwell type experiments, and by 2 orders of magnitude the best constraint obtained by comparing atomic clocks. This work is the first of a new generation of tests of fundamental physics using optical clocks and fiber links. As clocks improve, and as fiber links are routinely operated, we expect that the tests initiated in this Letter will improve by orders of magnitude in the near future.

12.
Int J Impot Res ; 29(4): 136-141, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28424498

ABSTRACT

Polylactic acid (PLA) fillers are widely used for cosmetic volume augmentation. But, no study has evaluated the use of PLA filler in penile augmentation (PA No. 4). We evaluated the efficacy and safety of a newly developed PLA filler for PA during a 18-month follow-up period. A total of 23 healthy adult men were prospectively enrolled between June and November 2012. Penile girth was measured at proximal-, mid- and distal-shaft at baseline, 3, 6, 12 and 18 months following injection. Subjects' satisfaction was assessed with visual analogue scale (VAS). Adverse events (AEs) were also reported. Mean injected volume was 20 ml. The circumference of proximal-, mid-, and distal-shaft increased by a mean of 2.2±0.2, 2.7±1.0 and 2.7±1.0 cm at 3 months, respectively (each P<0.001). No significant differences were noted in girth circumference between 3 and 18 months post-injection (each P>0.05). VAS score increased from 51.6±14.7 at baseline to 64.8±19.3 and 74.3±14.6 at 3 and 6 months, respectively (each P<0.05). Six cases of mild, transient treatment-emergent AEs were reported in 5 subjects. Serious AEs were not reported. In conclusion, penile injection of a newly developed PLA filler led to significant penile augmentative effects for up to 18 months and was well tolerated without serious AEs.


Subject(s)
Cosmetic Techniques , Microspheres , Patient Satisfaction , Penis , Polyesters/therapeutic use , Adult , Aged , Follow-Up Studies , Humans , Male , Middle Aged , Polyesters/adverse effects , Prospective Studies , Therapeutics , Treatment Outcome , Young Adult
13.
Arch Toxicol ; 91(10): 3225-3245, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28321485

ABSTRACT

The renal proximal tubule (PT) is the major target of cadmium (Cd2+) toxicity where Cd2+ causes stress and apoptosis. Autophagy is induced by cell stress, e.g., endoplasmic reticulum (ER) stress, and may contribute to cell survival or death. The role of autophagy in Cd2+-induced nephrotoxicity remains unsettled due to contradictory results and lack of evidence for autophagic machinery damage by Cd2+. Cd2+-induced autophagy in rat kidney PT cell line NRK-52E and its role in cell death was investigated. Increased LC3-II and decreased p62 as autophagy markers indicate rapid induction of autophagic flux by Cd2+ (5-10 µM) after 1 h, accompanied by ER stress (increased p-PERK, p-eIF2α, CHOP). Cd2+ exposure exceeding 3 h results in p62/LC3-II accumulation, but diminished effect of lysosomal inhibitors (bafilomycin A1, pepstatin A +E-64d) on p62/LC3-II levels, indicating decreased autophagic flux and cargo degradation. At 24 h exposure, Cd2+ (5-25 µM) activates intrinsic apoptotic pathways (Bax/Bcl-2, PARP-1), which is not evident earlier (≤6 h) although cell viability by MTT assay is decreased. Autophagy inducer rapamycin (100 nM) does not overcome autophagy inhibition or Cd2+-induced cell viability loss. The autophagosome-lysosome fusion inhibitor liensinine (5 µM) increases CHOP and Bax/Bcl-2-dependent apoptosis by low Cd2+ stress, but not by high Cd2+. Lysosomal instability by Cd2+ (5 µM; 6 h) is indicated by increases in cellular sphingomyelin and membrane fluidity and decreases in cathepsins and LAMP1. The data suggest dual and temporal impact of Cd2+ on autophagy: Low Cd2+ stress rapidly activates autophagy counteracting damage but Cd2+ stress accrual disrupts autophagic flux and lysosomal stability, possibly resulting in lysosomal cell death.


