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This review aims to summarize the health benefits of exposure to hypoxic conditions during exercise in patients with type 2 diabetes mellitus (T2DM). Exposure to hypoxic conditions during exercise training positively changes the physiological response in healthy subjects. Exposure to hypoxic conditions during exercise could markedly increase skeletal muscle glucose uptake compared to that in normoxic conditions. Furthermore, post-exercise insulin sensitivity of T2DM patients increases more when exercising under hypoxic than under normoxic conditions. Regular exercise under short-term hypoxic conditions can improve blood glucose control at lower workloads than in normoxic conditions. Additionally, exercise training under short-term hypoxic conditions can maximize weight loss in overweight and obese patients. Previous studies on healthy subjects have reported that regular exercise under hypoxic conditions had a more positive effect on vascular health than exercising under normoxic conditions. However, currently, evidence indicating that exposure to hypoxic conditions could positively affect T2DM patients in the long-term is lacking. Therefore, further evaluations of the beneficial effects of exercise under hypoxic conditions on the human body, considering different cycle lengths, duration of exposures, sessions per day, and the number of days, are necessary. In this review, we conclude that there is evidence that exercise under hypoxic conditions can yield health benefits, which is potentially valuable in terms of clinical care as a new intervention for T2DM patients.

[Purpose] This preliminary study aimed to develop a regression model to estimate the non-exercise activity thermogenesis (NEAT) of Korean adults using various easy-to-measure dependent variables. [Methods] NEAT was measured in 71 healthy adults (male n = 29; female n = 42). Statistical analysis was performed to develop a NEAT estimation regression model using the stepwise regression method. [Results] We confirmed that ageA, weightB, heart rate (HR)_averageC, weight × HR_averageD, weight × HR_ sumE, systolic blood pressure (SBP) × HR_restF, fat mass ÷ height2G, gender × HR_averageH, and gender × weight × HR_sumI were important variables in var ious NEAT activity regression models. There was no significant difference between the measured NEAT values obtained using a metabolic gas analyzer and the predicted NEAT. [Conclusion] This preliminary study developed a regression model to estimate the NEAT in healthy Korean adults. The regression model was as follows: sitting = 1.431 - 0.013 × (A) + 0.00014 × (D) - 0.00005 × (F) + 0.006 × (H); leg jiggling = 1.102 - 0.011 × (A) + 0.013 × (B) + 0.005 × (H); standing = 1.713 - 0.013 × (A) + 0.0000017 × (I); 4.5 km/h walking = 0.864 + 0.035 × (B) + 0.0000041 × (E); 6.0 km/h walking = 4.029 - 0.024 × (C) + 0.00071 × (D); climbing up 1 stair = 1.308 - 0.016 × (A) + 0.00035 × (D) - 0.000085 × (F) - 0.098 × (G); and climbing up 2 stairs = 1.442 - 0.023 × (A) - 0.000093 × (F) - 0.121 × (G) + 0.0000624 × (E).

[Purpose] This pilot study aimed to develop a re gression model to estimate the excess post-exercise oxygen consumption (EPOC) of Korean adults using various easy-to-measure dependent variables. [Methods] The EPOC and dependent variables for its estimation (e.g., sex, age, height, weight, body mass index, fat-free mass [FFM], fat mass, % body fat, and heart rate_sum [HR_sum]) were measured in 75 healthy adults ( 31 males, 44 females). Statistical anal ysis was performed to develop an EPOC estimation re gression model using the stepwise regression method. [Results] We confirmed that FFM and HR_sum were important variables in the EPOC regression models of various exercise types. The explanatory power and standard errors of estimates (SEE) for EPOC of each exercise type were as follows: the continuous exercise (CEx) regression model was 86.3% (R2) and 85.9% (adjusted R2), and the mean SEE was 11.73 kcal, interval exercise (IEx) regression model was 83.1% (R2) and 82.6% (adjusted R2), while the mean SEE was 13.68 kcal, and the accumulation of short-duration exercise (AEx) regression models was 91.3% (R2) and 91.0% (adjusted R2), while the mean SEE was 27.71 kcal. There was no significant difference between the measured EPOC using a metabolic gas analyzer and the predicted EPOC for each exercise type. [Conclusion] This pilot study developed a regression model to estimate EPOC in healthy Korean adults. The regression model was as follows: CEx = -37.128 + 1.003 × (FFM) + 0.016 × (HR_sum), IEx = -49.265 + 1.442 × (FFM) + 0.013 × (HR_sum), and AEx = -100.942 + 2.209 × (FFM) + 0.020 × (HR_sum).

