OBJECTIVE: Lithium inhibits the action of inositol monophosphatase(IMPase) in phosphoinositide(PI) signal transduction system at therapeutically relevant concentration. The depletion of inositol by lithium itself cannt explain the lithium's therapeutic effect. However, attention has focused on the abnormality of PI signal transduction system as the pathophysiology of bipolar affective disorder(BPD). We investigated whether IMPase mRNA levels of lymphocytes would be different between BPD patients(n=16) and age, sex-matched normal controls(n=16). We also investigated the change of IMPase mRNA level by lithium during 4 weeks to probe the possibility that IMPase mRNA levels could predict the therapeutic response to lithium and clinical course. METHOD: Relative IMPase mRNA levels in lymphocyte were quantified by reverse transcriptase(RT)-PCR in sixteen drug-free BPD patients and sex, age-matched normal controls. The psychopathology of patients were measured using YMRS(Young Mania Rating Scale) and CGI(Clinical Global Impression). RESULTS: There was no significant difference in IMPase mRNA levels between BPD patients and normal controls. And the IMPase mRNA levels were not significantly changed by 4 week treatment with lithium. However, the basal IMPase mRNA levels were negatively correlated with the changes of CGI after 4 weeks. Furthermore, the patients with relatively high basal IMPase mRNA levels showed much more improvement during 4 weeks. CONCLUSIONS: BPD patients and normal controls were not distinguished by lymphocyte IMPase mRNA level. Although we do not support the hypothesis that lymphocyte IMPase activity would be related with the pathogenesis of BPD and the action of lithium, these data raise the possibility that lymphocyte IMPase mRNA levels could function as a predictor of therapeutic response and clinical course of BPD.
5'-Nucleotidase ; Bipolar Disorder ; Humans ; Inositol* ; Lithium* ; Lymphocytes* ; Mood Disorders* ; Psychopathology ; RNA, Messenger* ; Signal Transduction

Chronic cavities of the dorsum of the foot often have bare bone and are unsuitable for free skin grafting. Local Flaps are often impossible because of surrounding scar tissue and dead space. A simple method is presented; it consists of the excision of the lesion, filling the cavity by a two staged random-pattern de-epithelialised turn over flap, and skin graft.
Cicatrix ; Foot ; Methods ; Skin ; Skin Transplantation ; Transplants

PURPOSE: This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm (34< or =GA<37) and preterm infants (GA<34). METHODS: A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. RESULTS: Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. CONCLUSION: Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.
Body Weight ; Breast Feeding/*statistics & numerical data ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Interviews as Topic ; Length of Stay ; Male ; Mothers/*psychology ; Occupations ; Time Factors

Purpose: : Exercise may prevent the worsening of chronic kidney disease (CKD) and progression of cardiovascular diseases in patients with CKD. This review aims to identify the best type of exercise modality and summarizes the beneficial effects of exercise on physical and renal function among older adults with pre-dialysis CKD. Methods: : A systematic search of PubMed, Embase, CINAHL, Cochrane Library, Web of Science, SCOPUS, and domestic database was performed for randomized controlled trials (RCTs) assessing the effect of exercise intervention on older adults with pre-dialysis CKD published until February 2023. A random-effects metaanalysis was conducted. The risk of bias was assessed using a Cochrane tool for assessing the risk of bias in RCTs (RoB 2.0). Results: : The systematic review included 11 RCTs (n = 591, average age 60.2–76), of which 8 could be included for meta-analysis. Exercise was significant in increasing peak oxygen consumption and knee muscle strength among physical functions, and also in improving glomerular filtration rate among kidney functions. Conclusion : Exercise has beneficial effects on physical and renal function among older adults with pre-dialysis CKD. In the future, it is necessary to verify the effectiveness of exercise by subdividing it by type, intensity, duration, and delivery.

