No abstract available.
Abdominal Wall ; Abscess ; Humans

BACKGROUND: The role of stratum corneum has been known to be the major barrier against percutaneous absorption. The change of osmotic gradient onto stratum corneum may affect the permeability barrier function though its mechanism has not been explained. OBJECTIVE: In this study, we have tested hyperosmolar glucose solution (1M, 0.1M) over the living skin or the separated epidermal sheets to determine the penetration-related pharmacokinetics such as absorption, saturation, diffusion kinetics in vivo or in vitro. METHODS: The hyperosmolar glucose patches were applied to 10 healthy volunteers' forearm skin to analyze the absorption profiles through stratum corneum. For investigating the role of osmotic pressure influencing the disposition of glucose, in vitro two compartment model was used to characterize the pharmacokinetics of glucose through epidermal sheets. RESULTS: The quantitative assay of applied hyperosmolar glucose from sequentially stripped stratum corneum of volunteers revealed the high glucose/protein ratio and steep concentration gradient at the uppermost layers down to lower layers. The pharmacokinetic profile of hyperosmolar glucose in vitro shows both the saturation delay pattern and steady flux pattern regarding glucose diffusion. CONCLUSION: The stratum corneum act as a major permeation barrier against glucose disposition, though the concentration-dependent pharmacokinetics by its osmotic gradient were rather different. Thus, the osmolarity-related event over stratum corneum might be a considerable factor during percutaneous absorption.
Absorption ; Diffusion ; Forearm ; Glucose* ; Kinetics ; Osmotic Pressure ; Permeability ; Pharmacokinetics* ; Skin ; Skin Absorption ; Volunteers

Pulmonary hypertension is an uncommon but serious complication of systemic lupus erythematosis (SLE).Usually its outcomes are ominous and may progress to heart failure and even sudden death.The pathophysiology is still unknown, but several mechanisms,such as pneumonitis,vasculitis,thromboembolism or thrombosis in situ have been proposed.There is no definitive therapy for this condition.Although supportive measures with vasodilators remain the mainstay of treatment,the responses are generally disappointing. We describe a case of improvement of pulmonary hypertension in SLE treated with cyclophosphamide pulse therapy as documented by hemodynamic data. Immunosuppressive treatment with cyclophosphamide was effective in this condition,suggested an immune mediated pathogenesis.
Cyclophosphamide* ; Heart Failure ; Hemodynamics ; Hypertension, Pulmonary* ; Lupus Erythematosus, Systemic* ; Thrombosis ; Vasodilator Agents

Background: Open reduction and internal fixation is the standard treatment for a displaced medial malleolus fracture (MMFx), achieving ankle stability and bony union to prevent post-traumatic arthritis. Previous fixation techniques including tension band wiring and unicortical screw fixation are not optimal for fixation of small fragments in MMFx due to their small size and poor manipulability. Here, we describe a novel surgical method using mini-screws only for fixation of small fragments in MMFx. Methods: We conducted a retrospective consecutive study of patients who underwent surgery using mini-screws for small fragment MMFx between April 2013 and March 2018. We reviewed the patients’ clinical characteristics and assessed the fracture features radiographically. Clinical outcomes were assessed by measuring the range of motion of both ankle joints and investigating symptomatic implants. We reviewed the radiographic outcomes of the medial malleolus and the functional outcomes using the Foot and Ankle Outcome Score (FAOS) at the last follow-up. Results: Nine patients were included in the study. The minimal follow-up period was 27 months. There was no incidental bone breakage during the procedure. All MMFx healed without reduction loss, nonunion, or implant failure at the last follow-up. Two patients had mild osteoarthritic changes of the ankle joint. The mean FAOS score of the patients was 80.99 (range, 65.44–98.42). No patients required removal of the hardware. Conclusions Fixation of comminuted fractures of the medial malleolus using mini-screws for young adult patients is a straightforward and simple technique. Safe fixation of the anterior and posterior colliculi reduces the risk of implant irritation symptoms that necessitate implant removal.

