[Effects of First Assisted Reproductive Technologies on Anxiety and Depression among Infertile Women: A Systematic Review and Meta-Analysis].

PURPOSE: The purpose of this study was to analyze anxiety and depression among infertile women at different time points during the first In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI) treatment through a systematic review and meta-analysis. METHODS: Seven out of 3,011 studies were included for meta-analysis. To estimate the effect size, a meta-analysis of the studies was performed using the RevMan 5.3 program. We compared the measurement outcomes at three time points: before the start of treatment (T0), cancellation of treatment after pregnancy detection (T2), one to six months after treatment (T3). The effect size used was the standardized mean difference (SMD). RESULTS: In comparing the different time points of the pregnant women from their cycle, significantly lower levels of depression were found at T2 than at T0. In non-pregnant women, anxiety at T2 and depression at T2 and T3 were significantly higher than those at T0. At T2 and T3, the non-pregnant women reported higher levels of anxiety and depression compared with the pregnant women. CONCLUSION: Anxiety and depression in infertile women undergoing the first IVF or ICSI are associated with the time points and pregnancy status after treatment. These findings suggest that attention should be paid to helping infertile women prepare for and cope with treatment and treatment failure.

[Influences of Oral Health Behaviors, Depression and Stress on Periodontal Disease in Pregnant Women].

PURPOSE: The purpose of this study was to identify the influences of oral health behaviors, depression, and stress on periodontal disease in pregnant women. METHODS: The participants in this study were 129 pregnant women. Data were collected using questionnaires which included individual characteristics, oral health care behaviors, the Center for Epidemiological Studies-Depression scale (CES-D), a global measure of perceived stress, and pregnancy stress. A dentist measured periodontal probing depth and classified stages of periodontal disease according to the Community Periodontal Index (CPI). Data were analyzed using descriptive statistics, Pearson correlation, and multiple regression. RESULTS: Periodontal disease had significant correlations with oral health care behaviors (r=-.56, p<.001), perceived stress (r=.44 p<.001), pregnancy stress (r=.37 p<.001), diet (r=-.33, p<.001) and depression (r=.18 p=.046). Factors influencing periodontal disease for these pregnant women were being in the 2nd (ß=.27, p<.001) or 3rd trimester (ß=.45, p<.001), having a pregnancy induced disease (ß=.20, p=.002), performing higher oral health behaviors (ß=-.30, p<.001), and having higher perceived stress (ß=.17, p=.028). The explanation power of this regression model was 61.6% (F=15.52, p<.001). CONCLUSION: The findings of this study indicated that periodic assessment of periodontal disease is essential for pregnant women who are in 2nd or 3rd trimester and have pregnancy induced diseases. Enhancing oral health care behaviors and reducing perceived stress are indicated as effective strategies to reduce periodontal disease in pregnant women.

Hexane Extract of Orthosiphon stamineus Induces Insulin Expression and Prevents Glucotoxicity in INS-1 Cells.

BACKGROUND: Hyperglycemia, a characteristic feature of diabetes, induces glucotoxicity in pancreatic ß-cells, resulting in further impairment of insulin secretion and worsening glycemic control. Thus, preservation of insulin secretory capacity is essential for the management of type 2 diabetes. In this study, we evaluated the ability of an Orthosiphon stamineus (OS) extract to prevent glucotoxicity in insulin-producing cells. METHODS: We measured insulin mRNA expression and glucose-stimulated insulin secretion (GSIS) in OS-treated INS-1 cells after exposure to a high glucose (HG; 30 mM) concentration. RESULTS: The hexane extract of OS elevated mRNA expression of insulin as well as pancreatic and duodenal homeobox-1 of INS-1 cells in a dose-dependent manner. The hexane OS extract also increased the levels of phosphorylated phosphatidylinositol 3-kinase (PI3K) in a concentration-dependent manner. Additionally, Akt phosphorylation was elevated by treatment with 100 and 200 µmol of the hexane OS extract. Three days of HG exposure suppressed insulin mRNA expression and GSIS; these expressions were restored by treatment with the hexane OS extract. HG elevated peroxide levels in the INS-1 cells. These levels were unaffected by OS treatment under both normal and hyperglycemic conditions. CONCLUSION: Our results suggested that the hexane extract of OS elevates insulin mRNA expression and prevents glucotoxicity induced by a 3-day treatment with HG. This was associated with the activation of PI-3K and Akt.

Efficacy and safety of everolimus in Korean patients with metastatic renal cell carcinoma.

