Publications by authors named "Young Ah Kim"

138 Publications

Apamin inhibits renal fibrosis via suppressing TGF-β1 and STAT3 signaling in vivo and in vitro.

J Mol Med (Berl) 2021 May 24. Epub 2021 May 24.

Department of Pathology, School of Medicine, Catholic University of Daegu, 33, Duryugongwon-ro 17-gil, Nam-gu, 42472, Daegu, Republic of Korea.

Renal fibrosis is a progressive and chronic process that influences kidneys with chronic kidney disease (CKD), irrespective of cause, leading to irreversible failure of renal function and end-stage kidney disease. Among the signaling related to renal fibrosis, transforming growth factor-β1 (TGF-β1) signaling is a major pathway that induces the activation of myofibroblasts and the production of extracellular matrix (ECM) molecules. Apamin, a component of bee venom (BV), has been studied in relation to various diseases. However, the effect of apamin on renal interstitial fibrosis has not been investigated. The aim of this study was to estimate the beneficial effect of apamin in unilateral ureteral obstruction (UUO)-induced renal fibrosis and TGF-β1-induced renal fibroblast activation. This study revealed that obstructive kidney injury induced an inflammatory response, tubular atrophy, and ECM accumulation. However, apamin treatment suppressed the increased expression of fibrotic-related genes, including α-SMA, vimentin, and fibronectin. Administration of apamin also attenuated the renal tubular cells injury and tubular atrophy. In addition, apamin attenuated fibroblast activation, ECM synthesis, and inflammatory cytokines such as TNF-α, IL-1β, and IL-6 by suppressing the TGF-β1-canonical and non-canonical signaling pathways. This study showed that apamin inhibits UUO-induced renal fibrosis in vivo and TGF-β1-induced renal fibroblasts activation in vitro. Apamin inhibited the inflammatory response, tubular atrophy, ECM accumulation, fibroblast activation, and renal interstitial fibrosis through suppression of TGF-β1/Smad2/3 and STAT3 signaling pathways. These results suggest that apamin might be a potential therapeutic agent for renal fibrosis. KEY MESSAGES: UUO injury can induce renal dysfunction; however, apamin administration prevents renal failure in UUO mice. Apamin inhibited renal inflammatory response and ECM deposition in UUO-injured mice. Apamin suppressed the activation of myofibroblasts in vivo and in vitro. Apamin has the anti-fibrotic effect on renal fibrosis via regulation of TGF-β1 canonical and non-canonical signaling.
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http://dx.doi.org/10.1007/s00109-021-02087-xDOI Listing
May 2021

Clinical outcomes of a nurse-led post-discharge education program for heart-transplant recipients: A retrospective cohort study.

Appl Nurs Res 2021 Jun 23;59:151427. Epub 2021 Mar 23.

Department of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. Electronic address:

Background: Advances in immunosuppressive therapeutics and medical technology have improved survival rates after heart transplantation. Although there is a rigorous schedule of outpatient visits and testing to detect early signs of rejection and other complications in the first year after transplantation, repeated unplanned readmissions of heart transplant recipients remains a challenge.

Objective: This study aimed to compare the effects of specialized nurse-led discharge education, including continuous post-transplant education and counselling, on heart transplant recipients' clinical outcomes, with the effects of existing discharge education.

Methods: Participants were 136 heart transplantation recipients at a university-affiliated hospital in South Korea from November 1, 1994, to November 30, 2018. Participants' electronic medical records were retrospectively analyzed. Participants were grouped according to usual care (n = 25), nurse-led program (n = 66), and nurse-led program with post-discharge education (n = 45). We assessed the number of outpatient visits with clinical problems and days to first unplanned rehospitalization within one year after transplantation.

Results: The nurse-led program with post-discharge education was associated with significantly reduced outpatient visits with clinical problems, compared to usual care and the existing nurse-led program. We also found a significantly longer time until first unplanned rehospitalization in the nurse-led program with post-discharge education group, compared to the usual care group.

Conclusion: This study identified the heart transplantation-specialized nurse-led discharge and subsequent post-discharge education as an effective strategy for positive clinical outcomes within one year after heart transplantation.
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http://dx.doi.org/10.1016/j.apnr.2021.151427DOI Listing
June 2021

In Vitro Prebiotic and Anti-Colon Cancer Activities of Agar-Derived Sugars from Red Seaweeds.

Mar Drugs 2021 Apr 12;19(4). Epub 2021 Apr 12.

Department of Biotechnology, Graduate School, Korea University, Seoul 02841, Korea.

Numerous health benefits of diets containing red seaweeds or agar-derived sugar mixtures produced by enzymatic or acid hydrolysis of agar have been reported. However, among various agar-derived sugars, the key components that confer health-beneficial effects, such as prebiotic and anti-colon cancer activities, remain unclear. Here, we prepared various agar-derived sugars by multiple enzymatic reactions using an endo-type and an exo-type of β-agarase and a neoagarobiose hydrolase and tested their in vitro prebiotic and anti-colon cancer activities. Among various agar-derived sugars, agarotriose exhibited prebiotic activity that was verified based on the fermentability of agarotriose by probiotic bifidobacteria. Furthermore, we demonstrated the anti-colon cancer activity of 3,6-anhydro-l-galactose, which significantly inhibited the proliferation of human colon cancer cells and induced their apoptosis. Our results provide crucial information regarding the key compounds derived from red seaweeds that confer beneficial health effects, including prebiotic and anti-colon cancer activities, to the host.
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http://dx.doi.org/10.3390/md19040213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8070132PMC
April 2021

Deep-learning-based cardiovascular risk stratification using coronary artery calcium scores predicted from retinal photographs.

Lancet Digit Health 2021 05;3(5):e306-e316

Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore.

Background: Coronary artery calcium (CAC) score is a clinically validated marker of cardiovascular disease risk. We developed and validated a novel cardiovascular risk stratification system based on deep-learning-predicted CAC from retinal photographs.

