Corticotrophin-releasing factor (CRF) plays a major role in coordinating stress responses. We aimed to test whether blocking endogenous CRF activity can prevent the stress-induced dilation of intercellular spaces in esophageal mucosa. Eighteen adult male rats were divided into 3 groups: 1) a non-stressed group (the non-stressed group), 2) a saline-pretreated stressed group (the stressed group), 3) and an astressin-pretreated stressed group (the astressin group). Immediately after completing the experiments according to the protocol, distal esophageal segments were obtained. Intercellular space diameters of esophageal mucosa were measured by transmission electron microscopy. Blood was sampled for the measurement of plasma cortisol levels. Mucosal intercellular spaces were significantly greater in the stressed group than in the non-stressed group. Mucosal intercellular spaces of the astressin group were significantly smaller than those of the stressed group. Plasma cortisol levels in the stressed group were significantly higher than in the non-stressed group. Pretreatment with astressin tended to decrease plasma cortisol levels. Acute stress in rats enlarges esophageal intercellular spaces, and this stress-induced alteration appears to be mediated by CRF. Our results suggest that CRF may play a role in the pathophysiology of reflux-induced symptoms or mucosal damage.
Animals ; Corticotropin-Releasing Hormone/*antagonists & inhibitors/metabolism/pharmacology ; Esophagus/anatomy & histology/*drug effects ; Extracellular Space/*drug effects ; Hydrocortisone/blood ; Male ; Mucous Membrane/anatomy & histology/*drug effects ; Neuroprotective Agents/pharmacology ; Peptide Fragments/*pharmacology ; Rats ; Rats, Wistar ; *Stress, Psychological/blood/physiopathology

Gastrointestinal (GI) tract metastasis of primary breast cancer is very rare. We present a patient with small bowel obstruction from distant metastasis of primary breast cancer. Each characteristic features of concern of GI tract distant metastasis from many pervious studies has been reported differently. We should remember that GI tract metastasis may coexist when patients with breast cancer have intermittent or recurrent abdominal pain with or without obstructive symptoms.
Abdominal Pain ; Breast Neoplasms ; Breast ; Gastrointestinal Tract ; Humans ; Intestinal Obstruction ; Neoplasm Metastasis ; Neoplasm Recurrence, Local

Congenital renal arteriovenous malformation is a rare disease. Renal arteriovenous malformations have been discovered with increasing frequency since they were first described by Varela in 1923. Patients with arteriovenous malformations may have gross hematuria, flank pain, urinary obstruction or may be asymptomatic. The diagnosis of arteriovenous malformation is usually made by renal angiogram. Treatment of arteriovenous malformation can be obtained with conservative treatment, ligation of the arterial branch, selective transcatheter embolization and surgical procedures. We experienced a case of congenital arteriovenous malformation manifested by gross hematuria and intermittent right flank pain, cured by means of transcatheter arterial embolization therapy with gelfoam and alcohol. Thus, we report a case with a brief review of literatures.
Arteriovenous Malformations* ; Diagnosis ; Flank Pain ; Gelatin Sponge, Absorbable ; Hematuria* ; Humans ; Ligation ; Rare Diseases

The aim of this study was to determine candidemia incidence among patients in a medical intensive-care unit (MICU) and the associated mortality rate and to identify risk factors associated with candidemia. We retrospectively performed a 1:3 matched case-control study of MICU patients with candidemia. Controls were matched for sex, age, and Acute Physiology and Chronic Health Evaluation (APACHE) II score. Candidemia incidence was 9.1 per 1,000 admissions. The most common pathogen was Candida albicans. Crude mortality was 96% among candidemia patients and 52% among controls (P<0.001). Mortality differed significantly between the groups according to Kaplan-Meier survival analysis (P=0.024). Multivariate analysis identified the following independent risk factors for candidemia: central venous catheterization (odds ratio [OR] = 3.2, 95% confidence interval [CI]=1.2-9.0), previous steroid therapy (OR=4.7, 95% CI=1.8-12.1), blood transfusion during the same admission period (OR=6.3, 95% CI=2.4-16.7), and hepatic failure upon MICU admission (OR=6.9, 95% CI=1.7-28.4). In conclusion, we identify an additional independent risk factor for candidemia, the presence of hepatic failure on MICU admission. Therefore, increased awareness of risk factors, including hepatic failure, is necessary for the management of candidemia.
Candidiasis/*diagnosis/*epidemiology ; Cross Infection/*diagnosis/*epidemiology ; Female ; Hospitalization/*statistics & numerical data ; Humans ; Incidence ; Intensive Care Units/*statistics & numerical data ; Korea/epidemiology ; Longitudinal Studies ; Male ; Middle Aged ; Pilot Projects ; Risk Assessment/methods ; Risk Factors

