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Background: The relationships of patient factors and caregiver contribution to patients' self-care to different types of self-care have been rarely examined in Korean patients with heart failure. Objective: The aim of this study was to examine patient (ie, age, depressive symptoms, and self-care confidence) and caregiver (ie, caregiver contribution to self-care maintenance and self-care management, and caregiver confidence in contributing to self-care) factors related to different types of self-care (ie, self-care maintenance, symptom perception, and self-care management) and self-care confidence in Korean patients with heart failure. Methods: In this cross-sectional, correlational study, data from 41 pairs of patients (mean age, 68.0 years) and caregivers (mean age, 54.1 years) were collected and analyzed using multiple regression. Results: Higher levels of self-care confidence in patients were related to higher levels of self-care maintenance in patients. Higher levels of self-care confidence in patients were related to higher levels of symptom perception. Higher levels of self-care confidence in patients and caregiver contribution to self-care maintenance were related to higher levels of self-care management. Less severe depressive symptoms in patients and higher levels of caregiver confidence in contributing to self-care were related to higher levels of self-care confidence. Conclusion: Different patient and caregiver factors were related to different types of self-care and self-care confidence in Korean patients, but patients' self-care confidence was related to all types of self-care. Clinicians and researchers need to develop and deliver effective interventions to both patients and their caregivers to improve patients' self-care confidence and, in turn, self-care, considering different factors associated with each type of self-care. [ABSTRACT FROM AUTHOR]

Persimmons are one of the most important export fruits in South Korea, where several tons are exported across the globe each year. In this study, the quality attributes of 'Wonmi' persimmon fruits were evaluated during an export simulation at 0 °C, 10 °C, and 24 °C with a combination of 1-Methylcyclopropene (1-MCP) and modified atmosphere packaging (MAP) treatments. The relative humidity during the export simulation was greater at room temperature (75–92%) and 0 °C (85% to 93%) than at 10 °C (42% to 60%). The results show that the application of 1-MCP and MAP treatments during the export simulation were effective in delaying the ripening of 'Wonmi' persimmons by reducing respiration and ethylene production. The suppressed expression of ethylene synthesis genes and cell wall modification genes reduced the ethylene production and maintain the fruit firmness, respectively. In addition, 1-MCP and MAP treatments were effective in maintaining SSC and color of 'Wonmi' persimmon fruits during the export simulation. Thus, by adopting these treatments, the overall quality of persimmon exports from South Korea can significantly improve. [ABSTRACT FROM AUTHOR]

This study investigated how changes in weather factors affect the prevalence of conjunctivitis using public big data in South Korea. A total of 1,428 public big data entries from January 2013 to December 2019 were collected. Disease data and basic climate/air pollutant concentration records were collected from nationally provided big data. Meteorological factors affecting eye diseases were identified using multiple linear regression and machine learning analysis methods such as extreme gradient boosting (XGBoost), decision tree, and random forest. The prediction model with the best performance was XGBoost (1.180), followed by multiple regression (1.195), random forest (1.206), and decision tree (1.544) when using root mean square error (RMSE) values. With the XGBoost model, province was the most important variable (0.352), followed by month (0.289) and carbon monoxide exposure (0.133). Other air pollutants including sulfur dioxide, PM10, nitrogen dioxides, and ozone showed low associations with conjunctivitis. We identified factors associated with conjunctivitis using traditional multiple regression analysis and machine learning techniques. Regional factors were important for the prevalence of conjunctivitis as well as the atmosphere and air quality factors. [ABSTRACT FROM AUTHOR]

Renal fibrosis is a type of chronic kidney disease (CKD) induced by infiltration of inflammatory cells, myofibroblast accumulation, and ECM production in the kidney. From a long time ago, Corni Fructus (CF) is known to supplement the liver and kidney with its tepid properties. In this study, we investigated the renal protective mechanism of CF, which is known to supplement the kidney, in rat model of unilateral ureteral obstruction (UUO). After inducing UUO through surgery, the group was separated (n = 8) and the drug was administered for 2 weeks; normal rats (normal), water-treated UUO rats (control), CF 100 mg/kg-treated UUO rats (CF100), and CF 200 mg/kg-treated UUO rats (CF200). As a result of histopathological examination of kidney tissue with H&E, MT, and PAS staining, it was confirmed that the infiltration of inflammatory cells and the erosion of collagen were relatively decreased in the kidneys treated with CF. Also, CF significantly reduced the levels of MDA and BUN in serum. As a result of confirming the expression of the factors through western blotting, CF treatment significantly reduced the expression of NADPH oxidase and significantly regulated the AMPK/LKB1/NF-κB pathway associated with inflammation. In addition, it downregulated the expression of major fibrotic signaling factors, such as α-SMA, collagen I, MMP-2, and TIMP-1, and significantly regulated the TGF-β1/Smad pathway, which is known as a major regulator of renal fibrosis. Taken together, these findings indicate that CF can alleviate renal fibrosis by regulating the TGF-β1/Smad pathway through inhibition of oxidative stress in UUO. [ABSTRACT FROM AUTHOR]

