Young Ju Suh

Efficacy of venlafaxine for symptomatic relief in young adult patients with functional chest pain: A randomized, double-blind, placebo-controlled, crossover trial

OBJECTIVES:Esophageal hypersensitivity is currently believed to have a crucial role in the pathogenesis of functional chest pain (FCP). The aim of this study was to evaluate the clinical efficacy of venlafaxine, a serotonin–norepinephrine reuptake inhibitor (SNRI), for FCP in young adult patients.METHODS:Patients diagnosed with FCP were randomized to either an extended-release formulation of venlafaxine (75 mg hora somni) or a placebo for 4 weeks. After a washout period of 2 weeks, patients crossed over to the other arm of the study. The primary efficacy variable was the number of patients with >50% improvement in symptom scores. The secondary efficacy variables were (i) the symptom intensity score during each week, (ii) quality of life (QOL), (iii) the Beck Depression Inventory (BDI) score, and (iv) side effects.RESULTS:A total of 43 patients (37 men, mean age 23.5±1.9 years) completed the study. A positive response was observed in 52.0% of patients during venlafaxine treatment; 4.0% had a positive response with placebo treatment as assessed by the intention-to-treat analysis (venlafaxine vs. placebo: odds ratio 26.0; 95% confidence interval 5.7–118.8; P<0.001). Results of Short-Form 36 (SF-36) indicated that patients who received venlafaxine treatment had a significantly greater improvement in body pain and emotional role compared with those who received placebo treatment (P=0.002 and P=0.002, respectively). No significant change was noted in the depression score after venalafaxine or placebo treatment. One patient withdrew from the study because of sleep disturbance and loss of appetite while receiving venlafaxine.CONCLUSIONS:Venlafaxine, an SNRI antidepressant, significantly improved symptoms in young adult patients with FCP.

PM10 and Pregnancy Outcomes : A Hospital-Based Cohort Study of Pregnant Women in Seoul

Objective: The aim of this study was to evaluate the effects of PM10 on birth outcomes using a prospective cohort of pregnant women. Methods: The multicenter prospective study was conducted in Korea from 2001 to 2004. To estimate the effects of PM10 exposure on birth outcomes, the logistic and linear regression model and the generalized additive model for nonlinear relationships were used. Results: Stillbirths were affected by PM10 level during the third trimesters (OR = 1.10, 95% CI = 1.02–1.14), and birth defects were influenced by the PM10 exposure during the second trimesters (OR = 1.16, 95% CI = 1.00–1.34). Intrauterine growth retardation was affected by the first trimesters PM10 exposure. On the other hand, premature birth was affected by the PM10 exposure during the third trimester, and low-birth-weight births were affected by the PM10 level during entire trimesters of pregnancy. Conclusions: PM10 exposure during pregnancy may result in adverse birth outcomes with different critical periods.

Effect of lifestyle modification on serum chemerin concentration and its association with insulin sensitivity in overweight and obese adults with type 2 diabetes

Chemerin, a recently identified adipokine, has been linked to adiposity, insulin resistance, metabolic syndrome risk factors and inflammation. Here, we evaluated whether a 12‐week lifestyle intervention in overweight and obese adults with type 2 diabetes could significantly affect the average blood glucose and serum chemerin levels over time.

Predicting idiopathic toxicity of cisplatin by a pharmacometabonomic approach

Cisplatin has been one of the most widely used anticancer agents, but its nephrotoxicity remains a dose-limiting complication. Here, we evaluated the idiopathic nature and the predose prediction of cisplatin-induced nephrotoxicity using a nuclear magnetic resonance (NMR)-based pharmacometabonomic approach. Cisplatin produced serious toxic responses in some animals (toxic group), but had little effect in others (nontoxic group), as judged by hematological and histological results. The individual metabolic profiles, assessed by urine NMR spectra, showed large differences between the post-administration profiles of the two groups, indicating the relevance of the NMR approach. Importantly, multivariate analysis of the NMR data showed that the toxic and nontoxic groups can be differentiated based on the pretreatment metabolite profiles. Leave-one-out analysis, performed to evaluate the practical performance of our approach, gave a 66% accuracy rate in predicting toxic responses based on the pretreatment metabolite profiles. Hence, we provide a working model that can explain the idiopathic toxicity mechanism based on marker metabolites found by NMR analysis consistent with tissue NADH measurements. Thus, a pharmacometabonomic approach using pretreatment metabolite profiles may help expedite personalized chemotherapy of anticancer drugs.

