OBJECTIVES: Recently, Korean psychiatrists have noticed the complaints from probands and family members that private health insurance companies do not pay for most psychiatric disorders. Furthermore, probands cannot even apply for insurance because of their medical record of psychiatric disorders. Authors investigated and reviewed contracts of Korean private insurance companies to find reasons for banning psychiatric disorders from insurance policies. METHODS: Authors reviewed more than 800 contracts from 48 insurance companies. RESULTS: Among all the psychiatric diagnoses, few of them-dementia and some other organic mental disorders-are guaranteed to be paid from insurance companies. Less then 10 contracts say they pay for psychiatric illnesses. Most insurance companies have contracts prohibiting F codes ; however, there are not enough reasons in these contracts. CONCLUSIONS: In the private health insurance system, psychiatric illnesses have almost no rooms. It is very urgent to add space for patients with psychiatric illnesses and psychiatrists in the insurance policies.
Diagnosis ; Humans ; Insurance* ; Insurance, Health ; Korea* ; Medical Records ; Psychiatry

The concept of e-sports is being established as a sport that we have previously recognized, not just a simple electronic game. However, it is not clear whether e-sports share the same characteristics as sports, and even if they do, how doping will be a problem in e-sports. In this paper, we examined how to deal with the doping issue in e-sports by comparing the characteristics of general sports and e-sports. We also investigated what form doping will take in e-sports and what information pharmacists should know in the future. In conclusion, it is necessary to expand the scope of anti-doping activities that have been actively implemented in existingsports to the field of e-sports to prevent damage to the health of e-sports athletes and maintain fairness and transparency in e-sportsactivities. In addition, it is thought that pharmacists, who are experts in medication, will need to understand the overall characteristicsof e-sports and the differences in the target group at risk of doping and activate their role in providing individualized pharmaceuticalservices in the future.

The concept of e-sports is being established as a sport that we have previously recognized, not just a simple electronic game. However, it is not clear whether e-sports share the same characteristics as sports, and even if they do, how doping will be a problem in e-sports. In this paper, we examined how to deal with the doping issue in e-sports by comparing the characteristics of general sports and e-sports. We also investigated what form doping will take in e-sports and what information pharmacists should know in the future. In conclusion, it is necessary to expand the scope of anti-doping activities that have been actively implemented in existingsports to the field of e-sports to prevent damage to the health of e-sports athletes and maintain fairness and transparency in e-sportsactivities. In addition, it is thought that pharmacists, who are experts in medication, will need to understand the overall characteristicsof e-sports and the differences in the target group at risk of doping and activate their role in providing individualized pharmaceuticalservices in the future.

The concept of e-sports is being established as a sport that we have previously recognized, not just a simple electronic game. However, it is not clear whether e-sports share the same characteristics as sports, and even if they do, how doping will be a problem in e-sports. In this paper, we examined how to deal with the doping issue in e-sports by comparing the characteristics of general sports and e-sports. We also investigated what form doping will take in e-sports and what information pharmacists should know in the future. In conclusion, it is necessary to expand the scope of anti-doping activities that have been actively implemented in existingsports to the field of e-sports to prevent damage to the health of e-sports athletes and maintain fairness and transparency in e-sportsactivities. In addition, it is thought that pharmacists, who are experts in medication, will need to understand the overall characteristicsof e-sports and the differences in the target group at risk of doping and activate their role in providing individualized pharmaceuticalservices in the future.

The concept of e-sports is being established as a sport that we have previously recognized, not just a simple electronic game. However, it is not clear whether e-sports share the same characteristics as sports, and even if they do, how doping will be a problem in e-sports. In this paper, we examined how to deal with the doping issue in e-sports by comparing the characteristics of general sports and e-sports. We also investigated what form doping will take in e-sports and what information pharmacists should know in the future. In conclusion, it is necessary to expand the scope of anti-doping activities that have been actively implemented in existingsports to the field of e-sports to prevent damage to the health of e-sports athletes and maintain fairness and transparency in e-sportsactivities. In addition, it is thought that pharmacists, who are experts in medication, will need to understand the overall characteristicsof e-sports and the differences in the target group at risk of doping and activate their role in providing individualized pharmaceuticalservices in the future.

While it is generally considered that tuberculous meningitis (TBM) causes various vascular complications, there have been few reports of moyamoya syndrome following TBM. A 23-year-old female was diagnosed as TBM. Preliminary brain MRA yielded normal findings. Follow-up MRA and cerebral angiography conducted 1.5 years later yielded findings that were consistent with moyamoya disease. They showed no interval change after 2 years, and the patient had no neurological deficits. This patient with TBM subsequently developed moyamoya syndrome during the course of antituberculosis medication.
Brain ; Cerebral Angiography ; Female ; Follow-Up Studies ; Humans ; Moyamoya Disease ; Tuberculosis, Meningeal ; Young Adult

Laryngeal involvement is a rare complication of systemic lupus erythematosus (SLE) and can range from mild mucosal inflammation, vocal cord paralysis, and edema to necrotizing vasculitis with airway obstruction. Cricoarytenoid arthropathy is rare cause of severe airway obstruction in laryngeal involvement of SLE. In contrast to patients with rheumatoid arthritis, patients with SLE typically present with acute arthritis of cricoarytenoid joints and respond to corticosteroid therapy alone. We describe here a 13-year-old girl with SLE who presented with intermittent fever, swallowing difficulty, vocal cord paralysis and acute dyspnea required emergent tracheostomy as the sole manifestation of active SLE. She was diagnosed as having SLE based on the findings of positive anti-nuclear antibody and anti-ds DNA antibody with high titers, hypocomplementemia, leukocytopenia, and transient polyarthritis and proteinuria. No other clinical symptoms were found. Endoscopic findings showed edema of aryepiglottic fold, bilateral fixation of the vocal cords and edematous supraglottic structure with engorged vessels. Computered tomography scan of the neck showed diffuse soft tissue edema around the arytenoid and cricoid cartilages and enhancement of the aryepiglottic fold.
Adolescent ; Airway Obstruction ; Arthritis ; Arthritis, Rheumatoid ; Cricoid Cartilage ; Deglutition ; DNA ; Dyspnea ; Edema ; Female ; Fever ; Humans ; Inflammation ; Joints ; Larynx ; Leukopenia ; Lupus Erythematosus, Systemic* ; Neck ; Proteinuria ; Tracheostomy ; Vasculitis ; Vocal Cord Paralysis ; Vocal Cords

