PURPOSE: Increasing clinical importance is being placed on the role of differential renal function (DRF) for the management of congenital ureteropelvic junction obstructions. Supranormal DRF of a hydronephrotic kidney, on a renal scan, is hypothesized to be due to an increase in single nephron filtration or nephron volume. However, the etiology of this paradoxical phenomenon still remains to be elucidated. We studied the histopathological changes of hydronephrotic kidneys with a supranormal DRF. MATERIALS AND METHODS: 35 children with unilateral congenital hydronephrosis and supranormal DRF (>55%), on preoperative renal scans, who had undergone pyeloplasty, were retrospectively evaluated. There were 3 female and 32 male patients. The mean age at the time of the operation was 12.6 months, ranging from 0.1 to 144 months. Needle biopsies, from 3 different sites at the lower pole of the kidney, were performed during surgery. To evaluate the presence of glomerular hypertrophy, the maximal planar area of the glomeruli was measured under light microscopy. Tissue samples were obtained in same manner from kidneys with no history of urinary tract disease on autopsy, and used as controls. The mean glomerular areas of the patient and control groups were plotted according to the patient's age. RESULTS: The mean glomerular area in the patient group was smaller than in the control group, with the exception of 4 patients. According to the logistical regression, the probability of larger renal glomeruli increased with decreasing DRF (p=0.1155). CONCLUSIONS: The glomerular area of a hydronephrotic kidney, with a supranormal renal function on a renal scan, was not significantly larger than the normal controls. Therefore, we believe that the theory of increased nephron volume as a cause of a supranormal DRF can be excluded.
Autopsy ; Biopsy, Needle ; Child ; Female ; Filtration ; Humans ; Hydronephrosis ; Hypertrophy* ; Kidney ; Male ; Microscopy ; Nephrons ; Retrospective Studies ; Urologic Diseases

PURPOSE: Increasing clinical importance is being placed on the role of differential renal function (DRF) for the management of congenital ureteropelvic junction obstructions. Supranormal DRF of a hydronephrotic kidney, on a renal scan, is hypothesized to be due to an increase in single nephron filtration or nephron volume. However, the etiology of this paradoxical phenomenon still remains to be elucidated. We studied the histopathological changes of hydronephrotic kidneys with a supranormal DRF. MATERIALS AND METHODS: 35 children with unilateral congenital hydronephrosis and supranormal DRF (>55%), on preoperative renal scans, who had undergone pyeloplasty, were retrospectively evaluated. There were 3 female and 32 male patients. The mean age at the time of the operation was 12.6 months, ranging from 0.1 to 144 months. Needle biopsies, from 3 different sites at the lower pole of the kidney, were performed during surgery. To evaluate the presence of glomerular hypertrophy, the maximal planar area of the glomeruli was measured under light microscopy. Tissue samples were obtained in same manner from kidneys with no history of urinary tract disease on autopsy, and used as controls. The mean glomerular areas of the patient and control groups were plotted according to the patient's age. RESULTS: The mean glomerular area in the patient group was smaller than in the control group, with the exception of 4 patients. According to the logistical regression, the probability of larger renal glomeruli increased with decreasing DRF (p=0.1155). CONCLUSIONS: The glomerular area of a hydronephrotic kidney, with a supranormal renal function on a renal scan, was not significantly larger than the normal controls. Therefore, we believe that the theory of increased nephron volume as a cause of a supranormal DRF can be excluded.
Autopsy ; Biopsy, Needle ; Child ; Female ; Filtration ; Humans ; Hydronephrosis ; Hypertrophy* ; Kidney ; Male ; Microscopy ; Nephrons ; Retrospective Studies ; Urologic Diseases

PURPOSE: This study was done to analyze how a death preparation education program have the effects on awareness of hospice palliative care and withdrawing life sustaining treatment in older adults. METHODS: This study employed a non-equivalent control group design among quasi-experimental designs. The experimental group was comprised with 35 adults and the control group with 40 adults. The death preparation program consisted of five two-hour sessions and was administered once a week for five straight weeks. Data were analyzed by descriptive statistics, t-test, chi2 test, Fisher's exact test, and ANCOVA using SPSS version 18.0. RESULTS: The mean age of the participants was 66.2 years. A significant difference between the experimental and control groups was observed in withdrawing life sustaining treatment (F=3.380, P=0.040). However, no significant difference was found in awareness of hospice palliative care (F=0.163, P=0.850). CONCLUSION: The study results indicate that death preparation training could positively affect people's awareness of withdrawing life sustaining treatment. More studies should be conducted to explore effects of death preparation education for all ages and help people better understand hospice palliative care.
Adult ; Education* ; Hospices* ; Humans ; Life Support Care ; Palliative Care*

