OBJECTIVES: The purpose of this study is investigate the clinical characteristics and the change of depression and anxiety in pathological gamblers who completed 10-week admission treatment programs. METHODS: To investigate the clinical characteristics, we included 40 pathological gamblers who completed admission treatment programs from Jan 2006 to Jun 2010. To measure the change through treatment, we included 16 patients who completed pre-treatment and post-treatment assessment scales, including the Korean-National Opinion Research Center DSM-IV Screen for Gambling Problems (K-NODS), Beck's Depression Inventory (BDI), and the State-trait Anxiety Inventory (STAI), from May 2008 to Aug 2008. RESULTS: Mean age of the patients was 42.9+/-9.0 years and mean intelligent quotient was 109.7+/-10.4. Thirty (75%) patients showed comorbid disorders, including depression (14 patients, 35%), anxiety disorder (five patients, 12.5%), alcohol use disorder (five patients, 12.5%), and personality disorder (four patients, 10%). After treatment, K-NODS, BDI, STAI-I, and STAI-II scores showed improvement, from 9.1+/-1.5 to 7.6+/-2.7, from 23.5+/-5.8 to 11.1+/-3.2, from 52.6+/-10.3 to 41.9+/-7.1, and from 53.7+/-10.6 to 46.0+/-4.4, respectively. CONCLUSION: In treatment of pathological gambling, comorbid psychiatric risk factors, such as depression and anxiety should be considered.
Anxiety ; Anxiety Disorders ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Gambling ; Humans ; Personality Disorders ; Risk Factors ; Weights and Measures

BACKGROUND: As individuals age, there is an obvious decline in their physical activity level. Thus, this is an area where an easy to use assessment instrument is needed. But presently, there is no tool that meets this need. In addition, there is no such instrument tailored for the Korean elderly. This study aimed to fill this void by developing a physical activity assessment instrument for this particular population that is easy to use. METHODS: Item collection was performed through a literature review and a survey of 100 elderly individuals residing in a community setting. Items were selected through expert consensus; and the Physical Activity Questionnaire for elderly (PAQE) was created. For validation, 120 community dwelling elderly persons were enrolled. PAQE and an accelerometer were administered to each participant, and the questionnaire was re-administered 2 weeks later. The Spearman rho between the questionnaire and the accelerometer was calculated for concurrent validity. The Cronbach's alpha was calculated for internal consistency. Test-retest reliability was assessed by calculating the Spearman rho. RESULTS: Of the 119 participants, 80.34% were female with the average age being 72.74+/-7.29 years. Energy expenditure measured by the accelerometer was 220.36+/-96.96 kcal/day compared to 368.33+/-257.29 kcal/day measured through the developed questionnaire. Although the Spearman rho between the energy expenditure measured by the accelerometer and calculated through the recreational activity report in the questionnaire was 0.235 (p=0.011), the total energy expenditure was 0.105 (p=0.259) and the energy expenditure by household activity was 0.002 (p=0.983). The Cronbach's alpha was 0.781. The Spearman rho was 0.720 (p<0.001) for test-retest reliability. CONCLUSION: Our findings show that PAQE is a reliable questionnaire, a valid instrument for estimating energy expenditure during recreational physical activity in the Korean elderly person. However, energy expenditure of household activity did not correlate well with the accelerometer. In conclusion, the PAQE questionnaire can be used to assess kinds and frequency of household activities.
Aged ; Energy Metabolism ; Family Characteristics ; Female ; Humans ; Motor Activity ; Surveys and Questionnaires ; Reproducibility of Results

BACKGROUND: Astrocytes, representing a major non-neuronal cell population in the central nervous system (CNS), contain opioid receptors and are actively involved in several brain functions. This study is designed to evaluate the effects by which morphine contributes to cytotoxicity of nitric oxide (NO) species including NO and peroxynitrite (ONOO(-)) in primary astrocytes isolated from the cerebral cortexes of 1 - 2 day Sprague-Dawley rats. METHODS: The cultured cells were pretreated with morphine and exposed to 3-morpholinosydnonimine (SIN-1) which simultaneously generates NO and superoxide, thus possibly forming peroxynitrite. The cell damage was assessed by using an MTT (methylthizol-2-yl-2, 5-diphenyl, tetrazolium bromide) assay. Morphological nuclear changes of the cells after exposure to SIN-1 for 24 hours was evaluated by using 4', 6-diamidino-2-phenylindole (DAPI) staining. RESULTS: Morphine significantly protected primary rat astrocytes in a dose-dependent manner from the death mediated by sodium nitroprusside (SNP), a donor of nitric oxide, and SIN-1. Moreover, it was found that naloxone antagonized the protective effect of morphine on SIN-1-induced cell death, revealed as apoptosis by the occurrence of morphological nuclear changes characteristic of apoptosis. Morphine also inhibited the nuclear condensation of SIN-1-treated cells, however the action of morphine was antagonized by pretreatment of naloxone. The protective role of morphine on SIN-1-induced cytotoxicity was inhibited by DL-Buthionine-[S, R]-sulfoximine (BSO). Furthermore, the effects of morphine on SIN-1-induced cytotoxicity were blocked by pretreatment of Gi protein inhibitor, pertussis toxin, and phosphoinositide 3-kinase (PI3 kinase) inhibitors, Wortmannin and LY294002. CONCLUSIONS: These results suggest that morphine may protect primary rat astrocytes from NO species via the signaling cascades involving G-protein and PI3-kinase, and possibly regulates the anti-oxidant, glutathione (GSH).
Animals ; Apoptosis ; Astrocytes* ; Brain ; Cell Death* ; Cells, Cultured ; Central Nervous System ; Cerebral Cortex ; Glutathione ; GTP-Binding Proteins ; Humans ; Morphine* ; Naloxone ; Nitric Oxide ; Nitroprusside ; Peroxynitrous Acid ; Pertussis Toxin ; Phosphatidylinositol 3-Kinases ; Rats* ; Rats, Sprague-Dawley ; Receptors, Opioid ; Superoxides ; Tissue Donors

