PURPOSE: The purpose of this study was to examine medical professionals' perception and knowledge of hospice and palliative care (HPC) and attitude toward death. METHODS: The survey was performed on 84 physicians and 172 nurses in Busan, Korea. Data were collected from April 5, 2012 to April 30, 2012. RESULTS: Regarding the purpose of HPC, the most popular perception was "To alleviate pain and accommodate comfort" among both physicians and nurses. For the need for HPC, "Terminal patients need a separate ward for emotional fluctuation" the answer chosen by both groups the most. Both groups scored low on knowledge of HPC. For pain and symptom management, physicians scored higher than nurses (physicians: 6.97+/-1.82, nurses: 5.68+/-1.93, P<0.001). CONCLUSION: Considering the survey results, we suggest development of a program to improve medical professionals' perception and knowledge of HPC and attitude toward death.
Hospice Care* ; Hospices* ; Humans ; Korea* ; Palliative Care

The VATER syndrome is defined as a nonrandom association of congenital anomalies including three or more of vertebral(V), anal(A), tracheoesophageal(TE) and radial or renal(R) deficiencies. We experienced one case of VATER syndrome in a 20 month-old male having lumbarization of sacrum, congenital imperforate anus (Ladd and Gross`s type 3) with urethrorectal fistula and left megaureter with right renal agenesis and urethrocutaneous fistula
Anus, Imperforate ; Fistula ; Humans ; Infant ; Male ; Sacrum

BACKGROUND: Tissue plasminogen activator (tPA) is known to be effective if given within 3 hours after the onset of ischemic stroke. However, no study has been performed regarding what proportion of patients with acute ischemic stroke are actually given tPA within this time window. We therefore tried to figure out the performance rate of thrombolytic therapy and acute prognosis in hyperacute ischemic stroke patients. METHODS: We prospectively registered all the acute ischemic stroke patients. Thrombolyic therapy was decided strictly according to the NINDS tPA protocol and clinical monitoring was done by the NIH Stroke Scale (NIHSS). If tPA was not given, the reason was recorded. RESULTS: Among 613 acute stroke patients during a period of 2.5 years, there were 146 (23.8%) hyperacute ischemic stroke patients within 3 hours after onset. Even in the 29 cases of in-hospital stroke, the rate of early detection and management was only 27.6% (8 cases). Among the hyperacute stroke population, 56 (38.4%) patients were treated with the thrombolytic agent and 27 patients showed positive responses. Thrombolytic therapy was not tried in the remaining 90 patients. The most common reason was expectation of favorable outcome without thrombolysis. But among these patients, subsequent neurological worsening was noticed in 9 patients, particularly in those with vertebrobasilar stroke. CONCLUSIONS: Urgent notice and management of ischemic stroke needs to be more emphasized not only to the general public, but also to medical personnel. More close observation is especially needed in vertebrobasilar stroke cases (J Korean Neurol Assoc 19(5):447~451, 2001)
Humans ; National Institute of Neurological Disorders and Stroke ; Prognosis* ; Prospective Studies ; Stroke* ; Thrombolytic Therapy* ; Tissue Plasminogen Activator

Esophageal perforation continues to be associated with high mortality - 20% to 30% - despite advances in surgical techniques. Traditional surgery has been the mainstay of treatment for perforation, but recent advances in endoscopic closure devices has increased therapeutic options for selected patients. Our patient had a fishbone-induced esophageal perforation. He was treated successfully with endoscopic clipping, antibiotics and parenteral nutrition. We report this case and provide a review of the relevant literature.
Anti-Bacterial Agents ; Esophageal Perforation ; Foreign Bodies ; Humans ; Parenteral Nutrition

Cis-diamminedichloroplatinum II (cisplatin) has been reported to induce cell death. However, the mechanism by which cisplatin is induced the apoptosis of cancer cells is still unclear. To evaluate the mechanistic insights of apoptosis by cisplatin, we tested the activities of apoptotic signaling pathway in HeLa cells. Apoptotic death of HeLa cells by cisplatin was confirmed by ladder-pattern fragmentation of genomic DNA. Cisplatin induced the activation of caspase-3 and 9 proteases in a time dependent manner. The caspase-3 protease activation and the cleavage of poly (ADP-ribose) polymerase (PARP) and procaspase-3 was demonstrated. We also showed that the expression of Bcl-2 and Bcl-xL was markedly decreased by the addition of cisplatin in HeLa cells. Moreover, expression of Fas and FasL proteins was increased by cisplatin. These data suggest that cisplatin triggers the activation of apoptotic signaling pathway in human cervical cancer, HeLa cells, via affects the expression of Fas, FasL and Bcl-2 families as well as triggers the activation of caspase-3 and -9 proteases.
Apoptosis ; Caspase 3 ; Cell Death ; Cisplatin* ; DNA ; Fas Ligand Protein ; HeLa Cells* ; Humans ; Peptide Hydrolases ; Uterine Cervical Neoplasms

No abstract available.
Aged ; Biopsy ; Chemotherapy, Adjuvant ; Colectomy ; Colonic Neoplasms/*pathology/therapy ; Humans ; Liposarcoma/*pathology/therapy ; Male ; Neoplasms, Second Primary/*pathology/therapy ; Radiotherapy, Adjuvant ; Retroperitoneal Neoplasms/*pathology/therapy ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome

