Aphasia, result from damage of language-dominant area of the brain, usually accompanied hemiparesis due to proximity of language centers and motor control areas. So, global aphasia without hemiparesis is a rare stroke syndrome. We report a case of right handed man with language disturbance after stroke. He showed global aphasia without hemiparesis. We use diffusion tensor image tractography (DTT) for evaluation of global aphasia without hemiparesis. DTT demonstrated that preservation of the corticospinal tract. After speech therapy, he showed improvement of language profile on K-WAB.

Background: Interprofessional education (IPE) is important for collaboration between professionals in the team-based practices of the healthcare field. Objectives: This study aimed to examine pharmacy students across in Korea on the experience of IPE and the perceptions of the importance of interprofessional collaboration (IPC) and the need of IPE. Methods: A cross-sectional survey using a 20 questionnaire to pharmacy students nationwide was conducted from March to May 2019. Results: A total of 555 students from 32 pharmacy schools participated. They recognized that the importance of close pharmacist-medical doctor collaboration was an average of 5.38 points (out of 6 points), but the current level of pharmacist-to-medical doctor collaboration was an average of 2.51 points (out of 6 points), and the reasons for the insufficient IPC were the lack of an environment encouraging mutual cooperation (79.5%) and the psychological distance to the other professional (35.3%). They perceived the necessity of IPE between pharmacistmedical doctor was 4.95 points (out of 6 points), with the curriculum including how to cooperate with medical doctors (78.2%), communication skills (51.0%), and understanding of medical doctors’ functions (44.5%), etc. Only 52 respondents (9.4%) had experience in IPE. Respondents who recognized the importance of IPC (≥5 points) showed 4.44-fold higher agreement on the need for IPE than those who did not (≤4 points) (OR 4.44, 95% CI 2.56, 7.68). Conclusions Further attention and discussion to add IPE program in the pharmacy school curriculum is necessary in order to cultivate pharmacists with sufficient professional collaboration capabilities.

The purpose of this study is to compare the volume stability depending on the mixing methods and storage time for the conventional alginate and extended-pouralginate. Materials and methods: An arch-shaped metal model was fabricated, and one conventional alginate and two extended-pour alginates were used to take impressionsusing different mixing methods (hand and automatic). 120 impressions were taken (40 per each alginate) and stone models were made in accordance with the different storagetimes (immediate, 2 days, 5 days, and 6 days). The models were scanned with a 3D table scanner and dimensional change was measured by superimposing the scan data.Using SAS 9.4 (SAS Institute Inc., Cary, NC, USA), the general linear model and Tukey’s post hoc test was conducted for statistical analysis (P<.001). Results: There wasno statistically significant difference in the dimensional accuracy between two mixing methods, and the volume change was minimum when the stone was poured immediatelyin all groups. Dimensional accuracy showed a statistically significant difference between groups after 2 days of storage, and extended-pour alginate showed higher accuracyafter 5 days of storage comparing to conventional one. Large amounts of volume change were showed at 2 - 5 days for conventional alginate and at 5 - 6 days forextended pour alginate. Conclusion: The mixing method of alginate does not affect volume stability. Although extended-pour alginate has better volume stability than conventionalalginate for a long time, it is recommended to pour stone as soon as possible. (J Korean Acad Prosthodont 2020;58:86-94)

Acute changes of the bilateral basal ganglia shown in the brain MRI a diabetic uremic patient have been rarely reported. We report a 52-year-old diabetic uremic patient who had neurological disturbances. At admission, axial diffusion-weighted images and T2-weighted images showed high signal intensities in the bilateral basal ganglia, and axial T1-weighted images visualized low signal intensities in same area. The underlying mechanism may be associated with metabolic as well as vascular factors.
Basal Ganglia* ; Brain ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Uremia

