Injuries and infectious diseases have been the most important public health problems since the beginning of human life. Injuries result in death of about 30,000 people each year in South Korea. In terms of years of life lost, injuries are considerably more costly than either heart disease or cancer. In terms of cost - both the direct costs of care and the indirect costs to individuals, families, and societies of a diminished life - injuries are among the most expensive of all social problems. The main purposes of this study are (1) to describe the outcomes as well as treatment process of brain injured patients and (2) to identify the factors impacting on length of stay during hospitalization and hospital fees. The research method used in this study was to review the medical records of five hundreds brain injured cases using systemic random sampling. The multiple logistic regression was administered to identify the factors impacting on the outcomes. The results are as follow: (1) the consultation rate was found to be 72.9% while referral rate was 11.2%; (2) nearly 30% of the respondents were hospitalized over 30 days; (3) multiple logistic regression analyses revealed that the determinants influencing LOS were number of consultations, number of lab tests, and surgery; (4) the determinants of hospital fee were severity of brain injury, gender of patients, number of consultations, number of lab tests, and surgery.
Beginning of Human Life ; Brain Injuries ; Brain* ; Communicable Diseases ; Surveys and Questionnaires ; Fees and Charges ; Heart Diseases ; Hospitalization ; Humans ; Korea ; Length of Stay ; Logistic Models ; Medical Records ; Public Health ; Referral and Consultation ; Social Problems

Self-renewal and differentiation are hallmarks of stem cells and controlled by various intrinsic and extrinsic factors. Increasing evidence indicates that estrogen (E2), the primary female sex hormone, is involved in regulating the proliferation and lineage commitment of adult and pluripotent stem cells as well as modulating the stem cell niche. Thus, a detailed understanding of the role of E2 in behavior of stem cells may help to improve their therapeutic potential. Recently, it has been reported that E2 promotes cell cycle activity of hematopoietic stem and progenitor cells and induces them to megakaryocyte-erythroid progenitors during pregnancy. This study paves the way towards a previously unexplored endocrine mechanism that controls stem cell behavior. In this review, we will focus on the scientific findings regarding the regulatory effects of E2 on the hematopoietic system including its microenvironment.
Adult ; Cell Cycle ; Estrogens* ; Female ; Hematopoiesis ; Hematopoietic Stem Cells* ; Hematopoietic System ; Humans ; Megakaryocyte-Erythroid Progenitor Cells ; Pluripotent Stem Cells ; Pregnancy ; Stem Cell Niche ; Stem Cells

PURPOSE: We evaluated the humoral and cellular immune response to varicella-zoster virus after vaccination with varicella vaccine (Oka/LG strain). METHODS: The seroprevalence rate of fluorescent antibody to membrane antigen (FAMA) was evaluated among 178 children and 15 adults. After vaccination, seroconversion rate of FAMA, varicella-zoster virus (VZV) specific IgG and cell mediated immune response to glycoprotein I was performed. RESULTS: The seropositive rate of FAMA against VZV in healthy children ages 3 to 6 was 43.1%. A past history of chickenpox illness was confirmed in 15.2% of children who had positive response in FAMA assay in 90.9%. 34.5% of those without a past history of chickenpox had antibodis. The seropositive rate in children vaccinated with varicella vaccine in the past was found to be 46.3% in questionnaire and 44.4% in immunization schedule, lower than that of other studies (greater than 90%). The seroconversion rates in children vaccinated with the Oka/LG were 97.1% with 2,500pfu and 100.0% with 5,000pfu. Antibodies appearing after the Oka/LG vaccination were found to have glycoprotein I zone confirmed by western blotting. The rate of cell mediated immune response was 88.2% in children and 100.0% in adults. CONCLUSION: Further investigation about the effect of the various varicella vaccines used in Korea and about the cause of their immunzation failure after vaccination is needed.
Adult ; Antibodies ; Blotting, Western ; Chickenpox Vaccine* ; Chickenpox* ; Child ; Glycoproteins ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Immunization Schedule ; Immunization* ; Immunoglobulin G ; Korea ; Membranes ; Surveys and Questionnaires ; Seroepidemiologic Studies ; Vaccination ; Vaccines

