[Show abstract][Hide abstract] ABSTRACT: Background
Given emerging evidence of the association between stress and disease, practitioners need a tool for measuring stress. Several instruments exist to measure perceived stress; however, none of them are applicable for population surveys because stress conceptualization can differ by population. The aim of this study was to develop and validate the Perceived Stress Inventory (PSI) and its short version for use in population surveys and clinical practice in Korea.
From a pool of perceived stress items collected from three widely used instruments, 20 items were selected for the new measurement tool. Nine of these items were selected for the short version. We evaluated the validity of the items using exploratory factor analysis of the preliminary data. To evaluate the convergent validity of the PSI, 387 healthy people were recruited and stratified on the basis of age and sex. Confirmatory analyses and examination of structural stability were also carried out. To evaluate discriminatory validity, the PSI score of a group with depressive symptoms was compared with that of a healthy group. A similar comparison was also done for persons with anxious mood.
Exploratory factor analysis supported a three-factor construct (tension, depression, and anger) for the PSI. Reliability values were satisfactory, ranging from 0.67 to 0.87. Convergent validity was confirmed through correlation with the Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and State-Trait Anxiety Inventory. People with depressive or anxious mood had higher scores than the healthy group on the total PSI, all three dimensions, and the short version.
The long and short versions of the PSI are valid and reliable tools for measuring perceived stress. These instruments offer benefits for stress research using population-based surveys.
[Show abstract][Hide abstract] ABSTRACT: Background/Aims
This study investigated the expression of nuclear factor κB (NF-κB) and the chemokine receptor (CXCR4) in patients with diffuse large B-cell lymphoma (DLBCL) who received rituximab-based therapy.
Seventy patients with DLBCL and treated with rituximab-CHOP (R-CHOP) were included, and immunohistochemistry was performed to determine the expression of NF-κB (IκB kinase α, p50, and p100/p52) and CXCR4. To classify DLBCL cases as germinal center B-cell-like (GCB) and non-GCB, additional immunohistochemical expression of CD10, bcl-6, or MUM1 was used in this study. The expression was divided into two groups according to the intensity score (negative, 0 or 1+; positive, 2+ or 3+).
The median age of the patients was 66 years (range, 17 to 87), and 58.6% were male. Twenty-seven patients (38.6%) had stage III or IV disease at diagnosis. Twenty-three patients (32.9%) were categorized as high or high-intermediate risk according to their International Prognostic Indexs (IPIs). The overall incidence of bone marrow involvement was 5.7%. Rates of positive NF-κB and CXCR4 expression were 84.2% and 88.6%, respectively. High NF-κB expression was associated with CXCR4 expression (p = 0.002), and 56 patients (80.0%) showed coexpression. However, the expression of NF-κB or CXCR4 was not associated with overall survival and EFS. On multivariate analysis that included age, gender, performance status, stage, and the IPI, no significant association between the grade of NF-κB or CXCR4 expression and survival was observed.
The current study suggests that the tissue expression of NF-κB and CXCR4 may not be an independent prognostic marker in DLBCL patients treated with R-CHOP.
Full-text · Article · Nov 2014 · The Korean Journal of Internal Medicine
[Show abstract][Hide abstract] ABSTRACT: Previous epidemiologic studies have shown the clinical association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD). However, there is only limited information about the effect of NAFLD on the development of hypertension. Accordingly, we investigated the clinical association between NAFLD and prehypertension. A prospective cohort study was conducted on the 11,350 Korean men without prehypertension for 5 yr. The incidences of prehypertension were evaluated, and Cox proportional hazard model was used to measure the hazard ratios (HRs) for the development of prehypertension according to the degree of NAFLD (normal, mild, moderate to severe). The incidence of prehypertension increased according to NAFLD states (normal: 55.5%, mild: 63.7%, moderate to severe: 70.3%, P<0.001). Even after adjusting for multiple covariates, the HRs (95% confidence interval) for prehypertension were higher in the mild group (1.18; 1.07-1.31) and moderate to severe group (1.62; 1.21-2.17), compared to normal group, respectively (P for trend <0.001). The development of prehypertension is more potentially associated with the more progressive NAFLD than normal and milder state. These findings suggest the clinical significance of NAFLD as one of risk factors for prehypertension.
