Serum is free of cellular components. Because DNA is located in the nuclei or mitochondria of cells, serum could be assumed DNA free. Few previously published case reports to date have used serum for DNA typing. Here, we report on human genotyping via short tandem repeat (STR) analysis using serum as a sample, and discuss problems involved in the process.
DNA Fingerprinting* ; DNA* ; Humans ; Microsatellite Repeats* ; Mitochondria

Background: The absence of effective antiviral medications and vaccines increased the focus on non-pharmaceutical preventive behaviors for mitigating against the coronavirus disease 2019 (COVID-19) pandemic. To examine the current status of non-pharmaceutical preventive behaviors practiced during the COVID-19 outbreak and factors affecting behavioral activities, we compared to the 2015 Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in Korea. Methods: This was a serial cross-sectional population-based study in Korea with four surveys conducted on June 2 and 25, 2015 (MERS-CoV surveys), and February 4, and April 2, 2020 (COVID-19 surveys). Of 25,711 participants selected using random digit dialing numbers, 4,011 participants (aged ≥ 18 years) were successfully interviewed, for the 2020 COVID-19 (n = 2,002) and 2015 MERS-CoV (n = 2,009) epidemics were included. Participants were selected post-stratification by sex, age, and province. The total number of weighted cases in this survey equaled the total number of unweighted cases at the national level. We measured the levels of preventive behaviors (social distancing [avoiding physical contact with others]), and practicing transmission-reducing behaviors such as wearing face mask and handwashing. Results: Between the surveys, respondents who reported practicing social distancing increased from 41.9%–58.2% (MERS-CoV) to 83.4%–92.3% (COVID-19). The response rate for the four surveys ranged between 13.7% and 17.7%. Practicing transmission-reducing behaviors (wearing face masks and handwashing) at least once during COVID-19 (78.8%, 80.2%) also increased compared to that during MERS-CoV (15.5%, 60.3%). The higher affective risk perception groups were more likely to practice transmission-reducing measures (adjusted odds ratio, 3.24–4.81; 95 confidence interval, 1.76–6.96) during both COVID-19 and MERS-CoV. Conclusion The study findings suggest markedly increased proportions of non-pharmaceutical behavioral practices evenly across all subgroups during the two different novel virus outbreaks in Korea. Strategic interventions are needed to attempt based on preventive behavior works.

It is very important for the anesthesiologists to manage this kind of patient during anesthesia because of severe hemodynamic change that is induced by aortic clamping and declamping, and its secondary effect on visce, heart and spinal cord, etc. To minimize the sudden severe hemodynamic change, we used the following agents and techniques in this clinical report. 1) Ethrane anesthesia with intermittent Innovar administration to minimize cardiac irritability. 2) To prevent secondary damage by distal hypotension during aortic clamping and declamping. 1. slight overhydration. 2. mannitol. 3. diuretics. 3) To prevent secondary damage by proximal hypertension during aortic clamping. 1. d-tubocurarine for muscle relaxation. 2. Morphine. 3. Chlorpromazine. 4. phentolamine. More over, we recommend this kind of anesthetic method in some other surgeries such as coarctation of aorta, aortic aneuryam and pheochromocytoma, etc. which may exhibit severe hemodynamic change during anesthesia.
Anesthesia ; Aortic Coarctation ; Chlorpromazine ; Constriction ; Diuretics ; Enflurane ; Heart ; Hemodynamics ; Humans ; Hypertension ; Hypertension, Renovascular* ; Hypotension ; Mannitol ; Morphine ; Muscle Relaxation ; Phentolamine ; Pheochromocytoma ; Spinal Cord ; Tubocurarine

No abstract available.
Forearm* ; Humerus*

An extended-release (ER) fixed-dose combination (FDC) of tramadol 37.5 mg/acetaminophen 325 mg was developed due to the demand for varying dosages. This study aimed to evaluate the pharmacokinetics (PKs) for two tablets of the new developed tramadol 37.5 mg/acetaminophen 325 mg ER FDC (DW-0920, Wontran Semi ER®) as test formulation compared to one tablet of the tramadol 75 mg/acetaminophen 650 mg ER FDC (DW-0919, Wontran ER®) as reference formulation. A randomized, open-label, 2-way crossover study was conducted in 30 healthy subjects. Subjects were orally administered one of 2 formulations followed by an alternate formulation with a 7-day washout period. Blood samples were collected up to 36 hours post-dose. Plasma concentrations of tramadol and acetaminophen were determined using a validated high-performance liquid chromatography with tandem mass spectrometric method. The geometric mean ratios (GMRs) and their 90% confidence intervals (90% CIs) of test formulation to reference formulation were calculated for the maximum plasma concentration (Cmax) and the area under the plasma concentration-time curve from zero to the last measurable time point (AUClast). The PK profiles of 2 formulations were comparable. The GMRs (90% CI) of Cmax and AUClast for tramadol were 1.086 (1.047–1.127) and 1.008 (0.975–1.042), respectively. The corresponding values for acetaminophen were 0.956 (0.897–1.019) and 0.986 (0.961–1.011), respectively. All the values were within the bioequivalence range of 0.80–1.25. Two tablets of DW-0920 were comparable to one tablet of DW-0919. The DW-0920 may be used for optimal pharmacotherapy for pain control with a lower dose.

