No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment* ; Humans

No abstract available.
Brain* ; Conus Snail* ; Dermoid Cyst* ; Magnetic Resonance Imaging ; Rupture

PURPOSE: The expression of the PIM-1 gene, which is a proto-oncogene that encodes a serine/threonine kinase, is associated with multiple cellular functions such as proliferation, differentiation, apoptosis and tumorigenesis. In particular, several studies have reported that the PIM-1 gene is associated with the development of lymphoma, leukemia and prostate cancer. Therefore, this study was conducted to evaluate the association between the single nucleotide polymorphisms in the PIM-1 gene and the risk of lung cancer occurrence in the Korean population. MATERIALS AND METHODS: To evaluate the role of the PIM-1 gene in the development of lung cancer, the genotypes of the PIM-1 gene were determined in 408 lung cancer patients and 410 normal subjects. RESULTS: We found that the T-C-T-C haplotypes of the PIM-1 gene (-1196 T>C, IVS4 +55 T>C, IVS4 +1416 T>A and +3684 C>A) were associated with an increased risk of lung cancer [adjusted odds ratio (aOR): 3.98; 95% CI: 1.24~12.75, p-value: 0.020]. In particular, these haplotypes showed an increased risk of lung cancer in males (aOR: 5.67; 95% CI: 1.32~24.30, p-value: 0.019) and smokers (aOR: 7.82; 95% CI: 1.75~34.98, p-value: 0.007). CONCLUSIONS: The present results suggest that the T-C-T-C haplotype of the PIM-1 gene could influence the risk of developing smoking-related lung cancer in the Korean population. Additional functional studies with an larger sample sized analysis are warranted to reconfirm our findings.
Apoptosis ; Cell Transformation, Neoplastic ; Genotype ; Haplotypes ; Humans ; Leukemia ; Lung ; Lung Neoplasms ; Lymphoma ; Male ; Odds Ratio ; Oncogenes ; Phosphotransferases ; Polymorphism, Single Nucleotide ; Prostatic Neoplasms ; Proto-Oncogenes

Development of a competence-based curriculum is important. This study aimed to develop competence assessment tools in emergency medicine and use it to assess competence of Cameroonian healthcare professionals. This was a cross-sectional, descriptive study. Through literature review, expert survey, and discrimination tests, we developed a self-survey questionnaire and a scenario-based competence assessment tool for assessing clinical knowledge and self-confidence to perform clinical practices or procedures. The self-survey consisted of 23 domains and 94 questionnaires on a 5-point Likert scale. Objective scenario-based competence assessment tool was used to validate the self-survey results for five life-threatening diseases presenting frequently in emergency rooms of Cameroon. Response rate of the self-survey was 82.6%. In this first half of competence assessment, knowledge of infectious disease had the highest score (4.6 ± 0.4) followed by obstetrics and gynecology (4.2 ± 0.6) and hematology and oncology (4.2 ± 0.5); in contrast, respondents rated the lowest score in the domains of disaster, abuse and assault, and psychiatric and behavior disorder (all of mean 2.8). In the scenario-based test, knowledge of multiple trauma had the highest score (4.3 ± 1.2) followed by anaphylaxis (3.4 ± 1.4), diabetic ketoacidosis (3.3 ± 1.0), ST-elevation myocardial infarction (2.5 ± 1.4), and septic shock (2.2 ± 1.1). Mean difference between the self-survey and scenario-based test was statistically insignificant (mean, −0.02; 95% confidence interval, −0.41 to 0.36), and agreement rate was 58.3%. Both evaluation tools showed a moderate correlation, and the study population had relatively low competence for specific aspects of emergency medicine and clinical procedures and skills.
Anaphylaxis ; Cameroon* ; Communicable Diseases ; Curriculum ; Delivery of Health Care* ; Developing Countries ; Diabetic Ketoacidosis ; Disasters ; Discrimination (Psychology) ; Emergencies* ; Emergency Medicine* ; Emergency Service, Hospital ; Gynecology ; Hematology ; Mental Competency* ; Multiple Trauma ; Myocardial Infarction ; Obstetrics ; Professional Competence ; Shock, Septic ; Surveys and Questionnaires

