Heat stroke, a medical emergency, occurs when the body's thermal regulation is upset and unable to dissipate adequate amounts of heat with a rise in body temperature. It is characterized by hyperyrexia, with a core temperature of 40degrees C or more, hot dry skin, and central nervous system disturbance and usually results in rhabdomyolysis and multiorgan failure. Our case, a 43-year-old healthy male, was caused by a marathon, half course, on a sunny day in late summer. He suddenly fell down on the road and was delivered to a nearby hospital, where a seizure developed. He was transfered to our hospital and then displayed Central Nervous System disturbance, hot dry skin, acute liver failure, rhabdomyolysis, anuric acute renal failure, and disseminated intravasculular coagulopathy. He was treated with general supportive care and hemofiltration. Despite the aggressive management, he died of shock on the fifth day after admission.
Acute Kidney Injury ; Adult ; Body Temperature ; Central Nervous System ; Emergencies ; Heat Stroke* ; Hemofiltration ; Hot Temperature* ; Humans ; Liver Failure, Acute ; Male ; Rhabdomyolysis ; Seizures ; Shock ; Skin

A clinico-pathologic study with an immunohistochemical examination for c-erbB-2 expression in 54 cases of ductal carcinoma in situ and 16 cases of Paget's disease of the breast was performed. c-erbB-2 oncoprotein overexpression was observed in 45% (24/54) and 88% (14/16) of ductal carcinoma in situ and Paget's disease, respectively. The overexpression of c-erbB-2 oncoprotein was significantly correlated with the nuclear grade of tumors and inversely with the status of the estrogen receptor. c-erbB-2 was positive in 4 out of 5 patients with metastasis to axillary lymph nodes and 3 out of 4 patients who died of the disease. Prognostic significance of c-erbB-2 oncoprotein in ductal carcinoma in situ was highly suggested. The expression of c-erbB-2 oncoprotein in Paget's disease was well correlated with coexisting infiltrating or in situ ductal carcinoma. The high positive rate of c-erbB-2 oncoprotein in ductal carcinoma with Paget's disease could be understood with a recent hypothesis that c-erbB-2 oncoprotein is involved in promotion of cell motility and the spread of carcinoma cells.
Neoplasm Metastasis

PURPOSE: Focusing manner is very powerful mind-body self-help and self-awareness competence. So focusing manner may affect nurses' emotional labor and nursing performance, but few are known about it to date. The purpose of this study was to identify the degree of focusing manner, emotional labor, nursing performance of clinical nurses, and the factors that affect nursing performance. METHODS: In order to collect data, structured questionnaires were administered to 212 nurses who worked at 2 university hospitals located in D city. Data were analyzed by t-test, ANOVA, correlation and multiple regression using SPSS/WIN 20.0. RESULTS: Nursing performance had positive relationship with focusing manner (r=.45, p<.001), and negative relationship with emotional labor (r=−.25, p<.001). And the most prediction factor influencing nursing performance was focusing manner (β=.41, p<.001) and the other factors were age (β=.30, p=.002), and emotional labor (β=.14, p=.012). The total variance was 37.1% by those predictors (F=25.87, p<.001). CONCLUSION: Based on the results of this study, it is necessary to develop and educational program on focusing manner-oriented psychotherapy in order to improve the nursing performance. Also, the management system for controlling emotional labor needs to be set up for nurses in clinical settings.
Hospitals, University ; Mental Competency ; Nursing ; Psychotherapy

