PURPOSE: The purpose of the study was to identify the optimal cutoff values of indices for cardiometabolic risk in postmenopausal Korean women. Specifically, we intended to determine the cutoffs of waist circumference, waist-to-hip ratio (WHR), serum lipid profile, and homeostatic model of assessment-insulin resistance (HOMA-IR) for detecting metabolic syndrome (MetS), and metabolic obesity (MO). METHODS: The study participants were 397 postmenopausal women. We defined MetS and MO with the International Diabetes Federation criteria except for waist circumference. A receive operating characteristic curve analysis was used to assess the accuracy of diagnostic indices for identifying MetS and MO. Cutoff values were obtained both from the point on the receive operating characteristic curve which was closest to (0,1) and from the Youden's index. RESULTS: Among the participants, 34.5% and 73% were classified as having MetS and MO. The optimal cutoff of waist circumference and WHR were 81.9 cm [area under curve (AUC): 0.687, sensitivity: 61.7%, specificity: 68.9%], 0.87 (AUC: 0.660, sensitivity: 64.7%, Specificity: 60.2%) for MetS and 77.4 cm (AUC: 0.655, sensitivity: 65.6%, specificity: 57.8%), 0.86 (AUC: 0.680, sensitivity: 67.0%, specificity: 62.7%) for MO. Triglyceride to high-density lipoprotein ratio for MetS and MO were 2.11 (AUC: 0.838, sensitivity: 71.5%, specificity: 79.6%) and 1.59 (AUC: 0.725, sensitivity: 65.9%, specificity: 68.2%) respectively. The HOMA-IR for MetS was 1.36 (AUC: 0.773, sensitivity: 73%, specificity: 71.9%) and for MO was 1.17 (AUC: 0.713, sensitivity: 64.5%, specificity: 69.2%). CONCLUSIONS: For postmenopausal women, we suggest waist circumference of 81.9 cm and WHR of 0.87 as criteria of MetS. However, women with waist circumference over 77.4 cm and WHR over 0.86 should be monitored for the future development of MetS.
Female ; Humans ; Lipoproteins ; Menopause ; Obesity ; Obesity, Abdominal ; Sensitivity and Specificity ; Triglycerides ; Waist Circumference ; Waist-Hip Ratio

Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

PURPOSE: The purpose of this research was to provide baseline data by utilizing solutions to health problems caused by work-related stress and to examine a way of treatment by comparing and analyzing how the stresses link to fatigue and quality of researchers' life. METHODS: A survey was conducted with 50 researchers working for in H research institute in Daejeon Metropolitan City from April 10th to May 10th, 2012 to examine the correlation of work stress, fatigue and quality of life. The data were analyzed using the Kruskal-Wallis test to look into examine the difference in work stress, fatigue, and quality of life. Also, the correlation of work stress, fatigue and quality of life was measured through by the Pearson correlation coefficient. The data collected through the questionnaires was were analyzed by SPSS 21.0 based on the significant level with a p-value, 0.05. RESULTS: The results showed that fatigue was caused by work stresses in researchers and quality of life was ranked in a relatively low level. Correlation of work stresses, quality of life and fatigue and work stresses against mental health index was negative and fatigue against physical index was also negative. CONCLUSION: It is necessary to maintain more detailed provisions in order to improve mental health and stress level of researchers. Moreover, systematic, in-depth evaluation should be done to reduce researcher's work-related stress and fatigue. In addition, stress management and prevention program should be implemented for these researchers.
Academies and Institutes ; Fatigue* ; Humans ; Mental Health ; Quality of Life* ; Surveys and Questionnaires ; Research Personnel

