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1.  Age- and Sex-Specific Relationships between Household Income, Education, and Diabetes Mellitus in Korean Adults: The Korea National Health and Nutrition Examination Survey, 2008-2010 
PLoS ONE  2015;10(1):e0117034.
Background
To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults.
Methods
Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels.
Results
The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment). The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment). However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected.
Conclusions
We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations.
doi:10.1371/journal.pone.0117034
PMCID: PMC4306546  PMID: 25622031
2.  Immunohistochemical Expression of Dual-Specificity Protein Phosphatase 4 in Patients with Colorectal Adenocarcinoma 
The role of dual-specificity protein phosphatase 4 (DUSP4) appears to vary with the type of malignant tumors and is still controversial. The purpose of our study was to clarify the exact role of DUSP4 expression in colorectal adenocarcinoma. We constructed tissue microarrays and investigated DUSP4 expression by immunohistochemistry. DUSP4 was more frequently expressed in adenocarcinomas and lymph node/distant metastases compared to that in normal colorectal tissues and tubular adenomas (P < 0.001). Mean DUSP4 expression score was significantly higher in malignant tumors than in benign lesions (P < 0.001). DUSP4 expression was significantly correlated with older age (P = 0.017), male gender (P = 0.036), larger tumor size (P = 0.014), nonmucinous tumor type (P = 0.023), and higher T stage (P = 0.040). Kaplan-Meier survival curves revealed a significant effect of DUSP4 expression on both overall survival and disease-free survival in AJCC stage I (P = 0.008 and P = 0.003, resp., log-rank test) and male gender (P = 0.017 and P = 0.049, resp., log-rank test). DUSP4 protein is frequently upregulated in colorectal adenocarcinoma and may play an important role in carcinogenesis and cancer progression and may be a marker of adverse prognosis.
doi:10.1155/2015/283764
PMCID: PMC4320794
3.  Mechanisms of cell death pathway activation following drug-induced inhibition of mitochondrial complex I 
Redox Biology  2015;4:279-288.
Respiratory complex I inhibition by drugs and other chemicals has been implicated as a frequent mode of mitochondria-mediated cell injury. However, the exact mechanisms leading to the activation of cell death pathways are incompletely understood. This study was designed to explore the relative contributions to cell injury of three distinct consequences of complex I inhibition, i.e., impairment of ATP biosynthesis, increased formation of superoxide and, hence, peroxynitrite, and inhibition of the mitochondrial protein deacetylase, Sirt3, due to imbalance of the NADH/NAD+ ratio. We used the antiviral drug efavirenz (EFV) to model drug-induced complex I inhibition. Exposure of cultured mouse hepatocytes to EFV resulted in a rapid onset of cell injury, featuring a no-effect level at 30 µM EFV and submaximal effects at 50 µM EFV. EFV caused a concentration-dependent decrease in cellular ATP levels. Furthermore, EFV resulted in increased formation of peroxynitrite and oxidation of mitochondrial protein thiols, including cyclophilin D (CypD). This was prevented by the superoxide scavenger, Fe-TCP, or the peroxynitrite decomposition catalyst, Fe-TMPyP. Both ferroporphyrins completely protected from EFV-induced cell injury, suggesting that peroxynitrite contributed to the cell injury. Finally, EFV increased the NADH/NAD+ ratio, inhibited Sirt3 activity, and led to hyperacetylated lysine residues, including those in CypD. However, hepatocytes isolated from Sirt3-null mice were protected against 40 µM EFV as compared to their wild-type controls. In conclusion, these data are compatible with the concept that chemical inhibition of complex I activates multiple pathways leading to cell injury; among these, peroxynitrite formation may be the most critical.
Highlights
•The antiviral drug efavirenz (EFV) induces complex I inhibition.•Complex I inhibition causes ATP depletion, ROS/RNS formation, and Sirt3 inhibition.•Iron porphyrins protect hepatocytes against EFV-induced lethal injury.•Genetic ablation of Sirt3 (Sirt3−/− mice) protects against EFV toxicity.•Peroxynitrite formation is a major mechanism of mitochondria-mediated cell injury.
doi:10.1016/j.redox.2015.01.005
PMCID: PMC4315936  PMID: 25625582
Sirt3; Efavirenz; Complex I inhibition; Mitochondria; Peroxynitrite; Drug-induced liver injury (DILI); CBA, coumarin-7-boronic acid; CYP, cytochrome P450; CypD, cyclophilin D; ETC, electron transport chain; Fe-TCP, Fe(III) tetrakis(4-carboxyphenyl) porphyrin; Fe-TMPyP, Fe(III) tetrakis(1-methyl-4-pyridyl) porphyrin; MitoSOX Red, mitochondria-targeted dihydroethidine; mPT, mitochondrial permeability transition; NQR, NADH:ubiquinone oxidoreductase; OXPHOS, oxidative phosphorylation; ROS, reactive oxygen species
4.  The Neural Correlates of the Face Attractiveness Aftereffect: A Functional Near-infrared Spectroscopy (fNIRS) Study 
NeuroImage  2013;85(0 1):10.1016/j.neuroimage.2013.04.092.
