Background: We aimed to investigate the annual incidence of trauma and stress-related mental disorder including acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) using the National Health Insurance Service Database. In addition, we estimated direct medical cost of ASD and PTSD in Korea. Methods: To examine the incidence, we selected patients who had at least one medical claim containing a 10th revision of the International Statistical Classification of Diseases and Related Health Problems code for ASD (F43.0) and PTSD (F43.1) and had not been diagnosed in the previous 360 days, from 2010 to 2017. We estimated annual incidence and the number of newly diagnosed patients of ASD and PTSD. Annual prevalence and direct medical cost of ASD and PTSD were also estimated. Results: The number of newly diagnosed cases of ASD and PTSD from 2011 to 2017 totaled 38,298 and 21,402, respectively. The mean annual incidence of ASD ranged from 8.4 to 13.7 per 100,000 population and that of PTSD ranged from 4.2 to 8.3 per 100,000 population, respectively. The incidence of ASD was found more in females and was highest among the 70–79 years of age group and the self-employed individuals group. The incidence of PTSD was also more common in the female group. However, the incidence of PTSD was highest in the 60–69 years of age group and in the medical aid beneficiaries group. The annual estimated medical cost per person of ASD ranged from 104 to 149 US dollars (USD). In addition, that of PTSD ranged from 310 to 426 USD. Conclusion From 2011 to 2017, the annual incidence and direct medical cost of ASD and PTSD in Korea were increased. Proper information on ASD and PTSD will not only allows us to accumulate more knowledge about these disorders themselves but also lead to more appropriate therapeutic interventions by improving the ability to cope with these trauma related psychiatric sequelae.

Background: We aimed to investigate the annual incidence of trauma and stress-related mental disorder including acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) using the National Health Insurance Service Database. In addition, we estimated direct medical cost of ASD and PTSD in Korea. Methods: To examine the incidence, we selected patients who had at least one medical claim containing a 10th revision of the International Statistical Classification of Diseases and Related Health Problems code for ASD (F43.0) and PTSD (F43.1) and had not been diagnosed in the previous 360 days, from 2010 to 2017. We estimated annual incidence and the number of newly diagnosed patients of ASD and PTSD. Annual prevalence and direct medical cost of ASD and PTSD were also estimated. Results: The number of newly diagnosed cases of ASD and PTSD from 2011 to 2017 totaled 38,298 and 21,402, respectively. The mean annual incidence of ASD ranged from 8.4 to 13.7 per 100,000 population and that of PTSD ranged from 4.2 to 8.3 per 100,000 population, respectively. The incidence of ASD was found more in females and was highest among the 70–79 years of age group and the self-employed individuals group. The incidence of PTSD was also more common in the female group. However, the incidence of PTSD was highest in the 60–69 years of age group and in the medical aid beneficiaries group. The annual estimated medical cost per person of ASD ranged from 104 to 149 US dollars (USD). In addition, that of PTSD ranged from 310 to 426 USD. Conclusion From 2011 to 2017, the annual incidence and direct medical cost of ASD and PTSD in Korea were increased. Proper information on ASD and PTSD will not only allows us to accumulate more knowledge about these disorders themselves but also lead to more appropriate therapeutic interventions by improving the ability to cope with these trauma related psychiatric sequelae.

