No abstract available.
Child* ; Humans ; Scrub Typhus*

Various cancer types have been associated with cancer-related cerebral infarction. In this study, we describe the first case of cancer-related cerebral infarction in which the underlying disease was primary bone marrow lymphoma (PBML). A 79-year-old man presented with abruptly developed bilateral lower extremity weakness and confusion. Diffusion-weighted imaging on admission showed multiple cortical and subcortical embolic infarction lesions in multiple vascular territories. Diagnostic evaluations to determine the embolic source revealed no abnormalities. Laboratory testing demonstrated elevated D-dimer (2.59 μg/mL) but no other prothrombotic abnormalities. In suspicion of cancer-related stroke, we performed chest CT, abdomen CT, and FDG-PET to detect the hidden malignancy. Findings revealed no evidence of cancer; however, they did reveal signs of anemia (hemoglobin 9.0 g/dL). Bone marrow aspiration biopsy showed large atypical B cell involvement suggestive of high-grade B cell lymphoma. The patient was diagnosed with primary bone marrow diffuse large B-cell lymphoma initially presenting with ischemic stroke. Our case suggests that primary bone marrow cancer may be a candidate for the differential diagnosis of hidden malignancy in patients with suspected cancer-related stroke. Bone marrow biopsy may be essential for establishing an appropriate differential diagnosis in patients with abnormal hematologic findings.

PURPOSE: The purpose of this study was to identify the relationship between response to violence, resilience and burnout and to investigate the factors that affect burnout in emergency room nurses. METHODS: Data from 237 nurses in 15 emergency rooms were collected using a structured questionnaire. Data were analyzed using SPSS 23.0, and the analyses included descriptive statistics, t-test, Mann-Whitney test, ANOVA, Kruskall Wallis test, Pearson correlation, and hierarchical multiple regression. RESULTS: Burnout was positively correlated with response to violence and negatively correlated with resilience in emergency room nurses. Response to violence (β=.466, p<.001), resilience (β=−.308, p<.001), and religion (β=−.131, p=.011) were significant predictors of burnout, and they explained 39.9% of emergency room nurses' burnout. CONCLUSION: Response to violence and resilience were identified as significant factors affecting burnout in emergency room nurses. Therefore, it is necessary to develop strategies to cope effectively with violence and to develop programs that can strengthen resilience.
Emergencies ; Emergency Service, Hospital ; Exposure to Violence ; Violence

T-bet is a critical transcription factor that regulates differentiation of Th1 cells from CD4+ precursor cells. Since T-bet directly binds to the promoter of the IFN-gamma gene and activates its transcription, T-bet deficiency impairs IFN-gamma production in Th1 cells. Interestingly, T-bet-deficient Th cells also display substantially augmented the production of IL-2, a T cell growth factor. Exogenous expression of T-bet in T-bet deficient Th cells rescued the IFN-gamma production and suppressed IL-2 expression. IFN-gamma and IL-2 reciprocally regulate Th cell proliferation following TCR stimulation. Therefore, we examined the effect of T-bet on Th cell proliferation and found that T-bet deficiency significantly enhanced Th cell proliferation under non-skewing, Th1-skewing, and Th2-skewing conditions. By using IFN-gamma-null mice to eliminate the anti-proliferative effect of IFN-gamma, T-bet deficiency still enhanced Th cell proliferation under both Th1- and Th2-skewing conditions. Since the anti-proliferative activity of T-bet may be influenced by IL-2 suppression in Th cells, we examined whether T-bet modulates IL-2-independent cell proliferation in a non-T cell population. We demonstrated that T-bet expression induced by ecdysone treatment in human embryonic kidney (HEK) cells increased IFN-gamma promoter activity in a dose dependent manner, and sustained T-bet expression considerably decreased cell proliferation in HEK cells. Although the molecular mechanisms underlying anti-proliferative activity of T-bet remain to be elucidated, T-bet may directly suppress cell proliferation in an IFN-gamma- or an IL-2-independent manner.
Animals ; Cell Proliferation ; Ecdysone ; Humans ; Interleukin-2 ; Kidney ; Mice ; Th1 Cells ; Transcription Factors