Authors examined 40,000 minifilms(boys and girls each 10,000 in junior and senior high schools) which were taken for survey of pulmonary tuberculosis for junior and senior high school students and checked the prevalence of scoliosis. It was considered lateral curvature of spine more than 10 degrees as nonpostural scoliosis, which were analyzed prevalence rate, degree of curvature, distribution of size of curvature, pattern of curve and direction of curvature. Following results were obtained. 1. The overall prevalence rate was 1.56; male 1.38. and female 1.70%(Junior high school 1.06%, Senior high school 2.05%). 2. Scoliosis secondary due to bony abnormality was found in 5 cases. 3. The most common pattern of curvature was the thoracic curve. 4. In sihgle curve, right to left ratio was 1.7, especially senior high school girls had more right curve and junior high school boys had more left curve. 5. The prevalence of senior high school students was greater than that of junior high school students and the degree of curvature was also severe in senior high school students than in junior high school students.
Busan ; Female ; Humans ; Korea ; Male ; Prevalence ; Scoliosis ; Spine ; Tuberculosis, Pulmonary

PURPOSE: The purpose of this study was to identify status and characteristics of patients who have been readmitted to ICU, and to analyze risk factors associated with the readmission to ICU within 48hours.METHODS: Data were collected from patient's electronic medical reports from one hospital in B city. Participants were 2,937 patients aged 18 years old or older admitted to the ICU. Data were analyzed using odd ratios (ORs) from multivariate logistic regressions.RESULTS: 2.2% of the 2,937 patients were early readmitted to ICU. Risk factors for early readmission to ICU were existence of respiratory disease, use of mechanical ventilator, and duration of hospitalization (longer).CONCLUSION: The assessment on the respiratory system of the patient who will be discharged from the ICU was identified as an important nursing activity. Therefore, the respiratory system management and education should be actively conducted. In addition, early ICU readmission may be prevented and decreased if a link was built to share the information on patient condition between the ICU and general wards.
Critical Care ; Education ; Hospitalization ; Humans ; Intensive Care Units ; Logistic Models ; Nursing ; Patient Readmission ; Patients' Rooms ; Respiratory System ; Risk Factors ; Ventilators, Mechanical

OBJECTIVES: This study determined the work schedules of public project workers who work an irregular shift and assessed the effect of these schedules on depression. METHODS: Study subjects were 2934 laborers who are members of seven labor unions. Each was given a questionnaire requesting basic personal information, habits, socioeconomic status, and work schedules. Information gathered on work schedules included daytime, nighttime, and weekend work hours. Depression was evaluated using the Beck Depression Inventory (BDI), with Laborers who checked "not depressed" and "slightly depressive" categorized to a low-risk group, whereas laborers who checked "depressed" and "severely depressed" were categorized to a high-risk group. We used the Chi-square test and multivariate logistic regression to examine associations between work schedules and depression. RESULTS: Laborers on an irregular work schedule averaged 47.8 hours/week and laborers who working over 48 hours/week comprised over half (54.5%) of the total population. Laborers performing night work, Sunday work, and Saturday work more than once in a month made up 25.7%, 30.8% and 33.5% of the examined population, respectively. A high-risk for depression was identified in 10.4% of laborers. Using logistic regression, depression was statistically associated with working : over 10 hours a day (OR=1.63, 95% CI 1.10~2.43), night work (OR=2.20, 95% CI 1.46~3.32), Sunday work (OR=1.81, 95% CI 1.15~2.85) and Saturday work (OR=1.82 95% CI 1.18~2.82). CONCLUSION: A significant number of laborers with irregular working shifts work long hours and on weekends. Depression was significantly associated with this type of work schedule.
Appointments and Schedules ; Depression ; Humans ; Labor Unions ; Logistic Models ; Public Sector ; Questionnaires ; Social Class

