PURPOSE: This study was to determine the effect of DHEA administration before, during, and after dexamethasone treatment on body weight and TypeI,II muscle weight of rat receiving dexamethasone treatment. METHOD: Wistar rats were divided into 6 groups: control(C), dexamethasone(D), DHEA administration for 3days after dexamethasone treatment for 7days(7D+3DH), dexamethasone treatment for 7days after DHEA administration for 3days(3DH+7D), DHEA administration during dexamethasone treatment for 4days after dexamethasone treatment for 3days(3D+4DDH), DHEA administration during dexamethasone treatment for 7days(7DDH). Dexamethasone was injected by subcutaneously daily at a dose of 5mg/kg. DHEA was orally administered daily at a dose of 5mg/kg for 7 days. Soleus(TypeI) muscle, and both plantaris and gastro- cnemius(TypeII) muscles were dissected on the 7th day of experiment. RESULT: Body weight of both 3DH+7D group and 3D+4DDH group increased significantly compared with that of 7D group. Body weight of 7D+3DH group decreased significantly compared with that of 7D group, 7DDH group, 3DH+7D group and 3D+4DDH group. Muscle weight of both plantaris and gastro- cnemius tended to decrease compared with that of 7D group. Muscle weight of 7DDH group, 3D+4DDH group and 3DH+7D group increased significantly compared with that of 7D+3DH group. Muscle weight of gastrocnemius of both 3DH+7D group and 3D+4DDH group increased significantly compared with that of 7D group. CONCLUSION: Based on these results, it can be suggested that DHEA administration before and during dexamethasone treatment can increase both body weight and mass of atrophied TypeII muscle induced by dexa- methasone treatment.
Animals ; Body Weight* ; Dehydroepiandrosterone* ; Dexamethasone* ; Muscles* ; Rats* ; Rats, Wistar

OBJECTIVES: The aim of this study was to explore clinical factors or high-risk factors associated with occurrence of delirium tremens (DT) during acute alcohol withdrawal in inpatients with alcohol dependence. METHODS: This study included 164 inpatients seeking treatment for acute alcohol withdrawal in the detoxification unit. All subjects were evaluated prospectively for known risk factors for DT and their occurrence of DT. Correlations were determined between risk factors obtained at admission and development of DT. RESULTS: Among all subjects, 42 patients (25.6%) suffered from delirium tremens within seven days after admission. DT patients had more severe alcohol withdrawal symptoms, the presence of past DT, and higher levels of aspartate aminotransferas, alanine aminotransferase, gamma-glutamyl-transpeptidase, and homocysteine, compared with patients who did not suffer DTs. According to results of a multiple regression, occurrence of DT showed correlation with the following factors at admission: tremor, a past history of DT, higher homocysteine level, and nausea and vomiting. CONCLUSION: Development of DT showed correlation with symptoms of severe alcohol withdrawal, past history of DT, and higher homocysteine level. Among these, a severity of alcohol withdrawal symptoms and a history of DT are factors that can be easily evaluated on the day of admission in order to predict the potential for occurrence of DT.
Alanine Transaminase ; Alcohol Withdrawal Delirium ; Alcoholism ; Aspartic Acid ; Delirium ; Homocysteine ; Humans ; Inpatients ; Nausea ; Prospective Studies ; Risk Factors ; Substance Withdrawal Syndrome ; Tremor

