• Korean Journal of Psychosomatic Medicine
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• v.32 no.1
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• pp.1-9
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• 2024

Frailty is a clinical syndrome as an increased vulnerability to stressors, leading to a decrease in physiologic reserves and a decline in the ability to maintain a good homeostasis. This condition leads to an increased risk of hospitalization, disability and mortality. Frailty occurs due to various causes and requires a multidimensional approach. It is also important to detect and manage it early. Frailty is also deeply related to neuropsychiatric problems such as pain and depression. In evaluating frailty, it is desirable to comprehensively consider not only physical areas such as disease, nutrition, movement, and sensory functions, but also psychosocial areas, and representative scales include Fried's physical frailty phenotype and Rockwood's frailty index. Physical activity and appropriate protein intake are important for frailty management, and inappropriate drug use should be reduced and oral care, cognitive function, and falls should also be noted. Frailty and pain can affect each other, and pain can promote frailty. Evidence has been published that hormone and protein abnormalities, immune system activity and inflammatory response, and epigenetic mechanisms work in common in the field of frailty and pain. More extensive and high-quality research should be conducted in the future, and the quality of life will be improved if the results are applied to the suppression and treatment of old age and pain.

• Biomolecules & Therapeutics
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• v.32 no.4
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• pp.481-491
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• 2024

Paxlovid is the first approved oral treatment for coronavirus disease 2019 and includes nirmatrelvir, a protease inhibitor targeting the main protease (M^pro) of SARS-CoV-2, as one of the key components. While some specific mutations emerged in M^pro were revealed to significantly reduce viral susceptibility to nirmatrelvir in vitro, there is no report regarding resistance to nirmatrelvir in patients and animal models for SARS-CoV-2 infection yet. We recently developed xenograft tumors derived from Calu-3 cells in immunodeficient mice and demonstrated extended replication of SARS-CoV-2 in the tumors. In this study, we investigated the effect of nirmatrelvir administration on SARS-CoV-2 replication. Treatment with nirmatrelvir after virus infection significantly reduced the replication of the parental SARS-CoV-2 and SARS-CoV-2 Omicron at 5 days post-infection (dpi). However, the virus titers were completely recovered at the time points of 15 and 30 dpi. The virus genomes in the tumors at 30 dpi were analyzed to investigate whether nirmatrelvir-resistant mutant viruses had emerged during the extended replication of SARS-CoV-2. Various mutations in several genes including ORF1ab, ORF3a, ORF7a, ORF7b, ORF8, and N occurred in the SARS-CoV-2 genome; however, no mutations were induced in the M^pro sequence by a single round of nirmatrelvir treatment, and none were observed even after two rounds of treatment. The parental SARS-CoV-2 and its sublineage isolates showed similar IC₅₀ values of nirmatrelvir in Vero E6 cells. Therefore, it is probable that inducing viral resistance to nirmatrelvir in vivo is challenging differently from in vitro passage.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.176-185
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• 2004

Purpose: Rapidly progressive glomerulonephritis (RPGN) is a clinicopathologic entity characterized by extensive crescent formation and rapid deterioration of renal function within few months. For better understanding of its clinical course and designing better treatment strategies, a clinicopathological study of childhood RPGN was performed. Methods: The clinical manifestations and pathological findings were reviewed retrospectively in 12 children who were diagnosed as having RPGN by clinical manifestations and renal biopsy during a period from 1991 to 2003. Several clinicopathological parameters were analyzed as prognostic factors. Results: Among a total of 12 patients, 4 were male and 8 were female. The median onset age was 11.5 years(range 5.5-14.6 years), and the median period of follow-up was 25 months(range 7 months-6.6 years). According to the pathological classification, 10 patients (83%) were type II RPGN(immune-complex mediated glomerulonephritis), 2 patients were type III RPGN(pauci-immune glomerulonephritis), and none was type I RPGN(anti-glomerular basement membrane nephritis). All patients were treated with oral steroid in various combinations with methylprednisolone pulse therapy(10 patients, 83%), cyclophosphamide(8 patients, 67%), or plasmapheresis(4 patients, 33%). Clinical outcomes of 12 patients were complete remission in 1(8%), end-stage renal disease in 2(17%), chronic renal insufficiency with persistent proteinuria in 2(17%), and normal renal function with persistent proteinuria in 7(58%) at the last follow-up. Poor prognosis is associated with increased serum creatinine level, severe anemia and younger age at the time of diagnosis. Conclusion: Immune-complex mediated glomerulonephritis is the major cause RPGN in children and most cases showed improvement of renal function with aggressive management. For better understanding of this rare disease, a prospective multicenter study should be done.

