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1.
Int J Biol Macromol ; 270(Pt 1): 132178, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38735614

RESUMO

In response to escalating environmental concerns and the urgent need for sustainable drug delivery systems, this study introduces biodegradable pH-responsive microcapsules synthesized from a blend of gelatin, alginate, and hyaluronic acid. Employing the coacervation process, capsules were created with a spherical shape, multicore structure, and small sizes ranging from 10 to 20 µm, which exhibit outstanding vitamin E encapsulation efficiency. With substantial incorporation of hyaluronic acid, a pH-responsive component, the resulting microcapsules displayed noteworthy swelling behavior, facilitating proficient core ingredient release at pH 5.5 and 7.4. Notably, these capsules can effectively deliver active substances to the dermal layer under specific skin conditions, revealing promising applications in topical medications and cosmetics. Furthermore, the readily biodegradable nature of the designed capsules was demonstrated through Biochemical Oxygen Demand (BOD) testing, with over 80 % of microcapsules being degraded by microorganisms after one week of incubation. This research contributes to the development of responsive microcapsules and aligns with broader environmental initiatives, offering a promising pathway to mitigate the impact of microplastics while advancing various applications.


Assuntos
Alginatos , Cápsulas , Preparações de Ação Retardada , Liberação Controlada de Fármacos , Gelatina , Ácido Hialurônico , Ácido Hialurônico/química , Alginatos/química , Gelatina/química , Concentração de Íons de Hidrogênio , Preparações de Ação Retardada/química , Portadores de Fármacos/química , Vitamina E/química
2.
J Korean Med Sci ; 38(44): e370, 2023 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-37967880

RESUMO

BACKGROUND: Evaluating the activities of daily living (ADL) is an important factor for diagnosing dementia. The Everyday Cognition (ECog) scale was developed to measure ADL changes that were correlated with specific neuropsychological impairments. A short form of the ECog (ECog-12) was also developed, consisting of 12 items, two from each of the six cognitive domains of the ECog. The Korean full version of ECog (K-ECog) has recently been standardized, but the need for a shortened version has been raised in clinical practice. The purpose of this study was to develop a Korean version of ECog-12 (K-ECog-12) and to verify its reliability and validity by comparing those to the full version of K-ECog. METHODS: The participants were 267 cognitively normal older adults (CN), 183 patients with mild cognitive impairment (MCI), and 89 patients with dementia. The Korean-Mini Mental State Examination (K-MMSE), Korean-Montreal Cognitive Assessment (K-MoCA), and Short form of Geriatric Depression Scale (SGDS) were administered to all participants. The K-ECog and Korean-Instrumental Activities of Daily Living (K-IADL) were rated by the informants of patients. RESULTS: K-ECog-12 was newly constructed by replacing one item for the visuospatial function in the original ECog-12 with another one through an item response theory analysis on Korean data. The internal consistencies (Cronbach's α) of K-ECog-12 and K-ECog were 0.95 and 0.99, respectively. The test-retest reliabilities (Pearson's r) were 0.67 for K-ECog-12 and 0.73 for K-ECog. The K-ECog-12 was significantly correlated with K-ECog as well as K-IADL, K-MMSE, and K-MoCA. The K-ECog-12 scores differed significantly between the CN, MCI, and dementia groups, as did the K-ECog scores. Receiver operating characteristic curve analyses showed that K-ECog-12, like K-ECog, could differentiate MCI and dementia patients from CN as well. CONCLUSION: The K-ECog-12 is as reliable and valid as the K-ECog in assessing ADL. Therefore, K-ECog-12 can be used as an alternative to the K-ECog in clinical and community settings in Korea.


