Purpose: Esophagojejunostomy leakage after total gastrectomy for gastric cancer is one of the most serious and sometimes life-threatening adverse events. The purpose of this study was to evaluate complications after total gastrectomy in patients with gastric cancer during the period when Histoacryl (B. Braun) injection was performed. Therapeutic outcome of endoscopic Histoacryl injection for esophagojejunostomy leakage was also determined. Methods: This was a single-center retrospective study. Between January 2016 and December 2021, clinicopathologic characteristics and surgical outcomes of 205 patients who underwent total gastrectomy were investigated. Baseline characteristics and clinical outcomes of 10 patients with esophagojejunostomy leakage were also investigated. Results: Postoperative complication and mortality rates of total gastrectomy in 205 patients were 25.4% and 0.9%, respectively. Serious complications more than Clavien-Dindo IIIb accounted for 6.3%. Ten (4.9%) esophagojejunostomy leakages occurred in 205 patients. Among 10 esophagojejunostomy leakage patients, endoscopic Histoacryl injection was performed on eight patients and leakage was successfully managed with endoscopic Histoacryl injection in seven patients (87.5%). Mean postinjection hospital stay of seven successfully managed patients was 13.8 days. They were able to drink water at 1–6 days after injection.Among eight patients with endoscopic Histoacryl injection, six patients were injected once and two patients were injected three times. Conclusion Endoscopic Histoacryl injection for esophagojejunostomy leakage after total gastrectomy can be considered as a useful treatment for some selected cases.

BACKGROUND: Harassment means systemic and repeated unethical acts. Research on workplace harassment have been conducted widely and the NAQ-R has been widely used for the researches. But this tool, however the limitations in revealing differended in sub-factors depending on the culture and in reflecting that unique characteristics of the Koren society. So, The workplace harassment questionnaire for Korean finace and service workers has been developed to assess the level of personal harassment at work. This study aims to develop a tool to assess the level of personal harassment at work and to test its validity and reliability while examining specific characteristics of workplace harassment against finance and service workers in Korea. METHODS: The framework of survey was established based on literature review, focused-group interview for the Korean finance and service workers. To verify its reliability, Cronbach’s alpha coefficient was calculated; and to verify its validity, items and factors of the tool were analyzed. The correlation matrix analysis was examined to verify the tool’s convergent validity and discriminant validity. Structural validity was verified by checking statistical significance in relation to the BDI-K. RESULTS: Cronbach’s alpha coefficient of this survey was 0.93, which indicates a quite high level of reliability. To verify the appropriateness of this survey tool, its construct validity was examined through factor analysis. As a result of the factor analysis, 3 factors were extracted, explaining 56.5 % of the total variance. The loading values and communalities of the 20 items were 0.85 to 0.48 and 0.71 to 0.46. The convergent validity and discriminant validity were analyzed and rate of item discriminant validity was 100 %. Finally, for the concurrent validity, We examined the relationship between the WHI-KFSW and pschosocial stress by examining the correlation with the BDI-K. The results of chi-square test and multiple logistic analysis indicated that the correlation with the BDI-K was satatisctically significant. CONCLUSION: Workplace harassment in actual workplaces were investigated based on interviews, and the statistical analysis contributed to systematizing the types of actual workplace harassment. By statistical method, we developed the questionare, 20 items of 3 categories.
Humans ; Korea ; Methods ; Reproducibility of Results*

Steroid sulfatase (STS) is an enzyme responsible for the hydrolysis of aryl and alkyl sulfates. STS plays a pivotal role in the regulation of estrogens and androgens that promote the growth of hormone-dependent tumors, such as those of breast or prostate cancer. However, the molecular function of STS in tumor growth is still not clear. To elucidate the role of STS in cancer cell proliferation, we investigated whether STS is able to regulate the integrin signaling pathway. We found that overexpression of STS in HeLa cells increases the protein and mRNA levels of integrin β1 and fibronectin, a ligand of integrin α5β1. Dehydroepiandrosterone (DHEA), one of the main metabolites of STS, also increases mRNA and protein expression of integrin β1 and fibronectin. Further, STS expression and DHEA treatment enhanced phosphorylation of focal adhesion kinase (FAK) at the Tyr 925 residue. Moreover, increased phosphorylation of ERK at Thr 202 and Tyr 204 residues by STS indicates that STS activates the MAPK/ERK pathway. In conclusion, these results suggest that STS expression and DHEA treatment may enhance MAPK/ERK signaling through up-regulation of integrin β1 and activation of FAK.
Androgens ; Breast ; Cell Proliferation ; Dehydroepiandrosterone ; Estrogens ; Fibronectins ; Focal Adhesion Protein-Tyrosine Kinases ; HeLa Cells ; Humans* ; Hydrolysis ; Phosphorylation ; Prostatic Neoplasms ; RNA, Messenger ; Steryl-Sulfatase* ; Sulfates ; Up-Regulation ; Uterine Cervical Neoplasms*