Mycobacterium abscessus (M. abscessus) is the second most common nontuberculous mycobacteria (NTM) in South Korea. Nevertheless, the diagnosis and treatment of M. abscessus lung disease can be problematic. Surgical resection has been tried for patients with localized M. abscessus lung disease refractory to medical treatment. Here, we report on a 25-year-old woman with M. abscessus lung disease who had been diagnosed and treated three times for pulmonary tuberculosis. She was initially diagnosed as having M. intracellulare lung disease; however, M. abscessus was isolated after several months of medication. She had multiple bronchiectatic and cavitary lesions bilaterally, and M. abscessus was repeatedly isolated from her sputa despite prolonged treatment with clarithromycin, ethambutol, moxifloxacin, and amikacin. She improved only after sequential bilateral lung resection. Based on the experience with this patient, we suggest that, if medical treatment fails, surgical resection of a diseased lung should be considered even in patients with bilateral lesions.
Adult ; Anti-Bacterial Agents/pharmacology/*therapeutic use ; Female ; Humans ; Lung Diseases/*drug therapy/*microbiology/surgery ; Mycobacteria, Atypical/drug effects/*physiology

Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ2 test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, P < 0.001) and higher levels of depressive symptoms (F [4, 767] = 19.145, P < 0.001), anxiety symptoms (F [4, 765] = 12.890, P < 0.001) and suicidal ideation (F [4, 653] = 6.970, P < 0.001). It also indicated lower levels of social function (F [4, 760] = 13.343, P < 0.001), and quality of life (F [4, 656] = 11.975, P < 0.001). However, there were no significant differences in alcohol consumption (F [4, 656] = 11.975, P < 0.001). The number of depressive symptoms can be used as an index of greater illness burden in clinical psychiatry.
Adult ; Alcohol Drinking ; Analysis of Variance ; Antidepressive Agents/therapeutic use ; Anxiety ; *Depression ; Depressive Disorder, Major/drug therapy/*pathology/psychology ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Severity of Illness Index ; Sex Factors ; Suicidal Ideation

We previously reported that Hydnocarpi Semen (HS) has a wound healing effect on diabetic foot ulcer lesion in mice. In this study, ethylacetate (EtOAc) fraction from HS extract were evaluated for their wound healing activity by using in vitro acute inflammation model. GC and GC/MS analysis shows that the main constituents in EtOAc fraction are chaulmoogric acid, hydnocarpic acid, and gorlic acid. EtOAc fraction activated macrophages to increase the production of TNF-alpha. The fraction also increased the production of TGF-beta and VEGF, which induced fibroblast activation and angiogenesis. These results suggest that the mechanism that the fraction helps to enhance healing of skin wound is possibly associated with the production of TNF-alpha, as well as secretion of VEGF, TGF-beta and HS may have a new bioactive material for the treatment of skin wound.
Animals ; Cytokines ; Diabetic Foot ; Fatty Acids ; Fibroblasts ; Inflammation ; Macrophages ; Mice ; Semen ; Skin ; Transforming Growth Factor beta ; Tumor Necrosis Factor-alpha ; Ulcer ; Vascular Endothelial Growth Factor A ; Wound Healing