Background: Open reduction and internal fixation is the standard treatment for a displaced medial malleolus fracture (MMFx), achieving ankle stability and bony union to prevent post-traumatic arthritis. Previous fixation techniques including tension band wiring and unicortical screw fixation are not optimal for fixation of small fragments in MMFx due to their small size and poor manipulability. Here, we describe a novel surgical method using mini-screws only for fixation of small fragments in MMFx. Methods: We conducted a retrospective consecutive study of patients who underwent surgery using mini-screws for small fragment MMFx between April 2013 and March 2018. We reviewed the patients’ clinical characteristics and assessed the fracture features radiographically. Clinical outcomes were assessed by measuring the range of motion of both ankle joints and investigating symptomatic implants. We reviewed the radiographic outcomes of the medial malleolus and the functional outcomes using the Foot and Ankle Outcome Score (FAOS) at the last follow-up. Results: Nine patients were included in the study. The minimal follow-up period was 27 months. There was no incidental bone breakage during the procedure. All MMFx healed without reduction loss, nonunion, or implant failure at the last follow-up. Two patients had mild osteoarthritic changes of the ankle joint. The mean FAOS score of the patients was 80.99 (range, 65.44–98.42). No patients required removal of the hardware. Conclusions Fixation of comminuted fractures of the medial malleolus using mini-screws for young adult patients is a straightforward and simple technique. Safe fixation of the anterior and posterior colliculi reduces the risk of implant irritation symptoms that necessitate implant removal.

Purpose: This study aimed to review the history and examine the current service system of the Korea Counseling Center for Fertility and Depression (KCCFD) by analyzing the characteristics of its users, and to suggest measures to improve the system. Methods: Data on 883 infertile patients counseled through the KCCFD’s counseling service over the last 2 years were collected for a demographic analysis. The clinical information of 396 female subjects who received regular counseling after registration were analyzed to investigate factors influencing depression. Finally, a matching sample t-test was conducted to verify the effects of the counseling service. Results: The screening test showed that 50.7% of the infertile patients in our study were registered at our centers and received registered counseling. A total of 27.6% of the subjects was identified as being at high-risk for depression, and 71.3% of those at high-risk received registered counseling. The logistic regression analysis showed that being a homemaker, having a history of psychiatric disorder, and having undergone in vitro fertilization three or more times were significant factors that predict moderate or more severe depression. The female infertility patients who underwent counseling showed a significant decrease in depression, anxiety, general stress, and infertility stress. Conclusion Screening tests need to be performed prior to assisted reproductive technology if any of the 3 risk factors is present. The rate of registered counseling, regular follow-up using psychological tests, and cross-linkages with affiliated agencies should serve as the metrics for the quality control of the counseling service. Early detection of individuals at high-risk for depression calls for an activated liaison among affiliated agencies and expanded regional centers.

Purpose: This study examined the current status of counseling services provided by the Korea Counseling Center for Fertility and Depression, analyzing the characteristics of peripartum women and baby-rearing mothers and establishing guidelines for providing psychological support, and suggesting measures for improving the system. Methods: Data on 3,660 peripartum women & their spouses and baby-rearing mothers counseled through the service over the last 4 years were collected and a demographic analysis was conducted. By analyzing the clinical information of 216 peripartum women and 219 baby-rearing mothers who have registered with the Center and received routine counseling services, factors affecting depression were identified. Finally, a paired sample t-test was conducted to verify the effect of counseling services. Results: An overall 20.4% of pregnant women & their spouses were screened for high risk for depression, of whom 27.3% received registered counseling services; further, 26.2% of baby-rearing parents were at high-risk group for depression, of whom 25% received registered counseling services. Results of a logistic regression analysis suggested that, for peripartum women, level of education and conflicts with partner and family were the crucial factors predicting moderate or severe depression. For baby-rearing mothers, obstetric history of spontaneous abortion was the crucial predicting factor. Conclusion For the early detection and prevention of peripartum depression, screening tests that start from early pregnancy should be routinely administered. Further, continuous management—covering the periods before and after childbirth—should be provided by establishing organic ties between domestic projects.