[Purpose] This preliminary study aimed to develop a regression model to estimate the resting metabolic rate (RMR) of young and middle-aged Koreans using various easy-to-measure dependent variables. [Methods] The RMR and the dependent variables for its estimation (e.g. age, height, body mass index, fat-free mass; FFM, fat mass, % body fat, systolic blood pressure, diastolic blood pressure, mean arterial pressure, pulse pressure, and resting heart rate) were measured in 53 young (male n = 18, female n = 16) and middle-aged (male n = 5, female n = 14) healthy adults. Statistical analysis was performed to develop an RMR estimation regression model using the stepwise regression method. [Results] We confirmed that FFM and age were important variables in both the regression models based on the regression coefficients. Mean explanatory power of RMR1 regression models estimated only by FFM was 66.7% (R2) and 66.0% (adjusted R2), while mean standard errors of estimates (SEE) was 219.85 kcal/ day. Additionally, mean explanatory power of RMR2 regression models developed by FFM and age were 70.0% (R2) and 68.8% (adjusted R2), while the mean SEE was 210.64 kcal/day. There was no significant difference between the measured RMR by the canopy method using a metabolic gas analyzer and the predicted RMR by RMR1 and RMR2 equations. [Conclusion] This preliminary study developed a regression model to estimate the RMR of young and middle-age healthy Koreans. The regression model was as follows: RMR1 = 24.383 × FFM + 634.310, RMR2 = 23.691 × FFM - 5.745 × age + 852.341.

This study aimed to analyze the status of sarcopenia, obesity, osteoporosis, and cardiometabolic disease according to the level of physical activity (PA) among elderly people in Korea. Among the data obtained from the National Health and Nutrition Survey (2008–2011), we analyzed the data of a total of 3,573 Korean elderly people over 65 years of age who were surveyed for dual X-ray absorptiometry (DXA) and PA. Higher levels of PA were associated with a lower prevalence of cardiometabolic disease (χ2 = 33.865, p < 0.001), osteoporosis (χ2 = 94.198, p < 0.001), sarcopenia, obesity, and sarcopenic obesity (χ2 = 71.828, p < 0.001). Above moderate-active PA was associated with lower body weight (p < 0.001), body fat mass (p < 0.001), and percent body fat (p < 0.001), and higher free-fat mass (p < 0.001) and appendicular skeletal muscle mass (ASM) (p < 0.001) than in low-active PA. In addition, when high-active is the risk factors of cardiometabolic were lower in waist circumference (p = 0.001), total cholesterol (TC) (p = 0.015), and triglyceride (TG) (p < 0.001) than low- and moderate-active PA, and higher in high-density lipoprotein cholesterol (HDL-C) (p < 0.001). The prevalence of cardiometabolic diseases was significantly decreased in high-active PA (odds ratio (OR) 0.60, 95% confidence interval (CI) 0.50–0.71); waist circumference (OR 0.85, 95% CI, 0.73–0.99; OR 0.59, 95% CI, 0.50–0.70) and HDL-C (OR 0.76, 95% CI, 0.65–0.88; OR 0.56, 95% CI, 0.47–0.67) significantly improved in moderate- and high-active PA, respectively, and TG (0.67 95% CI, 0.55–0.80) significantly improved in high-active PA. Osteoporosis (OR 0.62, 95% CI, 0.53–0.74; OR 0.46, 95% CI, 0.38–0.55) and sarcopenia (OR 0.77, 95% CI, 0.60–0.98; OR 0.73, 95% CI, 0.57–0.93) were significantly improved in moderate- and high-active PA, respectively. The incidence of obesity (OR 0.47, 95% CI, 0.39–0.57) and sarcopenic obesity (OR 0.47, 95% CI, 0.30–0.75) were significantly decreased in high-active PA. Therefore, we verified a lower prevalence of sarcopenia, osteoporosis, obesity, and cardiac metabolic disease in Korean elderly with more active PA. This suggests that more active PA maybe reduce the prevalence of sarcopenia, osteoporosis, obesity, and cardiometabolic diseases in older adults.

