No abstract available.
Plasma Exchange* ; Plasma*

Purpose: This study aimed to investigate the effects of aroma foot baths on stress and sleep in terminally ill cancer patients. Methods: We performed a non-randomized interventioncontrol study with 30 terminal cancer patients who were admitted to a palliative care unit.Participants responded to questionnaires on stress and sleep before and after a 5-day interval. The intervention group received a daily aroma foot bath for 5 days. We performed multivariate regression analysis to examine the changes in outcomes on stress and sleep for the intervention group compared to the control group. Results: The differences in baseline characteristics between groups, excluding subjective economic status and general weakness, did not show statistical significance. In contrast to the control group, the intervention group showed a statistically significant change in physical stress and psychological stress levels, but significant changes were not observed in quality of sleep. Compared to the control group, the intervention group showed a significant reduction in physical stress (P=0.068) and psychological stress (P=0.021). Conclusion Aroma foot baths are effective for reducing stress in patients hospitalized with terminal cancer.

Purpose: This study aimed to investigate the effects of aroma foot baths on stress and sleep in terminally ill cancer patients. Methods: We performed a non-randomized interventioncontrol study with 30 terminal cancer patients who were admitted to a palliative care unit.Participants responded to questionnaires on stress and sleep before and after a 5-day interval. The intervention group received a daily aroma foot bath for 5 days. We performed multivariate regression analysis to examine the changes in outcomes on stress and sleep for the intervention group compared to the control group. Results: The differences in baseline characteristics between groups, excluding subjective economic status and general weakness, did not show statistical significance. In contrast to the control group, the intervention group showed a statistically significant change in physical stress and psychological stress levels, but significant changes were not observed in quality of sleep. Compared to the control group, the intervention group showed a significant reduction in physical stress (P=0.068) and psychological stress (P=0.021). Conclusion Aroma foot baths are effective for reducing stress in patients hospitalized with terminal cancer.

Invasive diseases caused by Trichosporon beigelii are rare, usually fatal, opportunistic infections that occur exclusively in immunocompromised patients. This fungus has been known to produce cutaneous involvement in immunocompetent hosts, and is rarely reported to cause systemic disease in patients with cardiac valve replacement. In this report, we described a case of invasive Trichosporon beigelii pneumonia in a 9-year-old boy who presented with persistent cough and dyspnea for 1 week. He showed no abnormality in immunologic function tests and had no predisposing factors. Trichosporon beigelii was isolated from the bronchoalveolar lavage culture.
Bronchoalveolar Lavage ; Causality ; Child ; Cough ; Dyspnea ; Fungi ; Heart Valves ; Humans ; Immunocompromised Host ; Male* ; Opportunistic Infections ; Pneumonia* ; Trichosporon*

OBJECTIVES: Previous studies have shown that the endogenous opioid system, which plays an important role in drinking behavior, might be related to the genetic etiology of alcohol dependence. And a recent study reported that the affinity of micro opioid receptor, which is closely related to the endogenous opioid system activity, is affected by the genotype of micro opioid receptor gene (OPRM1) A118G. To investigate the gender difference in genetic etiology of alcohol dependence, this study examined the association of the genotype of OPRM1 A118G with female alcohol dependence in Koreans. METHODS: The author studied the genotype of OPRM1 A118G in 106 male and 35 female Korean with alcohol dependence and 80 male and 60 female healthy Koreans as control. RESULTS: 1) A statistically significant increase in A/G or G/G (G+) genotype of OPRM1 A118G was observed in women with alcohol dependence compared to the controls. 2) Among men with alcohol dependence, no significant difference in OPRM1 A118G polymorphism was observed relative to the age at which drinking started, age of onset of alcohol-related problems, age of first admission to psychiatric hospital for alcohol-related problems, drinking days per month, drinks per drinking day, family history of alcohol dependence in the first-degree relatives or history of severe alcohol withdrawal symptoms. But the drinking days per month is significantly less in those who have A/G or G/G genotypes of OPRM1 A118G. CONCLUSION: These results suggest that G+ genotypes of micro opioid receptor gene A118G are important genetic factors in the etiology of female alcohol dependence.
Age of Onset ; Alcoholics* ; Alcoholism ; Drinking ; Drinking Behavior ; Female* ; Genotype* ; Hospitals, Psychiatric ; Humans ; Male ; Receptors, Opioid* ; Substance Withdrawal Syndrome