Methods: We used 216 152 retinal photographs from five datasets from South Korea, Singapore, and the UK to train and validate the algorithms. First, using one dataset from a South Korean health-screening centre, we trained a deep-learning algorithm to predict the probability of the presence of CAC (ie, deep-learning retinal CAC score, RetiCAC). We stratified RetiCAC scores into tertiles and used Cox proportional hazards models to evaluate the ability of RetiCAC to predict cardiovascular events based on external test sets from South Korea, Singapore, and the UK Biobank. We evaluated the incremental values of RetiCAC when added to the Pooled Cohort Equation (PCE) for participants in the UK Biobank.

Findings: RetiCAC outperformed all single clinical parameter models in predicting the presence of CAC (area under the receiver operating characteristic curve of 0·742, 95% CI 0·732-0·753). Among the 527 participants in the South Korean clinical cohort, 33 (6·3%) had cardiovascular events during the 5-year follow-up. When compared with the current CAC risk stratification (0, >0-100, and >100), the three-strata RetiCAC showed comparable prognostic performance with a concordance index of 0·71. In the Singapore population-based cohort (n=8551), 310 (3·6%) participants had fatal cardiovascular events over 10 years, and the three-strata RetiCAC was significantly associated with increased risk of fatal cardiovascular events (hazard ratio [HR] trend 1·33, 95% CI 1·04-1·71). In the UK Biobank (n=47 679), 337 (0·7%) participants had fatal cardiovascular events over 10 years. When added to the PCE, the three-strata RetiCAC improved cardiovascular risk stratification in the intermediate-risk group (HR trend 1·28, 95% CI 1·07-1·54) and borderline-risk group (1·62, 1·04-2·54), and the continuous net reclassification index was 0·261 (95% CI 0·124-0·364).

Interpretation: A deep learning and retinal photograph-derived CAC score is comparable to CT scan-measured CAC in predicting cardiovascular events, and improves on current risk stratification approaches for cardiovascular disease events. These data suggest retinal photograph-based deep learning has the potential to be used as an alternative measure of CAC, especially in low-resource settings.

Funding: Yonsei University College of Medicine; Ministry of Health and Welfare, Korea Institute for Advancement of Technology, South Korea; Agency for Science, Technology, and Research; and National Medical Research Council, Singapore.
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http://dx.doi.org/10.1016/S2589-7500(21)00043-1DOI Listing
May 2021

Risk Factors for Extended-Spectrum-β-Lactamase-Producing in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea.

Ann Lab Med 2021 Sep;41(5):455-462

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Background: The prevalence of extended-spectrum β-lactamase-producing (ESBL-EC) in the community has increased worldwide due to multifactorial reasons. ESBL-EC bloodstream infection (BSI) complicates the decision for proper antimicrobial administration. In this multicenter study, we investigated the prevalence, risk factors, and molecular background of community-onset (CO) ESBL-EC BSI.

Methods: We included data for all episodes of ESBL-EC BSI of community origin from May 2016 to April 2017 obtained from the Korean national antimicrobial resistance surveillance system, which comprises six sentinel hospitals. Data, including previous history of admission and use of antimicrobials and medical devices before BSI, were collected, along with microbiological analysis results.

Results: Among 1,189 patients with CO BSI caused by , 316 (27%) were identified as ESBL producers. History of admission, especially to a long-term care hospital (LTCH), and previous use of β-lactams/β-lactamase inhibitors, carbapenem, lincosamide, aminoglycoside, and extended-spectrum cephalosporin were independent risk factors for CO ESBL-EC BSI; admission to an LTCH showed the highest odds ratio (3.8, 95% confidence interval 2.3-6.1). The most common genotype was CTX-M-15 (N=131, 41%), followed by CTX-M-14 (N=86, 27%). ST131 was the most common sequence type among ESBL-EC groups (57%).

Conclusions: In Korea, 27% of CO BSI were caused by ESBL producers. From perspectives of empirical treatment and infection control, history of admission to an LTCH and antimicrobial use should be noted.
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http://dx.doi.org/10.3343/alm.2021.41.5.455DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8041596PMC
September 2021

Inhibitory Effects of STAT3 Transcription Factor by Synthetic Decoy ODNs on Autophagy in Renal Fibrosis.

Biomedicines 2021 Mar 25;9(4). Epub 2021 Mar 25.

Department of Pathology, School of Medicine, Catholic University of Daegu, Daegu 42472, Korea.

Autophagy in the proximal tubules may promote fibrosis by activating tubular cell death, interstitial inflammation, and the production of pro-fibrotic factors. The signal transducer and activator of transcription 3 (STAT3) is activated as a potential transcription factor, which mediates the stimulation of renal fibrosis. We investigated the role of the STAT3 in autophagy and its effect on the prevention of interstitial renal fibrosis. In this study, we use synthesized STAT3 decoy oligonucleotides (ODN), which were injected into the tail veins of unilateral ureteral obstruction (UUO) mice, to explore the regulation of autophagy in UUO-induced renal fibrosis. The expression of interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and collagen were decreased by STAT3 decoy ODN. The autophagy markers microtubule-associated protein light chain 3 (LC3) and fibronectin, were identified through immunofluorescent staining, indicating that they were reduced in the group injected with ODN. The expressions of LC3, Beclin1, p62, and autophagy-related 5-12 (Atg5-12) and hypoxia inducible factor-1α (HIF-1α) were inhibited in the ODN injection group. We determined the inhibitory effect of autophagy in chronic kidney disease and confirmed that STAT3 decoy ODN effectively inhibited autophagy by inhibiting the expression of STAT3 transcription factors in the UUO group.
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http://dx.doi.org/10.3390/biomedicines9040331DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8064438PMC
March 2021

The rates of major malformations after gestational exposure to isotretinoin: a systematic review and meta-analysis.

Obstet Gynecol Sci 2021 Mar 17. Epub 2021 Mar 17.

Motherisk Israel and Adelson Faculty of Medicine, Ariel University, Ariel, Israel.

Objective: s Isotretinoin is among the most notorious human teratogens, documented originally as causing up to 30% of malformations. This systematic review and meta-analysis aimed to evaluate the rates of major malformation (MM) among isotretinoin-exposed pregnant women over the years through a systematic review and meta-analysis.

