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

OBJECTIVE: It has been suggested that hysterectomy has a disturbing influence on bowel function, mainly constipation. We performed a prospective study to assess the changes of ano-rectal physiology after hysterectomy. METHODS: Fourteen consecutive patients were assessed before and two months after hysterectomy. A detail questionnaire was devised to allow assessment of bowel function and ano-rectal pressure test and balloon expulsion test were performed before and after hysterectomy. The parameters measured in ano-rectal pressure test included the minimal sensible volume, ano-rectal resting pressure, maximal squeezing pressure, recto-anal inhibitory reflex and balloon expulsion test. Data analysis was carried out by paired t-test. Statistical significance was inferred when the p value was<0.05. RESULTS: Among the fourteen patients, the straining in defecation was found in three patients after operation, other defication habits were not significantly changed after hysterectomy(P>0.05). There were no significant changes in ano-rectal pressure test after hysterectomy. The disturbance of balloon expulsion capacity was increased in four patients after hysterectomy(29%). CONCLUSION: Our results demonstrate that hysterectomy does not cause a decrease in ano-rectal pressure and rectal sensitivity, but has an adverse effect on rectal expulsion capacity in a some of patients.
Constipation ; Defecation ; Humans ; Hysterectomy* ; Physiology ; Prospective Studies ; Surveys and Questionnaire ; Reflex ; Statistics as Topic

B13 analogues are being considered as therapeutic agents for cancer cells, since B13 is a ceramide analogue and inhibits ceramidase to promote apoptosis in cancer cells. B13 sulfonamides are assumed to have biological activity similar to B13, since they are made by bioisosterically substituting the carboxyl moiety of B13 with sulfone group. Twenty B13 sulfonamides were evaluated for their in vitro cytotoxicities against human colon cancer HT-29 and lung cancer A549 cell lines using MTT assays. Replacement of the amide group with a sulfonamide group increased cytotoxicity in both cancer cell lines. The sulfonamides with long alkyl chains exhibited activities two to three times more potent than that of B13 and compound (15) had the most potent activity with IC50 values of 27 and 28.7microM for HT-29 and A549, respectively. The comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA) were used to carry out QSAR molecular modeling of these compounds. The predictive CoMSIA models for HT-29 and A549 gave cross-validated q2 values of 0.703 and 0.830, respectively. From graphical analysis of these models, we suppose that the stereochemistry of 1,3-propandiol is not important for activity and that introduction of a sulfonamide group and long alkyl chains into B13 can increase cytotoxicity.
Apoptosis ; Cell Line ; Ceramidases ; Colonic Neoplasms ; Humans ; Inhibitory Concentration 50 ; Lung Neoplasms ; Models, Molecular ; Quantitative Structure-Activity Relationship ; Sulfonamides

Background: Fecal microbiota transplantation against gut colonization using a multidrugresistant organism is a technique used to treat infections through normalizing the gut microbiota via fecal microbiota transplantation in patients with confirmed colonization by carbapenem-resistant Enterobacteriaceae (CRE) or vancomycin-resistant enterococci (VRE) based on a fecal culture test within the past one week. In this study, we aimed to determinethe safety and effectiveness of this technique. Methods: The safety and effectiveness were assessed via a systematic review. A literature search was conducted using five Korean databases, such as KoreaMed, and international databases, including Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library. Results: Main results are described here. From the studies retrieved using the aforementioned search strategy, the remaining 581 studies were screened using the inclusion and exclusion criteria, resulting in the selection of nine studies for further consideration. In terms of safety, many studies reported deaths and adverse reactions associated with different causes. Fewer studies reported the rate of colonization; however, the effect of colony rate was inconsistent when compared to no treatment group. Additionally, none of the studies assessed the recurrence rate, a decrease in the prevalence of diseases related to infection by multidrugresistant bacteria, and the quality of life. Conclusion Fecal bacterial colonization for the decolonization of intestinal multidrugresistant bacteria was evaluated using a technique that requires further research as there is insufficient literature evidence to validate its safety and efficacy in treating infections through normalizing the intestinal flora of patients with confirmed colonization by CRE or VRE.

