Publications by authors named "Young-Hoon Lee"

219 Publications

Community-Dwelling Individuals with Coronary Artery Disease Have Higher Risk of Depression than the General Population in Female, But Not in Male.

Korean Circ J 2021 Jun 9. Epub 2021 Jun 9.

Department of Nursing, Chonnam National University, Gwangju, Korea.

Background And Objectives: The aim of this study was to assess sex difference in the association between coronary artery disease (CAD) status and depression in a representative nationwide Korean population.

Methods: In total, 4,620 male and 6,151 female aged ≥40 years, who participated in the Korea National Health and Nutrition Examination Survey conducted in 2014, 2016, and 2018, were included in the analysis. Depression was defined as ≥10 points on the 9-item Patient Health Questionnaire.

Results: Among male participants, no significant association between CAD status and depression was observed. However, female with CAD had higher odds ratio (OR) for depression (OR, 2.68; 95% confidence interval [CI], 1.78-4.03) compared with those without CAD in a multiple logistic regression analysis after adjustment for covariates. Younger age at diagnosis of CAD was a significant relating factor for depression in female; OR (95% CI) was 1.73 (0.88-3.40), 3.01 (1.52-5.97), and 4.11 (2.04-8.28) for age ≥65 years, 55-64 years, and ≤54 years, respectively, compared with that in non-CAD controls. In addition, shorter duration of CAD was a significant relating factor for depression in female; OR (95% CI) was 2.42 (1.26-4.67), 2.61 (1.32-5.16), and 3.13 (1.54-6.34) for duration ≥10 years, 5-9 years, and ≤4 years, respectively, compared with that in non-CAD controls.

Conclusions: Consistent screening and psychosocial supports for depression after discharge are required to improve the mental health care of CAD survivors in the community, especially for female diagnosed at a younger age and recently diagnosed.
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http://dx.doi.org/10.4070/kcj.2021.0009DOI Listing
June 2021

Comparison of Psychological Health Problems between Families Living with Stroke Survivors and the General Population in the Community.

Chonnam Med J 2021 May 24;57(2):118-125. Epub 2021 May 24.

Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.

This study aimed to identify and assess the differences in psychological health problems between families living with stroke survivors (FwSS) and the general population without stroke families (GwoSF). A total of 4,514 cases of FwSS were selected for analysis from the 2013 Korea Community Health Survey. In order to determine control groups in GwoSF, propensity scores were generated based on the sociodemographic characteristics of age, gender, residential region, marital status, educational level, monthly household income, and employment status. Each FwSS was matched to 3 controls of GwoSF (13,542 controls) using a greedy matching algorithm with 8 to 1 digit matching. After propensity score-matching, the proportion of usual stress (30.2% vs 24.6%), depressive mood (7.1% vs 6.1%), and suicidal ideation (13.0% vs 11.1%) in FwSS were all significantly higher than those in GwoSF (<0.05). Compared to GwoSF, the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for psychological health problems in FwSS were calculated using multiple logistic regression analysis. The aORs for usual stress (aOR 1.32, 95% CI 1.21-1.42), depressive mood (aOR 1.14, 95% CI 0.99-1.31; borderline significance), and suicidal ideation (aOR 1.17, 95% CI 1.05-1.30) were significantly higher among FwSS than GwoSF. Moreover, the psychological health problems of FwSS were more evident in females than in males. This study shows that FwSS have poorer psychological health outcomes than GwoSF with similar sociodemographic characteristics. Community-based strategies and family support programs, especially for female family members of stroke survivors, are essential to improve the psychological health of stroke families.
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http://dx.doi.org/10.4068/cmj.2021.57.2.118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167444PMC
May 2021

Changes in each retinal layer and ellipsoid zone recovery after full-thickness macular hole surgery.

Sci Rep 2021 May 31;11(1):11351. Epub 2021 May 31.

Department of Ophthalmology, Konyang University College of Medicine, Konyang University Hospital, #158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, Republic of Korea.

To analyze the changes in each retinal layer and the recovery of the ellipsoid zone (EZ) after full-thickness macular hole (FTMH) surgery. Patients who underwent surgery for FTMH were included. Spectral-domain optical coherence tomography (SD-OCT) was performed preoperatively and postoperatively at 1, 3, 6, 9, and 12 months. A total of 32 eyes were enrolled. Ganglion cell layer, inner plexiform layer, and inner nuclear layer showed significant reductions over time after surgery (P = 0.020, P = 0.001, and P = 0.001, respectively), but were significantly thicker than those of fellow eyes at 12 months postoperatively. The average recovery duration of the external limiting membrane (ELM), outer nuclear layer (ONL), and EZ was 1.5, 2.1, and 6.1 months, respectively. Baseline best-corrected visual acuity (BCVA) (P = 0.003), minimum linear diameter (MLD) (P = 0.025), recovery of EZ (P = 0.008), and IRL thickness (P < 0.001) were significant factors associated with changes in the BCVA. Additionally, axial length (P < 0.001), MLD (P = 0.020), and IRL thickness (P = 0.001) showed significant results associated with EZ recovery. The IRL gradually became thinner after FTMH surgery but was still thicker than that of the fellow eye at 12 months postoperatively. The recovery of ELM and ONL may be a prerequisite for the EZ recovery. The BCVA change was affected by baseline BCVA, MLD, recovery of EZ, and IRL thickness. Additionally, axial length, MLD, and IRL thickness were significantly associated with EZ recovery.
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http://dx.doi.org/10.1038/s41598-021-90955-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167100PMC
May 2021

Repeatability of Optical Coherence Tomography Angiography Measurements in Patients with Retinal Vein Occlusion.

Korean J Ophthalmol 2021 04 5;35(2):159-167. Epub 2021 Apr 5.

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea.

Purpose: To analyze the repeatability of vessel density (VD) measurements and manual foveal avascular zone (FAZ) measurements using optical coherence tomography angiography (OCTA) in patients with retinal vein occlusion (RVO) without macular edema.

Methods: The study population consisted of patients with RVO and central macular thickness <300 μm. For each subject, measurements were performed twice with a 5-minute interval. The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were calculated to analyze the repeatability of results obtained with the OCTA device. To identify factors related to repeatability, we performed Pearson correlation analyses based on the CV of potential factors.

Results: A total of 48 eyes were included in the study. The ICCs of the VDs in superficial capillary plexus (SCP) and the deep capillary plexus (DCP) were 0.748 and 0.665, respectively, and the CVs of the VDs in SCP and DCP were 9.1% and 12.6%, respectively. The ICCs associated with the FAZ of the superficial layer (SFAZ) and that of the deep layer (DFAZ) were 0.965 and 0.956, respectively, and the CV of the SFAZ and DFAZ were 8.8% and 9.7%, respectively. From Pearson correlation analyses, OCTA quality was significantly correlated with the CV of the VDs of SCP and DCP. However, there were no variables that were significantly correlated with the CV of SFAZ and DFAZ, including OCTA quality.