We investigated the effects of acute thermal stress (30 °C and 40 °C) and ordinary temperature (20 °C) on cardiorespiratory function, skeletal muscle oxygenation, and exercise performance in healthy men. Eleven healthy males (21.5 ± 2.3 years) performed a graded exercise test (GXT) using a cycle ergometer in each environmental condition (20 °C, 30 °C, and 40 °C) in a random order with an interval of 1 week between each test. Before the test, they were allowed to rest for 30 min in a given environmental condition. All dependent variables (body temperature, cardiorespiratory function parameters, skeletal muscle oxygenation profiles, and exercise performance) were measured at rest and during GXT. GXT was started at 50 W and increased by 25 W every 2 min until subjects were exhausted. Body temperature increased proportionally at rest and at the end of exercise as thermal stress increased. There were no differences in the rating of perceived exertion, oxygen uptake, respiratory exchange ratio, and carbon dioxide excretion between environmental conditions. Heart rate (HR), minute ventilation (VE), and blood lactate levels were significantly higher at 30 °C and 40 °C than at 20 °C, and oxygen pulse was significantly lower at 40 °C than at 20 °C at various exercise loads. None of the skeletal muscle oxygenation profiles showed significant changes at rest or during exercise. Maximal oxygen uptake, peak power, and exercise time significantly decreased proportionally as thermal stress increased, and this decrease was most pronounced at 40 °C. Acute thermal stress induces a decrease in exercise performance via increased body temperature, HR, VE, and blood lactate levels and decreased oxygen pulse during load-homogenized exercise. This phenomenon was more prominent at 40 °C than at 30 °C and 20 °C.

A 41-year-old male was diagnosed with tongue cancer. Preoperative imaging revealed no metastatic lymph nodes. Intraoperative sonography detected a minute hypoechoic lesion in the sublingual space. A pea-sized mass was found during dissection of that space and histopathology revealed a metastatic lymph node. The lingual lymph node should routinely be evaluated sonographically prior to surgical resection of tongue cancer.

Sarcopenia is defined as an age-related decrease in muscle mass, strength, and function. We investigated the effect of circuit training on body composition, balance, muscle mass and strength, and pulmonary function in Korean women with sarcopenia. We randomly assigned 26 Korean women with sarcopenia ( Mage = 74.9, SD = 4.5 years) to either an exercise group (EG) ( n = 13) or a control group (CG) ( n = 13). The EG performed 25-75 minutes of circuit exercise training (gradually increasing time periods) three times per week over 12 weeks, while the CG maintained their usual daily lifestyle during the intervention period. We measured body weight, body mass index, percent body fat, free fat mass, balance ability, peak torque in shoulder, knee, and lumbar joints normalized for bodyweight (BW), forced vital capacity, percentage of forced expiratory volume in one second, and forced expiratory flow 25–75% before and after the intervention. The EG showed improved body composition (i.e., body mass index, fat-free body mass, fat mass; all p 2 > 0.180), balance (i.e., right and left of static and dynamic balance and fast 10-m walk; all p 2 > 0.151), muscular function (i.e., 90°/s and 180°/s peak power per kilogram BW, 90°/s average power per kilogram BW, 180°/s total work, and 180°/s endurance ratio; all p 2 > 0.157), and pulmonary function (all p 2 > 0.292). On the other hand, the CG showed no significant changes. Circuit exercise training improves muscle mass and strength, body composition, balance, and pulmonary function in women with sarcopenia.

[Purpose] The purpose of this study was to confirm that the difference in excess post-exercise oxygen consumption (EPOC) during exercise of the spending the same calories between the continuous and interval exercise. [Methods] Thirty-four healthy college students who did not regularly exercise volunteered to participate in our study. Continuous exercise was performed on an ergometer for 30 min at 60% of maximal oxygen consumption (VO2 max). Interval exercise was performed on a cycle ergometer at 80% VO2 max for 2 min initially, followed by 40% VO2 max for 1 min, and 80% VO2 max for 3 min. This was repeated six times for a total of 26 min. [Results] The major findings were as follows: (1) energy consumption during exercise was not significantly different between continuous exercise and interval exercise groups; (2) EPOC was higher in interval exercise than in continuous exercise for all dependent variables (i.e., total oxygen consumption, total calories, summation of heart rate); and (3) there were no significant differences in the lipid profile between continuous and interval groups. [Conclusions] Our study confirmed that after equalizing energy expenditure for continuous and interval exercise on a cycle ergometer in subjects in their twenties, interval exercise results in higher EPOC than continuous exercise. These data suggest that interval exercise may be more effective than continuous exercise in reducing body fat, for a given amount of energy expenditure.

