Purpose: This study investigated the factors that influence depression in adolescents diagnosed with asthma in South Korea, providing basic data supporting efforts to improve adolescents' mental health. Methods: Multiple regression analysis was conducted on 4,020 subjects who had been diagnosed with lifelong asthma among the 57,303 respondents to the 15th Korea Youth Risk Behaviour Web-Based Survey from 2019. Results: The participants were more likely to have depression if they were female, in middle school, their academic achievement was poor, they were drinkers or smokers, if they felt a very high amount of stress, and if they experienced very inadequate recovery from fatigue. Adolescents with asthma were 9.00 times more likely to experience depression when they felt a very high amount of stress (95% confidence interval [CI]= 5.51-14.69, p<.001) than when they felt no stress. Conclusion Given these factors, measures to improve the mental health of adolescents should be developed and expanded, especially to decrease their stress levels. A separate program that is different from the school's regular health curriculum should be developed to manage the stress levels of adolescents with asthma, such as an after-school program or a program conducted at a local community centre.

PURPOSE: Tumor necrosis factor related apoptosis-inducing ligand (TRAIL) induces apoptosis in many human cancer cells but not in normal cells. Thyroid cancer cells, however, appear to be relatively resistant to TRAIL-induced apoptosis. We investigated the effect of troglitazone, a PPARγ agonist, on TRAIL-induced apoptosis in thyroid cancer cells. METHODS: We used 6 thyroid cancer cell lines: TPC-1, FTC- 133, FTC-236, FTC-238, XTC-1, and ARO82-1. We used flow cytometry to detect apoptosis and used MTT assay to measure anti-proliferation effects. ANOVA was used for statistical analysis. RESULTS: TPC-1 cells were the most sensitive to soluble TRAIL. FTC-133 and ARO82-1 were resistant to TRAIL and growth inhibition was less than 20% at concentration of 800 ng/ml of TRAIL. In both TPC-1 (TRAIL-sensitive) and FTC- 133 (TRAIL-resistant) thyroid cancer cell lines, pretreatment with troglitazone enhanced TRAIL-induced cell death significantly. Bcl-family proteins did not seem to be involved in sensitization of TRAIL-induced apoptosis by troglitazone. CONCLUSION: TRAIL in combination with troglitazone induces apoptosis in thyroid cancer cells at suboptimal concentrations that can not be achieved using TRAIL alone.
Apoptosis* ; Cell Death ; Cell Line* ; Flow Cytometry ; Humans ; Thyroid Gland* ; Thyroid Neoplasms* ; Tumor Necrosis Factor-alpha

Anterior clinoid process is a small bony structure but it is very important regarding its location and relationships with neighboring neurovascular, dural, and bony structures. Removal of this process has been used in various modification of standard pterional approach. The authors have speculated how much expansion of operative window could be obtained with anterior clinoidectomy, so we measured the lengths of optic nerve, internal carotid artery, and the length and width of optico-carotid triangle(OCT) before and after extradural anterior clinoidectomy 17 times in 10 cadaveric heads. This procedure provided about two fold increase in the length of optic nerve and OCT, and over three fold expansion in the width of OCT. The results indicate that the addition of this relatively simple and easy procedure to standard approach makes the operative field more comfortable and safe than expected. We believe this procedure can be used routinely with or without combination of wide skull base exposure in cases of such lesions as belows: 1) lesions causing optic nerve or chiasmatic compression, 2) lesions encircling/covering the optic nerve and internal carotid artery, 3) lesions arising from or extending into the optic canal, orbital apex, and paraclinoid region, 4) suprasellar/parasellar lesions with limited operative windows(e.g. prefixed chiasm, infra-optic or subchiasmatic locations or adherence).
Cadaver* ; Carotid Artery, Internal* ; Head ; Optic Nerve* ; Orbit ; Skull Base

Laparoscopic sleeve gastrectomy (LSG) has become a standalone primary procedure as a bariatric metabolic surgery since the early 2000s. The overall complication rate of LSG is reported to range from 2% to 15%. Staple line leakage (SLL) remains a major adverse event and occurs in approximately 1%–6% of patients. Choosing the optimal treatment modality is a complex process. Clinicians must understand that nutritional support and drainage of fluid collection are essential for initial management. Conservative endoscopic management and sufficient drainage can resolve approximately 70% of SLLs. Endoscopic management of bariatric complications has been rapidly evolving in recent years and can be considered in all patients who are hemodynamically stable. We will review the available endoscopic management techniques, including stent placement (self-expanding stents and bariatric-specific stents), clipping, tissue sealant application, and internal drainage (double-pigtail stents [DPS] placement, endoscopic vacuum therapy, and septotomy). Stent placement remains the mainstream treatment for SLLs. However, healing with stents requires multiple sessions/stents and a long course of recovery. Endoscopic internal drainage is gaining popularity and has the potential to be a superior method. The importance of early intervention and combined endoscopic methods should be recognized.