Conclusions: VD measurements in the SCP layer using OCTA exhibited good repeatability, and VD measurements in the DCP layer exhibited relatively low repeatability compared to that of SCP layer measurements in patients with RVO without macular edema after treatment with bevacizumab. Manual measurement of the FAZ area in both SCP and DCP layers resulted in good repeatability. In addition, the repeatability of VD measurements in SCP and DCP layers was correlated with OCTA image quality.
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http://dx.doi.org/10.3341/kjo.2020.0143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046611PMC
April 2021

Effects of prolonged type 2 diabetes on changes in peripapillary retinal nerve fiber layer thickness in diabetic eyes without clinical diabetic retinopathy.

Sci Rep 2021 Mar 24;11(1):6813. Epub 2021 Mar 24.

Department of Ophthalmology, Chungnam National University College of Medicine, #640 Daesa-dong, Jung-gu, Daejeon, 301-721, Republic of Korea.

To identify the effects of prolonged type 2 diabetes (T2DM) on changes in peripapillary retinal nerve fiber layer (pRNFL) thickness in patients without clinical diabetic retinopathy. Subjects were divided into two groups: controls and patients with T2DM (DM group). After the initial visits, the pRNFL thicknesses were measured three more times at 1-year intervals. Subgroup analyses were performed in patients with T2DM duration ≥ 10 years. The mean pRNFL thickness at each visit was 95.8 ± 8.1, 95.4 ± 8.3, 94.9 ± 8.1, and 94.5 ± 8.3 μm in the control group (P = 0.138) (n = 55); and 93.4 ± 9.1, 92.1 ± 9.3, 90.9 ± 9.3, and 89.5 ± 9.2 μm in the DM group (P < 0.001) (n = 85). The estimated rate of reduction in mean pRNFL thickness was - 0.45 μm/year in the control group and - 1.34 μm/year in the DM group, respectively. In the DM group, the BCVA and HbA1c (both P = 0.001) were significant factors associated with pRNFL reduction. In patients with T2DM duration ≥ 10 years, the estimated pRNFL reduction rate was - 1.61 μm/year, and hypertension was a significant factor affecting the pRNFL reduction (P = 0.046). We confirmed rapid pRNFL reduction over time in T2DM, and the reduction rate was higher in patients with T2DM ≥ 10 years. Additionally, BCVA and HbA1c levels were significantly associated with the change in pRNFL thickness in T2DM patients.
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http://dx.doi.org/10.1038/s41598-021-86306-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7991659PMC
March 2021

Surgical Outcomes of Vitrectomy for Macular Hole-induced Retinal Detachment According To Various Surgical Methods: A Multicenter Retrospective Study.

Semin Ophthalmol 2021 Mar 22:1-6. Epub 2021 Mar 22.

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea.

Purpose: To investigate the surgical outcomes of vitrectomy for macular hole-induced retinal detachment(MHRD), with respect to the surgical adjunctive method used.

Method: We performed retrospective multicenter study of patients who underwent vitrectomy for MHRD. The visual/anatomical outcomes after vitrectomy were analyzed. We also analyzed these outcomes according to surgical method and the presence of persistent macular hole after the vitrectomy.

Result: Thirty-four patients (34 eyes) from 6 hospitals were included in this study. The mean age of the patients was 64.56 ± 12.23 years; 31 patients (91.2%) were female. The mean LogMAR best-corrected visual acuity (BCVA) significantly improved 6 months after vitrectomy ( < .001). Retinal detachment completely improved in 32 eyes (94.1%). The visual prognoses and macular hole closure rates were not different depending on subretinal fluid drainage site. The presence or absence of a persistent macular hole after vitrectomy did not affect the visual outcomes. However, the recurrence of MHRD was significantly higher in eyes with persistent macular holes= .015).

Conclusion: The surgeries to treat MHRD differed in terms of the procedure depending on the surgeons, but the visual outcomes did not differ depending on the surgical adjunctive method employed. There were no differences in the visual prognoses, regardless of whether there was a persistent macular hole; however, recurrence was significantly higher in eyes with persistent macular holes. Therefore, further surgical treatment might be considered for eyes with persistent macular holes after MHRD surgery.
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http://dx.doi.org/10.1080/08820538.2021.1900288DOI Listing
March 2021

Peripapillary Retinal Nerve Fiber Layer and Microvasculature in Prolonged Type 2 Diabetes Patients Without Clinical Diabetic Retinopathy.

Invest Ophthalmol Vis Sci 2021 02;62(2)

Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea.

Purpose: The purpose of this study to identify the effects of prolonged type 2 diabetes (T2DM) on the peripapillary retinal nerve fiber layer (pRNFL) and peripapillary microvasculature in patients with prolonged T2DM without clinical diabetic retinopathy (DR).

Methods: Subjects were divided into 3 groups: controls (control group; 153 eyes), patients with T2DM < 10 years (DM group 1; 136 eyes), and patients with T2DM ≥ 10 years (DM group 2; 74 eyes). The pRNFL thickness and peripapillary superficial vessel density (VD) were compared. Linear regression analyses were performed to identify factors associated with peripapillary VD in patients with T2DM.

Results: The mean pRNFL thicknesses of the control group, DM group 1, and DM group 2 were 96.0 ± 7.9, 94.5 ± 0.9, and 92.2 ± 8.2 µm, respectively (P < 0.001). The VDs were 18.24 ± 0.62, 17.60 ± 1.47, and 17.15 ± 1.38 mm-1 in the control group, DM group 1, and DM group 2, respectively (P < 0.001). In multivariate linear regression analyses, visual acuity (B = -2.460, P = 0.001), axial length (B = -0.169, P = 0.008), T2DM duration (B = -0.056, P < 0.001), and pRNFL (B = 0.024, P = 0.001) were significant factors affecting the peripapillary VD in patients with T2DM.

Conclusions: Patients with T2DM without clinical DR showed thinner pRNFL and lower peripapillary VD and perfusion density (PD) compared with normal controls, and such damage was more severe in patients with T2DM ≥ 10 years. Additionally, peripapillary VD was significantly associated with best-corrected visual acuity (BCVA), axial length, T2DM duration, and pRNFL thickness in patients with T2DM.
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http://dx.doi.org/10.1167/iovs.62.2.9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873502PMC
February 2021

Increased adiponectin levels are associated with higher radiographic scores in the knee joint, but not in the hand joint.

