We report serial change of nerve conduction tests, somatosensory evoked potentials and brainstem auditory evoked pontenials in a case of puffer fish poisoning, who recovered completely from comatous state with respiratory and generalized muscle paralysis.
Brain Stem ; Evoked Potentials, Somatosensory ; Neural Conduction ; Paralysis ; Poisoning* ; Tetraodontiformes*

OBJECTIVES: The present study aims to investigate the effects of physical illness on depression in North Korean Defectors. METHODS: One hundred forty-four North Korean Defectors(20 males, 124 females) and 376 South Koreans 133 males, 243 females) in Incheon Metropolitan areas participated the present study. Face-to-face interview was conducted for demographic information including presence of physical illnesses. To investigate depressive symptoms, all participants were required to complete the Center for Epidemiologic Studies-Depression scale (CES-D). RESULTS: After controlling gender, age, marital status, educational year, employment status and physical illness, North Korean Defectors showed higher CES-D score than South Koreans(beta=0.449, p<0.001). Within North Korean Defectors, the presence of physical illnesses independently was related to higher CES-D score(beta=0.243, p<0.001). However, within South Koreans, the presence of physical illnesses did not significantly predict CES-D score. North Korean Defectors with physical illness have higher CES-D score than North Korean Defectors without physical illness(26.8+/-13.8 versus 19.7+/-12.7). However, there was no significant differences of CES-D score between South Koreans with physical illness and South Koreans without physical illness(10.3+/-9.8 versus 9.3+/-8.8). CONCLUSION: Compared to South Koreans, North Korean Defector showed higher depressive symptoms independently from gender, age, education, employment, marriage. In addition, only North Korean Defectors showed the relationship between depression and physical illness. Our study suggests that depression should be assessed when North Korean Defectors have physical illness.
Depression ; Employment ; Humans ; Male ; Marital Status ; Marriage

The pleomorphic adenoma is the most common neoplasm involving both the major and minor salivary glands. It is a benign, slowgrowing tumor, but local recurrences can occur. The pleomorphic adenoma gene 1 (PLAG1), which is a novel zinc finger gene, is frequently activated by reciprocal chromosomal translocations involving 8q12 in a subset of salivary gland pleomorphic adenomas. This experimental study was preformed to observe the translocation patterns between PLAG1 gene and the three translocation partner genes. We also have analyzed the presence of PLAG1 transcripts by RT-PCR. CTNNB1/PLAG1 gene fusion was observed in three of nine pleomorphic adnomas. However, LIFR/PLAG1 and SII/PLAG1 gene fusions were not detectable. All of three gene fusions was not detectable in one Warthin's tumor and three inflammatory salivary gland tissues. PLAG1 transcripts were expressed in all inflammatory salivary gland tissues and tumors except for three pleomorphic adenomas. Of particular one pleomorphic adenoma showing CTNNB1/P AG1 gene fusion did not express PLAG1 transcipt. Our data indicate that gene fusion involving PLAG1 is a frequent event in pleomorphic adenoma, but correlation between gene fusion involving PLAG1 and PLAG1 transcription is not definite.
Adenoma, Pleomorphic* ; Gene Fusion ; Recurrence ; Salivary Glands* ; Salivary Glands, Minor ; Translocation, Genetic ; Zinc Fingers

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

rcinoma (SCC) is the second most common skin cancer. In particular, invasive SCC has a high risk of metastasis and sometimes, this can be fatal. At present, the treatment of choice for invasive SCC is complete excision with a proper surgical margin, but most cases of SCC develop on cosmetically-sensitive areas, so sometimes significant scarring or deformities can lead to an unhappy result. An 80 year-old female presented with a 4x1.5cm sized SCC on her lower lip. Although surgery was the first line therapy for this invasive SCC, a cosmetically poor outcome was expected. Thus the patient did not want to undergo a surgical operation, so we had to explore other treatment options. Recently there have been many reports that show imiquimod 5% cream is effective in the treatment of invasive SCC. Therefore we started topical therapy with imiquimod 5% cream five times a week. After 6 months, the lesion size was reduced to 2x1.5cm and we could remove the remnant tumor by wedge resection with cosmetically acceptable result. We suggest this neo-adjuvant immunotherapy can be an alternative for the treatment of cosmetically-critical SCC and present this case as a good example that has shown successful size-reductive neoadjuvant immunotherapy using imiquimod in invasive SCC.
Aged, 80 and over ; Carcinoma, Squamous Cell* ; Cicatrix ; Congenital Abnormalities ; Female ; Humans ; Immunotherapy* ; Lip* ; Neoadjuvant Therapy ; Neoplasm Metastasis ; Skin Neoplasms

