This study was prospectively conducted to investigate any relationship of nutritional status at the time of admission to length of hospital stay and mortality. All patients admitted to the Asan Medical Center between October 13 and November 12, 1997 who met the study criteria were included in the study. Patients were classified as Not-at-risk, At-risk I or At-risk II based on the levels of serum albumin and total lymphocyte count in a computerized nutrition screening program. Sixty three percent of the patients were classified as Not-at-risk Group, 29% as At-risk Group I and 8% as At-risk Group II. Significant correlation was observed between nutritional status and LOS (P<0.01) as well as mortality rate (P<0.05). The more the patient had the nutritional risk factors, the longer the LOS and the higher the mortality rate were. Further studies have to be done in order to demonstrate cost-effectiveness of medical therapy for the malnourished hospitalized patients.
Chungcheongnam-do ; Humans ; Length of Stay* ; Lymphocyte Count ; Mass Screening* ; Mortality* ; Nutritional Status* ; Prospective Studies* ; Risk Factors ; Serum Albumin

Bruxism is a diurnal or nocturnal parafunctional activity that includes tooth clenching, bracing, gnashing, and grinding. The dopaminergic system seems to be the key pathophysiology of bruxism and diminution of dopaminergic transmission at the prefrontal cortex seems to induce it. We report two patients with diurnal bruxism in whom a bilateral frontal lobe injury resulted from hemorrhagic stroke or traumatic brain injury. These patients' bruxism was refractory to bromocriptine but responded to low-dose metoclopramide therapy. We propose that administering low doses of metoclopramide is possibly a sound method for treating bruxism in a brain injury patient with frontal lobe hypoperfusion on positron emission tomography imaging.
Braces ; Brain Injuries* ; Brain* ; Bromocriptine ; Bruxism* ; Frontal Lobe ; Humans ; Metoclopramide* ; Positron-Emission Tomography ; Prefrontal Cortex ; Receptors, Dopamine ; Stroke ; Tooth

Primary splenic tumors are rare and mainly found incidentally on radiologic studies. Among them, sclerosing angiomatoid nodular transformation (SANT) of the spleen is a new entity defined as a benign pathologic lesion. Most SANTs have no clinical symptoms and are occasionally accompanied by other splenic diseases such as malignancies. So, the exact diagnosis of the nature of the splenic tumor is mandatory for further treatment. But, preoperative diagnosis is not easy since it is difficult to obtain the tissue from the spleen for pathological study. Recently, laparoscopic splenectomy has become the more standard procedure for the spleen for diagnosis and treatment. Here, we report a rare case of SANT diagnosed following laparoscopic splenectomy.
Spleen ; Splenectomy ; Splenic Diseases

BACKGROUND/OBJECTIVES: Inflammation is associated with various types of acute and chronic alcohol liver diseases. In this study, we examined whether umbelliferone (7-hydroxycoumarin, UF) ameliorates chronic alcohol-induced liver damage by modulating inflammatory response and the antioxidant system. METHODS: Rats were fed a Liber-Decarli liquid diet containing 5% alcohol with or without UF (0.05 g/L) for 8 weeks, while normal rats received an isocaloric carbohydrate liquid diet. RESULTS: Chronic alcohol intake significantly increased serum tumor necrosis factor-alpha (TNF-alpha) and interleukin 6 levels and decreased interleukin 10 level; however, UF supplementation reversed the cytokines related to liver damage. UF significantly suppressed hepatic lipopolysaccharide binding protein, toll-like receptor 4 (TLR4), nuclear factor kappa B, and TNF-alpha gene expression increases in response to chronic alcohol intake. Masson's trichrome staining revealed that UF improved mild hepatic fibrosis caused by alcohol, and UF also significantly increased the mRNA expressions and activities of superoxide dismutase and catalase in liver, and thus, decreased lipid peroxide and mitochondrial hydrogen peroxide levels. CONCLUSIONS: The findings of this study indicate that UF protects against alcohol-induced liver damage by inhibiting the TLR4 signaling pathway and activating the antioxidant system.
Animals ; Antioxidants* ; Carrier Proteins ; Catalase ; Cytokines ; Diet ; Fibrosis ; Gene Expression ; Hydrogen Peroxide ; Inflammation ; Interleukin-10 ; Interleukin-6 ; Liver ; Liver Diseases ; NF-kappa B ; Rats* ; RNA, Messenger ; Superoxide Dismutase ; Toll-Like Receptor 4 ; Tumor Necrosis Factor-alpha