Sci Rep 2021 Jan 19;11(1):1842. Epub 2021 Jan 19.

Division of Rheumatology, Department of Internal Medicine, Chonnam National University Medical School & Hospital, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.

Several studies have evaluated the association between serum adiponectin levels and knee and hand osteoarthritis (OA); mixed results have been reported. We investigated the relationship between OA and serum adiponectin levels according to the radiographic features of knee and hand OA. A total of 2402 subjects was recruited from the Dong-gu Study. Baseline characteristics were collected via a questionnaire, and X-rays of knee and hand joints were scored using a semi-quantitative grading system. The relationship between serum adiponectin levels and radiographic severity was evaluated by linear and logistic regression analysis. Subjects in the higher serum adiponectin levels tertiles were older and had a lower body mass index (BMI) than those in the lower tertiles. Regarding knee joint scores, serum adiponectin levels was positively associated with the total (P < 0.001), osteophyte (P = 0.003), and joint space narrowing (JSN) scores (P < 0.001) after adjustment for age, sex, BMI, smoking, alcohol consumption, education, and physical activity. In terms of hand joint scores, no association was found between serum adiponectin levels and the total, osteophyte, JSN, subchondral cyst, sclerosis, erosion, or malalignment score after the above-mentioned adjustments. Similarly, subjects with serum adiponectin levels above the median had higher total radiographic scores in the knee joints, but not in the hand joints, after adjustment. An increased serum adiponectin levels was associated with a higher radiographic score in the knee joint, but not in the hand joint, suggesting the involvement of different pathophysiologic mechanisms in the development of OA between those joints.
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http://dx.doi.org/10.1038/s41598-021-81513-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815782PMC
January 2021

The longitudinal associations between trajectory of and quantity of alcohol consumption and subsequent changes in blood pressure levels among non-hypertensive adults.

Br J Nutr 2021 Jan 14:1-26. Epub 2021 Jan 14.

Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea.

Given the dynamic characteristic of an individual's drinking behaviors, comprehensive consideration of alcohol consumption variation using repeated measures may improve insight into the nature of its association with blood pressure (BP) change. We examined the association between longitudinal alcohol consumption (trajectory and quantity) and changes in BP and pulse pressure (PP) among Korean aged ≥40 years living in rural areas. Totally, 1682 hypertension-free participants who completed all three health examinations (median, 5.3 years) were included. All three visits were used to determine the cumulative trajectory of and quantity of alcohol consumption and the latest two visits and the last visit were used for the recent trajectory and the most recent quantity of alcohol consumption, respectively. Changes in BP and PP from the baseline to the 3rd visit were used as outcome. In men, ≥30 ml/d cumulative average alcohol consumption was associated with the greatest increase in systolic BP (SBP) in both baseline outcome-unadjusted (2.9 mmHg, p-value = 0.032) and -adjusted models (3.6 mmHg, p-value = 0.001) and the given association for the most recent alcohol consumption was observed in the baseline outcome-adjusted model (3.9 mmHg, p-value = 0.003). For PP, similar associations were observed only in the baseline outcome-adjusted model. No meaningful associations in diastolic BP in men and any BP or PP in women existed. The quantity of alcohol consumption than the trajectory may be significantly related to raised SBP and a possible short-term influence of the most recent alcohol consumption may exist when baseline SBP adjusted in men.
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http://dx.doi.org/10.1017/S0007114521000088DOI Listing
January 2021

Short-term effect of anti-VEGF for chronic central serous chorioretinopathy according to the presence of choroidal neovascularization using optical coherence tomography angiography.

PLoS One 2021 11;16(1):e0245342. Epub 2021 Jan 11.

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Republic of Korea.

Purpose: To analyze the short-term therapeutic efficacy of intravitreal injection of bevacizumab (IVB) for chronic central serous chorioretinopathy (CSC) according to the presence of choroidal neovascularization (CNV) using optical coherence tomography angiography (OCTA).

Methods: A retrospective chart review was perfomed on cases of CSC with CNV (Group 1: n = 31) and an age-matched cases of CSC without CNV (Group 2: n = 30). The response to IVB was evaluated by changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), choroidal thickness (CT), and pachyvessel diameter. Univariate and multivariate linear regression analyses were performed to identify factors associated with the visual outcome of chronic CSC with CNV after IVB.

Results: At baseline, the CT values differed significantly between Groups 1 and 2 (371.55 ± 67.09 vs. 417.33 ± 71.32 μm, p = 0.01). In Group 1, BCVA improved significantly (p < 0.001), and CMT (p < 0.001), CT (p = 0.001) and pachyvessel diameter (p = 0.045) decreased significantly, after IVB. In Group 2, only pachyvessel diameter (p = 0.001) was significantly smaller after IVB. Univariate analysis showed that the initial CT (B = 0.002, p = 0.026) and pachyvessel diameter (B = 0.002, p = 0.001) significantly affected visual outcome. In multivariate analysis, the initial pachyvessel diameter exhibited significant results (B = 0.002, p = 0.001).

Conclusions: IVB showed less effective short-term outcomes in chronic CSC patients without CNV than in patients with CNV. In chronic CSC with CNV, the short-term visual outcome after IVB was better in patients with a thinner choroid and smaller pachyvessels.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245342PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799826PMC
June 2021

Low serum 25-hydroxyvitamin D levels, tooth loss, and the prevalence of severe periodontitis in Koreans aged 50 years and older.

J Periodontal Implant Sci 2020 Dec;50(6):368-378

Department of Periodontology, Dental Science Research Institute, Chonnam National University School of Dentistry, Gwangju, Korea.

Purpose: Vitamin D deficiency may cause bone loss and increased inflammation, which are well-known symptoms of periodontal disease. This study investigated whether serum 25-hydroxyvitamin D (25(OH)D) levels are associated with periodontal disease status and tooth loss.

Methods: Cross-sectional data from 5,405 individuals aged ≥50 years (2,253 males and 3,152 females) were obtained from the 2008-2010 Dong-gu study, a prospective cohort study of risk factors for chronic diseases. Periodontal examinations were conducted to evaluate the number of remaining teeth, the periodontal probing depth (PPD), the clinical attachment level (CAL), and bleeding on probing. The percentages of sites with PPD ≥4 mm and CAL ≥4 mm were recorded for each participant. The severity of periodontitis was classified using the Centers for Disease Control and Prevention and the American Academy of Periodontology case definitions. Serum 25(OH)D levels were classified as reflecting severe deficiency, deficiency, insufficiency, or sufficiency. Multivariate linear regression analysis was performed to assess the associations of serum 25(OH)D levels with periodontal parameters and the number of remaining teeth after adjusting for confounders including age, smoking status, alcohol consumption status, month of blood collection, and physical activity. Multivariate logistic regression was used to evaluate the association between serum vitamin D levels and severe periodontitis. An overall statistical analysis and a stratified analysis by sex were performed.

