Lithium salts are being used increasingly to treat patient with affective disorders, especially acute mania, or bipolar manic-depressive illness. For therapeutic effect the lithium content must be maintained at or above a particular level. Lithium poisoning due to overdosage may be seen occasionally, and its course is determined primarily by the rate of renal lithium elimination. A search is therefore indicated for procedures that could raise the lithium clearance. In a number of reports renal lithium excretion has been studied in relation to the excretion of water, sodium, potassium and hydrogen, but effects of sodium or water on the lithium excretion has not yet been clarified. Hence the present study was undertaken to investigate the effects of corticosteroid on the excretion of lithium ion. The female rat (Sprague-Dowley), weighing from 200 to 300g, was injected with 50mg/kg of lithium chloride intraperitoneally, and then injected with graded dosage of fludrocortisones and dexamethasone in each group. During the injected rats were incubated in metabolic cage, 24 hour urine of rats were collected. At 24 hours after injection, the rats were sacrificed with guillotine, the blood were collected. And then the concentrations of Na⁺, K⁺, Li⁺ of collected urine and serum were checked by Flame photometer. The results are summarized as follows 1. Fludrocortisone decreased the serum concentration of lithium and increased the urinary excretion of lithium. 2. In the group treated with low dose of dexamethasone (0.1 mg/kg), the serum concentration of lithium was decreased and high dose of dexamethasone (1 mg/kg) increased the urinary excretion of lithium. 3. Fludrocortisone increased the urinary [Na⁺]/[K⁺] in serum and decreased [Na⁺]/[K⁺] inurine, but opposite effects were occurred in dexamethasone. By above results, it may be concluded that corticosteroid increased the urinary excretion of lithium and decreased the serum concentration of lithium, but it seems to be there in no relationship between these effects of corticosteroid and of the renal Na⁺ or K⁺ transport.
Adrenal Cortex Hormones* ; Animals ; Bipolar Disorder ; Dexamethasone ; Female ; Fludrocortisone ; Humans ; Hydrogen ; Lithium Chloride ; Lithium* ; Mood Disorders ; Poisoning ; Potassium ; Rats ; Renal Elimination* ; Salts ; Sodium ; Water

This study aimed at surveying recreational scuba divers in order to determine demographic characteristics such as diving certification level and diving times, history of medical illnesses or injuries, and incidence of accidents or risks during underwater diving. For this, the authors contacted the managers of 190 diving clubs, which are listed on an online site called "DiveWeb." Responses were obtained from 87 diving clubs, amounting to a total of 154 completed questionnaires. The authors also visited a 4-day-long "Seoul International Sports & Leisure Industry Show" and collected 168 completed questionnaires from certified divers who visited the show. The collected data were analyzed by SPSS for Windows, version 17.0. We found the following results among 314 divers: 261 (83.1%) were male, and 221 (70.4%) were aged 30 to 49 years; 174 divers (55.4%) had over 5 years of diving experience; average body mass index (24.13) was within normal limits; number of non-smokers (175) was greater than that of smokers (139); 110 (35.0%) divers reported past or present diseases (allergic rhinitis being the most common) or injury history. Risky situations that were encountered by the divers included currents, underwater environment, buddy system complications, and air depletion during diving. Underwater diving is a potentially hazardous activity, but at present, medical examinations or fitness tests are not a prerequisite for certified divers in Korea. To secure the safety of underwater divers, we need to establish policies for medical checkups and fitness tests before the divers begin training or attain certification.
Aged ; Body Mass Index ; Certification ; Diving ; Humans ; Incidence ; Korea ; Leisure Activities ; Male ; Rhinitis ; Sports ; Surveys and Questionnaires

A 44-year-old man was cutting an outer plate of a ship, at a depth of 25 m below sea level. Following a sudden explosion, he was discovered unconscious and was carried to the surface by other divers. There was no evidence of vital signs upon arrival at the hospital. Postmortem computed tomography, which was performed prior to autopsy, revealed massive pneumocephalus in the brain, pneumohemothorax, diffuse lung contusions with multiple traumatic lung cysts, air-fluid level in the cardiac chamber of the chest, and pneumoperitoneum in the abdomen. Postmortem external examination showed a circular abrasion on the jaw, diffuse subcutaneous emphysema, and contusion in the right upper arm. An internal examination revealed intravascular air bubbles in all four chambers of the heart, and diffuse pulmonary trauma including contusion, laceration, and multiple traumatic cysts. Blast injury to the chest, and air embolism due to the underwater explosion were established as the underlying cause of death.
Abdomen ; Adult ; Arm ; Autopsy ; Blast Injuries ; Brain ; Cause of Death ; Contusions ; Diving ; Embolism, Air ; Explosions* ; Heart ; Humans ; Jaw ; Lacerations ; Lung ; Pneumocephalus ; Pneumoperitoneum ; Ships ; Subcutaneous Emphysema ; Thorax ; Vital Signs