Subject(s)
Autophagy/drug effects , Cadmium/toxicity , Lysosomes/drug effects , Animals , Apoptosis/drug effects , Apoptosis/physiology , Cadmium/administration & dosage , Cell Line , Dose-Response Relationship, Drug , Endoplasmic Reticulum Stress/drug effects , Isoquinolines/pharmacology , Kidney Tubules, Proximal/cytology , Lysosomal Membrane Proteins/metabolism , Lysosomes/metabolism , Lysosomes/pathology , Microtubule-Associated Proteins/metabolism , Phenols/pharmacology , Rats , Sirolimus/pharmacology , Unfolded Protein Response/drug effects
14.
Hong Kong Med J ; 22(6): 534-7, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27609977

ABSTRACT

INTRODUCTION: An elevated serum urate level is recognised as a cause of gouty arthritis and uric acid stone. The level of serum uric acid that accelerates kidney stone formation, however, has not yet been clarified. This study aimed to find out if a high serum urate level is associated with nephrolithiasis. METHODS: Patients were recruited from the rheumatology clinic of Taipei City Hospital (Renai and Zhongxing branches) in Taiwan from March 2015 to February 2016. A total of 120 Chinese male patients with newly diagnosed gout and serum urate concentration of >7 mg/dL and no history of kidney stones were divided into two groups according to their serum urate level: <10 mg/dL (group 1, n=80) and ≥10 mg/dL (group 2, n=40). The mean body mass index, blood urea nitrogen level, creatinine level, urinary pH, and kidney ultrasonography were compared between the two groups. RESULTS: There were no significant differences in blood urea nitrogen or creatinine level between the two groups. The urine pH in both groups was similar and not statistically significant. Kidney stone formation was detected via ultrasonography in 6.3% (5/80) and 82.5% (33/40) of patients in groups 1 and 2, respectively (P<0.05). CONCLUSION: A serum urate level of ≥10 mg/dL may precipitate nephrolithiasis. Further studies are warranted to substantiate the relationship between serum urate level and kidney stone formation.


Subject(s)
Arthritis, Gouty/blood , Arthritis, Gouty/complications , Kidney Calculi/diagnostic imaging , Kidney Calculi/epidemiology , Uric Acid/blood , Adult , Blood Urea Nitrogen , Creatinine/blood , Humans , Male , Middle Aged , Taiwan , Tertiary Care Centers , Ultrasonography
15.
Cell Death Dis ; 7: e2163, 2016 Mar 31.
Article in English | MEDLINE | ID: mdl-27031960

ABSTRACT

In renal cell carcinoma, transglutaminase 2 (TGase 2) crosslinks p53 in autophagosomes, resulting in p53 depletion and the tumor's evasion of apoptosis. Inhibition of TGase 2 stabilizes p53 and induces tumor cells to enter apoptosis. This study explored the mechanism of TGase 2-dependent p53 degradation. We found that TGase 2 competes with human double minute 2 homolog (HDM2) for binding to p53; promotes autophagy-dependent p53 degradation in renal cell carcinoma (RCC) cell lines under starvation; and binds to p53 and p62 simultaneously without ubiquitin-dependent recognition of p62. The bound complex does not have crosslinking activity. A binding assay using a series of deletion mutants of p62, p53 and TGase 2 revealed that the PB1 (Phox and Bem1p-1) domain of p62 (residues 85-110) directly interacts with the ß-barrel domains of TGase 2 (residues 592-687), whereas the HDM2-binding domain (transactivation domain, residues 15-26) of p53 interacts with the N terminus of TGase 2 (residues 1-139). In addition to the increase in p53 stability due to TGase 2 inhibition, the administration of a DNA-damaging anti-cancer drug such as doxorubicin-induced apoptosis in RCC cell lines and synergistically reduced tumor volume in a xenograft model. Combination therapy with a TGase 2 inhibitor and a DNA-damaging agent may represent an effective therapeutic approach for treating RCC.