GSTM1 polymorphism along with PM10 exposure contributes to the risk of preterm delivery

We investigated the association between the risk of preterm delivery and each metabolic gene of glutathione S-transferases micro 1 (GSTM1), theta 1 (GSTT1) and cytochrome P450IA1 (CYP1A1) along with exposure to particulate matter<10 microm (PM10). This study was assumed to identify gene-environment interaction that increases the risk of preterm delivery. A case-control study was carried out on 117 women with preterm deliveries and 118 women with term deliveries in Seoul, Korea. Logistic regression analyses were performed to explore the impact of each gene, PM10 exposure and their interaction on the risk of preterm birth. The risk of preterm birth was associated with the GSTM1 null genotype only. Exposure to high levels of PM10 (>or=75th percentile) during the third trimester of pregnancy was associated with an increased risk of preterm birth when compared to low-level exposure to PM10 (<75th percentile). We found that exposure to high levels of PM10 during the third trimester in the presence of the GSTM1 null genotype is significantly associated with the risk of preterm delivery. This finding is biologically plausible and provides evidence for a gene-environment interaction that increases the risk of preterm birth.

Clinical association between non-alcoholic fatty liver disease and the development of hypertension.

Non‐alcoholic fatty liver disease (NAFLD) is getting an increasing attention for its clinical implications on cardiovascular disease (CVD). However, epidemiologic data are not so evident to sustain the causative association between NAFLD and hypertension, the major cause of CVD. Accordingly, we designed this study to investigate the clinical association between NAFLD and the development of hypertension.

The clinical availability of non alcoholic fatty liver disease as an early predictor of the metabolic syndrome in Korean men: 5-Year's prospective cohort study

OBJECTIVES There were many studies for the clinical association between non alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS). However, while most of studies have focused on the unilateral effects of MetS on NAFLD, studies for reverse association were comparatively rare. Therefore, we carried out a prospective cohort study to evaluate the longitudinal effects of NAFLD on the development of MetS according to the degree of NAFLD. PATIENTS AND METHODS A total of 46,874 men, who had participated in a medical health check-up program in 2005, were enrolled in this study. Out of them, a Mets-free cohort of 11,926 without excluding conditions was followed up until 2010. All participants were classified into 3 groups by their NAFLD status (normal, mild, moderate to severe). The baseline values of metabolic components and the development rates of MetS were compared according to the degree of NAFLD. Cox proportional hazards model was used to measure the hazard ratios (HRs) for MetS according to the degree of NAFLD. RESULTS During 41,912.1 person-years of follow-up, 1861 incident cases of MetS developed between 2006 and 2010. Even after adjusting for multiple covariates, the HRs (95% CI) for MetS were higher in the mild group (1.49; 1.30-1.70) and moderate to severe group (2.00; 1.46-2.73) compared to normal group, respectively (P for trend <0.001). These associations were apparent in the clinically relevant subgroup analyses. CONCLUSIONS NAFLD was independent risk factor for MetS during the 5-yr follow-up period.

The Effect of Cognitive Training in Patients with Mild Cognitive Impairment and Early Alzheimer's Disease: A Preliminary Study