PURPOSE: This study examined anxiety and depression among 108 North Korean adolescent and young adult (age, 12-29 years) defectors who settled in South Korea, and evaluated the relationship between their mental health and health-related quality of life (HRQoL). MATERIALS AND METHODS: Subjects completed a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), the Short Form with 36 questions (SF-36; consists of mental and physical health components) for measuring HRQoL, and items related to the period of time since defection and settlement and socio-demographic variables. RESULTS: Among the participants, 53.7% scored> or =8 on the anxiety measure questionnaire, and 22.2% scored> or =11; 36.1% of the participants scored> or =8 on the depression measure questionnaire and 14.8% scored> or =11. Both anxiety and depression subscales were associated with lower scores of total SF-36, physical component and mental component score. Depressive symptom appeared more frequently among the subjects who had lived in South Korea for <1 year than among the subjects who had lived in South Korea for 2 year or longer (odds ratio=3.77, 95% confidence intervals=1.12 to 12.70). CONCLUSION: Among North Korean adolescent and young adult defectors, anxiety and depression were associated with lower HRQoL. Therefore, it is needed to develop strategies to screen for mental health and intervene to reduce anxiety and depression during their early resettlement stage.
Adolescent ; Adult ; Anxiety/*epidemiology ; Child ; Democratic People's Republic of Korea ; Depression/*epidemiology ; Female ; Humans ; Male ; Prevalence ; Quality of Life ; Republic of Korea ; Sex Factors ; *Social Adjustment ; Time Factors

OBJECTIVES: Various cytokines induced by inhalation of coal dust may mediate inflammation and lead to tissue damage or fibrosis, such as coal workers' pneumoconiosis (CWP). METHODS: To investigate the relevance of serum cytokines in CWP, the levels of serum interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-alpha) as CWP biomarkers in 110 retired coal miners (22 controls and 88 CWP subjects) were related to cross sectional findings and 1-year progressive changes of the pneumoconiosis. Progressive changes of CWP were evaluated by paired comparison of chest radiographs. Analysis by a receiver operating characteristic curve assessed the biomarker potential of each cytokine. RESULTS: The mean serum IL-8 level was significantly higher in CWP compared to controls and IL-8 levels correlated with the degree of CWP. The median serum TNF-alpha level was significantly higher in subjects with progressive CWP compared to subjects without CWP progression. The area under the ROC curve for IL-8 (0.70) and TNF-alpha (0.72) for CWP identification and progression, respectively, indicated the biomarker potential of the two cytokines. Serum cutoff values of IL-8 and TNF-alpha were 11.63 pg/mL (sensitivity, 69%; specificity, 64%) and 4.52 pg/mL (sensitivity, 67%; specificity, 79%), respectively. CONCLUSION: The results suggest that high levels of serum IL-8 are associated with the presence of CWP and those of serum TNF-alpha are associated with the progression of CWP.
Anthracosis ; Biomarkers ; Coal ; Cytokines ; Dust ; Fibrosis ; Follow-Up Studies ; Inflammation ; Inhalation ; Interleukin-8 ; Matched-Pair Analysis ; Pneumoconiosis ; ROC Curve ; Sensitivity and Specificity ; Thorax ; Tumor Necrosis Factor-alpha

Flail arm syndrome (FAS), an atypical presentation of amyotrophic lateral sclerosis (ALS), is characterized by progressive, predominantly proximal, weakness of upper limbs, without involvement of the lower limb, bulbar, or respiratory muscles. When encountering a patient who presents with this symptomatic profile, possible diagnoses include upper limb onset ALS (UL-ALS), and FAS. The lack of information regarding FAS may make differential diagnosis between FAS and UL-ALS difficult in clinical settings. The aim of this study was to compare clinical and electromyographic findings from patients diagnosed with FAS with those from patients diagnosed with UL-ALS. To accomplish this, 18 patients with FAS and 56 patients with UL-ALS were examined. Significant differences were observed between the 2 groups pertaining to the rate of fasciculation, patterns of predominantly affected muscles, and the Medical Research Council scale of the weakest muscle. The presence of upper motor neuron signs and lower motor neuron involvement evidenced through electromyography showed no significant between-group differences.
Amyotrophic Lateral Sclerosis* ; Arm* ; Diagnosis ; Diagnosis, Differential ; Electromyography ; Fasciculation ; Humans ; Lower Extremity ; Motor Neuron Disease ; Motor Neurons ; Muscles ; Respiratory Muscles ; Upper Extremity*

BACKGROUND: The aim of this study was to investigate annual changes in pulmonary function in workers who were exposed to inorganic dust. METHODS: The subjects were 2,922 male patients who had been diagnosed with pneumoconiosis more than twice during 6 years from 2005 to 2010. RESULTS: Of the 2,922 cases, forced vital capacity (FVC) decreased by 54 mL in 1 year. In contrast, the annual change of forced expiratory volume in one second (FEV1) decreased by 56 mL. CONCLUSION: This is the first study that has investigated the annual change in pulmonary function in workers exposed to inorganic dust. The results will help estimate the pulmonary condition of patients who are unable to perform a pulmonary function test due to age or a disorder.
Dust ; Forced Expiratory Volume ; Humans ; Lung ; Male ; Pneumoconiosis ; Respiratory Function Tests ; Vital Capacity