Subject(s)
Apoptosis , GTP-Binding Proteins/metabolism , Transglutaminases/metabolism , Tumor Suppressor Protein p53/genetics , Animals , Antibiotics, Antineoplastic/pharmacology , Antibiotics, Antineoplastic/therapeutic use , Apoptosis/drug effects , Autophagy/drug effects , Carcinoma, Renal Cell/drug therapy , Carcinoma, Renal Cell/metabolism , Carcinoma, Renal Cell/pathology , Cell Line, Tumor , Chloroquine/pharmacology , DNA Damage/drug effects , Doxorubicin/pharmacology , Doxorubicin/therapeutic use , Female , GTP-Binding Proteins/antagonists & inhibitors , GTP-Binding Proteins/genetics , Humans , Kidney Neoplasms/drug therapy , Kidney Neoplasms/metabolism , Kidney Neoplasms/pathology , Mice , Mice, Inbred BALB C , Mice, Nude , Phosphorylation/drug effects , Protein Binding , Protein Glutamine gamma Glutamyltransferase 2 , Proto-Oncogene Proteins c-mdm2/antagonists & inhibitors , Proto-Oncogene Proteins c-mdm2/genetics , Proto-Oncogene Proteins c-mdm2/metabolism , Pyrazines/pharmacology , Pyrazines/therapeutic use , RNA-Binding Proteins/chemistry , RNA-Binding Proteins/metabolism , Transglutaminases/antagonists & inhibitors , Transglutaminases/genetics , Tumor Suppressor Protein p53/chemistry , Tumor Suppressor Protein p53/metabolism
17.
Osteoporos Int ; 27(7): 2249-2257, 2016 07.
Article in English | MEDLINE | ID: mdl-26883444

ABSTRACT

UNLABELLED: Because diabetic retinopathy increases fracture risk, we studied the association between bone mineral density (BMD) and diabetic retinopathy in a nationally representative sample. A significant association between the presence of diabetic retinopathy and low BMD was observed. Therefore, diabetic retinopathy might be considered as a marker of low BMD. INTRODUCTION: Several diabetic complications, including nephropathy, retinopathy, and peripheral neuropathy, are associated with a higher fracture risk in diabetic subjects. However, in contrast to diabetic nephropathy and peripheral neuropathy, which are associated with low bone mineral density (BMD), little is known about the association between BMD and diabetic retinopathy. The aim of the present study was to determine whether the prevalence of diabetic retinopathy is associated with BMD. METHODS: This cross-sectional study included a nationally representative sample consisting of 4357 men aged 50 years and older and 4392 postmenopausal women who participated in the Korea National Health and Nutritional Examination Survey (KNHANES) from 2008 to 2011 and underwent BMD measurement by dual-energy X-ray absorptiometry (DXA) and diabetic retinopathy assessments using seven standard gradable photographs. RESULTS: The diabetic women with retinopathy had lower mean BMD at all measured sites than those without retinopathy, although the BMD difference between the two groups was small (3-5 %). In addition, the diabetic women with retinopathy were 2.27 times more likely to have osteoporosis following adjustments for all clinically relevant covariates. However, the prevalence of diabetes mellitus (DM) or diabetic retinopathy was not associated with the prevalence of osteoporosis in men. CONCLUSIONS: This study has shown that the presence of diabetic retinopathy is significantly associated with a reduced BMD and increased prevalence of osteoporosis in diabetic women.


Subject(s)
Bone Density , Diabetic Retinopathy/epidemiology , Osteoporosis/epidemiology , Absorptiometry, Photon , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Nutrition Surveys , Republic of Korea
18.
Osteoporos Int ; 27(1): 257-65, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26373982

ABSTRACT

UNLABELLED: This study showed that a negative correlation between duration of breastfeeding and bone mineral density (BMD) in the lumbar spine and prolonged breastfeeding is an independent risk for osteoporosis in postmenopausal women. The present study suggests that postmenopausal women with a history of prolonged breastfeeding require more careful screening for osteoporosis. INTRODUCTION: Several studies suggest that breastfeeding and childbirth lead to maternal calcium loss and a decline in BMD. While the association between breastfeeding and BMD immediately after weaning is well-established, the effects of breastfeeding on postmenopausal women have been controversial. The aim of this study was to examine the effects of breastfeeding on bone mineral density (BMD) and the prevalence of osteoporosis in postmenopausal women. METHODS: The present study was a cross-sectional survey based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2010 and 2011 data. The association between breastfeeding and BMD and osteoporosis was examined in 1222 postmenopausal women. RESULTS: The duration of breastfeeding and BMD in the lumbar spine showed a negative correlation. The association between duration of breastfeeding and BMD remained significant after adjustment for reproductive factors and other confounding factors (P = 0.008). However, the number of deliveries and age at the time of delivery did not correlate with BMD at any site after adjustment. Moreover, the prevalence of osteoporosis in postmenopausal women with a history of prolonged breastfeeding was significantly higher than that in women with a short history of breastfeeding (≥37 months, OR = 3.292; 95 % CI 1.485-7.299). The prevalence of lumbar spine fracture showed a significant increasing trend with the increase in the duration of breastfeeding. CONCLUSION: Prolonged breastfeeding was significantly associated with low BMD in the lumbar spine and higher prevalence of osteoporosis. However, the number of deliveries or age at the time of childbirth did not influence BMD.