Purpose: The purpose of this study is to evaluate the usefulness of individualized metabolic surgery score for Korean patients in determining bariatric surgical procedures. Materials and Methods: A total of 135 patients with type 2 diabetes mellitus who underwent sleeve gastrectomy (n=19) or Roux-en-Y gastric bypass (n=116) at our institute with a 1-year follow up were analyzed for the predictive power of diabetes remission using the individualized metabolic surgery scoring system. Results: At the postoperative follow-up of 1 year, the remission of type 2 diabetes mellitus (HbA1C＜6.5%, off medications) was achieved in 88 (65.2%) patients. The remission rates showed no significant differences between patients who underwent sleeve gastrectomy and Roux-en-Y gastric bypass (63.2% versus 65.5%; P=0.84), regardless of the severity of type 2 diabetes mellitus. Although there was no statistically significant difference in the remission rate according to the bariatric surgery procedures (P＞0.99 in mild, P=0.11 in moderate, P＞0.99 in severe IMS score), remission rates were higher in moderate severity patients who underwent Roux-en-Y gastric bypass than in those who underwent sleeve gastrectomy (69.7% versus 37.5%). Conclusion The remission rates after bariatric surgery procedures were similar to that of the previously reported study. Despite the limitations of our data, the individualized metabolic surgery score can be used as a complement to other scoring systems in Korean patients.

Cesarean hysterectomy is associated with high risks of severe blood loss, postoperative complication, and maternal morbidity. This study was undertaken to identify the risk factors of cesarean hysterectomy and to reduce the postoperative complications and maternal morbidity. There were 6,362 deliveries between January 1992 and December 1996 at department of obstetrics and gynecology, Inchon Christian Hospital. 1'he results of this study were as follows, 15 cases of cesarean hysterectomy were performed during this period. Cesarean hysterectomy was performed in 10 cases (0.32 %) among 3178 cesarean deliveries and in 5 cases (0.16 %) among 3184 vaginal deliveries. The incidence of cesarean hysterectomy was 0.24 % (15/6,362). The age of patients ranged from 24 to 38 years old. The maternal mortality and morbidity were 0 % (0/15) and 86.7% (13/15), respectively. Indications for cesarean hysterectomy were uterine atony (53.3 %), uterine myoma with pregnancy (20.0 %), placenta accreta and/or increta(20.0 %), and placenta previa (6.7 %) in orders. The associated risk factors of cesarean hysterectomy were prior cesarean delivery (46.7 %) and placenta previa (6.7 %). The postoperative complications were anemia (60.0%), febrile morbidity (13.3 %), paralytic ileus (6.7 %), and wound disruption (6.7 %). We concluded that risk factors of cesarean hysterectomy were cesarean delivery, prior cesarean delivery, uterine myoma with pregnancy, placenta accreta and/or increta, and placenta previa and that sufficient fresh blood and careful prenatal care were needed in risk group of postpartum bleeding.
Adult ; Anemia ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Incheon ; Incidence ; Intestinal Pseudo-Obstruction ; Leiomyoma ; Maternal Mortality ; Obstetrics ; Placenta Accreta ; Placenta Previa ; Postoperative Complications ; Postoperative Hemorrhage ; Postpartum Period ; Pregnancy ; Prenatal Care ; Risk Factors ; Uterine Inertia ; Wounds and Injuries

PURPOSE: Troglitazone is a potent agonist for the peroxisome proliferator-activated receptor-gamma (PPARgamma), which is a ligand-activated transcription factor that regulates cell differentiation and growth. Antiproliferative effects of troglitazone have been reported in several human cancers including thyroid cancer. In the present study, we evaluated the redifferentiation effects of troglitazone in human cancers regarding the modulation of CD97 and sodium-iodide symporter (NIS) gene expression. METHODS: We used 3 human thyroid cancer cell lines: TPC-1 (papillary), FTC-133 (follicular), and XTC-1 (H rthle). Surface expression of CD97, a novel dedifferentiation marker, was measured by flow cytometry. mRNA expression of NIS gene was measured by real time quantitative PCR using TaqMan probe. RESULTS: Troglitazone down-regulated the surface expression of CD97 in FTC-133 cells and up-regulated (NIS) mRNA in TPC-1, FTC-133 and XTC-1 cells. CONCLUSION: Our investigations documented that troglitazone, a PPARgammaagonist, induced redifferentiation in thyroid cancer cell lines. In patients who have poorly differentiated thyroid cancer unresponsive to traditional treatments, PPARgammaagonists may therefore reintroduce the effectiveness of traditional treatments.
Cell Differentiation ; Cell Line* ; Flow Cytometry ; Gene Expression ; Humans* ; Ion Transport ; Peroxisomes ; Polymerase Chain Reaction ; RNA, Messenger ; Thyroid Gland* ; Thyroid Neoplasms* ; Transcription Factors