PURPOSE: Few studies have investigated the effects of everolimus therapy in Asian populations. This study evaluates the safety and efficacy of everolimus in Korean patients with metastatic renal cell carcinoma (mRCC). METHODS: We retrospectively reviewed records of Korean patients with mRCC (n = 22) who received everolimus between January 2009 and July 2010 and evaluated them for efficacy and safety. RESULTS: One patient achieved a partial response, and 16 patients had stable disease, corresponding to an overall response rate of 4.5 % and a disease control rate of 77.3 %. Median progression-free survival was 5.4 months (95 % CI 0.9-9.8). Median overall survival was not reached. Univariate analysis showed that Memorial Sloan-Kettering Cancer Center risk (P = .004), thrombocytopenia (P = .018), hyperglycemia (P = .007) and hypertriglyceridemia (P = .041) were associated with disease progression. The most common adverse events (AEs) were hypertriglyceridemia and anemia, similar to Western patients. Creatinine and aspartate aminotransferase levels were higher than those reported for Western patients. The most common grade ≥3 AEs in this study were hypertriglyceridemia and anemia, compared with lymphopenia (14 %) in Western patients. CONCLUSIONS: Safety of everolimus in Korean mRCC patients differed from that reported in Western patients. Therefore, liver function enzymes, hemoglobin levels, lipid profile and chest CT scans should be monitored more closely in Asian mRCC patients receiving everolimus.

Novel diagnostic model for the deficient and excess pulse qualities.

The deficient and excess pulse qualities (DEPs) are the two representatives of the deficiency and excess syndromes, respectively. Despite its importance in the objectification of pulse diagnosis, a reliable classification model for the DEPs has not been reported to date. In this work, we propose a classification method for the DEPs based on a clinical study. First, through factor analysis and Fisher's discriminant analysis, we show that all the pulse amplitudes obtained at various applied pressures at Chon, Gwan, and Cheok contribute on equal orders of magnitude in the determination of the DEPs. Then, we discuss that the pulse pressure or the average pulse amplitude is appropriate for describing the collective behaviors of the pulse amplitudes and a simple and reliable classification can be constructed from either quantity. Finally, we propose an enhanced classification model that combines the two complementary variables sequentially.

Discordance between HbA1c and fasting plasma glucose criteria for diabetes screening is associated with obesity and old age in Korean individuals.

We evaluated the agreement between HbA1c- and FPG-based criteria for screening of diabetes in an asymptomatic Korean population and identified independent factors associated with discordance. The discordance between the two diabetic criteria was significantly associated with obesity and older age.

Growth-suppressing activity of the transfected Cx26 on BICR-M1Rk breast cancer cell line.

There are accumulating evidences suggesting that connexin (Cx), a gap junction channel-forming protein, acts as a growth suppressor in various cancer cells, and this effect is attributed to the gap junction-mediated intercellular communication (GJIC). In order to characterize the relationship between the growth-arresting activity of Cx26 and its cytoplasmic localizations after expression, we linked a nuclear export signal (NES) sequence to Cx26 cDNA before transfecting into a rat breast cancer cell line. A confocal fluorescent microscopic observation revealed that the insertion of NES minimized the nuclear expression of Cx26, and increased its cytoplasmic expression, including plasma membrane junctions. Total cell counting and BrdUrd-labeling experiments showed that the growth of the breast cancer cells was inhibited by 74% upon transfection of Cx26-NES, whereas only 9% inhibition was observed with only Cx26 cDNA.

Body mass index and facial cues in sasang typology for young and elderly persons.

Facial characteristics may provide reliable information giving an insight into the inner nature of an individual. This study examines the differences in widely used facial metrics, including cheek-to-jaw width ratio (CJWR), width-to-height ratio (WHR), perimeter-to-area ratio (PAR), and facial masculinity indexes across Sasang constitutional types, to investigate the association between these facial cues and body mass index (BMI) and develop a predictive model for Sasang typing. 2D images of 911 participants were analyzed. The results indicated that TaeEum (TE) type generally has a squarer face, with the male TE type having a squarer and wider face than that of both SoYang (SY) and SoEum (SE) types. Male TE type has longer eyes than that of the SE type, and the lower face of the female TE type is longer than that of the SY type. PAR, WHR, CJWR, and eye size had associations with BMI, and the magnitude of correlation of CJWR in Korean men were twofold higher than that of the Caucasian and African men. BMI and facial metrics including PAR, WHR, CJWR, and eye size were good predictors for TE type, and the most parsimonious model for TE typing included BMI and CJWR with high predictive performances.

A case of idiopathic isolated hypoglossal nerve palsy in a Korean child.

