Malnutrition is an important condition at the elective surgical patient. Malnutrition results in the dysfunction of immune system by impairing the function of neutrophils and lymphocytes. Following gastrointestinal surgical stress, patients experience some degree of immunosuppression, increasing their risk for acquired infectious morbidity and mortality. Immune and nutrition related with infection and hospital stay in elective gastrointestinal surgical patients. Several specific nutrients such as arginine, glutamine, omega-3 fatty acids, zinc, and vitamin D, influence immunological parameters in patients undergoing surgery in laboratory and clinical studies. In conclusion, immune and nutrition may decrease infectious complication rates. However, the treatment effect varies depending on the patient population and the intervention. Further research needs to define the underlying mechanism by which immune and nutrition may be harmful and to identify which products and which patients are associated with clinical benefit.
Arginine ; Diet ; Fatty Acids, Omega-3 ; Glutamine ; Humans ; Immune System ; Immunosuppression ; Length of Stay ; Lymphocytes ; Malnutrition ; Neutrophils ; Vitamin D ; Zinc

To examine the expressed gene profile during encystation of Acanthamoeba castellanii Castellani, we used differentially expressed gene (DGE) screening by RT-PCR with 20 sets of random primers. From this analysis, we found that approximately 16 genes showed upregulation during encystation. We chose 6 genes, which had relatively higher expression levels, for further investigation. Based on homology search in database, DEG2 showed 55% of similarity with xylose isomerase, DEG9 showed 37% of similarity with Na P-type ATPase, and DEG14 showed 77% of similarity with subtilisin-like serine proteinase. DEG3 and DEG26 were identified as hypothetical proteins and DEG25 exhibited no significant similarity to any known protein. Encystation of Acanthamoeba has been suggested to be a process to resist adverse environmental or nutritional conditions. Further characterization studies of these genes may provide us with more information on the encystation mechanism of Acanthamoeba.
Acanthamoeba castellanii/*genetics/*growth & development ; Amino Acid Sequence ; Animals ; *Gene Expression Profiling ; Gene Expression Regulation ; *Life Cycle Stages ; Molecular Sequence Data ; Protozoan Proteins/*genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Alignment ; Sequence Homology, Amino Acid ; Up-Regulation

OBJECTIVES: The aim of this study was to identify the relationship between serum gamma-glutamyltransferase (GGT) and bone mineral density (BMD) in postmenopausal women. METHODS: We evaluated 200 postmenopausal women who were visiting a health promotion center at a university hospital from January 2009 to December 2011. Their current medical diseases and medication history were collected through medical records. Basic physical examinations and laboratory tests were performed on all subjects. RESULTS: The levels of serum GGT within their normal range were positively correlated with waist circumference (P = 0.01), triglycerides (P <0.001), alkaline phosphatase (P = 0.009), and uric acid (P = 0.01). The serum GGT within their normal range were negatively associated with the femur neck BMD (P = 0.002). In adjusted analysis including age and body mass index, the BMD of the femur neck was more strongly associated with a high-normal serum GGT level among the postmenopausal women as compared with those with a low-normal serum GGT level (P = 0.02). CONCLUSIONS: Serum GGT within its normal range is negatively correlated with the BMD in the femur neck among postmenopausal women. It can be useful for selecting a group that is at high risk for the bone fracture regardless of the underlying mechanism.
Alkaline Phosphatase ; Body Mass Index ; Bone Density ; Female ; Femur Neck ; Fractures, Bone ; gamma-Glutamyltransferase ; Health Promotion ; Humans ; Medical Records ; Physical Examination ; Postmenopause ; Reference Values ; Triglycerides ; Uric Acid ; Waist Circumference

Adenoid cystic carcinoma is an uncommon adenocarcinoma type which affects mainly the salivary gland and respiratory system. In the female reproductive tract it occurs more commonly in Bartholin's gland and than in uterine cervix. Almost patients are postmenopausal women. The main presenting complaint is vaginal spotting having an abnormal pap smear. It has been diagnostically confused with adenoid basal carcinoma which has a somewhat different clinical course and pathology. The treatment should be individualized to the patients by local recurrence or distant metastasis. It shows relatively unfavorable survival. Recently we experienced a case of adenoid cystic carcinoma arising in the cervix after menopause, so we report this case with a brief review of literature.
Adenocarcinoma ; Adenoids* ; Carcinoma, Adenoid Cystic* ; Cervix Uteri* ; Female ; Humans ; Menopause ; Metrorrhagia ; Neoplasm Metastasis ; Pathology ; Recurrence ; Respiratory System ; Salivary Glands