Assuntos
Disfunção Cognitiva , Demência , Humanos , Idoso , Demência/diagnóstico , Atividades Cotidianas/psicologia , Reprodutibilidade dos Testes , Testes Neuropsicológicos , Disfunção Cognitiva/diagnóstico , Cognição , República da Coreia
3.
JMIR Serious Games ; 11: e49216, 2023 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-37819707

RESUMO

BACKGROUND: Articulation disorder decreases the clarity of language and causes a decrease in children's learning and social ability. The demand for non-face-to-face treatment is increasing owing to the limited number of therapists and geographical or economic constraints. Non-face-to-face speech therapy programs using serious games have been proposed as an alternative. OBJECTIVE: The aim of this study is to investigate the efficacy of home therapy on logopedic and phoniatric abilities in children with articulation disorder using the Smart Speech game interface. METHODS: This study is a prospective single-arm clinical trial. Children with articulation disorders, whose Urimal Test of Articulation and Phonology (U-TAP) was -2 SDs or less and the Receptive and Expressive Vocabulary Test score was -1 SD or more, were enrolled. A preliminary evaluation (E0) was conducted to check whether the children had articulation disorders, and for the next 4 weeks, they lived their usual lifestyle without other treatments. Prior to the beginning of the training, a pre-evaluation (E1) was performed, and the children trained at home for ≥30 minutes per day, ≥5 times a week, over 4 weeks (a total of 20 sessions). The Smart Speech program comprised oral exercise training, breathing training, and speech training; the difficulty and type of the training were configured differently according to the participants' articulation error, exercise, and vocal ability. After the training, postevaluation (E2) was performed using the same method. Finally, 8 weeks later, postevaluation (E3) was performed as a follow-up. A voice evaluation included parameters such as maximum phonation time (MPT), fundamental frequency (F0), jitter, peak air pressure (relative average perturbation), pitch, intensity, and voice onset time. Articulation parameters included a percentage of correct consonants (PCC; U-TAP word-unit PCC, U-TAP sentence-unit PCC, and three-position articulation test) and alternate motion evaluation (diadochokinesis, DDK). Data obtained during each evaluation (E1-E2-E3) were compared. RESULTS: A total of 13 children with articulation disorders aged 4-10 years were enrolled in the study. In voice parameters, MPT, jitter, and pitch showed significant changes in repeated-measures ANOVA. However, only MPT showed significant changes during E1-E2 (P=.007) and E1-E3 (P=.004) in post hoc tests. Other voice parameters did not show significant changes. In articulation parameters, U-TAP, three-position articulation test (TA), and DDK showed significant changes in repeated-measures ANOVA. In post hoc tests, U-TAP (word, sentence) and TA showed significant changes during E1-E2 (P=.003, .04, and .01) and E1-E3 (P=.001, .03, and .003), and DDK showed significant changes during E1-E2 only (P=.03). CONCLUSIONS: Home-based serious games can be considered an alternative treatment method to improve language function. TRIAL REGISTRATION: Clinical Research Information Service KCT0006448; https://cris.nih.go.kr/cris/search/detailSearch.do/20119.

4.
Clin Exp Optom ; 106(4): 362-372, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-35504720

RESUMO

Keratoconus is a complex and multifactorial disease and its exact aetiology remains unknown. This current study examined the important environmental risk factors and their association with keratoconus. This study was registered in the PROSPERO International Prospective Register of systematic reviews under registration number CRD42021256792 in 2021. Scopus, Web of Science, PubMed, and Cochrane CENTRAL databases were searched for all relevant articles published from 1 January 1900 to 31 July 2021. National Institutes of Health Quality Assessment Tool was used to assess the methodological quality of the studies. The assessment for statistical heterogeneity was assessed using the Z-statistics on RevMan v5.4. P-value of <0.05 was considered as statistically significant and I2 < 25% as homogenous. Thirty studies were included in this meta-analysis. Pooled odds ratio was calculated with 95% CI. The pooled odds ratio (OR) of eye rubbing, atopy, asthma, and eczema was 3.64 (95% CI, 2.02, 6.57), 1.90 (95% CI, 1.22, 2.94), 1.36 (95% CI, 1.15, 1.61) and 1.90 (95% CI, 1.22, 2.94), respectively. The OR for diabetes was 0.86 (95% CI 0.73, 1.02), and use of sunglasses, contact lens, allergic conjunctivitis, side sleep position and prone sleep position was 0.40 (95% CI, 0.16, 0.99), 1.68 (0.70, 4.00), 2.24 (95% CI, 0.68, 7.36), 3.81 (95% CI, 0.31, 46.23), 12.76 (95% CI, 0.27, 598.58), respectively. Twenty studies were considered to be of high quality, nine to be moderate and one to be low. Environmental risk factors have been identified to play a role in the susceptibility of keratoconus. However, further large-scale longitudinal studies are needed to understand the mechanisms between environmental risk factors and keratoconus.