Background and Purpose The objective of this study was to determine the benefits of cognitive training in patients with amnestic mild cognitive impairment (aMCI) and those with early Alzheimers disease (AD). Methods Eleven patients with aMCI and nine with early AD (stage 4 on the Global Deterioration Scale) participated in this study. Six participants with aMCI and six with AD were allocated to the cognitive training group, while five participants with aMCI and three with AD were allocated to a wait-list control group. Multicomponent cognitive training was administered in 18 weekly, individual sessions. Outcome measures were undertaken at baseline, and at 2 weeks and 3 months of follow-up. Results In the trained MCI group, there were significant improvements in the delayed-recall scores on the Seoul Verbal Learning Test at both the 2-week and 3-month follow-ups compared with baseline (baseline, 1.6±1.5; 2 weeks, 4.4±1.5, p=0.04; 3 months, 4.6±2.3, p=0.04). The phonemic fluency scores (1.0±0.8 vs. 5.0±1.8, p=0.07) and Korean Mini-Mental State Examination scores (18.8±0.5 vs. 23.8±2.2, p=0.07) also showed a tendency toward improvement at the 2-week follow-up compared to baseline in the trained AD group. Conclusions This study provides evidence of the effectiveness of cognitive training in aMCI and early AD. The efficacy of cognitive training programs remains to be verified in studies with larger samples and a randomized design.

Effect of extremely low frequency magnetic fields on cell proliferation and gene expression.

Owing to concerns regarding possible effects of extremely low frequency magnetic fields (ELF-MF) on human health, many studies have been conducted to elucidate whether ELF-MF can induce modifications in biological processes. Despite this, controversies regarding effects of ELF-MF are still rife. In this study, we investigated biological effects of ELF-MF on MCF10A, MCF7, Jurkat, and NIH3T3 cell lines. ELF-MF with a magnetic flux density of 1 mT at 60 Hz was employed to stimulate cells for 4 or 16 h, after which the effects of ELF-MF on cell proliferation, cell death, cell viability, and DNA synthesis rates were assessed. Whereas Jurkat and NIH3T3 cells showed no consistent variation in cell number, cell viability, and DNA synthesis rate, MCF10A and MCF7 cells showed consistent and significant decreases in cell number, cell viability, and DNA synthesis rates. However, there was no effect of ELF-MF on cell death in any of tested cell lines. Next, to investigate the effect of ELF-MF on gene expression, we exposed MCF7 cells to 2 mT at 60 Hz for 16 h and examined transcriptional responses by using gene expression array. We found a gene, PMAIP1, that exhibited statistically significant variation using two-fold cut-off criteria and certified its expression change by using semi-quantitative and quantitative reverse transcription polymerase chain reaction. From these results, we concluded that ELF-MF could induce the delay of cell cycle progression in MCF7 and MCF10A cells in a cell context-specific manner and could up-regulate PMAIP1 in MCF7 cells.

Prevalence and Relationships of Iron Deficiency Anemia with Blood Cadmium and Vitamin D Levels in Korean Women

Anemia, iron deficiency (ID), and iron deficiency anemia (IDA) are common disorders. This study was undertaken to determine the prevalence of anemia, ID, and IDA in Korean females. We examined the associations between IDA, heavy metals in blood, vitamin D level and nutritional intakes. The study was performed using on data collected from 10,169 women (aged ≥10 yr), including 1,232 with anemia, 2,030 with ID, and 690 with IDA during the fifth Korea National Health and Nutrition Examination Survey (KNHANES V; 2010-2012). Prevalence and 95% confidence intervals were calculated, and path analysis was performed to identify a multivariate regression model incorporating IDA, heavy metals in blood, vitamin D level, and nutritional intakes. The overall prevalence of anemia, ID and IDA was 12.4%, 23.11%, and 7.7%, respectively. ID and IDA were more prevalent among adolescents (aged 15-18 yr; 36.5% for ID; 10.7% for IDA) and women aged 19-49 yr (32.7% for ID; 11.3% for IDA). The proposed path model showed that IDA was associated with an elevated cadmium level after adjusting for age and body mass index (β=0.46, P<0.001). Vitamin D levels were found to affect IDA negatively (β=-0.002, P<0.001). This study shows that the prevalence of anemia, ID, and IDA are relatively high in late adolescents and women of reproductive age. Path analysis showed that depressed vitamin D levels increase the risk of IDA, and that IDA increases cadmium concentrations in blood. Our findings indicate that systematic health surveillance systems including educational campaigns and well-balanced nutrition are needed to control anemia, ID, and IDA.