The transorbital intracranial injury is a rare penetrating brain injury and few homicidal cases were reported. We report a case of 37 year-old man who died from a homicidal transorbital intracranial injury. The assailant was one of his friends, who pierced his left eye by a metallic chopstick. Despite the intensive care, he died one week after. Postmortem examination revealed only a small laceration with subcutaneous hematoma in left lower eyelid, fractures of medial orbital roof, body of sphenoid bone and sella turcica, diffuse cerebral edema, basal subarachnoid hematoma, focal subdural hematoma, and intraventricular hematoma in the right lateral ventricle.
Adult ; Autopsy ; Brain Edema ; Eyelids ; Friends ; Head Injuries, Penetrating ; Hematoma ; Hematoma, Subdural ; Homicide ; Humans ; Critical Care ; Lacerations ; Lateral Ventricles ; Orbit ; Sella Turcica ; Sphenoid Bone

Munchausen syndrome by proxy (MSBP) is a rare form of mental disorder and is known as a particular type of child abuse. MSBP has been described since 1977 as a severe form of abuse with illness falsification or the intentional harming by guardians, mostly mothers. The perpetrator of MSBP may inflict damage to the child directly or indirectly through medical procedures. The perpetrator’s alleged motive is to satisfy her psychological needs, and she has a history of mental illness, mostly, factitious disorder, personality disorder, and somatic disorder. The pathology is not well known; as such, it is difficult for medical personnel to detect it early. In addition, it is hard to be handled effectively by the police and child welfare agencies because of the scarcity of evidence. Therefore, the authors attempt to examine the essential information from early detection and child abuse prevention by analyzing its clinical characteristics and the perpetrator’s characteristics, including alerting signs of MSBP. For this purpose, we focus on the role of nursing staff to detect this unusual cause of child abuse.

Purpose: To assess the prevalence of food allergy, with a focus on oral allergy syndrome (OAS) in a population of children and to investigate relevant allergen sensitization associated with these adverse reactions. Methods: This study involved 1,660 children (aged 4 to 13 years) experiencing seasonal allergy symptoms, who were enrolled in the 2015 prospective Seongnam Atopy Project (SAP 2015) in a South Korean municipality. Parents completed a structured questionnaire to assess children with OAS, collecting information on the duration, severity, and factors related to symptoms. Skin prick tests (n = 498) and blood sampling (n= 464) were performed to measure allergic sensitizations, total eosinophil counts, and levels both total immunoglobulin E (IgE) and birch-specific IgE. Results: The prevalence of OAS among the children enrolled in this study was 4.4% (95% confidence interval, 3.7%–5.1%). The most common symptom was mouth itching (n= 106, 65.0%), and the primary food allergen associated with symptoms was kiwi (n= 48, 29.5%). Peanut sensitization (14.8% vs. 57.1%, P< 0.001) and sensitization to other nut products (15.6% vs. 47.6%, P= 0.001) were linked to a higher incidence of systemic reactions. Conclusion The prevalence of 4.4% underscores the significant health impact of OAS, especially in children experiencing food allergy-related symptoms. Notably, common allergens, such as kiwi, and the potential for additional systemic reactions associated with this condition highlight the importance of raising awareness.

OBJECTIVES: Non-completion rate of cognitive behavioral therapy (CBT) for Obsessive Compulsive Disorder (OCD) was reported to be higher than expected and it could interfere with the effectiveness of treatment. The aim of this study was to investigate predictors of treatment non-completion and to compare the effectiveness of CBT for OCD between completers and non-completers. METHODS: We studied 107 patients with a principal diagnosis of OCD who initiated a 13-week CBT for OCD from June 2004 to June 2011. Demographic and clinical characteristics, psychiatric co-morbidity, and medication of 20 participants who did not complete therapy were compared with those of treatment completers (n=87). Clinical Global Impression scores were also compared between the two groups in order to evaluate the effect of CBT for OCD at the 13th week. RESULTS: The results showed a difference in marital status between treatment completers and non-completers : more non-completers were not married (p=0.04). Patients with aggressive obsessions at baseline showed a trend (p=0.06) toward lower treatment completion than those with only non-aggressive obsession. In addition, the non-completer group showed a trend of not being medicated (p=0.08). No other differences were observed between completers and non-completers. The 13th week Clinical Global Impression-Improvement scores were significantly different ; completers (2.5+/-0.8) and non-completers (3.2+/-0.8) (p<0.001). CONCLUSION: In this study, we confirmed that CBT could affect symptom improvement of OCD and treatment non-completion interfered with effectiveness of CBT. However, in the current state of our knowledge, no factor is clinically applicable as a predictor of treatment non-completion. Therefore, these results suggest that clinicians should monitor compliance during CBT for OCD patients.
Cognitive Therapy* ; Compliance* ; Diagnosis ; Fibrinogen ; Humans ; Marital Status ; Obsessive Behavior ; Obsessive-Compulsive Disorder*