Results: Overall, the rates of severe deficiency, deficiency, insufficiency, and sufficiency were 6.5%, 67.9%, 22.4%, and 3.2%, respectively. After adjustment for confounders, vitamin D levels were directly associated with the number of remaining teeth, an association that was significant in males, but not in females. Sufficient serum 25(OH)D was associated with a low frequency of severe periodontitis.

Conclusions: This population-based cross-sectional study indicates that low serum 25(OH)D is significantly associated with tooth loss and severe periodontitis in Koreans aged 50 years and older.
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http://dx.doi.org/10.5051/jpis.2002540127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7758301PMC
December 2020

Protection of Alcohol Dehydrogenase against Freeze-Thaw Stress by Ice-Binding Proteins Is Proportional to Their Ice Recrystallization Inhibition Property.

Mar Drugs 2020 Dec 13;18(12). Epub 2020 Dec 13.

Department of Chemistry, Pukyong National University, Busan 48513, Korea.

Ice-binding proteins (IBPs) have ice recrystallization inhibition (IRI) activity. IRI property has been extensively utilized for the cryopreservation of different types of cells and tissues. Recent reports demonstrated that IRI can also play a significant role in protecting proteins from freezing damage during freeze-thaw cycles. In this study, we hypothesized that the protective capability of IBPs on proteins against freeze-thaw damage is proportional to their IRI activity. Hence we used two IBPs: one with higher IRI activity (LeIBP) and the other with lower activity (FfIBP). Yeast alcohol dehydrogenase (ADH) was used as a freeze-labile model protein. IBPs and ADH were mixed, frozen at -20 °C, and thawed repeatedly. The structure of ADH was assessed using fluorescence emission spectra probed by 1-anilinonaphthalene-8-sulfonate over the repeated freeze-thaw cycles. The activity was monitored at 340 nm spectrophotometrically. Fluorescence data and activity clearly indicated that ADH without IBP was freeze-labile. However, ADH maintained about 70% residual activity after five repeated cycles at a minimal concentration of 0.1 mg mL of high IRI-active LeIBP, but only 50% activity at 4 mg mL of low active FfIBP. These results showed that the protection of proteins from freeze-thaw stress by IBPs is proportional to their IRI activity.
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http://dx.doi.org/10.3390/md18120638DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7764648PMC
December 2020

Cystatin C-based estimated GFR and albuminuria are independently associated with all-cause and CVD mortality in Korean population: The Dong-gu Study.

Maturitas 2021 Jan 2;143:178-183. Epub 2020 Nov 2.

Department of Preventive Medicine, Chosun University Medical School, 309, Pilmun-daero, Dong-gu, Gwangju, 61452, Republic of Korea. Electronic address:

Objective: To assess the associations among the estimated glomerular filtration rate (eGFR), albumin to creatinine ratio (ACR), and all-cause and CVD mortality rate and to compare the performances of eGFR, eGFR, and eGFR using receiver operating characteristic (ROC) analysis in Korean adults aged ≥ 50 years.

Methods: Of the 9,260 subjects who participated in the baseline survey of a prospective longitudinal study conducted in Korea, 9,009 (men: 3,574 (39.7%); women: 5,435 (60.3%)) were included in this analysis after the exclusion of 217 subjects with missing eGFR and 34 subjects with missing ACR data.

Main Outcome Measure: The associations of eGFR and ACR with all-cause and CVD mortality were investigated using Cox proportional hazards models that included sex, age, waist circumference, smoking, alcohol intake, degree of physical activity, hypertension, diabetes, systolic blood pressure, log-HbA, total cholesterol, log-triglyceride, log-HDL and log-ACR or eGFR.

Results: After adjustment for covariates, independent associations were found between all-cause mortality and the eGFR (mL/min per 1.73 m) [HR 1.23, 95% confidence interval (CI) 1.05-1.43 for 60-89 vs. ≥ 90; HR 1.87, 95% CI 1.49-2.34 for 45-59 vs. ≥ 90; HR 2.38, 95% CI 1.77-3.20 for 30-44 vs. ≥ 90; HR 2.82, 95% CI 1.89-4.23 for <30 vs. ≥ 90] and ACR (μg/mg creatinine) [HR 1.09, 95% CI 0.88-1.34 for Q2 vs. Q1; HR 1.34, 95% CI 1.10-1.63 for Q3 vs. Q1; HR 1.49, 95% CI 1.22-1.81 for Q4 vs. Q1]. In addition, independent associations of CVD mortality with the eGFR and ACR were significant. In the comparison of eGFR performance, the ROC-plot AUC for all-cause mortality was significantly greater for the eGFR than for the eGFR and eGFR.

Conclusion: The eGFR and ACR were associated independently with all-cause and CVD mortality after adjustment for covariates, including the eGFR and ACR. In addition, the ROC-plot AUC for all-cause mortality was greater for the eGFR than for the eGFR and eGFR in Korean adults aged ≥ 50 years.
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http://dx.doi.org/10.1016/j.maturitas.2020.10.016DOI Listing
January 2021

Comparison of Retinal Layer Thicknesses of Highly Myopic Eyes and Normal Eyes.

Korean J Ophthalmol 2020 12 3;34(6):469-477. Epub 2020 Dec 3.

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea.

Purpose: To evaluate the differences in individual segmental retinal layer thickness in adult patients with high myopia.

Methods: This study compared the retinal layers of patients with high myopia (axial length of ≥26.0 mm) with those of normal controls using spectral-domain optical coherence tomography. The thicknesses of the retinal layers were compared using nine Early Treatment Diabetic Retinopathy Study subfields. Choroidal thickness was also measured in the subfoveal area.

Results: We included 37 eyes with high myopia and 37 eyes of healthy subjects. The mean age was 42.95 and 47.73 years (p = 0.114), and the mean axial length was 27.28 and 24.47 mm (p < 0.001), respectively. The parafoveal areas (outer ring segment) of the ganglion cell layer and inner plexiform layer, all segmental areas except the subfoveal region of the inner nuclear layer, most segmental areas (inner superior, inner inferior, outer superior, outer temporal, and outer nasal) of outer plexiform layer, and most segmental areas (subfovea, inner temporal, inner inferior, inner nasal, outer temporal, and outer inferior) of outer nuclear layer were thinner in eyes with high myopia than in normal eyes (all p < 0.05). There were no statistically significant differences between the levels of photoreceptor layer, retinal pigment epithelium, and nerve fiber layer. The mean choroidal thickness was 153.81 ± 64.80 and 239.54 ± 44.28 μm in the high myopia and control groups, respectively, which were significantly different (p < 0.001).