Monoamine oxidase inhibitors (MAOI) have been widely used as antidepressants. Recently, there has been renewed interest in MAO inhibitors. The activity-guided fractionation of extracts from Angelica keiskei Koidzumi (A. keiskei K.) led to the isolation of two prenylated chalcones, xanthoangelol and 4-hydroxyderricin and a flavonoid, cynaroside. These three isolated compounds are the major active ingredients of A. keiskei K. to inhibit the MAOs and DBH activities. Xanthoangelol is a nonselective MAO inhibitor, and a potent dopamine beta-hydroxylase (DBH) inhibitor. IC50 values of xanthoangelol to MAO-A and MAO-B were calculated to be 43.4 microM, and 43.9 microM. These values were very similar to iproniazid, which is a nonselective MAO inhibitor used as a drug against depression. The IC50 values of iproniazid were 37 microM, and 42.5 microM in our parallel examination. Moreover, IC50 value of xanthoangelol to DBH was calculated 0.52 microM. 4-Hydroxyderricin is a potent selective MAO-B inhibitor and also mildly inhibits DBH activity. The IC50 value of 4-hydroxyderricin to MAO-B was calculated to be 3.43 microM and this value was higher than that of deprenyl (0.046 microM) used as a positive control for selective MAO-B inhibitor in our test. Cynaroside is a most potent DBH inhibitor. The IC50 value of cynaroside to DBH was calculated at 0.0410 microM. Results of this study suggest that the two prenylated chalcones, xanthoangelol and 4-hydroxyderricin isolated from A. keiskei K., are expected for potent candidates for development of combined antidepressant drug. A. keiskei K. will be an excellent new bio-functional food material that has the combined antidepressant effect.
Angelica* ; Antidepressive Agents ; Chalcones ; Depression ; Dopamine beta-Hydroxylase ; Inhibitory Concentration 50 ; Iproniazid ; Monoamine Oxidase ; Monoamine Oxidase Inhibitors ; Oxidoreductases* ; Selegiline

Eisenmenger's syndrome is defined as pulmonary hypertension with right-to-left or bidirectional shunting of blood through an intracardiac or aorto-pulmonary commumication. It can occur with complex congenital cardiac malformations, such as septal defect and patent ductus arteriosus. Parturients with Eisenmenger's syndrome are at high risk for peripartum morbidity and mortality. We experienced a case of parturient for cesarean section with Eisenmenger's syndrome and performed epidural anesthesia with fractionated doses of 2% lidocaine and fentanyl. The sensory block reached to T10 level and blood pressure was maintained with intravenous phenylephrine. After baby out, sudden hypotension with severe bradycardia developed and arterial oxygen saturation dropped. Immediate intubation and resuscitation was done, but cardiac rhythm disturbance, hypoxemia, and acidosis did not corrected. Cardiac standstill developed and stopped resuscitation. The neonate's Apgar score was 7 and he was transferred to pediatric ICU.
Acidosis ; Anesthesia, Epidural* ; Anoxia ; Apgar Score ; Blood Pressure ; Bradycardia ; Cesarean Section* ; Ductus Arteriosus, Patent ; Eisenmenger Complex* ; Female ; Fentanyl ; Hypertension, Pulmonary ; Hypotension ; Intubation ; Lidocaine ; Mortality ; Oxygen ; Peripartum Period ; Phenylephrine ; Pregnancy ; Resuscitation

No abstract available.
Leukemia, Plasma Cell* ; Plasma Cells* ; Plasma* ; Plasmacytoma*

