Gastric stricture is caused by the ingestion of caustic materials, or by the involvement of a gastric infiltrating carcinoma. Corrosive injury-induced stricture is uncommon and the gastric injury caused by calcium fertilizer has not been reported in Korea. Once the diagnosis of gastric stricture is confirmed, an early definitive surgical intervention should be performed. Sometimes balloon dilatation on stricture may be attempted in suitable cases. We report a case of gastric stricture caused by ingestion of chemical fertilizer containing calcium and managed with radiologic balloon dilatation in a 73-year-old man.
Aged ; Calcium ; Constriction, Pathologic* ; Diagnosis ; Dilatation ; Eating ; Humans ; Korea

At present, graduates of international pharmacy schools can apply to take the Korean Pharmacist Licensing Examination after passing a review by the Accreditation Board of the Pharmacy Schools and Licenses. However, since the educational content of different schools and the roles of pharmacists differ from country to country, a preliminary examination might be necessary before the Pharmacist Licensing Examination. To prepare to implement a preliminary examination for foreign pharmacy graduates in Korea, we summarized the preliminary examinations used in four other countries and presented a proposal for a preliminary examination. Data were collected via the internet and through telephone interviews with appropriate persons. The proposal was revised after a public forum. There are preliminary examinations in the USA, Canada, Australia, and the United Kingdom, and these involve written, oral, practice, and English proficiency tests. We proposed that the Korean preliminary examination consist of a written test on basic pharmacy, a test in the Korean language, and an interview. The preliminary examination should include suitable items that effectively evaluate international graduates. Graduates of international pharmacy schools who have an ability equivalent to graduates of Korean pharmacy schools should be eligible to write the Korean Licensing Examination.
Accreditation ; Australia ; Canada ; Great Britain ; Humans ; Internet ; Interviews as Topic ; Korea ; Licensure ; Pharmacists ; Pharmacy ; Schools, Pharmacy

The inner ear is composed of a cochlear duct and five vestibular organs in which mechanosensory hair cells play critical roles in receiving and relaying sound and balance signals to the brain. To identify novel genes associated with hair cell differentiation or function, we analyzed an archived gene expression dataset from embryonic mouse inner ear tissues. Since atonal homolog 1a (Atoh1) is a well known factor required for hair cell differentiation, we searched for genes expressed in a similar pattern with Atoh1 during inner ear development. The list from our analysis includes many genes previously reported to be involved in hair cell differentiation such as Myo6, Tecta, Myo7a, Cdh23, Atp6v1b1, and Gfi1. In addition, we identified many other genes that have not been associated with hair cell differentiation, including Tekt2, Spag6, Smpx, Lmod1, Myh7b, Kif9, Ttyh1, Scn11a and Cnga2. We examined expression patterns of some of the newly identified genes using real-time polymerase chain reaction and in situ hybridization. For example, Smpx and Tekt2, which are regulators for cytoskeletal dynamics, were shown specifically expressed in the hair cells, suggesting a possible role in hair cell differentiation or function. Here, by reanalyzing archived genetic profiling data, we identified a list of novel genes possibly involved in hair cell differentiation.
Animals ; Brain ; Cell Differentiation ; Cochlear Duct ; Ear, Inner ; Gene Expression ; Hair ; In Situ Hybridization ; Mice ; Real-Time Polymerase Chain Reaction

OBJECTIVE: We investigated whether patients with out-of-hospital cardiac arrest (OHCA) due to an acute myocardial infarction without cardiogenic shock required higher doses of vasopressors with low targeted temperature management (TTM) after return of spontaneous circulation. METHODS: We included consecutive comatose patients resuscitated from OHCA between January 2011 and December 2013. Patients with return of spontaneous circulation, regional wall motion abnormality on echocardiography, and coronary artery stenosis of ≥70% on percutaneous coronary artery angiography were enrolled. These patients received 36°C TTM or 33°C TTM following approval of TTM by patients’ next-of-kin (36°C and 33°C TTM groups, respectively). The cumulative vasopressor index was compared between groups. RESULTS: During induction phase, dose of vasopressors did not differ between groups. In the maintenance phase, the norepinephrine dose was 0.37±0.57 and 0.26±0.91 µg·kg⁻¹·min⁻¹ in the 33°C and 36°C TTM groups, respectively (P<0.01). During the rewarming phase, the norepinephrine and dopamine doses were 0.49±0.60 and 9.67±9.60 mcg·kg⁻¹·min⁻¹ in the 33°C TTM group and 0.14±0.46 and 3.13±7.19 mcg·kg⁻¹·min⁻¹ in the 36°C TTM group, respectively (P<0.01). The median cumulative vasopressor index was 8 (interquartile range, 3 to 8) and 4 (interquartile range, 0 to 8) in the 33°C and 36°C TTM groups, respectively (P=0.03). CONCLUSION: In this study, patients with OHCA due to acute myocardial infarction without cardiogenic shock had an elevated vasopressor requirement with 33°C TTM compared to 36°C TTM during the maintenance and rewarming phases.
Angiography ; Coma ; Coronary Stenosis ; Coronary Vessels ; Dopamine ; Echocardiography ; Humans ; Hypothermia ; Myocardial Infarction* ; Norepinephrine ; Out-of-Hospital Cardiac Arrest* ; Rewarming ; Shock, Cardiogenic* ; Vasoconstrictor Agents

