Volume 28, No. 2, pp.89-92, Table 1 is missing.
Polymerase Chain Reaction* ; Pseudomonas*

Gaucher disease is a glycosphingolipid storage disease caused by deficiency of glucocerebrosidase, resulting in the accumulation of glucosylceramide in lysosomes. The neuronopathic forms of this disease are associated with neuronal loss and neurodegeneration. However, the pathophysiological mechanisms leading to prenatal and neonatal death remain uncharacterized. To investigate brain dysfunction in Gaucher disease, we studied the effects of neurotrophic factors during development in a mouse model of Gaucher disease. The expression of brain-derived neurotrophic factor and nerve growth factor was reduced in the cerebral cortex, brainstem, and cerebellum of Gaucher mice, compared with that in wild-type mice. Extracellular signal-regulated kinase (ERK) 1/2 expression was downregulated in neurons from Gaucher mice and correlated with a decreased number of neurons. These results suggest that a reduction in neurotrophic factors could be involved in neuronal loss in Gaucher disease.
Signal Transduction ; Neurons/*metabolism ; Nerve Growth Factors/*metabolism ; Models, Animal ; Mice, Inbred C57BL ; Mice ; MAP Kinase Signaling System/physiology ; Gaucher Disease/*metabolism/pathology ; Down-Regulation ; Cells, Cultured ; Cell Survival ; Brain/*metabolism ; Animals

BACKGROUND: Interest in pharmacist participation in the multidisciplinary intensive care team is increasing. However, studies examining pharmacist interventions in the medical intensive care unit (MICU) are limited in Korea. The aim of this study was to describe the current status of pharmacist interventions and to identify common pharmacologic problems requiring pharmacist intervention in the MICU. METHODS: Between September 2013 and August 2014, a retrospective, observational study was conducted in the 22-bed MICU at a university hospital. Data were obtained from two trained pharmacists who participated in MICU rounds three times a week. In addition to patient characteristics, data on the cause, type, related drug, and acceptance rate of interventions were collected. RESULTS: In 340 patients, a total of 1211 pharmacologic interventions were performed. The majority of pharmacologic interventions were suggested by pharmacists at multidisciplinary rounds in the MICU. The most common pharmacologic interventions were adjustment of dosage and administration (n = 328, 26.0%), followed by parenteral/enteral nutritional support (n = 228, 18.1%), the provision of drug information (n = 228, 18.1%), and advice regarding pharmacokinetics (n = 118, 9.3%). Antimicrobial agents (n = 516, 42.6%) were the most frequent type of drug associated with pharmacist interventions. The acceptance rate of interventions was 84.1% with most accepted by physicians within 24 hours (n = 602, 92.8%). CONCLUSIONS: Medication and nutritional problems are frequently encountered pharmacotherapeutic problems in the MICU. Pharmacist interventions play an important role in the management of these problems.
Anti-Infective Agents ; Humans ; Critical Care ; Intensive Care Units* ; Korea ; Nutritional Support ; Observational Study ; Pharmacists* ; Pharmacokinetics ; Retrospective Studies

PURPOSE: Ultrasound is most effective study for evaluating thyroid nodules. In this review, we discuss that sonographic findings to differentiate benign from malignant nodules and suggest recommendations for indications of fine needle aspiration biopsy and thyroid nodule management. METHODS: Sonographic scans of 206 thyroid nodules in 164 patients were candidated for this study. We evaluated sonographic findings by shape, calcification, margin, and echogenicity, retrospectively. Sonographic findings that suggested malignancy included microcalcifications, a speculated margin, marked hypoechogenicity and a shape that was taller than wide. The final diagnosis of lesion as benign (n=180) or malignant (n=26) was confirmed by fine needle aspiration biopsy and follow-up (>6 months). We demonstrated the difference of the sensitivity, specificity, positive predictive value, negative predictive value and accuracy. RESULTS: Of 206 thyroid nodules, 26 were malignant. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy based on our sonographic classification method were 84.6%, 73.9%, 31.9%, 97.0% and 75.2%. CONCLUSION: Sonography can be helpful for making the differentiation between and malignant nodules. So, when well trained surgeon find thyroid nodules on sonography, we can make correct diagnosis of malignant nodules.
Biopsy ; Biopsy, Fine-Needle ; Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Methods ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Nodule* ; Ultrasonography*