Conclusions: In high myopia without pathologic changes, there was a meaningful thinning of the retina and choroid, especially in most Early Treatment Diabetic Retinopathy Study subfield areas of the deep vascular complex, perifoveal area of the superficial vascular complex, and most areas of the outer nuclear layer in the outer retinal layer, which are associated with myopic axial elongation.
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http://dx.doi.org/10.3341/kjo.2020.0012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738221PMC
December 2020

Indicators Related to Cardiopulmonary Resuscitation According to Occupation Among Family Members of Coronary Heart Disease Patients.

Chonnam Med J 2020 Sep 24;56(3):196-202. Epub 2020 Sep 24.

Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.

This study aimed to evaluate differences in cardiopulmonary resuscitation (CPR)-related indicators among families of community-dwelling coronary heart disease (CHD) patients according to their occupation. A total of 6,867 family members living with CHD patients were selected for analysis from the 2016 Korea Community Health Survey. Respondents' occupations were classified into managers and professionals (MP), clerks (CL), service and sales workers (SSW), agricultural/forestry/fishery workers (AFFW), mechanical and manual laborers (MML), and homemakers and unemployed (HU). The adjusted odds ratio (aOR) for awareness of CPR in the MP (3.82), SSW (1.73), and MML (1.29) groups were higher than that in HU (reference), while the CL (1.42) and AFFW (1.04) groups showed no significant difference compared to HU. The aORs for experience with CPR education and manikin-assisted CPR training were higher among the MP (4.00 and 3.94), CL (2.61 and 2.26), SSW (2.02 and 1.91), and MML (1.99 and 1.69) groups than in HU, and only AFFW (1.22 and 1.18) showed no difference from HU. Finally, the aOR for self-efficacy in CPR performance was significantly higher among the MP (3.17), CL (1.64), SSW (1.87), and MML (1.44) groups than in HU. However, there was no significant difference between AFFW (1.22) and HU in self-efficacy in CPR performance. To improve the survival rate of CHD patients through successful CPR at the pre-hospital stage during cardiac arrest, it is important to increase the ability of family members of CHD patients to perform CPR, especially among those in AFFW and HU occupations.
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http://dx.doi.org/10.4068/cmj.2020.56.3.196DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520363PMC
September 2020

Effect of Intrasilicone Bevacizumab Injection in Diabetic Tractional Retinal Detachment Surgery: A Retrospective Case-Control Study.

J Clin Med 2020 Sep 26;9(10). Epub 2020 Sep 26.

Department of Ophthalmology, Konyang University College of Medicine, Daejeon 35365, Korea.

Tractional retinal detachment (TRD) causes visual loss in diabetes mellitus patients. Silicone oil can be used as a tamponade to repair retinal detachment; however, intrasilicone injection is challenging. We aimed to evaluate the effect of intrasilicone bevacizumab injection in TRD surgery. This was a single-hospital, retrospective, case-control study of 44 patients (46 eyes). We reviewed medical histories and ophthalmic examination results. We administered silicone oil to 26 eyes (group I), and a combination of silicone oil and intravitreal bevacizumab injection to 20 eyes (group II). The main outcome measures were the logarithm of the minimum angle of resolution (logMAR) visual acuity and central macular thickness. Mean change in logMAR visual acuity was larger ( = 0.029) in group II (-0.99 ± 0.73) than in group I (-0.56 ± 0.80), 12 months postoperatively. Compared to group I, group II exhibited a lower mean (471.54 ± 120.14 μm vs. 363.40 ± 59.57 µm, respectively; = 0.001), and mean change (-22.39 ± 203.99 μm vs. -72.40 ± 139.35 µm, respectively; = 0.027), in central macular thickness, 1 month postoperatively. Intrasilicone bevacizumab injection immediately after vitrectomy may rapidly reduce central macular thickness and increase final visual acuity. Prospective studies are necessary to demonstrate long-term safety and efficacy.
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http://dx.doi.org/10.3390/jcm9103114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601065PMC
September 2020

Frustrated Lewis pairs with thermally activated delayed fluorescence properties: activation of formaldehyde.

Dalton Trans 2020 Oct;49(38):13198-13201

Department of Chemistry, University of Ulsan, Ulsan 44610, Republic of Korea.

Activation of formaldehyde (FA) by frustrated Lewis pairs (FLPs) that are comprised of bulky phosphines having a carbazolyl donor-triarylboryl acceptor unit and B(C6F5)3 led to the formation of FLP-FA adducts that exhibit a thermally activated delayed fluorescence.
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http://dx.doi.org/10.1039/d0dt02507kDOI Listing
October 2020

Centralized Ambulance Diversion Policy Using Rolling-Horizon Optimization Framework to Minimize Patient Tardiness.

Healthcare (Basel) 2020 Aug 12;8(3). Epub 2020 Aug 12.

Department of Industrial Engineering, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.

Ambulance diversion (AD) is a common method for reducing crowdedness of emergency departments by diverting ambulance-transported patients to a neighboring hospital. In a multi-hospital system, the AD of one hospital increases the neighboring hospital's congestion. This should be carefully considered for minimizing patients' tardiness in the entire multi-hospital system. Therefore, this paper proposes a centralized AD policy based on a rolling-horizon optimization framework. It is an iterative methodology for coping with uncertainty, which first solves the centralized optimization model formulated as a mixed-integer linear programming model at each discretized time, and then moves forward for the time interval reflecting the realized uncertainty. Furthermore, the decentralized optimization, decentralized priority, and No-AD models are presented for practical application, which can also show the impact of using the following three factors: centralization, mathematical model, and AD strategy. The numerical experiments conducted based on the historical data of Seoul, South Korea, for 2017, show that the centralized AD policy outperforms the other three policies by 30%, 37%, and 44%, respectively, and that all three factors contribute to reducing patients' tardiness. The proposed policy yields an efficient centralized AD management strategy, which can improve the local healthcare system with active coordination between hospitals.
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http://dx.doi.org/10.3390/healthcare8030266DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551726PMC
August 2020

Optimal cost adjustment for a selfish routing healthcare network.

Health Care Manag Sci 2020 Dec 8;23(4):585-604. Epub 2020 Aug 8.

Yonsei University, 50 yonsei-ro seodaemun-gu, Seoul, South Korea.