Background: Evodiae fructus is a natural plant that is used as a medicinal material in many Asian countries such as Korea and China. However, little is known about its effect on ulcerative colitis. Objectives: Thus, the purpose of this study was to find the improvement effect of Evodiae fructus in mice model with dextran sulfate sodium (DSS)-induced colitis. Materials and Methods: The animal experiments were conducted using ulcerative colitis animals induced by DSS. To induce ulcerative colitis in BALB/c mice used in the experiment, 5% DSS was supplied as drinking water for 7 days. BALB/c mice were divided into five groups (n = 8): Group 1 (normal group), Group 2 (5% DSS control group), Group 3 (5% DSS + sulfasalazine 60 mg/kg treated), Group 4 (5% DSS + Evodiae fructus water extract 50 mg/kg treated), Group 5 (5% DSS + Evodiae fructus water extract 100 mg/kg treated). After the animal experiment, the expression of antioxidant, oxidative stress, inflammatory, and necrosis-related factors in colonic tissues was analyzed by western blotting. Results: As a result, the Evodiae fructus treatment group reduced oxidative stress by increasing the expression of Nrf2, an antioxidant-related transcription factor. Also, the expression of NF-κB, an inflammatory transcription factor, was reduced, thereby reducing the expression of pro-inflammatory proteins and inflammatory cytokines. Conclusion: These results suggest that Evodiae fructus treatment has an inhibitory effect on inflammation against DSS-induced colitis. Therefore, Evodiae fructus has the potential to be used as a natural medicine for ulcerative colitis. [ABSTRACT FROM AUTHOR]

Background: The extent to which cognitive function differs between patients who receive implantable cardioverter-defibrillator (ICD) therapy and patients with heart failure (HF) who do not receive ICD therapy remains to be elucidated. Objectives: The aim of this study was to compare the cognitive function between patients with primary or secondary ICDs and patients with HF without an ICD. Methods : This descriptive, comparative study included 116 patients who received ICDs and 74 patients with HF who did not receive ICDs. Patients underwent neuropsychological assessment for general cognition, memory, and executive function. Results : Immediate recall memory loss (18.9%) occurred more often in patients with HF without an ICD than in patients with primary (3.1%) and secondary (7.1%) ICDs (P =.018). After adjusting for age and education, delayed recall memory of patients with HF without ICDs was significantly worse than that of patients with primary ICDs (4.0 vs 6.5; P <.001), whereas delayed recall memory of patients with primary ICDs was better than that of patients with secondary ICDs (6.0 vs 6.5; P =.006). Executive function of patients with HF without ICDs was significantly worse than that of patients with primary (35 vs 58 seconds; P <.001) and secondary (28 vs 58 seconds; P =.0012) ICDs. Conclusions : Patients with ICDs, regardless of primary or secondary indication, had less impairment of memory and executive function than patients with HF without ICDs, implying that ICD therapy did not interfere with cognitive performance. Cognitive screening as a part of routine care could be helpful for identifying impairment and implementing early cognitive training, especially in patients with HF. [ABSTRACT FROM AUTHOR]

Background: Although a better survival rate in women than in men has been reported in heart failure (HF) with reduced ejection fraction (HFrEF), the sex-specific prognosis has scarcely been addressed in HF with preserved EF (HFpEF). Thus, this study investigated the sex difference in clinical outcomes in patients with HFpEF, as well as in those with HFrEF. Materials and Methods: We studied clinical outcomes of 2,572 hospitalized patients due to HF (66.8 ± 14.4 years, 49.7% women) in the Korean Heart Failure Registry. Patients were divided into two groups by left ventricular EF (LVEF): HFpEF (LVEF ≥50%, n = 764) and HFrEF (LVEF <40%, n = 1,808) groups. Results: During a median follow-up of 1,121 days, there were 693 (28.7%) deaths and 1,073 (44.5%) composite events (death and HF readmission). There were no sex differences in the incidence of death or composite events during follow-up in both HFrEF and HFpEF groups (p > 0.05 for each). In 1:1 age-matched population (n = 1,005 in each sex), the long-term mortality was significantly lower in women than men in HFrEF group (p = 0.005), but not in HFpEF group (p = 0.786), while the incidences of composite events were similar between sex irrespective of LVEF (p > 0.05). However, there were no significant associations between sex and clinical outcomes in multivariable analysis (p > 0.05 for each). Conclusions: Sex per se was not the significant factor determining long-term clinical outcomes in HF patients regardless of the LVEF. [ABSTRACT FROM AUTHOR]