Hypoglossal nerve palsy (HNP) is an uncommon neurological abnormality that can provoke characteristic clinical signs, including unilateral atrophy of the tongue musculature. We present the case of a healthy 11-year-old Korean male who was admitted to the outpatient department of our institution with acute onset dysarthria, tongue fasciculations, and right-sided tongue weakness upon awakening. His evaluation included a virology work-up, neck magnetic resonance imaging (MRI), brain MRI, and otorhinolaryngological physical examination; all tests were normal and showed no evidence of inflammation. Fifteen days after the onset of symptoms, the patient recovered completely. Herein, we report a case of idiopathic isolated HNP in a Korean male.

Variations in non-invasive radial artery pulse waveform at different measuring positions.

Noninvasive radial artery pulse wave has been widely not only for the pulse wave analysis (PWA) itself but also for assessment of arterial stiffness with estimated aortic pulse wave from peripheral pulse wave. In this study, we tested the differences between the extracted parameters, including AIx, from radial artery pulse waves measured at three different positions preliminarily. A 30 years old female involved in this experiment and this subject has no evidence about cardiovascular diseases. Radial pulse waves were recorded at three different positions on left lower arm ten times for each position. These positions are widely used in pulse diagnosis of traditional medicine.As results of repeated measures ANOVA analysis, 9 parameters were found which had significantly differences in between measuring positions (P<0.05). These parameters wereP_AIx, PP_Amp, A_T1, A_Tr, AIx, AIx_@HR75, ESP, MP_Sysand MP_Dia. And, by Spearman correlation test at P2, it was observed that P_AIx (r =0.894), PP_Amp (r=-0.765),AIx_@HR75 (r=0.929), ESP (r=0.893) and MP_Dia (r=0.792)were highly correlated with AIx. Elaborately, the correlation coefficients between each parameter were high in similar degrees (r>0.70).Further studies on what make differences in these parameters between measuring positions are need. And, ultimately, we need to determine the best measuring process, including measuring position, hold-down pressure, signal quality validation and so on,so to achieve the optimal waveform which represents subject's health condition for both western medicine and traditional medicine.

Monitoring repair of DNA damage in cell lines and human peripheral blood mononuclear cells.

We introduce a method to follow DNA repair that is suitable for both clinical and laboratory samples. An episomal construct with a unique 8-oxoguanine (8-oxoG) base at a defined position was prepared in vitro using single-stranded phage harboring a 678-bp tract from exons 5 to 9 of the human P53 gene. Mixing curve experiments showed that the real-time PCR method has a linear response to damage, suggesting that it is useful for DNA repair studies. The episomal construct with a unique 8-oxoG base was introduced into AD293 cells or human peripheral blood mononuclear cells, and plasmids were recovered as a function of time. The quantitative real-time PCR assay demonstrated that repair of the 8-oxoG was 80% complete in less than 48 h in AD293 cells. Transfection of small interfering RNAs down-regulated OGG1 expression in AD293 cells and reduced the repair of 8-oxoG to 30%. Transfection of the episome into unstimulated white blood cells showed that 8-oxoG repair had a half-life of 2 to 5h. This method is a rapid, reproducible, and robust way to monitor repair of specific adducts in virtually any cell type.

[Effectiveness and complications of combination therapy with interferon alpha and ribavirin in patients with chronic hepatitis C].

BACKGROUND/AIMS: The effectiveness of combination therapy with conventional or pegylated interferon alpha and ribavirin in patients with chronic hepatitis C is well understood. However, the profound investigation about complications of the treatment has been rarely reported in Korea, where patients have broader spectrum of disease manifestations. The aim of this study was to evaluate the effectiveness and complications of the combination therapy of interferon alpha and ribavirin in patients with chronic hepatitis C. METHODS: Two hundred and forty patients with chronic hepatitis C were included. All patients were treated with interferon alpha (3 million units thrice a week) in combination with ribavirin (800-1,200 mg, depending on body weight). Patients were treated for 6 or 12 months according to the genotypes (genotype 1; 12 months, non-1; 6 months). We retrospectively evaluated ETR (end of treatment response) and SVR (sustained virologic response) on the basis of intent-to-treat in patients completing the therapy. RESULTS: In 154 patients who had completed the therapy, ETR was 79.2% and SVR was 61.0%. Multivariate analysis showed that genotype and early virologic response at 3 months of treatment were independent predictive factors of SVR. Due to insufficient response, 11.3% of the patients discontinued the therapy. In addition, 24.5% of the patients prematurely discontinued the therapy due to adverse events including aggravated liver function (15.4%), failure to return (7.9%), and others (1.2%). Dose modifications of interferon alpha or ribavirin were required due to anemia (15.4%), neutropenia (8.8%), or thrombocytopenia (4.6%). CONCLUSIONS: The overall SVR of patients who had completed the combination therapy with interferon alpha and ribavirin was 61.0%. However, about one third of the patients discontinued the therapy prematurely due to insufficient response, adverse events and/or noncompliance.