BACKGROUND: Secondary spinal cord injury (SCI) that follows an initial mechanical insult can exacerbate the overall damage, limit the restorative processes and eventually lead to an in- creased neurological deficit. We hypothesized that selective inhibition of cyclooxygenase-2 (COX-2) may decrease the delayed cell death, and so this will contribute to decreased level of the secondary injury. METHODS: The dorsal surface of the cord at the T9 level was subjected to weight drop impact using a 10 g rod. To block COX-2 activation, a selective COX-2 inhibitor (NS-398) was administered (5 mg/kg, i.p.) 15 min prior to SCI. The COX-1, COX-2, Caspase-3 and PGE2 expressions were measured by real time quantitative RT-PCR and fluorescence immunostaining. RESULTS: Many activated caspase-3 positive cells were observed at 6 h and they increased until 72 h after SCI. The expression of COX-2 peaked at 6 h after SCI, while the COX-1 expression was unaffected. The principal cells that showed a COX-2 expression were the neurons and microglia. Pretreatment with NS-398 caused a significant decrease in the expression of prostaglandin E2 and activated caspase-3 positive cells after SCI. CONCLUSION: These data suggest that COX-2 is one of the main factors related with the pathologic deficits from secondary SCI.
Animals ; Caspase 3 ; Cell Death ; Contusions* ; Cyclooxygenase 2 Inhibitors ; Cyclooxygenase 2* ; Dinoprostone ; Fluorescence ; Microglia ; Neurons ; Rats* ; Spinal Cord Injuries ; Spinal Cord*

OBJECTIVE: The aim of this study was to evaluate the temperament and character profiles of the patients with posttraumatic stress disorder(PTSD) after burn injury. METHODS: The study subjects consisted of 23 PTSD patients after burn injury, 24 patients not being diagnosed as PTSD after burn injury(non-PTSD) and 53 healthy controls. The assessment of PTSD was performed using clinician administered PTSD scale. All participants were instructed to complete the Temperament and Character Inventory(TCI), the Beck Depression Inventory and the State and Trait Anxiety Inventory of Spielberger. RESULTS: The PTSD group after burn injury, compared with the non-PTSD group and the normal controls, had the higher novelty seeking and harm avoidance scores. But there were no differences in other dimensions in the TCI among the three groups. CONCLUSION: The results of this study suggest that the PTSD group after burn injury showed the specific properties of temperament and character compared with the non-PTSD group and the normal group.
Anxiety ; Burns* ; Depression ; Humans ; Stress Disorders, Post-Traumatic* ; Temperament*

BACKGROUND: The QuantiFERON-TB Gold assay and tuberculin skin test (TST) have been useful test for diagnosing latent tuberculosis infections (LTBI). However, there are few reports on the efficacy of the QuantiFERON-TB Gold assay and TST in evaluating the response after the treatment of LTBI. This study examined the changes in the TST and QuantiFERON-TB Gold assay before and after a treatment for latent tuberculosis in health care workers (HCWs) at a local tertiary hospital. METHODS: A cohort of volunteers working as nurses and doctors who underwent a TST and QuantiFERON-TB Gold assay was established. The volunteers positive for the QuantiFERON-TB Gold assay had been treated with 3 months of isoniazid (INH) and rifampin (RFP). After completing treatment, the TST and QuantiFERON-TB Gold assay were repeated. RESULTS: Of the 48 participants (14 doctors, 34 nurses, M: F=11:37, mean age=29.9+/-5.5 years, mean employment period=74.9+/-64.3 months), 19 (39.6%) tested positive to the TST (mean induration=19.1+/-9.7 mm) and 8 (16.7%) were QuantiFERON-TB Gold assay. Among them, one had active pulmonary tuberculosis. Seven volunteers were consistently positive to both the TST and QuantiFERON-TB Gold assay after being medicated with INH and RFP for 3 months. CONCLUSION: TST and QuantiFERON-TB Gold assay are unsuitable for evaluating the treatment response of LTBI because they were consistently positive both before and after the anti-tuberculosis medication.
Cohort Studies ; Delivery of Health Care* ; Employment ; Isoniazid ; Latent Tuberculosis* ; Rifampin ; Skin Tests* ; Skin* ; Tertiary Care Centers* ; Tuberculin* ; Tuberculosis, Pulmonary ; Volunteers