BACKGROUND/AIMS: It is very important that people living with HIV (PLWH) maintain 95% medication adherence to increase health-related quality of life and prevent transmitting HIV. In this study, we analyzed factors influencing medication adherence among PLWH and used the basic data for practical interventions to increase medication adherence. METHODS: A total of 190 PLWH, who were taking highly active antiretroviral therapy (HAART) from nine hospitals in South Korea, were included. The data were collected by self-administered questionnaire between April 1 and June 31, 2014. RESULTS: About 92% of the subjects were male and 72.9% of the subjects belonged to the high compliance group. Medication-taking self-efficacy was significantly related to compliance. Efficacy expectancy, which is a subscale of medication-taking self-efficacy, indicated that a score of 1 point higher on a 10-point scale increased compliance by 2.63 times. CONCLUSIONS: Medication adherence is associated with increased medication-taking self-efficacy. Therefore, it is necessary to promote self-efficacy to improve compliance considering the infection period and adverse reactions to HAART among PLWH.
Antiretroviral Therapy, Highly Active ; Compliance ; HIV* ; Humans* ; Korea ; Male ; Medication Adherence* ; Quality of Life ; Self Efficacy

Recently, many natural medicines, whose advantages are less side effects and possibility of long-term use, have been studied for their capacity, their anti-bacterial and anti-inflammatory effects and regenerative potential of periodontal tissues. Cervi Parvum Cornu(CPC) have been traditionally used as an hale, growth, hematogenous, anti-aging, back pain in Eastern medicine. The purpose of present study was to investigate the effects of CPC extract on cell cycle progression and its molecular mechanism in human fetal osteoblasts. CPC extracts (10 microgram/ml) increased cell proliferation in the human fetal osteoblasts as compared to non-supplemented control. There was no significant change in the G1 and S phase, but a increase in the G2/M phase in 10 microgram/ml and 100 microgram/ml of CPC extracts group as compared to non-supplemented control. The protein expression of cyclin E, cdk 2, cyclin D, cdk 4, and cdk 6 was higher than that of control group. The level of p21 was lower than that of control. But that of pRb and p16 was not distinguished from control. These results indicate that the increase of cell proliferation by CPC extracts may be due to the increased expression of cyclin E , cdk 2, cyclin D, cdk 4 and cdk 6, and the decreased expression of p21 in human fetal osteoblasts .
Back Pain ; Cell Cycle* ; Cell Proliferation ; Cyclin D ; Cyclin E ; Cyclins ; Humans* ; Osteoblasts* ; S Phase

PURPOSE: Replication error is an important mechanism in carcinogenesis. The microsatellite instability (MSI-H) of colorectal cancers is associated with the development of multiple cancers. The influence of MSI-H on the development of multiple gastric cancers in sporadic gastric cancer patients has not been defined. This study was performed to reveal the association between the clinicopathologic features and MSI in sporadic gastric cancers. MATERIALS AND METHODS: Between July 2004 and March 2009, the clinicopathologic characteristics, including MSI status, were evaluated in 128 consecutive patients with sporadic gastric cancers. None of the patients had hereditary non-polyposis colorectal cancer of familial gastric cancer. The markers that were recommended by the NCI to determine the MSI status for colorectal cancers were used. RESULTS: MSI-H cancers were found in 10.9% of the patients (14/128). Synchronous gastric cancers were shown in 4 patients (3.1%). Synchronous cancers were found in 2 of 14 patients with MSI-H gastric cancer (14.3%) and 2 of 114 patients with MSS gastric cancer (1.8%; P=0.059, Fisher's exact test). Among the patients with synchronous cancer 50% (2/4) had MSI-H cancer, but 9.7% of the patients (12/124) without synchronous cancer had MSI-H cancer. MSI-H (RR, 24.7; 95% CI, 1.5~398.9; P=0.024) was related with to synchronous gastric cancer, but age, gender, family history, histologic type, location, gross morphology, size, and stage were not related to synchronous gastric cancer. CONCLUSIONS: MSI is associated with the intestinal-type gastric cancer and the presence of multiple gastric cancers in patients with sporadic gastric cancer. Special attention to the presence of synchronous and the development of metachronous multiple cancer in patients with MSI-H gastric cancer is needed.
Colorectal Neoplasms ; Humans ; Microsatellite Instability ; Microsatellite Repeats ; Stomach Neoplasms ; Succinimides