Chonnam medical journal最新文献

To compare optic nerve head (ONH) and peripapillary structural OCT parameters between eyes with and without visual field (VF) defects one year after an episode of acute primary angle closure (APAC) in a cohort treated uniformly treated with early clear-lens extraction. Forty-seven eyes of 47 patients with a history of APAC episode who underwent early clear-lens extraction at Chonnam National University Hospital were retrospectively reviewed. Spectral-domain optical coherence tomography (SD-OCT) performed one year after the episode was used to assess Bruch's membrane opening-minimum rim width (BMO-MRW), retinal nerve fiber layer (RNFL) thickness, lamina cribrosa (LC) thickness and depth, and parapapillary atrophy (PPA) subdivided into PPA+BM and PPA-BM. Patients were classified according to the presence or absence of VF defects. At one year, 23 eyes (48.9%) had variable degrees of visual field (VF) defects. Compared with eyes with normal VF, the VF-defect group showed significantly thinner global BMO-MRW (p<0.001) and peripapillary RNFL (p<0.001), reduced LC thickness (p<0.001), shallower LC depth (p=0.028), and a wider PPA+BM (p<0.001). APAC patients who underwent early lens extraction may develop residual VF defect despite normalization of IOP. These defects were associated with structural damage in the rim, RNFL, LC, and PPA+BM as detected by SD-OCT. Comprehensive OCT analysis may help identify patients at risk of long-term functional sequelae after APAC.

This study aimed to estimate the recurrence rate of pelvic organ prolapse (POP) following traditional total vaginal hysterectomy (TVH) with anteroposterior (AP) colporrhaphy using the Pelvic Organ Prolapse-Quantification (POP-Q) system, to evaluate the utility of these classical surgical approaches, and to identify risk factors associated with recurrence after pelvic organ prolapse surgery. In this retrospective cohort study, data were collected from 158 patients who underwent TVH with AP colporrhaphy for POP at Chonnam National University Hospital between January 2015 and April 2020 and had follow-up data exceeding 6 months. Data regarding age, body mass index, menopausal status, prolapse severity, surgical method, and POP-Q stage during outpatient post-operative tracking were collected. All 158 patients underwent TVH. Of these, 147 (93.0%) underwent TVH with AP colporrhaphy; two (1.3%) underwent hysterectomy with anterior colporrhaphy, and nine (5.7%) underwent hysterectomy with posterior colporrhaphy. Before the initial surgery, 16 (10.1%), 113 (71.5%), and 29 (18.3%) patients had stages II, III, and IV disease, respectively. The anterior compartment was the most commonly affected (74.1%), followed by the apical (19.6%) and the posterior (6.3%) compartments. Recurrence was observed in 13 patients (8.2%). Parity, menopausal status, and stage of POP did not significantly influence disease recurrence. Traditional TVH with AP colporrhaphy is associated with a relatively low recurrence rate and, thus, remains a valuable surgical treatment option for POP.

The COVID-19 pandemic has adversely affected the mental health of the global population. This study aimed to assess the acute and persistent symptoms of depression, as well as factors related to their manifestation, through a longitudinal study design. A total of 1,492 community-dwelling adults from an online public panel across three regions were evaluated at baseline, with 908 adults (60.9%) followed up after six months. Depression symptoms were evaluated using Patient Health Questionnaire-9 (PHQ-9). Participants also completed self-administered questionnaires on sociodemographic information, psychosocial experiences related to COVID-19, the UCLA Loneliness Scale, and the Korean version of the Gratitude Questionnaire (K-GQ-6).The prevalence of acute and persistent depression symptoms was 8.4% and 12.0%, respectively. Multivariate logistic regression analysis identified changes in predictors of depression over time, with younger age and self-isolation experience found to be associated with acute depression. Factors such as underlying mental illness, eating and sleeping disturbances, loneliness, and COVID-19-related stress emerged as significant risk factors for persistent depression. A disposition toward gratitude was identified as a protective factor for persistent depressive symptoms. These findings suggest that during any long-term pandemic crisis such as COVID-19, timely support and attention are essential for vulnerable populations, including young people and individuals with mental health conditions, to prevent depression. Specifically, promoting daily routines such as regular eating and sleeping patterns, and managing COVID-19-related stress may be critical in preventing persistent depression. Additionally, psychological support that reduces loneliness and fosters gratitude may help mitigate depression risk.