The proteasome inhibitor, bortezomib, is ineffective against many solid tumors. Nutlin-3 is a potent antagonist of human homolog of murine double minute 2/p53 interaction exhibiting promising therapeutic anti-cancer activity. In this study, we show that treatment of various p53-defective bortezomib-resistant solid tumor cells with bortezomib plus nutlin-3 induces paraptosis, which is a cell death mode accompanied by dilation of the endoplasmic reticulum (ER) and mitochondria. Bortezomib alone did not markedly alter cellular morphology, and nutlin-3 alone induced only a transient mitochondrial dilation. However, bortezomib/nutlin-3 co-treatment triggered the progressive fusion of swollen ER and the formation of megamitochondria, leading to cell death. Mechanistically, proteasomal-impairment-induced ER stress, CHOP upregulation and disruption of Ca²⁺ homeostasis were found to be critically involved in the bortezomib/nutlin-3-induced dilation of the ER. Our results further suggest that mitochondrial unfolded protein stress may play an important role in the mitochondrial dilation observed during bortezomib/nutlin-3-induced cell death. Collectively, these findings suggest that bortezomib/nutlin-3 perturbs proteostasis, triggering ER/mitochondria stress and irrecoverable impairments in their structure and function, ultimately leading to paraptotic cell death.
Bortezomib* ; Cell Death ; Endoplasmic Reticulum ; Homeostasis ; Humans ; Mitochondria ; Proteasome Inhibitors ; Up-Regulation

Posterior reversible encephalopathy syndrome (PRES) is a rare disorder that is associated with hypertensive crises. In this article, we present a 59-year-old male patient with posterior reversible encephalopathy syndrome (PRES) caused by an acute hypertensive crisis after entering a steam bath in alcohol intoxicated status. In our case, oxidative stress resulting from alcohol metabolism may have lead to blood brain barrier (BBB) breakdown, serving as an aggravating factor in PRES. Thus we must always consider the possibility of PRES when treating chronic alcoholic patients with abnormal neurologic symptoms.
Alcoholics* ; Blood-Brain Barrier ; Humans ; Hypertension ; Male ; Metabolism ; Middle Aged ; Neurologic Manifestations ; Oxidative Stress ; Posterior Leukoencephalopathy Syndrome* ; Steam Bath* ; Steam*

OBJECTIVE: The Revised Obsessive Intrusion Inventory (ROII) is a 52-item scale that evaluates obsessional intrusive thoughts. The aim of the present study was to validate a short, 20-item Korean version of the ROII (ROII-20). METHODS: Of the 1125 participants who completed the ROII-20, 895 participants completed the scale to examine the factor structure of the scale. A subgroup of these participants (n=53) completed the scale twice to determine test-retest reliability. To establish external validity, 230 participants completed the scale and other questionnaires. RESULTS: Exploratory factor analyses suggested a hierarchical model comprising two higher order factors of autogenous obsessions (resulting from aggressive thoughts and sexual thoughts) and reactive obsessions (resulting from thoughts about contamination, thoughts about accidents, and thoughts about dirt). Confirmatory factor analyses supported this model. The results indicated good internal consistency and test-retest reliability. External validity was supported by relationships with obsessive-compulsive symptoms and general distress. CONCLUSION: The ROII-20 presents good psychometric properties and may be considered as a promising instrument for measuring obsessional intrusions.
Obsessive Behavior ; Psychometrics* ; Surveys and Questionnaires