Assuntos
Conjuntivite Alérgica , Ceratocone , Humanos , Ceratocone/diagnóstico , Ceratocone/epidemiologia , Ceratocone/etiologia , Revisões Sistemáticas como Assunto , Fatores de Risco , Razão de Chances
5.
Children (Basel) ; 9(12)2022 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-36553416

RESUMO

This review discusses the current practices, attitudes, and trends in diagnosing and managing keratoconus (KC) in adults and children by optometrists and ophthalmologists in order to highlight the differences on a global scale. Two independent reviewers searched the electronic databases and grey literature for all potential articles published from 1 January 2000 to 1 June 2022 on management of KC. Keywords used in searches included "keratoconus", "diagnosis", "management", "treatment", "attitude", "practices", "opinion", "optometrist", "ophthalmologist", "consensus", and "protocol". A total of 19 articles was included in this review-12 from the database search and seven from the grey literature. Although a common stepwise approach of non-surgical management was noted, there were differences in the rates of prescribing rigid gas permeable lenses. Furthermore, while clinicians agreed on the need for early diagnosis, the timeline and type of referral varied significantly. A similar discordance was found in the milestones for surgical intervention and preferred surgical techniques. Practice patterns in keratoconus diagnosis and management vary throughout the world. Multiple recommendations and suggestions to minimise the differences have been provided in the literature, with the main themes being improvement in education, interdisciplinary patient care, and further research to reach consensus.

6.
Animals (Basel) ; 12(19)2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36230243

RESUMO

Gut microbiomes are well recognized to serve a variety of roles in health and disease, even though their functions are not yet completely understood. Previous studies have demonstrated that the microbiomes of juvenile and adult dogs have significantly different compositions and characteristics. However, there is still a scarcity of basic microbiome research in dogs. In this study, we aimed to advance our understanding by confirming the difference in fecal microbiome between young and adult dogs by analyzing the feces of 4-month and 16-month-old Jindo dogs, a domestic Korean breed. Microbiome data were generated and examined for the two age groups using 16S rRNA analysis. Comparison results revealed that the 16-month-old group presented a relatively high distribution of Bacteroides, whereas the 4-month-old group presented a comparatively high distribution of the Lactobacillus genus. Microbial function prediction analyses confirmed the relative abundance of lipid metabolism in 4-month-old dogs. In 16-month-old dogs, glucose metabolism was determined using microbial function prediction analyses. This implies that the functional microbiome changes similarly to the latter in adults compared with childhood. Overall, we discovered compositional and functional variations between genes of the gut microbial population in juveniles and adults. These microbial community profiles can be used as references for future research on the microbiome associated with health and development in the canine population.