Beneficial effects of simultaneous treatment with 15-deoxyspergualin and monoclonal antibodies to CD45RB and CD154 on murine islet transplantation recipients.

BACKGROUND: Treatment of transplant recipients with either 15-deoxyspergualin (DSG) or monoclonal antibodies (mAbs) to T-cell proteins CD45RB and CD154 (a two-signal blockade) has been shown to prolong islet graft survival. Therefore, we investigated the combined effect of DSG, anti-CD45RB, and anti-CD154 in murine islet model. METHODS: Chemically induced diabetic C57BL/6 mice underwent allografting with islets from BALB/c mice or xenografting with rat islets. After transplantation, they were treated with either DSG, the two-signal blockade, or both (the triple treatment). The tolerogenic effects of the posttransplant treatments were measured with an intraperitoneal glucose tolerance test (IPGTT), immunohistology, enzyme-linked immunosorbent assays, and flow cytometry. RESULTS: Blood glucose profiles measured after glucose challenges were improved in all islet recipients. Enhancement of xenograft survival in triple-treated groups was not statistically significant (P = 0.08), compared to graft survival in group received only the two-signal blockade. However, 15 days after transplantation, xenografts in the triple-treated group showed a significant decrease in the proportion of CD4, CD8, and CD4CD45RB T-cells, and in the expression of interleukin-10 and interferon-gamma, relative to grafts in the other treatment groups. In addition, reduced infiltration of the xenografts by CD3 T-cells was observed in groups that had received either the two-signal blockade or the triple treatment. With long-term (>248 days) xenografts, only those in the triple-treated group were free of inflammatory infiltrates. These grafts also exhibited larger islet clusters and contained more insulin- and glucagon-positive cells, relative to grafts in the other treatment groups. CONCLUSION: Triple treatment has a beneficial effect in murine islet xenotransplantation.

[Body weight, cardiovascular risk factors, and self-efficacy of diabetic control among obese type II diabetic patients].

PURPOSE: The purpose of this study was to examine the effects of problem solving nursing counseling and walking exercise on weight loss, cardiovascular risk factors, and self-efficacy of diabetic control among obese diabetic patients. The Polar heart rate monitor was used for walking exercise to utilize the Biofeedback mechanism. METHOD: Fifty nine diabetic patients were conveniently placed into experimental (n=35) and control groups (n=24). The experimental group participated in weekly nursing counseling for 12 weeks and was encouraged to do walking exercise using a Polar monitor. The control group remained in the same treatment as before. The data was collected from November 2003 to August 2004 and analyzed using t-tests and ANCOVAs. RESULTS: After 12 weeks, the participants in the experimental group reported significantly decreased body weight (p=.004) and total scores on the Parma scale (p=.001). While the participants in the control group reported significantly increased levels of blood triglyceride (p=.046) and HDL (p=.018). CONCLUSION: Based on the findings, we concluded that problem focused nursing counseling with intensified walking exercise could reduce the risk of cardiovascular complications and body weight among obese diabetic patients. Future research to explore the long-term effects of nursing counseling on diabetic complications is warranted.

[Self care activity, metabolic control, and cardiovascular risk factors in accordance with the levels of depression of clients with type 2 diabetes mellitus].

PURPOSE: The purpose of this study was to explore the levels of depression experienced by clients (N=152) with Type 2 Diabetes Mellitus(DM), and to compare the levels of self care activity, metabolic control and cardiovascular risk factors between depressed and non-depressed clients. METHOD: Participants aged 50 and above were conveniently recruited in B city. The levels of depression, self-care activity, metabolic control of glucose and lipids, and cardiovascular risk factors of the participants were measured by using questionnaires and blood tests from November, 2003 to June, 2004. Data was analyzed with descriptive statistics, Pearson correlation, Spearman rho and t-test using the SPSS WIN 10.0 program. RESULT: The prevalence of depression(CES-D=16) among the participants was 44.1%. The levels of self-care activities(p=.012), glucose(p=.019), total cholesterol(p=.022), LDL(.007) and cardiovascular risk factors(p=.012) were significantly higher in the depressed group than those in the non-depressed group. CONCLUSION: Based on the findings, we concluded that many DM patients experience depression and the depression of type 2 DM clients is significantly related with self care activities, diabetic control, and cardiovascular complications. However, this study did not address causality among these variables. Therefore, further research, such as a longitudinal cohort study, is needed to identify causality among these variables.