BACKGROUND AND OBJECTIVES: Ten to twenty percent of children with Kawasaki disease (KD) do not respond to initial intravenous immunoglobulin (IVIG) treatment. If untreated, approximately 15% to 25% of KD patients have complications. The aim of this study was to find useful predictors of responsiveness to initial IVIG treatment in KD. SUBJECTS AND METHODS: We retrospectively reviewed medical records of 91 children diagnosed with KD at Myong Ji Hospital from March 2012 to April 2014. Before and after (24 hours to 36 hours) IVIG treatment, the following laboratory data were obtained: hemoglobin (Hb) level, white blood cell count, proportion of neutrophil, lymphocyte and eosinophil, platelet count, erythrocyte sedimentation rate (ERS), C-reactive protein (CRP), creatine kinase (CK), creatine kinase MB (CK-MB), and N-terminal pro-brain natriuretic peptide (NT-proBNP). Subjects were then divided into two groups: IVIG-responsive or IVIG-resistant. RESULTS: Of 91 patients, 11 (12%) required retreatment. By univariate analysis, before-IVIG laboratory parameters of white blood cell count, % neutrophil, ERS, CRP, sodium, CK, CK-MB, and NT-proBNP were significantly different between IVIG-responsive and IVIG-resistant patient groups. In the after-IVIG laboratory parameters, Hb level, white blood cell count, % neutrophil, % lymphocyte, CRP, CK, CK-MB, and NT-pro-BNP were significantly different between the two groups. While the mean-differences were not statistically significant, fractional change (FC)-CRP and FC-% neutrophil showed significant difference. By multivariate analysis, FC-CRP was confirmed to be an independent predictor for initial IVIG resistance. CONCLUSION: Fractional change-C-reactive protein might be a useful and important value for predicting initial IVIG resistance in KD patients.
Blood Sedimentation ; C-Reactive Protein ; Child ; Creatine Kinase ; Eosinophils ; Humans ; Immunization, Passive* ; Immunoglobulins ; Immunoglobulins, Intravenous ; Leukocyte Count ; Lymphocytes ; Medical Records ; Mucocutaneous Lymph Node Syndrome* ; Multivariate Analysis ; Neutrophils ; Platelet Count ; Retreatment ; Retrospective Studies ; Risk Factors ; Sodium

PCR assays were developed to detect Pseudomonas tolaasii and Pseudomonas agarici using primer sets, PTOF/PTOR and PAGF/R23-1R. The primer set, PTOF and PTOR, was designed from the nucleotide sequence of pPTOF2 that showed specificity for P. tolaasii in dot blot previously. For development of primers specific for P. agarici, ITS I regions of seven P. agarici strains were analyzed. P. agarici strains contained from one up to three putative ITS I regions, which were different in size and nucleotide sequence from each other. From the sequence of the band (PaI-III) common to all P. agarici strains, primer PAGF was designed. PAGF was used for forward primer, and R23-1R as reverse primer to detect P. agarici. Multiplex PCR with two primer sets, PTOF/PTOR and PAGF/R23-lR, successfully produced two fragments (PTSF and PASF) specific for P. tolaasii and P. agarici with the mixture of DNA of P. tolaasii and P. agarici.
Base Sequence ; DNA ; Multiplex Polymerase Chain Reaction ; Polymerase Chain Reaction* ; Pseudomonas* ; Sensitivity and Specificity

Purpose: In contrast to the Western diffuse large B-cell lymphoma (DLBCL), prognostic impact of age in a Korean population with DLBCL has not been fully evaluated. Materials and Methods: Six hundred and eight DLBCL patients treated with rituximab-containing chemotherapeutic regimens from January 2002 to March 2012 in Asan Medical Center were enrolled. Survival models using the restricted cubic spine−transformed age variable were constructed to evaluate non-linear relationships between age and survival outcome. Finally, age was categorized according to the conventional international prognostic index (IPI), National Comprehensive Cancer Network (NCCN)-IPI, and Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea (GELTAMO)-IPI schemes and the prognostic implications were evaluated. Results: The relative hazard did not change significantly during the first to fifth decades, but began to increase exponentially in patients aged over 62 years. This pattern or relationship was also retained in a multivariate model fitted to the age-adjusted IPI and relative dose intensity. Multivariate survival analysis revealed that age > 75 years, but not age > 60 years, was associated independently with poor overall and progression-free survival when the relative dose intensity and age-adjusted IPI were taken into account. Conclusion The outcome of DLBCL in Korean populations may deteriorate rapidly as age exceeds 62 years. Therefore, a consensus cutoff value for age in Korean DLBCL patients should be determined to better predict prognosis.

