No effective therapy has yet developed for liver fibrosis/cirrhosis by directly inhibiting the accumulation of extracellular matrix. This study was undertaken to determine the effect of tetrandrine in rat model of liver fibrosis induced by carborn tetrachloride (CCl4) administration intraorally. Tetrandrine, a calcium channel blocker, is anti-inflammatory constituent of the families Menispermaceae and Ranunculaceae, which have been used as folk remedies in China. Repeated administration of CCl4 for 14 weeks to rats induced liver fibrosis with steatosis. Rats were killed after 4, 8 or 14 weeks of treatment with CCl4, CCl4 tetrandrine (30 mg/kg) or CCl4 tetrandrine (50 mg/kg). The histopathological findings of liver were observed semi-quantitatively by light microscopy and volume percentage of the collagen deposition was determined by image analyzer. Tetrandrine inhibited collagen deposition induced by CCl4 administration, as shown by less severe steatosis and fibrosis and significantly decreased volume percentage of collagen fibers in CCl4 tetrandrine treated animals compared with CCl4 only group. Thus, the administration of tetrandrine holds great promise for treating subjects with liver fibrosis/cirrhosis as a result of chronic hepatic injury.
Animals ; Calcium Channels ; Carbon Tetrachloride ; China ; Collagen ; Extracellular Matrix* ; Fibrosis* ; Humans ; Liver ; Liver Cirrhosis ; Medicine, Traditional ; Menispermaceae ; Microscopy ; Models, Animal ; Ranunculaceae ; Rats*

No abstract available.
Erythroblastosis, Fetal* ; Infant, Newborn

OBJECTIVES: The purpose of this study was to examine the prenatal, perinatal and developmental risk factors of attention-deficit hyperactivity disorder (ADHD), compared to unaffected siblings (SIB), and typically developing children (TC). METHODS: Subjects with ADHD, their SIB, and TC were recruited from the child psychiatry outpatient clinic of the Asan Medical Center Children's Hospital. The parents of the children completed questionnaires on perinatal and developmental risk factors. RESULTS: Fifty-eight subjects with ADHD (41 boys, 7.7+/-1.3 years), 21 SIB (8 boys, 8.2+/-1.8 years), and 22 TC (8 boys, 8.5+/-2.1 years) were included. The ADHD group showed higher rates of maternal stress during pregnancy than the SIB group (p=.002), and the ADHD group showed higher rates of familial psychiatric history than the TC (odds ratio, 8.76 ; 95% confidence interval, 1.69 to 45.45). CONCLUSION: These findings suggest that among perinatal and developmental factors, maternal stress during pregnancy contribute to the development of ADHD. Future prospective studies will be needed in order to determine the causal relationship between perinatal risk factors and development of ADHD.
Ambulatory Care Facilities ; Child ; Child Psychiatry ; Chungcheongnam-do ; Humans ; Parents ; Pregnancy ; Risk Factors* ; Siblings ; Surveys and Questionnaires

The gastrointestinal lymphoma is a well known entity for bleeding or perforation during treatment, but spontaneous perforation is not common. We report the CT findings of an unusual case of small bowel lymphoma which presented with massive pneumoperitoneum following spontaneous perforation.
Hemorrhage ; Intestinal Neoplasms ; Lymphoma* ; Pneumoperitoneum*

Purpose: To determine associations of illness symptoms, perception of illness, coping with quality of life (QOL) of thyroid cancer patients and identify factors affecting their QOL. Methods: A cross-sectional study was performed using a self-administered questionnaire for 111 thyroid cancer patients after thyroidectomy. They were recruited from the outpatient clinic of one university hospital.Data collection was conducted from August 2018 to November 2018. Results: The QOL was significantly associated with interpersonal coping (β= 0.31, p< .001), monthly household income (β= 0.30, p< .001), illness symptoms (β= -0.22, p= .017), perception of illness (β= -0.20, p= .031), and education (β= 0.18, p= .037) in stepwise multiple regression. These factors explained 33.1% of QOL of thyroid cancer patients. Conclusion Interpersonal coping is a major contributing factor to QOL. Therefore, thyroid cancer patients need good interpersonal coping for better quality of life.

Here, we report a case of electrical injury-induced reversible advanced second-degree atrioventricular (AV) block. A 28-year-old male visited the emergency department for palpitations 3 days after receiving an electrical injury from 220 volt alternating current. The initial electrocardiogram (ECG) showed sinus rhythm and first-degree AV block with a prolonged PR interval of 400 ms. There was no structural heart disease or electrolyte imbalance. Follow up ECGs acquired 4-6 days after the electrical injury showed intermittent AV block with a prolonged PR interval of 400-460 ms. Exercise treadmill and atropine provocation tests performed 6 days after electrical injury induced advanced second-degree AV block. His bundle electrogram showed intermittent AH block in a Wenckebach pattern with a prolonged AH interval of 220-360 ms and a normal HV interval. Episodes of AV block decreased remarkably 4 weeks after the electrical injury, and the prolonged PR interval returned to 220 ms after 5 months.
Adult ; Atrioventricular Block* ; Atropine ; Electricity ; Electrocardiography ; Electrophysiologic Techniques, Cardiac ; Emergency Service, Hospital ; Follow-Up Studies ; Heart Diseases ; Humans ; Male