Methods: Eligible studies were searched and identified using various databases. Single-arm meta-analysis and meta-analysis of odd ratios among controlled studies were performed using Review Manager version 5.3.

Results: Ten eligible studies that combined 2,783 isotretinoin-exposed women were included in our study. The rate of MM weighted for the sample size was 15%. Three studies that included an unexposed comparison group were eligible for the meta-analysis. The pooled odds ratio of MM for isotretinoin-exposed women was 3.76. After 2006, the pooled odds ratio of MM for isotretinoin exposure was significantly lower at 1.04.

Conclusion: The current rate of MM in isotretinoin-exposed women was substantially lower after 2006.
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http://dx.doi.org/10.5468/ogs.20373DOI Listing
March 2021

State and Trait Anxiety of Adolescents with Autism Spectrum Disorders.

Psychiatry Investig 2021 Mar 19;18(3):257-265. Epub 2021 Mar 19.

Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Objective: This study examined how state and trait anxiety of adolescents with autism spectrum disorders (ASD) are associated with their demographic characteristics, repetitive and restricted behaviors (RRBs), and internalizing and externalizing problem behaviors.

Methods: A total of 96 participants with ASD (mean age=14.30 years; 91 males) completed a battery of tests including the State/Trait Anxiety Inventory (STAI), the Autism Diagnostic Interview-Revised, the Social Responsiveness Scale (SRS), and a cognitive test measuring intelligence quotient (IQ). Participants' parents completed the Child Behavior Checklist (CBCL). Pearson's correlations among age, IQ, two subscales of the STAI (i.e., STAIS and STAIT, measuring self-reported state and trait anxiety, respectively), and the Anxiety subscale of CBCL (i.e., CBCL-Anxiety, measuring parent-reported trait anxiety) were computed. Subsequently, Pearson's correlations were computed among the three anxiety measures, RRBs, and problem behaviors, while controlling for participants' age and IQ.

Results: The STAIS and CBCL-Anxiety were both significantly correlated with higher age, sensory sensitivity, depressive symptoms, somatic complaints, and aggressive behaviors. All three anxiety variables were significantly and positively correlated with total SRS RRB scores. Additionally, the STAIS and STAIT were significantly associated with more severe Compulsion/Adherence behaviors, and the CBCL-Anxiety was also significantly associated with more severe Rule-breaking Behaviors.

Conclusion: Self-reported state anxiety showed association patterns similar to those of parent-reported trait anxiety. Future studies investigating the precise operationalization of different anxiety instruments are needed to accurately measure the anxiety of adolescents with ASD.
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http://dx.doi.org/10.30773/pi.2020.0328DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8016686PMC
March 2021

How to approach the rupture of tubo-ovarian abscess during pregnancy: A case report and literature review.

J Obstet Gynaecol Res 2021 Mar 31;47(3):1199-1203. Epub 2021 Jan 31.

Department of Obstetrics and Gynecology, Dongguk University Ilsan Hospital, Goyang, South Korea.

We present the case of a 26-year-old multiparous woman who experienced rupture of a tubo-ovarian abscess during the second trimester of pregnancy. She presented with epigastric and right lower quadrant pain at 12 + 0 weeks' gestation. There were no other specific findings on the magnetic resonance imaging images. We recommended hospitalization to observe the changes in pain, but she refused confinement. About 3 weeks later, she revisited our emergency room at 15 + 4 weeks' gestation. She complained of worsening abdominal pain with fever. She underwent right salpingo-oophorectomy and appendectomy due to uncontrollable, severe abdominal pain without any obstetric abnormal condition. There was a rupture site in the right adnexa, which was covered with pus. The rupture of tubo-ovarian abscess during pregnancy is very rare. Therefore, obstetricians should carefully monitor the adnexal masses observed during pregnancy, which should be treated with caution, whether or not the patient is symptomatic.
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http://dx.doi.org/10.1111/jog.14691DOI Listing
March 2021

Preparation and Characterization of Ionic Conductive Poly(acrylic Acid)-Based Silicone Hydrogels for Smart Drug Delivery System.

Polymers (Basel) 2021 Jan 27;13(3). Epub 2021 Jan 27.

Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup-si, Jeollabuk do 56212, Korea.

In this study, we developed a smart drug delivery system that can efficiently deliver the required amounts of drugs using the excellent ion conductivity of poly(acrylic acid) (PAA) and an electrical stimulus. As a result of its having carboxyl groups, PAA hydrogel can be used in drug delivery patches to release drugs by ionic conductivity. However, PAA hydrogel has low durability and poor mechanical properties. The carboxyl group of PAA was combined with a siloxane group of silicone using electron-beam irradiation to easily form a crosslinked structure. The PAA-silicone hydrogel has excellent mechanical properties. Specifically, the tensile strength increased more than 3.5 times. In addition, we observed its cell compatibility using fluorescence staining and CCK-8 assays and found good cell viability. Finally, it was possible to control the drug delivery rate efficiently using the voltage applied to the ion-conductive hydrogel. As the voltage was increased to 3, 5, and 7 V, the amount of drug released was 53, 88, and 96%, respectively. These excellent properties of the PAA-silicone hydrogel can be used not only for whitening or anti-wrinkling cosmetics but also in medical drug-delivery systems.
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http://dx.doi.org/10.3390/polym13030406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7865612PMC
January 2021

Prediction of systemic biomarkers from retinal photographs: development and validation of deep-learning algorithms.

Lancet Digit Health 2020 10;2(10):e526-e536

Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore. Electronic address:

Background: The application of deep learning to retinal photographs has yielded promising results in predicting age, sex, blood pressure, and haematological parameters. However, the broader applicability of retinal photograph-based deep learning for predicting other systemic biomarkers and the generalisability of this approach to various populations remains unexplored.

Methods: With use of 236 257 retinal photographs from seven diverse Asian and European cohorts (two health screening centres in South Korea, the Beijing Eye Study, three cohorts in the Singapore Epidemiology of Eye Diseases study, and the UK Biobank), we evaluated the capacities of 47 deep-learning algorithms to predict 47 systemic biomarkers as outcome variables, including demographic factors (age and sex); body composition measurements; blood pressure; haematological parameters; lipid profiles; biochemical measures; biomarkers related to liver function, thyroid function, kidney function, and inflammation; and diabetes. The standard neural network architecture of VGG16 was adopted for model development.