Recently, increasing evidence suggests that neuroinflammation may be a critical factor in the development of Parkinson’s disease (PD) in addition to the ratio of acetylcholine/dopamine because dopaminergic neurons are particularly vulnerable to inflammatory attack. In this study, we investigated whether botulinum neurotoxin A (BoNT-A) was effective for the treatment of PD through its anti-neuroinflammatory effects and the modulation of acetylcholine and dopamine release. We found that BoNT-A ameliorated MPTP and 6-OHDA-induced PD progression, reduced acetylcholine release, levels of IL-1β, IL-6 and TNF-α as well as GFAP expression, but enhanced dopamine release and tyrosine hydroxylase expression. These results indicated that BoNT-A had beneficial effects on MPTP or 6-OHDA-induced PD-like behavior impairments via its anti-neuroinflammation properties, recovering dopamine, and reducing acetylcholine release.

Objective: Network analysis can be used in terms of a novel psychopathological approach for depressive syndrome. We aimed to estimate the successive network structures of depressive symptoms in patients with depressive disorder using data from the Clinical Research Center for Depression study. Methods: We enrolled 1,152 South Korean adult patients with depressive disorders who were beginning treatment for first-onset or recurrent depressive episodes. We examined the network structure of the severities of the items on the Hamilton Depression Rating Scale (HAMD) at baseline and at weeks 2, 12, 25, and 52. The node strength centrality of all the HAMD items at baseline and at week 2, 12, 25, and 52 in terms of network analysis. Results: In the severity networks, the anxiety (psychic) item was the most centrally situated in the initial period (baseline and week 2), while loss of weight was the most centrally situated item in the later period (weeks 25 and 52). In addition, the number of strong edges (i.e., edges representing strong correlations) increased in the late period compared to the initial period. Conclusion Our findings support a period-specific and symptom-focused therapeutic approach that can provide complementary information to the unidimensional total HAMD score.

Background: The Korean Society of Thoracic Radiology (KSTR) recently constructed a nation-wide coronavirus disease 2019 (COVID-19) database and imaging repository, referred to the Korean imaging cohort of COVID-19 (KICC-19) based on the collaborative efforts of its members. The purpose of this study was to provide a summary of the clinico-epidemiological data and imaging data of the KICC-19. Methods: The KSTR members at 17 COVID-19 referral centers retrospectively collected imaging data and clinical information of consecutive patients with reverse transcription polymerase chain reaction-proven COVID-19 in respiratory specimens from February 2020 through May 2020 who underwent diagnostic chest computed tomography (CT) or radiograph in each participating hospital. Results: The cohort consisted of 239 men and 283 women (mean age, 52.3 years; age range, 11–97 years). Of the 522 subjects, 201 (38.5%) had an underlying disease. The most common symptoms were fever (n = 292) and cough (n = 245). The 151 patients (28.9%) had lymphocytopenia, 86 had (16.5%) thrombocytopenia, and 227 patients (43.5%) had an elevated CRP at admission. The 121 (23.4%) needed nasal oxygen therapy or mechanical ventilation (n = 38; 7.3%), and 49 patients (9.4%) were admitted to an intensive care unit.Although most patients had cured, 21 patients (4.0%) died. The 465 (89.1%) subjects underwent a low to standard-dose chest CT scan at least once during hospitalization, resulting in a total of 658 CT scans. The 497 subjects (95.2%) underwent chest radiography at least once during hospitalization, which resulted in a total of 1,475 chest radiographs. Conclusion The KICC-19 was successfully established and comprised of 658 CT scans and 1,475 chest radiographs of 522 hospitalized Korean COVID-19 patients. The KICC-19 will provide a more comprehensive understanding of the clinical, epidemiological, and radiologic characteristics of patients with COVID-19.