OBJECTIVE: To compare the skin temperature change between supine and prone position during application of hot pack on the back. METHOD: 15 healthy adults were recruited as subjects. We applied two hot packs to the lumbar region for two consecutive days. On the first day, the body part was on the top of hot pack and on the second day, the hot pack was placed over the body part. We measured peak skin temperature, skin temperature elevation, time required to peak skin temperature, skin temperature after 20 minutes and visual analogue scale(VAS) of subjective feeling of heat (hot). RESULTS: In the peak skin temperature, the means were 44.4+/-0.70degrees C and 42.7+/-0.99degrees C in the supine and prone position, respectively. In the skin temperature elevation, the means were 11.2+/-1.1degrees C and 9.5+/-1.6degrees C, respectively. In the time required to peak skin temperature elevation, the means were 6'49"+/-15" and 10'33"+/-15", respectively. In the skin temperature after 20 minutes, the means were 42.4+/-0.7degrees C and 41.6+/-0.8degrees C, respectively. In the VAS of subjective feeling of heat (hot), the means were 8.66+/-1.11 and 5.72+/-1.48, respectively. CONCLUSION: The patient's position is one of the important factors in determining temperature elevation. Therefore, it should be considered during application of the hot pack.
Adult ; Hot Temperature ; Humans ; Lumbosacral Region ; Prone Position* ; Skin Temperature* ; Skin*

BACKGROUND: To develop a novel treatment strategy for hepatitis B virus infection, a major cause of liver chirosis and cancer, we aimed to make human monoclonal antibodies inhibiting RNase H activity of P protein playing in important role in HBV replication. In this regard, phage display technology was employed and demonstrated as an efficient cloning method for human monoclonal antibody. So this study analysed the usability of human monoclonal antibody as protein based gene therapy. METHODS: RNase H of HBV was expressed as fusion protein with maltose binding protein and purified with amylose resin column. Single chain Fv (scFv) phage antibody library was constructed by PCR cloning using total RNAs of PBMC from 50 healthy volunteers. Binders to RNase H were selected with BIAcore 2000 from the constructed library, and purified as soluble antibody fragment. The affinity and sequences of selected antibody fragments were analyzed with BIAcore and ABI automatic sequencer, respectively. And finally RNase H activity inhibiting assay was carried out. RESULTS: Recombinant RNase H expressed in E. coli exhibited an proper enzyme activity. Naive library of 4.46 X 10(9) cfu was screened by BIAcore 2000. Two clones, RN41 and RN56, showed affinity of 4.5 X 10(-7) M and 1.9 X 10(-7) M, respectively. But RNase H inhibiting activity of RN41 was higher than that of RN56. CONCLUSION: We cloned human monoclonal antibodies inhibiting RNase H activity of P protein of HBV. These antibodies can be expected to be a good candidate for protein-based antiviral therapy by preventing a replication of HBV if they can be expressed intracellularly in HBV-infected hepatocytes.
Amylose ; Antibodies ; Antibodies, Monoclonal ; Bacteriophages* ; Cell Surface Display Techniques* ; Clone Cells ; Cloning, Organism ; Genetic Therapy ; Healthy Volunteers ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hepatocytes ; Humans* ; Immunoglobulin Fragments ; Liver ; Maltose-Binding Proteins ; Polymerase Chain Reaction ; Ribonuclease H* ; Ribonucleases* ; RNA ; Single-Chain Antibodies

Tricuspid regurgitation due to rupture of a chorda is a rare disease in newborns. Recently, we experienced one day old male with tricuspid regurgitation due to rupture of a chorda of anterior papillary muscle, and who had suffered from severe hypoxemia, acidosis, cyanosis, and bradycardia. Preoperative diagnosis was pulmonary atresia with intact ventricular septum, massive tricuspid regurgitation, and patent ductus arteriosus by echocardiogram, which demonstrated no flow through the pulmonic valve. At operation, the pulmonic valve was intact and a chorda of anterior papillary muscle was ruptured. Tricuspid regurgitation was corrected successfully with reconstruction of the chorda. Postoperative course was complicated by pneumonia and sepsis, but the infant recovered and discharged at postoperative 20 days.
Acidosis ; Anoxia ; Bradycardia ; Cyanosis ; Diagnosis ; Ductus Arteriosus, Patent ; Humans ; Infant ; Infant, Newborn* ; Male ; Papillary Muscles ; Pneumonia ; Pulmonary Atresia ; Rare Diseases ; Rupture* ; Sepsis ; Tricuspid Valve Insufficiency* ; Ventricular Septum