Psoas abscesses are rare clinical entities complicating Crohn's disease (CD). However, psoas abscesses can cause poor outcomes because the diagnosis is frequently delayed due to the non-specific clinical features. Recently, we managed a case of a huge iliopsoas abscess in a 21-year-old man with a 4-year history of CD who presented with a limping gait and flexion contractures of the sacroiliac joint. Notably, the iliopsoas abscess developed during induction treatment with infliximab. The patient was successfully treated with antibiotics, surgical drainage, and a right hemicolectomy. Herein we present the case with a brief review of the literature.
Anti-Bacterial Agents ; Antibodies, Monoclonal ; Contracture ; Crohn Disease ; Drainage ; Gait ; Humans ; Infliximab ; Psoas Abscess ; Sacroiliac Joint ; Young Adult

Psoas abscesses are rare clinical entities complicating Crohn's disease (CD). However, psoas abscesses can cause poor outcomes because the diagnosis is frequently delayed due to the non-specific clinical features. Recently, we managed a case of a huge iliopsoas abscess in a 21-year-old man with a 4-year history of CD who presented with a limping gait and flexion contractures of the sacroiliac joint. Notably, the iliopsoas abscess developed during induction treatment with infliximab. The patient was successfully treated with antibiotics, surgical drainage, and a right hemicolectomy. Herein we present the case with a brief review of the literature.
Anti-Bacterial Agents ; Antibodies, Monoclonal ; Contracture ; Crohn Disease ; Drainage ; Gait ; Humans ; Infliximab ; Psoas Abscess ; Sacroiliac Joint ; Young Adult

BACKGROUND: Dendritic cell (DC)-based vaccines are currently being evaluated as a novel strategy for tumor vaccination and immunotherapy. However, inducing long-term regression in established tumor-implanted mice is difficult. Here, we show that deoxypohophyllotoxin (DPT) induces maturation and activation of bone marrow-derived DCs via Toll-like receptor (TLR) 4 activation of MAPK and NF-kappaB. METHODS: The phenotypic and functional maturation of DPT-treated DCs was assessed by flow cytometric analysis and cytokine production, respectively. DPT-treated DCs was also used for mixed leukocyte reaction to evaluate T cell-priming capacity and for tumor regression against melanoma. RESULTS: DPT promoted the activation of CD8+ T cells and the Th1 immune response by inducing IL-12 production in DCs. In a B16F10 melanoma-implanted mouse model, we demonstrated that DPT-treated DCs (DPT-DCs) enhance immune priming and regression of an established tumor in vivo. Furthermore, migration of DPT-DCs to the draining lymph nodes was induced via CCR7 upregulation. Mice that received DPT-DCs displayed enhanced antitumor therapeutic efficacy, which was associated with increased IFN-gamma production and induction of cytotoxic T lymphocyte activity. CONCLUSION: These findings strongly suggest that the adjuvant effect of DPT in DC vaccination is associated with the polarization of T effector cells toward a Th1 phenotype and provides a potential therapeutic antitumor immunity.
Animals ; Dendritic Cells ; Immunotherapy ; Interleukin-12 ; Lymph Nodes ; Lymphocyte Culture Test, Mixed ; Lymphocytes ; Mice ; Phenotype ; Podophyllotoxin ; T-Lymphocytes ; Toll-Like Receptors ; Up-Regulation ; Vaccination ; Vaccines