Background: Cognitive decline, which often occurs in heart failure, is likely to decrease health-related quality of life and increase morbidity and mortality (major events), but it has been scantly addressed. Aims: To examine whether baseline cognitive domains of global cognition, memory and executive function predict baseline health-related quality of life and 15-month major events among patients with heart failure. Methods: This prospective study included 117 patients (mean age 65.5 ± 9.42 years; men 58.1%; New York Heart Association class III/IV 25.6%), who completed questionnaires, including neuropsychological testing for cognitive evaluation, depressive symptoms, self-care and health-related quality of life measures. Their 15-month major events were extracted from medical record reviews. Results: Approximately one-third of the sample had cognitive impairment. Forty-one patients (35.0%) experienced major events. Patients with major events had significantly worse memory (immediate recall memory 13.9 vs. 11.5, P =0.030; delayed recall memory 4.3 vs. 3.1, P =0.014) and reduced executive function (trail-making test A 28.1 vs. 38.0 seconds, P =0.031). After controlling for age, sex, heart failure severity and comorbidity, memory loss with depressive symptoms was associated with worse health-related quality of life, and odds ratios of experiencing major events increased only with reduced cognitive function in global cognition and executive function. Conclusion: Cognitive function is an important factor for health-related quality of life and major events, and memory loss – worsened health-related quality of life and poor executive function was more likely to increase the risk of major events. Future studies should consider both cognitive function and depressive symptoms when designing heart failure interventions to improve patient outcomes. [ABSTRACT FROM AUTHOR]

This study was performed to investigate the association between four BP measurements (systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP], and pulse pressure [PP]) and four TOD parameters (left ventricular mass index [LVMI], E/e', estimated glomerular filtration rate [eGFR], and obstructive coronary artery disease [CAD]). Data were obtained from a nation-wide registry, composed of 652 patients (471 women, 58.4 ± 10.5 years) with suspected CAD who underwent elective invasive coronary angiography (CAG). A total of 217 patients (33.2%) had obstructive CAD (≥50%). In multivariable analyses, E/e' was associated with SBP, MAP and PP, and CAD was associated with SBP and PP (P < 0.05 for each). All four BP measurements were not associated with LVMI and eGFR (P > 0.05 for each). In patients undergoing elective invasive CAG, SBP, and PP had stronger relationships with E/e' and CAD than DBP and MAP. [ABSTRACT FROM AUTHOR]

Purpose: Recently, the diastolic strain rate (DSR) utilizing speckle‐tracking echocardiography has been proposed as a novel parameter for left ventricular diastolic function. We aimed to present normal reference data for those in a large‐sized, selected group of healthy individuals. Methods: The current study was a part of the Normal echOcardiogRaphic Measurements in KoreAn popuLation (NORMAL), a prospective nationwide survey from 23 centers in Korea. We analyzed 447 subjects (age 48 ± 15 years, 234 females) without any history of cardiovascular disease and presented the early and late DSRs (SRe and SRa, respectively) in a total and gender‐/age‐specified groups. Results: Among the total subjects, the mean SRe and SRa were 1.6 ± 0.4 S−1 and 0.8 ± 0.3 S−1, respectively. With increasing age, there were significant trends of decreasing SRe and increasing SRa. Although both gender groups showed comparable age, the female group presented significantly higher SRe compared to male subjects with age of 20–59 years, which diminished after the age of 60 years. However, the SRa was comparable between genders in all age groups. On multiple linear regression, age showed independent associations with both SRe (β = −0.132, P = .010) and SRa (β = 0.440, P < .001), whereas gender did not show any association with SRe or SRa. Conclusion: We present normal reference data of a novel parameter, DSR, in a large‐sized selected group with healthy Korean subjects. Additionally, we present significant age‐related changes both in SRe and SRa without the impact of their gender. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the comparative evaluation of pharmacological efficacy between sulfasalazine alone and sulfasalazine in combination with herbal medicine on dextran sodium sulfate- (DSS-) induced UC in mice. Balb/c mice received 5% DSS in drinking water for 7 days to induce colitis. Animals were divided into five groups (n=9): Group I (normal group), Group II (DSS control group), Group III (DSS + sulfasalazine (30 mg/kg)), Group IV (DSS + sulfasalazine (60 mg/kg)), and Group V (DSS + sulfasalazine (30 mg/kg) + Cinnamomi Cortex and Bupleuri Radix mixture (30 mg/kg) (SCB)). Colonic pathological changes were analyzed using hematoxyline/eosin staining. The antioxidant, inflammatory, and apoptotic protein levels were determined using western blotting. SCB supplementation, as well as sulfasalazine, suppressed colonic length and mucosal inflammatory infiltration. In addition, SCB treatment significantly reduced the expression of proinflammatory signaling molecules through suppression of both mitogen-activated protein kinases (MAPK) and nuclear factor-kappa B (NF-κB) signaling pathways and prevented the apoptosis of the colon. Moreover, SCB administration significantly led to the upregulation of antioxidant enzymes including SOD and catalase. Taken together, SCB treatment might offer a better treatment for human UC than sulfasalazine alone or may be useful as an alternative therapeutic strategy against UC, without any evidence of side effects. [ABSTRACT FROM AUTHOR]

