Occupational exposure and idiopathic pulmonary fibrosis: a multicentre case-control study in Korea

SETTING

Multicentred hospital-based cases and control subjects in Korea.

OBJECTIVE

To evaluate the association between idiopathic pulmonary fibrosis (IPF) and hazardous materials to which people are occupationally exposed.

DESIGN

A multicentre, hospital-based, matched case-control study was performed. The ratio of IPF cases to controls was 1:1 (n = 78 in each group). IPF cases and controls were matched in terms of age group, sex and place of residence. Conditional logistic regression analysis was performed.

RESULTS

In simple logistic regression analysis, exposure to metal dust and any exposure for >1 year in an occupational setting were significantly associated with IPF (metal dust OR 4.00, 95%CI 1.34-11.97; any exposure OR 3.67, 95%CI 1.02-13.14). After adjustment for environmental and military exposures and smoking history, the OR for metal dust exposure was 4.97 (95%CI 1.36-18.17) in multiple logistic regression analysis.

CONCLUSIONS

Metal dust was associated with incident IPF in Seoul and Gyeonggi Provinces in Korea. This information will be used to support a tailored preventive strategy in specific industries or occupations.

A programmable platform for sub-second multichemical dynamic stimulation and neuronal functional imaging in C. elegans

Caenorhabditis elegans (C. elegans) is a prominent model organism in neuroscience, as its small stereotyped nervous system offers unique advantages for studying neuronal circuits at the cellular level. Characterizing temporal dynamics of neuronal circuits is essential to fully understand neuronal processing. Characterization of the temporal dynamics of chemosensory circuits requires a precise and fast method to deliver multiple stimuli and monitor the animal's neuronal activity. Microfluidic platforms have been developed that offer an improved control of chemical delivery compared to manual methods. However, stimulating an animal with multiple chemicals at high speed is still difficult. In this work, we have developed a platform that can deliver any sequence of multiple chemical reagents, at sub-second resolution and without cross-contamination. We designed a network of chemical selectors wherein the chemical selected for stimulation is determined by the set of pressures applied to the chemical reservoirs. Modulation of inlet pressures has been automated to create robust, programmable sequences of subsecond chemical pulses. We showed that stimulation with sequences of different chemicals at the second to sub-second range can generate different neuronal activity patterns in chemosensory neurons; we observed previously unseen neuronal responses to a controlled chemical stimulation. Because of the speed and versatility of stimulus generated, this platform opens new possibilities to investigate neuronal circuits.

Four-week individual caging of male ICR mice alters body composition without change in body mass

Understanding the physiological implications of caging conditions for mice is crucial in improving the replicability and reliability of animal research. Individual caging of mice is known to alter mouse psychology, such as triggering depression-like symptoms in mice, suggesting that caging conditions could have negative effects on mice. Therefore, we hypothesized that individual caging could affect the physical composition of outbred mice. To investigate this, dual X-ray absorptiometry (DXA) was used to compare the mass, bone mineral content (BMC), bone mineral density (BMD), lean tissue percentage and fat tissue percentage between group and individual caged mice. We also conducted open field test to compare mouse activities in different caging conditions. Our results showed significantly reduced BMD and lean tissue percentage and significantly increased fat tissue percentage in individually-caged male mice. Furthermore, there were no differences in body mass and activity between the grouped and individual mice, suggesting that these physical alterations were not induced by group-related activity. In this study, we conclude that individual caging could alter the body composition of mice without affecting external morphology.

The Development of Emergency Medicine in South Korea: Academic Productivity in Highly Cited Journals

Introduction

The purpose of this study was to examine the number of publications by South Korean emergency physicians in highly cited journals and the increase in their numbers. It also sought to assess the impact factors of such publications.

Methods

The present study was a retrospective quantitative literature review of the publications by South Korean emergency physicians from 1996 to 2011 in the category of “emergency medicine” in the science edition of Journal Citation Reports 2011. We analysed the total number of articles published by South Korean emergency physicians and their impact factors.

Results

Between 1996 and 2011, the number of South Korean board-certified emergency physicians increased from 51 to 958, and 230 articles were published in 14 highly cited journals. The total impact factor (IF) of the original articles published during that period was 227.86, and the mean IF was 1.93. More than 10 articles had been published annually in the past 5 years in highly cited journals and there were over 400 South Korean board-certified emergency physicians.

