The purpose of this study was to verify the validity of the Patient Severity Classification Tool by examining the correlations between the APACHE III and the Patient Severity Classification Tool and to propose admission criteria to the ICU. The instruments used for this study were the APACHE III developed by Knaus and thePatient Severity Classification Tool developed by Korean Clinical Nurses Association. Data was collected from the 156 Medical ICU patients during their first 24 hours of admission at the Seoul National University Hospital by three trained Medical ICU nurses from April 20 to August 31 1999. Data were analyzed using the frequency, X2, Wilcoxon rank sum test, and Spearman rho. There was statistically significant correlations between the scores of the APACHE III and the Patient Severity Classification Tool. Mortality rate was increased as patients classification of severity in both the APACHE III and the Patient Severity Classification Tool scored higher. The Patient Severity Classification Tool was proved to be a valid and reliable tool, and a useful tool as one of the severity predicting factors, ICU admission criteria, information sharing between ICUs, quality evaluations of ICUs, and ICU nurse staffing. 1) This paper was awarded the first prize at the Seoul National Hospital Nursing Department Research Contest.
APACHE* ; Awards and Prizes ; Classification* ; Humans ; Information Dissemination ; Mortality ; Nursing ; Seoul

BACKGROUND: The phosphoinositide 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) signaling axis has emerged as a novel target for cancer therapy. Agents that inhibit this pathway are currently under development for lung cancer treatment. In the present study, we have tested whether dual inhibition of PI3K/Akt/mTOR signaling can lead to enahnced antitumor effects. We have also examined the role of autophagy during this process. METHODS: We analyzed the combination effect of the mTOR inhibitor, temsirolimus, and the Akt inhibitor, GSK690693, on the survival of NCI-H460 and A549 non-small cell lung cancer cells. Cell proliferation was determined by MTT assay and apoptosis induction was evaluated by flow cytometry and terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Autophagy induction was also evaluated by acridine orange staining. Changes of apoptosis or autophagy-related proteins were evaluated by western blot analysis. RESULTS: Combination treatment with temsirolimus and GSK690693 caused synergistically increased cell death in NCI-H460 and A549 cells. This was attributable to increased induction of apoptosis. Caspase 3 activation and poly(ADP-ribose) polymerase cleavage accompanied these findings. Autophagy also increased and inhibition of autophagy resulted in increased cell death, suggesting its cytoprotective role during this process. CONCLUSION: Taken together, our results suggest that the combination of temsirolimus and GSK690693 could be a novel strategy for lung cancer therapy. Inhibition of autophagy could also be a promising method of enhancing the combination effect of these drugs.
Acridine Orange ; Apoptosis ; Autophagy ; Axis, Cervical Vertebra ; Blotting, Western ; Carcinoma, Non-Small-Cell Lung ; Caspase 3 ; Cell Death ; Cell Proliferation ; DNA Nucleotidylexotransferase ; Flow Cytometry ; Lung Neoplasms ; Oxadiazoles ; Phosphatidylinositol 3-Kinases ; Poly(ADP-ribose) Polymerases ; Proteins ; Sirolimus ; TOR Serine-Threonine Kinases

PURPOSE: We aimed to determine whether Autism Spectrum Disorder (ASD) would show neural abnormality of the social reward system using functional MRI (fMRI). MATERIALS AND METHODS: 27 ASDs and 12 typically developing controls (TDCs) participated in this study. The social reward task was developed, and all participants performed the task during fMRI scanning. RESULTS: ASDs and TDCs with a social reward learning effect were selected on the basis of behavior data. We found significant differences in brain activation between the ASDs and TDCs showing a social reward learning effect. Compared with the TDCs, the ASDs showed reduced activity in the right dorsolateral prefrontal cortex, right orbitofrontal cortex, right parietal lobe, and occipital lobe; however, they showed increased activity in the right parahippocampal gyrus and superior temporal gyrus. CONCLUSION: These findings suggest that there might be neural abnormality of the social reward learning system of ASDs. Although this study has several potential limitations, it presents novel findings in the different neural mechanisms of social reward learning in children with ASD and a possible useful biomarker of high-functioning ASDs.
Brain/*physiopathology ; Brain Mapping ; Case-Control Studies ; Child ; Child Development Disorders, Pervasive/*physiopathology ; Female ; Functional Neuroimaging/*methods ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Neural Pathways/*physiopathology ; Psychiatric Status Rating Scales ; Republic of Korea ; *Reward ; *Social Behavior

No abstract available.