Objective: : This study compared the quality of recovery (QoR) after minicraniotomy for clipping of unruptured intracranial aneurysms (UIAs) between patients with and without scalp nerve block (SNB). Methods: : Patients were randomly assigned to the SNB (SNB using ropivacaine with epinephrine, n=27) and control (SNB using normal saline, n=25) groups. SNB was performed at the end of surgery. To assess postoperative QoR, the QoR-40, a patient-reported questionnaire, was used. The QoR-40 scores were measured preoperatively, 1–3 days postoperatively, at hospital discharge, and 1 month postoperatively. Pain and intravenous patient-controlled analgesia (IV-PCA) consumption were evaluated 3, 6, 9, and 12 hours and 1–3 days postoperatively. Results: : All QoR-40 scores, including those measured 1 day postoperatively (primary outcome measure; 155.0 [141.0–176.0] vs. 161.0 [140.5–179.5], p=0.464), did not significantly differ between the SNB and control groups. The SNB group had significantly less severe pain 3 (numeric rating scale [NRS]; 3.0 [2.0–4.0] vs. 5.0 [3.5–5.5], p=0.029), 9 (NRS; 3.0 [2.0–4.0] vs. 4.0 [3.0–5.0], p=0.048), and 12 (NRS; 3.0 [2.0–4.0] vs. 4.0 [3.0–5.0], p=0.035) hours postoperatively. The total amount of IV-PCA consumed was significantly less 3 hours postoperatively in the SNB group (2.0 [1.0–4.0] vs. 4.0 [2.0–5.0] mL, p=0.044). Conclusion : After minicraniotomy for clipping of UIAs, SNB reduced pain and IV-PCA consumption in the early postoperative period but did not improve the QoR-40 scores.

BACKGROUND: Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. METHOD: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. RESULTS: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. 2) Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82% of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1% and large opacity is 17.9%. Small opacity has t/t type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest X-ray density, the more decreasing FEV1 (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. 6) Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. CONCLUSION: These findings indicate that tuberculosis infection has a decisive influence on the progress and prognosis of pneumoconiosis.
Chest Pain ; Coal ; Cough ; Disease Progression ; Dust ; Dyspnea ; Electrocardiography ; Hemoptysis ; Humans ; Inhalation ; Korea ; Lung Diseases ; Medical Records ; Pneumoconiosis* ; Prevalence ; Prognosis ; Pulmonary Heart Disease ; Respiratory Function Tests ; Respiratory Insufficiency ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND/AIMS: Tetraploid cells are frequently observed in the inflamed mucosal epithelial cells of the patients with Barrett's esophagus or chronic ulcerative colitis. Polyploidy often occurs during cell fusion, abortive cell cycle, and endoreplication. Most tetraploid cells are engaged to apoptotic pathway, but some remaining stable tetraploid cells consequently cause aneuploidization and chromosomal instability. We investigated whether tetraploid cells could acquire survival advantage and hold a dominant position for natural selection. METHODS: We established tetraploid cell line (HCT116GH) from parental diploid colorectal cancer cell line (HCT116) via PEG-mediated cell fusion and compared its cell viability, cell cycle response and apoptotic fractions responded to H2O2 with diploid HCT116 and p53 suppressed HCT116/H6 cell lines. RESULTS: Using MTT assay, plating efficiency and clonogenicity, we evaluated the survival of each cell line. Tetraploid cell line HCT116GH demonstrated an 83 fold greater resistance to 100 microM H2O2 than the parental diploid HCT116, and 6 fold greater than even the p53 negative diploid HCT116/E6. Cellular sensitivity, G2/M arrests, and apoptotic proportion were observed less in response to H2O2 in HCT116GH compared with HCT116 and HCT116/E6. HCT116GH expressed lower level of p53 and p21 than diploid HCT116. CONCLUSIONS: Stable tetraploid cell lines showed enhanced viability in comparison to parental diploid cell lines. The enhanced viability observed in tetraploidization surpassed that from downregulation of p53. Frequent appearance of tetraploid cells in stressful condition can be caused by natural selection owing to their enhanced viability and may consequently contribute to cancer cell transformation.
Apoptosis ; Cell Division ; Cell Line, Tumor ; Cell Survival ; Chromosomal Instability ; Colonic Neoplasms/*genetics/metabolism ; Cyclin-Dependent Kinase Inhibitor p21/metabolism ; G2 Phase ; Humans ; Hydrogen Peroxide/toxicity ; Oxidative Stress ; *Polyploidy ; Tumor Suppressor Protein p53/metabolism