7.
Anim Biosci ; 35(11): 1808-1816, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36108700

RESUMO

OBJECTIVE: The study of Hanwoo (Korean native cattle) has mainly been focused on meat quality and productivity. Recently the field of microbiome research has increased dramatically. However, the information on the microbiome in Hanwoo is still insufficient, especially relationship between vagina and feces. Therefore, the purpose of this study is to examine the microbial community characteristics by analyzing the 16S rRNA sequencing data of Hanwoo vagina and feces, as well as to confirm the difference and correlation between vaginal and fecal microorganisms. As a result, the goal is to investigate if fecal microbiome can be used to predict vaginal microbiome. METHODS: A total of 31 clinically healthy Hanwoo that delivered healthy calves more than once in Cheongju, South Korea were enrolled in this study. During the breeding season, we collected vaginal and fecal samples and sequenced the microbial 16S rRNA genes V3-V4 hypervariable regions from microbial DNA of samples. RESULTS: The results revealed that the phylum-level microorganisms with the largest relative distribution were Firmicutes, Actinobacteria, Bacteroidetes, and Proteobacteria in the vagina, and Firmicutes, Bacteroidetes, and Spirochaetes in the feces, respectively. In the analysis of alpha, beta diversity, and effect size measurements (LefSe), the results showed significant differences between the vaginal and fecal samples. We also identified the function of these differentially abundant microorganisms by functional annotation analyses. But there is no significant correlation between vaginal and fecal microbiome. CONCLUSION: There is a significant difference between vaginal and fecal microbiome, but no significant correlation. Therefore, it is difficult to interrelate vaginal microbiome as fecal microbiome in Hanwoo. In a further study, it will be necessary to identify the genetic relationship of the entire microorganism between vagina and feces through the whole metagenome sequencing analysis and meta-transcriptome analysis to figure out their relationship.

8.
Diagnostics (Basel) ; 12(8)2022 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-36010174

RESUMO

Artificial intelligence (AI) techniques can be a solution for delayed or misdiagnosed pneumothorax. This study developed, a deep-learning-based AI model to estimate the pneumothorax amount on a chest radiograph and applied it to a treatment algorithm developed by experienced thoracic surgeons. U-net performed semantic segmentation and classification of pneumothorax and non-pneumothorax areas. The pneumothorax amount was measured using chest computed tomography (volume ratio, gold standard) and chest radiographs (area ratio, true label) and calculated using the AI model (area ratio, predicted label). Each value was compared and analyzed based on clinical outcomes. The study included 96 patients, of which 67 comprised the training set and the others the test set. The AI model showed an accuracy of 97.8%, sensitivity of 69.2%, a negative predictive value of 99.1%, and a dice similarity coefficient of 61.8%. In the test set, the average amount of pneumothorax was 15%, 16%, and 13% in the gold standard, predicted, and true labels, respectively. The predicted label was not significantly different from the gold standard (p = 0.11) but inferior to the true label (difference in MAE: 3.03%). The amount of pneumothorax in thoracostomy patients was 21.6% in predicted cases and 18.5% in true cases.

9.
eNeurologicalSci ; 26: 100390, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35257031

RESUMO

•VKH is an idiopathic autoimmune disease presenting with uveomeningeal syndrome.•Granulomatous uveitis and serious retinal detachments are the most common findings of VKH.•VKH can masquerade as IIH by presenting with severe headache and optic disc edema.•The characteristic retinal finding of VKH can be easily missed by direct funduscopy.

10.
Dement Neurocogn Disord ; 20(4): 62-69, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34795769

RESUMO

BACKGROUND AND PURPOSE: The Korean-Color Word Stroop Test: Color Reading (K-CWST: CR) included in the Seoul Neuropsychological Screening Battery, 2nd Edition (SNSB-II) examines inhibitory control deficit. It provides normative data for both 60- and 120-second conditions, but the validity of the 60-second condition has not yet been proven. This study examined the validity of the 60-second condition by observing concordance between the performances in cognitively normal, MCI, and mild dementia groups. METHODS: There were 1,336 patients performed the SNSB-II, including the K-CWST: CR. Based on the cognitive test results, activities of daily living, and clinical interview, the patients were assigned to normal cognition (n=104), MCI (n=884), or mild dementia (n=348) groups. Abnormal performance on the K-CWST: CR was operationally defined as 1SD below the normative mean. The receiver operating characteristic curve analyses were conducted to compare the discriminability between the 60- and 120-second conditions. RESULTS: The percentages of abnormal performance in the MCI group were 41.5% and 42.3%, and those in the mild dementia group were 82.7% and 82.4% for the 60- and 120-second conditions, respectively. The areas under the curve for the 60- and 120-seconds were as follows; 0.80 and 0.81 in differentiating normal from MCI; 0.95 and 0.96 in normal from mild dementia; and 0.77 and 0.77 in MCI from mild dementia. CONCLUSIONS: The 60-second condition of the K-CWST showed very similar results, not statistically different from the 120-second condition. Therefore, the 60-second condition could be used interchangeably with the 120-second condition in a clinical setting.