Purpose: Children have few small alveoli, which reduce lung compliance; in contrast, their cartilaginous rib cage makes their chest wall highly compliant. This combination promotes lung collapse. Prolonged inspiratory to expiratory (I:E) ratio ventilation is used to optimize gas exchange and respiratory mechanics in surgery. However, the optimal ratio is unclear in children. We hypothesized that, compared to a 1:2 I:E ratio, a 1:1 I:E ratio would improve dynamic compliance and oxygenation, and affect the peak airway pressure in pediatric patients undergoing surgery. Materials and Methods: Forty-eight patients aged ≤6 years who were scheduled to undergo surgery under general anesthesia with an arterial line were randomly allocated to receive 1:1 (group 1:1) or 1:2 (group 1:2) I:E ratio ventilation. Airway pressure, respiratory system compliance, and arterial blood gas analyses were compared between groups immediately after induction (T0), 30 min after induction (T1), 60 min after induction (T2), immediately after surgery (T3), and on arrival at the post-anesthesia care unit (T4). Results: Peak and plateau airway pressures were significantly lower in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.048, respectively). The dynamic and static compliances were significantly higher in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.045, respectively). However, the partial pressure of oxygen did not significantly differ between groups. Conclusion Compared to a 1:2 I:E ratio, a 1:1 I:E ratio improved dynamic compliance and lowered the peak airway pressure without complications in pediatric patients. Nevertheless, our results do not support its use solely for improving oxygenation.

Purpose: Children have few small alveoli, which reduce lung compliance; in contrast, their cartilaginous rib cage makes their chest wall highly compliant. This combination promotes lung collapse. Prolonged inspiratory to expiratory (I:E) ratio ventilation is used to optimize gas exchange and respiratory mechanics in surgery. However, the optimal ratio is unclear in children. We hypothesized that, compared to a 1:2 I:E ratio, a 1:1 I:E ratio would improve dynamic compliance and oxygenation, and affect the peak airway pressure in pediatric patients undergoing surgery. Materials and Methods: Forty-eight patients aged ≤6 years who were scheduled to undergo surgery under general anesthesia with an arterial line were randomly allocated to receive 1:1 (group 1:1) or 1:2 (group 1:2) I:E ratio ventilation. Airway pressure, respiratory system compliance, and arterial blood gas analyses were compared between groups immediately after induction (T0), 30 min after induction (T1), 60 min after induction (T2), immediately after surgery (T3), and on arrival at the post-anesthesia care unit (T4). Results: Peak and plateau airway pressures were significantly lower in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.048, respectively). The dynamic and static compliances were significantly higher in group 1:1 than in group 1:2 at T1 (p=0.044 and 0.045, respectively). However, the partial pressure of oxygen did not significantly differ between groups. Conclusion Compared to a 1:2 I:E ratio, a 1:1 I:E ratio improved dynamic compliance and lowered the peak airway pressure without complications in pediatric patients. Nevertheless, our results do not support its use solely for improving oxygenation.

Pseudomyxoma peritonei is a poorly understood condition characterized by mucinous ascites and multifocal peritoneal mucinous tumors. Pseudomyxoma peritonei is most commonly associated with mucinous tumors of the ovary and appendix. When two lesions are morphologically similar, it is difficult to determine whether one reflects a metastasis or whether the tumors are independent. Many studies concluded that most cases in which both the appendix and ovary were involved were primary appendiceal tumor with secondary involvement of the ovary, but we have experienced one case of pseudomyxoma peritonei originated from independent primary borderline mucinous tumors of the ovary and appendix. So we report this case with the brief review of literatures
Appendix* ; Ascites ; Female ; Mucins* ; Neoplasm Metastasis ; Ovary* ; Pseudomyxoma Peritonei*

BACKGROUND: Coffee is a rich source of dietary antioxidants and is one of the most popular beverages worldwide. In recent times, substantial research has been published on its anti-oxidative and anti-inflammatory effect in addition to its effect as a stimulant. Chronic low-grade inflammation is known to affect the pathogenesis of diverse diseases such as cerebrovascular and cardiovascular disease, cancer, metabolic syndrome, type 2 diabetes mellitus, and obesity. Serum C-reactive protein (CRP) is a good marker of chronic inflammation in the body. Therefore, we examined the relationship between coffee consumption and serum CRP.METHODS: Participants were 759 men and 1,003 women, aged 20–64 years, who participated in the Korea National Health and Nutrition Examination Survey, 2015. We categorized coffee consumption as follows: less than one cup a day, two to four cups a day, and five or more cups a day. Additionally, we classified women into pre- and post-menopausal women. Multiple linear regression analyses were conducted to evaluate the relationship between coffee consumption and serum CRP.RESULTS: Coffee consumption showed no measurable relationship with serum CRP in men and in pre- and post-menopausal women. However, serum CRP increased progressively with increase in coffee consumption in men reported high-risk alcohol use (P=0.005).CONCLUSION: Except for high-risk male drinkers, there is no association between coffee consumption and serum CRP.
Adult ; Alcohols ; Antioxidants ; Beverages ; C-Reactive Protein ; Caffeine ; Cardiovascular Diseases ; Coffee ; Diabetes Mellitus, Type 2 ; Female ; Humans ; Inflammation ; Korea ; Linear Models ; Male ; Nutrition Surveys ; Obesity

