The aim of this study was to provide normative data on the Literacy Independent Cognitive Assessment (LICA) and to explore the effects of age, education/literacy, and gender on the performance of this test.
Eight hundred and eighty-eight healthy elderly subjects, including 164 healthy illiterate subjects, participated in this study. None of the participants had serious medical, psychiatric, or neurological disorders including dementia. Bivariate linear regression analyses were performed to examine the effects of age, education/literacy, and sex on the score in each of the LICA cognitive tests. The normative scores for each age and education/literacy groups are presented.
Bivariate linear regression analyses revealed that total score and all cognitive tests of the LICA were significantly influenced by both age and education/literacy. Younger and more-educated subjects outperformed older and illiterate or less-educated subjects, respectively, in all of the tests. The normative scores of LICA total score and subset score were presented according to age (60-64, 65-69, 70-74, 75-80, and ≥80 years) and educational levels (illiterate, and 0-3, 4-6, and ≥7 years of education).
These results on demographic variables suggest that age and education should be taken into account when attempting to accurately interpret the results of the LICA cognitive subtests. These normative data will be useful for clinical interpretations of the LICA neuropsychological battery in illiterate and literate elderly Koreans. Similar normative studies and validations of the LICA involving different ethnic groups will help to enhance the dementia diagnosis of illiterate people of different ethnicities.
LICA; Normative study; Age; Education; Literacy
The purpose of this study was to develop and validate a tool called the Pictorial Cognitive Screening Inventory (PCSI), which consists of pictorial memory and attention tests that are not influenced by literacy level.
Patients and methods
PCSI, Mini Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) questionnaires were administered to 80 elderly participants (20 illiterate normal, 20 illiterate with dementia, 20 literate normal, and 20 literate with dementia).
PCSI scores were highly correlated with those of the MMSE (r 0.51) and the CDR (r −0.71). In addition, the PCSI scores differed significantly between the normal group and the dementia group (mean difference 1.71, standard error [SE] 0.14, P<0.001), while no such difference was observed between the illiterate group and the literate group (mean difference 0.00, SE 0.24, P=0.997). Diagnostic validity of the PCSI is excellent, with a sensitivity of 90% and a specificity of 98% for screening dementia, whereas the MMSE has a sensitivity of 85% and a specificity of 60%.
These results indicate that the PCSI is a sensitive and reliable test for screening dementia, regardless of an individual’s literacy skills. The PCSI meets the increasing needs for screening of dementia in illiterate elderly populations in developing countries.
screening; dementia; literacy; cognition
Whether obesity is a risk factor for atopic dermatitis (AD) remains unclear. The aim of the present study was to investigate the association between obesity and AD in Korean young adults.
We included nationally representative data of 5,202 Korean adults aged 19-40 years, obtained from the cross-sectional Korea National Health and Nutrition Examination Survey 2008-2010.
Single (unmarried) status was more frequently observed in AD patients (male, [P=0.0002] and female, [P<0.0001]). AD prevalence exhibited a U-shape trend in relation to body mass index (BMI), waist circumference (WC), and total body fat (BF) percentage, especially in young adult women. Women with BMI ≥25 kg/m2, WC ≥80 cm, and highest quartile (Q4) of total BF percentage had the highest prevalence of AD. The odds ratio (OR) for participants with both BMI ≥25 kg/m2 and WC ≥80 cm was 3.29 (95% confidence interval [CI] 1.71-3.55); therefore, having both general and abdominal obesity was considered a prominent risk factor for AD in young women. After adjustment for confounding factors, including age, smoking, alcohol drinking, exercise, vitamin D, income level, and single status, high BMI (≥30 kg/m2) (OR=4.08, 95% CI: 1.53-10.93), high WC (≥80 cm) (OR=2.05, 95% CI: 1.07-3.94), and high BF percentage (Q4) (OR=2.10, 95% CI: 1.24-3.57) were shown to be significantly associated with AD in young adult women.