South Korea's large hospitals are severely burdened by patient congestion because patients throng to these places expecting to get treated better given their higher-quality healthcare. Effective cost management of the healthcare system is one way to reduce patient congestion in a large hospital. This study proposes methods that can help direct patient flows in a desirable direction and suggests ways to effectively manage the cost of healthcare. The study also discusses how selfish patients act in ways that maximize their benefits by choosing a specific hospital and in turn forcing the hospital and the healthcare network to bear more costs than is necessary. The study proposes a model describing the need for intervention from the government to control the cost escalation resulting from selfish routing. The study proposes two heuristic algorithms to solve the suggested model. The flow-based algorithm addresses the target quantum of flows, and the utility-based algorithm targets the value of cost functions. Performances of heuristics are evaluated through numerical experiments. The utility-based algorithm yields higher values for objectives, while the flow-based algorithm controls the extent of investment. A case study based on data from the Seoul city database is also analyzed. The cost adjustment policy is compared with simple, uniformly improved network policies, and findings show that such policies have the strength needed to improve the cost-effectiveness of the healthcare system if implemented fully and effectively.
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http://dx.doi.org/10.1007/s10729-020-09512-6DOI Listing
December 2020

Long-Term Outcome of Epiretinal Membrane Surgery in Patients with Internal Limiting Membrane Dehiscence.

J Clin Med 2020 Aug 1;9(8). Epub 2020 Aug 1.

Department of Ophthalmology, Konyang University College of Medicine, Daejeon 35365, Korea.

Purpose: To identify the effect of internal limiting membrane (ILM) dehiscence on surgical outcomes in eyes that have undergone epiretinal membrane (ERM) removal.

Methods: Consecutive eyes with performed vitrectomy for ERM removal were included. Subjects were divided into two groups: patients with ILM dehiscence (group 1) and without ILM dehiscence (group 2). The best-corrected visual acuity (BCVA) and retinal layer thickness before and after surgery were compared between the two groups.

Results: A total of 86 eyes were enrolled. Forty-six eyes (53.5%) showed ILM dehiscence before surgery. The baseline BCVAs were 0.46 ± 0.29 and 0.45 ± 0.25 in groups 1 and 2, respectively ( = 0.801). The BCVAs at 3, 6, and 12 months after surgery differed significantly between the two groups. The subfoveal thickness and inner retinal layer thickness (IRLT) of group 1 vs. 2 were 507.4 ± 80.0 vs. 417.6 ± 63.6 μm, and 270.2 ± 74.3 vs. 182.6 ± 60.4 μm, respectively (both < 0.001). These differences between the groups remained significant until 12 months after surgery. In multivariate analyses, the location of ILM dehiscence (B = -0.105, = 0.034) and final IRLT (B = 0.001, = 0.046) were significant factors affecting the final BCVA.

Conclusions: ILM dehiscence is a relatively common finding and associated with preoperative and postoperative increased IRLT, which results in worse surgical outcomes compared to the absence of ILM dehiscence in patients with ERM. Additionally, the final BCVA was significantly affected by its location and final IRLT in patients with ILM dehiscence.
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http://dx.doi.org/10.3390/jcm9082470DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7465423PMC
August 2020

Effects of Prolonged Type 2 Diabetes on the Inner Retinal Layer and Macular Microvasculature: An Optical Coherence Tomography Angiography Study.

J Clin Med 2020 Jun 13;9(6). Epub 2020 Jun 13.

Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon 35015, Korea.

Purpose: To identify the effects of prolonged type 2 diabetes (T2DM) on macular microcirculation and the inner retinal layer in diabetic eyes without clinical diabetic retinopathy (DR).

Methods: 97, 92, and 57 eyes in the control, patients with T2DM < 10 years (DM group one), and patients with T2DM ≥ 10 years (DM group two) were enrolled. The ganglion cell-inner plexiform layer (GC-IPL) thickness and superficial vessel density (VD) were compared. Linear regression analyses were performed to identify factors associated with VD in T2DM patients.

Results: GC-IPL thicknesses in the control, DM group one, and DM group two were 84.58 ± 0.89, 83.49 ± 0.70, and 79.04 ± 0.96 μm, respectively ( < 0.001). The VDs of the full area were 20.32 ± 0.15, 19.46 ± 0.17, and 18.46 ± 0.23 mm ( < 0.001). Post-hoc analyses revealed that the VDs of the full area was significantly different in the control vs. DM group one ( = 0.001), control vs. DM group two ( < 0.001), and DM group one vs. DM group two ( = 0.001). Multivariate linear regression analyses revealed that DM duration ( = 0.037), visual acuity ( = 0.013), and GC-IPL thickness ( < 0.001) were significantly associated with the VD of T2DM patients.

Conclusions: We confirmed GC-IPL thinning and decreased superficial VD in the macular areas using OCTA in T2DM patients. Patients with T2DM ≥ 10 years exhibited significantly more severe macular microcirculation impairment compared to patients with T2DM < 10 years and normal controls.
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http://dx.doi.org/10.3390/jcm9061849DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355838PMC
June 2020

Sex-specific associations of habitual intake of soy protein and isoflavones with risk of type 2 diabetes.

Clin Nutr 2021 01 4;40(1):127-136. Epub 2020 May 4.

Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea; Institute for Health and Society, Hanyang University, Seoul, South Korea.

Background & Aims: A possible mechanism by which intake of soy isoflavones leads to an improvement in glucose metabolism has been suggested. However, epidemiological evidence of a link between dietary soy isoflavone and type 2 diabetes is not convincing. This study aimed to evaluate the prospective associations between intake of dietary soy protein and isoflavones (total isoflavones, daidzein and genistein) and risk of type 2 diabetes in a community-based cohort of Korean adults aged ≥ 40 years, the Korean Multi-Rural Communities Cohort (MRCohort).

Methods: A total of 8269 participants who did not have type 2 diabetes were enrolled. Dietary intake was calculated using a food frequency questionnaire.

Results: Over 50,063 person-years of follow-up, 531 participants developed type 2 diabetes. Significant dose-response inverse associations were observed between dietary soy protein and isoflavones (quartiles) and type 2 diabetes in women (incidence rate ratio, IRR = 0.63, 95% CI = 0.45-0.87, P for trend = 0.0078 for soy protein; IRR = 0.62, 95% CI = 0.45-0.86, P for trend = 0.0031 for total isoflavones for the highest quartile compared with the lowest quartile). Similar significant linear trends were found for both daidzein and genistein. However, there were no significant associations with soy protein and isoflavones in men. The sex-specific differences in associations between soy protein and isoflavones intakes and type 2 diabetes risk were statistically significant (all P for interaction < 0.05).