Background: Fecal microbiota transplantation against gut colonization using a multidrugresistant organism is a technique used to treat infections through normalizing the gut microbiota via fecal microbiota transplantation in patients with confirmed colonization by carbapenem-resistant Enterobacteriaceae (CRE) or vancomycin-resistant enterococci (VRE) based on a fecal culture test within the past one week. In this study, we aimed to determinethe safety and effectiveness of this technique. Methods: The safety and effectiveness were assessed via a systematic review. A literature search was conducted using five Korean databases, such as KoreaMed, and international databases, including Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library. Results: Main results are described here. From the studies retrieved using the aforementioned search strategy, the remaining 581 studies were screened using the inclusion and exclusion criteria, resulting in the selection of nine studies for further consideration. In terms of safety, many studies reported deaths and adverse reactions associated with different causes. Fewer studies reported the rate of colonization; however, the effect of colony rate was inconsistent when compared to no treatment group. Additionally, none of the studies assessed the recurrence rate, a decrease in the prevalence of diseases related to infection by multidrugresistant bacteria, and the quality of life. Conclusion Fecal bacterial colonization for the decolonization of intestinal multidrugresistant bacteria was evaluated using a technique that requires further research as there is insufficient literature evidence to validate its safety and efficacy in treating infections through normalizing the intestinal flora of patients with confirmed colonization by CRE or VRE.

Objectives: The aim of this study was to analyze the relationship between objective social isolation (SI) and unmet medical needs (UMN) in adults aged 19 and older. Methods: A cross-sectional analysis was conducted of 208 619 adults aged 19 and older, excluding missing data, using the 2019 Korea Community Health Survey. To analyze the association between objective SI and UMN, the chi-square test and logistic regression analysis were performed. Results: The prevalence of UMN was 1.14 times higher (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.06 to 1.23) among those with SI than among those without SI, and the OR for groups with 5 SI types was 2.77 (95% CI, 1.86 to 4.12) compared to those with no SI types. In addition, a stratified analysis by age group showed that the association between SI and UMN existed even in groups under 64 years old. However, among those aged 65 and older, SI was associated with an OR of 1.53 (95% CI, 1.37 to 1.71) for UMN compared to non-SI. As the number of SI types increased, the prevalence of UMN also increased, indicating a strong association between SI and UMN in older adults. Conclusions This study found that individuals with SI experienced UMN due to fear and anxiety about interpersonal relationships. Therefore, based on the results of this cross-sectional study, it is necessary to investigate the causal relationship between SI and UMN through future longitudinal data.

PURPOSE: This study examined anxiety and depression among 108 North Korean adolescent and young adult (age, 12-29 years) defectors who settled in South Korea, and evaluated the relationship between their mental health and health-related quality of life (HRQoL). MATERIALS AND METHODS: Subjects completed a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), the Short Form with 36 questions (SF-36; consists of mental and physical health components) for measuring HRQoL, and items related to the period of time since defection and settlement and socio-demographic variables. RESULTS: Among the participants, 53.7% scored> or =8 on the anxiety measure questionnaire, and 22.2% scored> or =11; 36.1% of the participants scored> or =8 on the depression measure questionnaire and 14.8% scored> or =11. Both anxiety and depression subscales were associated with lower scores of total SF-36, physical component and mental component score. Depressive symptom appeared more frequently among the subjects who had lived in South Korea for <1 year than among the subjects who had lived in South Korea for 2 year or longer (odds ratio=3.77, 95% confidence intervals=1.12 to 12.70). CONCLUSION: Among North Korean adolescent and young adult defectors, anxiety and depression were associated with lower HRQoL. Therefore, it is needed to develop strategies to screen for mental health and intervene to reduce anxiety and depression during their early resettlement stage.
Adolescent ; Adult ; Anxiety/*epidemiology ; Child ; Democratic People's Republic of Korea ; Depression/*epidemiology ; Female ; Humans ; Male ; Prevalence ; Quality of Life ; Republic of Korea ; Sex Factors ; *Social Adjustment ; Time Factors