Extensive behavioral evidence shows that our internal representation of faces, or face prototype, can be dynamically updated by immediate experience. This is illustrated by the robust attractiveness aftereffect phenomenon whereby originally unattractive faces become attractive after we are exposed to a set of unattractive faces. Although behavioral evidence suggests this effect to have a strong neural basis, limited neuroimaging evidence exists. Here we used functional near-infrared spectroscopy methodology (fNIRS) to bridge this gap. During the pre-adaptation trials, participants judged the attractiveness of three sets of faces: normal/undistorted faces, compressed faces (the internal features and distances between them were compressed), and expanded faces (the internal features and distances between them were stretched). Then, participants were shown extremely compressed faces for 5 minutes as adaptation stimuli, after which participants judged the same three sets of faces in post-adaptation trials. Behaviorally, after the adaptation trials, participants rated the compressed faces more attractive whereas they judged the other two sets of faces as less attractive, replicating the robust adaptation effect. fNIRS results showed that short-term exposure to compressed faces led to significant decreases in neural activity to all face types, but in a more extended network of cortical regions in the frontal and occipital cortexes for undistorted faces. Taken together, these findings suggest that the face attractiveness aftereffect mainly reflects changes in the neural representation of the face prototype in response to recent exposures to new face exemplars.
doi:10.1016/j.neuroimage.2013.04.092
PMCID: PMC3795914  PMID: 23648964
face processing; face perception; fNIRS; attractiveness aftereffects; norm-based
5.  Neural correlates of own- and other-race face recognition in children: A functional near-infrared spectroscopy study 
NeuroImage  2013;85(0 1):10.1016/j.neuroimage.2013.07.051.
The present study used the functional Near-infrared Spectroscopy (fNIRS) methodology to investigate the neural correlates of elementary school children’s own- and other-race face processing. An old-new paradigm was used to assess children’s recognition ability of own- and other-race faces. FNIRS data revealed that other-race faces elicited significantly greater [oxy-Hb] changes than own-race faces in the right middle frontal gyrus and inferior frontal gyrus regions (BA9) and the left cuneus (BA18). With increased age, the [oxy-Hb] activity differences between own- and other-race faces, or the neural other-race effect (NORE), underwent significant changes in these two cortical areas: at younger ages, the neural response to the other-race faces was modestly greater than that to the own-race faces, but with increased age, the neural response to the own-race faces became increasingly greater than that to the other-race faces. Moreover, these areas had strong regional functional connectivity with a swath of the cortical regions in terms of the neural other-race effect that also changed with increased age. We also found significant and positive correlations between the behavioral other-race effect (reaction time) and the neural other-race effect in the right middle frontal gyrus and inferior frontal gyrus regions (BA9). These results taken together suggest that children, like adults, devote different amounts of neural resources to processing own- and other-race faces, but the size and direction of the neural other-race effect and associated functional regional connectivity change with increased age.
doi:10.1016/j.neuroimage.2013.07.051
PMCID: PMC3859716  PMID: 23891903
fNIRS; face processing; face recognition; the other-race effect; own-race or other-race face recognition; functional connectivity; children; development
6.  Clinical Implications of Microsatellite Instability in T1 Colorectal Cancer 
Yonsei Medical Journal  2014;56(1):175-181.
Purpose
The estimation of regional lymph node metastasis (LNM) risk in T1 colorectal cancer is based on histologic examination and imaging of the primary tumor. High-frequency microsatellite instability (MSI-H) is likely to decrease the possibility of metastasis to either regional lymph nodes or distant organs in colorectal cancers. This study evaluated the clinical implications of MSI in T1 colorectal cancer with emphasis on the usefulness of MSI as a predictive factor for regional LNM.
Materials and Methods
A total of 133 patients who underwent radical resection for T1 colorectal cancer were included. Genomic DNA was extracted from normal and tumor tissues and amplified by polymerase chain reaction (PCR). Five microsatellite markers, BAT-25, BAT-26, D2S123, D5S346, and D17S250, were used. MSI and clinicopathological parameters were evaluated as potential predictors of LNM using univariate and multivariate analyses.
Results
Among 133 T1 colorectal cancer patients, MSI-H, low-frequency microsatellite instability (MSI-L), and microsatellite stable (MSS) colorectal cancers accounted for 7.5%, 6%, and 86.5%, respectively. MSI-H tumors showed a female predominance, a proximal location and more retrieved lymph nodes. Twenty-two patients (16.5%) had regional LNM. Lymphovascular invasion and depth of invasion were significantly associated with LNM. There was no LNM in 10 MSI-H patients; however, MSI status was not significantly correlated with LNM. Disease-free survival did not differ between patients with MSI-H and those with MSI-L/MSS.