PURPOSE: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. METHODS: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. RESULTS: The mean score on the difficulty of EOLC was 3.41 out of 5. The education needs derived from the qualitative analysis was categorized into four themes: 1) guidelines on professional EOLC, 2) spiritual care, 3) a program to take care of feelings of patients, families and nurses, and 4) activities to think about death. CONCLUSION: This study confirmed that ICU nurses were experiencing an extreme difficulty in providing EOLC. In addition, a qualitative analysis confirmed that they needed an EOL nursing program. To mitigate the difficulties experienced by nurses involved in EOLC, there is an urgent need to develop an education program for EOLC tailored to nurses' needs.
Critical Care ; Education ; Humans ; Intensive Care Units ; Methods ; Needs Assessment ; Nursing ; Terminal Care

PURPOSE: This study examined the immunological activity and optimized the mixture conditions of Sargassum horneri (S. horneri) extracts in vitro and in vivo models.METHODS: S. horneri was extracted using three different methods: hot water extraction (HWE), 50% ethanol extraction (EE), and supercritical fluid extraction (SFE). Splenocyte proliferation and cytokine production (Interleukin-2 and Interferon-γ) were measured using a WST-1 assay and enzyme-linked immunosorbent assay, respectively. The levels of nitric oxide and T cell activation production were measured using a Griess assay and flow cytometry, respectively. The natural killer (NK) cell activity was determined using an EZ-LDH kit.RESULTS: Among the three different types of extracts, HWE showed the highest levels of splenocyte proliferation and cytokine production in vitro. In the animal model, three different types of extracts were administrated for 14 days (once/day) at 50 and 100 mg/kg body weight. HWE and SFE showed a high level of splenocyte proliferation and cytokine production in the with and without mitogen-treated groups, whereas EE administration did not induce the splenocyte activation. When RAW264.7 macrophage cells were treated with different mixtures (HWE with 5, 10, 15, 20% of SFE) to determine the optimal mixture ratio of HWE and SFE, the levels of nitric oxide and cytokine production increased strongly in the HWE with 5% and 10% of SFE containing group. In the animal model, HWE with 5% and 10% of SFE mixture administration increased the levels of splenocyte proliferation, cytokine production, and activated CD4⁺ cell population significantly, with the highest level observed in the HWE with 5% of SFE group. Moreover, the NK cell activity was increased significantly in the HWE with 5% of SFE mixture-treated group compared to the control group.CONCLUSION: The optimal mixture condition of S. horneri with immune-enhancing activity is the HWE with 5% of SFE mixture. These results confirmed that the extracts of S. horneri and its mixtures are potential candidate materials for immune enhancement.
Body Weight ; Chromatography, Supercritical Fluid ; Enzyme-Linked Immunosorbent Assay ; Ethanol ; Flow Cytometry ; In Vitro Techniques ; Killer Cells, Natural ; Macrophages ; Models, Animal ; Nitric Oxide ; Sargassum ; Water

PURPOSE: Sargassum horneri (S. horneri) is a species of brown macroalgae that is common along the coast of Japan and Korea. The present study investigated the immuno-modulatory effects of different types of S. horneri extracts in RAW264.7 macrophages. METHODS: S. horneri was extracted by three different methods, hot water extraction, 50% ethanol extraction, and supercritical fluid extraction. Cell viability was then measured by MTT assay, while the production levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and nitric oxide (NO) were measured by enzyme-linked immunosorbent assay and Griess assay, respectively. The expression and activation levels of inducible NO synthase (iNOS), mitogen-activated protein kinase (MAPK) and nuclear factor κB (NF-κB) were examined by western blot analysis. RESULTS: The three different S. horneri extracts were nontoxic against RAW 264.7 cells up to 50 µg/mL, among which treatment with hot water extract (HWE) of S. horneri significantly enhanced the production of TNF-α, IL-6, and NO in a dose-dependent manner. Hot water extract of S. horneri also increased the expression level of iNOS, suggesting that up-regulation of iNOS expression by HWE of S. horneri was responsible for the induction of NO production. In addition, treatment of RAW 264.7 macrophages with HWE of S. horneri increased the phosphorylation levels of ERK, p38 and JNK. Furthermore, the activation and subsequent nuclear translocation of NF-κB was enhanced upon treatment with HWE of S. horneri, indicating that HWE of S. horneri activates macrophages to secrete TNF-α, IL-6 and NO and induces iNOS expression via activation of the NF-κB and MAPKs signaling pathways. CONCLUSION: Taken together, these findings suggest that HWE of S. horneri possesses potential as a functional food with immunomodulatory activity.
Blotting, Western ; Cell Survival ; Chromatography, Supercritical Fluid ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Ethanol ; Functional Food ; Interleukin-6 ; Japan ; Korea ; Macrophages* ; Necrosis ; Nitric Oxide ; Nitric Oxide Synthase ; Phosphorylation ; Protein Kinases ; RAW 264.7 Cells ; Sargassum* ; Seaweed ; Up-Regulation ; Water