Findings: In addition to previously reported systemic biomarkers, we showed quantification of body composition indices (muscle mass, height, and bodyweight) and creatinine from retinal photographs. Body muscle mass could be predicted with an R of 0·52 (95% CI 0·51-0·53) in the internal test set, and of 0·33 (0·30-0·35) in one external test set with muscle mass measurement available. The R value for the prediction of height was 0·42 (0·40-0·43), of bodyweight was 0·36 (0·34-0·37), and of creatinine was 0·38 (0·37-0·40) in the internal test set. However, the performances were poorer in external test sets (with the lowest performance in the European cohort), with R values ranging between 0·08 and 0·28 for height, 0·04 and 0·19 for bodyweight, and 0·01 and 0·26 for creatinine. Of the 47 systemic biomarkers, 37 could not be predicted well from retinal photographs via deep learning (R≤0·14 across all external test sets).

Interpretation: Our work provides new insights into the potential use of retinal photographs to predict systemic biomarkers, including body composition indices and serum creatinine, using deep learning in populations with a similar ethnic background. Further evaluations are warranted to validate these findings and evaluate the clinical utility of these algorithms.

Funding: Agency for Science, Technology, and Research and National Medical Research Council, Singapore; Korea Institute for Advancement of Technology.
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http://dx.doi.org/10.1016/S2589-7500(20)30216-8DOI Listing
October 2020

Prevalence and Molecular Epidemiology of Extended-Spectrum-β-Lactamase (ESBL)-Producing From Multiple Sectors of the Swine Industry in Korea: A Korean Nationwide Monitoring Program for a One Health Approach to Combat Antimicrobial Resistance.

Ann Lab Med 2021 May;41(3):285-292

Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.

Background: One health is a flexible concept with many facets, including the environment, community, and the nosocomial super-bacteria resistance network. We investigated the molecular prevalence of extended-spectrum-β-lactamase-producing (ESBL-EC) in workers, livestock, and the farm environment in Korea.

Methods: ESBL-EC isolates were obtained from samples from 19 swine farms, 35 retail stores, seven slaughterhouses, and 45 related workers throughout Korea from August 2017 to July 2018, using ChromID ESBL (BioMérieux, Marcy l'Etoile, France) agar and enrichment broth. The presence of ESBL and mobilized colistin resistance () genes and antimicrobial resistance were determined. Clonality was evaluated with pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST).

Results: In total, 232 ESBL-EC isolates were obtained from 1,614 non-duplicated samples (14.4% positive rate). The ESBL-EC isolates showed regional and source-related differences. (N=100), (N=65), (N=33), and (N=23) were common ESBL types. The ESBL-EC isolates showed high resistance rates for various antimicrobial classes; however, all isolates were susceptible to carbapenem. One swine-originating colistin-resistant isolate did not carry any known gene. PFGE was successful for 197 of the 232 isolates, and most PFGE types were heterogeneous, except for some dominant PFGE types (O, R, T, U, and V). MLST of 88 isolates was performed for representative PFGE types; however, no dominant sequence type was observed.

Conclusions: The proportion of ESBL-EC in swine industry-related samples was significant, and the isolates harbored common clinical ESBL gene types. These molecular epidemiologic data could provide important evidence for antimicrobial-resistance control through a one health approach.
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http://dx.doi.org/10.3343/alm.2021.41.3.285DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748096PMC
May 2021

Utility of the Autism Diagnostic Observation Schedule and the Brief Observation of Social and Communication Change for Measuring Outcomes for a Parent-Mediated Early Autism Intervention.

Autism Res 2021 02 4;14(2):411-425. Epub 2020 Dec 4.

Department of Biostatistics and Health Informatics, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.

Measuring outcomes for autistic children following social communication interventions is an ongoing challenge given the heterogeneous changes, which can be subtle. We tested and compared the overall and item-level intervention effects of the Brief Observation of Social Communication Change (BOSCC), Autism Diagnostic Observation Schedule (ADOS-2) algorithm, and ADOS-2 Calibrated Severity Scores (CSS) with autistic children aged 2-5 years from the Preschool Autism Communication Trial (PACT). The BOSCC was applied to Module 1 ADOS assessments (ADOS-BOSCC). Among the 117 children using single or no words (Module 1), the ADOS-BOSCC, ADOS algorithm, and ADOS CSS each detected small non-significant intervention effects. However, on the ADOS algorithm, there was a medium significant intervention effect for children with "few to no words" at baseline, while children with "some words" showed little intervention effect. For the full PACT sample (including ADOS Module 2, total n=152), ADOS metrics evidenced significant small (CSS) and medium (algorithm) overall intervention effects. None of the Module 1 item-level intervention effects reached significance, with largest changes observed for Gesture (ADOS-BOSCC and ADOS), Facial Expressions (ADOS), and Intonation (ADOS). Significant ADOS Module 2 item-level effects were observed for Mannerisms and Repetitive Interests and Stereotyped Behaviors. Despite strong psychometric properties, the ADOS-BOSCC was not more sensitive to behavioral changes than the ADOS among Module 1 children. Our results suggest the ADOS can be a sensitive outcome measure. Item-level intervention effect plots have the potential to indicate intervention "signatures of change," a concept that may be useful in future trials and systematic reviews. LAY SUMMARY: This study compares two outcome measures in a parent-mediated therapy. Neither was clearly better or worse than the other; however, the Autism Diagnostic Observation Schedule produced somewhat clearer evidence than the Brief Observation of Social Communication Change of improvement among children who had use of "few to no" words at the start. We explore which particular behaviors are associated with greater improvement. These findings can inform researchers when they consider how best to explore the impact of their intervention.
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http://dx.doi.org/10.1002/aur.2449DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7898818PMC
February 2021

Fusobacterium nucleatum in biopsied tissues from colorectal cancer patients and alcohol consumption in Korea.

Sci Rep 2020 11 16;10(1):19915. Epub 2020 Nov 16.

Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.