Subject(s)
Bone Density/physiology , Breast Feeding/adverse effects , Lactation/physiology , Osteoporosis, Postmenopausal/etiology , Absorptiometry, Photon/methods , Aged , Cross-Sectional Studies , Female , Femur/physiopathology , Health Surveys , Humans , Lumbar Vertebrae/physiopathology , Middle Aged , Osteoporosis, Postmenopausal/epidemiology , Osteoporosis, Postmenopausal/physiopathology , Republic of Korea/epidemiology , Spinal Fractures/epidemiology , Spinal Fractures/etiology , Spinal Fractures/physiopathology , Time Factors
19.
Ann Biomed Eng ; 44(7): 2292-301, 2016 07.
Article in English | MEDLINE | ID: mdl-26558395

ABSTRACT

Since heart rate variability (HRV) analysis is widely used to evaluate the physiological status of the human body, devices specifically designed for such applications are needed. To this end, we developed a smart electrocardiography (ECG) patch. The smart patch measures ECG using three electrodes integrated into the patch, filters the measured signals to minimize noise, performs analog-to-digital conversion, and detects R-peaks. The measured raw ECG data and the interval between the detected R-peaks can be recorded to enable long-term HRV analysis. Experiments were performed to evaluate the performance of the built-in R-wave detection, robustness of the device under motion, and applicability to the evaluation of mental stress. The R-peak detection results obtained with the device exhibited a sensitivity of 99.29%, a positive predictive value of 100.00%, and an error of 0.71%. The device also exhibited less motional noise than conventional ECG recording, being stable up to a walking speed of 5 km/h. When applied to mental stress analysis, the device evaluated the variation in HRV parameters in the same way as a normal ECG, with very little difference. This device can help users better understand their state of health and provide physicians with more reliable data for objective diagnosis.


Subject(s)
Electrocardiography/instrumentation , Electrocardiography/methods , Heart Rate , Signal Processing, Computer-Assisted/instrumentation , Humans , Locomotion , Stress, Psychological/physiopathology
20.
East Asian Arch Psychiatry ; 25(3): 128-36, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26429840

ABSTRACT

OBJECTIVES: To determine the prevalence of psychiatric morbidity and identify the correlates, as well as to evaluate the effectiveness of the Hospital Anxiety and Depression Scale and the 12-item General Health Questionnaire to screen for psychiatric morbidity in Chinese adults with type 1 diabetes. METHODS: Subjects were recruited from a local public diabetes specialist outpatient clinic from August 2013 to January 2014. Demographic and clinical factors were recorded. Psychiatric diagnosis was established using the Chinese-bilingual version of the Structured Clinical Interview for the DSM-IV Axis I disorders. Scores for the Hospital Anxiety and Depression Scale and the 12-item General Health Questionnaire were compared with the psychiatric diagnosis. RESULTS: Of the 136 patients, the point prevalence of overall psychiatric, depressive, and anxiety disorders was 39.7%, 23.5%, and 25.7%, respectively. Family history of mental illness, smoking status, history of mental illness, presence of social problems, perceived absence of confidant, presence of neuropathy and hyperlipidaemia, as well as higher level of glycosylated haemoglobin were found to be the associated factors. CONCLUSION: Psychiatric disorders were common in Chinese adults with type 1 diabetes. Finding out associated factors and using the Hospital Anxiety and Depression Scale and the 12-item General Health Questionnaire as a screening tool helped to identify patients in a diabetes clinic with psychiatric disorders.


Subject(s)
Diabetes Mellitus, Type 1/psychology , Mental Disorders/epidemiology , Adult , Aged , Comorbidity , Cross-Sectional Studies , Diabetes Mellitus, Type 1/epidemiology , Female , Hong Kong/epidemiology , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Young Adult
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