PURPOSE: Although acute nonspecific mesenteric lymphadenitis (ANML) is probably common cause of abdominal pain in children, which can be severe enough to be an abdominal emergency, the clinical features of mesenteric lymphadenitis are not clear. Also, a differential diagnosis with acute appendicitis (APPE) is indispensable to avoid serious complications. The clinical features of ANML were determined, and the risk factors for differential diagnosis with APPE were analyzed. METHODS: Between November 2000 and May 2001, data from 26 patients (aged 1 to 11 years) with ANML and 21 patients (aged 2 to 13 years) with APPE were reviewed. ANML was defined as a cluster of five or more lymph nodes measuring 10 mm or greater in their longitudinal diameter in the right lower quadrant (RLQ) without an identifiable specific inflammatory process on the ultrasonographic examination. There were risk factors on patient's history, physical examination, and laboratory examination; the location of abdominal pain, abdominal rigidity, rebound tenderness, fever, nocturnal pain, the vomiting intensity, the diarrhea intensity, the symptom duration, and the peripheral blood leukocytes count. RESULTS: Of the 26 ANML patients and 21 APPE patients, abdominal pain was noted on periumbilical (76.9% vs 14.2%), on RLQ (11.5% vs 71.4%), with abdomen rigidity (7.6% vs 80.9%), with rebound tenderness (0.0% vs 76.1%)(p<0.05), in the lower abdomen (11.5% vs 14.2%), and at night (80.8% vs 100.0%) (p>0.05). The clinical symptoms were vomiting (38.4% vs 90.4%), the vomiting intensity (1.5+/-0.7 [1~3] /day vs 4.5+/-2.9 [1~10] /day), diarrhea (65.3% vs 28.5%) (p<0.05), and fever (61.5% vs 76.2%)(p>0.05). The period to the subsidence of abdominal pain in the ANMA patients was 2.5+/-0.5 (2~3) days. The laboratory data showed a significant difference in the peripheral blood leukocytes count (8,403+/-1,737 [5,900~12,300] /mm3 vs 15,471+/-3,749 [5,400~20,800] /mm3)(p<0.05). Discriminant analysis between ANML and APPE showed that the independent discriminant factors were a vomiting intensity and the peripheral blood leukocytes count and the discriminant power was 95.7%. CONCLUSION: The clinical characteristics of ANML were abrupt onset of periumbilical pain without rigidity or rebound tenderness, a mild vomiting intensity, normal peripheral leukocytes count, and relatively short clinical course. If the abdominal pain persist for more than 3 days, and/or the vomiting intensity is more than 3 times/day, and/or the peripheral leukocytes count is over 13,500/mm3, abdominal ultrasonography is recommended to rule out APPE.
Abdomen ; Abdominal Pain ; Appendicitis* ; Child ; Diagnosis, Differential* ; Diarrhea ; Emergencies ; Fever ; Humans ; Leukocytes ; Lymph Nodes ; Mesenteric Lymphadenitis* ; Physical Examination ; Risk Factors ; Ultrasonography ; Vomiting

PURPOSE: The three categories of failure to thrive are based on anthropometric measurements of weight, length, and head circumference for age. Type 1 is a failure to gain weight(FGW) due mainly to malnutrition. This study was performed to observe the clinical outcomes of infants with FGW, Type 1, among out-patients. METHODS: Between October 2002 and July 2003, data from the clinical outcomes of 83 consecutive patients at a Pediatric FGW Out-patients Clinic, all under 2 years of age, with inadequate growth or loss of body weight, was reviewed. This study concentrated on the Type 1 anthropometric category, with emphasis on the organic causes. FGW was defined as a weight loss for over two weeks in infants under 2 years of age. We observed four cases of breast feeding associated also as cases of misconception of diarrhea. RESULTS: Of the 87 cases, the eight most prevalent final diagnoses were gastrointestinal cow milk allergy(32.2%), breast feeding associated(16.1%), misconception of diarrhea(15.0%), lactose intolerance (15.0%), gastroesophageal reflux disease(GERD)(5.7%), laryngomalacia(3.4%), solid foods associated (1.1%), and other organic diseases(11.5%). The period from onset of symptom to diagnosis was 3.9+/-3.3 months, with over three months observed in 49.4% of patients. Although the birth weights were within a 10-90 percentile range in all patients, the body weight on diagnosis was below the 3 percentile in 63.8% of patinets. CONCLUSION: The most prevalent causes of FGW were gastrointestinal cow milk allergy, breast feeding associated, and misconception of diarrhea. The delayed diagnosis of FGW of over three months was frequently observed, and induced serious inadequate growth.
Anthropometry ; Birth Weight ; Body Weight ; Breast Feeding ; Delayed Diagnosis ; Diagnosis ; Diarrhea ; Failure to Thrive ; Gastroesophageal Reflux ; Head ; Humans ; Infant* ; Lactose Intolerance ; Malnutrition ; Milk ; Milk Hypersensitivity ; Outpatients* ; Weight Loss