OBJECTIVE: Our purpose was to estimate the prevalence of hepatitis C virus seropositivity and define the risk factors for HCV infection in a group of pregnant women and the effect of HCV infection to mother and baby at the time of delivery. METHODS: From March 1997 to February 1998, 5655 women who delivered over 20 gestational weeks at our hospital were screened for HCV-Antibody(RIA), and the samples of most of HCV-Ab positive cases were analyzed for HCV-RNA by polymerase chain reaction(PCR). We also studied the risk factors for HCV infection, the effect of HCV infection to mothers and neonates at delivery. RESULTS: Of 5655 mothers 25 (0.44%) were HCV-Ab positive, and 20 of HCV-Ab positive mothers were analyzed for HCV-RNA by PCR. Of 20 HCV-Ab positive mothers 12 cases (60%) were HCV-RNA positive. Risk factors significantly more prevalent among HCV-seropositive patients were : a history of habitual intraveneous drug use, a history of smoking, alcohol drinking during pregnancy, having liver cirrhorsis. The proportions who had received a blood transfusion, had a history or ongoing syphilis or were positive for hepatitis B virus surface antigen were not significantly different between seropositive and seronegative women. Liver function test at delivery was abnormal in 4 cases(16%) of HCV-Ab positive group. And the number of abnomal liver function test cases in HCV-Ab negative group were 47(0.83%). This had statistical difference. In neonates at delivery, all 20 neonates of 20 ones having HCV-Ab positive mother were HCV-Ab positive. But only 2 cases of 20 babies were HCV-RNA positive. CONCLUSION: Mothers who have risk factors such as injecting drug use, smoking, alchohol drinking and liver cirrhorsis, should undergo HCV-Ab testing and quantitative HCV-RNA testing by PCR. More advanced studies about vertical transmission of HCV infection are needed.
Alcohol Drinking ; Antigens, Surface ; Blood Transfusion ; Drinking ; Female ; Hepacivirus* ; Hepatitis B virus ; Hepatitis C* ; Hepatitis* ; Humans ; Infant, Newborn ; Liver ; Liver Function Tests ; Mothers ; Polymerase Chain Reaction ; Pregnancy* ; Pregnant Women ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Syphilis

BACKGROUND: The purpose of this study was to develop and to evaluate the applicability of the Korean comprehensive geriatric assessment tools through reliability and validity testing. METHODS: We developed standard and short-form assessment tools comprised of questionnaires on medical, functional, mental, socioeconomic status and lifestyle information and functional tests. The tools were administered as test-retest on 111 elderly outpatients at four university hospitals and two welfare centers in Seoul. Weighted kappa value, kappa value, Pearson's correlation coefficients and overall percent agreement were calculated to evaluate reliability. Validity coefficient was estimated by using the reliability coefficient. RESULTS: Reliability and validity coefficients were higher than 0.50 (fair or good) for 29 of 36 items. For test-retest reliability, the median was 0.66 (range, 0.29 to 1.00) for the kappa value and 0.83 (range, 0.53 to 1.00) for the Pearson's correlation coefficients. Compared to the standard form, the short-form assessment questionnaires showed to be reliable and valid. CONCLUSION: The Korean Comprehensive Assessment Tools, both the standard form and the short form, were shown to be a reliable and valid screening medium for assessing the health status of the elderly in the ambulatory care setting. These instruments can be used conveniently for comprehensive outpatient geriatric assessment.
Aged ; Ambulatory Care ; Ambulatory Care Facilities ; Geriatric Assessment ; Hospitals, University ; Humans ; Life Style ; Mass Screening ; Outpatients ; Surveys and Questionnaires ; Reproducibility of Results ; Social Class

Ruptured aneurysms complicate the course of polyarteritis nodosa only infrequently. Most often they occur in renal or mesenteric vessels. We experienced a case of 48-year old woman with systemic necrotizing vasculitis who developed multiorgan failure and spontaneous intra-abdominal hemorrhage. Angiography showed diffuse narrowing and spontaneous hemorrhage of medium and small sized arteries in visceral and pelvic vasculature. So emergency embolization and removal of hematoma was done. About 3000cc of blood was collected in the abdominal cavity. There were fine small aneurysmal dilatations of arteries with multiple collaterals and they oozed spontaneously. Bleeding small vessels were ligated. Pathologic findings of the involved arteries showed severe inflammation and necrosis of vessel wall. She was treated with corticosteroid and cyclophsphamide for one year and achieved improvement in her clinical status.
Abdominal Cavity ; Aneurysm ; Aneurysm, Ruptured ; Angiography ; Arteries ; Dilatation ; Emergencies ; Female ; Hematoma ; Hemorrhage* ; Humans ; Inflammation ; Middle Aged ; Necrosis ; Polyarteritis Nodosa ; Vasculitis*

Meckel's diverticulum is an embryonic derivative of the omphalomesenteric duct and the most commonly encountered congenital anomaly of the gastrointestinal tract. Its incidence records about 2%. Among them, only 5% are symptomatic with complications-bleeding, intestinal obstruction, inflammation, and perforation. In particular, bleeding is a common complication and has always been caused by an ulceration of the ileal mucosa adjacent to the acid-producing ectopic mucosa in a Meckel's diverticulum. Wireless capsule endoscopy is a new method enabling non-invasive diagnostic endoscopy of the entire small intestine. We experienced a case of Meckel's diverticulum detected by wireless capsule endoscopy in a 34 year-old man who presented with chronic obscure gastrointestinal bleeding.
Adult ; Chronic Disease ; *Endoscopy, Gastrointestinal ; English Abstract ; Gastrointestinal Hemorrhage/*diagnosis/*etiology ; Humans ; Male ; Meckel Diverticulum/*complications/diagnosis