A dysfunction of endoplasmic reticulum (ER) stress response can result in various diseases, including cancer, inflammation, diabetes and neurodegenerative disorders. To investigate whether ER stress response can play an essential role in the induction and treatment of chronic constipation, alterations in the key parameters for ER stress were measured in loperamide (Lop) induced constipation Sprague Dawley (SD) rats treated with aqueous extracts of Liriope platyphylla (AEtLP), which has been shown to have a laxative effect. Symptoms of chronic constipation including alteration of stool parameters and the transverse colon's structure were successfully induced by Lop treatment. Laxative effects such as enhancement of stools parameters, recovery of the mucosa thickness, increased muscle thickness and recovery of flat luminal surface were also observed in the Lop+AEtLP treated group. Furthermore, enhancement of eukaryotic initiation factor 2 alpha (eIF2α) phosphorylation and inositol-requiring enzyme 1 beta (IRE1β) expression, key indicators for ER stress, that were observed in the Lop+vehicle treated group were significantly recovered in the Lop+AEtLP treated group, although the phosphorylation level of c-Jun N-terminal protein kinase (JNK) remained constant. Moreover, alterations in the transcription level of the marker genes X-box binding protein 1 (XBP-1) and growth arrest and DNA damage-inducible protein (GADD34) were similar to those of eIF2α and IRE1β. However, their level was slightly or completely recovered after AEtLP treatment. Overall, this study provides the first evidence that ER stress response may be tightly correlated with chronic constipation induced by Lop treatment, as well as the laxative effects of AEtLP.
Animals ; Carrier Proteins ; Constipation* ; DNA ; Endoplasmic Reticulum Stress* ; Endoplasmic Reticulum* ; Eukaryotic Initiation Factor-2 ; Inflammation ; Loperamide ; Mucous Membrane ; Neurodegenerative Diseases ; Phenobarbital ; Phosphorylation ; Protein Kinases ; Rats*

We report a case of increased values of entropy parameters Response Entropy (RE) and State Entropy (SE) during intravenous general anesthesia in a sleepwalking patient. An ASA class II, 64-year-old woman with stress incontinence underwent mid-urethral sling surgery. Prior to surgery, the patient had been administered paroxetine, valproic acid and clonazepam for the treatment of sleepwalking disorder. After 10 min of target-controlled infusion of propofol and remifentanil, entropy values increased up to 94 (RE) and 88 (SE) for 10 min. The target effect-site concentrations of anesthetics increased from 4 to 7 microg/ml propofol and 4 ng/ml remifentanil, at which point values fell back to adequate anesthesia levels. Episodes of recall or of explicit memories did not occur during the anesthesia. In conclusion, sleepwalking patients with long-term use medications may need increment of anesthetic dose caused by the anesthetic drug metabolism activation or impairment or immaturity of inhibitory circuits in brain.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Brain ; Clonazepam ; Entropy* ; Female ; Humans ; Metabolism ; Middle Aged ; Paroxetine ; Propofol* ; Somnambulism* ; Suburethral Slings ; Valproic Acid

We report a case of increased values of entropy parameters Response Entropy (RE) and State Entropy (SE) during intravenous general anesthesia in a sleepwalking patient. An ASA class II, 64-year-old woman with stress incontinence underwent mid-urethral sling surgery. Prior to surgery, the patient had been administered paroxetine, valproic acid and clonazepam for the treatment of sleepwalking disorder. After 10 min of target-controlled infusion of propofol and remifentanil, entropy values increased up to 94 (RE) and 88 (SE) for 10 min. The target effect-site concentrations of anesthetics increased from 4 to 7 microg/ml propofol and 4 ng/ml remifentanil, at which point values fell back to adequate anesthesia levels. Episodes of recall or of explicit memories did not occur during the anesthesia. In conclusion, sleepwalking patients with long-term use medications may need increment of anesthetic dose caused by the anesthetic drug metabolism activation or impairment or immaturity of inhibitory circuits in brain.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Brain ; Clonazepam ; Entropy* ; Female ; Humans ; Metabolism ; Middle Aged ; Paroxetine ; Propofol* ; Somnambulism* ; Suburethral Slings ; Valproic Acid

Kikuchi-Fujimoto disease (KFD) is a benign self-limiting disease characterized by fever and lymphadenitis. The etiology and pathogenesis of KFD is unclear. However, two hypotheses have been suggested: a viral infection hypothesis and an autoimmune hypothesis. Several KFD patients with various types of autoimmune diseases have been reported, and these reports support the hypothesis for autoimmune pathogenesis of KFD. Here, we report the case of a 17-year-old female patient diagnosed with KFD and autoimmune thyroiditis. This case serves as additional evidence that the etiology of KFD is autoimmune origin.
Adolescent ; Autoimmune Diseases ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymphadenitis ; Thyroiditis, Autoimmune