PURPOSE: To evaluate the usefulness of CT in patients with gastrointestinal fistula. MATERIALS AND METHODS: We retrospectively reviewed the CT scans of 17 patients with various type of gastrointestinal fistula. The presence of these fistulae was confirmed by laparotomy in seven patients and by barium studies in fifteen. We evaluated the diagnostic accuracy of CT in these cases, and in correlation with barium studies and surgical findings, subsequently analyzed the CT findings. We determined the presence or absence of fistula tract, flow diversion of oral contrast media, bowel wall changes adjacent to the fistula tract, and extraluminal manifestations such as soft tissue mass, free air, leakage of oral contrast media, and peritoneal changes. RESULTS: The diagnosis of gastrointestinal fistula was possible on CT in nine (53%) of the 17 patients by using the CT criteria of direct visualization of the fistula tract (n=6) or flow diversion of oral contrast media (n=4). Other ancillary findings included bowel wall thickening adjacent to fistula tract in 15 patients, extraluminal soft-tissue mass in five, extraluminal free air in ten, extraluminal contrast leakage in four, and varying degrees of mesenteric and/or omental infiltration in 15. CONCLUSION: CT scanning is useful for the diagnosis of gastrointestinal fistula, which may be possible if the fistula tract and flow diversion of oral contrast materials are seen. It is also useful for evaluation of the extent of the etiologic disease.
Barium ; Contrast Media ; Diagnosis ; Fistula* ; Humans ; Laparotomy ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: The purpose of this study is to determine whether luminacin, a marine microbial extract from the Streptomyces species, has anti-tumor effects on head and neck squamous cell carcinoma (HNSCC) cell lines via autophagic cell death. MATERIALS AND METHODS: Inhibition of cell survival and increased cell death was measured using cell viability, colony forming, and apoptosis assays. Migration and invasion abilities of head and cancer cells were evaluated using wound healing, scattering, and invasion assays. Changes in the signal pathway related to autophagic cell death were investigated. Drug toxicity of luminacin was examined in in vitro HaCaT cells and an in vivo zebrafish model. RESULTS: Luminacin showed potent cytotoxicity in HNSCC cells in cell viability, colony forming, and fluorescence-activated cell sorting analysis. In vitro migration and invasion of HNSCC cells were attenuated by luminacin treatment. Combined with Beclin-1 and LC3B, Luminacin induced autophagic cell death in head and neck cancer cells. In addition, in a zebrafish model and human keratinocyte cell line used for toxicity testing, luminacin treatment with a cytotoxic concentration to HNSCC cells did not cause toxicity. CONCLUSION: Taken together, these results demonstrate that luminacin induces the inhibition of growth and cancer progression via autophagic cell death in HNSCC cell lines, indicating a possible alternative chemotherapeutic approach for treatment of HNSCC.
Apoptosis ; Autophagy* ; Carcinoma, Squamous Cell* ; Cell Death ; Cell Line ; Cell Survival ; Drug-Related Side Effects and Adverse Reactions ; Flow Cytometry ; Head and Neck Neoplasms ; Head* ; Humans ; Keratinocytes ; Neck* ; Signal Transduction ; Streptomyces ; Toxicity Tests ; Wound Healing ; Zebrafish

PURPOSE: Cow's milk protein-induced enterocolitis (CMPIE) is a symptom complex of vomiting and/ or diarrhea caused by delayed hypersensitivity and may result in serious complications. This study was undertaken to identify high risk factors to facilitate the early recognition of CMPIE. METHODS: We reviewed the data of 101 patients, aged 15 to 45 days, admitted due to vomiting and/ or diarrhea between 2003 and 2004. After excluding 13 patients absolutely breast-fed and 2 patients transferred from other hospitals with the impression of CMPIE, the 86 study subjects were divided into three groups based on the underlying etiologies; CMPIE, infectious and non-infectious group. RESULTS: CMPIE was diagnosed in 11 patients (12.8%). On admission, failure to gain weight (P= 0.003), hypoalbuminemia (P=0.003), peripheral leukocytosis (P=0.015), and metabolic acidosis (P=0.014) were more significant in the CMPIE group than in the others. Multiple logistic regression analysis showed that the independent predictors of high risks for CMPIE were failure to gain weight < 10 g/day (OR, 10.25[95% CI, 1.62-65.06]) and serum hypoalbuminemia < 3.5 g/dL (OR, 9.18[95% CI, 1.69- 49.74]). Cow's milk challenges were performed in the 11 CMPIE patients; vomiting (81.8%), abnormal stool test (80.0%), peripheral leukocyte count and absolute neutrophil count (ANC) increase (100.0%) (P< 0.05), and enteropathy (100.0%). CONCLUSION: CMPIE is not a rare clinical disease in early infancy. The high risk factors of CMPIE were identified as follow: failure to gain weight below 10 g/day, hypoalbuminemia on admission and a rapid decrease during admission. Cow's milk challenge test with endoscopic duodenal biopsy was helpful to confirm CMPIE.
Acidosis ; Biopsy ; Diarrhea ; Enterocolitis* ; Humans ; Hypersensitivity, Delayed ; Hypoalbuminemia ; Leukocyte Count ; Leukocytosis ; Logistic Models ; Milk* ; Neutrophils ; Risk Factors* ; Vomiting