[Purpose] The purpose of this study was to comparatively investigate the correlation among body composition, resting metabolic rate (RMR), and physical activity (PA) between young and middle-aged Korean adults. [Methods] A total of 53 [male n=23, female n=30] subjects were included in this study, among whom 34 subjects were healthy young adults [male n=18, female n=16] and 19 were middle-aged adults [male n=5, female n=14]. The body composition and RMR of all the participants were measured after overnight fasting (≥8 h). The Korean version of the WHO Global Physical Activity Questionnaire (GPAQ) was used to assess physical activity. [Results] Body composition was not significantly different between young adults and middle-aged adults. Whole-body bone mineral density and bone mineral contents (BMC) were significantly lower in middle-aged adults than in young adults. Total blood cholesterol (TC) and blood glucose levels were significantly higher in middle-aged adults (TC; 195.21 ± 43.34, glucose; 103.57 ± 12.61 mg/dL) than in young adults. RMR was significantly lower in middle-aged adults (1619.57 ± 290.28 kcal/day) than in young adults (1894.37 ± 405.00 kcal/day). In middle-aged adults physical activity (PA). PA (METs, min, EE) was inversely correlated with fat mass (FM, kg, and %) and blood triglyceride (TG) level in young adults. In middle-aged adults, PA showed a significant positive correlation with lean body mass (LBM), FM (%), and RMR. Furthermore, PA EE showed significant interrelatedness with BMC among middle-aged adults. [Conclusion] These results demonstrated that high PA levels enable LBM and RMR maintenance in middle- aged adults. Furthermore, in young adults, more PA is required to induce change in body composition.

Hypoxic training is often performed by competitive swimmers to enhance their performance in normoxia. However, the beneficial effects of aerobic continuous and interval training under hypoxia on hemodynamic function, autonomic nervous system (ANS) function, and endurance exercise performance remain controversial. Here we investigated whether six weeks of aerobic continuous and interval training under hypoxia can improve hematological parameters, hemodynamic function, ANS function, and endurance exercise performance versus normoxia in amateur male swimmers. Twenty amateur male swimmers were equally assigned to the hypoxic training group or normoxic training group and evaluated before and after six weeks of training. Aerobic continuous and interval training in the hypoxia showed a more significantly improved hemodynamic function (heart rate, −653.4 vs. −353.7 beats/30 min, oxygen uptake, −62.45 vs. −16.22 mL/kg/30 min, stroke volume index, 197.66 vs. 52.32 mL/30 min) during submaximal exercise, ANS function (root mean square of successive differences, 10.15 vs. 3.32 ms, total power, 0.72 vs. 0.20 ms2, low-frequency/high-frequency ratio, −0.173 vs. 0.054), and endurance exercise performance (maximal oxygen uptake, 5.57 vs. 2.26 mL/kg/min, 400-m time trial record, −20.41 vs. −7.91 s) than in the normoxia. These indicate that hypoxic training composed of aerobic continuous and interval exercise improves the endurance exercise performance of amateur male swimmers with better hemodynamic function and ANS function.

We demonstrated the hypothesis that combined exercise improves body composition, cardiometabolic risk factors, blood pressure (BP), arterial stiffness, and physical functions, in obese older men. Older men (n = 20) were randomly assigned to combined exercise training (EXP, n = 10) or control groups (CON, n = 10). The combined exercise was comprised of elastic-band resistance training and walking/running on a treadmill and bicycle at 60&ndash, 70% of maximal heart rate for 3 days/weeks. EXP showed significant decreases in body weight, body mass index, and %body fat (p &lt, 0.05). The exercise program significantly reduced BP, mean arterial pressure, pulse pressure, and brachial-ankle pulse wave velocity. Furthermore, while the plasma levels of low-density lipoprotein cholesterol and epinephrine were significantly reduced in EXP, VO2 peak and grip strength were significantly enhanced (p &lt, 0.05). In conclusion, it is indicated that 12-week regular combined exercise improves body composition, cardiometabolic risk factors, hemodynamics, and physical performance in obese older men.

This study evaluated the effects of intermittent interval training in hypoxic conditions for six weeks compared with normoxic conditions, on hemodynamic function, autonomic nervous system (ANS) function, immune function, and athletic performance in middle- and long-distance runners. Twenty athletes were divided into normoxic training (normoxic training group (NTG), n = 10, residing and training at sea level) and hypoxic training (hypoxic training group (HTG), residing at sea level but training in 526-mmHg hypobaric hypoxia) groups. All dependent variables were measured before, and after, training. The training frequency was 90 min, 3 d per week for six weeks. Body composition showed no significant difference between the two groups. However, the HTG showed more significantly improved athletic performance (e.g., maximal oxygen uptake). The hemodynamic function (e.g., oxygen uptake, oxygen pulse, and cardiac output) during submaximal exercise and ANS function (e.g., standard deviation and root mean square of successive differences, high frequency, and low/high frequency) improved more in the HTG. Immune function parameters were stable within the normal range before and after training in both groups. Therefore, hypoxic training was more effective in enhancing athletic performance, and improving hemodynamic and ANS function, further, it did not adversely affect immune function in competitive runners.