Diospyros burmanica Kurz. is an evergreen deciduous tree distributed in Mandalay of Myanmar, which belongs to the family of Ebenaceae. In Myanmar, it has been used to treat diarrhea, diabetes, diabetes and also as lumbers. In this study, seven flavonoids (1 - 7), a phenolic compound (8), and five triterpenes (9 - 13) were isolated from the barks of D. burmanica and their chemical structures were elucidated. Isolates were identified to be (+)-catechin (1), (+)-catechin 3-O-alpha-L-rhamnopyranoside (2), (+)-catechin 3-O-gallate (3), (-)-epicatechin (4), (-)-epicatechin 3-O-gallate (5), (+)-afzelechin 3-O-alpha-L-rhamnopyranoside (6), (+)-2,3-trans-dihydrokaempferol 3-O-alpha-L-rhamnopyranoside (7), methyl gallate (8), lupeol (9), methyl lup-20(29)-en-3-on-28-oate (10), beta-amyrin (11), alpha-amyrin (12), 3beta-hydroxy-D:B-friedo-olean-5-ene (13) through MS, 1H NMR and 13C NMR spectroscopic evidences.
Catechin ; Diarrhea ; Diospyros* ; Ebenaceae ; Flavonoids ; Humans ; Myanmar ; Phenol* ; Trees ; Triterpenes*

Most of the patients with hemorrhagic fever with renal syndrome (HFRS) by Hantaviruses recover completely. However, the prevalence of hypopituitarism as sequel of HFRS may be approximately 10%. However, it is rare for hyponatremia to present as a manifestation of hypopituitarism due to HFRS. A 42-year-old Asian woman presented with anorexia, nausea, and vomiting. She had a history of HFRS 7 years ago. During her first hospital admission, her serum sodium was 103 mmol/L. The rapid adrenocorticotropic hormone (ACTH) stimulation test showed no abnormal findings suggesting the possibility of adrenal insufficiency. After she underwent fluid therapy for 5 days, her serum sodium level was slightly increased to 131 mmol/L, and her clinical symptoms were improving. The next day after she was discharged, she suffered from the same symptoms and was admitted to our hospital again. On the day of her second admission, her serum sodium was 117 mmol/L. A combined pituitary function test showed diminished function of the anterior pituitary gland, which led to secondary adrenal insufficiency. Magnetic resonance imaging findings of her sella were compatible with empty sella turcica. After the replacement of prednisolone, her serum sodium levels returned to normal. Pituitary dysfunction should be included in the differential diagnosis of severe hyponatremia, especially in patients who suffered HFRS. This case also suggests that the rapid ACTH stimulation test has limitations with regard to the differential diagnosis of primary or secondary adrenal insufficiency.
Adrenal Insufficiency ; Adrenocorticotropic Hormone ; Adult ; Anorexia ; Asian Continental Ancestry Group ; Diagnosis, Differential ; Empty Sella Syndrome ; Female ; Fluid Therapy ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Hyponatremia ; Hypopituitarism ; Magnetic Resonance Imaging ; Nausea ; Pituitary Function Tests ; Pituitary Gland, Anterior ; Prednisolone ; Prevalence ; Sodium ; Vomiting