The purpose of this study was to assess dental hygienists' awareness of medical technician jurisprudence. The study was conducted over a 2-month period from March 1 to May 1, 2016. A self-reported questionnaire was completed by 201 dental hygienists in Seoul, Gyeonggi, and Incheon province. The questionnaire consisted of items on the awareness of the jurisprudence pertaining to medical technician jurisprudence. Data were analyzed using the IBM SPSS Statistics ver. 19.0 program. We found that 32.8% of the respondents were aware of medical technician jurisprudence. Low awareness that result was due to “insufficient public relations efforts.” The respondents thought that medical technician jurisprudence are inefficient in clinical settings. Of the dental hygienists, 75.9% replied that task distribution was unclear and 40.0% lacked awareness of the distribution of dentists' duties (40.0%). A total of 59.8% of respondents showed intention to participate in medical jurisprudence seminars. Of the dental hygienists, 77.0% agreed with the insert dental hygienists under medical jurisprudence category. In conclusion, dental hygienists' awareness of medical technician jurisprudence should be improved. In addition, the dental hygienist jurisprudence need to be revised regarding job status.
Dental Hygienists ; Gyeonggi-do ; Humans ; Incheon ; Intention ; Jurisprudence* ; Public Relations ; Seoul ; Surveys and Questionnaires

PURPOSE: To determine the change in lacrimal gland (LG) acinar cells induced by in vivo dry eye (DE). METHODS: Six to 8-week-old (C57BL/6) mice were placed in a controlled environment chamber at <20% humidity for 2 weeks, and a control group was bred in a normal environment. After these 2 weeks of dry eye (DE) induction, the mice were sacrificed and their LGs were collected. Lacrimal gland acinar cell organelle structures were observed with Transmission Electron Microscopy (TEM). TEM images were analyzed using the Image J program. RESULTS: The size of the LGs of DE-induced mice decreased compared to those of normal mice. Terminal deoxynucleotidyl transferase dUTP Nick End Labeling (TUNEL) staining was negative in DE-induced LGs. Under the TEM, the endoplasmic reticulum (ER) lumen was dilated and the lumen density increased in DE-induced mice. Additionally, cell organelles were surrounded by elongated ER lumens. The mitochondrial structure was destroyed and the number of vacuoles increased in the LGs of DE-induced mice. CONCLUSIONS: Structural changes of the LG developed due to DE induction. This suggests that the detailed mechanisms of these changes were ER stress and autophagy. However, there were no definite signs of apoptosis in the acinar cells of the DE-induced LGs. These findings are regarded as an important clue of the pathogenesis of non-Sjogren-type dry eye.
Acinar Cells* ; Animals ; Apoptosis ; Autophagy ; DNA Nucleotidylexotransferase ; Endoplasmic Reticulum ; Environment, Controlled ; Humidity ; Lacrimal Apparatus* ; Mice ; Microscopy, Electron, Transmission ; Organelles ; Vacuoles

Behcet's disease is an inflammatory disorder of unknown etiology with multi-organ involvement. Although it rarely involves the heart, once the heart is involved the results can be devastating. However, since cardiac involvement has various manifestations, diagnosis is challenging. The clinical features and echocardiographic findings of cardiac Behcet's may mimic culture-negative infective endocarditis. A correct diagnosis is usually made postoperatively. Here, we report the case of a 55-year-old male who was initially diagnosed with infective endocarditis that caused metastatic vertebral osteomyelitis. He underwent immediate cardiac surgery and received empirical antibiotics, but all culture findings were negative; however, he had a sustained fever and elevated inflammatory marker levels. After reviewing the results of pathologic and imaging studies, a final diagnosis of cardiac Behcet's disease was made. He was successfully treated with a high dose of corticosteroids. This report demonstrates a rare case of cardiac Behcet's disease mimicking culture-negative infective endocarditis.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Behcet Syndrome ; Diagnosis ; Echocardiography ; Endocarditis* ; Fever ; Heart ; Humans ; Male ; Middle Aged ; Osteomyelitis ; Spondylitis ; Thoracic Surgery