Giant fusiform aneurysms at the basilar trunk tend to have a poor natural history and surgical management for these aneurysms remains controversial. For these aneurysms, basilar trunk occlusion with endovascular coiling is difficult when the collateral supply from the carotid circulation is relatively poor. Interestingly, we herein present a successfully treated case of a partially thrombosed giant fusiform aneurysm at the basilar trunk with relatively poor collateral supply using endovascular coil occlusion following bypass surgery (superficial temporal artery-radial artery-superior cerebellar artery anastomosis).
Aneurysm ; Arteries ; Natural History

Cardiac arrest (CA) in children is associated with high mortality rates. In Korea, cohort studies regarding the outcomes of pediatric CAs are lacking, especially in emergency departments (EDs) or in-hospital settings. This study was conducted to examine the trends in epidemiology and survival outcomes in children with resuscitation-attempted CAs using data from a cross-sectional, national, ED-based clinical registry. We extracted cases in which cardiopulmonary resuscitation and/or manual defibrillation were performed according to treatment codes using the National Emergency Department Information System (NEDIS) from 2008 to 2012. The total number of ED visits registered in the NEDIS during the 5-yr evaluation period was 20,424,530; among these, there were 2,970 resuscitation-attempted CAs in children. The annual rates of pediatric CAs per 1,000 ED visits showed an upward trend from 2.81 in 2009 to 3.62 in 2012 (P for trend = 0.045). The median number of estimated pediatric CAs at each ED was 7.8 (25th to 75th percentile, 4 to 13) per year. The overall rates for admission survival and discharge survival were 35.2% and 12.8%, respectively. The survival outcome of adults increased substantially over the past 5 yr (11.8% in 2008, 11.7% in 2010, and 13.6% in 2012; P for trend = 0.001); however, the results for children did not improve (13.6% in 2008, 11.4% in 2010, and 13.7% in 2012; P for trend = 0.870). Conclusively, we found that the overall incidence of pediatric CAs in EDs increased substantially over the past 5 yr, but without significantly higher survival outcomes.
Adolescent ; Cardiopulmonary Resuscitation/*mortality ; Child ; Child, Preschool ; Cross-Sectional Studies ; Emergency Service, Hospital/*statistics & numerical data ; Female ; Heart Arrest/*epidemiology/*prevention & control ; *Hospital Mortality ; Humans ; Incidence ; Infant ; Male ; *Registries ; Republic of Korea/epidemiology ; Risk Factors ; Survival Rate ; Treatment Outcome ; Young Adult

Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma, which mostly occurs in the upper aerodigestive tracts. Basaloid squamous cell carcinoma also typically arises in the anal canal, but is extremely rare in the lower gastrointestinal tract. A 70-year-old man presented with loose stool and intermittent hematochezia 2 months ago. Colonoscopy showed an ulceroinfiltrative mass on the rectosigmoid colon from 16 cm to 18 cm above the anal verge. Conventional colonoscope could not pass through the lesion but it was possible with pediatric colonoscope. Abdominal CT scan showed 1.6 cm sized wall thickening with circumferential luminal narrowing in the rectosigmoid colon and multiple ill-defined low density masses in both lobes of the liver. Therefore, colon cancer with liver metastasis was suspected. However, basaloid cells were noted on histologic examination, and they were weakly positive for synaptophysin on immunohistochemical study. After palliative lower anterior resection, histologic examination of the resected specimen revealed basaloid differentiation with keratin pearls, and tumor cells were positively stained with high molecular weighted cytokeratin (34BE12) and CK 5/6. Thus, the patient was finally diagnosed with basaloid squamous cell carcinoma of rectosigmoid colon with distant metastases.
Aged ; Carcinoma, Squamous Cell/*diagnosis/pathology/surgery ; Colonoscopy ; Colorectal Neoplasms/*diagnosis/pathology/surgery ; Humans ; Immunohistochemistry ; Keratins/metabolism ; Liver Neoplasms/radiography/secondary ; Lung Neoplasms/radionuclide imaging/secondary ; Male ; Positron-Emission Tomography ; Synaptophysin/metabolism ; Tomography, X-Ray Computed

A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.
Adenocarcinoma ; Aged ; Biopsy ; Brain ; Diagnosis ; Emergencies ; Endoscopy ; Humans ; Leg ; Magnetic Resonance Imaging ; Neoplasm Grading ; Neoplasm Metastasis ; Pathology ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Spinal Cord Compression ; Spine ; Ultrasonography

OBJECTIVES: Nursing is a job with high stress. This study investigated the relationship between temperament and character traits, heart rate variability, and the severity of occupational stress in new nursing employees. METHODS: Ninety-seven nurses newly employed in a Seoul Medical Center from April 2014 to September 2015 were included to the study. Before beginning employment, all subjects were asked to complete a sociodemographic questionnaire and Temperament and Character Inventory (TCI). After they were employed for a month, we administered a heart rate variability test and Korean Occupational Stress Scale (KOSS). RESULTS: Harm avoidance (r=0.334, p=0.001), self-transcendence (r=0.224, p=0.028) and KOSS scores were positively correlated. Self-directedness (r=-0.278, p=0.006) and cooperativeness (r=-0.263, p=0.009) were negatively correlated with KOSS scores. In multiple regression analyses, harm avoidance and cooperativeness were risk factors for severe occupational stress. Physical parameters of total power (r=0.303, p=0.003), very low frequency (VLF ; r=0.318, p=0.002), and standard deviation of the NN interval (r=0.220, p=0.030) were significantly associated with higher KOSS scores. In multiple regression analysis, VLF was significant correlated with KOSS scores. CONCLUSION: Individual factors, such as personality trait or autonomic function, may affect the occupational stress vulnerability on this study. Harm avoidance, cooperativeness in TCI parameters are associated with severity of the occupational stress.
Employment ; Heart Rate* ; Heart* ; Nursing* ; Risk Factors ; Seoul ; Temperament*