11.
Dement Neurocogn Disord ; 20(4): 80-88, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34795771

RESUMO

BACKGROUND AND PURPOSE: Everyday Cognition (ECog) has been widely used to differentiate individuals with mild cognitive impairment (MCI) and dementia from normal elderly individuals. It has also been used to assess subjective cognitive decline (SCD). This study investigated the feasibility of using ECog as a screening measure for SCD in community-dwelling elderly individuals. METHODS: The participants included 84 older adults with and 93 without SCD living in the community. These 2 groups were classified based on their response ("yes" or "no") to the question "Do you perceive memory or cognitive difficulties?" All participants were evaluated using the Korean-Mini Mental State Examination (K-MMSE), Short form of the Geriatric Depression Scale (SGDS), and the Korean version of Everyday Cognition (K-ECog). RESULTS: The scores of all participants were within the normal range on the K-MMSE and SGDS. The total K-MMSE score did not differ significantly between the 2 groups after controlling for age, education, and depression. The scores of SCD group were significantly higher than those of the non-SCD group for memory, language, and executive function: planning domains, as well as K-ECog total score. Receiver operating characteristic curve analysis revealed that the K-ECog total score was effective in moderately differentiating between subjects with and without SCD (area under the curve: 0.73). CONCLUSIONS: ECog is a feasible and useful screening measure for SCD in older adults living in the community, and can be used to assess the full spectrum of cognitive and functional deficits, ranging from SCD to MCI and dementia.

13.
Cell Mol Gastroenterol Hepatol ; 12(5): 1761-1787, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34358714

RESUMO

BACKGROUND & AIMS: The liver is the major organ for metabolizing lipids, and malfunction of the liver leads to various diseases. Nonalcoholic fatty liver disease is rapidly becoming a major health concern worldwide and is characterized by abnormal retention of excess lipids in the liver. CCCTC-binding factor (CTCF) is a highly conserved zinc finger protein that regulates higher-order chromatin organization and is involved in various gene regulation processes. Here, we sought to determine the physiological role of CTCF in hepatic lipid metabolism. METHODS: We generated liver-specific, CTCF-ablated and/or CD36 whole-body knockout mice. Overexpression or knockdown of peroxisome proliferator-activated receptor (PPAR)γ in the liver was achieved using adenovirus. Mice were examined for development of hepatic steatosis and inflammation. RNA sequencing was performed to identify genes affected by CTCF depletion. Genome-wide occupancy of H3K27 acetylation, PPARγ, and CTCF were analyzed by chromatin immunoprecipitation sequencing. Genome-wide chromatin interactions were analyzed by in situ Hi-C. RESULTS: Liver-specific, CTCF-deficient mice developed hepatic steatosis and inflammation when fed a standard chow diet. Global analysis of the transcriptome and enhancer landscape revealed that CTCF-depleted liver showed enhanced accumulation of PPARγ in the nucleus, which leads to increased expression of its downstream target genes, including fat storage-related gene CD36, which is involved in the lipid metabolic process. Hepatic steatosis developed in liver-specific, CTCF-deficient mice was ameliorated by repression of PPARγ via pharmacologic blockade or adenovirus-mediated knockdown, but hardly rescued by additional knockout of CD36. CONCLUSIONS: Our data indicate that liver-specific deletion of CTCF leads to hepatosteatosis through augmented PPARγ DNA-binding activity, which up-regulates its downstream target genes associated with the lipid metabolic process.