Objectives: This study aimed to investigate the association between oral health behaviors and dental scaling to suggest effective preventive oral health behaviors. Methods: This cross-sectional survey examined linked datasets derived from the Korean National Health Insurance Service and Korean National Health and Nutrition Examination Survey, 2014-2017. The data of 4,258 adults aged ≥19 years were included. A multivariate regression analysis was performed to evaluate the effect of oral health behaviors on willingness to undergo dental scaling. Results: The multivariate regression analysis revealed that the participants whose oral hygiene habits included a thrice-daily tooth brushing frequency were 1.5% more likely to undergo dental scaling (95% confidence interval [CI], 1.167-1.881) than the others. Furthermore, those whose oral hygiene habits included a thrice-daily tooth brushing frequency and the daily use of dental floss or an interdental brush were 1.6% more likely to undergo dental scaling (95% CI, 1.194-2.032) than their counterparts. Conclusions The group with the most favorable oral health behaviors underwent dental scaling more frequently. Better personal oral health habits may lead to willingness to undergo dental scaling, and incremental dental hygiene improvements can be achieved through further oral health education. Educational programs are needed to raise awareness of and promote improvements in individual oral health behaviors.

Objectives: This study aimed to investigate differences in the anti-hepatitis A (HAV) antibody seropositivity rate by age and gender. Methods: We collected information on anti-HAV immunoglobulin G and immunoglobulin M status from samples submitted for HAV antibody testing in 2012–2022. A total of 1,333,615 cases were included in the analysis. Results: By age, the seropositivity rate was represented by a U-shaped curve, such that the rate was low for the group aged 20 to 39 years and higher in those who were younger or older. Over time, the curve shifted rightward, and the seropositivity rate declined gradually in the group aged 35 to 39 years and older. A gender-based difference in antibody seropositivity rate was especially noticeable in the group aged 20 to 29 years. This difference between genders widened in the participants’ early 20s—when men in the Republic of Korea enlist in the military—and the divergence continued subsequently for older individuals. Conclusion These results indicate a higher risk of severe infection among older individuals and a gender-based difference in seroprevalence. Therefore, it is necessary to implement policies to promote vaccination in adults.

OBJECTIVE: To explore the features that predict size increase and development of potential malignant features in incidentally detected, unilocular cystic pancreatic lesions (CPLs) less than 3 cm in diameter, during subsequent follow-up. MATERIALS AND METHODS: We retrieved data of patients diagnosed with unilocular CPLs less than 3 cm in diameter during the period from November 2003 through December 2014, using a computerized search. All serial CT and MR images were analyzed to identify the number, size, and location of CPLs; dilatation of the main pancreatic duct; and occurrence of worrisome features and high-risk stigmata of malignancy in the lesion. The characteristics of CPLs were compared between the increase (i.e., size increase during subsequent follow-up) and no-increase groups. For CPLs in the increase group, subgroup analysis was performed according to the lesion size at the last follow-up (< 3 cm vs. ≥ 3 cm). RESULTS: Among 553 eligible patients, 132 (23.9%) had CPLs that increased in size, and 421 (76.1%) had CPLs that did not, during follow-up. Of the 132, 12 (9.1%) CPLs increased to diameters ≥ 3 cm at the final follow-up. Among the various factors, follow-up duration was a significant independent factor for an interval size increase of CPLs (p < 0.001). In the increase group, initial cyst size was a significant independent factor to predict later size increase to or beyond 3 cm in diameter (p < 0.001), and the initial cyst diameter ≥ 1.5 cm predicted such a growth with a sensitivity and specificity of 83% and 72%, respectively. No significant factors to predict the development of potential malignant features were identified. CONCLUSION: Follow-up duration was associated with an interval size increase of CPLs. Among the growing CPLs, initial cyst size was associated with future lesion growth to and beyond 3 cm.
Christianity ; Dilatation ; Follow-Up Studies ; Humans ; Pancreas ; Pancreatic Cyst* ; Pancreatic Ducts ; Risk Factors ; Sensitivity and Specificity