PURPOSE: The staging of bladder carcinoma is a major determinant of operative management. CT of bladder carcinoma has been widely used to diagnose external extension (pT3b and over), but tumors confined to the bladder wall (from pT1 to pT3a) are poorly delineated. The authors describe CT findings of the superficial bladder carcinoma (below T1, stage A) in thin section CT with air insufflation technique (air insufflation-CT) to facilitate early detection and to aid correct staging of the superficial bladder carcinoma. MATERIALS AND METHODS: The materials consisted of proved 24 cases (1'9 patients, single tumor: 16 patients, multiple tumors :3 patients) of stage A bladder carcinomas. Air insufflation-CT was performed by the infusion of approximately 200 mL of air into the bladder via a Foley catheter. After the routine pelvic CT, bladder tumors were re-scanned with 1.5 to 5 mm thickness and intervals. RESULTS: The superficial bladder carcinomas were detected as nodular(5 cases, 20.8%), papillary(15 cases, 62.5%), pyramidal(2 cases, 8.3%), and domed(2 cases, 8.3%) forms on air insufflation CT. These tumors were classified into three types according to the size of the tumoral neck:type I(pedundulated polypold tumor:4 cases, 16.6%), type II(polypid tumor with short neck :13 cases, 54.2%), and type Ill(sessile tumor :7 cases, 29. 2%). The mean size(tumoral width x height x base o, neck/stalk) of the tumors was 22 x 20 x 16mm. The average tumoral sizes according to each type of the superficial tumors were type 1:22 x 25 x 6mm, type 11:23 x 22 x 18mm, and type III :18 x 15 x 18mm. The mean width of the type I--II tumoral necks was 15mm. The mean length of the type I tumoral neck(pedicle) was 2.5mm. Papillary fronds of the tumors were seen in 10 cases(41.7%) of 24 superficial tumors. Outer margin of the involved bladder wall was smooth in all cases. CONCLUSION: Thin-sectin CT with air insufflation technique for bladder carcinoma was useful in tumoral demonstration, and characteristics of the superficial bladder carcinomas were small polypold tumors had a short neck mostly and smooth outer wall of the involved bladder wall.
Catheters ; Humans ; Insufflation* ; Neck ; Urinary Bladder Neoplasms ; Urinary Bladder*

Central hypoventilation syndrome (CHS) can be caused by any lesions to the medullary respiratory centers, cerebral cortex, corticospinal pathways, and their connections. We report 5 patients with central hypoventilation syndrome and analyzed 26 patients who experienced central hypoventilation syndrome during sleep and waking states. We compared initial clinical symptoms and signs, maximal neurologic deficits, brain MRI and pathologic findings, and associated autonomic dysfunctions. The patients with respiratory failure during waking states showed quadriplegia, a rapidly progressing respiratory failure. The patients who had automatic respiratory failure showed mild hemiparesis, bulbar dysfunction, dysautonomia, and subacute to chronic recurrent respiratory failures. These results support the concept of two separate respiratory systems: a voluntary system and an automatic system. The respiratory management of these patients with central hypoventilation syndrome should be considered critical to their survival.
Brain ; Cerebral Cortex ; Humans ; Hypoventilation* ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Paresis ; Primary Dysautonomias ; Pyramidal Tracts ; Quadriplegia ; Respiratory Center ; Respiratory Insufficiency ; Respiratory System

A Swan-Ganz catheter is a useful monitoring device for measuring the pulmonary artery pressure, pulmonary capillary wedge pressure and cardiac output, but its insertion brings about many complications, including dysrhythmias, pulmonary artery rupture, thrombosis and infection. We report here on a case of malposition of a Swan-Ganz catheter in a 49-year-old female patient who had undergone liver transplantation due to alcoholic liver cirrhosis.
Cardiac Output ; Catheters* ; Female ; Humans ; Liver Cirrhosis, Alcoholic ; Liver Transplantation ; Middle Aged ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Rupture ; Thrombosis

Speckled lentiginous nevus(SLN) is characterized by a tan background patch on which more darkly pigmented macules and papules are randomly distributed. The presence of agminated Spitz nevi with SLN is well known, but a solitary Spitz nevus arising on a SLN is rare. We herein report a case of SLN with two Spitz nevi developed individually and congenital melanocytic nevus in a 9-year-old boy.
Child ; Humans ; Male ; Nevus* ; Nevus, Epithelioid and Spindle Cell ; Nevus, Pigmented ; Triacetoneamine-N-Oxyl