Conclusion
MSI status could serve as a negative predictive factor in estimating LNM in T1 colorectal cancer, given that LNM was not detected in MSI-H patients. However, validation of our result in a different cohort is necessary.
doi:10.3349/ymj.2015.56.1.175
PMCID: PMC4276753  PMID: 25510762
Microsatellite instability; lymph node metastasis; early colorectal cancer; T1; prognosis
7.  Epidemiology of Trauma Patients and Analysis of 268 Mortality Cases: Trends of a Single Center in Korea 
Yonsei Medical Journal  2014;56(1):220-226.
Purpose
There is an increasing incidence of mortality among trauma patients; therefore, it is important to analyze the trauma epidemiology in order to prevent trauma death. The authors reviewed the trauma epidemiology retrospectively at a regional emergency center of Korea and evaluated the main factors that led to trauma-related deaths.
Materials and Methods
A total of 17007 trauma patients were registered to the trauma registry of the regional emergency center at Wonju Severance Christian Hospital in Korea from January 2010 to December 2012.
Results
The mean age of patients was 35.2 years old. The most frequent trauma mechanism was blunt injury (90.8%), as well as slip-and-fall down injury, motor vehicle accidents, and others. Aside from 142 early trauma deaths, a total of 4673 patients were admitted for further treatment. The most common major trauma sites of admitted patients were on the extremities (38.4%), followed by craniocerebral, abdominopelvis, and thorax. With deaths of 126 patients during in-hospital treatment, the overall mortality (142 early and 126 late deaths) was 5.6% for admitted patients. Ages ≥55, injury severity score ≥16, major craniocerebral injury, cardiopulmonary resuscitation at arrival, probability of survival <25% calculated from the trauma and injury severity score were independent predictors of trauma mortality in multivariate analysis.
Conclusion
The epidemiology of the trauma patients studied was found to be mainly blunt trauma. This finding is similar to previous papers in terms of demographics and mechanism. Trauma patients who have risk factors of mortality require careful management in order to prevent trauma-related deaths.
doi:10.3349/ymj.2015.56.1.220
PMCID: PMC4276759  PMID: 25510768
Trauma; epidemiology; mortality; injury severity score; predictor
8.  Dovitinib (TKI258), a multi-target angiokinase inhibitor, is effective regardless of KRAS or BRAF mutation status in colorectal cancer 
Introduction: We aimed to determine whether KRAS and BRAF mutant colorectal cancer (CRC) cells exhibit distinct sensitivities to the multi-target angiokinase inhibitor, TKI258 (dovitinib). Materials and methods: We screened 10 CRC cell lines by using receptor tyrosine kinase (RTK) array to identify activated RTKs. MTT assays, anchorage-independent colony-formation assays, and immunoblotting assays were performed to evaluate the in vitro anti-tumor effects of TKI258. In vivo efficacy study followed by pharmacodynamic evaluation was done. Results: Fibroblast Growth Factor Receptor 1 (FGFR1) and FGFR3 were among the most highly activated RTKs in CRC cell lines. In in vitro assays, the BRAF mutant HT-29 cells were more resistant to the TKI258 than the KRAS mutant LoVo cells. However, in xenograft assays, TKI258 equally delayed the growth of tumors induced by both cell lines. TUNEL assays showed that the apoptotic index was unchanged following TKI258 treatment, but staining for Ki-67 and CD31 was substantially reduced in both xenografts, implying an anti-angiogenic effect of the drug. TKI258 treatment was effective in delaying CRC tumor growth in vivo regardless of the KRAS and BRAF mutation status. Conclusions: Our results identify FGFRs as potential targets in CRC treatment and suggest that combined targeting of multiple RTKs with TKI258 might serve as a novel approach to improve outcome of patients with CRC.
PMCID: PMC4300687  PMID: 25628921
Colorectal cancer; FGFR; KRAS; BRAF; Dovitinib (TKI258); multi-target angiokinase inhibitor
9.  Comparative study of SoxR activation by redox-active compounds 
Molecular microbiology  2013;90(5):10.1111/mmi.12410.
Summary
SoxR from E. coli and related enterobacteria is activated by a broad range of redox-active compounds through oxidation or nitrosylation of its [2Fe-2S] cluster. Activated SoxR then induces SoxS, which subsequently activates more than 100 genes in response. In contrast, non-enteric SoxRs directly activate their target genes in response to redox-active compounds that include endogenously produced metabolites. We compared the responsiveness of SoxRs from Streptomyces coelicolor (ScSoxR), Pseudomonas aeruginosa (PaSoxR) and E. coli (EcSoxR), all expressed in S. coelicolor, toward natural or synthetic redox-active compounds. EcSoxR responded to all compounds examined, whereas ScSoxR was insensitive to oxidants such as paraquat (Eh −440 mV) and menadione sodium bisulfite (Eh −45 mV) and to NO generators. PaSoxR was insensitive only to some NO generators. Whole cell EPR analysis of SoxRs expressed in E. coli revealed that the [2Fe-2S]1+ of ScSoxR was not oxidizable by paraquat, differing from EcSoxR and PaSoxR. The mid-point redox potential of purified ScSoxR was determined to be −185 ± 10 mV, higher by ~100 mV than those of EcSoxR and PaSoxR, supporting its limited response to paraquat. The overall sensitivity profile indicates that both redox potential and kinetic reactivity determine the differential responses of SoxRs toward various oxidants.