This study aimed to compare the effects of an acute Pilates program under hypoxic vs. normoxic conditions on the metabolic, cardiac, and vascular functions of the participants. Ten healthy female Pilates experts completed a 50-min tubing Pilates program under normoxic conditions (N trial) and under 3000 m (inspired oxygen fraction = 14.5%) hypobaric hypoxia conditions (H trial) after a 30-min exposure in the respective environments on different days. Blood pressure, branchial ankle pulse wave velocity, and flow-mediated dilation (FMD) in the branchial artery were measured before and after the exercise. Metabolic parameters and cardiac function were assessed every minute during the exercise. Both trials showed a significant increase in FMD, however, the increase in FMD was significantly higher after the H trial than that after the N trial. Furthermore, FMD before exercise was significantly higher in the H trial than in the N trial. In terms of metabolic parameters, minute ventilation, carbon dioxide excretion, respiratory exchange ratio, and carbohydrate oxidation were significantly higher but fat oxidation was lower during the H trial than during the N trial. In terms of cardiac function, heart rate was significantly increased during the H trial than during the N trial. Our results suggested that, compared to that under normoxic conditions, Pilates exercise under hypoxic conditions led to greater metabolic and cardiac responses and also elicited an additive effect on vascular endothelial function.

Objective Although several prior works showed the white matter (WM) integrity changes in amnestic mild cognitive impairment (aMCI) and Alzheimer's disease, it is still unclear the diagnostic accuracy of the WM integrity measurements using diffusion tensor imaging (DTI) in discriminating aMCI from normal controls. The aim of this study is to explore diagnostic validity of whole brain automated probabilistic tractography in discriminating aMCI from normal controls. Methods One hundred-two subjects (50 aMCI and 52 normal controls) were included and underwent DTI scans. Whole brain WM tracts were reconstructed with automated probabilistic tractography. Fractional anisotropy (FA) and mean diffusivity (MD) values of the memory related WM tracts were measured and compared between the aMCI and the normal control groups. In addition, the diagnostic validities of these WM tracts were evaluated. Results Decreased FA and increased MD values of memory related WM tracts were observed in the aMCI group compared with the control group. Among FA and MD value of each tract, the FA value of left cingulum angular bundle showed the highest area under the curve (AUC) of 0.85 with a sensitivity of 88.2%, a specificity of 76.9% in differentiating MCI patients from control subjects. Furthermore, the combination FA values of WM integrity measures of memory related WM tracts showed AUC value of 0.98, a sensitivity of 96%, a specificity of 94.2%. Conclusion Our results with good diagnostic validity of WM integrity measurements suggest DTI might be promising neuroimaging tool for early detection of aMCI and AD patients.

[Purpose] Hemodynamic function is a parameter indicating oxygen delivery and utilization capacity and is an important determinant of exercise performance. The present study aimed to determine whether intermittent hypoxic training (IHT) ameliorates hemodynamic function and exercise performance in competitive swimmers. [Methods] Twenty competitive swimmers (10 men, 10 women) volunteered to participate in the study. Participants were divided into the normoxic training (NT) group and the hypoxic training (HT) group and were subjected to training in a simulated altitude of 3000 m. We evaluated hemodynamic function profiles over 30 min of submaximal exercise on a bicycle and exercise performance before and after 6 weeks of training, which involved continuous exercise at 80% maximal heart rate (HRmax) for 30 min and interval exercise at 90% of HRmax measured before training for 30 min (ten rounds comprising 2 min of exercise followed by 1 min of rest each round). [Results] Significant changes in oxygen consumption (decrease) and end-diastolic volume (increase) were observed only in the HT group. Heart rate (HR), cardiac output (CO), and ejection fraction (EF) were significantly reduced in both groups, but the reduction rates of HR and CO were greater in the HT group than in the NT group. Exercise performance measures, including maximal oxygen consumption and 400-m time trial, were significantly increased only in the HT group. [Conclusion] Our findings suggested that 6 weeks of IHT, which involved high-intensity continuous and interval exercise, can effectively improve exercise performance by enhancing hemodynamic function in competitive swimmers.