Conclusions: Habitual intake of soy protein and isoflavones may be inversely associated with type 2 diabetes in women, but not in men. Dietary soy components may play different roles in the development of type 2 diabetes in men and women.
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http://dx.doi.org/10.1016/j.clnu.2020.04.035DOI Listing
January 2021

Repeatability of Manual Measurement of Foveal Avascular Zone Area in Optical Coherence Tomography Angiography Images in High Myopia.

Korean J Ophthalmol 2020 04;34(2):113-120

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea.

Purpose: To analyze the repeatability of manual measurement of foveal avascular zone (FAZ) area in an optical coherence tomography angiography (OCTA) image in high myopia.

Methods: This study comprised patients with high myopia and controls. Two consecutive FAZ areas of the superficial and deep capillary plexus were obtained using OCTA. The intraclass correlation coefficient (ICC) and coefficient of variation (CV) were assessed, and univariate and multivariate generalized linear mixed models were conducted to identify factors related to repeatability.

Results: Thirty eyes with high myopia and 34 eyes of healthy subjects were included in the study. The mean age in high myopia and control subjects was 55.5 and 60.8 years, respectively, the mean spherical equivalent was -9.98 and -0.55 diopters, and the mean axial length was 28.0 and 23.9 mm. The ICCs of FAZ area of the superficial capillary plexus (SCP) were 0.891 and 0.919, while the CVs were 8.8% and 8.5%. In measurement of the deep capillary plexus, the ICCs were 0.788 and 0.907, while the CVs were 11.2% and 11.0%, which were acceptable but exhibited lower repeatability than those of SCP. Multivariate analyses showed that older age ( = 0.030) and greater axial length ( = 0.005) were significantly associated with lower repeatability of SCP FAZ area measurements. In addition, greater axial length ( = 0.044) was a significant factor for lower repeatability of deep capillary plexus FAZ area measurements.

Conclusions: Manual measurement of FAZ area using OCTA exhibited relatively good repeatability for high myopia. Age and axial length affected repeatability and should be considered when analyzing FAZ areas in high myopia patients.
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http://dx.doi.org/10.3341/kjo.2019.0105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7105788PMC
April 2020

Improving Emergency Department Efficiency by Patient Scheduling Using Deep Reinforcement Learning.

Healthcare (Basel) 2020 Mar 27;8(2). Epub 2020 Mar 27.

Department of Industrial Engineering, Yonsei University, 50 Yonsei-ro, Seoul 03722, Korea.

Emergency departments (ED) in hospitals usually suffer from crowdedness and long waiting times for treatment. The complexity of the patient's path flows and their controls come from the patient's diverse acute level, personalized treatment process, and interconnected medical staff and resources. One of the factors, which has been controlled, is the dynamic situation change such as the patient's composition and resources' availability. The patient's scheduling is thus complicated in consideration of various factors to achieve ED efficiency. To address this issue, a deep reinforcement learning (RL) is designed and applied in an ED patients' scheduling process. Before applying the deep RL, the mathematical model and the Markov decision process (MDP) for the ED is presented and formulated. Then, the algorithm of the RL based on deep Q-networks (DQN) is designed to determine the optimal policy for scheduling patients. To evaluate the performance of the deep RL, it is compared with the dispatching rules presented in the study. The deep RL is shown to outperform the dispatching rules in terms of minimizing the weighted waiting time of the patients and the penalty of emergent patients in the suggested scenarios. This study demonstrates the successful implementation of the deep RL for ED applications, particularly in assisting decision-makers under the dynamic environment of an ED.
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http://dx.doi.org/10.3390/healthcare8020077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7349722PMC
March 2020

Dietary iodine, seaweed consumption, and incidence risk of metabolic syndrome among postmenopausal women: a prospective analysis of the Korean Multi-Rural Communities Cohort Study (MRCohort).

Eur J Nutr 2021 Feb 24;60(1):135-146. Epub 2020 Mar 24.

Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea.

Purpose: Despite a beneficial role of iodine and seaweed consumption against metabolic syndrome (MetS), which is high in postmenopausal women, few studies investigated such associations in a prospective study. This study aimed to investigate the association of dietary iodine and seaweed consumption with the incidence of MetS and its components in postmenopausal women.

Methods: A total of 2588 postmenopausal women aged ≥ 40 years were recruited between 2005 and 2011 in the Multi-Rural Communities Cohort (MRCohort). A validated semiquantitative food frequency questionnaire was used to collect dietary intake data. MetS was defined as three of five components [abdominal obesity, elevated blood pressure, glucose, triglyceride, and low-high density lipoprotein cholesterol (HDL-C)] and the incidence of MetS was checked every 2-4 years. The incidence rate ratio (IRR) was estimated using a modified Poisson regression model with a robust error estimator.

Results: During the mean follow-up period (3.4 ± 2.1 years), MetS occurred in 481 participants. The median cumulative average iodine intake was 108.9 µg/day (interquartile range, 60.8-190.2 µg/day). In multivariable analyses, average iodine and seaweed consumption were inversely associated with MetS (IRR = 0.61, 95% CI 0.47-0.78 in the highest quartile of iodine intake, P for trend = 0.0018; IRR = 0.52, 95% CI 0.39-0.69 in the highest quartile of seaweed consumption, P for trend = 0.0004). Among MetS components, blood glucose (> 100 mg/dL), blood pressure (≥ 130/85 mmHg), and lipid profiles (triglyceride, ≥ 150 mg/dL and HDL-C, < 50 mg/dL) were significantly inversely associated with dietary iodine and seaweed consumption, but there was no clear association for waist circumference (≥ 85 cm).

Conclusion: Dietary iodine and seaweed consumption may be inversely associated with MetS incidence and its individual abnormalities in postmenopausal women.
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http://dx.doi.org/10.1007/s00394-020-02225-0DOI Listing
February 2021

Effect Modification of Acetaldehyde Dehydrogenase 2 rs671 Polymorphism on the Association between Alcohol Intake and Blood Pressure: the Dong-gu Study.

J Korean Med Sci 2020 Mar 9;35(9):e14. Epub 2020 Mar 9.

Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.

Background: Elevated blood pressure is a major preventable cause of cardiovascular diseases. Alcohol consumption is a well-known risk factor of elevated blood pressure. The aldehyde dehydrogenase 2 () polymorphism is common in Eastern Asians, and inactive genotypes are associated with both avoiding alcohol consumption and aldehyde accumulation. Therefore, this study assessed the associations between alcohol consumption and hypertension and blood pressure according to the genotypes.

Methods: This study consists of 8,526 participants in the Dong-gu Study. Multivariate logistic regression was used to calculate the odds ratio (OR) according to alcohol consumption after stratifying by gender and genotypes. Multivariate linear regression was performed to estimate the systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to the amount of alcohol consumed.