doi:10.1111/mmi.12410
PMCID: PMC3872530  PMID: 24112649
SoxR; Fe-S; redox-active compounds; EPR; Redox potential
10.  Influence of Panax ginseng on Alpha-Adrenergic Receptor of Benign Prostatic Hyperplasia 
Purpose
Benign prostatic hyperplasia (BPH) is the most common prostate problem in older men. The present study aimed to investigate the inhibitory effect of Panax ginseng C.A. Meyer (P. ginseng) on a rat model of testosterone-induced BPH.
Methods
The rats were divided into 3 groups (each group, n=10): control, testosterone-induced BPH (20 mg/kg, subcutaneous injection), and P. ginseng (200 mg/kg, orally) groups. After 4 weeks, all animals were sacrificed to examine the blood biochemical profiles, prostate volume, weight, histopathological changes, alpha-1D adrenergic receptor (Adra1d) mRNA expression, and epidermal growth factor receptor (EGFR) and B-cell CLL/lymphoma 2 (BCL2) protein expression.
Results
The group treated with P. ginseng showed significantly lesser prostate size and weight than the testosterone-induced BPH group. In addition, P. ginseng decreased the mRNA expression of Adra1d as well as the expression of EGFR and BCL2 in prostate tissue.
Conclusions
These results suggest that P. ginseng may inhibit the alpha-1-adrenergic receptor to suppress the development of BPH.
doi:10.5213/inj.2014.18.4.179
PMCID: PMC4280437  PMID: 25558416
Prostatic Hyperplasia; Receptors, Adrenergic, alpha-1; Panax; Testosterone
11.  First Report of the Ash Dieback Pathogen Hymenoscyphus fraxineus in Korea 
Mycobiology  2014;42(4):391-396.
In the past two decades, European ash trees (Fraxinus spp.) have been severely damaged due to ash dieback disease, which is caused by the fungal species Hymenoscyphus fraxineus (Chalara fraxinea in the anamorphic stage). Recent molecular phylogenetic and population genetic studies have suggested that this fungus has been introduced from Asia to Europe. During a fungal survey in Korea, H. fraxineus-like apothecia were collected from fallen leaves, rachises, and petioles of Korean ash and Manchurian ash trees. The morphological and ecological traits of these materials are described with the internal transcribed spacer rDNA sequence comparison of H. fraxineus strains collected from Korea, China and Japan.
doi:10.5941/MYCO.2014.42.4.391
PMCID: PMC4298844  PMID: 25606012
Ash dieback; Chalara fraxinea; Hymenoscyphus fraxineus; Korean ash; Manchurian ash
12.  Thermal Characteristics and Bacterial Diversity of Forest Soil in the Haean Basin of Korea 
The Scientific World Journal  2014;2014:247401.
To predict biotic responses to disturbances in forest environments, it is important to examine both the thermophysical properties of forest soils and the diversity of microorganisms that these soils contain. To predict the effects of climate change on forests, in particular, it is essential to understand the interactions between the soil surface, the air, and the biological diversity in the soil. In this study, the temperature and thermal properties of forest soil at three depths at a site in the Haean basin of Korea were measured over a period of four months. Metagenomic analyses were also carried out to ascertain the diversity of microorganisms inhabiting the soil. The thermal diffusivity of the soil at the study site was 5.9 × 10−8 m2·s−1. The heat flow through the soil resulted from the cooling and heating processes acting on the surface layers of the soils. The heat productivity in the soil varied through time. The phylum Proteobacteria predominated at all three soil depths, with members of Proteobacteria forming a substantial fraction (25.64 to 39.29%). The diversity and richness of microorganisms in the soil were both highest at the deepest depth, 90 cm, where the soil temperature fluctuation was the minimum.
doi:10.1155/2014/247401
PMCID: PMC4241682  PMID: 25431780
13.  The Functional Architecture for Face-processing Expertise: FMRI Evidence of the Developmental Trajectory of the Core and the Extended Face Systems 
Neuropsychologia  2013;51(13):10.1016/j.neuropsychologia.2013.08.005.