Full-text · Article · Jul 2014 · Journal of Korean Medical Science
[Show abstract][Hide abstract] ABSTRACT: Background and aim:
Non-alcoholic fatty liver disease (NAFLD) is getting an increasing attention for its clinical implications on cardiovascular disease (CVD). However, epidemiologic data are not so evident to sustain the causative association between NAFLD and hypertension, the major cause of CVD. Accordingly, we designed this study to investigate the clinical association between NAFLD and the development of hypertension.
To assess the natural course of blood pressure according to degree of NAFLD (normal, mild, and moderate to severe), we conducted a prospective cohort study on the 22 090 Korean men without hypertension for 5 years. We serially checked the various metabolic factors including systolic and diastolic blood pressure in order to monitor the development of hypertension.
The incidence rate of hypertension increased according to the degree of NAFLD (normal: 14.4%, mild: 21.8%, moderate to severe: 30.1%, P < 0.001). Even after adjusting for other multiple covariates, the hazard ratios (95% confidence intervals) for hypertension were higher in the mild group (1.07; 1.00-1.15) and moderate to severe group (1.14; 1.00-1.30), compared with normal group, respectively (P for trend < 0.001).
Development of hypertension is more potentially associated with the more progressive NAFLD than normal or milder state. In addition, NAFLD was an independent risk factor for hypertension.
Full-text · Article · Jun 2014 · Journal of Gastroenterology and Hepatology
[Show abstract][Hide abstract] ABSTRACT: Eremias argus, which specifically inhabits riverside or coastal sand dune, is an endangered species designated by the Ministry of Environment of Korea because it has been drastically decreasing due to the destruction of habitat and the human activities. Therefore, it is required to prepare a countermeasure for the strategic and systematic solutions for the conservation of the E. argus. This study analyzed mtDNA cytochrome oxidase subunit I (COI) gene of E. argus inhabiting Yoobu-do island and Sohwang sand dune. This study aims to provide fundamental genetic information through phylogeographical analysis between two regions. Of 11 individuals of E. argus used in the analysis, the total 652~656 bp of mtDNA COI genes for 3 individuals of Takydromus wolteri as 'out group' were analyzed. Intraspecific genetic distance for E. argus was shown to be the same result of 0.000. As for T. wolteri, it was 0.005, showing very similar result. T. wolteri inhabiting Gapcheon stream in Daejeon metropolitan city was found to be the highest intraspecific genetic distance (0.008). The NJ tree of E. argus and T. wolteri indicated there was almost no genetic difference between habitat for E. argus. For T. wolteri, however, there was slight difference between the individuals inhabiting Yoobu-do island and those inhabiting Gapcheon stream in Daejeon metropolitan city. Therefore, it is necessary to prepare conservation strategies to increase genetic diversity of E. argus in Yoobu-do island in the future because it is highly presumed that the population of E. argus in Yoobu-do island have been flown from nearby coastal sand dune.
[Show abstract][Hide abstract] ABSTRACT: Stress is an area of research that has grown and diversified enormously since the early work of W. E. Cannon and Hans Selye. This development has been accompanied by an accelerated and renewed interest in instruments for evaluating stress and related factors. At present, the questionnaire method is the most popular for stress measurement. However, there is no consensus on how to measure stress because of the diverse scope of stress dynamic. There are many different kinds of questionnaires for measuring stress. And these questionnaires are different according to the various aspects, such as external stressors, individual's sense of control or coping, susceptibility, personality type, and subjective symptoms. Each questionnaire has its own drawbacks as a tool for measuring stress. Therefore choosing the appropriate instruments for evaluating stress objectively is a basic and crucial step for developing effective stress reduction strategies. Another important problem is that many of the questionnaires for measuring stress currently used in the field lack an appropriate cross-cultural adaptation process for the translated version and sufficient evidence of validity and reliability.
Preview · Article · Jun 2013 · Journal of the Korean Medical Association
[Show abstract][Hide abstract] ABSTRACT: The present report describes two chronic myelogenous leukemia (CML) patients with the JAK2-V617F mutation who were in complete hematologic and cytogenetic remission and subsequently developed clinical features of essential thrombocythemia under treatment with tyrosine kinase inhibitors. In light of the findings from previous reports, screening for the JAK2-V617F mutation should be considered for any Ph(+) CML patients with thrombocytosis, leukocytosis, or erythrocytosis at diagnosis and for patients who subsequently develop thrombocytosis, leukocytosis, or erythrocytosis during follow-up, even for CML patients in complete cytogenetic response and major molecular response.