Cervical cancer remains a significant public health concern, with persistent high-risk human papillomavirus (HPV) infections being a major contributing factor. This retrospective study investigates the correlation between multiple HPV infections and cervical cytology abnormalities in patients tested at a single hospital in Seoul, South Korea. A total of 6,869 HPV genotyping tests conducted between January 2017 and December 2023 were analyzed, with 1,396 cases testing positive for HPV. High-risk HPV (HRHPV) types were detected in 59.0% of HPV-positive cases, with HPV 53 being the most prevalent genotype. The frequency of squamous intraepithelial abnormalities (SIA) increased with the number of concurrent HPV infections. Among single infections, 24.2% had SIA, compared to 38.4% for two genotypes, 43.9% for three, and 70.0% for four. HRHPV-positive cases had a significantly higher prevalence of high-grade lesions (ASC-H and HSIL) compared to non-HRHPV and HPV-negative cases. However, no significant difference in cytological outcomes was observed among different co-infection groups. These findings suggest that multiple HPV infections may associated with increased cytological abnormalities, particularly in HRHPV-positive cases. Regional variations in HPV genotype prevalence highlight the need for tailored vaccination and screening strategies. While this study provides valuable epidemiological insights, its retrospective nature and lack of long-term follow-up warrant further research.

The pathogenesis of endotoxin-induced acute lung injury is fundamentally driven by dysregulated innate immune responses, where macrophage-mediated cytokine surges and subsequent signaling cascades trigger neutrophil infiltration and tissue damage. This study investigated whether curcumin modulates inflammatory signaling pathways and attenuates lung injury in experimental endotoxemia. Using endotoxin-stimulated murine macrophages and a mouse model of intratracheal lipopolysaccharide challenge, inflammatory cytokine production, mitogen-activated protein kinase activation, pulmonary edema, neutrophil accumulation, histopathologic injury, and short-term survival were assessed. Curcumin suppressed endotoxin-induced tumor necrosis factor-α production and selectively inhibited ERK1/2 and JNK phosphorylation without affecting p38 signaling in macrophages. In vivo, curcumin reduced pulmonary cytokine levels, neutrophil infiltration, lung edema, and histologic injury, and was associated with improved survival following severe endotoxin exposure. These findings indicate that curcumin attenuates acute lung injury by selectively modulating intracellular inflammatory signaling pathways, supporting the concept that targeted inhibition of specific kinase cascades may mitigate inflammatory lung damage without broad immune suppression.

Obesity is a systemic vascular disease characterized by the convergence of metabolic excess and adipose dysfunction, leading to endothelial injury and plasticity. Beyond hemodynamic stress, chronic nutritional and inflammatory stimuli trigger oxidative and pro-thromboinflammatory pathways, reduce nitric oxide bioavailability, and promote endothelial-to-mesenchymal transition (EndMT). This process contributes to fibrotic remodeling, plaque vulnerability, arterial stiffening, and microvascular rarefaction. Non-coding RNAs (ncRNAs)-microRNAs (miRNAs), long ncRNAs (lncRNAs), and circular RNAs (circRNAs)-play pivotal roles as regulators within the vascular wall and across tissues via extracellular vesicles (EVs) derived from adipose tissue and perivascular fat. We synthesize evidence demonstrating that ncRNAs integrate TGF-β/Smad, NF-κB, HIF-1α, and Wnt/β-catenin signaling pathways with the endothelial metabolic state, including the epigenetic regulation of EndMT linked to fatty acid oxidation. Single-cell and lineage-tracing studies identify nascent EndMT subpopulations in obese tissues, while in vitro models reveal cytokine and lipotoxic triggers that shift ncRNA networks, stabilizing mesenchymal programs. Translationally, circulating and EV-associated ncRNAs mirror adiposity, dyslipidemia, insulin resistance, and endothelial dysfunction, improving with weight loss. This underscores their potential as dynamic biomarkers for patient stratification, particularly when integrated with vascular imaging and functional assays. Furthermore, we discuss therapeutic strategies such as miRNA antagomirs, lncRNA gapmers, and circRNA inhibitors, addressing the critical challenge of endothelium-targeted delivery through approaches like ligand-directed nanoparticles, endothelial-tropic liposomes, and engineered EVs. This review positions obesity-associated vascular disease as an ncRNA-driven network disorder and outlines pathways toward precision diagnostics and RNA-based interventions.