OBJECTIVE: To determine the relationship between whole body vibration (WBV) induced helicopter flights and degenerative changes of the cervical and lumbar spine. METHODS: We examined 186 helicopter pilots who were exposed to WBV and 94 military clerical workers at a military hospital. Questionnaires and interviews were completed for 164 of the 186 pilots (response rate, 88.2%) and 88 of the 94 clerical workers (response rate, 93.6%). Radiographic examinations of the cervical and the lumbar spines were performed after obtaining informed consent in both groups. Degenerative changes of the cervical and lumbar spines were determined using four radiographs per subject, and diagnosed by two independent, blinded radiologists. RESULTS: There was no significant difference in general and work-related characteristics except for flight hours and frequency between helicopter pilots and clerical workers. Degenerative changes in the cervical spine were significantly more prevalent in the helicopter pilots compared with control group. In the cervical spine multivariate model, accumulated flight hours (per 100 hours) was associated with degenerative changes. And in the lumbar spine multivariate model, accumulated flight hours (per 100 hours) and age were associated with degenerative changes. CONCLUSION: Accumulated flight hours were associated with degenerative changes of the cervical and lumbar spines in helicopter pilots.
Aircraft* ; Hospitals, Military ; Humans ; Informed Consent ; Military Personnel ; Spine* ; Vibration ; Surveys and Questionnaires

BACKGROUND: In cancer cells, autophagy is generally induced as a pro-survival mechanism in response to treatment-associated genotoxic and metabolic stress. Thus, concurrent autophagy inhibition can be expected to have a synergistic effect with chemotherapy on cancer cell death. Monensin, a polyether antibiotic, is known as an autophagy inhibitor, which interferes with the fusion of autophagosome and lysosome. There have been a few reports of its effect in combination with anticancer drugs. We performed this study to investigate whether erlotinib, an epidermal growth factor receptor inhibitor, or rapamycin, an mammalian target of rapamycin (mTOR) inhibitor, is effective in combination therapy with monensin in non-small cell lung cancer cells. METHODS: NCI-H1299 cells were treated with rapamycin or erlotinib, with or without monensin pretreatment, and then subjected to growth inhibition assay, apoptosis analysis by flow cytometry, and cell cycle analysis on the basis of the DNA contents histogram. Finally, a Western blot analysis was done to examine the changes of proteins related to apoptosis and cell cycle control. RESULTS: Monensin synergistically increases growth inhibition and apoptosis induced by rapamycin or erlotinib. The number of cells in the sub-G1 phase increases noticeably after the combination treatment. Increase of proapoptotic proteins, including bax, cleaved caspase 3, and cleaved poly(ADP-ribose) polymerase, and decrease of anti-apoptotic proteins, bcl-2 and bcl-xL, are augmented by the combination treatment with monensin. The promoters of cell cycle progression, notch3 and skp2, decrease and p21, a cyclin-dependent kinase inhibitor, accumulates within the cell during this process. CONCLUSION: Our findings suggest that concurrent autophagy inhibition could have a role in lung cancer treatment.
Apoptosis ; Apoptosis Regulatory Proteins ; Autophagy ; Blotting, Western ; Carcinoma, Non-Small-Cell Lung ; Caspase 3 ; Cell Cycle ; Cell Cycle Checkpoints ; Cell Death ; DNA ; Epidermal Growth Factor ; Flow Cytometry ; Lung ; Lung Neoplasms ; Lysosomes ; Monensin ; Phosphotransferases ; Poly(ADP-ribose) Polymerases ; Proteins ; Quinazolines ; Receptor, Epidermal Growth Factor ; Receptor, erbB-2 ; Sirolimus ; Stress, Physiological ; TOR Serine-Threonine Kinases ; Erlotinib Hydrochloride