Background: Pretest probability (PTP) and an exercise treadmill test (ETT) are recommended for the initial evaluation of possible coronary artery disease (CAD), but the applicability of these tests in Korean women has not been evaluated. Methods: Korean women with PTP, ETT, and invasive coronary angiography results were enrolled. Across all PTP levels, PTP and ETT statistics were evaluated and independent CAD predictors obtained. Results: Of the 335 patients (mean age 58.0 ± 10.2 years), 99 and 236 were in the low (LPTP) and intermediate PTP (IPTP) groups, respectively. The observed prevalence of CAD was significantly lower than the PTP. (7.1% vs. 9.1 ± 4.9% in LPTP, p < 0.001; 23.3% vs. 33.0 ± 15.1% in IPTP, p < 0.001) The ETT's sensitivity and positive predictive values (PPVs) appeared lower than previously reported (LPTP: 42.9% and 16.7%; IPTP: 61.8% and 37.0%), whereas the negative predictive values (NPVs) were higher (LPTP: 95.1%; IPTP: 85.4%). After multivariate adjustments, positive ETT (odds ratio 3.276, 95% confidence interval 1.643-6.532, p = 0.001) independently predicted the presence of CAD, but the PTP showed only marginal predictability (odds ratio 1.019, 95% confidence interval 0.998-1.041, p = 0.069). Conclusions: In Korean women, the observed prevalence of CAD was lower than the PTP, and PTP showed only marginal CAD predictability. Although a positive ETT independently predicted CAD, the ETT showed lower sensitivity and PPVs than previously reported. Despite the limited value of PTP and ETT, the high NPVs of ETT appear useful for saving patients from unnecessary further examinations. [ABSTRACT FROM AUTHOR]

Background: Whether reproductive factors are associated with coronary artery disease (CAD) has been debated. The aim of this study was to investigate etiologic associations of a wide range of reproductive factors of women with the presence of angiographic obstructive CAD. Materials and Methods: Study data were obtained from a nationwide registry that enrolled 687 Korean women (59.9 ± 11.4 years) with chest pain undergoing invasive coronary angiography (ICA). Obstructive CAD was defined as ≥50% luminal stenosis of one or more epicardial coronary arteries in ICA. Information on reproductive history, including ages at menarche and menopause, duration of reproductive capacity, number of pregnancies, hormonal replacement therapy, and history of twin pregnancy, was obtained using a standardized questionnaire. Results: A total of 178 women (25.9%) had obstructive CAD. Multivariable logistic regression analysis identified that later age at menarche (odds ratio [OR] = 1.265, 95% confidence interval [CI] = 1.064-1.504, p = 0.008, per year) and increased number of pregnancies (OR = 1.223, 95% CI = 1.026-1.457, p = 0.025, per pregnancy) were the independent predictors of obstructive CAD even after controlling for potential confounders, including age, diabetes mellitus, hypertension, dyslipidemia, renal function, high-density lipoprotein level, white blood cell count, hemoglobin, and E/e'. Conclusions: Later age at menarche and increased number of pregnancies may be reproductive risk factors for angiographic obstructive CAD, suggesting the important role of hormonal status in the development of CAD. [ABSTRACT FROM AUTHOR]