In this large-scale nation-wide study of Korean adults, obesity was positively related to the presence of AD in women. Our findings suggest that weight management may help prevent AD.
Atopic dermatitis; obesity; body mass index; waist circumference; body fat; prevalence
This study was investigated the effects of culture media conditions on production of eggs fertilized in vitro of embryos from ovaries of high grade Korean native cow, Hanwoo.
The IVMD 101 and IVF 100 were used for in vitro maturation of selected Hanwoo oocytes and In vitro embryo culture after in vitro fertilization, respectively. The IVMD 101 and IVD 101 were used for in vitro culture and completely free of serum.
The cleavage rates of 2-cell embryos in reference to Hanwoo oocytes were 86.7, 92.9 , and 90.1 % in the control group, IVDM101 medium and IVD101 medium, respectively which indicates that the IVDM101 medium and IVD101 medium may result favorable outcomes. The in vitro development rates of blastocysts were 12.4, 38.4 and 32.4 % in the control group, serum free IVMD101 medium and IVD101 medium, respectively. For hatched blastocysts, it was 5.3, 33.9, and 28.6 % in the control group, serum free IVMD101 medium and IVD101 medium, respectively. Hence, more favorable results were expected for the hatched blastocysts in which the IVMD101 medium and IVD101 medium were used than the control group. Average cell numbers of blastocysts were 128.3, 165.7, and 163.6 in the groups of TCM-199 + 10 % FBS medium, IVMD 101 medium, and IVD 101 medium, respectively which clearly show that the IVMD 101 and IVD 101 medium consequence significantly higher cell numbers compared to the control group (i.e., TCM-199 + 10 % FBS medium). Pregnancy rate after embryo transfer was 39.6 % when the serum free medium was used which is higher than that of the medium supplemented with serum (32.8 %). In addition, stillbirth rates were 4.9 % in the group of serum free medium whereas it was 13.6 % in the serum supplemented medium (13.6 %).
Taken altogether, serum free media, the IVMD 101 and IVD 101 represented more favorable results in the embryo development rate of embryos, cell numbers of blastocyst, and pregnancy rate. Of note, the IVMD 101 medium showed better outcomes hence, it might be a better option for future applications for in vitro culture of bovine embryos.
Hanwoo ovary; IVF; Serum free medium; Blastocyst; Embryo transfer
Pterygium inversum unguis (PIU) is a rare nail abnormality in which the distal nail bed adheres to the ventral surface of the nail plate, with obliteration of the distal groove. Because of the rarity of this condition, its exact origin is unknown. This disorder can be either congenital or acquired, with or without a family history. The acquired forms may be idiopathic or secondary to systemic connective tissue diseases or other causes such as stroke, neurofibromatosis, leprosy, or the use of nail fortifiers. We present an unusual case of acquired idiopathic PIU of the 10 fingernails in a 22-year-old man.
Malformed nails; Pterygium inversum unguis
Cholinergic urticaria is a type of physical urticaria characterized by heat-associated wheals. Several reports are available about cholinergic urticaria; however, the clinical manifestations and pathogenesis are incompletely understood.
The purpose of this study was to investigate the clinical characteristics of cholinergic urticaria in Korea.
We performed a retrospective study of 92 patients with cholinergic urticaria who were contacted by phone and whose diagnoses were confirmed by the exercise provocation test among those who had visited The Catholic University of Korea, Catholic Medical Center from January 2001 to November 2010.
All 92 patients were male, and their average age was 27.8 years (range, 17~51 years). Most of the patients had onset of the disease in their 20s and 30s. Non-follicular wheals were located on the trunk and upper extremities of many patients, and the symptoms were aggravated by exercise. Eight patients showed general urticaria symptoms and 15 had accompanying atopic disease. Forty-three patients complained of seasonal aggravation. Most patients were treated with first and second-generation antihistamines.