Objective Recently developed 18F-labelled amyloid beta (Aβ) positron emission tomography (PET) tracers have demonstrated potentials to enable more prevalent application of amyloid imaging in the clinical setting. The aim of this study is to demonstrate cerebral retention of Aβ in cognitively normal older adults, by implementing voxel-based analysis on images acquired from 18F-Florbetaben amyloid PET. Methods Fifty cognitive normal elderly subjects were recruited and included in the study. Demographic data and cognitive measurements were collected. Magnetic resonance imaging (MRI) and 18F-Florbetaben PET data were obtained followed by whole brain voxel-based analysis. Results Compared to the florbetaben (FBB) (-) counterpart, FBB (+) showed significantly higher Aβ deposition in the brain regions comprising anterior cingulate, middle cingulate, posterior cingulate and precuneus (family wise error corrected p

Background: Obesity is recognized as an important global health problem that increases the risk of all-cause death. It is a major risk factor for various cardiovascular and metabolic diseases. Methods: We conducted this review through searching the related literature plus internet links. Results: Recently, many researchers have been applying various efficient alternative exercise paradigms for treating obesity, such as high-intensity interval training, whole-body vibration training, and hypoxic therapy. Compared with moderate-intensity continuous training, high-intensity interval training involves a shorter exercise time but higher energy expenditure and excess post-exercise oxygen consumption via a higher exercise intensity and is effective for treating obesity. Whole-body vibration training effectively reduces the rate of fat production and accumulation through passive vibration of the whole body and improving the body composition, muscle function, and cardiovascular function of the obese population. Hypoxic therapy has been reported to improve obesity and obesity-related diseases through appetite loss, reduced dietary intake, increased energy consumption, improved glycogen storage and fatty acid oxidation, angiogenesis and left ventricle remodeling, decreased mechanical load, and reduced sarcopenia progression due to aging. Conclusion: The new therapeutic exercise modalities, namely, high-intensity interval training, whole-body vibration training, and hypoxic therapy, are practical, useful, and effective for improving obesity and various metabolic and cardiovascular diseases induced by obesity.

Ji Han Lee,1 Won Sang Jung,2 Woo Hee Choi,3 Hyun Kook Lim4 1Washington University in St Louis, St Louis, MO, USA; 2Department of Radiology, 3Department of Nuclear Medicine, 4Department of Psychiatry, Saint Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, South Korea Objective: Among patients with Alzheimer’s disease (AD), sleep disturbances are common and serious noncognitive symptoms. Previous studies of AD patients have identified deformations in the brain stem, which may play an important role in the regulation of sleep. The aim of thisstudy was to further investigate the relationship between sleep disturbances and alterations in brain stem morphology in AD.Materials and methods: In 44 patients with AD and 40 healthy elderly controls, sleep disturbances were measured using the Neuropsychiatry Inventory sleep subscale. We employed magnetic resonance imaging-based automated segmentation tools to examine the relationship between sleep disturbances and changes in brain stem morphology.Results: Analyses of the data from AD subjects revealed significant correlations between the Neuropsychiatry Inventory sleep-subscale scores and structural alterations in the left posterior lateral region of the brain stem, as well as normalized brain stem volumes. In addition, significant group differences in posterior brain stem morphology were observed between the AD group and the control group.Conclusion: This study is the first to analyze an association between sleep disturbances and brain stem morphology in AD. In line with previous findings, this study lends support to the possibility that brain stem structural abnormalities might be important neurobiological mechanisms underlying sleep disturbances associated with AD. Further longitudinal research is needed to confirm these findings. Keywords: Alzheimer’s disease, sleep, brain stem, MRI, shape analysis

Purpose The purpose of this study was to evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) elasticity imaging. Materials and Methods One hundred and twenty-seven thyroid nodules were examined by both ARFI elastography and B-mode sonography. Virtual Touch tissue quantification (VTQ) values of the thyroid nodules were measured. Scoring of B-mode sonographic findings of each thyroid nodules was performed. The sums of these VTQ and the B-mode scores were determined. The comparative diagnostic performances of the VTQ value, the B-mode score, and the combined score were analyzed. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of each scoring mode were: B-mode score, 84%, 85%, 66%, 94%, and 85%; VTQ, 75%, 91%, 73%, 92%, and 86%; and combined score, 88%, 87%, 70%, 95%, and 88%. The areas under the curves for B-mode, VTQ, and combined score were 0.895, 0.837, and 0.912, respectively. Pairwise comparisons of receiver-operating characteristic curves showed no statistical differences between B-mode and VTQ, and B-mode and combined score. Combined score showed better diagnostic performance than VTQ value (p = 0.0023). Conclusion ARFI VTQ value is a good diagnostic modality for differentiating malignant thyroid nodules from benign nodules. However, ARFI evaluation is not superior to B-mode sonographic evaluation, but only has a better diagnostic performance when combined with B-mode sonographic findings.