The roles of individual bacteria and their relationship in the development of colorectal cancer (CRC) remain unclear. We aimed to determine the prevalence of CRC-associated bacteria using quantitative real-time PCR (qPCR) or 16S rRNA analysis and the statistical correlations of patient demographics and clinical characteristics comprising alcohol consumption with CRC-associated bacteria. We determined the prevalence of five CRC-associated bacterial species in 38 CRC patients (39 samples) and 21 normal individuals using qPCR, and the relative abundance of bacterial taxa in the gut microbiome was assessed using 16S rRNA analysis. Fusobacterium nucleatum was the only bacterium that was significantly (P < 0.0001) more prevalent in the cancer tissue (82.1%) than in the normal tissue (0%) by qPCR. 16S rRNA analysis showed a significant correlation between six operational taxonomic units (OTUs), namely, the genera Fusobacterium, Peptostreptococcus, Collinsella, Prevotella, Parvimonas, and Gemella, in patients with CRC. An integrated analysis using 16S rRNA data and epidemiological characteristics showed that alcohol consumption was significantly correlated with the abundance of Fusobacterium OTUs. The correlation of alcohol consumption with the abundance of Fusobacterium OTUs in cancer tissue discovered using 16S rRNA analysis suggests a possible link between alcohol metabolism and subsequent tumorigenesis caused by F. nucleatum.
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http://dx.doi.org/10.1038/s41598-020-76467-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7669878PMC
November 2020

How Do Children with Autism Spectrum Disorder Encode and Reproduce Visuospatial Stimuli?: Investigation into Visuospatial Processing Abilities and Styles.

Psychiatry Investig 2020 Nov 18;17(11):1105-1107. Epub 2020 Nov 18.

Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Objective: The purpose of this study was to examine the visuospatial processing abilities of children with autism spectrum disorder (ASD) using the Rey Osterrieth Complex Figure (ROCF).

Methods: One-hundred thirty-four children with ASD [mean age (MA)=113.56 months], 150 siblings of children with ASD (MA= 111.67 months), and 55 typically developing (TD) children (MA=109.02 months) were included in this study. During their one-time visit, participants completed the ROCF, various autism diagnostic assessments, and the Korean-Leiter International Performance ScaleRevised. Repeated-measures Analysis of Covariance (ANCOVA) and post-hoc Tukey-Kramer comparisons were computed to compare the ROCF scores. Partial correlations and multiple regressions were computed to examine the association between ROCF scores and the severity of autistic symptoms, as measured by the Autism Diagnostic Interview-Revised (ADI-R) among children with ASD.

Results: There were significant main effects of the analysis group in Structural and Incidental Accuracy, Error, and Style. More siblings than TD children drew in a part-oriented way, but the performance of the sibling group was comparable or superior to that of the TD group in all parameters. Social Interaction scores of children with ASD were significantly associated with Organization scores in Copy condition. Whether or not a child drew in the Part-Oriented style significantly predicted his/her repetitive and restricted behavior scores.

Conclusion: The findings add to the evidence for altered visuospatial processing patterns of ASD as a potential inherent and genetic trait and suggest that this particular cognitive style should not be considered as a deficit. Educational and theoretical implications are discussed.
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http://dx.doi.org/10.30773/pi.2020.0189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711121PMC
November 2020

Risk Factors for Carbapenemase-Producing Infection or Colonization in a Korean Intensive Care Unit: A Case-Control Study.

Antibiotics (Basel) 2020 Oct 8;9(10). Epub 2020 Oct 8.

Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul 03722, Korea.

The purpose of this study is to identify the factors related to the infection and/or colonization of carbapenemase-producing (CPE) based on clinical and microbiological data for patients in the intensive care unit (ICU). All patients admitted to medical ICU were screened for CPE on admission and weekly, and this 1:2 case-control study included patients with CPE identified by screening or clinical cultures from 2017 to 2018. The clonal relatedness was evaluated by pulsed-field gel electrophoresis (PFGE). A total of 45 CPE patients were identified with a prevalence of 3.8%. The most frequent organism was (69%) and the carbapenemases belonged to the class A Carbapenemase (KPC-2) (87%), class B New Delhi Metallo-β-lactamase (NDM) (11%), and Imipenemase (IMP-1) (2%) strains. The PFGE profiles showed two large clustered groups of KPC-2-producing . In the multivariate analysis, pneumonia/chronic pulmonary disease, previous fluoroquinolone use, and previous use of nasogastric tube were the significant risk factors for CPE infection or colonization in ICU-admitted patients. Critical illness and underlying medical conditions such as pneumonia/chronic pulmonary disease, antimicrobial selective pressure, and the use of a medical device are identified as risk factors for CPE infection or colonization in ICU. Person to person transmission also contributed.
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http://dx.doi.org/10.3390/antibiotics9100680DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600752PMC
October 2020

Apoptosis and fibrosis of vascular smooth muscle cells in aortic dissection: an immunohistochemical study.

Int J Clin Exp Pathol 2020 1;13(8):1962-1969. Epub 2020 Aug 1.

Department of Pathology, College of Medicine, Catholic University of Daegu Daegu, Republic of Korea.

Aortic dissection (AD) is a fatal disease characterized by a ruptured intima that leads to the complete rupture of the aorta. The aim of this study is to examine the immunohistochemical expression of inflammation/fibrosis-associated chemical mediators in AD patients. Surgical specimens of aortic tissues were obtained from 37 patients who underwent an open thoracic aortic repair. AD was detected with histological staining. Local congestion and hemorrhage as well as chronic inflammatory cells infiltrations were observed at the dissection. Moreover, extensive disarrangement and disruption of elastic fibers were observed in the medial layer of the aorta with dissection. In summary, our study revealed that the apoptotic rate of vascular SMCs (VSMCs) in the vascular middle layer is higher in the dissected aortas than in the control aortas, suggesting that abnormally elevated apoptosis is correlated with AD pathogenesis. Functional studies of key genes identified in the apoptotic pathways as well as in extracellular matrix would be critical in thoroughly understanding the underlying mechanisms of AD development. Targeting the mediators related to TGF-β1, the Smad family proteins, and caspase 3 or anti-apoptotic agents may provide diagnostic markers and therapeutic targets that could be used to prevent AD.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476953PMC
August 2020

Older adult psychopathology: international comparisons of self-reports, collateral reports, and cross-informant agreement.

