Enhancement of Ground-level Ozone in Seoul during 2018 Heatwave

Inseon Suh,Junsu Gil,Meehye Lee,Ho-Jun Rhee,Joo-Ae Kim,Yunyoung Choi,Kyuil Kwak,Jeewon Son,Jeonghwan Kim,Gangwoong Lee 한국대기환경학회 2018 한국대기환경학회 학술대회논문집 Vol.2018 No.10

Executive Summary of the 2021 International Conference of Korean Dementia Association: A Report From the Academic Committee of the Korean Dementia Association

박기형,장재원,Suh Jeewon,Yi SangHak,배재성,Lim Jae-Sung,Lee Hyon,Chin Juhee,Park Young Ho,Hong Yun Jeong,김건하 대한치매학회 2022 Dementia and Neurocognitive Disorders Vol.21 No.2

Recently, aducanumab, a beta amyloid targeted immunotherapy, has been approved by the US Food and Drug Administration for the treatment of Alzheimer’s dementia (AD). Although many questions need to be answered, this approval provides a promising hope for the development of AD drugs that could be supported by new biomarkers such as blood-based ones and composite neuropsychological tests that can confirm pathologic changes in early stages of AD. It is important to elucidate the complexity of AD which is known to be associated with other factors such as vascular etiologies and neuro-inflammation. Through the second international conference of the Korean Dementia Association (KDA), researchers from all over the world have participated in the exchange of opinions with KDA members on the most up-to-date topics. The Academic Committee of the KDA summarizes lectures to provide the depth of the conference as well as discussions. This will be an important milestone to widen the latest knowledge in the research of AD’s diagnosis, therapeutics, pathogenesis that can lead to the establishment of future directions.

Liver injury in acute hepatitis A is associated with decreased frequency of regulatory T cells caused by Fas-mediated apoptosis

Choi, Yoon Seok,Lee, Jeewon,Lee, Hyun Woong,Chang, Dong-Yeop,Sung, Pil Soo,Jung, Min Kyung,Park, Jun Yong,Kim, Ja Kyung,Lee, Jung Il,Park, Hana,Cheong, Jae Youn,Suh, Kyung-Suk,Kim, Hyung Joon,Lee, Jun BMJ Publishing Group Ltd 2015 Gut Vol.64 No.8

<P><B>Objective</B></P><P>Foxp3<SUP>+</SUP>CD4<SUP>+</SUP>CD25<SUP>+</SUP> regulatory T cells (Tregs) control immune responses, but their role in acute viral hepatitis remains elusive. Herein, we investigated alteration in the peripheral blood Treg population during acute hepatitis A (AHA) and its implication in the immune-mediated liver injury.</P><P><B>Design</B></P><P>The study included 71 patients with AHA, and peripheral blood mononuclear cells (PBMCs) were isolated. The suppressive activity of Treg population was determined by assessing anti-CD3/CD28-stimulated proliferation of Treg-depleted and reconstituted PBMCs. Treg cell frequency, phenotype and apoptosis in PBMCs were analysed by flow cytometry.</P><P><B>Results</B></P><P>The frequency of circulating Tregs was reduced during AHA. Moreover, the suppressive activity of the total Treg pool in the peripheral blood was attenuated during AHA. Treg frequency and suppressive activity of the Treg population inversely correlated with the serum alanine aminotransferase level. Fas was overexpressed on Tregs during AHA, suggesting their susceptibility to Fas-induced apoptosis. Indeed, increased apoptotic death was observed in Tregs of patients with AHA compared with healthy controls. In addition, agonistic anti-Fas treatment further increased apoptotic death of Tregs from patients with AHA. The decreased Treg frequency and Fas overexpression on Tregs were not observed in other acute liver diseases such as acute hepatitis B, acute hepatitis C and toxic/drug-induced hepatitis.</P><P><B>Conclusions</B></P><P>The size of the Treg pool was contracted during AHA, resulting from apoptosis of Tregs induced by a Fas-mediated mechanism. Decrease in Treg numbers led to reduced suppressive activity of the Treg pool and consequently resulted in severe liver injury during AHA.</P>

Designing a Chatbot for a Brief Motivational Interview on Stress Management: Qualitative Case Study

Park, SoHyun,Choi, Jeewon,Lee, Sungwoo,Oh, Changhoon,Kim, Changdai,La, Soohyun,Lee, Joonhwan,Suh, Bongwon JMIR Publications 2019 Journal of medical Internet research Vol.21 No.4

