We report a 47-year old traumatic brain injury male patient who was treated for the rigidity and tremor with sinemet (carbidopa levodopa) and artane (trihexyphenidyl). He came to the emergency room ten days after the stopping of sinemet. Acute onset of increased obtunded, immobile, rigid, deep coma, and minimal response to a deep pain was presented. There was no evidence of the focal neurological signs. Over the next two days, he awoke with a normal mental status. His muscle tone become normal and he returned to home without residual medical problems or complications. We report a serotonin syndrome in a traumatic brain injury patient who was treated with sinemet and artane, which resulted in a dysregulation of serotonin activity.
Brain Injuries* ; Coma ; Emergency Service, Hospital ; Humans ; Male ; Middle Aged ; Serotonin Syndrome* ; Serotonin* ; Tremor ; Trihexyphenidyl

Motor point block with phenol solution has the advantage of technical ease, bedside performance, and repetition as necessary in reducing spasticity. To our knowledge, however, complicating stress fracture that occur during the course of treatment after motor point block has not been described. We report the occurance of stress fracture of the head of right talus after motor point block with phenol solution. A 17-year-old boy had a gait disturbance due to excessive plantar flexion and inversion of right ankle by spasticity. Percutaneous motor point block to right tibialis posterior and right gastrocnemius was done with 7% aqueous phenol solution. Just after the block, he began to bear his weight on right heel and physical therapy including gait training was started. He complained of right ankle pain a week after resumption of weight-bearing while walking. Bone scan and magnetic resonance imaging of right ankle revealed stress fracture of talus of right foot. This case illustrated that physiatrists involved in the management of such patients should be aware that secondary stress fractures can occur.
Adolescent ; Ankle ; Foot ; Fractures, Stress* ; Gait ; Head ; Heel ; Humans ; Magnetic Resonance Imaging ; Male ; Muscle Spasticity ; Phenol* ; Talus* ; Walking ; Weight-Bearing

PURPOSE: This study aimed to identify the influence of nurses' resilience and anger expression styles on their nursing work performance in emergency departments. METHODS: The study included 107 nurses from 5 hospitals in Seoul and Gyeonggi-do who consented to participate. Data ware collected from March to April 2016. Multiple regression analysis was used to identify factors influencing nurses' performance. RESULTS: Nurses' performance was higher when resilience was high and anger expression was low. The result of the multiple regression indicated that present working years in the emergency room, work satisfaction, anger expression, anger control, and resilience predicted 39.4%(F=7.27, p < .001) of the nursing performance of hospital nurses in emergency departments. The most powerful predictor was resilience (β=.45, p < .001), followed by anger-out (β=−.25, p=.006). CONCLUSION: This study showed that the most influential variables of work performance in emergency nurses ware resilience and anger expression. To enhance the nursing performance of hospital nurses in emergency departments, it is necessary to develop and implement mentorship programs that enhance resilience and educational programs that help them manage their anger.
Anger ; Emergencies ; Emergency Service, Hospital ; Gyeonggi-do ; Humans ; Job Satisfaction ; Mentors ; Nursing ; Seoul ; Work Performance

PURPOSE: This study aimed to identify the influence of nurses' resilience and anger expression styles on their nursing work performance in emergency departments. METHODS: The study included 107 nurses from 5 hospitals in Seoul and Gyeonggi-do who consented to participate. Data ware collected from March to April 2016. Multiple regression analysis was used to identify factors influencing nurses' performance. RESULTS: Nurses' performance was higher when resilience was high and anger expression was low. The result of the multiple regression indicated that present working years in the emergency room, work satisfaction, anger expression, anger control, and resilience predicted 39.4%(F=7.27, p < .001) of the nursing performance of hospital nurses in emergency departments. The most powerful predictor was resilience (β=.45, p < .001), followed by anger-out (β=−.25, p=.006). CONCLUSION This study showed that the most influential variables of work performance in emergency nurses ware resilience and anger expression. To enhance the nursing performance of hospital nurses in emergency departments, it is necessary to develop and implement mentorship programs that enhance resilience and educational programs that help them manage their anger.