Int Psychogeriatr 2020 Sep 4:1-12. Epub 2020 Sep 4.

Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.

Objectives: To conduct international comparisons of self-reports, collateral reports, and cross-informant agreement regarding older adult psychopathology.

Participants: We compared self-ratings of problems (e.g. I cry a lot) and personal strengths (e.g. I like to help others) for 10,686 adults aged 60-102 years from 19 societies and collateral ratings for 7,065 of these adults from 12 societies.

Measurements: Data were obtained via the Older Adult Self-Report (OASR) and the Older Adult Behavior Checklist (OABCL; Achenbach et al., 2004).

Results: Cronbach's alphas were .76 (OASR) and .80 (OABCL) averaged across societies. Across societies, 27 of the 30 problem items with the highest mean ratings and 28 of the 30 items with the lowest mean ratings were the same on the OASR and the OABCL. Q correlations between the means of the 0-1-2 ratings for the 113 problem items averaged across all pairs of societies yielded means of .77 (OASR) and .78 (OABCL). For the OASR and OABCL, respectively, analyses of variance (ANOVAs) yielded effect sizes (ESs) for society of 15% and 18% for Total Problems and 42% and 31% for Personal Strengths, respectively. For 5,584 cross-informant dyads in 12 societies, cross-informant correlations averaged across societies were .68 for Total Problems and .58 for Personal Strengths. Mixed-model ANOVAs yielded large effects for society on both Total Problems (ES = 17%) and Personal Strengths (ES = 36%).

Conclusions: The OASR and OABCL are efficient, low-cost, easily administered mental health assessments that can be used internationally to screen for many problems and strengths.
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http://dx.doi.org/10.1017/S1041610220001532DOI Listing
September 2020

Dizygotic twin sisters with normosmic idiopathic hypogonadotropic hypogonadism caused by an FGFR1 gene variant.

Ann Pediatr Endocrinol Metab 2020 Sep 29;25(3):192-197. Epub 2020 Jul 29.

Department of Pediatrics, Inje University Ilsan Paik Hospital, Goyang, Korea.

Isolated hypogonadotropic hypogonadism (IHH) is a rare genetic disorder that is clinically and genetically heterogeneous. It is characterized by absent or incomplete pubertal development owing to an isolated defect in the production, secretion, or action of gonadotropin-releasing hormone. The incidence of IHH is estimated at 1:30,000 in males and 1:125,000 in females. Although the vast majority of IHH cases are sporadic, some X-linked recessive, autosomal dominant, and autosomal recessive modes of inheritance have been described. IHH can be classified into Kallmann syndrome with anosmia and normosmic IHH. Here, we report dizygotic twin sisters with normosmic IHH who showed short stature and absence of puberty as a result of a variant of the FGFR1 gene. They had a normal sense of smell, and brain magnetic resonance imaging (MRI) showed well-defined olfactory bulbs. The older sister and the twins' mother had cleft palate, while the younger sister did not. The mother had menarche at the age of 16 years after hormonal replacement owing to delayed puberty. Molecular analysis of the FGFR1 gene identified a missense variant c.874C>G (p.His292Asp) in the twins and their mother. Herein, we described the clinical heterogeneity observed in the 2 affected twins who carry an identical variant in the FGFR1 gene. Further studies of the effects of modifier genes and epigenetic factors on the expression of FGFR1, as well as the various clinical manifestations of its mutations, are warranted.
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http://dx.doi.org/10.6065/apem.1938148.074DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7538301PMC
September 2020

Development of the Korean Developmental Screening Test for Infants and Children (K-DST).

Clin Exp Pediatr 2020 11 14;63(11):438-446. Epub 2020 May 14.

Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.

Background: Most developmental screening tools in Korea are adopted from foreign tests. To ensure efficient screening of infants and children in Korea, a nationwide screening tool with high reliability and validity is needed.

Purpose: This study aimed to independently develop, standardize, and validate the Korean Developmental Screening Test for Infants and Children (K-DST) for screening infants and children for neurodevelopmental disorders in Korea.

Methods: The standardization and validation conducted in 2012-2014 of 3,284 subjects (4-71 months of age) resulted in the first edition of the K-DST. The restandardization and revalidation performed in 2015-2016 of 3.06 million attendees of the National Health Screening Program for Infants and Children resulted in the revised K-DST. We analyzed inter-item consistency and test-retest reliability for the reliability analysis. Regarding the validation of K-DST, we examined the construct validity, sensitivity and specificity, receiver operating characteristic curve analysis, and a criterion-related validity analysis.

Results: We ultimately selected 8 questions in 6 developmental domains. For most age groups and each domain, internal consistency was 0.73-0.93 and test-retest reliability was 0.77-0.88. The revised K-DST had high discriminatory ability with a sensitivity of 0.833 and specificity of 0.979. The test supported construct validity by distinguishing between normal and neurodevelopmentally delayed groups. The language and cognition domain of the revised K-DST was highly correlated with the K-Bayley Scales of Infant Development-II's Mental Age Quotient (r=0.766, 0.739), while the gross and fine motor domains were highly correlated with Motor Age Quotient (r=0.695, 0.668), respectively. The Verbal Intelligence Quotient of Korean Wechsler Preschool and Primary Scales of Intelligence was highly correlated with the K-DST cognition and language domains (r=0.701, 0.770), as was the performance intelligence quotient with the fine motor domain (r=0.700).

Conclusion: The K-DST is reliable and valid, suggesting its good potential as an effective screening tool for infants and children with neurodevelopmental disorders in Korea.
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http://dx.doi.org/10.3345/cep.2020.00640DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642140PMC
November 2020

Impact of -Positive Enterococcus faecium Exhibiting Diverse Susceptibility Phenotypes to Glycopeptides on 30-Day Mortality of Patients with a Bloodstream Infection.

Antimicrob Agents Chemother 2020 06 23;64(7). Epub 2020 Jun 23.

Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea

This study was performed to evaluate the impacts of positivity of exhibiting diverse susceptibility phenotypes to glycopeptides on clinical outcomes in patients with a bloodstream infection (BSI) through a prospective, multicenter, observational study. A total of 509 patients with BSI from eight sentinel hospitals in South Korea during a 2-year period were enrolled in this study. Risk factors of the hosts and causative isolates were assessed to determine associations with the 30-day mortality of BSI patients via multivariable logistic regression analyses. The gene was detected in 35.2% (179/509) of isolates; 131 isolates exhibited typical VanA phenotypes (group -VanA), while the remaining 48 isolates exhibited atypical phenotypes (group -atypical), which included VanD ( = 43) and vancomycin-variable phenotypes ( = 5). A multivariable logistic regression indicated that positivity of causative pathogens was independently associated with the increased 30-day mortality rate in the patients with BSI; however, there was no significant difference in survival rates between the patients of the -VanA and -atypical groups (log rank test, 0.904). A high 30-day mortality rate was observed in patients with -positive BSIs, and positivity of causative isolates was an independent risk factor for early mortality irrespective of the susceptibility phenotypes to glycopeptides; thus, intensified antimicrobial stewardship is needed to improve the clinical outcomes of patients with -positive BSI.
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http://dx.doi.org/10.1128/AAC.02180-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318022PMC
June 2020

LncRNAs Act as a Link between Chronic Liver Disease and Hepatocellular Carcinoma.

Int J Mol Sci 2020 Apr 20;21(8). Epub 2020 Apr 20.

Department of Pathology, Catholic University of Daegu School of Medicine, Daegu 42472, Korea.

Long non-coding RNAs (lncRNAs) are emerging as important contributors to the biological processes underlying the pathophysiology of various human diseases, including hepatocellular carcinoma (HCC). However, the involvement of these molecules in chronic liver diseases, such as nonalcoholic fatty liver disease (NAFLD) and viral hepatitis, has only recently been considered in scientific research. While extensive studies on the pathogenesis of the development of HCC from hepatic fibrosis have been conducted, their regulatory molecular mechanisms are still only partially understood. The underlying mechanisms related to lncRNAs leading to HCC from chronic liver diseases and cirrhosis have not yet been entirely elucidated. Therefore, elucidating the functional roles of lncRNAs in chronic liver disease and HCC can contribute to a better understanding of the molecular mechanisms, and may help in developing novel diagnostic biomarkers and therapeutic targets for HCC, as well as in preventing the progression of chronic liver disease to HCC. Here, we comprehensively review and briefly summarize some lncRNAs that participate in both hepatic fibrosis and HCC.
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http://dx.doi.org/10.3390/ijms21082883DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216144PMC
April 2020

The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma.

Yeungnam Univ J Med 2020 Jul 10;37(3):202-209. Epub 2020 Apr 10.

Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.

Background: Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC.

Methods: We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed.

Results: CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different.

Conclusion: Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.
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http://dx.doi.org/10.12701/yujm.2020.00031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384906PMC
July 2020

Ovarian pregnancy rupture in second trimester manifesting mental change in pregnancy: a case report.

Obstet Gynecol Sci 2020 Mar 5;63(2):209-212. Epub 2020 Feb 5.

Department of Obstetrics and Gynecology, Ilsan-Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Ovarian pregnancies comprise approximately 3% of ectopic pregnancies. Moreover, ovarian pregnancies in the second trimester are extremely rare. We herein present a case of ruptured ovarian pregnancy in the second trimester. A 26-year-old Asian woman presented to our hospital complaining of an abrupt mental change. She was pregnant; however, she had not been receiving antenatal care. Her initial vital signs were unstable, and pelvic ultrasound revealed pelvic fluid collection. We analyzed the hemoperitoneum and performed exploratory laparotomy. When her abdomen was opened, we observed that her right ovary was ruptured. Placental cord insertion originated from the ovary, and a fetus was found in the pelvic cavity. The ovarian pregnancy was detected in a delayed state. Pregnant women require appropriate antenatal care, and pelvic ultrasound should be performed in the second trimester to ensure that the fetus is in the intrauterine cavity.
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http://dx.doi.org/10.5468/ogs.2020.63.2.209DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073367PMC
March 2020

Usefulness of 1-year of thyroid stimulating hormone suppression on additional levothyroxine in patients who underwent hemithyroidectomy with papillary thyroid microcarcinoma.

Gland Surg 2019 Dec;8(6):636-643

Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.

Background: The purpose of this study was to identify usefulness of 1-year of thyroid stimulating hormone (TSH) suppression, on additional levothyroxine in patients who underwent hemithyroidectomy with papillary thyroid microcarcinoma (PTMC).

Methods: Two-hundred consecutive patients who had received hemithyroidectomy February 2011 to March 2013, were enrolled, retrospectively. Group 1, only, was taking levothyroxine for a year, postoperatively. We evaluated postoperative hypothyroidism through serum TSH level, measured periodically.

Results: Postoperative TSH >10 was significantly different, at 13% and 25%, between two groups (P=0.036). Twenty patients in group 1, and 32 patients in group 2, received additional levothyroxine. Multivariate analysis showed that 1-year suppression, clinical thyroiditis, and preoperative TSH >2, were significantly associated with additional levothyroxine (OR 2.17, P=0.025 and OR 2.00, P=0.046 and OR 2.64, P=0.006). Too, 1-year TSH suppression, preoperative TSH >2, were also significantly associated with postoperative TSH >10 (OR 2.55, P=0.022 and OR 2.22, P=0.048).

Conclusions: We suggest 1-year TSH suppression after hemithyroidectomy, for PTMC in patients with preoperative TSH >2 mU/L and clinical thyroiditis, to reduce additional levothyroxine.
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http://dx.doi.org/10.21037/gs.2019.10.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6989902PMC
December 2019

The generalizability of Older Adult Self-Report (OASR) syndromes of psychopathology across 20 societies.

Int J Geriatr Psychiatry 2020 05 18;35(5):525-536. Epub 2020 Feb 18.

Departamento de Psicología, Universidad Autónoma de Cuidad Juárez, Cuidad Juárez, Mexico.