PURPOSE: This study evaluated the effect of first nocturnal ejaculation timing on risk and sexual behaviors of Korean male adolescents. METHODS: We analyzed data from the 10th edition of the Korea Youth Risk Behavior Web-based survey that was conducted with male high school adolescents in grades 10–12. The survey included 17,907 adolescents, and 10,326 responded their experience of first nocturnal ejaculation. Of these, 595 had their first nocturnal ejaculation in ≤grade 4 (“early puberty”) and 9,731 had their first nocturnal ejaculation in ≥grade 5 (“normal puberty”). We analyzed differences between these 2 groups in risk and sexual behaviors. RESULTS: Early first nocturnal ejaculation showed a positive association with sexual intercourse (odds ratio [OR], 3.27; 95% confidence interval [CI], 2.56–4.17), sexual debut at elementary school age (OR, 7.45; 95% CI, 5.00–11.10), and having had a sexually transmitted disease (OR, 6.60; 95% CI, 3.94–11.08). After a multiple logistic regression to adjust for socio-demographic variables, early first nocturnal ejaculation was still positively associated with sexual intercourse (OR, 2.73; 95% CI, 2.03–3.69), sexual debut at elementary school age (OR, 5.96; 95% CI, 3.47–10.22), and having had a sexually transmitted disease (OR, 5.17; 95% CI, 2.52–10.20). Early first nocturnal ejaculation was positively associated with alcohol consumption, smoking, and substance use. However, this was not statistically significant after adjusting for several socio-demographic variables. CONCLUSION: There is a positive association between early nocturnal ejaculation and sexual behaviors in male adolescents. Proactive education about sexual behaviors is required for adolescents who reach sexual maturity early.
Adolescent* ; Alcohol Drinking ; Coitus ; Education ; Ejaculation* ; Humans ; Korea ; Logistic Models ; Male ; Male* ; Puberty ; Risk-Taking ; Sexual Behavior* ; Sexually Transmitted Diseases ; Smoke ; Smoking

The ethical statement was omitted unintentionally.

Background: : Since primary emergency treatment should be performed appropriately and promptly, efficient and accurate communication between paramedics and medical staff is paramount to a successful primary emergency treatment and patient handover. The problem of the training program in Korea is that it concentrates more on in-class lectures, often delivered by non-medical specialists, who may lack in practical experience and without proper communication training. To solve this problem, we have devised a simulation based training that focuses on event debriefings and two-way communication. Methods: : 62 paramedics from 3 stations enrolled in the study. 4 different courses with different emergency situations were created and each course was taken twice resulting in a total of 8 classes. All courses were based on actual cases. The curriculum consisted of subject lectures with guidelines, skill practice courses, and simulation courses based on hands-on method. In simulation courses, paramedics use standardized check list to communicate with medical specialists. All curriculums except subject lectures include debriefing, which allows free talking with educators comprised of medical specialists. In order to measure the educational impact, all students performed self-assessment through a structured questionnaire before and after the training. Results: : Regardless different situations and paramedics’ education level, their performance and communication skills have improved after simulation training course. Paramedics mentioned learning skills in simulation course through communication with medical staffs as the biggest advantage. Conclusion : Receiving the simulation training with standardized communication tools is effective at enhancing the communication between the paramedics and medical staff.

PURPOSE: To compare initial CT findings of non-tuberculous mycobacteria (NTM) pulmonary infection between stable and progressed groups and determine whether they could be used to predict disease prognosis and treatment response. MATERIALS AND METHODS: From July 2006 to October 2013, 71 patients with NTM infection were retrospectively reviewed. Lung lesion pattern of CT finding, specific species, disease duration, and follow-up period were analyzed. These patients were classified into NTM stable (n = 46) and progressed (n = 25) groups. RESULTS: The most common CT findings of NTM infection were small nodules (n = 71, 100%) and bronchiectasis (n = 67, 94%). Large consolidation (> 2 cm, n = 34, 48%) and involvement of more than four lobes (n = 49, 69%) were also commonly observed. According to disease prognosis, large consolidation (n = 18, 72%, p = 0.003), cavitary lesion (n = 17, p = 0.002), and involvement of four or more lobes (n = 21, p = 0.044) on CT were significantly more frequent in disease progressed group than that in the stable group. CONCLUSION Among common CT findings of NTM disease, some CT findings such as large consolidation, cavitary lesion, and disease extent are good predictors of response to treatment in NTM pulmonary disease.

Currently, no vaccine or established therapeutic agents are available for coronavirus disease 2019. The sharp increase in demand for personal protective equipment (PPE) necessitates an improvement in the protective efficacy of PPE. We evaluated the potential antimicrobial and antiviral effects of a surface-coating disinfectant (3-(trimethoxysilyl)propyldimethyl octadecyl ammonium chloride, Si-QAC) when applied onto PPE. Si-QAC-pre-coated PPE was artificially contaminated with either influenza virus or Salmonella. The results showed significantly reduced influenza and Salmonella titers in Si-QAC-coated PPE; these antimicrobial effects lasted 7 days. This suggests that this surface-coating disinfectant effectively reduces pathogen contamination of PPE, enabling their safe and long-term use.

BACKGROUND: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder presenting low platelet count in peripheral blood without any other abnormalities in other blood cell lineage. There were many studies that investigated the mechanism of ITP and the factors related to its chronicity, but much remains controversial. Neutrophil to lymphocyte ratio (NLR) is considered an indicator representing the severity of acute or chronic inflammation. The aim of this study was to assess whether NLR can predict the outcome of ITP and its chronicity.METHODS: Patients who were diagnosed as ITP at Dong-A University Hospital between March 2000 and March 2016 were analyzed retrospectively. NLR results and other medical records at diagnosis and after treatment were analyzed and compared between two groups; patients with single episode and chronic ITP group.RESULTS: Of a total of 67 patients, 39 patients (58.21%) were chronic ITP. Patients with single episode showed low NLR at diagnosis than patients with chronic ITP (1.23±1.38 vs. 1.54±1.15, P=0.42), but NLR after recovery were significantly high (1.58±1.71 vs. 1.31±0.76, P=0.21). However, patients with chronic ITP showed a trend of high NLR at the time of relapse.CONCLUSION: Chronic ITP patients showed higher NLR at the time of diagnosis compared with the patients with single episode. Also, the NLR at the time of relapse showed higher level compared to those at diagnosis. Relationship between NLR and chronic ITP need to be further studied.
Blood Cells ; Diagnosis ; Humans ; Inflammation ; Lymphocytes ; Medical Records ; Neutrophils ; Platelet Count ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic ; Recurrence ; Retrospective Studies