No preview · Article · Apr 2013 · International journal of hematology
[Show abstract][Hide abstract] ABSTRACT: Unlabelled:
There have been several reports about the clinical association between type 2 diabetes mellitus (DM) and nonalcoholic fatty liver disease (NAFLD). However, most of the studies were about the unilateral effects of type 2 DM on NAFLD, and studies on the reverse relation are rare. Thus, this study was designed to investigate the effect of NAFLD on type 2 DM. We conducted a prospective cohort study on 25,232 Korean men without type 2 DM for 5 years. We serially checked the various metabolic factors including fasting glucose and hemoglobin A1c (HbA1c), and monitored the development of type 2 DM. The incidence rate of type 2 DM was compared according to the degree of NAFLD (normal, mild, and moderate to severe), and a Cox proportional hazards model was used to measure the hazard ratios (HRs) of NAFLD on type 2 DM. The incidence rate of type 2 DM increased according to the degree of NAFLD (normal: 7.0%, mild: 9.8%, moderate to severe: 17.8%, P < 0.001). Even after adjusting for other multiple covariates, the HRs (95% confidence interval [CI]) for type 2 DM development was higher in the mild group (1.09; 0.81-1.48) and moderate to severe group (1.73; 1.00-3.01) compared to the normal group, respectively (P for trend <0.001).
The development of type 2 DM is potentially more associated with more progressive NAFLD than a normal or milder state. In addition, NAFLD was an independent risk factor for the future development of type 2 DM. These results suggest the potential availability of NAFLD as an early predictor of type 2 DM.
[Show abstract][Hide abstract] ABSTRACT: Objectives:
There were many studies for the clinical association between non alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS). However, while most of studies have focused on the unilateral effects of MetS on NAFLD, studies for reverse association were comparatively rare. Therefore, we carried out a prospective cohort study to evaluate the longitudinal effects of NAFLD on the development of MetS according to the degree of NAFLD.
Patients and methods:
A total of 46,874 men, who had participated in a medical health check-up program in 2005, were enrolled in this study. Out of them, a Mets-free cohort of 11,926 without excluding conditions was followed up until 2010. All participants were classified into 3 groups by their NAFLD status (normal, mild, moderate to severe). The baseline values of metabolic components and the development rates of MetS were compared according to the degree of NAFLD. Cox proportional hazards model was used to measure the hazard ratios (HRs) for MetS according to the degree of NAFLD.
During 41,912.1 person-years of follow-up, 1861 incident cases of MetS developed between 2006 and 2010. Even after adjusting for multiple covariates, the HRs (95% CI) for MetS were higher in the mild group (1.49; 1.30-1.70) and moderate to severe group (2.00; 1.46-2.73) compared to normal group, respectively (P for trend <0.001). These associations were apparent in the clinically relevant subgroup analyses.
NAFLD was independent risk factor for MetS during the 5-yr follow-up period.
[Show abstract][Hide abstract] ABSTRACT: This retrospective study evaluated the transplantation outcomes of patients with adult lymphoid malignancies who received chemotherapy-based conditioning with busulfan and fludarabine (BuFlu) and busulfan and cyclophosphamide (BuCy2).
Thirty-eight patients (34 with acute lymphoblastic leukemia and 4 with lymphoblastic lymphoma) were included in the current study. The conditioning regimen was BuCy2 for 14 patients and BuFlu for the remaining 24 patients. Eight and 13 patients were high risk disease in the BuCy2 and BuFlu groups, respectively.
The cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) was 56.5% and 55.2% and that of extensive chronic GVHD 17.0% and 55.6% (p = 0.018) for the BuFlu and BuCy2 groups, respectively. The 3-year relapse rate was 27.8% and 31.4% and 3-year overall survival 34.3% and 46.8% for the BuFlu and BuCy2 groups, respectively. Treatment-related mortality (TRM) was significantly lower in the BuFlu group (16.9%) than in the BuCy2 group (57.1%, p = 0.010). In multivariate analyses, the BuFlu regimen was identified as an independent favorable risk factor for TRM (hazard ratio [HR], 0.036; p = 0.017) and extensive chronic GVHD (HR, 0.168; p = 0.034).
Our BuFlu regimen would appear to be an acceptable conditioning option for lymphoid malignancies, including high-risk diseases. It was safely administered with a lower TRM rate than BuCy2 conditioning.