[The effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among clients with DM Type II].

PURPOSE: The purpose of the study was to identify the effects of problem solving nursing counseling and intensified walking exercise on diabetic self-care, coping strategies, and glycemic control among older adults with DM type II. METHOD: Ninety nine DM patients who were older than 50 were recruited from DM clinics or public health centers and conveniently assigned into three groups: the Polar (n=41), counseling (n=30) and control groups (n=28). Participants in both Polar and counseling groups attended weekly problem solving nursing counseling for 12 weeks. Polar heart rate monitors were used in the Polar group to intensify walking exercise. Data was collected from November 2003 to August 2004 and analyzed by ANOVA or ANCOVA using the SPSS WIN program. RESULT: After a 12 week intervention, participants in both the Polar and counseling groups reported increased diabetic self care behaviors and decreased blood glucose levels, which is significantly different from those in the control group. There were no distinctively different program effects between the Polar and counseling groups. CONCLUSION: Based on the findings, we concluded that problem solving counseling alone could have positive effects on diabetic self care and glycemic controls for older adults with DM. Future research is needed to identify long-term effects of the program.

[The effect of problem solving group counseling on the index of obesity and health habits of obese children].

PURPOSE: This study was to investigate the effects of problem solving group counseling on the index of obesity and health habits for obese children. METHOD: Forty seven obese children participated in the study(Exp.=22, Cont.=25). Children were recruited from the forth and fifth grade with higher than 20% of the obesity degree. The problem solving counseling lasted for 10 weeks. In order to evaluate the effects of counseling, physical characteristics and health habits were measured three times; pretest, posttest, and at 10 weeks follow-up. The obtained data was analyzed by chi(2)-test, t-test, and repeated measures ANOVA, using the SPSS WIN 10.0 program. RESULT: Problem solving group counseling was effective on the physical characteristics(BMI, obesity degree, body fat ratio, waist measurement) and health habits over time. Children in the experimental group controlled their body weight better and reported lower scores in the index of obesity than children in the control group at 10 weeks follow-up. CONCLUSION: This counseling program helped obese children modify their health habits so that they could decrease their scores in the obesity index. It can be concluded that problem-solving counseling enhanced problem-solving abilities of obese children, which could help modify their ordinary health habits.

[Predictors of depression among family caregivers of older adults with dementia].

PURPOSE: This study was to identify important predictors of depression among characteristics of caregiving situation and utilized resources in order to provide basic information for effective nursing interventions to reduce depression experienced by family caregivers of older adults with dementia. METHOD: Seventy one family caregivers were identified from community service centers and face-to-face interviewed using structured questionnaires. Data were analyzed with descriptive statistics, Pearson correlation and hierarchical multiple regression using SPSS WIN 10.0 program. RESULT: Family caregivers reported high levels of depression, moderate levels of social support, and moderate utilization of coping strategies. Female caregivers who (beta=.22) utilized 'negative' coping strategies more often (beta=.48) and 'cognitive reconstructuring' coping strategies less often (beta=-.23) were more likely to report higher depression (R2=0.63). CONCLUSION: Nursing interventions increasing family caregivers' utilization of positive coping strategies such as problem solving, existential growth, and help seeking and decreasing their utilization of negative coping strategies such as self-blaming are needed to decrease their depression levels.

[Factors influencing on the compliance of breast self-examination of nurses in a local area].

PURPOSE: The purpose of this study was to identify the influencing factors on the compliance of breast self-examination (BSE) among nurses who work at three general hospitals in Kyung-Nam areas. METHOD: 258 hospital nurses were included in the study. Data were collected using structured self-administered questionnaires and analyzed by descriptive statistics, t-test, chi(2) test and logistic regression analysis. RESULT: Nurses reported medium levels of knowledge, self efficacy and health believes about breast cancer and BSE, and 26% of the nurses performed the BSE at least once during the last 6 months. Compliers of BSE perceived significantly higher levels of self-efficacy, susceptability and health motivation, and lower level of barrier compared to non-compliers. Significant influencing factors on BSE compliance were 'experience of getting recommendation for breast self-examination', 'susceptibility', 'barrier', and 'self-efficacy' and those variables explained 22.5% of variance in compliance of BSE. CONCLUSION: Nurses, who must play as a role model for health promoting behaviors, did not have enough knowledge of breast cancer and BSE. Also, their performance rate of BSE was quite low. Thus, it is essential to provide an educational program for breast cancer and BSE to nurses in order to enhance nurses' performance rate of BSE.