Rheumatoid arthritis (RA) is a multifactorial autoimmune disease whose etiopathogenesis is not well understood. Although soluble (s) forms of 4-1BB (s4-1BB) and 4-1BB legand (s4-1BBL) have been detected in the sera of RA patients, their significance is not known. We compared the serum levels of s4-1BB and s4-1BBL in RA patients with those in systemic lupus erythematosus (SLE) and Behcet's disease (BD) patients. Serum levels of s4-1BB and s4-1BBL were significantly higher in RA patients compared with healthy controls, SLE or BD patients, and the abundance was correlated with disease severity in patients with RA. The serum levels of s4-1BB in RA patients were inversely corroborated with 4-1BB expression levels on activated T lymphocytes. In addition, there was a correlation between serum levels of s4-1BB and s4-1BBL. The augmented secretion of s4-1BB and s4-1BBL levels into the serum may reflect the clinical symptoms of RA and levels of s4-1BB and s4-1BBL in sera at the time of diagnosis may be indicative of the severity and outcome of RA.
Adult ; Aged ; Antigens, CD/metabolism ; Arthritis, Rheumatoid/*blood/drug therapy/immunology/*pathology ; Behcet Syndrome/blood/immunology ; Comparative Study ; Female ; Humans ; Immunosuppressive Agents/metabolism/therapeutic use ; Leukocytes, Mononuclear/metabolism ; Lupus Erythematosus, Systemic/blood/immunology ; Male ; Middle Aged ; Random Allocation ; Receptors, Nerve Growth Factor/*blood ; Receptors, Tumor Necrosis Factor/*blood ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S. ; Severity of Illness Index ; Statistics ; Tumor Necrosis Factor-alpha/*metabolism

PURPOSE: Emergency Department (ED) overcrowding is a national problem and the quantitative measure of ED overcrowding is required. National Emergency Department Overcrowding Scale (NEDOCS) was designed for objective evaluation and quantification of ED overcrowding based on the standard of emergency providers' opinion. NEDOCS is a simple screening tool that can be used to determine the degree of ED overcrowding easily. The purpose of this study was to analyze the overcrowding in a local emergency department using NEDOCS. METHODS: This was a prospective study that medical record obtained from ED census and Order Communicating System (OCS). Three study periods were 1st study-period (from 14 March 2005 to 3 April 2005), 2nd study-period (from 27 October 2005 to 16 November 2005) and 3rd study-period (from 1 March 2006 to 21 March 2006). Sixparameters, the admission time (Admit time), the patient index (Patindex), the bed ratio (BR), the provider ratio (PR), the acuity ratio (AR), and the demand value (DV), were used to estimate overcrowding. The comparison between weekday and weekend overcrowding was assessed by using t-test. Also, the same statistical method was used to analyze differences between the 1st study-period and the 3rd study-period. The relationship between NEDOCS and six-parameters was tested by using Pearson's correlation analysis and multiple linear regression analysis. RESULTS: The total number of patients was 4,280. Of these, 2,403 (56.1%) were male and 1,877 female (43.9%). This study showed that ED overcrowding in weekend increased significantly. However, there was no significant change of ED overcrowding during 1 year (between the 1st study-period and the 3rd study-period). NEDOCS has a positive correlation with the Patindex (r=0.856, p=0.000), the BR (r=0.734, p=0.000), the PR (r=0.610, p=0.000), and the DV (r=0.559, p=0.000). Multiple linear regression analysis showed that Patindex was the only independent factor of NEDOCS (beta=0.854, p=0.000, adjusted R2=0.724). CONCLUSION: In conclusion, the NEDOCS was well correlated with overcrowding parameters and the only independent factor of NEDOCS was Patindex.
Censuses ; Crowding ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Linear Models ; Male ; Mass Screening ; Medical Records ; Prospective Studies ; Weights and Measures

Retroperitoneal fibrosis (RPF), although rare, can lead to significant intestinal obstruction. A case of RPF resulting in obstruction of the rectosigmoid colon is presented. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) revealed a characteristic fibrotic mass impinging on the rectosigmoid colon.
Colon ; Intestinal Obstruction ; Magnetic Resonance Imaging ; Retroperitoneal Fibrosis*

A new hypolipidemic agent, lovastatin, hydroxy-methyl-gultaryl coenzyme A reductase inhibitor was administred to 25 patients with primary hyperlipidemia 20 to 40 mg daily for 12 weeks and sequential changes of serum lipid profile were analysed as follow. 1) Mean average at baseline period of serum total cholesterol, triglyceride, HDL and low desity lipoprotein cholesterol were 271, 179, 51 and 185 mg/dl respectively. 2) Total cholesterol showed 20% decrease at 4th week and 23% decrease at the end of 12th week while low density lipoprotein cholesterol decreased 31% and 33% respectively. 3) Triglyceride dropped 7% at 8th week and 3% at 12th week. High density lipoprotein cholesterol increased 4% at 4th week and showed 2% decrease at the end of study. 4) Only one patient complained of moderate abdominal pain, which subsided after 2 weeks drug withdrawal. In conclusion, lovastatin was well tolerated and effective, in the treatment of primary hyperlipidemia.
Abdominal Pain ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Coenzyme A ; Humans ; Hyperlipidemias* ; Lipoproteins ; Lovastatin ; Oxidoreductases ; Triglycerides