This study was performed to investigate the pancreatic exocrine dysfunction in streptozotocin- induced diabetic rats. Changes in pancreatic enzymes secretion and in pancreatic enzymes content were observed. The output and the tissue content of amylase were significantly reduced in diabetic rats, while the output and the content of lipase were increased. Plasma secretin and cholecystokinin (CCK) concentrations of diabetic rats were significantly increased compared to those of normal rats. The altered pancreatic exocrine function was abolished by the exogenous insulin administration. The exogenous insulin also restored the increased plasma secretin and CCK concentrations. From the above results, it is suggested that, in streptozotocin-induced diabetic rats, anticoordinated changes in pancreatic enzymes secretion as well as pancreatic enzymes content are attributable to insulin deficiency and that the insulin deficiency is responsible for the increased plasma concentrations of both secretin and CCK. However, it is not clear whether the elevated plasma secretin and CCK concentrations played a direct role in changes of pancreatic exocrine function.
Amylases ; Animals ; Cholecystokinin ; Gastrointestinal Hormones* ; Insulin ; Lipase ; Plasma ; Rats* ; Secretin ; Streptozocin

Melioidosis is an infection of the Gram-negative bacterium Burkholderia pseudomallei. While it is known as an important cause of sepsis or chronic abscessforming disease in Southeast Asia and northern Australia, no case has yet been reported in Korea. A 50-yr-old man visited our hospital for intermittent fever associated with dry cough and sputum. Roentgenographic examination showed migrating pulmonary infiltration. Symptoms and chest radiograph and computed tomography (CT) image findings did not improve despite use of fluoroquinolone antibiotics. Gram-negative bacteria were isolated on bronchoscopic washing culture and were identified as B. pseudomallei on DNA sequencing of 16S ribosomal RNA with 100% homology. Treatment for melioidosis was commenced with high dose ceftazidime, and the patient's fever, cough, and sputum were improved and the lesion on chest radiograph and CT almost disappeared.
Anti-Bacterial Agents/pharmacology ; Burkholderia pseudomallei/metabolism ; Ceftazidime/pharmacology ; Diagnosis, Differential ; Fluoroquinolones/pharmacology ; Humans ; Korea ; Lung/*microbiology ; Lung Diseases/diagnosis/*microbiology ; Male ; Melioidosis/diagnosis/*pathology ; Middle Aged ; RNA, Ribosomal, 16S/chemistry ; Sepsis ; Sequence Analysis, DNA ; Temperature ; Time Factors ; Tomography, X-Ray Computed

Background: Folic acid is involved in inflammatory reactions; however, the association between folic acid and allergic diseases, particularly asthma, remains unclear. Thus, this study aimed to evaluate the association between serum folic acid levels and asthma in Koreans. Methods: This study analyzed the serum folic acid levels of 6,615 individuals included in the 2016–2018 Korea National Health and Nutrition Examination Survey. The prevalence of asthma was determined using a questionnaire that identified cases of physician-diagnosed asthma. The relationship between serum folic acid levels and asthma was analyzed using logistic regression analysis. Results: Multiple logistic regression analysis showed that a 1 ng/mL increase in serum folic acid level significantly reduced the risk of asthma after adjusting for confounding factors including sex, age, household income, current smoking, current alcohol use, and body mass index (odds ratio [OR], 0.930; 95% confidence interval [CI], 0.876– 0.987; P=0.017). The relationship between the adjusted odds of asthma and serum folic acid levels were consistently inverse (OR, 2.266; 95% CI, 1.126–4.420; P for trend=0.038). Conclusion Serum folic acid levels are inversely associated with physician-diagnosed asthma in the Korean population.

Background: Sleep duration is associated with hearing loss, especially presbycusis, which is the most common type of hearing loss; however, there is limited evidence regarding this association among the Korean population. We aimed to determine the relationship between sleep duration and high-frequency hearing loss in Korean adults aged ≥40 years. Methods: We examined 5,547 Korean adults aged ≥40 years who completed audiometric tests and questionnaires regarding sleep duration during the 2010–2012 cycle of the Korea National Health and Nutrition Examination Survey. Mild presbycusis was defined as >25 decibels (dB) and <40 dB, whereas moderate-to-severe presbycusis was defined as >40 dB pure tone averages at high frequencies (3,000, 4,000, and 6,000 Hz) for both ears. Additionally, the sleep duration was divided into quartiles. Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression after adjusting for covariates. Results: The prevalence of presbycusis in South Korean adults was 62.1%, of which 61.4% showed moderate to severe presbycusis. The incidence of moderate-to-severe, but not mild, presbycusis showed a significant positive correlation with sleep duration. Conclusion Our findings suggest that sleep duration is associated with the prevalence of presbycusis.