Conclusions

Emergency medicine in South Korea started about 20 years ago, but academic productivity, indicated by at least ten articles annually in highly cited journals, was only achieved in the last five years. The mean IF of these articles was similar to that in other highly productive countries. (Hong Kong j.emerg.med. 2014;21:205-212)

Corpectomy and circumferential fusion for advanced thoracolumbar Kümmell's disease

BACKGROUND

The aim of this study was to investigate the surgical treatment of neurologically compromised advanced Kümmell's disease. The surgical treatment of Kümmell's disease has various options according to clinical and radiologic status. Far collapsed Kümmell's disease patients with neurological deficit need to be treated surgically.

MATERIALS AND METHODS

We retrospectively analyzed 22 patients operated to our hospital with neurologically compromised Kümmell's disease between January 2011 and January 2014. Surgical approach was vertebrectomy, mesh cage insertion and segmental cement-augmented pedicle screw fixation. Corpectomy tissue was examined histopathologically. Anterior vertebral heights, kyphotic angle, the visual analog scale (VAS) and the Frankel classification were used to evaluate the effects of the surgery.

RESULTS

The mean time of follow-up was 26 months (range, 13-40 months). The VAS, anterior vertebral heights, kyphotic angle and neurological state were improved significantly immediate postoperatively and at the last follow-up compared with the preoperative examinations (P < 0.05). Most of the patients in this study exhibited intravertebral clefts, and postoperative pathology revealed bone necrosis.

CONCLUSION

Posterior vertebrectomy with mesh cage insertion and segmental cement-augmented pedicle screw fixation is an effective option for advanced Kümmell's disease with neurological deficits.

Reduction of Slit Diaphragm-associated Molecules by Sirolimus: Is it Enough to Induce Proteinuria?

Sirolimus (SRL), a mammalian target of rapamycin inhibitor, is widely used in transplantation, but the mechanisms whereby it induces adverse effects, such as proteinuria and edema, remain unclear. To determine whether isolated SRL induces proteinuria or not, the authors intraperitoneally injected C57BL/6 mice with different doses of SRL (0 mg/[kg·d], 3 mg/[kg·d], 10 mg/[kg·d], or 30 mg/[kg·d]) for 24 days. Urinary albumin excretion was then quantified using a double-sandwich enzyme-linked immunosorbent assay, and serum creatinine levels were measured using a single dry-film chemistry auto-analyzer. The mRNA expression levels of various genes were also measured by polymerase chain reaction. Urinary albumin was not detected in the SRL-treated mice, but serum creatinine levels were found to increase dose-dependently and were significantly higher in the animals treated with 30 mg/kg of SRL than in untreated controls. Glomerular mRNA expression profiling showed down-regulations of podocyte-related genes (Wilms tumor 1, synaptopodin, nephrin, CD2-associated protein, and podocin) and of transforming growth factor-beta (a marker of fibrosis) in sirolimus-treated mice. In addition, expressions of the antiapoptotic genes Bcl-2 and Bcl-xL were also down-regulated. Furthermore, the protein levels of these genes in mice kidney were also decreased by sirolimus. Although sirolimus treatment reduced the expressions of slit diaphragm-associated molecules and increased serum creatinine levels, it failed to induce proteinuria. Our findings indicate that proteinuria is not induced by isolated SRL treatment. Further studies are required to identify conditions in which sirolimus induces proteinuria.

Identification of a novel HLA-B allele, HLA-B*55:81

The new allele, B*55:81, differs from B*55:02:01:02 by 2 nucleotide substitutions in codon 116 (TTA → TAC).

The effect of Korean-group cognitive behavioural therapy among patients with panic disorder in clinic settings

WHAT IS KNOWN ON THE SUBJECT?: Panic disorder patients display various panic-related physical symptoms and catastrophic misinterpretation of bodily sensations, which lower their quality of life by interfering with daily activities. Cognitive behavioural therapy (CBT) is a useful strategy for panic disorder patients to manage symptoms associated with inaccurate cognitive interpretation of situations resulting from the patient's cognitive vulnerability. In South Korea, however, despite the increasing prevalence of panic disorder, CBT is not a common element of nursing care plans for panic disorder patients. Moreover, few Korean researchers have attempted to assess the effects of CBT on such patients. WHAT THIS PAPER ADD TO EXISTING KNOWLEDGE?: In a strategy combining CBT and routine treatments, patients with panic disorder can experience greater positive effects in the acute treatment phase than those they experience when receiving only routine treatment. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health professionals, especially psychiatric nurses in local clinics who operate most special mental health programmes for panic disorder patients, should apply a panic disorder management programme that integrates CBT and routine treatments. The integrated approach is more effective for reducing the number of panic attacks and cognitive misinterpretation in patients than providing routine treatment alone. For patients with panic disorder, the objective of CBT is to understand the relationship between psychological panic disorder sensations, emotions, thoughts and behaviours. Therefore, nurses can help patients address and improve biological, social and psychological aspects of physical health problems as well as help them improve their coping skills in general.