BACKGROUND AND PURPOSE: The most important treatment for subcortical vascular dementia (SVaD) is controlling the blood pressure (BP). However, the few studies that have investigated the relationships between diurnal BP rhythm and subcortical ischemic vascular cognitive impairment have produced inconclusive results. In the study presented here, the 24-hour BP values of three groups of subjects-patients with subcortical vascular mild cognitive impairment (SvMCI), patients with SVaD, and normal controls-were compared using working criteria and 24-hour ambulatory BP (ABP) monitoring. METHODS: The subjects (42 patients with SVaD, 37 patients with SvMCI, and 30 controls) were selected according to the study's inclusion/exclusion criteria. All subjects underwent brain magnetic resonance (MR) imaging and MR angiography, detailed neuropsychological testing, and 24-hour ABP monitoring. RESULTS: The prevalence of nondippers differed markedly between the control group and both the SVaD and SvMCI groups. Loss of nocturnal dipping was significantly associated with SVaD [odds ratio (OR), 4.827; 95% confidence interval (CI), 1.07-12.05]. CONCLUSIONS: It was found that SVaD is associated with loss of nocturnal BP dipping combined with increased pulse pressure and systolic BP (SBP) variability. Correction of these factors could therefore be important in the prevention of SVaD, independent of measures used to reduce BP.
Angiography ; Blood Pressure ; Brain ; Dementia, Vascular ; Humans ; Magnetic Resonance Spectroscopy ; Mild Cognitive Impairment ; Neuropsychological Tests ; Prevalence

A 73-year-old woman developed visual disturbances in the right side of the visual fields along with headache. A neurological examination showed right upper quadrantanopsia and right hemiachromatopsia. She reported that she could only see in shades of gray in the right hemifield. She also had difficulties in recognizing and naming the colors of objects presented in the right hemifield. A color-sorting test revealed generalized impairments involving all color axes. A brain MRI showed acute infarction in the left fusiform and lingual gyri.
Aged ; Brain ; Female ; Headache ; Hemianopsia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Neurologic Examination ; Visual Fields

PURPOSE: Stress during pregnancy is a risk factor for the development of anxiety-related disorders in offspring later in life. The effects of treadmill exercise on anxiety-like behaviors and hippocampal cell proliferation were investigated using rats exposed to prenatal stress. METHODS: Exposure of pregnant rats to a hunting dog in an enclosed room was used to induce stress. Anxiety-like behaviors of offspring were evaluated using the elevated plus maze test. Immunohistochemistry for the detection of 5-bromo-2'-deoxyuridine and doublecortin (DCX) in the hippocampal dentate gyrus and 5-hydroxytryptamine 1A receptors (5-HT(1A)) in the dorsal raphe was conducted. Brain-derived neurotrophic factor (BDNF) and tyrosine kinase B (TrkB) levels in the hippocampus were evaluated by western blot analysis. RESULTS: Offspring of maternal rats exposed to stress during pregnancy showed anxiety-like behaviors. Offspring also showed reduced expression of BDNF, TrkB, and DCX in the dentate gyrus, decreased cell proliferation in the hippocampus, and reduced 5-HT(1A) expression in the dorsal raphe. Postnatal treadmill exercise by offspring, but not maternal exercise during pregnancy, enhanced cell proliferation and expression of these proteins. CONCLUSIONS: Postnatal treadmill exercise ameliorated anxiety-like behaviors in offspring of stressed pregnant rats, and the alleviating effect of exercise on these behaviors is hypothesized to result from enhancement of cell proliferation through 5-HT(1A) activation in offspring rats.
Animals ; Anxiety* ; Blotting, Western ; Brain-Derived Neurotrophic Factor ; Bromodeoxyuridine ; Cell Proliferation* ; Dentate Gyrus ; Dogs ; Dorsal Raphe Nucleus ; Exercise Test ; Hippocampus ; Immunohistochemistry ; Pregnancy ; Prenatal Exposure Delayed Effects ; Protein-Tyrosine Kinases ; Rats* ; Receptor, Serotonin, 5-HT1A* ; Risk Factors ; Serotonin*