Expertise in processing faces is a cornerstone of human social interaction. However, the developmental course of many key brain regions supporting face preferential processing in the human brain remains undefined. Here, we present findings from an FMRI study using a simple viewing paradigm of faces and objects in a continuous age sample covering the age range from 6 years through adulthood. These findings are the first to use such a sample paired with whole-brain FMRI analyses to investigate development within the core and extended face networks across the developmental spectrum from middle childhood to adulthood. We found evidence, albeit modest, for a developmental trend in the volume of the right fusiform face area (rFFA) but no developmental change in the intensity of activation. From a spatial perspective, the middle portion of the right fusiform gyrus most commonly found in adult studies of face processing was increasingly likely to be included in the FFA as age increased to adulthood. Outside of the FFA, the most striking finding was that children hyperactivated nearly every aspect of the extended face system relative to adults, including the amygdala, anterior temporal pole, insula, inferior frontal gyrus, anterior cingulate gyrus, and parietal cortex. Overall, the findings suggest that development is best characterized by increasing modulation of face-sensitive regions throughout the brain to engage only those systems necessary for task requirements.
doi:10.1016/j.neuropsychologia.2013.08.005
PMCID: PMC3825803  PMID: 23948645
Functional MRI; Brain Development; Fusiform Face Area: Face Processing Expertise; Core and Extended Face Networks
14.  Underweight Body Mass Index as a Predictive Factor for Surgical Site Infections after Laparoscopic Appendectomy 
Yonsei Medical Journal  2014;55(6):1611-1616.
Purpose
Analyses of risk factors associated with surgical site infections (SSIs) after laparoscopic appendectomy (LA) have been limited. Especially, the association of an underweight body mass index (BMI) with SSIs has not been clearly defined. This study aimed to identify the impact of underweight BMI in predicting SSIs after LA.
Materials and Methods
The records of a total of 101 consecutive patients aged ≥16 years who underwent LA by a single surgeon between March 2011 and December 2012 were retrieved from a prospectively collected database. The rate of SSIs was compared among the underweight, normal and overweight and obese groups. Also, univariate and multivariate analyses were performed to identify the factors associated with SSIs.
Results
The overall rate of SSIs was 12.8%. The superficial incisional SSI rate was highest in the underweight group (44.4% in the underweight group, 11.0% in the normal group, and 0% in the overweight and obese group, p=0.006). In univariate analysis, open conversion and being underweight were determined to be risk factors for SSIs. Underweight BMI was also found to be a significant predictor for SSIs in multivariate analysis (odds ratio, 10.0; 95% confidence interval, 2.0-49.5; p=0.005).
Conclusion
This study demonstrated underweight BMI as being associated with SSIs after LA. Surgeons should be more cautious to prevent SSIs in patients that are underweight when performing LA.
doi:10.3349/ymj.2014.55.6.1611
PMCID: PMC4205702  PMID: 25323899
Appendicitis; laparoscopic appendectomy; surgical site infection; body mass index; morbidity
15.  Tumor-associated macrophages in stage IIIA pN2 non-small cell lung cancer after neoadjuvant chemotherapy and surgery 
Purpose: Most of the patients with stage IIIA pN2 non-small cell lung cancer (NSCLC) develop recurrence after surgery. It is not clear whether post neoadjuvant chemotherapy tumor-associated macrophages is associated with recurrence. Patients and Methods: Stage IIIA pN2 NSCLC patients underwent cisplatin/docetaxel neoadjuvant chemotherapy and surgery were retrospectively enrolled. Immunohistochemical staining of CD68 was used to identify macrophages in surgical resected stored tissues. Results: The objective response rate of cisplatin/docetaxel was 68%, overall median disease-free survival (DFS) was 13.1 months and median overall survival (OS) 36.8. months. Multiple Cox regression analysis showed low total macrophage numbers and mediastinal lymph nodes downstaging were independent factors for longer DFS, whereas high islet/stromal macrophages ratio was an independent facto for OS. In patients downstaged to pN0, low total macrophage numbers was also associated with longer DFS. Conclusions: Low total macrophage number is an independent factor for better DFS in pN2 stage IIIA NSCLC patients receiving neoadjuvant chemotherapy and surgical resection, which association was kept in those downstaged to pN0. Further studies are warrant to confirm the predictive role of TAMs and their potential causative role in tumor recurrence.
PMCID: PMC4212933  PMID: 25360223
Lung cancer biology; immunochemistry; immunology
16.  Serum homocysteine levels are correlated with behavioral and psychological symptoms of Alzheimer’s disease 
Purpose
Homocysteine has been associated with cognitive impairment and various psychiatric symptoms. This study was designed to clarify whether a relationship exists between the serum levels of homocysteine and the behavioral and psychological symptoms of dementia.
Methods
Patients with Alzheimer’s disease (n=77) and control subjects (n=37) were included in this study. History taking, physical examination, and cognitive assessment were carried out as part of the investigation for the diagnosis of Alzheimer’s disease based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The Mini-Mental State Examination, Global Deterioration Scale, Clinical Dementia Rating, and the Korean version of the Neuropsychiatric Inventory were applied to all patients. The patients’ serum homocysteine, folate, and vitamin B12 levels were measured.
Results
Patients with Alzheimer’s disease had statistically significantly lower Mini-Mental State Examination scores and higher serum homocysteine levels compared to the control subjects. Mean serum folate and vitamin B12 concentration were significantly lower in patients with Alzheimer’s disease compared to control subjects. A statistically significant positive correlation was found between the serum homocysteine levels and the Neuropsychiatric Inventory subdomains, including delusion, agitation/aggression, depression/dysphoria, elation/euphoria, apathy/indifference, and disinhibition. No statistically significant correlation was found between the serum homocysteine concentration and the Mini-Mental State Examination, Global Deterioration Scale, or Clinical Dementia Rating.