Background: As the coronavirus disease 2019 (COVID-19) has continued for a couple of years, the long-term effects of the pandemic and the subsequent school curriculum modification on the mental health of children and parents need to be investigated. To clarify the changes that can occur during one school year and to predict the risk factors for vulnerable groups, this study identified parameters relative to children’s screen time, their problematic behavior, and parental depression. Methods: A total of 186 participants were analyzed who were parents of elementary schoolchildren in South Korea. These parents were required to complete a web-based questionnaire twice. The questionnaires were conducted in June 2020 and September 2021. Participants’ general demographics including family income, children’s screen time, sleep patterns, problematic behavior, and parental depression were assessed via the parental questionnaire that included various measurement tools. Results: Children’s body mass index (BMI) increased significantly in 2021 (18.94 ± 3.75 vs. 18.14 ± 3.30, P < 0.001). Smartphone frequency of use per week (5.35 vs. 4.54, P < 0.001) and screen time per day (3.52 vs. 3.16, P < 0.001) significantly increased during the period of the COVID-19 pandemic. The television screen time (2.88 vs. 3.26, P < 0.001), frequency of viewing (3.77 vs. 4.77, P < 0.001), and children’s problematic behaviors significantly decreased (9.15 vs. 11.85,P < 0.001). A lower income household was a key predictor of increased smartphone frequency (B = 1.840, 95% confidence interval [CI], 0.923–2.757, P < 0.001) and smartphone screen time (B = 1.992, 95% CI, 1.458–2.525, P < 0.001). The results showed that the lower income household (B = 5.624, 95% CI, 2.927–8.320, P < 0.001) and a child’s psychiatric treatment history (B = 7.579, 95% CI, 5.666–9.492, P < 0.001) was the most significant predictor of problematic behaviors of children and parental depression (B = 3.476, 95% CI, 1.628–5.325, P < 0.001; B = 3.138, 95% CI, 1.827–4.450, P < 0.001). Conclusion This study suggested that children’s smartphone screen time and BMI increased during COVID-19 because of the school curriculum modification following school closures in South Korea. The increased children’s problematic behaviors and parental depression were predicted by lower-income households and the previous psychiatric history of children. These results indicate that multiple social support systems to the vulnerable group are needed during the ongoing pandemic and that a modified school setting is required.

Tetanus is a bacterial infection by Clostridium tetani. Its neurotoxin causes spastic paralysis and autonomic dysfunction. Intrathecal infusion of baclofen has been suggested as a pertinent treatment for generalized spasm. Our case describes a patient who had a severe generalized form of tetanus, and was effectively treated with intrathecal baclofen infusion. He showed cerebral and brainstem dysfunction during baclofen infusion, which were reversed without sequelae when baclofen was discontinued.

Tendon and ligament (T/L) have been known to be obviously different from each other in tissue level. However, due to the overlapping gene markers, distinction in cellular level has not been clearly verified yet. Recently, the use of nuclear magnetic resonance (NMR) spectroscopy has shown the potential to detect biological markers in cellular level. Therefore, in this study we applied a non-invasive technique based on NMR spectroscopy to establish biomarkers to distinguish between T/L fibroblasts. In addition the cellular morphologies and gene expression patterns were also investigated for comparison through optical microscopy and real-time polymerase chain reaction (PCR). No difference was observed from morphology and real-time PCR results, either as expected. However, we found clear differences in their metabolomic spectra using ¹H NMR spectroscopy. The calculated integral values of fatty acids (with chemical shifts at ~0.9, 1.26, 1.59, 2.05, 2.25, and 2.81 ppm), lactate (~1.33 ppm), and leucine (~2.72 ppm) were significantly different between the two types of fibroblasts. To be specific tendon group exhibited higher level of the metabolite than ligament group. In conclusion, in-cell metabolomic evaluation by NMR technique used in this study is believed to provide a promising tool in distinguishing cell types, especially T/L cells, which cannot be classified by conventional biological assays.
Biological Assay ; Biomarkers ; Fatty Acids ; Fibroblasts* ; Gene Expression ; Genes, Overlapping ; Lactic Acid ; Leucine ; Ligaments* ; Magnetic Resonance Spectroscopy* ; Metabolomics ; Microscopy ; Real-Time Polymerase Chain Reaction ; Spectrum Analysis* ; Tendons*