Full-text · Article · Mar 2012 · The Korean Journal of Internal Medicine
[Show abstract][Hide abstract] ABSTRACT: Chronic widespread pain (CWP) is known as a common symptom of several organic and psychological disorders. Although medically unexplained CWP (MUE) has lots of clinical distress symptoms, there were no distinct symptoms or signs. Therefore, we conducted this study to investigate clinical distress symptoms of MUE distinct from those of medically explained CWP (ME).
One hundred nine patients with CWP were enrolled in the study. We classified the study subjects into three groups depending on their medical problems associated with CWP: organic group (ORG), psychological group (PSY), and MUE. All subjects were asked to fill out self-report questionnaires consisting of clinical distress scales including the Korean version of the Fibromyalgia Impact Questionnaire (FIQ-K), fatigue scale, depression scale, and stress scale. And physicians examined 18 tender points over their entire body of the subjects.
MUE patients had higher FIQ-K and fatigue severity scores than ORG patients (all P < 0.05). The average number of tender points were 11.33 in MUE patients, 6.48 in ORG patients and 5.02 in PSY patients and statistically significant (P < 0.0001). There were no statistically different factors between MUE and PSY patients with exception for the number of tender points. Depressive symptom was the highest in PSY patients but not statistically different from MUE patients.
MUE patients had higher physical impairments, fatigue severity and more number of tender points than ORG patients, but had no different clinical characteristics from PSY patients except for the number of tender points.
[Show abstract][Hide abstract] ABSTRACT: Background: In the primary care setting, compliance with lipid lowering therapy was relatively low. In order to compare the efficacy of a short messaging service (SMS) text messaging and postal reminder as means of improving attendance rates during the first 24 weeks of lipid-lowering therapy, a randomized controlled trial of 918 patients from 19 family practice clinics was conducted between February 2003 and June 2006. Methods: Patients were randomly assigned into 3 groups: SMS (327), postal (294),and control (297) group. To ascertain attendance rates, patients were followed up at 24 weeks after their treatment. Reminders were sent at 16 weeks from the coordinating center. Results: Overall attendance rate was 74.1%. This differed between groups, with 76.1% attendance for the SMS group, 73.5% for the postal group, and 72.4% for the control group. According to a multivariate analysis, the SMS group had a significantly higher attendance rate (Odds ratios [OR] 1.48; 95% confidence interval [CI], 1.01 to 2.16) than the control group, but the postal group (OR, 1.15; 95% CI, 0.79 to 1.69) did not. Moreover, the cost per attendance for the SMS reminder (155 Korean Won [KRW]) was much lower than that for the postal reminder (722 KRW). Conclusion: SMS reminder may be more cost saving method to improve the attendance rate compared with the postal reminder.
Full-text · Article · Apr 2010 · Korean Journal of Family Medicine
[Show abstract][Hide abstract] ABSTRACT: Cyclin-dependent kinases (CDKs) are involved in the regulation of the cell cycle and the growth of tumor cells. In this study, we investigated the antitumor effect and differentially expressed genes (DEGs) in head and neck cancer cells treated by a novel CDK inhibitor, 2-[1,1'-biphenyl]- 4-yl-N-[5-(1,1-dioxo-1lambda(6)-isothiazolidin-2-yl)-1H-indazol-3-yl] acetamide (BAI).
Cell growth was measured by XTT assay. Cell cycle and apoptosis were determined using flow cytometry. GeneFishing PCR was utilized to identify DEGs. Protein expression was analyzed by Western blot.
Exposure to BAI of 2 different head and neck cancer cell lines, AMC-HN4 and AMC-HN6, induced apoptosis in association with growth inhibition, cell cycle arrest, caspase-3 activation and cytochrome c release. Significantly, data from GeneFishing PCR experiments demonstrated 10 DEGs in AMC-HN6 cells treated with BAI. Some of these DEGs turned out to encode proteins with functions related to key cellular processes.
These results indicate that BAI has strong anticancer activities on head and neck cancer cells, and the DEGs induced by BAI may become involved in BAI-induced cancer cell death.
