BACKGROUND: The precore mutant hepatits B virus (HBV) cannot produce HBeAg due to the formation of transnational stop codon at nucleotide 1896 of the HBV-DNA precore region. This mutant has been detected worldwide in acute fulminant hepatitis, carrier and chronic HBV infections. It has been controversial whether the emergence of precore mutant HBV is related to the severity of the chronic hepatitis B or not. METHODS: To determine the prevalence and clinical implication of precore mutant infection, 137 HBsAg (+) patients including 12 acute hepatitis, 59 carriers, 41 chronic hepatitis, 15 liver cirrhosis, and 10 hepatomas were examined with mutation site specific assay-polymerase chain reaction (MSSA-PCR). The specificity for the detection of mutant by MSSA-PCR method was confirmed by direct sequencing of PCR products. RESULTS: The precore mutant HBV was detected in 67 of 137 (49%) subjects : none of 12 (0%) acute hepatitis patients, 17 of 59 (29%) carriers, 31 of 41 (76%) chronic hepatitis patients, 12 of IS (80%) liver cirrhosis patients, and 6 of 10 (60%) hepatoma patients. According to the status of serum HBeAg, the emergence rate of precore mutant HBV in HBeAg(-) cases was relatively higher than in HBeAg(+) cases with blood donor and chronic hepatitis. In anti-HBe (+) patients with chronic hepatitis, the precore mutant HBV was found regardless of ALT level in all patients. Emergence rate of precore mutant HBV was abruptly increased after 30 years of age. Among HBV-DNA (-) sera by DNA probe method, the core region of HBV was amplified in 94% of sera by MSSA-PCR method. CONCLUSIONS: The presence of precore mutant HBV may be related to the duration of HBV infections and there seems to be no causal relationship between the presence of precore mutant HBV and the severity of chronic hepatitis.
Blood Donors ; Carcinoma, Hepatocellular ; Codon, Terminator ; DNA ; Hepatitis ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Herpesvirus 1, Cercopithecine ; Humans ; Liver Cirrhosis ; Polymerase Chain Reaction ; Prevalence ; Sensitivity and Specificity

No abstract available.
Eosinophilia*

PURPOSE: The purpose of this study was to determine the frequency of CD4+CD25+FoxP3+ regulatory T cells (Treg) in the peripheral blood of patients with childhood chronic immune thrombocytopenic purpura (ITP) exhibiting thrombocytopenia and spontaneous remission. The findings of this study indicate the possibility of predicting spontaneous recovery and pathogenesis of childhood chronic ITP. METHODS: Eleven children with chronic ITP (seven thrombocytopenic and four spontaneous remission cases; mean age, 8.8 years; range, 1.7-14.9 years) were enrolled in this study. Five healthy children and eight healthy adults were included as controls. The frequency of Treg was evaluated by flow cytometry in the peripheral blood. RESULTS: In this study, four patients (36%) achieved spontaneous remission within 2.8 years (mean year; range, 1.0-4.4 years). The frequency of Treg was significantly lower in patients with persisting thrombocytopenia (0.13%+/-0.09%, P<0.05), than that in the patients with spontaneous remission (0.30%+/-0.02%), healthy adults controls (0.55%+/-0.44%), and healthy children controls (0.46%+/-0.26%). A significantly positive correlation was found between the frequency of Treg and the platelet count in children. CONCLUSION: These data suggest that a lower frequency of Treg contributes to the breakdown of self-tolerance, and may form the basis for future development of specific immunomodulatory therapies. Furthermore, Treg frequency has prognostic implication toward the natural course and long-term outcomes of childhood chronic ITP.
Adult ; Child ; Flow Cytometry ; Humans ; Immunomodulation ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Remission, Spontaneous ; T-Lymphocytes, Regulatory* ; Thrombocytopenia

No abstract available.
Anemia, Megaloblastic* ; Megaloblasts* ; Primary Myelofibrosis*

PURPOSE: This study was conducted to provide basic data for development of health care programs for cleaners working in hospitals by analyzing job-related injuries among them and related factors. METHODS: The study surveyed cleaners working in 6 general hospitals in D metropolitan city. The questionnaire was structurally designed to include items about job-related injuries, working conditions, health related characteristics. For the analysis of the collected data, the SPSS/WIN 21.0 software was used, and t-test, ANOVA, correlation analysis, and regression analysis were conducted. RESULTS: Factors that affect health damages were gender and income levels. Inadequate safety facilities and equipment, noise, and income levels were found to be the factors affecting accident injuries. CONCLUSION: In order to reduce the job-related injuries, efforts need to be made to improve working conditions to deal with inadequate safety facilities and equipment and control noise. To fulfill this need, not only employers of cleaners but also hospitals in which they work should make efforts to educate those cleaners who have little knowledge of health and medical care, and improve their working conditions.
Delivery of Health Care ; Hospitals, General ; Noise