OBJECTIVE: The present study aimed to determine the intracellular action of the antidepressant, venlafaxine, in C6 glioma cells using heat shock protein 70 (HSP70) immunocytochemistry and HSP70 Western blots; HSP70 is known to be associated with stress and depression. METHODS: The extent of HSP70 expression was measured after rat C6 glioma cells were treated with 1) dexamethasone only, 2) venlafaxine only, 3) simultaneous venlafaxine and dexamethasone, or 4) dexamethasone after venlafaxine pretreatment. Dexamethasone (10 microM, 6 hours) did not affect the level of HSP70 expression relative to control. RESULTS: Short-term (1 hour) venlafaxine treatment significantly increased the level of HSP 70 expression. Simultaneous long-term (72 hours) venlafaxine and dexamethasone treatment significantly reduced the level of HSP70 expression. Dexamethasone treatment administered following long-term (24 and 72 hours) pretreatment with venlafaxine also significantly reduced the level of HSP70 expression. CONCLUSION: Short-term treatment with venlafaxine increases the expression of HSP70, but prolonged treatment with dexamethasone suppresses the venlafaxine-induced expression of HSP70. These findings suggest that HSP70 and dexamethasone play a significant role in the pathophysiology of depression.
Animals ; Cyclohexanols ; Depression ; Dexamethasone ; Glioma ; Heat-Shock Proteins ; HSP70 Heat-Shock Proteins ; Immunohistochemistry ; Rats ; Venlafaxine Hydrochloride

In the preoperative evaluation before coronary artery bypass surgery, review of the coronary arteriogram is the most important step. Expected "normal" lumen diameter at a given coronary anatomic location is a basis for quantative estimation of coronary disease severity that could be more useful than the traditional "percent stenosis". The distribution and number of major coronary artery branches are determinants of number of bypass grafts needed. We reviewed the coronary artery anatomy in 174 adult patients who revealed no coronary pathology in angiographic studies done from September 1994 to June 1996. Quantative analysis was done in all cases by a single person using a Computerized System (Arripro 35(r)). The results were follows; 1) The mean diametre of left main coronary artery was 4.45 mm (range 2.74~6.72). The pattern of branching was bifurcation in 67.24%, trifurcation in 28.74% and quadrifurcation in 4.02% of the patients. 2) The mean diametre of left anterior descending artery was 3.17 mm (range 2.10~5.85), 2.79 (range 1.55~5.59) and 2.17 mm (range 1.37~3.81) in the proximal, mid, and the distal portions, respectively. The number of diagonal branches of left anterior artery was from one to four (mode=2). 3) The mean diametre of proximal and distal left circumflex artery were 3.17mm (range 1.74~4.89) and 2.19 mm (range 1.21~4.46). The number of obtuse marginal branches of left circumflex artery is from one to six (mode 2). 4) The mean diametre of proximal and distal right coronary artery, the posterior descending artery and the largest posterolateral branch were mean 3.51 mm (range 2.07~5.67), 2.09 mm (range 1.42~3.60), 2.09 mm (range 1.02~3.60) and 2.30 mm (range 1.39~4.39). 5) The right coronary artery dominant was 163 cases (93.68%) of the total 174 cases. 6) The large significant acute marginal artery was visualized in more than half of the people.
Adult ; Arteries ; Computer Systems ; Coronary Artery Bypass ; Coronary Disease ; Coronary Vessels ; Humans ; Pathology* ; Single Person ; Transplants

Diabetes, which has shown an explosive increase in terms of its incidence, is regarded as a serious disease that must be overcome for the sake of human life. Among animal models used for testing of drug efficacy, the mini-pig model has shown a rapid upload due to its many similarities with human, particularly concerning the pharmacokinetics of compounds after subcutaneous administration, the structure and function of the gastrointestinal tract, the morphology of the pancreas, and overall metabolic status. Based on these various advantages, we sought to develop an animal model of type II diabetic mellitus using the Micro-pig, which differs from other miniature pigs. We used six male Micro-pigs for induction of a moderate insulin deficient model with nicotinamide (NIA)/streptozotocin (STZ) treatment and three animals for control. For evaluation of incidence of type II diabetes, we measured blood glucose level, and performed oral glucose tolerance test and immunohistochemistry on pancreatic tissue using insulin antibody. Compared to control animals, all animals treated with NIA/STZ showed high levels of glucose and low levels of insulin. In addition, we observed the partially destroyed beta cell population from tissue of the pancreas in treated animals. Based on these results, we report that the Micro-pig model developed in this study can be used for testing of the efficacy of therapeutic agents for treatment of Type 2 diabetic mellitus.
Animals ; Blood Glucose ; Gastrointestinal Tract ; Glucose ; Glucose Tolerance Test ; Humans ; Immunohistochemistry ; Incidence ; Insulin ; Male ; Models, Animal ; Niacinamide ; Pancreas ; Swine