Edema ; Humans ; Lifting ; Maxillary Sinus ; Sinus Floor Augmentation ; Sinusitis ; Stress, Psychological ; Transplants

Leptomeningeal metastasis (LM) is a rare but fatal clinical condition with a short survival time. The incidence of LM from epidermal growth factor receptor mutant (EGFRm) non–small cell lung cancer (NSCLC) has increased due to the limited efficacy of first- or second-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in the central nervous system (CNS). Osimertinib is a third-generation, irreversible, CNS penetrant, oral EGFR TKI that demonstrates promising efficacy in CNS metastases regardless of T790M. Herein, we report four cases of T790M-negative EGFRm NSCLC patients treated with osimertinib combined with systemic chemotherapy, who progressed on prior EGFR TKI and developed LM with extracranial lesions. The combination treatment was well tolerated, and the mean overall survival from LM diagnosis was 14.7 months (95% confidence interval, 10.4 to 19.0). These results suggest that osimertinib combined with systemic chemotherapy would be a reasonable treatment option for T790M-negative EGFRm NSCLC patients who develop LM with extracranial progression to prior EGFR TKI. A further prospective study is warranted.

Cadmium (Cd), a major component of cigarette smoke, disrupts the normal functions of airway cells and can lead to the development of various pulmonary diseases such as chronic obstructive pulmonary disease (COPD). However, the molecular mechanisms involved in Cd-induced pulmonary diseases are poorly understood. Here, we identified a cluster of genes that are altered in response to Cd exposure in human bronchial epithelial cells (BEAS-2B) and demonstrated that Cd-induced ER stress and inflammation are mediated via CCAAT-enhancer-binding proteins (C/EBP)-DNA-damaged-inducible transcript 3 (DDIT3) signaling in BEAS-2B cells. Cd treatment led to marked upregulation and downregulation of genes associated with the cell cycle, apoptosis, oxidative stress and inflammation as well as various signal transduction pathways. Gene set enrichment analysis revealed that Cd treatment stimulated the C/EBP signaling pathway and induced transcriptional activation of its downstream target genes, including DDIT3. Suppression of DDIT3 expression using specific small interfering RNA effectively alleviated Cd-induced ER stress and inflammatory responses in both BEAS-2B and normal primary normal human bronchial epithelial cells. Taken together, these data suggest that C/EBP signaling may have a pivotal role in the early induction of ER stress and inflammatory responses by Cd exposure and could be a molecular target for Cd-induced pulmonary disease.
Apoptosis ; Cadmium ; CCAAT-Enhancer-Binding Proteins ; Cell Cycle ; Down-Regulation ; Epithelial Cells* ; Humans* ; Inflammation* ; Lung Diseases ; Oxidative Stress ; Pulmonary Disease, Chronic Obstructive ; RNA, Small Interfering ; Signal Transduction ; Smoke ; Tobacco Products ; Transcriptional Activation ; Up-Regulation

BACKGROUND: Airway epithelial cells are the first line of defense, against pathogens and environmental pollutants, in the lungs. Cellular stress by cadmium (Cd), resulting in airway inflammation, is assumed to be directly involved in tissue injury, linked to the development of lung cancer, and chronic obstructive pulmonary disease (COPD). We had earlier shown that ACN9 (chromosome 7q21), is a potential candidate gene for COPD, and identified significant interaction with smoking, based on genetic studies. However, the role of ACN9 in the inflammatory response, in the airway cells, has not yet been reported. METHODS: We first checked the anatomical distribution of ACN9 in lung tissues, using mRNA in situ hybridization, and immunohistochemistry. Gene expression profiling in bronchial epithelial cells (BEAS-2B), was performed, after silencing ACN9. We further tested the roles of ACN9, in the intracellular mechanism, leading to Cd-induced production, of proinflammatory cytokines in BEAS-2B. RESULTS: ACN9 was localized in lymphoid, and epithelial cells, of human lung tissues. ACN9 silencing, led to differential expression of 216 genes. Pathways of sensory perception to chemical stimuli, and cell surface receptor-linked signal transduction, were significantly enriched. ACN9 silencing, further increased the expression of proinflammatory cytokines, in BEAS-2B after Cd exposure. CONCLUSION: Our findings suggest, that ACN9 may have a role, in the inflammatory response in the airway.
Cadmium ; Cytokines ; Environmental Pollutants ; Epithelial Cells* ; Gene Expression ; Gene Expression Profiling ; Humans* ; Immunohistochemistry ; In Situ Hybridization ; Inflammation ; Lung ; Lung Neoplasms ; Pulmonary Disease, Chronic Obstructive ; RNA, Messenger ; Signal Transduction ; Smoke ; Smoking ; Succinate Dehydrogenase