Recently, immediately after losing teeth, implant placement has been greatly attempted. Implant can help restoration of tooth functions within short time. This study was an attempt to examine the extent of osseointergation when the implants will be placed immediately after teeth extraction using domestic implant systems. Implants were inserted in beagle dogs and evaluated the clinical, radiological, histological and histomorphometric assay at 6 weeks and 12 weeks. For experimental materials, STAGE-1(R)(4.1x8mm, Lifecore, USA), SS-III(R)(4.0x8mm, OSSTEM, Korea) and IFI(R)(4.0x8 mm, DIO, Korea) implants treated with RBM were placed. All the placed site showed normal results without fail and inflammation clinically and radiologically. As a result of measurement by periotest, it showed -2 ~ -5 and stable status comprehensively. There was no statistically significant difference among implants(p<0.05). Bone tissue adjacent to implant showed increased marrow tissue at 6 weeks. Nevertheless, osteogenic structure was not observed remarkably. In a 12 weeks opinion, bone tissue composed of osseointegration along implant interface showed significantly decreased marrow tissue containing central vessels unlike a 6 weeks opinion and matured compact bone whose osteogenic structure is well formed. BIC were 42.4%, 32.0% and 34.9%, respectively in 6 weeks and there was no statistically significant difference among groups(p<0.05). In 12 weeks, BIC were 58.8%, 61.9% and 57.5%, respectively and there was no statistically significant difference among groups(p<0.05). It is considered that all 3 implant systems are suitable for immediate implant placement.
Animals ; Bone and Bones ; Bone Marrow ; Dogs* ; Inflammation ; Osseointegration ; Tooth

Extramedullary plasmacytoma is a relatively rare tumor, occuring in a wide variety of organs and tissues, and is most frequently seen in the oral cavity and upper respiratory tract. Solitary extramedullary plasmacytoma located in the gastrointestinal tract is rare, especially the in colon. We report a case of solitary extramedullary plasmacytoma in the cecum of a 58-year-old man which simulated a carcinoma both endoscopically and radiologically. But histopathologic evaluation demonstrated a sheet-like proliferation of pure plasma cells with monoclonality for IgM and lamda chain which confirmed the diagnosis of plasmacytoma.
Cecum ; Colon* ; Diagnosis ; Gastrointestinal Tract ; Humans ; Immunoglobulin M ; Middle Aged ; Mouth ; Plasma Cells ; Plasmacytoma* ; Respiratory System

BACKGROUND: Influenza causes morbidity and mortality, resulting in the medical and socioeconomic costs. We aimed to analyse whether socioeconomic and medical factors may affect influenza vaccination status divided into 2 groups; one aged 19 to 64 years old and the other aged 65 or over who are eligible for free vaccination. METHODS: The study included 1,412 individuals aged 19 and over who responded to influenza vaccination survey, based on 2013 National Health and Nutrition Examination Survey. Related factors were categorized into socioeconomic factors and medical factors. Univariate analyses were conducted to examine the correlations between vaccination rate and each variables. Multivariate analysis was obtained after adjusting variables which were statistcally significant. RESULTS: Influenza vaccination rate was significantly different in the population aged 19 to 64 (24.9%) and the population aged 65 or over (80.5%). In the former population, high vaccination rate was associated with healthcare usage (odds ratio [OR]=1.37, 95% confidence interval [CI]=1.03-1.83), underlying chronic diseases (OR=2.21, 95% CI=1.43-3.40), and public assistance recipient households (OR=2.21, 95% CI=1.03-4.78), while low vaccination rate was correlated with no use of medical check up (OR=0.70, 95% CI=0.52-0.94) and heavy alcoholics (OR=0.41, 95% CI=0.24-0.70). In the latter population aged 65 or over, high vaccination rate was associated with healthcare usage (OR=1.82, 95% CI=1.28-2.59), and underlying malignancies (OR=4.79, 95% CI=1.07-21.54), whereas low vaccination rate was associated with public assistance recipient households (OR=0.33, 95% CI=0.14-0.76), and no use of medical check up (OR=0.37, 95% CI=0.19-0.73). CONCLUSIONS: In the population below 65 years old, vaccination rate would be expected to rise by the recommendation of medical care providers and expanding the coverage of free vaccination. In elderly, individualized care for those who have less access to medical care and high susceptibility is highly recommended.
Adult* ; Aged ; Alcoholics ; Chronic Disease ; Delivery of Health Care ; Family Characteristics ; Humans ; Influenza Vaccines ; Influenza, Human* ; Mortality ; Multivariate Analysis ; Nutrition Surveys ; Public Assistance ; Socioeconomic Factors ; Vaccination*