OBJECTIVE: The aim of this study was to examine the effect of dexamethasone and fluoxetine on the expression of 70 kDa heat shock protein (HSP70) in C6 glioma cells. METHODS: The C6 glioma cells belong to control group were incubated with DMEM culture solution, the cells belong to dexamethasone group were incubated with dexamethasone for 6 hours, and the cells belong to fluoxetine group were incubated with fluoxetine for 1, 6, 24, and 72 hours, separately, and then exposed to dexamethasone for an additional 6 hours. Crude extracts from control, dexamethasone and fluoxetine-treated C6 glioma cells were separated on a 10% SDS-PAGE and probed with anti-HSP70 mAb. RESULTS: 1) Dexamethasone (10 uM, 6 hours) reduced the level of HSP70 expression relative to control, but this reduction was not statistically significant. 2) Pretreatment with fluoxetine (10 uM, 1, 6, 24, and 72 hours) and exposure to dexamethasone (10 uM, 6 hours) decreased the level of HSP70 expression according to the duration of fluoxetine treatment. 3) Fluoxetine significantly reduced the level of HSP70 at 24 and 72 hours compared to control. However, compare to the level of HSP70 expression at 24 hours, the level of HSP70 expression at 72 hours was elevated. CONCLUSION: These findings suggest that dexamethasone and fluoxetine may affect HSP70 expression through effects on GR.
Animals ; Complex Mixtures ; Dexamethasone ; Electrophoresis, Polyacrylamide Gel ; Fluoxetine* ; Glioma* ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Rats*

OBJECTIVE: The aim of this study was to examine the effect of dexamethasone and fluoxetine on the expression of 70 kDa heat shock protein (HSP70) in C6 glioma cells. METHODS: The C6 glioma cells belong to control group were incubated with DMEM culture solution, the cells belong to dexamethasone group were incubated with dexamethasone for 6 hours, and the cells belong to fluoxetine group were incubated with fluoxetine for 1, 6, 24, and 72 hours, separately, and then exposed to dexamethasone for an additional 6 hours. Crude extracts from control, dexamethasone and fluoxetine-treated C6 glioma cells were separated on a 10% SDS-PAGE and probed with anti-HSP70 mAb. RESULTS: 1) Dexamethasone (10 uM, 6 hours) reduced the level of HSP70 expression relative to control, but this reduction was not statistically significant. 2) Pretreatment with fluoxetine (10 uM, 1, 6, 24, and 72 hours) and exposure to dexamethasone (10 uM, 6 hours) decreased the level of HSP70 expression according to the duration of fluoxetine treatment. 3) Fluoxetine significantly reduced the level of HSP70 at 24 and 72 hours compared to control. However, compare to the level of HSP70 expression at 24 hours, the level of HSP70 expression at 72 hours was elevated. CONCLUSION: These findings suggest that dexamethasone and fluoxetine may affect HSP70 expression through effects on GR.
Animals ; Complex Mixtures ; Dexamethasone ; Electrophoresis, Polyacrylamide Gel ; Fluoxetine* ; Glioma* ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Rats*

PURPOSE: This study aimed to compare the postoperative outcomes of open total gastrectomy (OTG) and laparoscopic-assisted total gastrectomy (LATG) and prove that postoperative outcomes of LATG can be improved through a surgeon's experience.METHODS: 62 patients who underwent OTG and 82 patients who underwent LATG were enrolled in this study. To objectively assess the postoperative outcomes, we decided to apply the Clavien-Dindo classification. This study was performed based on postoperative complications occurring within 30 days after total gastrectomy.RESULTS: There was no statistically significant difference between the two groups with regard to intraoperative transfusion (P>0.99), overall postoperative complications (P>0.99), and major postoperative complications (P=0.731). Leakage of esophagojejunostomy was the most common complication after LATG. There is no statistically significant difference in the number of overall postoperative complications between the early LATG and late LATG groups (P=0.349). However, there is significant difference in the number of major complications between the two groups (P=0.026).CONCLUSION: LATG is not inferior to OTG and improved by learning in terms of postoperative outcomes in this study.
Classification ; Gastrectomy ; Humans ; Laparoscopy ; Learning ; Postoperative Complications ; Stomach Neoplasms