<P><B>Background</B></P><P>In addition to addiction and substance abuse, motivational interviewing (MI) is increasingly being integrated in treating other clinical issues such as mental health problems. Most of the many technological adaptations of MI, however, have focused on delivering the action-oriented treatment, leaving its relational component unexplored or vaguely described. This study intended to design a conversational sequence that considers both technical and relational components of MI for a mental health concern.</P><P><B>Objective</B></P><P>This case study aimed to design a conversational sequence for a brief motivational interview to be delivered by a Web-based text messaging application (<I>chatbot</I>) and to investigate its conversational experience with graduate students in their coping with stress.</P><P><B>Methods</B></P><P>A brief conversational sequence was designed with varied combinations of MI skills to follow the 4 processes of MI. A Web-based text messaging application, Bonobot, was built as a research prototype to deliver the sequence in a conversation. A total of 30 full-time graduate students who self-reported stress with regard to their school life were recruited for a survey of demographic information and perceived stress and a semistructured interview. Interviews were transcribed verbatim and analyzed by Braun and Clarke’s thematic method. The themes that reflect the process of, impact of, and needs for the conversational experience are reported.</P><P><B>Results</B></P><P>Participants had a high level of perceived stress (mean 22.5 [SD 5.0]). Our findings included the following themes: Evocative Questions and Clichéd Feedback; Self-Reflection and Potential Consolation; and Need for Information and Contextualized Feedback. Participants particularly favored the relay of evocative questions but were less satisfied with the agent-generated reflective and affirming feedback that filled in-between. Discussing the idea of change was a good means of reflecting on themselves, and some of Bonobot’s encouragements related to graduate school life were appreciated. Participants suggested the conversation provide informational support, as well as more contextualized feedback.</P><P><B>Conclusions</B></P><P>A conversational sequence for a brief motivational interview was presented in this case study. Participant feedback suggests sequencing questions and MI-adherent statements can facilitate a conversation for stress management, which may encourage a chance of self-reflection. More diversified sequences, along with more contextualized feedback, should follow to offer a better conversational experience and to confirm any empirical effect.</P>

Coping with Dementia in the Middle of the COVID-19 Pandemic

Nayoung Ryoo,Jung-Min Pyun,백민재,Jeewon Suh,Min Ju Kang,Min Jeong Wang,Young Chul Youn,양동원,Seong Yoon Kim,박영호,김상윤 대한의학회 2020 Journal of Korean medical science Vol.35 No.42

Multiple neurological complications have been associated with the coronavirus disease-19 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2. This is a narrative review to gather information on all aspects of COVID-19 in elderly patients with cognitive impairment. First, the following three mechanisms have been proposed to underlie the neurological complications associated with COVID-19: 1) direct invasion, 2) immune and inflammatory reaction, and 3) hypoxic brain damage by COVID-19. Next, because the elderly dementia patient population is particularly vulnerable to COVID-19, we discussed risk factors and difficulties associated with cognitive disorders in this vulnerable population. We also reviewed the effects of the patient living environment in COVID-19 cases that required intensive care unit (ICU) care. Furthermore, we analyzed the impact of stringent social restrictions and COVID-19 pandemic-mediated policies on dementia patients and care providers. Finally, we provided the following strategies for working with elderly dementia patients: general preventive methods; dementia care at home and nursing facilities according to the activities of daily living and dementia characteristics; ICU care after COVID-19 infection; and public health care system and government response. We propose that longitudinal follow-up studies are needed to fully examine COVID-19 associated neurological complications, such as dementia, and the efficacy of telemedicine/telehealth care programs.

Clinical Practice Guideline for Dementia (Diagnosis and Evaluation): 2021 Revised Edition

이진산,김건하,김희진,Kim Hee Jin,Na Seunghee,박기형,Park Young Ho,Suh Jeewon,Shin Joon Hyun,오성일,Yoon Bora,이학영,Lim Jae-Sung,장재원,Chin Juhee,Hong Yun Jeong,심용수 대한치매학회 2022 Dementia and Neurocognitive Disorders Vol.21 No.1

Novel amyloid precursor protein mutation, Val669Leu (“Seoul <i>APP</i>”), in a Korean patient with early-onset Alzheimer's disease

Bagyinszky, Eva,Kang, Min Ju,Van Giau, Vo,Shim, KyuHwan,Pyun, Jung-Min,Suh, Jeewon,An, Seong Soo A.,Kim, SangYun Elsevier 2019 NEUROBIOLOGY OF AGING Vol.84 No.-