BACKGROUND: Increased expression of MDR1 gene is one of the major mechanisms responsible for multidrug resistance in cancer cells. Two alternative promoters, upstream and downstream, are responsible for transcription of MDR1 gene in the human. However, the molecular mechanism regarding the transactivation of MDR1 upstream promoter (USP) has not been determined. METHODS: Dual-luciferase reporter gene assays were used to assess the effect of Nkx-2.5 on MDR1 USP activity using reporter plasmids for human MDR1 USP and its mutants. MDR1 mRNA level was examined by quantitative real-time PCR. The direct binding of Nkx-2.5 to the USP of MDR1 was evaluated by promoter enzyme immunoassays and chromatin immunoprecipitation assays.
Breast Neoplasms ; Breast ; Chromatin Immunoprecipitation ; Drug Resistance, Multiple ; Genes, Reporter ; Humans ; Immunoassay ; Immunoenzyme Techniques ; Phenotype ; Plasmids ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Transcriptional Activation

PURPOSE: Intussusception is one of the most common cause of childhood intestinal obstructions. Early diagnosis is essential to avoid treatment delays, which can increase morbidity and mortality. METHODS: In order to evaluate the factors contributing to air-reduction failure, we reviewed cases of childhood intussusception admitted via the ER and managed by air enema reduction from 1994 to 1998. They were divided into two groups and compared retrospectively by using medical records. Group I was the operation group after air-reduction failure, and group II was the air-reduction group. RESULTS: In 319 cases (279 patients), group I consisted of 112 cases (110 patients), and group II consisted of 207 cases (169 patients). No differences in age, sex, body weight, location of intussusception, laboratory findings (leukocytosis and thrombocytosis), presence of bloody stool, and body temperature were noted between the two groups. Factors significantly contributing to air-reduction failure were duration of symptoms, type of intussusception and a few physical findings (abdominal distension, palpable mass, lethargy, and vomiting). The recurrence rate of group I was significantly lower than that of group II, and most recurrences developed in the first postoperative month. CONCLUSION: Childhood intussusceptions of a non-ileocolic type with longer durations of symptoms and severe clinical findings have a higher chance of air-reduction failure.
Body Temperature ; Body Weight ; Early Diagnosis ; Enema ; Intestinal Obstruction ; Intussusception* ; Lethargy ; Medical Records ; Mortality ; Recurrence ; Retrospective Studies

Many young women suffer from premenstrual syndrome (PMS). The purpose of this study was to examine the effect of isoflavone on serum sex hormone and PMS during the luteal phase of the menstrual cycle. We investigated the incidence of PMS in 116 Korean female college students. The incidence of PMS was 19.8%. Among them, 9 PMS and 13 control were given 90 mg isoflavone per day during 2 menstrual cycles. The changes in anthropometric measurements, dietary intakes, serum parameters including sex hormones, and PMS symptoms were observed. Isoflavone supplementation did not affect anthropometric measurements. However, SBP and DBP were significantly decreased in control. Dietary intakes were not changed after supplementation of isoflavones. Serum SHBG was lower in PMS group than in control and significantly decreased in control with isoflavone supplementation. PMS symptoms such as backache, sweet, salty, and fatty food craving, coffee/tea drinking, and anxiety were significantly lessened. Based on these results, isoflavone supplementation may benefit young women by reducing some of PMS. Further studies of soy isoflavones effect on sex hormone and PMS may help to prepare for PMS management.
Anxiety ; Back Pain ; Drinking ; Female* ; Gonadal Steroid Hormones ; Humans ; Incidence ; Isoflavones ; Luteal Phase ; Menstrual Cycle ; Premenstrual Syndrome*