PURPOSE: Double primary colorectal cancer (CRC) and gastric cancer (GC) represent the most common multiple primary malignant tumors (MPMT) in Korea. The recognition and screening of hidden malignancies other than the primary cancer are critical. This study aimed to investigate the clinicopathologic characteristics and survival rates in patients with synchronous or metachronous double primary CRC and GC.METHODS: Between January 1994 and May 2018, 11,050 patients were diagnosed with CRC (n=5,454) or GC (n=5,596) at Gil Medical Center. MPMT and metastatic malignant tumors were excluded from this study. A total of 103 patients with double primary CRC and GC were divided into two groups: the synchronous group (n=40) and the metachronous group (n=63). The incidence, clinicopathologic characteristics, and survival rate of the two groups were analyzed.RESULTS: The incidence of synchronous and metachronous double primary CRC and GC was 0.93%. Double primary CRC and GC commonly occurred in male patients aged over 60 years with low comorbidities and minimal previous cancer history. There were significant differences between the synchronous and metachronous groups in terms of age, morbidity, and overall survival. Metachronous group patients were 6 years younger on average (P=0.009), had low comorbidities (P=0.008), and showed a higher 5-year overall survival rate (94.8% and 61.3%, P < 0.001) in contrast to synchronous group.CONCLUSION: When primary cancer (CRC or GC) is detected, it is important to be aware of the possibility of the second primary cancer (GC or CRC) development at that time or during follow-up to achieve early detection and better prognosis.
Colorectal Neoplasms ; Comorbidity ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Male ; Mass Screening ; Neoplasms, Multiple Primary ; Neoplasms, Second Primary ; Prognosis ; Stomach Neoplasms ; Survival Rate

Dopa-responsive dystonia (DRD) is characterized by lower limb-onset, diurnally fluctuating dystonia and dramatic and sustained response to levodopa treatment. Segawa disease, an autosomal dominant deficiency of guanosine triphosphate cyclohydrolase 1 (encoded by GCH1) is the most common and well-known condition manifesting as DRD. However, similar clinical manifestations can be seen in individuals with deficiencies of other enzymes that are involved in the biosynthesis of dopamine. We describe the case of an 11-year-old girl who presented with abnormal gait, which had initially begun 2 years back. The patient showed diurnally fluctuating dystonia in both legs. She was able to walk without support in the morning, but was unable to stand without support in the evening. She had been diagnosed as having spastic cerebral palsy and had been managed with physical therapy at a local rehabilitation clinic. The patient had been healthy until the development of dystonia, and did not have a history of perinatal problems or developmental delay. Routine hematologic and biochemical test results were normal. Brain magnetic resonance imaging and electroencephalography showed no abnormalities. When levodopa was administered, the patient's abnormal gait dramatically improved 1 hour after receiving the medication. Genetic testing for the GCH1 gene revealed a missense mutation (c.293C>T [p.A98V]) that has previously been reported in patients with DRD. This case demonstrated that a levodopa trial is vital for accurate and early diagnosis of DRD in patients with dystonia resulting from an unknown cause.
Brain ; Cerebral Palsy* ; Child ; Diagnostic Errors ; Dopamine ; Dystonia* ; Early Diagnosis ; Electroencephalography ; Female ; Gait ; Genetic Testing ; Guanosine Triphosphate ; Humans ; Leg ; Levodopa ; Magnetic Resonance Imaging ; Mutation, Missense ; Rehabilitation