BACKGROUND: Spa therapy is widely used in many countries for the treatment of atopic dermatitis. There have been some reports about the therapeutic efficacies and mechanisms of spa therapy for the treatment of atopic dermatitis (AD) from other countries, but there have been no such reports from Korea. OBJECTIVE: The purpose of this study was to investigate the therapeutic efficacy and the safety of Hae-Un-Dae spa therapy for adult AD patients. METHODS: A total of 15 patients with AD were recruited in this study. The patients were classified into the mild group (n=5) and severe group (n=10) according to their eczema area and severity index (EASI) score at baseline. They had a bath in a Hae-Un-Dae spa three times per week for 4 weeks. To evaluate the therapeutic efficacy, the EASI score, the physician's global assessment (PGA) and the visual analogue scale (VAS) for pruritus were assessed every week. The skin hydration, the skin pH and the transepidermal water loss (TEWL) were also measured weekly to investigate the changes of the skin barrier function during the spa therapy. RESULTS: Compared to baseline, the EASI scores of the total group and the severe group decreased at 2, 3 and 4 weeks. Furthermore, the VAS for pruritus of the total group and the severe group was also decreased. Among the factors of the skin barrier function, the skin pH decreased in the mild group and it increased in the severe group during the spa therapy. Of the 15 patients, one patient experienced exacerbation of symptoms and two patients reported a transient pickling sensation during the spa therapy. CONCLUSION: Our study suggests that Hae-Un-Dae spa therapy could be an effective and safe modality for the management of adult AD, yet more studies should be performed to determine the therapeutic mechanism.
Adult ; Baths ; Dermatitis, Atopic ; Eczema ; Humans ; Hydrogen-Ion Concentration ; Pruritus ; Sensation ; Skin

OBJECTIVES: Vitamin D is regarded as one of the major nutrients that significantly influence bone metabolism. This study aims to look at the effect of supplementary vitamin D on bone mineral density (BMD) in female osteoporosis patients. METHODS: The retrospective hospital record review was performed on 282 patients who were diagnosed with osteoporosis and treated with selective estrogen receptor modulators (SERMs) between January 2015 and December 2016. Of these patients, 151 were treated with SERMs only while 131 were treated using both SERMs and vitamin D supplements. The BMD and any occurrence of osteoporotic fracture episode were investigated after one year. The result of two groups was compared to find the significance of vitamin D. RESULTS: Overall, improvement in BMD score was observed in 76% of the patients. The BMD of the SERMs only group improved by 3% in spine and 1% in the hip while that of the SERMs with vitamin D group improved by 6% and 1% respectively. Statistical significance was noticed in the spine only. One distal radius fracture and one single level vertebral fracture occurred in patients of SERMs group while two distal radius fractures occurred in SERMs with vitamin D group. There was no occurrence of around hip fracture in both groups. CONCLUSION: The result of the current study suggests that additional vitamin D may have some additive effect on improving BMD of the spine. Further study with the larger study population and the extended study period is recommended.
Bone Density ; Female ; Hip ; Hospital Records ; Humans ; Metabolism ; Osteoporosis ; Osteoporotic Fractures ; Radius Fractures ; Retrospective Studies ; Selective Estrogen Receptor Modulators ; Spine ; Vitamin D ; Vitamins

Bioassay-guided fractionation of the roots of Asarum sieboldii led to the isolation of the six compounds methylkakuol (1), sesamin (2), asarinin (3), xanthoxylol (4), and (2E,4E,8Z,10E/Z)-N-(2-methylpropyl) dodeca-2,4,8,10-tetraenamide (5/6). Among the isolates, xanthoxylol (4) exhibited significant cytotoxicity against human breast cancer cells MCF-7 and MDA-MB-231 in vitro with IC₅₀ values of 9.15 and 13.95 µM, respectively.
Asarum ; Breast Neoplasms ; Breast ; Humans ; In Vitro Techniques