Dermatologists should consider these characteristics in patients with cholinergic urticaria. Further investigation and follow-up studies are necessary to better understand the epidemiological and clinical findings of cholinergic urticaria.
Cholinergic; Epidemiology; Phenotype; Signs and symptoms; Urticaria
Population-based studies of atopic dermatitis (AD) in Korean children are lacking. Thus, the purpose of this study was to determine the prevalence, geographic distribution, and risk factors of AD in the Korean pediatric population. We examined AD prevalence using data from the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES), which was a cross-sectional survey of 8,947 children up to age 18 throughout the country. Overall, 13.50% of children reported a diagnosis of AD. The age-standardized prevalence ranged from 9.13% to 17.67% between cities and provinces, with the highest prevalence-observed in many of the larger cities at low latitudes, as well as Jeju-do. After adjusting for confounders, high economic status was found to be a significant factor for predicting increased prevalence of AD, with an odds ratio of 1.35 (95% confidence interval of 1.02-1.79, P=0.0034). Urban living (odds ratio 1.24, 95% confidence interval of 1.00-1.53, P=0.0526) was also associated with a higher prevalence of AD. In this first large scale, nationwide study in Korean children, we found that the overall prevalence of AD depends on age, household income, and geographic distribution.
Atopic dermatitis; Korean; child; prevalence
Hierarchical nanostructures of CuO nanoflowers on nanograss were investigated for self-cleaning and surface plasmonic applications. We achieved the hierarchical nanostructures using one-step oxidation process by controlling the formation of flower-like nanoscale residues (nanoflowers) on CuO nanograss. While the nanograss structure of CuO has a sufficient roughness for superhydrophobic characteristics, the additional hierarchy of nanoflowers on nanograss leads to a semi-reentrant structure with a high repellency even for a very small droplet (10 nL) of low surface tension liquid such as 25 % ethanol (~35 mN/m), thus providing non-wettable and self-cleaning properties. Furthermore, the CuO hierarchical nanostructure serves as a substrate for surface-enhanced Raman spectroscopy (SERS). Both of the CuO nanograss and nanoflower provide many nanoscale gaps that act as hot-spots for surface-enhanced Raman signal of 4-mercaptopyridine (4-Mpy), thus enabling a non-destructive detection in a short analysis time with relatively simple preparation of sample. Especially, the CuO nanoflower has larger number of hot-spots at the nanogaps from floral leaf-like structures, thus leading to three times higher Raman intensity than the CuO nanograss. These multifunctional results potentially provide a path toward cost-effective fabrication of a non-wettable surface for self-maintenance applications and a SERS substrate for sensing applications.
Electronic supplementary material
The online version of this article (doi:10.1186/s11671-015-1214-7) contains supplementary material, which is available to authorized users.
CuO nanostructure; Hierarchical structure; Superhydrophobic; Oleophobic; Non-wetting; Surface-enhanced Raman spectroscopy
Although rarely life threatening, dermatological diseases may have a considerable influence on a patient's quality of life and psychological well-being. As with morbidity and mental distress from other chronic diseases, a skin disorder can be the one of the main causes of depression in the geriatric population.
To determine the prevalence of depression in elderly patients with dermatological disease in Korea and to identify factors associated with depression.
Patients over the age of 60 years with dermatologic diseases were solicited for a questionnaire survey. The Geriatric Depression Scale (GDS) was used to obtain a patient-based measurement of depression. Additionally, demographic information and medical history were collected.
The questionnaire was completed by 313 patients (39.94% men, mean age 69.04 years, mean disease duration 3.23 years). Dermatological disease overall had a significant effect on patients' depression (χ2=177.13, p<0.0001), with a mean GDS score of 12.35 (out of 30). The patients who had a GDS score greater than 10 was 62.3% which indicated increased prevalence of mild to severe depression when compared to the general population among whom only 22.22% percent have GDS score greater than 10. In the univariate analysis, physical health, education level, and the presence of concurrent diseases were risk factors for geriatric depression. However, we did not find any demographic or disease related variables that were independent predictors of depression.