Conclusion
Associations between the serum homocysteine levels and behavioral and psychological symptoms of dementia were observed, raising the possibility of an etiological role. However, the correlations between the folate or vitamin B12 levels and the Neuropsychiatric Inventory scores were not significant. The pathophysiological mechanisms underlying these findings remain to be elucidated. This was a cross-sectional study and the findings should be confirmed by repetitive, prospective longitudinal studies in a larger group of patients with neurodegenerative disorders.
doi:10.2147/NDT.S68980
PMCID: PMC4200070  PMID: 25336954
Alzheimer’s disease; homocysteine; behavioral and psychological symptoms of dementia (BPSD)
17.  Elastic facial movement influences part-based but not holistic processing 
Face processing has been studied for decades. However, most of the empirical investigations have been conducted using static face images as stimuli. Little is known about whether static face processing findings can be generalized to real world contexts, in which faces are constantly moving. The present study investigates the nature of face processing (holistic vs. part-based) in elastic moving faces. Specifically, we focus on whether elastic moving faces, as compared to static ones, can facilitate holistic or part-based face processing. Using the composite paradigm, participants were asked to remember either an elastic moving face (i.e., a face that blinks and chews) or a static face, and then tested with a static composite face. The composite effect was (1) significantly smaller in the dynamic condition than in the static condition, (2) consistently found with different face encoding times (Experiments 1–3), and (3) present for the recognition of both upper and lower face parts (Experiment 4). These results suggest that elastic facial motion facilitates part-based processing, rather than holistic processing. Thus, while previous work with static faces has emphasized an important role for holistic processing, the current work highlights an important role for featural processing with moving faces.
doi:10.1037/a0031631
PMCID: PMC3889867  PMID: 23398253
elastic facial movement; holistic processing; part-based processing; composite face paradigm
18.  Use of a Hyaluronic Acid-Carboxymethylcellulose Adhesion Barrier on the Neurovascular Bundle and Prostatic Bed to Facilitate Earlier Recovery of Erectile Function After Robot-Assisted Prostatectomy: An Initial Experience 
Journal of Endourology  2013;27(10):1230-1235.
Abstract
Purpose
To investigate the efficacy of hyaluronic acid-carboxymethylcellulose (HACM) in facilitating early recovery of erectile function (EF) after radical prostatectomy, we report our initial experience of HACM use on the neurovascular bundle (NVB) after robot-assisted radical prostatectomy (RARP).
Patients and Methods
Between 2008 and 2010, 459 consecutive patients who underwent RARP with bilateral nerve-sparing technique were included in this study. Patients were classified into two groups: HACM (group 1; n=162) and non-HACM (group 2; n=287). HACM was delivered to the anatomic location of the NVB after prostate removal. We retrospectively analyzed the surgical outcomes including EF, continence, and perioperative complications.
Results
At 6 months after surgery, EF recovery rate was 28.5% in group 1 and 17.4% in group 2 (P=0.006). In a subgroup analysis consisting of 225 patients with a preoperative International Index of Erectile Function Short Survey (IIEF)-5 score ≥20, the difference in EF recovery at 6 months was significant with 62.8% in group 1 and 27.0% in group 2 (P=0.002), respectively. HACM use was an independent predictor for EF recovery at 6 months after surgery (odds ratio, 2.735; 95% confidence interval, 1.613–4.638; P<0.001). Age and preoperative IIEF-5 were also independent predictors. No differences in continence at 6 months or perioperative complications were found between the two groups. EF recovery was not different between the two groups after 18 months.
Conclusions
HACM use around the NVBs is safe and facilitates early recovery of EF after nerve-sparing RARP. HACM use is more effective in patients with normal preoperative sexual function.
doi:10.1089/end.2013.0345
PMCID: PMC3787401  PMID: 23879531
19.  REViewer: A tool for linear visualization of repetitive elements within a sequence query 
Genomics  2013;102(4):10.1016/j.ygeno.2013.07.008.
A species-specific population of arrangements of repetitive elements (REs), called RE arrays, exists in the human and mouse genomes. We developed an RE analytical tool, named REViewer, for visualizing RE occurrences within RE arrays and other genomic regions as an interactive line map. REViewer utilizes an RE reference library which is established with two RE types: 1) REMiner-generated undefined REs and 2) RepeatMasker-derived defined REs. RE occurrences within queries are visualized as a line map using these two RE types. The REViewer’s controller provides analytical options, such as zoom, customization of axis unit, and RE type selection. The functionality of REViewer was evaluated using the human chromosome Y sequence. The REViewer is determined to be an efficient tool that facilitates visualization of up to 6000 REs in RE arrays and other genomic regions. The maximum query size is linked to the RE mining tools (e.g., REMiner, RepeatMasker), not to REViewer.
doi:10.1016/j.ygeno.2013.07.008
PMCID: PMC3819206  PMID: 23891933
20.  Long-Term Clinical Outcomes of Korean Patient With Crohn's Disease Following Early Use of Infliximab 
Intestinal Research  2014;12(4):281-286.