PURPOSE: To report a case of primary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), of the eyelid. METHODS: A 48-year-old healthy male patient presented with a mass on the upper lid of 2 months in duration. The lesion was reddish, well-demarcated, oval shaped, and measured approximately 8 x 4 mm. The mass did not respond to incisional drainage and intra-lesional triamcinolone. An excisional biopsy for diagnosis was performed. RESULTS: On microscopic examination, a localized dense lymphocytic infiltration was observed in the subepithelial area, and cytologic atypia was observed under high power. On immunohistochemical examination, tumor cells were positive for CD3 but negative for CD20, CD30, CD56, k-light chain immunoglobulin, lambda-light chain immunoglobulin, and increased Ki-67 activity was noted. A histopathological diagnosis of PTCL-NOS was made. CONCLUSIONS: PTCL-NOS, which rarely occurs on the eyelids, commonly accompanies generalized lymphadenopathy and "B symptoms" such as fever and weight loss. Herein, the authors report a case of PTCL-NOS of the eyelid presenting as a rapidly growing solid mass in an otherwise healthy patient.
Biopsy ; Drainage ; Eyelids ; Fever ; Humans ; Immunoglobulins ; Lymphatic Diseases ; Lymphoma, T-Cell, Peripheral ; Male ; Middle Aged ; Triamcinolone ; Weight Loss

PURPOSE: Nurses' resilience plays an important role in overcoming the challenges that nurses often encounter at clinic, and many factors have been examined which influence on nurses' resilience levels. Through this study, those factors were systematically searched and quantitatively synthesized. METHODS: In order to find relevant studies, both English and Korean academic databases were searched, and, finally, a total of 33 articles were identified and included in this analysis. RESULTS: The effect size on the protective variables was large and that of the risk variables was medium. In the protective variable group, the job variable group showed a larger effect size compared to the organizational variable group. Among the protective variables, compassion satisfaction showed the highest contribution on enhancing the resilience level of nurses. In the risk variable group, the personal variable group showed the highest effect size, which was followed by the organizational and job variables. Among the risk variables, the personal stress response showed the highest contribution to decreasing the level of resilience of nurses. CONCLUSION: This study provides a meaningful data for future studies in terms of developing evidence-based interventions to enhance the levels of resilience among Korean nurses.
Empathy ; Humans

Background: Regeneration of soft tissue defects is essential for adipose tissue pathologies and disease, trauma, or injury-induced damage. Here, we show that umbilical cord blood-derived mesenchymal stem cells could potentially be tailored and used for the reconstruction of specific damaged sites. Adipogenesis can be exploited in soft tissue reconstruction. Also, primary cilia play a role in the control of adipogenesis. Methods: The adipogenic differentiation capacity of mesenchymal stem cells (MSCs) was shown to influence ciliogenesis. MSCs transfected with intraflagellar transport 88 (IFT88) small interfering RNA (siRNA), which blocks the assembly and maintenance of cilia, were examined to confirm the relationship between adipogenesis and ciliogenesis. Also, 1,2-Bis(2-aminophenoxy) ethane-N,N,N′,N′-tetraacetic acid tetrakis(acetoxymethyl ester) (BAPTA-AM), calcium chelator, inhibited the ciliogenesis of MSCs in adipogenic differentiation. Results: IFT88-knockdown led to decreased cilia formation and limitation of cilia elongation in adipogenesis. Additionally, intracellular calcium triggered cilia formation in MSCs adipogenesis. Interestingly, intracellular calcium cannot overcome the inhibition of adipogenesis caused by low numbers of cilia in MSCs. Conclusion Our data suggested that ciliogenesis was negatively regulated by Wnt5a/β-catenin signaling during adipogenesis. Thus, we suggest that calcium induction triggers adipogenesis and ciliogenesis.