Background: /Aim: Despite the increasing proportion of elderly patients with hepatocellular carcinoma (HCC) over time, treatment efficacy in this population is not well established. Methods: Data collected from the Korean Primary Liver Cancer Registry, a representative cohort of patients newly diagnosed with HCC in Korea between 2008 and 2017, were analyzed. Overall survival (OS) according to tumor stage and treatment modality was compared between elderly and non-elderly patients with HCC. Results: Among 15,186 study patients, 5,829 (38.4%) were elderly. A larger proportion of elderly patients did not receive any treatment for HCC than non-elderly patients (25.2% vs. 16.7%). However, OS was significantly better in elderly patients who received treatment compared to those who did not (median, 38.6 vs. 22.3 months; P<0.001). In early-stage HCC, surgery yielded significantly lower OS in elderly patients compared to non-elderly patients (median, 97.4 vs. 138.0 months; P<0.001), however, local ablation (median, 82.2 vs. 105.5 months) and transarterial therapy (median, 42.6 vs. 56.9 months) each provided comparable OS between the two groups after inverse probability of treatment weighting (IPTW) analysis (all P>0.05). After IPTW, in intermediate-stage HCC, surgery (median, 66.0 vs. 90.3 months) and transarterial therapy (median, 36.5 vs. 37.2 months), and in advanced-stage HCC, transarterial (median, 25.3 vs. 26.3 months) and systemic therapy (median, 25.3 vs. 26.3 months) yielded comparable OS between the elderly and non-elderly HCC patients (all P>0.05). Conclusions Personalized treatments tailored to individual patients can improve the prognosis of elderly patients with HCC to a level comparable to that of non-elderly patients.

Patients with non-small-cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) amplification or sensitive muta-tions initially respond to the tyrosine kinase inhibitor gefitinib, however, the treatment becomes less effective over time by resis-tance mechanism including mesenchymal-epithelial transition (MET) overexpression. A therapeutic strategy targeting MET and EGFR may be a means to overcoming resistance to gefitinib. In the present study, we found that picropodophyllotoxin (PPT), derived from the roots of Podophyllum hexandrum, inhibited both EGFR and MET in NSCLC cells. The antitumor efficacy of PPT in gefitinib-resistant NSCLC cells (HCC827GR), was confirmed by suppression of cell proliferation and anchorage-independent colony growth. In the targeting of EGFR and MET, PPT bound with EGFR and MET, ex vivo, and blocked both kinases activity. The binding sites between PPT and EGFR or MET in the computational docking model were predicted at Gly772/Met769 and Arg1086/Tyr1230 of each ATP-binding pocket, respectively. PPT treatment of HCC827GR cells increased the number of annexin V-positive and subG1 cells. PPT also caused G2/M cell-cycle arrest together with related protein regulation. The inhibition of EGFR and MET by PPT treatment led to decreases in the phosphorylation of the downstream-proteins, AKT and ERK. In addition, PPT induced reactive oxygen species (ROS) production and GRP78, CHOP, DR5, and DR4 expression, mitochondrial dysfunc-tion, and regulated involving signal-proteins. Taken together, PPT alleviated gefitinib-resistant NSCLC cell growth and induced apoptosis by reducing EGFR and MET activity. Therefore, our results suggest that PPT can be a promising therapeutic agent for gefitinib-resistant NSCLC.

True non-parasitic splenic cysts are rare. Series have reported over 30 cases of true splenic cysts producing elevated serum CA 19-9 levels. A 27-year-old woman presented with a painless mass in her left upper abdomen. Computed tomography (CT) of the abdomen showed a 16-cm cyst in the spleen. The serum CA 19-9 and CEA levels were 432 U/mL and 1.67 ng/mL, respectively. The cystic fluid CA 19-9 and CEA levels were markedly elevated. A splenectomy was performed. The pathology showed a benign true epidermoid cyst, which was negative for CEA. The serum CA 19-9 level returned to normal after removing the splenic cyst. This is the first reported case of a true benign splenic cyst producing high levels of CA 19-9 and CEA in Korea.
Abdomen ; Adult ; Epidermal Cyst ; Female ; Humans ; Korea ; Spleen ; Splenectomy