• Journal of Life Science
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• v.21 no.5
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• pp.647-655
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• 2011

The neurotoxicity of aggregated amyloid ${\beta}$ ($A{\beta}$) has been implicated as a critical cause in the pathogenesis of Alzheimer's disease (AD). It can cause neurotoxicity in AD by evoking a cascade of apoptosis to neuron. Here, we investigated the neuroprotective effects of cilostazol, which acts as a phosphodiesterase III inhibitor, on $A{\beta}_{25-35}$-induced cytotoxicity in mouse neuronal cells and cognitive decline in the C57BL/6J AD mouse model via peroxisome proliferator-activated receptor (PPAR)-${\gamma}$ activation. $A{\beta}_{25-35}$ significantly reduced cell viability and increased the number of apoptotic-like cells. Cilostazol treatment recovered cells from $A{\beta}$-induced cell death as well as rosiglitazone, a PPAR-${\gamma}$ activator. These effects were suppressed by GW9662, an antagonist of PPAR-${\gamma}$ activity, indicative of a PPAR-${\gamma}$-mediated signaling. In addition, cilostazol and rosiglitazone also restored PPAR-${\gamma}$ activity levels that had been altered as a result of $A{\beta}_{25-35}$ treatment, which were antagonized by GW9662. Furthermore, cilostazol also markedly decreased the number of apoptotic-like cells and decreased the Bax/Bcl-2 ratio. Intracerebroventricular injection of $A{\beta}_{25-35}$ in C57BL/6J mice resulted in impaired cognitive function. Oral administration of cilostazol (20 mg/kg) for 2 weeks before $A{\beta}_{25-35}$ injection and once a day for 4 weeks post-surgery almost completely prevented the $A{\beta}_{25-35}$-induced cognitive deficits, as did rosiglitazone. Taken together, our findings suggest that cilostazol could attenuate $A{\beta}_{25-35}$-induced neuronal cell injury and apoptosis as well as promote the survival of neuronal cells, subsequently improving cognitive decline in AD, partly because of PPAR-${\gamma}$ activation. The phosphodiesterase III inhibitor cilostazol may be the basis of a novel strategy for the therapy of AD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.1
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• pp.12-20
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• 2008

Purpose: Chronic pulmonary disease may be caused by aspiration of gastric contents secondary to gastroesophageal reflux. At present, there is no gold standard for documenting pulmonary aspiration. The purpose of this study was to investigate the usefulness of radionuclide scintigraphy in the detection of gastroesophageal reflux and pulmonary aspiration. Methods: Thirty-five patients with suspected aspiration pneumonia, and five normal control subjects, were included in the study. All subjects underwent gastroesophageal reflux scintigraphy after the ingestion of a $^{99m}Tc$-tin colloid mixture. Dynamic images to detect gastroesophageal reflux were obtained for 1 hour. Additional static images of the chest, to detect lung aspiration, were obtained at 6 and 24 hours after oral ingestion of the tin colloid. In addition to visual analysis, pulmonary aspiration was quantitated by counting the number of pixels labeled with radioactive isotope in the region of interest (ROI) of both lung fields. Aspiration index (AI) was obtained by subtracting the pixel counts of the background from the pixel counts of the ROI. Results: Among 35 patients with suspected aspiration pneumonia, 23 proved to have gastroesophageal reflux by scintigraphy. One patient showed definite pulmonary accumulation of activity by visual analysis of the 6-hour image. Thirty of 35 (85.7%) patients showed higher AI beyond the upper limit of AI in the healthy controls. When we compared the reflux group with the non-reflux group, there was a significantly higher AI at 6 hours in the reflux group (p<0.05). Conclusion: The results suggest that radionuclide scintigraphy is useful in detecting small pulmonary aspiration in patients with suspected aspiration pneumonia secondary to reflux.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7367-7369
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• 2013

Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-${\beta}$) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1217-1223
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• 2003

Purpose : This study was conducted to assess clinical practices related to the evaluation and treatment of patients with acute gastrointestinal infection(AGI) in infants and children. This survey also evaluated the current opinion regarding the use of rotavirus vaccine. Methods : This survey was conducted using a self-administered questionnaire provided to 82 pediatricians in private clinics of Jeonbuk province. From April to June, 2002, 63 of 82 pediatricians(76.8 %) responded to the survey. Results : The annual proportion of patients with AGI was 13%. The highest proportion of patients with diarrhea were reported for the months of October through December. For the treatment of diarrhea, pediatricians preferred to prescribe lactobacillus products, oral rehydration solution, enzyme products, anti-emetics, anti-diarrheal formula, nothing by mouth(NPO) and bowel movement inhibitors in descending order of frequency. Most pediatricians(79.4%) prescribed antibiotics in less than 20% of patients with AGI. Amoxicillin was the most commonly prescribed antibiotics followed by trimethoprim/sulfamethoxazole(TMP/SMX) and amoxicillin/clavulanate. Clinical manifestations that pediatricians considered as important factors in prescribing antibiotics were bloody diarrhea, mucoid diarrhea, high fever, persisting disease and abdominal pain. Diagnostic procedures that pediatricians preferred for AGI patients were stool examination(rotavirus antigen, RBC, WBC), abdominal X-ray, and serum electrolytes. Pediatricians had a strong interest in rotavirus vaccine(71.4%). Conclusion : Acute gastrointestinal illness remains a common problem, especially during the winter months in Korea. AGI manifesting as watery diarrhea is appropriately treated with commonly available agents but pediatricians appear ready to consider additional approaches to decrease the sizable disease burden of AGI among children in Korea.

• Tuberculosis and Respiratory Diseases
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• v.51 no.1
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• pp.35-43
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• 2001

Background : The eosinophil chemotactic and activating effects of eotaxin and the known association of eosinophils with asthma suggest that eotaxin expression is increased during an asthma attack. This study was aimed to determine whether the plasma eotaxin levels are higher in patients during an asthma attack and to correlate the eotaxin levels with the disease activity, severity and response to therapy. Method : A case-control study of the plasma eotaxin levels was performed in 100 patients with exacerbated asthma and 48 age- and sex-matched subjects with stable asthma. Results : The plasma eotaxin levels were significantly higher in the 100 patients with exacerbated asthma($233{\pm}175\;pg/mL$) than in the 48 subjects with stable asthma($169{\pm}74\;pg/mL$). A trend toward higher eotaxin levels was observed in asthmatic subjects who were taking oral steroids ($332{\pm}225\;pg/mL$) than in those who were not ($214{\pm}159\;pg/mL$) and higher levels were found in those admitted to the hospital ($275{\pm}212\;pg/mL$) than in those discharged after receiving only emergency treatment ($190{\pm}115\;pg/mL$). The eotaxin levels inversely correlated with the $FEV_$ (r=-0.25, p<0.01). The eotaxin levels were higher in moderate persistent ($323{\pm}256\;pg/mL$) and severe persistent asthmatics ($276{\pm}170\;pg/mL$) than in mild intermittent asthmatics ($l60{\pm}60\;pg/mL$). Conclusion : Eotaxin expression is directly associated with asthma exacerbation, impaired pulmonary function and the disease severity.

• Korean Journal of Health Education and Promotion
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• v.1 no.1
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• pp.57-71
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• 1983