Tuberculous meningitis is qutie a common disease and delay in treatment is associated with poor prognosis. But the study on the prognosis of tuberculous meningitis is rare in Korea. We analyzed the clinical and laboratory findings of 159 cases seen between 1986 and 1990 at the Yonsei University College of Medicine, Severance Hospital. The specific aims of this study were to evaluate the clinical presentation, course and outcome and to determine the factors that may have influence on the outcome of tuberculous meningitis. The following results were obtained. 1. The highest incidence of age was noted in third decade as 37 cases (23.3%)and there was a tendency that the annual incidence of tuberculous meningitis declined since 1989. 2. The most presenting symptoms on admission were headache in 114 cases (71.7%), fever and chilling in 112 cases (70.4%), nausea and vomiting in 71 cases (44.7%), altered consciousness in 38 cases(23.9%) in order and clinical stage on admission revealed 83 cases of stage 2 and 14 cases of stage 3. 3. Associated tuberculous lesions other than central nervous system were found in 56 cases (35.2%) including miliary tuberculosis (15.7%), pulmonary tuberculosis (13.8%), spinal tuberculosis (3.1%), renal tuberculosis and so on. 4. Comparing with those who have not developed neurological sequelae on discharge, the mean protein value of cerebrospinal fluid on admission was increased and the mean glucose value and WBC count were decreased in patients who have developed neurological sequelae. 5. Brain computed tomography scan was performed in 122 cases and it revealed no abnormal findings in 54 cases (44.3%), enlarged ventricle in 44 cases (36.1%), basal enhancement in 25 cases (20.5%), lacunes in 18 cases (14.8%) and tuberculous granu-lomas in 8 cases (6.6%). 6. The neurological sequelae were developed in 53 cases (33.3%) including altered consciousness (13.2%), cranial nerve palsies (10.1%), death (5.0%), hemiparesis (4.4%), paraparesis(3.1%)and so on. 7. Prognosis of tuberculous meningitis app.
Brain ; Central Nervous System ; Cerebrospinal Fluid ; Consciousness ; Cranial Nerve Diseases ; Fever ; Glucose ; Headache ; Humans ; Incidence ; Korea ; Nausea ; Paresis ; Prognosis ; Tuberculosis, Meningeal* ; Tuberculosis, Miliary ; Tuberculosis, Pulmonary ; Tuberculosis, Renal ; Tuberculosis, Spinal ; Vomiting

No abstract available.
Condylomata Acuminata* ; Dermoscopy* ; Diagnosis, Differential* ; Lymphangioma* ; Vulva*

PURPOSE: The association of age, sex and renal parenchymal damage (RPD) in vesicoureteral reflux (VUR) is well known. We compared various factors between infants and children in a cohort of patients with primary VUR. MATERIALS AND METHODS: Medical records of 147 patients diagnosed as VUR between 1997 and 2010 were reviewed. Of these children 91 (61.9%) were boys and 56 (38.1%) were girls. 99 (67.3%) of the 147 patients were younger (Group 1), and 48 (32.7%) were older than 1 year (Group 2). The impact of patient's gender and age as well as VUR grade on RPD were analyzed in each patient. The Fisher's exact test and chi square test was done with SPSS ver. 12.0 (SPSS Inc., Chicago, IL, USA). RESULTS: VUR was unilateral in 88 patients (59.9%) and bilateral in 59 patients (40.1%). Abnormal renal scan was found in 78 (37.7%) renal units. The incidence of VUR was significantly higher in male in group 1 (p<0.01) and in female in group 2 (p<0.01). The incidence of abnormal renal scan was significantly higher in intermediate and high grade VUR comparing low grade VUR in group 1 (p=0.042). In both group, abnormal renal scan didn't show any difference between male and female statistically (p>0.05). CONCLUSIONS: Our data showed that VUR in infant was significantly higher in male than in female, whereas VUR in children was significantly higher in female. This may be due to that characteristic of a population where neonatal circumcision is not a common procedure in infant and urinary tract infections are more common in female children. Further study may be needed to identify gender difference in RPD in infant with high grade reflux.
Chi-Square Distribution ; Chicago ; Child ; Circumcision, Male ; Cohort Studies ; Female ; Humans ; Incidence ; Infant ; Male ; Medical Records ; Urinary Tract Infections ; Vesico-Ureteral Reflux