Assuntos
Fator de Ligação a CCCTC/deficiência , Hepatopatia Gordurosa não Alcoólica/etiologia , Hepatopatia Gordurosa não Alcoólica/metabolismo , PPAR gama/metabolismo , Transdução de Sinais , Animais , Biomarcadores , Suscetibilidade a Doenças , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Histonas/metabolismo , Imuno-Histoquímica , Camundongos , Camundongos Knockout , Hepatopatia Gordurosa não Alcoólica/patologia , Especificidade de Órgãos/genética , Fenótipo
14.
J Clin Med ; 10(13)2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34202829

RESUMO

Neuroimaging and neuropsychological investigations have indicated that migraineurs exhibit frontal lobe-related cognitive impairment. We investigated whether orbitofrontal and dorsolateral functioning differed between individuals with episodic migraine (EM) and chronic migraine (CM), focusing on orbitofrontal dysfunction because it is implicated in migraine chronification and medication overuse headache (MOH) in migraineurs. This cross-sectional study recruited women with CM with/without MOH (CM + MOH, CM - MOH), EM, and control participants who were matched in terms of age and education. We conducted neuropsychological assessments of frontal lobe function via the Trail Making Test (TMT) A and B, the Wisconsin Card Sorting Test (WCST), and the Iowa Gambling Task (IGT). We enrolled 36 CM (19 CM + MOH, 17 CM - MOH), 30 EM, and 30 control participants. The CM patients performed significantly (p < 0.01) worse on the TMT A and B than the EM patients and the control participants. The WCST also revealed significant differences, with poorer performance in the CM patients versus the EM patients and the control participants. However, the net scores on the IGT did not significantly differ among the three groups. Our findings suggest that the CM patients exhibited frontal lobe dysfunction, and, particularly, dorsolateral dysfunction. However, we found no differences in frontal lobe function according to the presence or absence of MOH.

15.
Dement Neurocogn Disord ; 19(4): 161-169, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33377669

RESUMO

BACKGROUND AND PURPOSE: The Mini Mental State Examination, 2nd edition: Expanded version (MMSE-2: EV) involves an immediate recall (IR) of story memory (SM). A full version of SM has been developed and standardized; it includes delayed recall (DR) and recognition tests in addition to IR to increase its clinical utility as an independent story recall test. This study was conducted to provide norms for the full version of SM in the Korean version of MMSE-2: EV for clinical use. METHODS: A total of 1,168 participants (496 males and 672 females) were included in the study. The ages ranged from 19 to 90 years, and the education level ranged from illiterate to post-graduate. Regression analysis was used to evaluate the relative contributions of demographic variables (age, education, and sex) on the SM measures. RESULTS: We stratified age into 11 groups, and categorized the education level into 6 groups. It was found that the IR, DR, and recognition scores of SM were affected by age, education level, and sex. We provided corrected means and standard deviations of the IR, DR, and recognition scores of the SM for the demographic variables. CONCLUSIONS: The results indicate the importance of considering demographic variables in interpreting the full version of SM measures. The normative data we have provided in this study should be useful in clinical and research settings for detecting the impairment in verbal memory.

16.
Medicine (Baltimore) ; 99(46): e23204, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181702

RESUMO

RATIONALE: Steroid is known to cause generalized immunosuppression, thereby increasing the risk of new infection or recurrence of tuberculosis. However, corticosteroid as a culprit for exacerbation of miliary tuberculosis-from a cryptic to an overt form-has rarely been described in the literature. Moreover, miliary tuberculosis is hardly diagnosed in a living patient as a primary cause of ARDS even in TB-endemic regions. To the best of our knowledge, this is the first case of a steroid-induced progression of cryptic miliary tuberculosis to ARDS, provided with clear depiction of its radiologic evolution. PATIENT CONCERNS: A 36-year-old male was treated with corticosteroid under suspicion of adult onset still's disease for six-week history of fever. Within 2 weeks since the initiation of corticosteroid therapy, the patient experienced acute exacerbation of cryptic miliary tuberculosis, which evolved to an overt form, appearing as miliary nodules on both chest radiograph and HRCT. Then, his condition suddenly deteriorated to severe acute respiratory distress syndrome in less than a day. DIAGNOSIS: The final diagnosis was miliary tuberculosis complicated by severe acute respiratory distress syndrome. INTERVENTIONS: The patient was placed on classic quadruple anti-TB treatment (isoniazide, ethambutol, rifampin, and pyrazinamide). OUTCOMES: His fever subsided in about 6 weeks and 3 consecutive sputum AFB smears collected on different days were confirmed negative. Diffuse infiltrates on his chest x-ray were completely resolved. LESSONS: The case described here draws a clinical and radiological picture of how an occult form of miliary TB evolved to an overt form with use of steroid, and then suddenly progressed to acute respiratory distress syndrome in an immunocompetent young male. This raises awareness on the potential risk of using corticosteroid in patients with cryptic miliary TB. There is formidable challenge in the diagnosis of miliary TB, especially in the early stages. Atypical or even normal outcomes of clinical, microbiochemical, and radiologic evaluation should not be overlooked and dedicated diagnostic work-up should be performed. For equivocal cases, active surveillance with serial radiographs can be helpful.