OBJECTIVE: To test whether there are gender differences in the clinical characteristics of patients with psychotic depression (PD). METHODS: Using data from the Clinical Research Center for Depression (CRESCEND) study in South Korea, we tested for potential gender differences in clinical characteristics among 53 patients with PD. The Psychotic Depression Assessment Scale (PDAS) and other psychometric scales were used to evaluate various clinical features of the study subjects. Independent t-tests were performed for normally distributed variables, Mann-Whitney U-tests for non-normally distributed variables, and chi2 tests for discrete variables. In addition, to exclude the effects of confounding variables, we carried out an analysis of covariance (ANCOVA) for the normally distributed variables and binary logistic regression analyses for discrete variables, after adjusting the effects of marital status. RESULTS: We identified more prevalent suicidal ideation (adjusted odds ratio [aOR]=10.316, p=0.036) and hallucinatory behavior (aOR=8.332, p=0.016), as well as more severe anxiety symptoms (degrees of freedom [df]=1, F=6.123, p=0.017), and poorer social and occupational functioning (df=1, F=6.265, p=0.016) in the male patients compared to the female patients. CONCLUSION: Our findings suggest that in South Korean patients with PD, suicidal ideation, hallucinatory behavior, and anxiety is more pronounced among males than females. This should be taken into consideration in clinical practice.
Anxiety ; Confounding Factors (Epidemiology) ; Cost of Illness ; Depression* ; Female ; Freedom ; Humans ; Korea ; Logistic Models ; Male ; Marital Status ; Odds Ratio ; Psychometrics ; Suicidal Ideation ; Weights and Measures

BACKGROUND: Recently, VE1, a monoclonal antibody against the BRAFV600E mutant protein, has been investigated in terms of its detection of the BRAFV600E mutation. Although VE1 immunostaining and molecular methods used to assess papillary thyroid carcinoma in surgical specimens are in good agreement, evaluation of VE1 in thyroid cytology samples is rarely performed, and its diagnostic value in cytology has not been well established. In present study, we explored VE1 immunoexpression in cytology samples from ex vivo papillary thyroid carcinoma specimens in order to minimize limitations of low cellularity and sampling/targeting errors originated from thyroid fineneedle aspiration and compared our results with those obtained using the corresponding papillary thyroid carcinoma tissues. METHODS: The VE1 antibody was evaluated in 21 cases of thyroid cytology obtained directly from ex vivo thyroid specimens. VE1 immunostaining was performed using liquid-based cytology, and the results were compared with those obtained using the corresponding tissues. RESULTS: Of 21 cases, 19 classic papillary thyroid carcinomas had BRAFV600E mutations, whereas two follicular variants expressed wild-type BRAF. VE1 immunoexpression varied according to specimen type. In detection of the BRAFV600E mutation, VE1 immunostaining of the surgical specimen exhibited 100% sensitivity and 100% specificity, whereas VE1 immunostaining of the cytology specimen exhibited only 94.7% sensitivity and 0% specificity. CONCLUSIONS: Our data suggest that VE1 immunostaining of a cytology specimen is less specific than that of a surgical specimen for detection of the BRAFV600E mutation, and that VE1 immunostaining of a cytology specimen should be further evaluated and optimized for clinical use.
Biopsy, Fine-Needle ; Immunohistochemistry ; Mutant Proteins ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Neoplasms*

OBJECTIVES: To evaluate the effectiveness of an anti-smoking readership training program on the knowledge, attitude and practice in health managers and supervisors in the workplace. METHODS: We surveyed 482 health managers and supervisors in the workplace from April 2005 to September 2005. The questionnaire included whether or not a smoking cessation program was conducted in their workplace. We assessed before and after educations program about knowledge, attitude and practice for smoking cessation. The 10-hour education program included the benefit of quit smoking, the law for smoking restriction, cognitive therapy, stress management, nicotine addiction, replacement therapy, case study about workplace for anti-smoking policy and program. RESULTS: For the change in the mean scores of all items in knowledge, attitude and practice were significantly increased after the intervention. CONCLUSION: Even a short, 10-hour intervention course of anti-smoking leadership training program was effective for improving the knowledge, attitude, practice to quit smoking activity in workplace. Nevertheless, the program effectiveness would be increased by including a re-training course and website support.
Cognitive Therapy ; Education ; Health Promotion ; Jurisprudence ; Leadership* ; Nicotine ; Program Evaluation ; Questionnaires ; Smoke ; Smoking ; Smoking Cessation