Opioid-induced chest wall rigidity is an uncommon complication of opioids. Because of this, it is often difficult to make a differential diagnosis in a mechanically ventilated patient who experiences increased airway pressure and difficulty with ventilation. A 76-year-old female patient was admitted to the intensive care unit (ICU) after surgery for periprosthetic fracture of the femur neck. On completion of the surgery, airway pressure was increased, and oxygen saturation fell below 95% after a bolus dose of fentanyl. After ICU admission, the same event recurred. Manual ventilation was immediately started, and a muscle relaxant relieved the symptoms. There was no sign or symptom suggesting airway obstruction or asthma on physical examination. Early recognition and treatment should be made in a mechanically ventilated patient experiencing increased airway pressure in order to prevent further deterioration.
Aged ; Airway Obstruction ; Analgesics, Opioid ; Asthma ; Diagnosis, Differential ; Female ; Femur Neck ; Fentanyl* ; Humans ; Intensive Care Units ; Lung Diseases, Obstructive ; Muscle Rigidity ; Oxygen ; Periprosthetic Fractures ; Physical Examination ; Thoracic Wall* ; Thorax* ; Ventilation

PURPOSE: To determine the MR parameters affecting India ink artifacts on opposed-phase chemical shift magnetic resonance (MR) imaging.MATERIALS AND METHODS: The use of a female Sprague-Dawley rat was approved by our Institutional Animal Care and Use Committee. Using an iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) images, which is a modified Dixon method, axial opposed-phase images of the abdominal cavity were obtained with different MR parameters: series 1, different repetition times (TRs; 400, 2000, and 4000 ms); series 2, different echo times (TEs; 10, 50, and 100 ms); series 3, different field of views (FOVs; 6, 8, 16, and 24 cm); series 4, different echo train lengths (ETLs; 2, 4, and 8); series 5, different bandwidths (25, 50, and 85); and series 6, different slice thicknesses (1, 2, 4, 8, and 16 mm). Artifacts on opposed images obtained with different parameters were compared subjectively by two radiologists. For objective analysis, the thickness of the artifact was measured. Spearman's correlation between altered MR parameters and thicknesses of India ink artifact was obtained via objective analysis.RESULTS: India ink artifact was increasingly apparent using shorter TE, larger FOV and ETL, and thicker slices upon subjective analysis. The objective analysis revealed a strong negative correlation between the thickness of the artifact and TE (r = -0.870, P < 0.01); however, strong positive correlations were found between FOV (r = 0.854, P < 0.01) and slice thickness (r = 0.971, P < 0.01).CONCLUSION: India ink artifact was thicker with shorter TE, larger FOV, and larger slice thickness.
Abdominal Cavity ; Animals ; Artifacts ; Female ; Humans ; India ; Ink ; Methods ; Rats ; Rats, Sprague-Dawley ; Water

Objectives: The aim of this study was to investigate the impact of mixed cognitive intervention training using spaced retrieval training, and errorless learning in participants with early onset dementia.This was based on reality orientation therapy for cognitive function, depression, and occupational performance of patients. Methods: Two early onset vascular dementia patients (> 65 years) with mild or moderate impairment were enrolled in a pre-test - post-test single-subject research design study. Prior to the study, the caregivers were interviewed about meaningful times, people, places, and areas of interest for the participant. A list of individual training words were selected based upon this information, and the participant was instructed to recall them after a 45-second, 90-second, 6-minute, and 12-minute delay. Baseline (3 sessions), intervention (20 sessions), and a second baseline period (3 sessions) were conducted. Activities of daily living were measured, and cognition was measured using the Consortium to Establish a Registry of Alzheimer’s Disease Korean version, whilst depression was measured using the Korean Form Geriatric Depression Scale, and task performance and satisfaction measured by the Canadian Occupational Performance Measure. Results: After intervention, both participants showed improvements in activities of daily living (ADL), word list memory/recognition, trail making A, occupational performance, and satisfaction improvement, which was clinically significant in 1 participant who also had a reduced score in the scale of depression classifying him as not depressed. Conclusion Spaced retrieval training and errorless learning based on reality orientation therapy is an effective intervention in patients with early onset dementia and mild or moderate impairment.

Background: This study aimed to analyze the effects of periodontal treatment and individual- and tooth-related factors on tooth extraction in people with disabilities. Methods: The Korea National Health Insurance claims data of individuals with disabilities aged 40∼64 years with chronic periodontitis in 2008 were obtained. Of these, data on the disabled who underwent scaling/root plaining, subgingival curettage/periodontal surgery, or non-periodontal treatments, and data on their teeth were selected. The extraction of 716,688 teeth from 39,097 patients was tracked until 2018, and the patient- and tooth-level factors related to tooth loss were identified using a mixed-effect logistic regression analysis. Results: Data from approximately 17% of the teeth were extracted during a follow-up period of approximately 11 years. Among the tooth-level variables, scaling/root planing treatment at baseline and periodontal treatment during the follow-up period were associated with a lower risk of tooth loss (odds ratio=0.692 and 0.769, respectively, p＜0.001). Non-vital teeth increased the risk of tooth loss by 3.159 times (p＜0.001). Among the patient-level variables, females were less likely to have lost their teeth than males, and those with orthopedic impairment or brain lesions/mental disabilities, a higher age group, lower income level, or residents in medium/small cities or rural areas were more likely to have lost their teeth (p＜0.001). Conclusion Through approximately 11 years of follow-up, scaling or root planing, experience with periodontal treatment at leastonce, female sex, older age, lower income, smaller residential areas, type of disability, and pulp vitality were found to be associated with tooth loss in individuals with disabilities aged 40∼64 years with chronic periodontitis. To prevent tooth loss in individuals with disabilities, it is necessary to establish a dental treatment plan that considers the timing of periodontal treatment and the characteristics of the patient and teeth.