Background The purpose of this study was (1) to develop a virtual reality (VR) intervention program based on the psychological needs of patients residing in nursing facilities in South Korea to alleviate their behavioral and psychological symptoms and (2) to confirm the possibility of utilizing VR in patients with dementia. Methods In the first phase, patients with dementia residing in nursing homes and experiencing behavioral and psychological symptoms were recruited. Surveys and questionnaires were used to identify activities that alleviated the behavioral and psychological symptoms of dementia (BPSD) among the patients. These activities were classified into five types of psychological needs. In the second phase, a fully immersive, interactive, easy-to-use VR platform was developed that reflected these psychological needs. Patients with dementia experienced the VR content. The researchers assessed the level of the participants’ immersion, preference, and interaction with the VR using a 5-point Likert scale. Results In the feasibility test, 10 nursing home residents were recruited. The mean immersion score was 4.93 ± 0.16 points, the mean preference score was 4.35 ± 0.41 points, and the mean interaction score was 3.84 ± 0.43 points using a 5-point Likert scale. Higher mean scores indicated a more positive outcome. Six of the 10 participants required assistance while using the VR. The mean VR experience duration was 10.00 ± 3.46 min. Conclusions The VR-based intervention program that was developed to reduce BPSD was feasible for the participants and provided them with a high degree of satisfaction and immersion. Furthermore, this study also confirmed the convenience and safety of the program. These findings support the potential use of VR-based BPSD intervention programs to treat patients with dementia.

Summary Objective Oxidative stress is associated with obesity, metabolic syndrome and inflammation, suggesting it could be an early event in the pathology of chronic diseases. We tested the hypothesis that elevated levels of oxidative stress markers are associated with increased C‐reactive protein (CRP) and that this is independent of obesity and insulin resistance. Research design and methods This study was cross‐sectional designed and nondiabetic postmenopausal women (n = 1821) with CRP levels ≤10 mg/l was enrolled. The CRP levels were categorized into quartiles from the lowest to the highest concentrations (Q1–Q4). The degree of insulin resistance was determined using the homoeostasis model assessment of insulin resistance (HOMA‐IR). We measured oxidative stress using urinary 8‐epi‐prostaglandin F2α (8‐epi‐PGF2α) and plasma oxidized low‐density lipoprotein (ox‐LDL). Results After adjustments for age and lifestyle habits, including smoking and drinking, we found higher body mass index (BMI) and HOMA‐IR scores in Q2 and Q3 vs Q1. The Q4 BMI and HOMA‐IR scores were higher than all other quartiles. The plasma ox‐LDL was higher in Q4 than in Q1. Urinary 8‐epi‐PGF2α was higher in Q3 and Q4 than in Q1 or Q2. Urinary 8‐epi‐PGF2α positively correlated with CRP (r = 0·235, P < 0·001), whereas no correlation was found between ox‐LDL and CRP. Multiple linear regression analyses of BMI and HOMA‐IR showed that the association between urinary 8‐epi‐PGF2α and CRP levels remained significant (P < 0·001). Conclusions Oxidative stress measured by increased concentration of urine 8‐epi‐PGF2α is strongly associated with CRP levels. This finding was independent of obesity and insulin resistance in nondiabetic postmenopausal women.

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Abstract. Supravalvular aortic stenosis (SVAS), an inherited vascular disease, is caused by mutations in the elastin gene (ELN). Our aim was to identify novel mutations of ELN and to determine the expression of ELN in patients with SVAS. For screening mutations in ELN, we performed PCR-directed sequence analysis with genomic DNA isolated from SVAS patients and control subjects. Expression of ELN at the mRNA and protein levels were assessed by real-time PCR and Western blot analyses, respectively, using primary skin fibroblast cultures established from SVAS patients and control subjects. We identified two novel mutations of ELN, G297_A308del and Q700X, in two unrelated Korean patients with isolated SVAS. G297_A308del occurred de novo while Q700X was derived maternally. In the patient with G297_A308, elastin expression was not significantly altered at the mRNA level, but was reduced to ~50% of the normal control at the protein level. The elastin expression levels in the patient with Q700X were reduced to <50% of the normal controls at both the mRNA and protein levels. Our findings confirm that functional haploinsufficiency of elastin is responsible for the pathogenesis associated with isolated SVAS across different ethnic backgrounds.