<P><B>Abstract</B></P> <P>In this study, a novel mutation in <I>APP</I> gene, Val669Leu (“Seoul <I>APP</I>”), was reported in a Korean female patient with Alzheimer's disease. She developed cognitive decline at 56 years of age, and her memory declined rapidly over one-year period from her 1st visit to the hospital. Her Mini-Mental State Examination scores dropped from 25/30 to 13/30. Two years later, she developed parkinsonian features, myoclonic jerk, and generalized seizure. As the disease progressed, aggravated diffuse brain atrophy and small-vessel ischemic lesion was also observed, and she became mute and vegetative in 4 years from the symptom onset. Magnetic resonance imaging showed mild medial temporal lobe and hippocampal atrophy, and 18F-fluoro-deoxyglucose positron emission tomography showed bilateral temporoparietal hypometabolism. Plasma amyloid oligomer analysis revealed highly elevated Aβ oligomers levels in the proband patient. Family history revealed positive without biochemical confirmation because family members testified similar type of cognitive decline from the proband's mother and one of her aunt/uncle. Her half-siblings did not present any signs of memory impairment. Sanger sequencing of the proband patient revealed a novel mutation in <I>APP</I> gene, Val669Leu, but mutation was not found in her unaffected half-sisters. A designed algorithm by Guerreiro et al. on early-onset Alzheimer's disease–associated mutations suggested the mutation as possibly pathogenic mutation. On the other hand, PolyPhen2 and SIFT tools suggested as otherwise. Since the mutation was located nearby the β-secretase cleavage site of APP, right next to the Swedish APP (Lys,Met670/671Asn,Leu) mutation, it was named as “Seoul <I>APP”</I> mutation. 3D modeling revealed that this mutation could result in significant changes in loop orientation of APP and also its intramolecular interactions. Hence, a novel <I>APP</I> Val669Leu mutation could alter the binding interactions between APP and β-secretase, which may influence the Aβ40 and Aβ42 generations.</P> <P><B>Highlights</B></P> <P> <UL> <LI> A novel variant in APP, Val669Leu, was found in a Korean patient, named Seoul APP. </LI> <LI> Proband patient developed disease phenotype in her 50s. </LI> <LI> Family history may be positive, and mutation may segregate with disease. </LI> <LI> Mutation is located nearby the beta-secretase site of APP, and potentially disturbs the enzyme mechanism. </LI> </UL> </P>

The Usefulness of 18F-FDG PET to Differentiate Subtypes of Dementia: The Systematic Review and Meta-Analysis

Na Seunghee,Kang Dong Woo,Kim Geon Ha,Kim Ko Woon,Kim Yeshin,Kim Hee-Jin,Park Kee Hyung,Park Young Ho,Byeon Gihwan,Suh Jeewon,Shin Joon Hyun,Shim YongSoo,Yang YoungSoon,Um Yoo Hyun,Oh Seong-il,Wang Sh 대한치매학회 2024 Dementia and Neurocognitive Disorders Vol.23 No.1

Background and Purpose: Dementia subtypes, including Alzheimer’s dementia (AD), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD), pose diagnostic challenges. This review examines the effectiveness of 18F-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) in differentiating these subtypes for precise treatment and management. Methods: A systematic review following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was conducted using databases like PubMed and Embase to identify studies on the diagnostic utility of 18F-FDG PET in dementia. The search included studies up to November 16, 2022, focusing on peer-reviewed journals and applying the gold-standard clinical diagnosis for dementia subtypes. Results: From 12,815 articles, 14 were selected for final analysis. For AD versus FTD, the sensitivity was 0.96 (95% confidence interval [CI], 0.88–0.98) and specificity was 0.84 (95% CI, 0.70–0.92). In the case of AD versus DLB, 18F-FDG PET showed a sensitivity of 0.93 (95% CI 0.88-0.98) and specificity of 0.92 (95% CI, 0.70–0.92). Lastly, when differentiating AD from non-AD dementias, the sensitivity was 0.86 (95% CI, 0.80–0.91) and the specificity was 0.88 (95% CI, 0.80–0.91). The studies mostly used case-control designs with visual and quantitative assessments. Conclusions: 18F-FDG PET exhibits high sensitivity and specificity in differentiating dementia subtypes, particularly AD, FTD, and DLB. This method, while not a standalone diagnostic tool, significantly enhances diagnostic accuracy in uncertain cases, complementing clinical assessments and structural imaging.