OBJECTIVE: The study was to evaluate the biological significance of Ki-67 expression in common epithelial ovarian carcinomas. We investigated the correlation between Ki-67 expression and clinicopathological parameters. METHODS: One hundred patients with epithelial ovarian carcinomas stage I-IV treated at Department of Obstertrics and Gynecology, Korea University Hospital from January 1994 to December 2004 were used as study group. We determined expression of Ki-67 by immunohistochemistry using MIB-1 monoclonal antibody reactivity. RESULTS: Ki-67 overexpression was higher in high stage (III-IV) than low stage (I-II) (P<0.013). Ki-67 overexpression was higher in serous cystadenocarcinoma (76.3%) than mucinous cystadenocarcinoma (53.6%), endometrioid carcinoma (54.5%) and clear cell carcinoma (58.3%) but it was not statistically significant (P<0.191). Ki-67 expression was higher in high grade but it was not statistically significant (P<0.096). Ki-67 overexpression was not correlated with serum CA-125 level (P<0.172). Overall survival revealed significant survival difference between patients whose tumor showed Ki-67 overexpressions compared with remaining patients. CONCLUSIONS: Ki-67 overexpressions was a poor prognostic indicator in epithelial ovarian carcinomas.
Antibodies, Antinuclear ; Antibodies, Monoclonal ; Carcinoma, Endometrioid ; Cystadenocarcinoma, Mucinous ; Cystadenocarcinoma, Serous ; Female ; Gynecology ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; Korea ; Ovary

BACKGROUND: Enhanced lipogenesis plays a critical role in cell senescence via induction of expression of the mature form of sterol regulatory element binding protein 1 (SREBP1), which contributes to an increase in organellar mass, one of the indicators of senescence. We investigated the molecular mechanisms by which signaling molecules control SREBP1-mediated lipogenesis and senescence. METHODS: We developed cellular models for stress-induced senescence, by exposing Chang cells, which are immortalized human liver cells, to subcytotoxic concentrations (200 microM) of deferoxamine (DFO) and H2O2. RESULTS: In this model of stress-induced cell senescence using DFO and H2O2, the phosphorylation profile of glycogen synthase kinase 3alpha (GSK3alpha) and beta corresponded closely to the expression profile of the mature form of SREBP-1 protein. Inhibition of GSK3 with a subcytotoxic concentration of the selective GSK3 inhibitor SB415286 significantly increased mature SREBP1 expression, as well as lipogenesis and organellar mass. In addition, GSK3 inhibition was sufficient to induce senescence in Chang cells. Suppression of GSK3 expression with siRNAs specific to GSK3alpha and beta also increased mature SREBP1 expression and induced senescence. Finally, blocking lipogenesis with fatty acid synthase inhibitors (cerulenin and C75) and siRNA-mediated silencing of SREBP1 and ATP citrate lyase (ACL) significantly attenuated GSK3 inhibition-induced senescence. CONCLUSION: GSK3 inactivation is an important upstream event that induces SREBP1-mediated lipogenesis and consequent cell senescence.
Aging* ; Aminophenols ; ATP Citrate (pro-S)-Lyase ; Carrier Proteins* ; Cell Aging ; Deferoxamine ; Fatty Acid Synthetase Complex ; Glycogen Synthase Kinase 3* ; Glycogen Synthase Kinases* ; Glycogen Synthase* ; Glycogen* ; Humans ; Lipogenesis* ; Liver ; Maleimides ; Multienzyme Complexes ; Oxo-Acid-Lyases ; Phosphorylation ; RNA, Small Interfering ; Sterol Regulatory Element Binding Protein 1

BACKGROUND: Enhanced lipogenesis plays a critical role in cell senescence via induction of expression of the mature form of sterol regulatory element binding protein 1 (SREBP1), which contributes to an increase in organellar mass, one of the indicators of senescence. We investigated the molecular mechanisms by which signaling molecules control SREBP1-mediated lipogenesis and senescence. METHODS: We developed cellular models for stress-induced senescence, by exposing Chang cells, which are immortalized human liver cells, to subcytotoxic concentrations (200 microM) of deferoxamine (DFO) and H2O2. RESULTS: In this model of stress-induced cell senescence using DFO and H2O2, the phosphorylation profile of glycogen synthase kinase 3alpha (GSK3alpha) and beta corresponded closely to the expression profile of the mature form of SREBP-1 protein. Inhibition of GSK3 with a subcytotoxic concentration of the selective GSK3 inhibitor SB415286 significantly increased mature SREBP1 expression, as well as lipogenesis and organellar mass. In addition, GSK3 inhibition was sufficient to induce senescence in Chang cells. Suppression of GSK3 expression with siRNAs specific to GSK3alpha and beta also increased mature SREBP1 expression and induced senescence. Finally, blocking lipogenesis with fatty acid synthase inhibitors (cerulenin and C75) and siRNA-mediated silencing of SREBP1 and ATP citrate lyase (ACL) significantly attenuated GSK3 inhibition-induced senescence. CONCLUSION: GSK3 inactivation is an important upstream event that induces SREBP1-mediated lipogenesis and consequent cell senescence.
Aging* ; Aminophenols ; ATP Citrate (pro-S)-Lyase ; Carrier Proteins* ; Cell Aging ; Deferoxamine ; Fatty Acid Synthetase Complex ; Glycogen Synthase Kinase 3* ; Glycogen Synthase Kinases* ; Glycogen Synthase* ; Glycogen* ; Humans ; Lipogenesis* ; Liver ; Maleimides ; Multienzyme Complexes ; Oxo-Acid-Lyases ; Phosphorylation ; RNA, Small Interfering ; Sterol Regulatory Element Binding Protein 1

