Medical Expenses of North Korean Defectors with Post-Traumatic Stress Disorder

Objective The purpose of this study was to establish the prevalence of PTSD among North Korean defectors who visited the National Medical Center, Seoul, South Korea over a period of approximately 10 years by examining their medical records and to examine differences in the medical service usage patterns of patients with and without PTSD. Methods Data from North Korean defectors who used outpatient services at the National Medical Center during a period of 10 years and 3 months (January 1 2006 to February 28, 2016) were analyzed. The general characteristics of the defectors were analyzed by frequency analyses, and descriptive statistics were generated. Additionally, independent t-tests and chi square analyses were performed to examine differences between PTSD patients and those without PTSD. Linear regression analysis was performed to examine factors affecting the mental health of North Korean defectors suffering from PTSD. Results This study assessed the correlations between PTSD, the average number of outpatient visits, and the total revenue. The regression analysis showed a relationship between PTSD and the average number of outpatient visits. There was also a correlation between PTSD and total revenue. The average number of outpatient visits was 41.8 for PTSD patients, whereas it was 33.2 for those without PTSD. The. total revenue visit was 953.6 USD for PTSD sufferers and 231.1 USD for those without PTSD. Conclusion This study found that the majority of North Korean defectors visit psychiatry departments, and that PTSD patients use outpatient services more frequently and have higher total revenue than those without PTSD. Additionally, patients with PTSD used a greater variety of medical services. Considering the high medical care expenses of North Korean defectors residing in South Korea, future investigations should examine the medical service usage patterns of such patients, especially those diagnosed with PTSD, in greater detail

Toll-like Receptors and Antimicrobial Peptides Expressions of Psoriasis: Correlation with Serum Vitamin D Level

To evaluate the association of Toll-like receptors (TLRs), antimicrobial peptides (AMPs) and vitamin D receptors (VDRs) in psoriasis, lesional (PP) and perilesional skin (PN) from psoriasis, atopic dermatitis (AD) patients and healthy controls (NN) were studied by immunohistochemistry. Compared with PN, AD and NN skin, dysregulated expression of TLRs, AMPs and VDR was detected in PP skin. Noteworthy, our results showed altered correlation between TLR2 and VDR expression in PP and PN skin. Human beta defensin 2 (HBD2) and cathelicidin (LL-37) expressions in the PP skin were higher in serum vitamin D sufficient (VDS) groups than serum vitamin D deficient (VDD) groups. Negative correlation was found between TLR2 and VDR expression in the PP skin of VDD groups. However, positive correlation was noted in the PP skin of VDS groups. Based on the present results, therapies targeting the activity of TLRs, AMPs and vitamin D, including modulation of the TLR-VDR pathways, might provide new therapeutic approaches to the psoriasis and other inflammatory skin diseases

Susceptibility and disease pathogenesis of North American domestic and feral pigs to Japanese encephalitis virus

Doctor of PhilosophyDepartment of Diagnostic Medicine/PathobiologyDana L. VanlandinghamJapanese encephalitis virus (JEV), a mosquito-borne flavivirus capable of causing fatal encephalitis, is maintained in nature between infected mosquitoes and viremic swine and avian species, with humans as a dead-end host. At present, JEV is only endemic to parts of the Asia-Pacific region, but the presence of large numbers of susceptible vertebrate hosts and competent vectors outside its endemic areas is a significant concern in its potential for dispersal into new territories. Previously, North American avian species and Culex species mosquitoes have been shown to be susceptible and competent for JEV transmission. A critical but missing gap of knowledge is whether or not the swine species in the United States are also susceptible to JEV. The objective of this dissertation was to address this important research gap and determine the susceptibility profile and pathogenesis of JEV in North American pigs. Three specific aims were pursued to test the central hypothesis that North American domestic and feral pigs are susceptible to JEV and can potentially support its transmission. In Aim 1, the susceptibility of North American domestic pigs to JEV was determined through the invasive challenge of intravenous inoculation. All pigs became viremic, seroconverted, and developed similar pathologic outcomes as observed in published studies. In Aim 2, our approach was to mimic the natural route of transmission more closely via intradermal inoculation. In the same experiment, mosquito salivary gland extract (SGE) was inoculated with infectious viruses to investigate the effects of mosquito saliva in the disease pathogenesis of JEV. Piglets were simultaneously co-inoculated with JEV and SGE to recapitulate the actual infection route in nature. In contrast to the enhanced virus infection and disease severity reported in mice, the presence of mosquito saliva in the JEV inoculation altered the fever and viral nasal shedding kinetics but, interestingly, did not impact the dynamics and severity of viremia, clinical signs, and neuroinvasion. Lastly, Aim 3 was conducted to establish a feral pig model for JEV, using the Sinclair miniature research swine that has been bred to have a feral genotypic and phenotypic background. Intradermal JEV challenge of these pigs resulted in high viremia, viral nasal shedding, and systemic dissemination comparable to JEV infection in domestic pigs. Together, our results indicate that many potential enzootic hosts needed for JEV transmission cycle are present in North America. These findings provided a better understanding of how JEV behaves in its enzootic hosts – the domestic and feral pigs. The work presented in this dissertation provides valuable data and novel animal models of JEV to further our understanding of this significant pathogen and contribute to the development of effective countermeasures to ultimately protect the public health and the agricultural industry

Effect of natural antioxidants on the aggregation and disaggregation of beta-amyloid

Purpose: To examine the relationship between higher antioxidant activity and aggregation or disaggregation of beta-amyloid (Aβ) for 21 plants.Methods: Twenty-nine natural plant extracts and their antioxidant activities were analyzed using DPPH assay. The aggregation and disaggregation of Aβ were analyzed using Thioflavin-T assay.Results: Eleven plant extracts exhibited high antioxidant activities with the half-maximal inhibitory concentration (IC50) values < 20.0 μg/mL. Furthermore, the plant extracts efficiently inhibited Aβ aggregation with a mean IC50 value of 17.0 μg/mL. However, four plant extracts exhibiting low antioxidant activities (IC50 > 80.0 μg/mL) inhibited Aβ aggregation less efficiently with a mean IC50 value of 75.7 μg/mL. Furthermore, plant extracts with high antioxidant activities were not invariably efficient for disaggregating pre-formed Aβ aggregates.Conclusion: High antioxidant activities were positively correlated with the inhibition of Aβ aggregation, although not with the disaggregation of pre-formed Aβ aggregates. Nevertheless, potent antioxidants may be helpful in treating Alzheimer’s disease.Keywords: Alzheimer’s disease, β-Amyloid, Aggregation, Disaggregation, Antioxidant