Geriatric patients with dermatological disease experience an increase burden of depression. Thus, it is important for clinicians to evaluate geriatric patients with dermatologic diseases for depression.
Depression; Geriatric population; Skin disorder
Helicobacter pylori infection is associated with chronic gastritis, peptic ulcer, and gastric cancer. There is evidence that IL-1β is associated with the development of gastric cancer. Therefore, downregulation of H. pylori-mediated IL-1β production may be a way to prevent gastric cancer. Withaferin A (WA), a withanolide purified from Withania somnifera, is known to exert anti-inflammatory and anti-tumor effects. In the present study, we explored the inhibitory activity of WA on H. pylori-induced production of IL-1β in murine bone marrow-derived dendritic cells (BMDCs) and the underlying cellular mechanism. Co-treatment with WA decreased IL-1β production by H. pylori in BMDCs in a dose-dependent manner. H. pylori-induced gene expression of IL-1β and NLRP3 (NOD-like receptor family, pyrin domain containing 3) were also suppressed by WA treatment. Moreover, IκB-α phosphorylation by H. pylori infection was suppressed by WA in BMDCs. Western blot analysis revealed that H. pylori induced cleavage of caspase-1 and IL-1β, as well as increased procaspase-1 and pro IL-1β protein levels, and that both were suppressed by co-treatment with WA. Finally, we determined whether WA can directly inhibit ac tivation of the NLRP3 inflammasome. NLRP3 activators induced IL-1β secretion in LPS-primed macrophages, which was inhibited by WA in a dose-dependent manner, whereas IL-6 production was not affected by WA. Moreover, cleavage of IL-1β and caspase-1 by NLRP3 activators was also dose-dependently inhibited by WA. These findings suggest that WA can inhibit IL-1β production by H. pylori in dendritic cells and can be used as a new preventive and therapeutic agent for gastric cancer.
Dendritic cells; Helicobacter pylori; Interleukin 1β; NLRP3 inflammasome; Withaferin A
The current model of compact bone is that of a system of Haversian (longitudinal) canals connected by Volkmann's (transverse) canals. Models based on either histology or microcomputed tomography do not accurately represent the morphologic detail and microstructure of this system, especially that of the canal networks and their spatial relationships. The aim of the present study was to demonstrate the morphologic pattern and network of the Haversian system and to compare endosteal and periosteal sides in rats using three-dimensional (3D) reconstruction. Ten Sprague-Dawley rats aged 8-10 weeks were used. The femurs were harvested from each rat and fixed, decalcified with 10% EDTA-2Na, serially sectioned at a thickness of 5 µm, and then stained with hematoxylin and eosin. The serial sections were reconstructed three-dimensionally using Reconstruct software. The Haversian canals in the endosteal region were found to be large, highly interconnected, irregular, and close to neighboring canals. In contrast, the canals in the periosteal region were straight and small. This combined application of 3D reconstruction and histology examinations to the Haversian system has confirmed its microstructure, showing a branched network pattern on the endosteal side but not on the periosteal side.
Haversian system; Compact bone; Three-dimensional reconstruction; Microstructure; Histology; Rat
This study investigated gender differences in symptom profiles of major depressive disorder (MDD) in the Korean general population. Data were pooled from the series of nationwide Korean Epidemiologic Catchment Area surveys conducted in 2001, 2006 and 2011, respectively. Of the 18,807 participants, 507 (397 women and 110 men) were diagnosed with MDD within the prior 12 months. In agreement with previous studies, women with MDD appeared to be more vulnerable to experiencing atypical depressive episodes defined as depression with two or more symptoms of fatigue, increased appetite and hypersomnia (P < 0.001). In terms of individual symptoms, female gender was significantly related with higher prevalence of fatigue (P = 0.008), hypersomnia (P = 0.001), noticeable psychomotor retardation (P = 0.029) and suicidal attempts (P = 0.016) with adjustment for birth cohort effect, partner status, and employment status. In the same analysis, men with MDD appeared more vulnerable to decreased libido than women (P = 0.009). This is the first report to demonstrate gender differences in symptomatology of MDD in the general Korean population, and the results are comparable to previous investigations from western societies. Assumingly, the intercultural similarity in female preponderance to atypical depression might reflect the common biological construct underlying the gender difference in mechanism of MDD. In clinical settings, gender differences of MDD should be carefully considered, because these features could be related with treatment response and drug side effects.