ABSTRACT

Introduction In panic disorder, sensitivity to bodily sensations increases due to the patient's cognitive vulnerability. Cognitive behavioural therapy (CBT) can help to decrease sensitivity to bodily sensations by correcting these cognitive distortions by controlling negative thoughts and panic attacks. Aims This study verified whether group CBT is more effective than treatment as usual (TAU) in South Korean patients with panic disorder. Methods The study participants consisted of 76 panic disorder patients. Patients in the therapy condition attended sessions once a week for a total of 12 sessions in addition to drug treatment. Results In the therapy condition, there were significant decreases in panic-related bodily sensations and ranking and belief scores for catastrophic misinterpretation of external events. Discussion Group CBT, in comparison to TAU, decreases panic and agoraphobia symptom severity in South Korean patients with panic disorder. Our study provides evidence for the effectiveness of a panic disorder management programme that integrates group CBT and traditional pharmacotherapeutic treatment for patients with panic disorder. Implications for Practice The cognitive behavioural approach is needed to reduce panic and agoraphobia symptoms for hospitalized patients with panic disorder more than activity therapies, medications and supportive counselling by doctors and nurses.

Direct Gingival Fibroblast/Osteoblast Transdifferentiation via Epigenetics

Alveolar bone resorption caused by trauma or periodontal diseases has represented a challenge for both dental clinicians and researchers. In this study, we evaluate the osteogenic potential of human gingival fibroblasts (HGFs) through a direct transdifferentiation from HGFs to functional osteoblasts via epigenetic modification and osteogenic signaling with bone morphogenetic protein 2 (BMP2) in vitro and in vivo. HGF treatment with 5-aza-2'-deoxycytidine (5-aza-dC) induced demethylation in the hypermethylated CpG islands of the osteogenic lineage marker genes RUNX2 and ALP, and subsequent BMP2 treatment successfully drove the fibroblasts to the osteoblasts' lineage. Cell morphological changes viewed under microscopy and alkaline phosphatase (ALP) and alizarin red S (ARS) staining confirmed the osteoblastic change mediated by epigenetic modification as did real-time polymerase chain reaction (PCR), methylation-specific PCR (MSP), and chromatin immunoprecipitation (ChIP) assay, which demonstrated the altered methylation patterns in the RUNX2 and ALP promoter regions and their effect on gene expression. Furthermore, micro-computed tomography (CT) analysis of in vivo mouse cell transplantation experiments showed high-density signal in the epigenetically modified HGF group; in addition, a significant amount of bone formation was observed in the transplanted material using hematoxylin and eosin (H&E) staining as well. Collectively, our results indicate that epigenetic modification permits the direct programming of HGFs into functional osteoblasts, suggesting that this approach might open a novel therapeutic avenue in alveolar bone regeneration.

Effects of solids retention time on the fate of tetracycline resistance in SBRs for the treatment of carcass leachate

In the event of a foot and mouth disease outbreak, further spread of the virus is generally prevented by culling of infected animals in burial pits. This practice may eventually lead to groundwater contamination through leaching of wastewater from the animal carcasses. Wastewater from carcass leachate often contains antibiotic resistant bacteria and genes as well as traces of pharmaceuticals, and a high nutrient content. The role of operational parameters used in activated sludge treatment of this wastewater in the spread of antibiotic resistance has not been fully understood. This study investigated the fate of tetracycline-resistant bacteria and genes in sequencing batch reactors with synthetic carcass leachate at different solid retention times. Escherichia coli DH5α was used as the representative tetracycline-resistant bacteria with multiple antibiotic-resistant genes encoded in plasmid pB10. Solids retention time contributed to an increase in antibiotic resistance in SBRC (SRT = 25 days) with TRB values up to 1.25 × 10(7) CFU/mL which is one log higher than the influent. Microbial community analysis of the DNA samples from effluent of SBRC showed four major phyla: Proteobacteria, Bacteroidetes, Firmicutes, and Actinobacteria under which are ecologically-important microbial species. It was shown that antibiotic resistance genes cannot be eliminated during treatment of synthetic carcass leachate in a lab-scale sequencing batch reactor.