BACKGROUND: Infusion methods during regional analgesia using perineural catheters may influence the quality of postoperative analgesia. This study was conducted to compare the effects of combined or bolus-only infusion of 0.2% ropivacaine on the postoperative analgesia in interscalene brachial plexus block (ISBPB) with perineural catheterization. METHODS: Patients scheduled for arthroscopic rotator cuff repair were divided into two groups, one that would receive a combined infusion (group C, n = 32), and one that would receive intermittent infusion (group I, n = 32). A perineural catheter was inserted into the interscalene brachial plexus (ISBP) using ultrasound (US) and nerve stimulation, and 10 ml of 0.2% ropivacaine was administered. After the operation, group C received a continuous infusion of 4 ml/h, and a 4 ml bolus with a lockout interval of 60 min. Group I received only a 4 ml bolus, and the lockout interval was 30 min. Postoperative pain by the numeric rating scale (NRS) and the forearm muscle tone by the manual muscle test (MMT) were checked and evaluated at the following timepoints: preoperative, and postoperative 1, 4, 12, 24, 36, and 48 h. Supplemental opioid requirements, total consumed dose of local anesthetic, and adverse effects were compared between the two groups. RESULTS: Sixty-four patients completed the study and the postoperative values such as operation time, time to discharge, and operation site were comparable. There were no differences in NRS scores and supplemental opioid requirements between the two groups. The MMT scores of group I at 4 and 12 h after surgery were significantly higher than those of group C (P < 0.05). The total consumed dose of local anesthetic was significantly lower in group I than in group C (P < 0.05). The adverse effects were not different between the groups. CONCLUSIONS: The bolus-only administration of 0.2% ropivacaine provided a similar analgesic effect with a lower total volume of local anesthetic and decreased motor weakness compared to combined infusion. Therefore, bolus-only administration is an effective postoperative analgesic method in ISBPB with perineural catheterization after rotator cuff repair.
Analgesia ; Analgesia, Patient-Controlled ; Arthroscopy ; Brachial Plexus* ; Catheterization ; Catheters ; Forearm ; Humans ; Pain, Postoperative* ; Rotator Cuff* ; Ultrasonography

Cushing's syndrome associated with nodular adrenal hyperplasia glands is divided into 4 main categories: adrenal adenoma, adrenal carcinoma, primary pigmented nodular adrenal dysplasia and macronodular adrenal hyperplasia(MAH). The mechanism of bilateral MAH, when ACTH is suppressed, was previously unknown, and referred to as being "autonomous". Recently, several reports have shown MAH to be under the control of ectopic or eutopic membrane hormone. Here, a case of Cushing's syndrome, caused by bilateral MAH, is reported. A 62-year-old woman presented with Cushingoid features, hypertension and diabetes mellitus. In her case, abnormal adrenal stimulation of cortisol secretion in response to exogenous vasopression stimulation was shown. Her urine free cortisol was 726.0microgram/dL, which was not suppressed after administration of high-dose dexamethasone. Her plasma cortisol level was elevated, but without circadian rhythm. ACTH was undetectable. An abdomen CT scan demonstrated bilaterally enlarged multinodular adrenal glands. A Sella MRI revealed no alteration of the pituitary gland. The patient underwent a laparoscopic bilateral adrenalectomy. Histological examination revealed bilateral macronodular hyperplasia. After having recovered, the patient showed progressive regression of the Cushingoid status.
Abdomen ; Adenoma ; Adrenal Glands ; Adrenalectomy ; Adrenocorticotropic Hormone ; Circadian Rhythm ; Cushing Syndrome ; Dexamethasone ; Diabetes Mellitus ; Female ; Humans ; Hydrocortisone ; Hyperplasia* ; Hypertension ; Magnetic Resonance Imaging ; Membranes ; Middle Aged ; Pituitary Gland ; Plasma ; Tomography, X-Ray Computed ; Vasopressins*