Depressive Disorder, Major; Symptoms; Sex; Women, Korea
While decreasing trend in gender differences in alcohol use disorders was reported in Western countries, the change in Asian countries is unknown. This study aims to explore the shifts in gender difference in alcohol abuse (AA) and dependence (AD) in Korea. We compared the data from two nation-wide community surveys to evaluate gender differences in lifetime AA and AD by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Face-to-face interviews using the Composite International Diagnostic Interview (CIDI) were applied to all subjects in 2001 (n=6,220) and 2011 (n=6,022). Male-to-female ratio of odds was decreased from 6.41 (95% CI, 4.81-8.54) to 4.37 (95% CI, 3.35-5.71) for AA and from 3.75 (95% CI, 2.96-4.75) to 2.40 (95% CI, 1.80-3.19) for AD. Among those aged 18-29, gender gap even became statistically insignificant for AA (OR, 1.59; 95% CI, 0.97-2.63) and AD (OR, 1.18; 95% CI, 0.80-2.41) in 2011. Men generally showed decreased odds for AD (0.55; 95% CI, 0.45-0.67) and women aged 30-39 showed increased odds for AA (2.13; 95% CI 1.18-3.84) in 2011 compared to 2001. Decreased AD in men and increased AA in women seem to contribute to the decrease of gender gap. Increased risk for AA in young women suggests needs for interventions.
Alcohol-related Disorders; Alcohol Abuse and Dependence; Prevalence; Gender; Social Change; Republic of Korea; Diagnostic and Statistical Manual of Mental Disorders; Composite International Diagnostic Interview (CIDI)
The cutaneous manifestations of hemophagocytic lymphohistiocytosis (HLH) are variable and nonspecific. A 42-year-old man presented with multiple annular, erythematous patches on the trunk for 3 months. Two months later, he presented with bullae along with high fever. The laboratory examination showed pancytopenia, hypertriglyceridemia, and hypofibrinogenemia. The bone marrow biopsy specimen showed an active hemophagocytosis. On the basis of these findings, a diagnosis of HLH was concluded. After five cycles of chemotherapy, his skin lesion completely resolved. Taking the results together, we suggest that annular skin lesion can be added to the list of cutaneous manifestations of HLH.
Annular skin lesions; Hemophagocytic lymphohistiocytosis
Pigmentary demarcation lines are abrupt transition lines between the areas of deeper pigmentation and the areas of lighter, normal pigmentation. Type B pigmentary demarcation lines involve the posterior medial portion of the lower extremities and are more commonly associated with pregnancy. We present a case of pigmentary demarcation lines of pregnancy with erythematous changes, involving both the anterior and posterior aspects of the lower extremities.
Erythema; Knee; Pigmentation; Pregnancy; Thigh
Older adults commonly experience somatic symptoms, and those who do are more likely to have depressive disorders as well. Our goal in this study is to examine the influence of the number and severity of somatic symptoms on the severity of depressive symptoms, including suicidality, in elderly adults.
This study was conducted as part of the Ansan Geriatric (AGE) Study, a community-based cohort study in Ansan City, South Korea. A total of 3,210 elderly adults aged 60 years or over (1,388 males and 1,770 females) participated in this study. The Korean version of the Beck Depression Inventory (BDI) was used to measure depressive symptoms and suicidality. Somatic symptoms were assessed by the Patient Health Questionnaire-15 (PHQ-15).