Sex education is necessary for the youth that they should have an adequate sexual knowledge, attitudes and behaviors in their adolescent period. Four major objectives of this study are as follows; 1. To know the level of sexual knowledge of commercial girl's high school students in Seoul. 2. To know their actual state for the attitudes and behaviors toward sex. 3. To compare the sexual knowledge, attitudes and behaviors of day time school students with those of night time school students. 4. To compare the factors associated with their sexual knowledge, attitudes and behaviors with the individual level. Data were collected on 986 students in Seoul from April 1 to April 10, 1983. As the result of this survey, the following conclusions were obtained. 1. The level of sexual knowledge. (1) The level of knowledge of day time high school students about the physiology of female and pregnancy is shown higher than those of night time students. 64.2% of the respondents are aware of the organ producing ovum. 56.4% the ovulation period. 95.6% the cause of pregnancy. 74.5% the pregnantable period and 12.7% the place of fetilization. (2) Out of 986 respondents. 71.8% knew about contraceptive method correctly, and day time school students knew litter better than night time school students, by showing 73.9% and 69.7% respectively. They knew about contraceptive method with 'oral pills'. 'menstrual cycles', 'condoms'. and 'loops' in the same order. 3) Kinds of veneral disease was correctly known by 37.9%. Day time students knew much better than night time school students. by showing 67.8% and 7.9%. respectively. Transmission method of veneral disease was correctly known by 28.3%. Day time students knew much better than night time students, by showing 51.2% and 5.3%, respectively. (4) The major information source of sexual knowledge was 'book and magazine' (39.9%) and 'friends' (27.4%). 2. Actual state of attitudes and behaviors toward sex. (1) Out of 986 respondents, 84.0% answered that premarital purity should be kept. (2) Out of 986 respondents, 60.8% had an acquaintance of the opposite sex. 45.2% of students with opposite sex reported introduction of their friends as the main channel of making an acquaintance of the opposite sex. (3) Of those who responded to this study 13.8% reported having masturbation, 21.5% kissing, 6.2% petting and 3.7% sex intercourse. (4) 64.8% had sexual problems, which was mensturance (27.2%), aquaintance of the opposite sex (25.4%). The main method to solve the problems were consultation with 'friends' and 'books and magazine' percentage being 39.1% and 30.8%, respectively, whereas very small students discussed with 'teachers' and 'parents' percentages being 0.3% and 5.9%, respectively. (5) Out of 986 respondents, 62.2% had experience in educating about sex, the percentage of day time school was higher than that of night time school. (6) 88.2% of students wanted sex education in school, which were 'general information about sex' (35.4%), 'sexual morality and solution of sexual desire' (18.5%), 'aquaintance of the opposite sex' (13.3%) and 'marriage and role of man and woman' (12.4%) in the same order. They wanted to be instructed about sexes in the lecture of physical education, home economics, biology, military training (59.9%), regular curriculum (17.5%), special lecture (16.9%) and by the counselor or school nurse (5.7%). 3. Analyse concerning the factors about the knowledge, attitudes and behaviors. (1) The better school record was, the higher the level of sexual knowledge. (2) Those who have the religion considered the permarital purity more important than those who have not, the percentage showing 86.7% and 80.7%, respectively. (3) The result of dyad analysis of making acquaintance of the opposite sex in the friendship network showed that a high index of the acquaintance of the opposite sex tends to be a high adoption of making one at the individual level in the group, while the low index tends to be a low adoption of making one in the group.

• Journal of dental hygiene science
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• v.9 no.5
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• pp.563-570
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• 2009

This study carried out the survey of the actual condition targeting 303 patients with execution of treatment after medical examination among patients who visited from January 2, 2008 to December 31, 2008 at dental hospital where is located in K region, and analyzed by using a program of SPSS13.0. The ratio of treatment in posterior was high with 76.9% in central incisor, 62.3% in the 1st bicuspids, and 45.3% in the first permanent molars as for health in the right teeth of maxillary, and with 77.9% in central incisor, 64.4% in the 1st bicuspids, and 47.6% in the first permanent molars as for the left teeth. In the lower jaw, the ratio of treatment in posterior was high with 92.1% in central incisor, 73.9% in the 1st bicuspids, and 42.6% in the first permanent molars as for health in the right teeth, and with 92.1% in central incisor, 75.9% in the 1st bicuspids, and 43.2% in the first permanent molars as for the left teeth. The upper left cuspid was treated in older patients by age(${\chi}^2=32.33$, p=0.000), in the more patients with high blood pressure(${\chi}^2=12.60$, p=0.000), and in case of systemic disease. The significant difference was shown(${\chi}^2=6.37$, p=0.012). The older patients led to being treated cuspid among right teeth in the lower jaw. The significant difference was shown according in the more patients with high blood pressure(${\chi}^2=8.26$, p=0.004). The left cuspid in the lower jaw was treated in the older patients by age the statistically significant difference was shown(${\chi}^2=12.10$, p=0.007).