BACKGROUND/AIMS: Orientia -tsutsugamushi infection is an acute febrile disease due to the accidental transmission through human skin of forest dwelling vector Leptotrombidium larva. The authors observed liver dysfunctions in patients diagnosed with tsutsugamushi disease (Scrub typhus) in the past 3 years and report the data in the hope of bringing attention to this disease in the differential diagnosis of autumn-season hepatitis, especially of non-A, non-B and non-C hepatitis. METHODS: Medical records of 22 patients diagnosed with tsutsugamushi disease by the hemagglutinin method between October 2000 and November 2002 were reviewed. RESULTS: Female gender was dominant in the ratio of 3.4:1. Mean age was 56.4 +/- 2.6. Admission was between 23rd September and 15th November with the peak between mid October and early November. Fever, being the most common symptom, was observed in 21 cases, myalgia in 13, arthralgia in 12, chills in 6, and skin rash in 6. An incubation period of 7-9 days was most common (10 cases), 13-15 days (4), 10-12 days (3), within 3 days (3), and 4-6 days (2). Average ALT, AST and GGTP were increased to 93.2 +/- 17.3 IU/L (18 +/- 345 IU/L), 92.5 +/- 11.7 IU/L (34-255 IU/L) and 132.2 +/- 14.5 IU/L (19-251 IU/L), respectively, but total bilirubin was normal. All the patients improved with doxycycline therapy. CONCLUSIONS: Since it usually shows liver dysfunction, it is important to take Orientia tsutsugamushi into consideration in differential diagnosis of autumn-season, febrile hepatic disease.
Adult ; Aged ; Diagnosis, Differential ; *Disease Outbreaks ; Hepatitis/*diagnosis/microbiology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Scrub Typhus/complications/*diagnosis/epidemiology

Background: Normocalcemic primary hyperparathyroidism (NPHPT) was first described in 2008. It is defined as consistently elevated serum parathyroid hormone (PTH) levels with normal serum calcium (sCa) concentration, after excluding secondary causes of PTH elevation. However, the exact definition and management strategy for NPHPT remain controversial. We retrospectively investigated the clinicopathological features and short-term outcomes of NPHPT patients. Methods: A total of 280 patients who were surgically indicated for primary hyperparathyroidism (PHPT) at the Yonsei Severance Medical Center between 2015 and 2019 were included. Patients were classified according to preoperative PTH, corrected sCa, and ionized calcium (iCa) levels as follows: typical primary hyperparathyroidism (TPHPT, elevated PTH, sCa, and iCa, n = 158) and NPHPT (elevated PTH, normal sCa, n = 122). Results: NPHPT was commonly seen in younger individuals (aged < 50 years, P = 0.025);nephrolithiasis and bone fractures were common. Preoperative PTH level was higher in the TPHPT group (P < 0.001). The NPHPT group had higher numbers of multiple parathyroid lesions (P = 0.004) that were smaller (P = 0.011). NPHPT patients were further divided into two subgroups according to iCa levels: the elevated (n = 95) and normal iCa (n = 27) groups. There was no significant difference between the two subgroups regarding symptoms and multiplicity of lesions. Conclusion We found that NPHPT may be a heterogeneous disease entity of PHPT with high rates of multi-gland disease, which appears to be biochemically milder but symptomatic.Intraoperative PTH monitoring might help increase the surgery success rate. Moreover, the short-term outcomes of NPHPT after surgery did not differ from that of TPHPT.