PURPOSE: Sodium-4-phenylbutyrate (Na-4-PB) is an analogue of phenylacetate, which is a well-known redifferentiating agent. In vitro and in vivo studies on this agent have been done and the clinical relevance of Na-4-PB has been studied in other malignancies, but not in thyroid cancer. We investigated the effect of Na-4-PB on cell proliferation and differentiation in thyroid cancer cell lines. METHODS: We used 5 thyroid cancer cell lines: TPC-1, FTC-133, FTC-236, FTC-238 and XTC-1. MTT assay and flowcytometry were used to measure the agent's antiproliferative effects and the cell cycle change. We evaluated the PPARgamma expression via western blotting and the mRNA expressions of NIS, Tg and CD 97 were determined by performing RT-PCR. Troglitazone, a potent PPARgamma agonist, was used in combined treatment with Na-4-PB. RESULTS: Na-4-PB inhibited cell proliferation in a dose and time dependent manner in all 5 thyroid cancer cell lines. By performing flowcytometry in the FTC-133 and TPC-1 cell lines, we identified that the antiproliferative effect of Na-4-PB was associated with an increased apoptotic cell population. Treatment with Na-4-PB upregulated the PPARgamma expression, but the combined treatment of Na-4-PB with troglitazone did not seem to be synergistic for the antiproliferative effect. Treatment with Na-4-PB downregulated the CD97 mRNA expression and it upregulated the NIS and Tg mRNA expressions in both the FTC-133 and TPC-1 cell lines. CONCLUSION: Na-4-PB inhibited thyroid cancer cell proliferation by inducing apoptosis in a dose dependent manner. Treatment with Na-4-PB increased the expression of PPARgamma and it upregulated such differentiation markers as NIS and Tg, and it downregulated CD97, a dedifferentiation marker. Na-4-PB should be further evaluated as a new potential therapeutic agent for patients with thyroid cancer.
Antigens, Differentiation ; Apoptosis ; Blotting, Western ; Cell Cycle ; Cell Line ; Cell Proliferation ; Chromans ; Histone Deacetylase Inhibitors ; Humans ; Phenylacetates ; PPAR gamma ; RNA, Messenger ; Thiazolidinediones ; Thyroid Gland ; Thyroid Neoplasms

OBJECTIVES: To compare results of 4 different extraction methods in laparoscopic management of dermoid cyst. STUDY DESIGN: This article is a retrospective, multicenter study for 247 patients with benign dermoid cyst in period of 1995-1998. Dermoid cyst was extracted by Endopouch (99 cases), puncture-irrigation-extraction (69 cases), colpotomy (35 cases), and dermoid cyst as a "pouch bag" (44 cases). RESULTS: We analyzed irrigation amount, operative time, postoperative hospital stay and complications by four different extraction methods. Endopouch extraction method needed less amount of irrigation fluid for cleaning the abdominal cavity and had a shorter postoperative hospital stay (ANOVA, p=0.0001). There were no significant differences in operative times among groups. There were four cases of morbidity in puncture-irrigation-extraction method (6%), three had fever (> 38degrees C) and one intraabdominal abscess. One incisional hernia was noted in "pouch bag" method (2%). CONCLUSIONS: We recommend minimal spillage method for extraction of dermoid and careful irrigation of abdominal cavity to prevent potential risk of chemical peritonitis such as Endopouch, "pouch bag", and colpotomy with the exception of puncture-irrigation-extraction method.
Abdominal Cavity ; Abscess ; Colpotomy ; Dermoid Cyst* ; Fever ; Hernia ; Humans ; Laparoscopy* ; Length of Stay ; Operative Time ; Peritonitis ; Retrospective Studies*

PURPOSE: The in vitro dissolution of intrahepatic stones was evaluated using the various solvent mixtures. MATERIALS AND METHODS: Sixty four intrahepatic stones from 16 patients were used. Four kinds of solvent mixtures(No. 1 = basic buffer + EDTA, No. 2=1 + Sulfobetain-12, No. 3=2 + N-acetylcysteine, No. 4=3 + urea) were used. Dissolution rates were determined by measuring the weight loss of stones after 6, 12, 24, 48 hours incubation periods, respectively. RESULTS: The highest dissolution rates in dissolving intrahepatic stones were achieved with No. 4 solvent mixture(1% W/V EDTA/80mM, Sulfobetain-12/1 M, urea, pH 9.5). CONCLUSION: lntrahepatic stones could be largely dissolved up to about 70% of their initial weight after 48 hours incubation period in vitro.
Acetylcysteine ; Edetic Acid ; Humans ; Hydrogen-Ion Concentration ; Urea ; Weight Loss