[Show abstract][Hide abstract] ABSTRACT: Background: It is well-known that patients with chronic fatigue or frequent pain seek complementary and alternative medicine therapies (CAT) in Western countries. We conducted this study to determine the pattern of CAT use and the factors related to CAT use in patients with chronic fatigue or pain in Korea. Methods: This was a cross-sectional study. The participants (n = 143) with chronic fatigue or pain completed a self-reported questionnaire including demographic characteristics and lifestyle as well as disease-related and CAT-related items. Results: The frequency of CAT use was 51.0% and 39.2% over the past 10 years and 1 year, respectively. The most common type of CAT used was herbal medicine. The therapeutic effects of the CAT were similar to physicians' prescriptions. CAT were most often used in combination with conventional medicine rather than alone. More than 70.0% of subjects did not consult their physicians for the use of CAT. The duration of illness, severity of fatigue and pain was signifi cantly related to the use of CAT. Conclusion: Many patients with chronic fatigue or pain use CAT. Most of these patients do not consult their physicians regarding CAT use.
Preview · Article · Mar 2009 · Korean Journal of Family Medicine
[Show abstract][Hide abstract] ABSTRACT: There have been many epidemiological and clinical researches on chronic fatigue (CF) and chronic fatigue syndrome (CFS) since the 1990s, but such studies have been quite limited in Korea. The aim of this study was to investigate the point prevalence of CF and CFS in patients who visited community-based eight primary care clinics in Korea. The study subjects were 1,648 patients aged 18 yr and over who visited one of eight primary care clinics in Korea between the 7th and 17th of May 2001. The physicians determined the status of the subjects through fatigue-related questionnaires, medical history, physical examination, and laboratory tests. The subjects were categorized into no fatigue, prolonged fatigue, CF and then CF were further classified to medically explained CF (Physical CF and Psychological CF) and medically unexplained CF (CFS and idiopathic chronic fatigue). The point prevalence of CF and CFS were 8.4% (95% CI 7.1-9.7%) and 0.6% (95% CI 0.2-1.0%). Medically explained CF was 80.5% of CF, of which 57.1% had psychological causes. The clinical characteristics of CFS were distinguished from explained CF. CF was common but CFS was rare in community-based primary care settings in Korea.
Preview · Article · Sep 2005 · Journal of Korean Medical Science
[Show abstract][Hide abstract] ABSTRACT: A microbial secondary metabolite, arisostatins A (As-A), was originally discovered as a substance carrying the antibiotic activity against Gram-positive bacteria and shown to possess potent anti-tumor properties. The mechanism by which arisostatins A initiates apoptosis remains poorly understood. In the present report we investigated the effect of arisostatins A on activation of the apoptotic pathway in HN-4 cells. Arisostatins A was shown to be responsible for the inhibition of HN-4 cell growth by inducing apoptosis. Treatment with 4 microM arisostatins A for 24h produced morphological features of apoptosis and DNA fragmentation in HN-4 cells. Arisostatins A caused dose-dependent apoptosis and DNA fragmentation of HN-4 cells used as a model. Treatment with caspase inhibitor significantly reduced the arisostatins A-induced caspase 3 activation. In addition, arisostatins A-induced apoptosis was associated with the generation of reactive oxygen species (ROS), which was prevented by an antioxidant NAC (N-acetyl-cysteine). These data indicate that cytotoxic effect of arisostatins A on HN-4 cells is attributable to the induced apoptosis and that arisostatins A-induced apoptosis is mediated by caspase-3 activation pathway, loss of mitochondrial transmembrane potential (DeltaPsi(m)), and release of cytochrome c into cytosol.
No preview · Article · Oct 2003 · Biochemical and Biophysical Research Communications
[Show abstract][Hide abstract] ABSTRACT: In order to assess the determinants of non-compliance with a lipid-lowering therapy, a prospective study of the hyperlipidemic Korean subjects was carried out.
A total of 1019 patients was observed by 46 family physicians for the period of 1 year from January 1999 to January 2000. To ascertain the compliance associated with a lipid lowering drug (Simvastatin), we regularly followed up the hyperlipidemic patients at intervals of 4, 12 and 24 weeks. The criterion for evaluating compliance is to measure clinic attendance. Using a structured questionnaire, patients and physicians were asked about risk factors for the compliance.
During the first 24 weeks of treatment, the lipid-lowering medication was continued by 52.3% and discontinued by 19.7%. The remaining 28% dropped out. Patient-related factors for non-compliance were young age, current smoker, lack of low fat diet and exercise, new user, no concomitant medication, and occurrence of adverse reactions. Physician-related factors for non-compliance were low patients' satisfaction with the physician, small number of hyperlipidemic patients per month and working in a relatively small hospital.
Compliance with the lipid-lowering therapy was relatively low and several factors for non-compliance were detected.
No preview · Article · Dec 2002 · Pharmacoepidemiology and Drug Safety