This study aimed to analyze the differences in energy intake and physical activity (PA) levels according to sex and the presence of metabolic syndrome (MetS) among elderly people in Korea. Data of 3720 elderly people (aged &gt, 65 years) were obtained from the Korean National Health and Nutrition Examination Survey (2016&ndash, 2018). We analyzed PA levels (occupational and recreational PA) and energy intakes (carbohydrate, protein, and fat). The MetS group showed lower levels of moderate intensity recreational PA and place movement than the non-MetS group (p &lt, 0.05), in the MetS group, PA levels were significantly lower in women than in men (p &lt, 0.05). The intakes of total energy, carbohydrate, fat, and protein were lower in the MetS group than in the non-MetS group (p &lt, 0.001). Both the non-MetS and MetS groups showed lower energy intakes in women than men (p &lt, 0.001). Our study shows that elderly people, especially women, with MetS have significantly lower total PA levels and total energy intakes. We confirmed the importance of increased PA and proper nutritional intake in elderly people. Therefore, it is believed that practical measures such as nutrition education and nutrition guidance and PA education are urgently needed to reduce the incidence of MetS among the elderly.

We aimed to evaluate the effects of a 2-week exercise training program in hypobaric hypoxic conditions on exercise performance and immune function in Korean national cycling athletes with disabilities. Six Korean national cycling athletes with disabilities participated in exercise training consisting of continuous aerobic exercise and anaerobic interval exercise in hypobaric hypoxic conditions. The exercise training frequency was 60 min (5 days per week for 2 weeks). Before and after the exercise training, exercise performance and immune function were measured in all athletes. Regarding the exercise performance parameters, the 3-km time trial significantly decreased and blood lactate levels after the 3-km time trial test significantly increased by exercise training in hypobaric hypoxic conditions. Regarding the oxygen-transporting capacity, significant differences were not observed. Regarding immune function, the number of leukocytes and natural killer cells significantly decreased and that of eosinophils, B cells, and T cells significantly increased. These results indicated that our 2-week hypoxic training showed the potential to improve exercise performance in Korean national disabled athletes. However, the effects of our hypoxic training method on immune function remained unclear.

Previous studies have shown aberrant functional connectivity in preclinical Alzheimer’s disease (AD). However, the effects of beta-amyloid (Aβ) retention on regional functional synchronization in cognitively normal older adults still remain unclear. The aim of this study was to explore the distinctive association pattern between Aβ retention and regional functional synchronization in cognitively normal older adults. Sixty-one older adults with normal cognition underwent functional magnetic resonance imaging and regional functional synchronizations were quantified using regional homogeneity (ReHo). Subjects were dichotomized using 18F-Florbetaben positron emission tomography imaging into subjects with (Aβ+; n = 30) and without (Aβ-; n = 31) Aβ burden. The Aβ+ group exhibited significantly higher ReHo in the fusiform gyrus and lower ReHo in the precuneus compared with the Aβ- group. We found significant negative correlations between global Aβ retention and ReHo in the precuneus and medial prefrontal cortex and positive correlations between global Aβ retention and ReHo in the bilateral lingual gyrus, left fusiform gyrus, and right middle temporal gyrus in the Aβ+ group. Our findings suggest that regional functional synchronization might have distinctive association patterns with Aβ retention in the cognitively normal older adults. These findings can enrich the functional characterization of early stages of disease progression in AD.

The present study examined the effect of a 12-week combined resistance and aerobic exercise training program on cardiometabolic biomarkers and red blood cell (RBC) hemorheological function in 20 obese older men (mean age: 68.8 &plusmn, 0.9 years). Subjects were randomly divided into two groups (exercise intervention [EXP, n = 10] and control [CON, n = 10]). The EXP subjects performed resistance and aerobic exercise training program three times per week for 12 weeks, and the CON subjects maintained their regular lifestyle during the intervention period. Body composition was estimated using bioelectrical impedance analysis equipment. Cardiometabolic biomarkers (glucose, insulin, homeostasis model assessment-estimated insulin resistance (HOMA-IR), HOMA &beta, cell function, and leptin) and RBC hemorheological parameters (RBC deformability and aggregation) were analyzed. Percent body fat decreased significantly in the EXP group during the intervention period but increased significantly in the CON group. Insulin increased significantly in the CON group over the 12-week period and both insulin and HOMA-IR were significantly higher in the CON group than in the EXP group at post-test. RBC deformability (RBC EI_3Pa) and aggregation (RBC AI_3Pa) improved significantly only in the EXP group. The present study suggests that combined exercise training can be useful for improving cardiometabolic biomarkers and RBC hemorheological parameters in obese older men and may help prevent metabolic syndrome and cardiovascular diseases.