BACKGROUND: Hereditary spherocytosis(HS) is a clinically and biochemically very heterogeneous disorder The purpose of this study is to detect erythrocyte membrane protein abnormalities by SDS-PAGE and to investigate the frequency of erythrocyte membrane protein defects in hereditary spherocytosis and correlation between some of the hereditary spherocytosis biochemical subsets and the selected clinical phenotype. METHODS: We evaluated the clinical and laboratory characteristics of 14 normal healthy persons and 23 hereditary spherocytosis patients and 8 their family members. The patients were divided into three groups based on clinical and hematological severity(mild, typical, severe). In addition to routine hematologic determlnatlons, osmotic fragility and autohemolysis, RBC membrane protein analysis were performed in all patients by densitometric tracing of SDS-PAGE(sodium dodecyl sulphate polyacrylamide gel electrophoresis) stained by Coomassle blue utilizing both the discontinuous buffer system of Laemmli with acrylamide linear gradient from 4% to 12% and the continuous buffer system of Fairbank with exponential gradient of acrylamide from 3.5% to 17%. RESULTS: 1) The patients could be seperated into three classes of different clinical severity as mild(3 cases), moderate(16 cases) and severe(4 cases) on the clinical feature. 2) Eighteen patients(82.6%) among 23 hereditary spherocytosis revealed abnormal erythrocyte membrane protein and we detected six patients(26.1%) with spectrin deficiency combined with ankyrin reduction, 4 patients(17.4%) with ankyrin deficiency, 4 patients(17.4%) with isolated spectrin deficiency and 3 patients(13.0%) with band 3 deficiency. Five HS patients(21.7%) showed normal RBC membrane protein. 3) Eight HS and their family members showed same RBC membrane protein deficiency. 4) The type and degree of RBC membrane protein reduction were variale with spectrin at 66~94%, with ankyrin at 48~82% of normal levels. These showed that each patient had different clinical severities according to different RBC membrane protein levels and type. CONCLUSION: RBC membrane protein abnormalities were observed in 82.6% of HS patients. The combined spectrin and ankyrin deficiency is the most common molecular defect in HS. The clinical severity and biochemical expression is heterogeneous. SDS-PAGE analysis of RBC membrane protein was provided the diagnosis of RBC membrane defects and basic molecular studies. We believed that the early identification of the biochemical defect responsible for HS is important because it is helpful starling point for the identification of the primary molecular defect, and it could help to anticipate the clinical outcome of the disease. For these reasons, we consider the SDS-PAGE of the red cell membrane to be of crucial importance for a complete evaluation of children with HS. Further studies with more cases would be to clarify the correlation between clinical and biochemical phenotypes.
Acrylamide ; Ankyrins ; Cell Membrane ; Child ; Diagnosis ; Electrophoresis, Polyacrylamide Gel* ; Erythrocyte Membrane* ; Erythrocytes* ; Erythrocytes, Abnormal ; Humans ; Membrane Proteins ; Membranes ; Osmotic Fragility ; Phenotype ; Population Characteristics* ; Spectrin ; Starlings

The current Food and Drug Administration-approved systemic treatments for advanced hepatocellular carcinoma (HCC) include multikinase inhibitors (tyrosine kinase inhibitor [TKI]) and immune checkpoint inhibitors (ICIs). Among ICIs, nivolumab is used as secondline therapy for advanced HCC after sorafenib failure or patient intolerance. In this case, a patient with infiltrative HCC and portal vein tumor thrombosis was treated with hepatic arterial infusion chemotherapy (HAIC) and radiation therapy. New lung metastasis developed after HAICs; thus, lenvatinib treatment was initiated. However, the disease progressed. Thereafter, sorafenib treatment was initiated but he developed intolerance, with grade 3 sorafenib-related diarrhea. Subsequently, nivolumab was administered as rescue therapy. He demonstrated a partial response to nivolumab after the third treatment and viable HCCs in the lungs and liver completely disappeared after the 24th treatment. These findings suggest that nivolumab could be used as an effective rescue therapy for advanced HCC progression after TKI treatment.

The current Food and Drug Administration-approved systemic treatments for advanced hepatocellular carcinoma (HCC) include multikinase inhibitors (tyrosine kinase inhibitor [TKI]) and immune checkpoint inhibitors (ICIs). Among ICIs, nivolumab is used as secondline therapy for advanced HCC after sorafenib failure or patient intolerance. In this case, a patient with infiltrative HCC and portal vein tumor thrombosis was treated with hepatic arterial infusion chemotherapy (HAIC) and radiation therapy. New lung metastasis developed after HAICs; thus, lenvatinib treatment was initiated. However, the disease progressed. Thereafter, sorafenib treatment was initiated but he developed intolerance, with grade 3 sorafenib-related diarrhea. Subsequently, nivolumab was administered as rescue therapy. He demonstrated a partial response to nivolumab after the third treatment and viable HCCs in the lungs and liver completely disappeared after the 24th treatment. These findings suggest that nivolumab could be used as an effective rescue therapy for advanced HCC progression after TKI treatment.