Background/Aims
Several recent studies have reported that the early use of infliximab (IFX) improves the prognosis of Crohn's disease (CD). However, no data are available from Asian populations, as the forementioned studies have all been conducted in Western countries. The aim of the current study was to evaluate the impact of early use of IFX on the prognosis of Korean patients with CD.
Methods
Patients with a diagnosis of CD established between July 1987 and January 2012 were investigated in 12 university hospitals in Korea. Because insurance coverage for IFX treatment began in August 2005, patients were assigned to either of 2 groups based on diagnosis date. The first group included patients diagnosed from July 1987 to December 2005, and the second from January 2006 to January 2012. We compared the cumulative probabilities of operation and reoperation between the two groups using the Kaplan-Meier method and a log-rank test.
Results
Of the 721 patients investigated, 443 (61.4%) comprized the second group. Although the cumulative probabilities of immunosuppressant (P<0.001) and IFX use (P<0.001) after diagnosis were significantly higher in the second group, there were no significant differences in cumulative probabilities of operation (P=0.905) or reoperation (P=0.418) between two groups.
Conclusions
The early use of IFX did not reduce CD-related surgery requirements in Korean patients with CD. These study results suggest that the early use of IFX may have little impact on the clinical outcome of CD in Korean patients in the setting of a conventional step-up algorithm.
doi:10.5217/ir.2014.12.4.281
PMCID: PMC4214954  PMID: 25374493
Crohn disease; Infliximab; Prognosis
21.  Artemisinin attenuates platelet-derived growth factor BB-induced migration of vascular smooth muscle cells 
Nutrition Research and Practice  2014;8(5):521-525.
BACKGROUND/OBJECTIVES
Artemisinin (AT), an active compound in Arternisia annua, is well known as an anti-malaria drug. It is also known to have several effects including anti-oxidant, anti-inflammation, and anti-cancer activities. To date, the effect of AT on vascular disorders has not been studied. In this study, we investigated the effects of AT on the migration and proliferation of vascular smooth muscle cells (VSMC) stimulated by platelet-derived growth factor BB (PDGF-BB).
MATERIALS/METHODS
Aortic smooth muscle cells were isolated from Sprague-Dawley rats. PDGF-BB stimulated VSMC migration was measured by the scratch wound healing assay and the Boyden chamber assay. Cell viability was determined by using an EZ-Cytox Cell Viability Assay Kit. The production of reactive oxygen species (ROS) in PDGF-BB stimulated VSMC was measured through H2DCF-DA staining. We also determined the expression levels of signal proteins relevant to ROS, including measures of extracellular signal-regulated kinase (ERK) 1/2 measured by western blot analysis and matrix metalloproteinase (MMP) 9 measured by reverse transcription-polymerase chain reaction (RT-PCR).
RESULTS
AT (10 µM and 30 µM) significantly reduced the proliferation and migration of PDGF-BB stimulated VSMC in a dose-dependent manner. The production of ROS, normally induced by PDGF-BB, is reduced by treatment with AT at both concentrations. PDGF-BB stimulated VSMC treated with AT (10 µM and 30 µM) have reduced phosphorylation of ERK1/2 and inhibited MMP9 expression compared to untreated PDGF-BB stimulated VSMC.
CONCLUSIONS
We suggest, based on these results, that AT may exert an anti-atherosclerotic effect on PDGF-BB stimulated VSMCs by inhibiting their proliferation and migration through down-regulation of ERK1/2 and MMP9 phosphorylation.
doi:10.4162/nrp.2014.8.5.521
PMCID: PMC4198964  PMID: 25324931
Artemisinin; vascular smooth muscle cells; platelet-derived growth factor-BB; ERK1/2; MMP9
22.  Investigation of the effect of the structure of large-area carbon nanotube/fuel composites on energy generation from thermopower waves 
Nanoscale Research Letters  2014;9(1):536.
Thermopower waves are a recently developed energy conversion concept utilizing dynamic temperature and chemical potential gradients to harvest electrical energy while the combustion wave propagates along the hybrid layers of nanomaterials and chemical fuels. The intrinsic properties of the core nanomaterials and chemical fuels in the hybrid composites can broadly affect the energy generation, as well as the combustion process, of thermopower waves. So far, most research has focused on the application of new core nanomaterials to enhance energy generation. In this study, we demonstrate that the alignment of core nanomaterials can significantly influence a number of aspects of the thermopower waves, while the nanomaterials involved are identical carbon nanotubes (CNTs). Diversely structured, large-area CNT/fuel composites of one-dimensional aligned CNT arrays (1D CNT arrays), randomly oriented CNT films (2D CNT films), and randomly aggregated bulk CNT clusters (3D CNT clusters) were fabricated to evaluate the energy generation, as well as the propagation of the thermal wave, from thermopower waves. The more the core nanostructures were aligned, the less inversion of temperature gradients and the less cross-propagation of multiple thermopower waves occurred. These characteristics of the aligned structures prevented the cancellation of charge carrier movements among the core nanomaterials and produced the relative enhancement of the energy generation and the specific power with a single-polarity voltage signal. Understanding this effect of structure on energy generation from thermopower waves can help in the design of optimized hybrid composites of nanomaterials and fuels, especially designs based on the internal alignment of the materials. More generally, we believe that this work provides clues to the process of chemical to thermal to electrical energy conversion inside/outside hybrid nanostructured materials.