Background: ; Liver transplantation usually requires blood transfusion, and a red blood cell (RBC) antibody screen is essential for the prevention of a hemolytic reaction. Since proper ABO-compatible grafts are lacking, ABO-incompatible living donor liver transplantation (ABO-i LDLT) with desensitization is a feasible therapy. Desensitization includes intravenous rituximab injection and plasmapheresis before surgery.Case: A 60-year-old female was diagnosed with hepatitis B virus-related hepatocellular carcinoma and planned for ABO-i LDLT. She tested positive in a RBC antibody screen over two years; however, she tested negative for the test after desensitization. Clinicians noted the seroconversion during induction, and thus, a delay in the preparation of adequate packed RBC was unavoidable. Conclusions Even when the latest RBC antibody screen is negative after immunosuppression, clinicians should consider the possibility of a prior positive result to promote safer medical treatment and management.

OBJECTIVE: The purpose of this study was to test the hypothesis that cardiovascular risk is associated with cognitive impairments in clinically stable late-life depression. METHODS: A total of 59 clinically stable late-life depression patients over age 60 were enrolled in a cross-sectional study. Evaluation tools used in this study include Hamilton Rating Scale for Depression, Geriatric Depression Scale, State-Trait Anxiety Inventory, the Framingham general cardiovascular disease risk profile and the cognitive function battery designed for this study. Correlation analysis, analysis of variance and analysis of covariance were performed. RESULTS: Patients with higher cardiovascular risk performed significantly poorer in the domains of executive function and short-term or long-term memory. In models adjusted for age, sex, education, 10% higher cardiovascular risk was associated with poorer executive function. CONCLUSION: Our findings suggested that cardiovascular risk could be a significant factor associated with poor executive function in clinically stable late-life depression and the management which is necessary as a component of treatment planning. This pilot study provided good prospects for future studies to document this relationship on larger samples.
Anxiety ; Cardiovascular Diseases ; Cross-Sectional Studies ; Depression* ; Education ; Executive Function ; Humans ; Memory, Long-Term ; Pilot Projects*

We report here on the multiple genital tract neoplasms in a 41-yr-old Korean woman with Peutz-Jeghers Syndrome (PJS). The patient presented with lower abdominal pain. Her previous medical history was PJS and breast cancer. Pelvic ultrasound showed a multilocular cyst at the right adnexal region, diagnosed as bilateral ovarian mucinous borderline tumors. An ovarian sex cord tumor with annular tubules was incidentally diagnosed together with a minimal deviation adenocarcinoma of the uterine cervix and mucinous metaplasia of both the Fallopian tubal mucosa and the endometrium. Although the cases of multiple genital tract tumors with PJS has rarely been reported, the present case appears to be the first in Korea in which the PJS syndrome was complicated by multiple genital tract tumors and infiltrating carcinoma of the breast. The clinical significance of the multiple genital tract tumors and breast cancer associated with PJS is reviewed.
Uterine Cervical Neoplasms/complications/*pathology ; Sex Cord-Gonadal Stromal Tumors/complications/pathology ; Peutz-Jeghers Syndrome/complications/*pathology ; Ovarian Neoplasms/complications/*pathology ; Metaplasia ; Korea ; Humans ; Female ; Fallopian Tubes/pathology ; Endometrium/pathology ; Carcinoma, Ductal, Breast/complications/pathology ; Breast Neoplasms/complications/*pathology ; Adult ; Adenocarcinoma/complications/pathology