PURPOSE: The Korean Triage and Acuity Scale (KTAS), which was developed in 2012 due to the need for a single triage tool for emergency patients in Korea, has since become nationalized. Although five years has passed, there has been limited evidence of its validation. Therefore, this study was conducted to analyze the validity of the new triage system. METHODS: We conducted a multicenter prospective study. Data were collected from seven hospitals and 42,187 patients were classified using the KTAS from April 1, 2013 to July 6, 2014. We analyzed whether the indirect severity variables showed meaningful differences according to KTAS levels. The variables consisted of disposition from emergency room, length of stay, numbers of consultations, examination of computed tomography, emergency room costs, and performance of emergent interventions. RESULTS: From KTAS level 1 to 5, a decreasing trend in the length of stay in emergency room, frequency of consultation with other departments, admission, computed tomography rate, emergency intervention rate, and emergency room costs was observed. Upon binominal logistic regression, disposition from emergency room and emergent intervention rate showed the highest odds ratio with statistical significance. CONCLUSION: The results of this study demonstrated that KTAS is a valid emergency triage tool that reflects the severity of the patient with indirect indicators. The results of this study will be useful as a reference for quality control of KTAS.
Emergencies ; Emergency Service, Hospital ; Health Resources ; Humans ; Korea ; Length of Stay ; Logistic Models ; Odds Ratio ; Prospective Studies ; Quality Control ; Referral and Consultation ; Triage

Purpose: We investigated the association between continuous renal replacement therapy (CRRT) and mortality after acute glyphosate or glufosinate intoxication. Methods: The electronic medical records of patients with acute herbicide ingestion who were admitted to the regional emergency center of a metropolitan city in Korea from 3/1/2013 to 2/28/2022 were analyzed and reviewed retrospectively. The case group received CRRT, while the control group did not. In total, 96 patients experienced acute herbicide intoxication in the study period. Baseline characteristics were analyzed and compared between the two groups after propensity score matching. The outcome variable was mortality fitted by a Cox proportional hazard model. Results: After full matching between cases of CRRT use and controls (patients who did not receive CRRT) using propensity scores, 96 patients (27 cases, 69 controls) were analyzed. Propensity matching yielded adequate balance (standardized mean differences <0.25) for all covariates. We fit a Cox proportional hazards model with survival as the outcome and CRRT as a factor, including the matching weights in the estimation. The estimated hazard ratio was 0.41 (95% confidence interval, 0.23–0.76; p=0.0044), indicating that CRRT reduced mortality. Conclusion In this propensity score-matched analysis, CRRT reduced mortality in patients who visited the hospital with acute glyphosate or glufosinate intoxication. In patients with acute herbicide poisoning with high severity calculated by the APACHE II (Acute Physiology and Chronic Health Evaluation II) score and SOFA (Sequential Organ Failure Assessment) score, CRRT should be actively considered to improve the survival rate.

No abstract available.
Brain Diseases ; Hashimoto Disease ; Memory ; Neuroimaging ; Seizures ; Vasculitis

Anthocyanins are water soluble plant pigments which are responsible for the blue, red, pink, violet colors in several plant organs such as flowers, fruits, leaves and roots. In recent years, anthocyanin-rich foods have been favored as dietary supplements and health care products due to diverse biological activities of anthocyanins including antioxidant, anti-allergic, anti-diabetic, anti-microbial, anti-cancer and preventing cardiovascular disease. High-performance countercurrent chromatography (HPCCC) coupled with reversed-phase medium pressure liquid chromatography (RP MPLC) method was applied for the rapid and efficient isolation of cyanidin 3-glucoside (C3G) and peonidin 3-glucoside (P3G) from black rice (Oryza sativa L., Poaceae). The crude black rice extract (500 mg) was subjected to HPCCC using two-phase solvent system composed of tert-butyl methyl ether/n-butanol/acetonitrile/0.01% trifluoroacetic acid (TBME/B/A/0.01% TFA, 1 : 3 : 1 : 5, v/v, flow rate - 4.5 mL/min, reversed phase mode) to give enriched anthocyanin extract (37.4 mg), and enriched anthocyanin extract was sequentially chromatographed on RP-MPLC to yield C3G (16.5 mg) and P3G (8.7 mg). The recovery rate and purity of isolated C3G were 76.0% and 98.2%, respectively, and those of P3G were 58.3% and 96.3%, respectively. The present study indicates that HPCCC coupled with RP-MPLC method is more rapid and efficient than multi-step conventional column chromatography for the separation of anthocyanins.
Anthocyanins ; Cardiovascular Diseases ; Chromatography* ; Chromatography, Liquid ; Countercurrent Distribution* ; Delivery of Health Care ; Dietary Supplements ; Flowers ; Fruit ; Plants ; Trifluoroacetic Acid ; Viola