PURPOSE: To report a case of recovery of bilateral cortical blindness in a patient with posterior reversible encephalopathy syndrome. CASE SUMMARY: A 46-year-old female visited the ophthalmology department due to abrupt visual acuity decrease. Ten days earlier, she had received conservative management due to anemia caused by menorrhagia and uterine prolapse. She underwent a gynecological operation to remove a uterine myoma two days previously, and was given a blood transfusion postoperatively because of excessive bleeding. After the transfusion, she complained of acute blurred vision. Her best corrected visual acuity (BCVA) was hand motion 10 cm in both eyes. There were no abnormal specific findings except retinal dot hemorrhage at the temporal side in the left eye on fundus examination. Her pupillary light reflex was normal and optical coherence tomography examination was unremarkable in both eyes. However, flash visual evoked potential findings showed reduced P100 amplitude in both eyes and she was diagnosed with posterior reversible encephalopathy syndrome based on brain magnetic resonance imaging. After close observation without any treatment, the symptoms gradually improved. Finally, her BCVA recovered to 1.0 and P1 and P100 amplitudes were restored to normal range in both eyes at 16 weeks from the first diagnosis. CONCLUSIONS: A patient complained of bilateral visual loss without other neurological symptoms after chronic blood loss and blood transfusion. She recovered visual acuity completely with prompt diagnosis of posterior reversible encephalopathy syndrome and close observation only.
Anemia ; Blindness, Cortical ; Blood Transfusion ; Brain ; Diagnosis ; Evoked Potentials, Visual ; Female ; Hand ; Hemorrhage ; Humans ; Leiomyoma ; Magnetic Resonance Imaging ; Menorrhagia ; Middle Aged ; Ophthalmology ; Posterior Leukoencephalopathy Syndrome* ; Reference Values ; Reflex ; Retinaldehyde ; Tomography, Optical Coherence ; Uterine Prolapse ; Vision Disorders* ; Visual Acuity

The effect of triamcinolone acetonide(TA) on the expression of Gl related genes was investigated the cultured keloid fibroblast. The addition of TA to the culture medium resulted in growth inhibition of keloid fibroblast. TA reduced the expression of cyclin A, B, E and cyclin dependent kinase(CDK) 2 mRNA, but unexpectedly, the expression of cyclin C, Dl and CDK4 mRAN was not affected significantly as compared with those of normal fibroblast. Expressions of p16, p21 and p27, the wellestabilished CDK-inhibitors, were also investigated. The level of p16 was not detected in both normal and keloid fibroblasts and the expression of p27 was significantly decreased in keloid fibroblast. The expression of p21 was dramatically increased in keloid fibroblast but not significantly changed in normal fibroblast. Also the expressions of p53 and pRb, the well known tumor suppressor genes, were increased by the addition of TA. These data suggested that the observed growth inhibitory effect of TA may be related to transcriptional inactivation of cyclin A, B, E and CDK2 and to the transcriptional activation of p21, but the mechanisms of unchanged expression of cyclin C, Dl and CDK4 mRNA remain to be elucidated.
Cell Cycle* ; Cyclin A ; Cyclin C ; Cyclins ; Fibroblasts* ; Genes, Tumor Suppressor ; Keloid* ; RNA, Messenger ; Transcriptional Activation ; Triamcinolone Acetonide* ; Triamcinolone*

BACKGROUND: The Caregiver Activity Survey (CAS) has been designed to collect information about the time caregivers spend providing care during a typical 24-hour period. This study aimed to develop the Korean version of the CAS (CAS-K) in caregivers of community dwelling elderly with dementia. METHODS: The study sample consisted of 61 elderly with dementia and their caregivers. For the elderly with dementia, the data on demographic characteristics, cognitive function, activities of daily living, global severity of dementia, depressive symptoms, and physical illness were investigated. For the caregivers, CAS-K was administered, and data on demographic characteristics, care burden, and general psychopathology were assessed. Using the data above, analyses on reliabilities and validities of CAS-K were carried out. RESULTS: In the elderly with dementia, the global severity was classified into mild (N=44; 72%), moderate (N=12; 20%), and severe (N=5; 8%). The mean caregiving time per day measured by the CAS-K was seven hours across all dementia elders. However, the time was increased according to the global severity of dementia. Test-retest reliability of the CAS-K was good. Times on the CAS-K was significantly correlated with scores on cognitive function, activities of daily living, and the global severity of the elderly with dementia; and with care burden and general psychopathology of the caregivers. CONCLUSIONS: Our results suggest that the CAS-K might be a reliable and valid instrument for investigating the caregiving time required by Korean caregivers. It could be used as an outcome measure of drug trials or an indirect index of costs in the management of dementia patients.
Activities of Daily Living ; Aged* ; Caregivers* ; Dementia* ; Depression ; Humans ; Outcome Assessment (Health Care) ; Psychopathology