Purpose: For the dignity of patients nearing the end of their lives, it is essential to provide end-of-life (EoL) care in a separate, dedicated space. This study investigated the utilization of specialized rooms for dying patients within a hospice unit. Methods: This retrospective study examined patients who died in a single hospice unit between January 1, 2017, and December 31, 2021. Utilizing medical records, we analyzed the circumstances surrounding death, the employment of specialized rooms for terminally ill patients, and the characteristics of those who received EoL care in a shared room. Results: During the 1,825-day survey period, deaths occurred on 632 days, and 799 patients died. Of these patients, 496 (62.1%) received EoL care in a dedicated room. The average duration of using this dedicated space was 1.08 days. Meanwhile, 188 patients (23.5%) died in a shared room. Logistic regression analysis revealed that a longer stay in the hospice unit was associated with a lower risk of receiving EoL care in a shared room (odds ratio [OR]=0.98, 95% confidence interval [CI] 0.97~0.99; P=0.002). Furthermore, a higher number of deaths on the day a patient died was associated with a greater risk of receiving EoL care in a shared room (OR=1.66, 95% CI 1.33~2.08; P＜0.001). Conclusion To ensure that more patients receive EoL care for an adequate duration in a private setting, additional research is necessary to increase the number of dedicated rooms and incorporate them into the hospice unit at an early stage.

BACKGROUND: Acute left main coronary artery occlusion is a dramatic condition with very high mortality. The study was aimed to evaluate the effect of primary stenting in patients with left main coronary artery disease in the setting of acute myocardial infarction. METHODS: Between June 1997 and April 2002, primary stenting for left main coronary artery disease was performed in eighteen patients with acute myocardial infarction. We evaluated clinical outcomes and prognostic determinants in this clinical setting. RESULTS: Mean ages of patients were 59 +/- 12 years. Fourteen patients had cardiogenic shock on admission. Angiographic success (TIMI flow >or= 2 and diameter stenosis < 30% after stenting) was achieved in 17 patients (94%). In-hospital death occurred in 8 patients (44%). Two patients (11%) received emergent bypass surgery because of hemodynamic instability after primary stenting. On univariate analysis, good pre-intervention TIMI flow (grade >or= 2) was identified as a good prognostic determinant of in-hospital survival. During mean follow-up of 39 +/- 22 months, there was no late death and 1 patient received bypass surgery. Probability of freedom from death at 3-year was 56 +/- 12%. CONCLUSION: Primary stenting is a valuable therapeutic strategy for left main coronary disease in the setting of acute myocardial infarction, and it might save the life especially in patients with good pre-intervention TIMI flow (grade >or= 2). Long-term clinical outcome of patients surviving to hospital discharge is favorable.
Constriction, Pathologic ; Coronary Artery Disease ; Coronary Disease ; Coronary Stenosis* ; Coronary Vessels* ; Follow-Up Studies ; Freedom ; Hemodynamics ; Humans ; Mortality ; Myocardial Infarction* ; Shock, Cardiogenic ; Stents*

We describe a 37-yr-old man who developed central pontine myelinolysis (CPM) after allogeneic hematopoietic stem cell transplantation (HSCT) for acute lymphoblastic leukemia. After HSCT, desquamation developed on the whole body accompanied by hyperbilirubinemia. The liver biopsy of the patient indicated graft-versus-host disease- related liver disease, and the dose of methylprednisolone was increased. Then, the patient developed altered mentality with eye ball deviation to the left, for which electroencephalogram and magnetic resonance imaging (MRI) scans were done. Brain MRI scan demonstrated the imaging findings consistent with central pontine myelinolysis and extrapontine myelinolysis. He did not have any hyponatremia episode during hospitalization prior to the MRI scan. To the best of our knowledge, presentation of CPM after allogeneic HSCT is extremely rare in cases where patients have not exhibited any episodes of significant hyponatremia. We report a rare case in which hepatic dysfunction due to graft-versus-host disease has a strong association with CPM after HSCT.
Adult ; Biopsy ; Brain/pathology ; Electroencephalography ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation/*adverse effects ; Humans ; Hyperbilirubinemia/etiology ; Liver/pathology ; Magnetic Resonance Imaging ; Male ; Myelinolysis, Central Pontine/complications/*etiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications/*therapy ; Time Factors ; Treatment Outcome