Assuntos
Metilprednisolona/efeitos adversos , Síndrome do Desconforto Respiratório/etiologia , Tuberculose Miliar/complicações , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Adulto , Serviço Hospitalar de Emergência/organização & administração , Febre/etiologia , Humanos , Masculino , Metilprednisolona/uso terapêutico , Síndrome do Desconforto Respiratório/tratamento farmacológico , Síndrome do Desconforto Respiratório/fisiopatologia , Doença de Still de Início Tardio/complicações , Doença de Still de Início Tardio/tratamento farmacológico , Doença de Still de Início Tardio/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Tuberculose Miliar/tratamento farmacológico , Tuberculose Miliar/fisiopatologia
17.
Taehan Yongsang Uihakhoe Chi ; 81(2): 272-289, 2020 Mar.
Artigo em Coreano | MEDLINE | ID: mdl-36237388

RESUMO

Current advances in CT techniques allow thorough evaluation of the beating heart. The strengths of cardiac CT relative to echocardiography and magnetic resonance imaging are its high availability in most institutions, rapid production of high-quality images, and outstanding delineation of the anatomy. For many normal variants and pathologic conditions, such as thrombi, masses, and congenital abnormalities of the left atrium, CT findings are sufficient to make a presumptive diagnosis. Assessments of the left atrium and left atrial appendage are particularly important for the management of atrial fibrillation, as various catheter-based procedures are aimed at the mechanical and electrical isolation of these structures. CT offers information crucial to a successful catheter-based procedure or surgery. Therefore, a comprehensive review of the geometry (shape, size, and relative position), along with various CT imaging features of pathologic states, should be provided in radiology reports to be of clinical value.

18.
Dement Neurocogn Disord ; 18(3): 96-104, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31681444

RESUMO

BACKGROUND AND PURPOSE: The Korean version of Story Memory (SM) in the Korean-Mini Mental State Examination, 2nd Edition: Expanded Version (K-MMSE-2: EV) was developed. Based on the SM, we additionally developed a full version of SM including delayed recall (DR) and recognition adding to immediate recall (IR). This study aimed to examine the reliabilities and validities of the newly developed SM in the K-MMSE-2: EV and its full version. METHODS: Ninety-five healthy elderly individuals (HE), 90 patients with amnestic mild cognitive impairment (aMCI), and 53 patients with dementia of the Alzheimer's type (DAT) participated in the study. They were administered the full version of SM with the Seoul Verbal Learning Test-Elderly's version (SVLT-E) and Rey Complex Figure Test (RCFT). In addition, the SM was re-administered to 51 participants after a 5-week interval. Two clinical neuropsychologists independently rated the performance of 50 participants. RESULTS: The test-retest reliabilities of the IR, DR, and recognition of the SM were statistically significant. The inter-rater reliabilities (Cohen's kappa) were high (0.87-1.00) for all the measures. The IR, DR, and recognition of SM had significant positive correlations with those of the SVLT-E and RCFT. Significant group differences in IR and DR of SM were found among the HE, aMCI, and DAT groups. The recognition scores were significantly different between the aMCI and DAT groups, but not between the HE and aMCI groups. CONCLUSIONS: The newly developed full version of SM in the K-MMSE-2: EV was proven to be a reliable and valid memory measure for clinical use.