The taxonomy of Acanthamoeba spp., an amphizoic amoeba which causes granulomatous amoebic encephalitis and chronic amoebic keratitis, has been revised many times. The taxonomic validity of some species has yet to be assessed. In this paper, we analyzed the morphological characteristics, nuclear 18s rDNA and mitochondrial 16s rDNA sequences and the Mt DNA RFLP of the type strains of four Acanthamoeba species, which had been previously designated as A. divionensis, A. parasidionensis, A. mauritaniensis, and A. rhysodes. The four isolates revealed characteristic group II morphology. They exhibited 18S rDNA sequence differences of 0.2-1.1% with each other, but more than 2% difference from the other compared reference strains. Four isolates formed a different clade from that of A. castellanii Castellani and the other strains in morphological group II on the phylogenetic tree. In light of these results, A. paradivionensis, A. divionensis, and A. mauritaniensis should be regarded as synonyms for A. rhysodes.
Acanthamoeba/*classification/*genetics ; Animals ; DNA, Mitochondrial/genetics ; DNA, Ribosomal/genetics ; Phylogeny ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 18S/genetics

The mature cyst of Acanthamoeba is highly resistant to various antibiotics and therapeutic agents. Cyst wall of Acanthamoeba are composed of cellulose, acid-resistant proteins, lipids, and unidentified materials. Because cellulose is one of the primary components of the inner cyst wall, cellulose synthesis is essential to the process of cyst formation in Acanthamoeba. In this study, we hypothesized the key and short-step process in synthesis of cellulose from glycogen in encysting Acanthamoeba castellanii, and confirmed it by comparing the expression pattern of enzymes involving glycogenolysis and cellulose synthesis. The genes of 3 enzymes, glycogen phosphorylase, UDP-glucose pyrophosphorylase, and cellulose synthase, which are involved in the cellulose synthesis, were expressed high at the 1st and 2nd day of encystation. However, the phosphoglucomutase that facilitates the interconversion of glucose 1-phosphate and glucose 6-phosphate expressed low during encystation. This report identified the short-cut pathway of cellulose synthesis required for construction of the cyst wall during the encystation process in Acanthamoeba. This study provides important information to understand cyst wall formation in encysting Acanthamoeba.
Acanthamoeba castellanii/*enzymology/genetics/growth & development ; Amebiasis/*parasitology ; Cell Wall/*metabolism ; Cellulose/*biosynthesis/genetics ; Glucosyltransferases/genetics/metabolism ; Glycogen Phosphorylase/genetics/metabolism ; Protozoan Proteins/genetics/*metabolism ; UTP-Glucose-1-Phosphate Uridylyltransferase/genetics/metabolism

BACKGROUND: The goals of this study are to evaluate the propensity to depression in Korean internet users associated with internet using environment and attempt to aid proper management of internet users in the field of family practice. METHODS: A group of 1,674 subjects who replied to internet research were selected from March 26 to 28, 1999. Making use of CES-D-K for Korean internet users, we investigated the propensity to depression. At the same time, general characteristics, internet using environmental characteristics were investigated and their relationship was assssed. RESULTS: The CES-D-K score was 16.19. The CES-D-K score was significantly higher in females, in younger age and low education level group(P<0.001). There was no significance between CES-D-K score and region. In internet using environmental characteristics, the CES-D-K score was significantly higher in low velocity users, long internet using time per day group (P<0.001). There was no significance between CES-D-K score and internet using year. CONCLUSION: There was a significant correlation between internet using velocity, internet using time per day and the propensity to depression. Therefore, family physician should think about the correlation of the propensity to depression and internet using environment, if internet users have symptoms of depression.
Depression* ; Education ; Family Practice ; Female ; Humans ; Internet* ; Physicians, Family

