OBJECTIVESIsolation due to the management of infectious diseases is thought to affect mental health, but the effects are still unknown. We examined the prevalence of anxiety symptoms and anger in persons isolated during the Middle East Respiratory Syndrome (MERS) epidemic both at isolation period and at four to six months after release from isolation. We also determined risk factors associated with these symptoms at four to six months.METHODSOf 14,992 individuals isolated for 2-week due to having contact with MERS patients in 2015, when MERS was introduced to Korea, 1,692 individuals were included in this study. Anxiety symptoms were evaluated with the Generalized Anxiety Disorder 7-item scale and anger was assessed with the State-Trait Anger Expression Inventory at four to six months after release from isolation for MERS.RESULTSOf 1,692 who came in contact with MERS patients, 1,656 were not diagnosed with MERS. Among 1,656, anxiety symptoms showed 7.6% (95% confidence interval [CI], 6.3 to 8.9%) and feelings of anger were present in 16.6% (95% CI, 14.8 to 18.4%) during the isolation period. At four to six months after release from isolation, anxiety symptoms were observed in 3.0% (95%CI, 2.2 to 3.9%). Feelings of anger were present in 6.4% (95% CI, 5.2 to 7.6%). Risk factors for experiencing anxiety symptoms and anger at four to six months after release included symptoms related to MERS during isolation, inadequate supplies (food, clothes, accommodation), social networking activities (email, text, Internet), history of psychiatric illnesses, and financial loss.CONCLUSIONSMental health problems at four to six month after release from isolation might be prevented by providing mental health support to individuals with vulnerable mental health, and providing accurate information as well as appropriate supplies, including food, clothes, and accommodation.

Acute myelogenous leukemia (AML) is a heterogeneous disorder characterized by clonal proliferation of stem cell-like blasts in bone marrow (BM); however, their unique cellular interaction within the BM microenvironment and its functional significance remain unclear. Here, we assessed the BM microenvironment of AML patients and demonstrate that the leukemia stem cells induce a change in the transcriptional programming of the normal mesenchymal stromal cells (MSC). The modified leukemic niche alters the expressions of cross-talk molecules (i.e., CXCL12 and JAG1) in MSCs to provide a distinct cross-talk between normal and leukemia cells, selectively suppressing normal primitive hematopoietic cells while supporting leukemogenesis and chemoresistance. Of note, AML patients exhibited distinct heterogeneity in the alteration of mesenchymal stroma in BM. The distinct pattern of stromal changes in leukemic BM at initial diagnosis was associated with a heterogeneous posttreatment clinical course with respect to the maintenance of complete remission for 5 to 8 years and early or late relapse. Thus, remodeling of mesenchymal niche by leukemia cells is an intrinsic self-reinforcing process of leukemogenesis that can be a parameter for the heterogeneity in the clinical course of leukemia and hence serve as a potential prognostic factor. Cancer Res; 75(11); 2222-31. Ó2015 AACR.

BackgroundBlood pressure (BP) is directly and causally associated with body size in the general population. Whether muscle mass is an important factor that determines BP remains unclear.ObjectiveTo investigate whether sarcopenia is associated with hypertension in older Koreans.ParticipantsWe surveyed 2,099 males and 2,747 females aged 60 years or older.MeasurementsSarcopenia was defined as an appendicular skeletal muscle mass divided by body weight (ASM/Wt) that was <1 SD below the gender-specific mean for young adults. Obesity was defined as a body mass index (BMI) ≥25 kg/m2. Subjects were divided into four groups based on presence or absence of obesity or sarcopenia. Hypertension was defined as a systolic BP (SBP) ≥140 mmHg, a diastolic BP (DBP) ≥90 mmHg, or a self-reported current use of antihypertensive medications.ResultsThe overall prevalence of hypertension in the four groups was as follows 49.7% for non-obese non-sarcopenia, 60.9% for non-obese sarcopenia, 66.2% for obese non-sarcopenia and 74.7% for obese sarcopenia. After adjustment for age, gender, regular activity, current smoking and alcohol use, the odds ratio (OR) for having hypertension was 1.5 (95% confidence interval (CI) = 1.23–1.84) in subjects in the non-obese sarcopenia group, 2.08 (95% CI = 1.68–2.57) in the obese non-sarcopenia group and 3.0 (95% CI = 2.48–3.63) in the obese sarcopenia group, compared with the non-obese non-sarcopenia group (p for trend <0.001). Controlling further for body weight and waist circumference did not change the association between hypertension and sarcopenia. The association between sarcopenia and hypertension was more robust in the subjects with diabetes mellitus.ConclusionBody composition beyond BMI has a considerable impact on hypertension in elderly Koreans. Subjects with sarcopenic obesity appear to have a greater risk of hypertension than simply obese or sarcopenia subjects.

Purpose: To evaluate the correlation of the mean and minimal apparent diffusion coefficient values (ADC mean , ADC minimal ) and dynamic magnetic resonance imaging (MRI) findings with prognostic factors in invasive ductal carcinoma. Materials and Methods:A total of 107 women with invasive ductal cancer underwent breast MRI. The ADC mean and ADC minimal of the cancers were computed. MRI findings were retrospectively evaluated according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon: mass or nonmass type, mass shape, mass margin, nonmass distribution, and enhancement pattern. Histological records were reviewed for tumor size, lymph node metastasis, histologic grade, and expression of estrogen receptors (ER), progesterone receptors (PR), c-erbB-2(HER2), Ki-67, and epidermal growth factor receptors (EGFR). Correlations of ADC values and MR findings with prognostic factors were determined using the Mann-Whitney U-test and the Kruskal-Wallis test.Results: The mean ADC minimal was 0.78 6 0.24 (Â10 À3 mm 2 /s), and the mean ADC mean was 1.01 6 0.23 (Â10 À3 mm 2 /s). There was a significant correlation of the ADCmean value with ER expression (P ¼ 0.027) and HER2 expression (P ¼ 0.018). There was no significant relationship between ADC minimal and prognostic factors or between ADC mean and traditional prognostic factors, PR, Ki-67 and EGFR. The majority of the mass type lesions were less than 5 cm in size and the majority of nonmass type lesions were more than 2 cm in size (P ¼ 0.022). The margin of mass was significantly associated with lymph node metastasis (P ¼ 0.031), ER expression (P ¼ 0.013), PR expression (P ¼ 0.036), HER2 expression (P ¼ 0.019), and EGRF expression (P ¼ 0.041). The rim internal enhancement was significantly correlated with Ki-67 expression (P ¼ 0.008). Conclusion:The low ADC mean value was related to positive expression of ER and negative expression of HER2. A spiculated margin was related to a good prognosis, but rim enhancement was associated with a poor prognosis.

There were high degrees of inter- and intraobserver agreement using the "Guidelines for diagnostic thyroid ultrasonography," of the TSGKSNRHNR in the description and categorization of thyroid nodules.