doi:10.1186/1556-276X-9-536
PMCID: PMC4183947  PMID: 25285059
Carbon nanotube; Alignment of nanostructures; Thermopower waves; Combustion; Energy conversion
23.  Crohn's disease in Korea: past, present, and future 
The epidemiology, genetics, and clinical manifestations of Crohn's disease (CD) vary considerably among geographic areas and ethnic groups. Thus, identifying the characteristics of Korean CD is important for establishing management strategies appropriate for Korean patients. Since the mid-2000s, many studies have investigated the characteristic features of Korean CD. The incidence and prevalence rates of CD have been increasing rapidly in Korea, especially among the younger population. Unlike Western data, Korean CD shows a male predominance and a lower proportion of isolated colonic disease. Perianal lesions are more prevalent than in Western countries. Genome-wide association studies have confirmed that genetic variants in TNFSF15, IL-23R, and IRGM, but not ATG16L1, are associated with CD susceptibility in the Korean population. Studies of the associations between genetic mutations and the clinical course of CD are underway. Although it has been generally accepted that the clinical course of Korean CD is milder than that in Western countries, recent studies have shown a comparable rate of intestinal resection in Korean and Western CD patients. An ongoing nationwide, hospital-based cohort study is anticipated to provide valuable information on the natural history and prognosis of Korean CD in the near future.
doi:10.3904/kjim.2014.29.5.558
PMCID: PMC4164717  PMID: 25228829
Crohn disease; Epidemiology; Genetics; Prognosis; Korea
24.  Preoperative colonoscopy through the colonic stent in patients with colorectal cancer obstruction 
World Journal of Gastroenterology : WJG  2014;20(30):10570-10576.
AIM: To evaluate the feasibility of a preoperative colonoscopy through a self-expendable metallic stent (SEMS) and to identify the factors that affect complete colonoscopy.
METHODS: A total of 48 patients who had SEMS placement because of acute malignant colonic obstruction underwent preoperative colonoscopy. After effective SEMS placement, patients who showed complete resolution of radiological findings and clinical signs of acute colon obstruction underwent a standard bowel preparation. Preoperative colonoscopy was then performed using a standard colonoscope. If the passage of colonoscope was not feasible gastroscope was used. After colonoscopy, cecal intubation time, grade of bowel preparation, tumor location, stent location, presence of synchronous polyps or cancer, damage to colonoscopy and bleeding, and stent migration after colonoscopy were recorded.
RESULTS: Complete evaluation with colonoscope was possible in 30 patients (62.5%). In this group, adenoma was detected in 13 patients (43.3%). The factors that affected complete colonoscopy were also analyzed: Tumor location at an angle; stent placement at an angle; and stent expansion diameter, which affected complete colonoscopy significantly. However in multivariate analysis, stent expansion diameter was the only significant factor that affected complete colonoscopy. Complete evaluation using additional gastroscope was feasible in 42 patients (87.5%).
CONCLUSION: Preoperative colonoscopy through the colonic stent using only conventional colonoscope was unfavorable. The narrow expansion diameter of the stent may predict unfavorable outcome. In such a case, using small caliber scope should be considered and may expect successful outcome.
doi:10.3748/wjg.v20.i30.10570
PMCID: PMC4130868  PMID: 25132777
Colon cancer; Stent; Preoperative colonoscopy; Complete colonoscopy
25.  An esthetic appliance for the management of crown-root fracture: a case report 
Orthodontic extrusion is usually performed by means of a fixed orthodontic appliance that utilizes arch wire attached to adjacent teeth and transfers the desired force by elastic from the wire to the root. However, clinicians often encounter cases where the bonding required for tooth traction is not possible because the adjacent teeth have been restored with ceramic or veneer. The purpose of this case report is to describe a modified orthodontic extrusion appliance that is useful when conventional orthodontic treatment is not possible. The modified appliance was fabricated using an artificial tooth, clear plastic sheeting, and a braided fiber-reinforced composite strip that covered adjacent teeth without bonding. It satisfied the esthetic and functional needs of the patient and established the optimal biologic width.
doi:10.5395/rde.2014.39.3.226
PMCID: PMC4125588  PMID: 25110648
Biologic width; Ceramics; Fiber-reinforced composite; Orthodontic appliances; Orthodontic extrusion

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