Both mild and severe somatic symptoms significantly increased the risk for severe depression and high suicidality. Severe somatic symptoms doubled the risk for severe depression and suicidal intent.
Somatic symptoms not fully explained as medical illnesses are closely associated with late-life depression, even after adjustments for comorbid physical illnesses and other confounding factors. The presence of somatic symptoms concurrent with, but not fully explained by comorbid physical illness or disability, seems to be an independent marker for predicting the severity of late-life depression and suicidality.
Depressive Disorder; Somatoform Disorders; Suicidal Ideation
Serum tumor necrosis factor-α (TNF-α) was evaluated in Vibrio vulnificus-infected patients at admission. The median TNF-α concentration in the non-survivor group was determined to be 261.0 pg/mL, in contrast to 69.5 pg/mL in the survivor group (P = 0.001). Hence, serum TNF-α concentration may potentially be an early predictor of the mortality in patients with Vibrio septicemia.
A fixed drug eruption (FDE) is characterized by the presence of a solitary or multiple, pruritic, well-circumscribed, erythematous plaques. These lesions have tendency to recur at same sites and heal with residual hyperpigmenation. With repeated attacks, the size and/or number of the lesions may increase. So far, more than 100 drugs have been implicated in causing FDEs, including ibuprofen, sulfonamide, naproxen, and tetracylines. FDE caused by allopurinol has been rarely reported in the literature, but there has been no confirmed case based on oral provocation test. Herein, we report a case of FDE in which the lesions recurred whenever allopurinol was administered for the treatment of gout. A 64-year-old male experienced repeated episodes of well-demarcated dusky erythematous patches on the whole body for 2 months. He took allopurinol intermittently for amelioration of his gout symptom, but denied other medication history. Pruritic erythematous edema developed on the previous lesions 12 hours after oral provocation of 200 mg of allopurinol.
Allopurinol; Fixed drug eruption; Oral provocation test; Topical provocation test
Disseminated superficial actinic porokeratosis (DSAP) is a skin condition that usually shows a poor response to different modalities of treatment. Herein we describe 2 patients with DSAP on the face, each treated with 3 to 4 sessions of photodynamic therapy combined with laser vaporization.
Disseminated superficial actinic porokeratosis (DSAP); Face; Laser vaporization; Photodynamic therapy (PDT)
Granulocytic sarcoma is an extramedullary tumor composed of granulocytic precursor cells. It usually presents as a nodular mass in the course of acute myelogenous leukemia. Rarely, the tumor develops in non-hematological conditions or in a patient with complete remission from the acute myelogenous leukemia. In such cases, aleukemic granulocytic sarcoma can be a preceding sign of systemic leukemia or a first sign of hematologic relapse of leukemia. We present an unusual case of multiple granulocytic sarcomas developed in a patient with longstanding complete remission of acute myelogenous leukemia, who has not had bone marrow and peripheral blood involvement for a long time.
Aleukemic leukemia cutis; AML M1; Granulocytic sarcoma
Acrokeratosis verruciformis of Hopf is a rare genodermatosis with an autosomal dominant mode of inheritance. It is a disorder of keratinization, characterized by multiple, flat-topped, skin-colored keratotic lesions resembling plane warts typically observed on the dorsum of the hands and feet. Histopathologically, the lesion shows considerable hyperkeratosis, acanthosis, and papillomatosis, mimicking a "church spire", and a thickened granular layer. It arises in early life, often at birth or infancy. Herein, we report on a rare sporadic case of acrokeratosis verruciformis of Hopf. A 44-year-old Caucasian man presented with multiple, grouped, hyperkeratotic, whitish, flat papules on his shins and feet, which had been present for more than one year. Histopathological examination showed typical findings of acrokeratosis verruciformis of Hopf. Our case is unique in that the patient had no familial history of similar skin lesions.
Acrokeratosis verruciformis of Hopf; Non-familial acrokeratosis verruciformis