Results: In men, alcohol consumption was positively associated with both SBP and DBP in active carriers, but not in inactive carriers. In active carriers, compared to non-drinkers, the OR of hypertension was 1.16 (95% confidence interval [CI], 0.91-1.49) for < 1 drink/day, and 1.44 (95% CI, 1.15-1.80) for ≥ 1 drink/day in men. With each 1 drink/day increase, SBP and DBP increased by 3 and 1 mmHg in men, respectively. There was no significant association between genotypes and hypertension and blood pressure in women.

Conclusion: genotype modified the association between alcohol consumption and blood pressure in men. There was a positive relationship between alcohol consumption and blood pressure in active carriers, but no significant relationship in inactive carriers.
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http://dx.doi.org/10.3346/jkms.2020.35.e14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061145PMC
March 2020

Positive association of alcohol consumption with incidence of hypertension in adults aged 40 years and over: Use of repeated alcohol consumption measurements.

Clin Nutr 2020 10 31;39(10):3125-3131. Epub 2020 Jan 31.

Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, South Korea.

Background & Aims: Managing alcohol consumption may be an effective way of preventing hypertension, which is an important modifiable risk factor for cardiovascular diseases. However, there is little evidence on the temporal relationship between alcohol consumption and incidence of hypertension. We investigated the prospective association between repeated measures of alcohol consumption and hypertension incidence among Korean adults aged 40 and over.

Methods: This study included a total of 4989 participants that were not taking antihypertensive drugs and had normal blood pressure (BP) (systolic < 140 mmHg and diastolic < 90 mmHg). We used three measures of alcohol consumption (baseline, most recent, and average) as exposures and compared the three approaches. Using a modified Poisson regression model with a robust error estimator, we estimated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for hypertension.

Results: Over a total of 17,689 person-years (average 3.5 years of follow-up), 574 incident cases of hypertension were identified. In multivariable models, consuming ≥30 ml/d of alcohol was associated with a risk of hypertension among men (IRR = 1.72, 95% CI = 1.20-2.48, p trend = 0.017 for baseline alcohol consumption; IRR = 1.69, 95% CI = 1.23-2.33, p trend = 0.005 for the most recent alcohol consumption; IRR = 1.49, 95% CI = 1.09-2.03, p trend = 0.014 for average alcohol consumption). After additional adjustment for baseline BP the positive association remained only when the most recent alcohol consumption measure was used. There was no significant association between alcohol consumption and hypertension among women, and no interaction effect between alcohol consumption and baseline BP levels on incidence of hypertension (all p interaction > 0.05) existed.

Conclusions: Alcohol consumption, especially consuming ≥30 ml/d, may be positively linked with incidence risk of hypertension among men.
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http://dx.doi.org/10.1016/j.clnu.2020.01.020DOI Listing
October 2020

Effect of 0.1% Bromfenac for Preventing Macular Edema after Cataract Surgery in Patients with Diabetes.

Korean J Ophthalmol 2020 02;34(1):46-55

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea.

Purpose: To investigate the effect of 0.1% bromfenac sodium hydrate ophthalmic solution for prevention of macular edema after cataract surgery in patients with diabetes.

Methods: A retrospective analysis of 75 patients with diabetes who underwent cataract surgery was performed. Thirty-eight patients (52 eyes) were instilled with 0.1% bromfenac solution (bromfenac group) and 37 patients (46 eyes) were not (control group).

Results: There were no significant preoperative between-group differences. Compared to the control group, at 1 month after surgery, the bromfenac group showed slightly better best-corrected visual acuity (0.12 ± 0.12 vs. 0.32 ± 0.42, = 0.142), lower central macular thickness (265.58 ± 31.28 vs. 314.15 ± 76.11 μm, < 0.001), and lower macular volume (8.46 ± 0.60 vs. 9.14 ± 1.53 mm³, = 0.022). There were no significant differences between the two groups at 4 and 6 months postoperatively ( > 0.05). Mean changes in central macular thickness showed significant differences at 1 and 4 months postoperatively (-1.44 ± 11.72 and 10.44 ± 22.48 μm in bromfenac group vs. 47.19 ± 70.24 and 31.69 ± 48.04 μm in control group, < 0.001 and = 0.016) and mean changes in macular volume showed a significant difference at 1 month postoperatively (-0.08 ± 0.47 mm³ in bromfenac group vs. 0.58 ± 1.28 mm³ in control group, < 0.001). There were no significant differences thereafter ( > 0.05).

Conclusions: Treatment with 0.1% bromfenac sodium hydrate ophthalmic solution showed good efficacy for preventing cystoid macular edema early after cataract surgery in patients with diabetes.
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http://dx.doi.org/10.3341/kjo.2019.0044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7010466PMC
February 2020

Comparison of Awareness of Stroke Warning Signs between Community-Dwelling Stroke Survivors and Families and the General Population without Stroke.

Authors:
Young-Hoon Lee

J Stroke 2020 Jan 31;22(1):150-152. Epub 2020 Jan 31.

Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.

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http://dx.doi.org/10.5853/jos.2019.01907DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005346PMC
January 2020

Can natural killer cell activity help screen patients requiring a biopsy for the diagnosis of prostate cancer?

Int Braz J Urol 2020 Mar-Apr;46(2):244-252

Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

Purpose: To evaluate the usefulness of natural killer cell activity (NKA) in diagnosing prostate cancer (PC).

Materials And Methods: The medical records of patients who underwent transrectal prostate biopsy (TRBx) at Korea University Ansan Hospital between May 2017 and December 2017 were retrospectively reviewed. NKA levels were measured using NK VueR Tubes (ATgen, Sungnam, Korea). All blood samples were obtained at 8 AM on the day of biopsy. Patients with other malignancies, chronic inflammatory conditions, high prostate-specifi c antigen (PSA) level (>20ng/mL), or history of taking 5-alphareductase inhibitor or testosterone replacement therapy were excluded.

Results: A total of 102 patients who underwent TRBx for PC diagnosis were enrolled. Among them, 50 were diagnosed with PC. Significant differences in age and NKA level were observed between the PC and no-PC groups. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off of NKA level for the prediction of PC was 500pg/dL, with a sensitivity of 68.0% and a specifi city of 73.1%. In addition, NKA level (0.630) had the greatest area under the ROC curve compared to those for the ratio of total PSA to free PSA (0.597) and PSA density (0.578).

Conclusions: The results of this pilot study revealed that low NKA and high PSA levels were likely to be associated with a positive TRBx outcome. NKA detection was easy and improved the diagnostic accuracy of PC.
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http://dx.doi.org/10.1590/S1677-5538.IBJU.2019.0268DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7025844PMC
May 2020