Objectives: As the world population ages, psychiatrists will increasingly need instruments for measuring constructs of psychopathology that are generalizable to diverse elders. The study tested whether syndromes of co-occurring problems derived from self-ratings of psychopathology by US elders would fit self-ratings by elders in 19 other societies.

Methods/design: The Older Adult Self-Report (OASR) was completed by 12 826 adults who were 60 to 102 years old in 19 societies from North and South America, Asia, and Eastern, Northern, Southern, and Western Europe, plus the United States. Individual and multigroup confirmatory factor analyses (CFAs) tested the fit of the seven-syndrome OASR model, consisting of the Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited syndromes.

Results: In individual CFAs, the primary model fit index showed good fit for all societies, while the secondary model fit indices showed acceptable to good fit. The items loaded strongly on their respective factors, with a median item loading of .63 across 20 societies, and 98.7% of the loadings were statistically significant. In multigroup CFAs, 98% of items demonstrated approximate or full metric invariance. Fifteen percent of items demonstrated approximate or full scalar invariance, and another 59% demonstrated scalar invariance across more than half of societies.

Conclusions: The findings supported the generalizability of OASR syndromes across societies. The seven syndromes offer empirically based clinical constructs that are relevant for elders of different backgrounds. They can be used to assess diverse elders and as a taxonomic framework to facilitate communication, services, research, and training in geriatric psychiatry.
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http://dx.doi.org/10.1002/gps.5268DOI Listing
May 2020

Co-occurrence of apocrine adenocarcinoma and invasive mammary-type ductal carcinoma in extramammary Paget disease of the axilla.

Arch Plast Surg 2020 Jan 15;47(1):83-87. Epub 2020 Jan 15.

Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.

Extramammary Paget disease (EMPD) is an uncommon malignancy that occurs in apocrine gland-rich areas of the body. EMPD of the axilla is rare, but a few cases have been reported. Some cases of EMPD have been reported with underlying apocrine adenocarcinoma; rarely, mammary-type ductal carcinoma can accompany EMPD. Here, we report a very rare case of EMPD with apocrine adenocarcinoma and invasive mammary-type ductal carcinoma. A 55-year-old woman was referred with a brownish pigmented plaque accompanying an area of ulceration in the left axilla. A preoperative biopsy indicated Paget disease, and an additional evaluation was performed to determine whether it was of primary or secondary origin. A wide excision was made, and the axilla was reconstructed using a thoracodorsal artery perforator flap. The biopsy showed apocrine adenocarcinoma and invasive mammary-type ductal carcinoma with pagetoid spreading. The patient had no evidence of recurrence or other postoperative complications.
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http://dx.doi.org/10.5999/aps.2019.01172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6976753PMC
January 2020

Gamma Ray-Induced Polymerization and Cross-Linking for Optimization of PPy/PVP Hydrogel as Biomaterial.

Polymers (Basel) 2020 Jan 5;12(1). Epub 2020 Jan 5.

Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongup-si, Jeollabuk-do 56212, Korea.

Conducting polymer (CP)-based hydrogels exhibit the behaviors of bending or contraction/relaxation due to electrical stimulation. They are similar in some ways to biological organs and have advantages regarding manipulation and miniaturization. Thus, these hydrogels have attracted considerable interest for biomedical applications. In this study, we prepared PPy/PVP hydrogel with different concentrations and content through polymerization and cross-linking induced by gamma-ray irradiation at 25 kGy to optimize the mechanical properties of the resulting PPy/PVP hydrogel. Optimization of the PPy/PVP hydrogel was confirmed by characterization using scanning electron microscopy, gel fraction, swelling ratio, and Fourier transform infrared spectroscopy. In addition, we assessed live-cell viability using live/dead assay and CCK-8 assay, and found good cell viability regardless of the concentration and content of Py/pTS. The conductivity of PPy/PVP hydrogel was at least 13 mS/cm. The mechanical properties of PPy/PVP hydrogel are important factors in their application for biomaterials. It was found that 0.15PPy/PVP20 (51.96 ± 6.12 kPa) exhibited better compressive strength than the other samples for use in CP-based hydrogels. Therefore, it was concluded that gamma rays can be used to optimize PPy/PVP hydrogel and that biomedical applications of CP-based hydrogels will be possible.
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http://dx.doi.org/10.3390/polym12010111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023038PMC
January 2020

Evaluation of Xpert Carba-R Assay v.2 to Detect Carbapenemase Genes in Two Hospitals in Korea.

Ann Lab Med 2020 May;40(3):209-215

Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Background: As the spread of carbapenemase-producing poses a critical threat to public health, rapid detection of carbapenemase genes is urgently required for prompt initiation of appropriate antimicrobial therapy and infection control. We evaluated the performance of Xpert Carba-R v.2 (Cepheid, USA) compared with that of culture-based conventional PCR.

Methods: Using the results of 5,479 consecutive clinical rectal swabs, discrepant analysis (enriched culture followed by PCR) was performed for all discordant samples (N=100), which were Carba-R v.2-positive and culture-negative.

Results: Among the samples, 206 carbapenemase genes (3.6%) were detected by Carba-R v.2. The sensitivity and specificity were 95.0% and 98.1%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 49.0% and 99.9%, respectively. Following discrepant analysis, the PPV increased to 73.5% and the low PPV (8.1%) of the 86 non-KPC improved to 48.8%. Among the 105 discrepancies, NDM was the most frequently observed (N=56), followed by KPC (N=26), VIM (N=10), IMP (N=8), OXA-48 (N=5). The threshold cycle values between discordant vs. concordant and resolved groups were significantly different (<0.001).

Conclusions: Carba-R v.2 is a rapid and sensitive method for detecting carbapenemase-encoding genes compared with culture-based conventional PCR. Most of our discrepant results were non-KPC genes. Thus, the clinical significance of the non-KPC positive cases detected by Carba-R v.2 should be investigated. This assay would be useful for deciding whether to isolate pre-exposed patients in hospital settings, based on the high specificity and NPV.
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http://dx.doi.org/10.3343/alm.2020.40.3.209DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933065PMC
May 2020