BACKGROUND: Burnout is a common problem for interns and residents. It may be related to medical error, but little is known about this relationship. The purpose of this study was to determine the association between burnout and perceived medical errors among interns and residents. METHODS: The study group consisted of interns and residents working in a university hospital in Busan. Data were provided by 86 (58.5%) of 147 interns and residents. They completed a questionnaire including self-assessment of medical errors, a linear analog self-assessment of overall quality of life (QOL), fatigue, the Epworth Sleepiness Scale (ESS) score, the Maslach Burnout Inventory, and a validated depression screening tool. RESULTS: According to univariate logistic regression analyses, there was an association between perceived medical errors and fatigue (odds ratio [OR], 1.37 per unit increase; 95% confidence interval [CI], 1.12 to 1.69; P < 0.003) and ESS scores (OR, 1.13 per unit increase; 95% CI, 1.03 to 1.23; P < 0.009). Perceived medical errors were also associated with burnout (ORs per 1-unit change; emotional exhaustion OR, 1.07; 95% CI, 1.02 to 1.13; P < 0.005; depersonalization OR, 1.11; 95% CI, 1.02 to 1.21; P < 0.013), a negative depression screen (OR, 0.29; 95% CI, 0.11 to 0.76; P < 0.013), and overall QOL (OR, 0.80; 95% CI, 0.70 to 0.98; P < 0.033). In multivariate logistic regression analyses, an association was identified between perceived medical errors and emotional exhaustion (OR, 1.06; 95% CI, 1.00 to 1.11; P < 0.046) when adjusted for ESS, and depersonalization (OR, 1.01; 95% CI, 1.01 to 1.19; P < 0.04) when adjusted for fatigue. CONCLUSION: Higher levels of burnout among interns and residents were associated with perceived medical errors.
Depersonalization ; Depression ; Fatigue ; Logistic Models ; Mass Screening ; Medical Errors ; Quality of Life ; Self-Assessment

BACKGROUND: Fatigue is a common problem in medical students and is thought to be related to poor academic performance. Fatigue is expected to be highly related to dietary habits, but previous research was not enough. Therefore, the aims of this study were to investigate the relationship between dietary habits and the prevalence of fatigue and also to give an update on basic research data for improving academic performance in medical students. METHODS: The study group consisted of 170 healthy second-year medical students attending three university school of medicine in Busan. They completed a questionnaire dealing with fatigue (Fatigue Severity Scale), dietary habits, lifestyle, and academic performance. RESULTS: On multivariate logistic regression analyses, skipping breakfast (completely skipping breakfast everyday versus having breakfast everyday; odds ratio 7.23; 95% confidence interval, 2.07 to 25.28; P = 0.002) was positively correlated with the complaints of fatigue. CONCLUSION: Skipping breakfast was associated with the complaints of fatigue in medical students.
Breakfast ; Fatigue ; Food Habits ; Humans ; Life Style ; Logistic Models ; Odds Ratio ; Prevalence ; Students, Medical ; Surveys and Questionnaires

Encystation mediating cyst specific cysteine proteinase (CSCP) of Acanthamoeba castellanii is expressed remarkably during encystation. However, the molecular mechanism involved in the regulation of CSCP gene expression remains unclear. In this study, we focused on epigenetic regulation of gene expression during encystation of Acanthamoeba. To evaluate methylation as a potential mechanism involved in the regulation of CSCP expression, we first investigated the correlation between promoter methylation status of CSCP gene and its expression. A 2,878 bp of promoter sequence of CSCP gene was amplified by PCR. Three CpG islands (island 1–3) were detected in this sequence using bioinformatics tools. Methylation of CpG island in trophozoites and cysts was measured by bisulfite sequence PCR. CSCP promoter methylation of CpG island 1 (1,633 bp) was found in 8.2% of trophozoites and 7.3% of cysts. Methylation of CpG island 2 (625 bp) was observed in 4.2% of trophozoites and 5.8% of cysts. Methylation of CpG island 3 (367 bp) in trophozoites and cysts was both 3.6%. These results suggest that DNA methylation system is present in CSCP gene expression of Acanthamoeba. In addition, the expression of encystation mediating CSCP is correlated with promoter CpG island 1 hypomethylation.
Acanthamoeba castellanii* ; Acanthamoeba* ; Computational Biology ; CpG Islands ; Cysteine Proteases ; DNA Methylation* ; DNA* ; Epigenomics ; Gene Expression Regulation ; Gene Expression* ; Methylation ; Negotiating ; Polymerase Chain Reaction ; Trophozoites