OBJECTIVE: The aim of this study was to compare the shear bond strength (SBS) of orthodontic brackets bonded to zirconia surfaces using three different zirconia primers and one silane primer, and subjected to thermocycling. METHODS: We designed 10 experimental groups following the surface treatment and thermocycling. The surface was treated with one of the following method: no-primer (NP), Porcelain Conditioner (PC), Z-PRIME Plus (ZP), Monobond Plus (MP) and Zirconia Liner Premium (ZL) (n=20). Then each group was subdivided to non-thermocycled and thermocycled groups (NPT, PC, ZPT, MPT, ZLT) (n=10). Orthodontic brackets were bonded to the specimens using Transbond(TM) XT Paste and light cured for 15 s at 1,100 mW/cm2. The SBS was measured at a 1 mm/min crosshead speed. The failure mode was assessed by examination with a stereomicroscope and the amount of bonding resin remaining on the zirconia surface was scored using the modified adhesive remnant index (ARI). RESULTS: The SBS of all experimental groups decreased after thermocycling. Before thermocycling, the SBS was ZL, ZP > or = MP > or = PC > NP but after thermocycling, the SBS was ZLT > or = MPT > or = ZPT > PCT = NPT (p > 0.05). For the ARI score, both of the groups lacking primer (NP and NPT) displayed adhesive failure modes, but the groups with zirconia primers (ZP, ZPT, MP, MPT, ZL, and ZLT) were associated with mixed failure modes. CONCLUSIONS: Surface treatment with a zirconia primer increases the SBS relative to no-primer or silane primer application between orthodontic brackets and zirconia prostheses.
Adhesives ; Dental Porcelain ; Orthodontic Brackets* ; Prostheses and Implants

Purpose: This study aims to explore mothers’ experiences of anger while raising a child in South Korea based on a qualitative descriptive approach. Methods: A total of ten mothers of children aged 1-3 years participated in the study. In-depth individual interviews were conducted from August to September 2019 to collect data, which were then subjected to thematic analysis. Results: A total of 4 main themes and 10 subthemes were identified. The 4 themes were “individual and environmental factors that influence anger,” “a vicious cycle of anger expression and guilt,” “being a little bit more mature as a mother,” and “need for anger management.” This study described various causes, ways of expressing, and effects of anger, as well as the mother’s coping strategies. These experiences were viewed as milestones along the journey to becoming a real parent and helped mothers develop empathy for other children and mothers. The participants expressed support for expanding the social support system for child-rearing and providing psychological programs for mothers. Conclusion Mothers of children aged 1-3 years experienced anger owing to various factors, but adapted by developing coping skills. This study recommends family-based support interventions to help mothers manage their emotions and parenting roles.

BACKGROUND: Dense breast reduced the sensitivity of mammography in breast cancer screening and known as an independent risk factor of breast cancer. The relationship between breast density and age, body mass index has studied. However, there are few studies on the relationship between breast density and lifestyle related disease. In this study, we investigated the relationship between mammographic breast density and lifestyle related disease. METHODS: Retrospective cross sectional research was carried out from people who visited a single health screening center in Busan from January 2015 to December 2015. We investigated age, past history of the subjects and measured their height, weight, blood pressure and waist circumference. The biochemical test was carried out using their blood. All patients underwent mammography. The breast density on mammography determined by the basis of American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) breast composition and 996 people was recruited. RESULTS: In the distribution of breast density, 16.3% of women (n=160) had dense breast. Age (under 49), body mass index (BMI) (underweight) were positively correlated with the BI-RADS composition category 3, 4 but the number of lifestyle related disease were negatively correlated (age ρ=0.17, BMI ρ=0.39, the number of lifestyle related disease ρ=-0.21). The odds ratio (OR) of dense breast increased with decreasing lifestyle related disease severity (OR=3.06, 95% confidence interval: 1.13-8.22, P=0.027). CONCLUSIONS: This study showed that the number of lifestyle related disease was negatively correlated with mammographic density. The OR of dense breast increased with decreasing lifestyle related disease severity. Therefore, primary physicians should consider negative correlation between breast density and lifestyle related disease in breast cancer screening.
Blood Pressure ; Body Mass Index ; Breast Neoplasms ; Breast* ; Busan ; Female ; Humans ; Information Systems ; Life Style* ; Mammography* ; Mass Screening ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Waist Circumference