Most submucosal tumors of the stomach are of mesenchymal origin. Gastric schwannoma, which is a subset of mesenchymal tumors, is a rare tumor taking origin from Schwann's cells. A 61-year-old woman whose endoscopy showed a well circumscribed submucosal mass measuring 2.5 cm on the midbody of the stomach. Endosonographically, the tumor was well circumscribed, low echoic submucosal mass with cystic lesion in the 4th layer of the gastric wall. The patient underwent wedge resection. Microscopically, the cells were made up of irregular fasciculating bundles of spindle cells featured with benign nuclear atypia and peripheral lymphoid cell cuffing, involving muscularis propria. Immunohistochemical staining showed positivity for S-100 protein and the neuron-specific enolase, but were negative to CD 34, desmin and smooth muscle actin. From these findings, this tumor was diagnosed as a schwannoma.
Actins ; Desmin ; Endoscopy ; Female ; Humans ; Lymphocytes ; Middle Aged ; Muscle, Smooth ; Neurilemmoma* ; Phosphopyruvate Hydratase ; S100 Proteins ; Stomach

Progressive transformation of germinal centers (PTGC) is an atypical feature seen in lymph nodes with unknown pathogenesis. PTGC most commonly presents in adolescent and young adult males as solitary painless lymphadenopathy with various durations. Cervical nodes are the most commonly involved ones while involvements of axillary and inguinal nodes are less frequent. PTGC develops extremely rarely in other locations. We report a rare case of solitary mass present in the presacral space. The mass as subsequently proven to be PTGC. To the best of our knowledge, PTGC in the presacral space has not been previously reported in the literature.
Adolescent ; Germinal Center* ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Magnetic Resonance Imaging* ; Male ; Young Adult

PURPOSE: We have performed this study to obtain reference data for the distribution of chromosomal aberrations in Korea. METHODS: We analyzed 1,180 chromosomal study cases from Kwang ju Christian Hospital during the past 25 years. 756 cases suspected of characteristic chromosomal aberration syndromes and 424 cases with hermaphroditism, mild sexual abnormalities, multiple anomalies, or mental and growth retardation were included. RESULTS: The male to female ratio of autosomal aberration syndromes was 1.2 : 1. 78.6% of autosomal aberrations were diagnosed under 1 year of age, whereas 89.8% of sex chromosomal aberrations were diagnosed over 12 years of age. Among 1,180 cases, 612 ones had chromosomal aberrations(51.9%) : 590 of 756 cases suspected of chromosomal aberration syndromes had aberrations(78.0%), whereas 22 of 424 showing the above other features had aberrations(5.2%). Autosomal aberrations appeared in 514 cases(83.8%) and sex chromosomal aberrations appeared in 98 cases(16.2%). The most frequently observed abberation in autosomal aberrations was Down syndrome, followed by E, D, B, A and C group aberrations. The most common abberation in sex chromosomal aberrations was Turner syndrome, followed by Klinefelter syndrome and Fragile X syndrome. CONCLUSION: It is of vital importance that patients suspected of chromosomal aberrations undergo chromosomal analysis. Further advanced chromosomal staining and molecular genetic methods will raise the detection rate of chromosomal aberrations.
Abnormalities, Multiple ; Chromosome Aberrations* ; Disorders of Sex Development ; Down Syndrome ; Female ; Fragile X Syndrome ; Gwangju ; Humans ; Klinefelter Syndrome ; Korea ; Male ; Molecular Biology ; Turner Syndrome

Autism spectrum disorder (ASD) is a highly prevalent neurodevelopmental disorder characterized by impaired social communication and restricted and repetitive behaviors (RRBs). Over the past decade, neuroimaging studies have provided considerable insights underlying neurobiological mechanisms of ASD. In this review, we introduce recent findings from brain imaging studies to characterize the brains of ASD across the human lifespan. Results of structural Magnetic Resonance Imaging (MRI) studies dealing with total brain volume, regional brain structure and cortical area are summarized. Using task-based functional MRI (fMRI), many studies have shown dysfunctional activation in critical areas of social communication and RRBs. We also describe several data to show abnormal connectivity in the ASD brains. Finally, we suggest the possible strategies to study ASD brains in the future.
Autistic Disorder* ; Brain* ; Child ; Autism Spectrum Disorder* ; Humans ; Magnetic Resonance Imaging ; Neuroimaging