Objectives: Patients undergoing hemodialysis suffer from a variety of complications related to end-stage renal disease. This prospective, observational pilot study aims to determine the feasibility, safety, and possible benefits of acupuncture for symptom management in patients undergoing hemodialysis. Methods: Twenty-four (24) patients undergoing hemodialysis received acupuncture treatment for their symptoms. Manually stimulated, individualized acupuncture treatments were provided twice a week for 6 consecutive weeks on a nondialysis day or on the day of hemodialysis prior to initiating treatment. Symptoms were evaluated using the Measure Your Medical Outcome Profiles 2 questionnaire, and quality of life was measured by Kidney Disease Quality of Life-Short Form (KDQOL-SF™) Version 1.3 at baseline, 7 weeks and 11 weeks from baseline. Statistical analysis was conducted on the basis of the intention-to-treat principle. Results: Twenty-one (21) patients (87%) completed the whole treatment course and follow-up evaluation. Three (3) patients dropped out due to increased fatigue ( n = 1), pancreatic and renal transplantation ( n = 1), and infections of the arteriovenous fistula used for hemodialysis access ( n = 1). Patients experienced a significant improvement of symptoms considered the most bothersome, reporting a decrease of 1.87 and 2.08 points on a 0-6 symptom scale at 7 weeks and 11 weeks, respectively (both p < 0.0001). Some subscales of KDQOL-SF™ showed significant improvement at 7 weeks (effects of kidney disease, burden of kidney disease, role-limitations physical, emotional well-being, and energy/fatigue) and 11 weeks (physical functioning and energy/fatigue). No serious adverse events related to acupuncture occurred. Conclusions: Acupuncture seems feasible and safe for symptom management in patients undergoing hemodialysis. Future controlled trials are needed to confirm the benefits of acupuncture. [ABSTRACT FROM AUTHOR]

Abstract: A novel nested reverse transcription-polymerase chain reaction (RT-PCR)-based kit is described for detecting Japanese encephalitis virus (JEV), especially for genotype 1 and 3 strains. The assay consists of a first round RT-PCR and a subsequent nested PCR amplification. It has unique features such as the use of a premix system in which all reagents are lyophilized in reaction tubes and the inclusion of control RNA in each reaction to monitor false negative results. In addition, an automatic tissue homogenizer and a RNA extraction system are used concurrently for assay standardization and increasing throughput. The assay using the kit proved specific for JEV with no amplification of other JEV-related flaviviruses. The detection limits were approximately 0.1PFU/ml and 1PFU/ml for JEV genotypes 1 and 3, respectively. The assay protocol has been validated in large-scale field trials in South Korea during the 2008–2009 surveillance seasons. Nineteen of 1136 pools of mosquitoes (54,583 mosquitoes total) were identified as JEV positive. This nested RT-PCR kit combined with control RNA and an automatic RNA extraction system should be suitable for routine JEV surveillance programs. [ABSTRACT FROM AUTHOR]

• Hantaan virus showing geographical clustering in the Republic of Korea. • Geographical variation presenting genetic divergence of Hantaan virus. • Genetic divergence indicates the emergence of new Hantavirus strains. • High hantavirus prevalence and seasonal variation in A. agrarius captured from Jeju. Several studies on hantavirus evolution have shown that genetic reassortment plays an important role in the evolution and epidemiology of this disease. To understand the genetic epidemiology of human hantaviruses, samples from rodent reservoirs were subjected to reverse-transcription nested polymerase chain reaction (RT-N-PCR) targeting the L - and S-segments of the hantavirus genome. Positive isolates from Gwangju, Boseong-gun (Jeollanam-do Province), and Jeju Island were confirmed as Hantaan virus using DNA sequencing. Phylogenetic analysis showed that all isolates grouped together as Hantaan virus but with each region forming a distinct cluster. In addition, these three clusters were distinct from other Hantaan isolates reported in previous studies from Korea and its neighboring countries China and Russia. This suggests Hantaan viruses exhibit a considerable degree of geographical clustering, and there may be a novel Hantaan genotype in southwestern ROK. This study helps expand our knowledge regarding the emergence of new hantavirus strains and their degree of geographical variation. Hantaan virus, a pathogenic prototype hantavirus carried by Apodemus agrarius , is found throughout China, Russia, and Korea. Here, we examined the genetic diversity of hantaviruses to expand our knowledge regarding the emergence of new hantavirus strains and their degree of geographical variation. We found that hantaan viruses show a considerable degree of geographical clustering, which may allude to the development of a new genotype variant in the southwestern region of the ROK. [ABSTRACT FROM AUTHOR]