19.
Proc Natl Acad Sci U S A ; 116(17): 8289-8294, 2019 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-30948645

RESUMO

DNA-reactive compounds are harnessed for cancer chemotherapy. Their genotoxic effects are considered to be the main mechanism for the cytotoxicity to date. Because this mechanism preferentially affects actively proliferating cells, it is postulated that the cytotoxicity is specific to cancer cells. Nonetheless, they do harm normal quiescent cells, suggesting that there are other cytotoxic mechanisms to be uncovered. By employing doxorubicin as a representative DNA-reactive compound, we have discovered a cytotoxic mechanism that involves a cellular noncoding RNA (ncRNA) nc886 and protein kinase R (PKR) that is a proapoptotic protein. nc886 is transcribed by RNA polymerase III (Pol III), binds to PKR, and prevents it from aberrant activation in most normal cells. We have shown here that doxorubicin evicts Pol III from DNA and, thereby, shuts down nc886 transcription. Consequently, the instantaneous depletion of nc886 provokes PKR and leads to apoptosis. In a short-pulse treatment of doxorubicin, these events are the main cause of cytotoxicity preceding the DNA damage response in a 3D culture system as well as the monolayer cultures. By identifying nc886 as a molecular signal for PKR to sense doxorubicin, we have provided an explanation for the conundrum why DNA-damaging drugs can be cytotoxic to quiescent cells that have the competent nc886/PKR pathway.


Assuntos
Apoptose/efeitos dos fármacos , DNA/metabolismo , MicroRNAs/metabolismo , RNA não Traduzido , Linhagem Celular , Doxorrubicina/farmacologia , Humanos , MicroRNAs/genética , RNA Polimerase III/metabolismo , RNA não Traduzido/genética , RNA não Traduzido/metabolismo , Transdução de Sinais/efeitos dos fármacos , eIF-2 Quinase/metabolismo
20.
J Korean Med Sci ; 34(9): e67, 2019 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-30863265

RESUMO

BACKGROUND: In the early diagnosis of dementia, an important factor is the evaluation of activities of daily living. The Everyday Cognition (ECog) scale was developed to measure functional changes that are the everyday correlates of specific neuropsychological impairments. This study aimed to examine the validity of the Korean version of Everyday Cognition (K-ECog). METHODS: The participants were 268 cognitively normal older adults (NA), 151 amnestic mild cognitive impairment (aMCI), and 77 dementia of the Alzheimer's type (DAT). The Korean-Mini Mental State Examination (K-MMSE), Korean-Montreal Cognitive Assessment (K-MoCA), and Short form of the Geriatric Depression Scale (SGDS) were administered to all the participants. The K-ECog and Korean-Instrumental Activities of Daily Living (K-IADL) were rated by their informants. RESULTS: Internal consistency (Cronbach's α) of K-ECog global function was 0.93, and its test-retest reliability (Pearson's r) was 0.73. K-ECog was significantly correlated with K-IADL (0.66), K-MMSE (-0.38), and K-MoCA (-0.26). Confirmatory factor analysis of K-ECog yielded seven factor model that the original ECog proposed. K-ECog global score and six domain scores were significantly different across the NA, aMCI, and DAT groups. Receiver operating characteristic curve analyses showed that K-ECog effectively differentiated aMCI and DAT patients from NA, suggesting that K-ECog is as sensitive for detecting functional impairments as K-IADL. The proposed optimal cut-off score to differentiate aMCI from NA was 1.41. CONCLUSION: K-ECog is proven reliable and valid for clinical use. K-ECog can be used to distinguish very early stages of impaired ADL and cognitive impairment in the community.


Assuntos
Disfunção Cognitiva/diagnóstico , Demência/diagnóstico , Testes Neuropsicológicos , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , República da Coreia
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