OBJECTIVE: Caregivers for patients with Alzheimer's disease (AD) suffer from psychological and financial burdens. However, the results of the relationship between burden and cognitive function, performance of activities of daily living, and depressive symptoms have remained inconsistent. Therefore, the aim of this study was to examine which factors are more significant predictors of heightened burden, cognitive impairment or functional decline, besides neuropsychiatric symptoms. METHODS: A cross-sectional study was conducted in a sample comprised of 1,164 pairs of patients with AD and caregivers from the Clinical Research of Dementia of South Korea study cohorts. The cognitive function of each sub-domain, functional impairments, depressive symptoms, and caregiver burden were assessed using the dementia version of Seoul Neuropsychological Screening Battery (SNSB-D), Barthel Index for Daily Living Activities (ADL), Seoul-Instrumental Activities of Daily Living (S-IADL), the Clinical Dementia Rating Sum of Box (CDR-SB), the Global Deterioration Scale (GDS), the Korean version of the Neuropsychiatric Inventory (K-NPI), and the 15-item Geriatric Depression Scale. RESULTS: We found that higher severity (higher CDR-SB and GDS scores) and more functional impairment (lower ADL and higher S-IADL scores) were significantly associated with higher caregiver burden. In addition, depressive symptoms of patients (higher Geriatric Depression Scale scores) were associated with higher caregiver burden. CONCLUSION: Therefore, interventions to help maintain activities of daily living in patients with AD may alleviate caregiver burden and improve caregiver well-being.
Activities of Daily Living ; Alzheimer Disease* ; Caregivers* ; Cognition ; Cohort Studies ; Cross-Sectional Studies ; Dementia ; Depression ; Humans ; Korea ; Mass Screening ; Seoul

Frontotemporal dementia (FTD) is a clinical syndrome characterized by profound changes in personality and behavior. It is associated with degeneration of the prefrontal and anterior temporal cortex. There have been reports of patients with FTD who developed a new interest or increased creativity in the visual arts during their illness. To our knowledge, this is the first case report of a patient with a newfound interest in drawing after the onset of FTD in Korea.
Creativity ; Frontotemporal Dementia ; Humans ; Korea

Axl receptor tyrosine kinase has been implicated in cancer progression, invasion, and metastasis in various cancer types. Axl overexpression has been observed in many cancers, and selective inhibitors of Axl, including R428, may be promising therapeutic agents for several human cancers, such as breast, lung, and pancreatic cancers. Here, we examined the cell growth inhibition mediated by R428 and auranofin individually as well as in combination in the human breast cancer cell lines MCF-7 and MDAMB-231 to identify new advanced combination treatments for human breast cancer. Our data showed that combination therapy with R428 and auranofin markedly inhibited cancer cell proliferation. Isobologram analyses of these cells indicated a clear synergism between R428 and auranofin with a combination index value of 0.73. The combination treatment promoted apoptosis as indicated by caspase 3 activation and poly (ADP-ribose) polymerase cleavage. Cancer cell migration was also significantly inhibited by this combination treatment. Moreover, we found that combination therapy significantly increased the expression level of Bax, a mitochondrial proapoptotic factor, but decreased that of the X-linked inhibitor of apoptosis protein. Furthermore, the suppression of cell viability and induction of Bax expression by the combination treatment were recovered by treatment with N-acetylcysteine. In conclusion, our data demonstrated that combined treatment with R428 and auranofin synergistically induced apoptosis in human breast cancer cells and may thus serve as a novel and valuable approach for cancer therapy.

OBJECTIVES: We aimed to investigate the prevalence of Extrapyramidal signs (EPS) and the associations between EPS and cognitive subdomains in patients with Alzheimer disease (AD). METHODS: We recruited 1,324 patients with AD from the Clinical Research of Dementia of South Korea (CREDOS), a hospital based cohort study with fifty-six participating hospitals. We estimated cognitive subdomain using the Seoul Neuropsychological Screening Battery-Dementia version (SNSB-D). Dementia severity was measured by Clinical Dementia Rating Sum of Boxes (CDR-SB) and Korean version of Mini-Mental Status Examination (K-MMSE). The EPS group was defined by the presence of at least one EPS based on a focused neurologic examination. RESULTS: The prevalence of patients with EPS was 11%. These had higher CDR-SB scores than non-EPS group. After controlling for demographic, radiological, and dementia severity (CDR-SB) factors, EPS group showed lower cognitive ability in the subdomains for visuospatial and frontal-executive function than non-EPS group. The patients with EPS were showed significantly higher scores in the subdomain for memory function. CONCLUSION: The presence of EPSs in patients with AD was associated with lower visuospatial, frontal-executive function and higher memory function.
Alzheimer Disease ; Cohort Studies ; Dementia ; Humans ; Mass Screening ; Memory ; Neurobehavioral Manifestations ; Prevalence ; Republic of Korea