OBJECTIVES: Paraoxonase is a high density lipoprotein (HDL)-associated enzyme, which has been implicated in preventing low density lipoprotein-cholesterol (LDL-C) from oxidation. The human paraoxonase gene is codominantly expressed as allele A and B. The A allele codes for glutamine (A subtype) and the B allele for arginine (B subtype) at codon 192 of the paraoxonase enzyme. This genetic polymorphism divides the enzyme into high and low activity form. It has been believed that this difference of specific activity might change the metabolism of cholesterol and the prevalence of coronary artery disease. The present study investigated the association among the paraoxonase gene polymorphism and the level of plasma lipoprotein and coronary artery disease. METHODS: The 416 subjects who have undergone coronary angiography in SNUH were recruited. The patients (n=251) had >50% stenosis of at least one of the major coronary arteries. To identify the genotype of paraoxonase, we amplified the target region in the paraoxonase gene by PCR ( polymerase chain reaction) and electrophoresed the products. RESULTS: There was no difference between the two groups in the allele frequency (A : B = 0.41 : 0.59 in patients, A : B = 0.37 : 0.63 in controls; p=0.21) or in the genotype frequency (AA:AB:BB= 45:116:90 in patients, AA:AB:BB=22:77:66 in controls; p=0.41). There was no association of the paraoxonase genotype with serum lipoprotein level and acute coronary syndrome in this study. The B allele was not an independent risk factor for coronary artery disease in this study. CONCLUSION: The paraoxonase gene 192 polymorphism was not an independent risk factor for coronary artery disease in this study.
Acute Coronary Syndrome ; Alleles ; Arginine ; Aryldialkylphosphatase* ; Cholesterol ; Codon ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Gene Frequency ; Genotype ; Glutamine ; Humans ; Lipoproteins ; Metabolism ; Plasma ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Prevalence ; Risk Factors

OBJECTIVE: Pneumomediastinum (PnM), a rare complication of dermatomyositis and polymyositis (DM/PM), is sporadic and has an unclear pathogenesis. PnM is almost always associated with interstitial lung disease (ILD), and is a poor prognostic factor in inflammatory myositis patients. We studied the prevalence of PnM in Korean DM/PM and its clinical significance. METHODS: We retrospectively studied the medical records of 161 patients diagnosed with DM/PM meeting Bohan-Peter's criteria at Hanyang University Hospital for Rheumatic Diseases from 1995 to 2010. We collected following findings; demographic data, diagnosis, lung involvement, cause of death, and duration from diagnosis to death. RESULTS: One hundred nineteen patients (73.9%) were DM and 42 patients (26.1%) were PM. Eighty three patients (51.6%) developed ILD at diagnosis or during follow up. Eighteen patients (11.2%) died because of ILD aggravation, infection, or malignancy. The mean duration from diagnosis to death was 11.5 months, with 10 patients (6.2%) dying from from ILD aggravation but none with spontaneous PnM. 6 patients (3.7%) presented with PnM, and it was associated with ILD worsening in all cases. PnM resolved with O2 inhalation, corticosteroids, and/or immunosuppressive agents after 11 weeks (mean) of therapy. CONCLUSION: PnM is rare but associates with DM and aggravation of ILD. PnM does not usually cause fatalities and can be cured by appropriate therapy.
Adrenal Cortex Hormones ; Cause of Death ; Dermatomyositis ; Follow-Up Studies ; Humans ; Immunosuppressive Agents ; Inhalation ; Lung ; Lung Diseases, Interstitial ; Mediastinal Emphysema ; Medical Records ; Myositis ; Polymyositis ; Prevalence ; Prognosis ; Retrospective Studies ; Rheumatic Diseases

PURPOSE: The rate of second primary lung cancer development for patients with head and neck cancer (HNC) has been noted. The aim of our study was to evaluate the incidence and clinical features of suspected second primary lung cancer that developed in patients with primary HNC. MATERIALS AND METHODS: We conducted a retrospective study of 469 patients who were newly diagnosed with HNC at the Korea University Medical Center between January 2000 and December 2006. RESULTS: A total of 469 patients were included (389 men and 80 women). Eighteen patients (3.8%) had suspected second primary lung cancers. Statistically significant clinical variables for lung cancer development included the origin site for the primary HNC (oro-hypopharynx and larynx) (p=0.048), abnormal chest x-ray findings (p=0.027) and the histological HNC type (squamous cell carcinoma) (p=0.032). When the second primary lung cancers were combined with HNCs, the adjusted overall survival of patients with a second primary lung cancer was 16 months (p<0.001). CONCLUSIONS: Considering the relative risk factors for a second primary lung cancer developing in patients with HNC, advanced diagnostic tools, such as chest CT or PET CT scan, should be applied for the early detection of a second primary lung cancer.
Academic Medical Centers ; Head ; Head and Neck Neoplasms ; Humans ; Incidence ; Korea ; Lung ; Lung Neoplasms ; Male ; Neoplasms, Second Primary ; Retrospective Studies ; Risk Factors ; Thorax