With recent advancement in amyloid imaging, diagnostic application of this new modality has become a great interest among researchers. New ligands, such as 18F- florbetaben, florbetapir and flutemetamol, have been discovered to overcome limitations of preexisting ligand Pittsburgh compound B. We report here a case of a 37-year-old male patient whose initial complaints comprised of gradual cognitive decline, apraxia, disorientation and sleep disturbances. 18F-Florbetaben amyloid imaging of the patient showed diffuse amyloid retention with prominent striatal uptake. This finding supports the clinical utility of amyloid imaging in diagnostic process of early-onset AD. Moreover, striatal dominant uptake pattern demonstrated in this patient include some meaningful clinical implications that warrant special attention among clinicians.

Background Although there is substantial evidence of associations between frontal-striatal circuits and cerebral vascular burden in late-onset depression (LOD), relationships between vascular burden and hippocampal subfields are not clear. The purpose of this study was to investigate relationships between cerebral vascular burden and hippocampal subfield volume in LOD patients. Methods Fifty subjects with LOD and 50 group-matched healthy control subjects underwent magnetic resonance imaging scanning. Hippocampal subfields volumes were measured and compared between the groups. In addition, association patterns between white matter hyperintensity (WMH) volumes, clinical measures and hippocampal subfield volumes were investigated in the LOD group. Results Subjects with LOD exhibited significant hippocampal volume reductions in the total hippocampus, cornu ammonis (CA) 1 and 3 and dentate gyrus (DG) areas compared with healthy subjects. Total WMH volume was negatively correlated with left total hippocampal volume and CA1 in the LOD group. In addition, depression severity was negatively associated with left and right CA3 volumes in the LOD group. Limitation Our findings of distinctive relationships between WMH and hippocampal subfields demonstrate a simple correlation, but do not prove causation Conclusion This study is the first to elaborate distinctive association patterns between hippocampal subfield volumes and cerebral vascular burden in LOD. These structural changes in the hippocampal CA1, CA3 and DG areas might be at the core of the underlying neurobiological mechanisms of hippocampal dysfunction in LOD. However, longitudinal studies will be needed to identify the mechanisms of these structural changes.

The aim of this study was to examine and compare two automated quantitative software tools (PMOD and MIMneuro) for the quantification of amyloid positron emission tomography (PET). A total of 30 subjects—15 Alzheimer’s disease (AD) patients and 15 cognitively normal age- and sex-matched controls—were enrolled. All subjects underwent structural volumetric magnetic resonance imaging (MRI) and amyloid PET scans with F-18 florbetaben. Regional standardized uptake value ratios (SUVRs) using the cerebellar cortex as a reference region were obtained using PMOD and MIMneuro. The SUVRs using both PMOD and MIMneuro showed high discriminatory power between the AD patients and cognitively normal controls. While PMOD and MIMneuro yielded significantly different SUVRs in some brain regions, the two methods had good overall agreement. MIMneuro provides comparable performance to PMOD without the need to acquire brain MRI. Therefore, MIMneuro might be suitable for clinical use to determine amyloid positivity.

Background The deep subcutaneous adipose tissue (dSAT) is closely related to the obesity-associated complications similarly to the characteristics of visceral adipose tissue (VAT). However, the association between dSAT and metabolic syndrome (MS) is unclear. The purpose of our study was to evaluate the association of distinct abdominal adipose tissue with the cardiometabolic risk factors and MS. Methods Abdominal computed tomography (CT) images were obtained in 365 asymptomatic subjects (187 subjects with MS and 178 without MS). The axial images segmented into superficial and deep SAT by manually tracing the fascia superficialis at L4–5 levels. The concentrations of serum inflammatory cytokines and adipokines were also measured. Results The MS group had significantly lower adiponectin levels but significantly higher levels of resistin, leptin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), intercellular adhesion molecule (ICAM), monocyte chemotactic protein-1 (MCP-1), and oxLDL than the control group (p

Parkinson's disease dementia (PDD) is notorious for its debilitating clinical course and high mortality rates. Consequently, various attempts to investigate predictors of cognitive decline in Parkinson's disease (PD) have been made. Here we report a case of a 75-year-old female patient with PD who visited the clinic with complaints of recurrent visual hallucinations and cognitive decline, whose symptoms were ameliorated by the titration of rivastigmine. Imaging results showed pronounced diffuse cortical amyloid deposition evidenced by 18F-florbetaben amyloid positron emission tomography (PET) imaging. This observation suggests that pronounced amyloid deposition and visual hallucinations in PD patients could be clinically significant predictors of cognitive decline in PD patients. Future research should concentrate on accumulating more evidence for possible predictors of cognitive decline and their association with PD pathology that can enable an early intervention and standardized treatment in PDD patients.