BACKGROUND: Epidural morphine has side effects, especially pruritus, nausea, and vomiting. Butorphanol has been added in studies to reduce these side effects in post cesarean patients. The purpose of this study was to evaluate the side effects and analgesic efficacy when a combination of epidural morphine and butorphanol was administered in patients having combined local anesthetic and opioid epidural infusion. METHODS: Sixty patients having epidural anesthesia for cesarean section were randomly divided into two groups. Group M (n=30) received a bolus of 0.25% bupivacaine 4 ml, morphine 2 mg, and saline 0.75 ml, whereas group B (n=30) received a bolus of 0.25% bupivacaine 4 ml, morphine 2 mg, and butorphanol 1.5 mg (0.75 ml). Continuous epidural infusion was done by Two-day Infusor containing either 0.25% bupivacaine 75 ml, morphine 5 mg, and saline 20 ml in group M or 0.25% bupivacaine 75 ml, morphine 5 mg, butorphanol 4 mg (2 ml), and saline 18 ml in group B. We compared the side effect and analgesic effect of group M to those of group B for 2 days. RESULTS: The incidence of pruritus and vomiting were reduced significantly in group B (p<0.05). There were no significant differences between both groups in the incidence of nausea or other side effects as well as no differences in analgesic effect. CONCLUSIONS: We conclude that the addition of butorphanol to morphine in combined local anesthetic and opioid epidural infusion for postoperative analgesia decreases the occurrence of pruritus and vomiting without significant increase of other side effects and adverse effect on analgesia.
Analgesia ; Anesthesia, Epidural ; Bupivacaine ; Butorphanol* ; Cesarean Section* ; Female ; Humans ; Incidence ; Infusion Pumps ; Morphine* ; Nausea ; Pregnancy ; Pruritus ; Vomiting

Attention deficit hyperactivity disorder (ADHD) has been associated with an elevated risk for obesity but this seems to be paradoxical to the fact that many youths with ADHD have symptoms of hyperactivity. People diagnosed with ADHD tend to have a high risk of developing undesirable diet habits and consequently have health related problems. However, less attention has been paid to obesity in ADHD while many efforts have been devoted to the prevention of childhood obesity in mentally normal people. Hence the purpose of this study was to explore the nutritional status and life habits of children and adolescents with ADHD (n = 76) based on degree of obesity by utilizing the Korean National Health and Nutrition Examination Survey (KNHANES) data from 2005–2013. As results the levels of blood pressure, total triglycerides and the fat intake relative to total energy intake in overweight ADHD group were higher than those in normal weight group. Interestingly, overweight ADHD subjects consumed significantly less amount of iron compared to normal weight ADHD subjects and the level of serum ferritin was lower in the overweight ADHD group (59.0 ng/mL) than in the normal weight ADHD group (47.9 ng/mL). After adjusting total energy intake, total vegetable consumption was 14.3% lower in overweight group compared to the consumption in normal weight group. These results indicate a plausible relationship of iron status and obesity in ADHD subjects but this relationship may not be specific to ADHD. A future study with case-control design is necessary to investigate the association of obesity, nutrient intake, and cognitive/mental status of ADHD.
Adolescent* ; Attention Deficit Disorder with Hyperactivity* ; Blood Pressure ; Case-Control Studies ; Child* ; Energy Intake ; Ferritins ; Food Habits ; Humans ; Iron ; Nutrition Surveys ; Nutritional Status* ; Obesity ; Overweight ; Pediatric Obesity ; Triglycerides ; Vegetables

The purpose of this study was to develop the CORE Program for sex offenders and to determine its effectiveness. The CORE Program was designed with an aim to achieve cognitive restructuring, improve the ability to empathize in interpersonal relationships, and enhance self-esteem and intimacy. We conducted this program over 48 sessions for 28 sex offenders. The effectiveness of the program was evaluated using the Interpersonal Responsiveness Index (IRI), Self-esteem Questionnaire (SEQ), UCLA Loneliness Scale (UCLALS), Coping Using Sex Inventory (CUSI), Rape Myth Acceptance Scale (RMAS), and Wilson's Sex Fantasy Questionnaire (WSFQ). The data were analyzed using paired t-tests. Our results showed no significant changes in the SEQ, UCLALS, and IRI scores after the treatment program. However, the scores for the CUSI, RMAS, and WSFQ significantly improved after this program. In this paper, we demonstrate the effectiveness of the CORE Program for sex offenders. We also discuss the limitations of our study and provide suggestions for future research. Our findings indicate that this treatment program should be provided to sex offenders for preventing recidivism.
Criminals ; Fantasy ; Humans ; Loneliness ; Paraphilic Disorders ; Rape ; Surveys and Questionnaires

BACKGROUND AND OBJECTIVES: The identification of a specific etiology of effusive pericardial disease is difficult because of the limited yield of cytologic and microbiologic pericardial fluid analysis. We performed retrospective study to find out whether pericardial biopsy was superior to pericardial fluid analysis in search of the etiology of pericardial effusion. MATERIALS AND METHOD: We reviewed 76 cases of moderate to severe pericardial effusion on which we performed surgical pericardial biopsy from Sep. 1986 to Sep. 1996. The results of pericardial fluid analysis, clinical manifestation, pericardial biopsy were compared retrospectively. RESULTS: 1)Clinical diagnosis of pericardial effusion were as follow:neoplastic disease (7.9%), tuberculosis (72.4%), constrictive pericarditis (17.1%), and others (2.6%). 2)By the percutaneous pericardial biopsy, we confirmed 19 cases (25%). Etiology of 4 cases (5.3%) were malignancy and 15 cases (19.7%) tuberculosis. Fifteen out of 76 patients who were diagnosed by biopsy as tuberculous pericarditis and 28 patients who were suspected as tuberculous pericarditis clinically were treated with antituberculous medications. Ten patients (66.7%) of pathologically diagnosed patients and 18 patients (69.2%) of clinically diagnosed patients showed complete resolution of pericarditis. CONCLUSION: By pericardial biopsy, we only confirmed 19 cases (25.0%). It means that pericardial biopsy is not superior to pericardial fluid analysis in searching of etiology of pericardial effusion. Moreover, it is not sufficient for final diagnosis of pericardial effusion.
Biopsy* ; Diagnosis ; Humans ; Pericardial Effusion ; Pericarditis ; Pericarditis, Constrictive ; Pericarditis, Tuberculous ; Retrospective Studies ; Tuberculosis

The N-terminal sequence of HIV1 gp41 (amino acid residues 584-623) was known to be the immundominant region of HIV1 gp41 protein. In order to determine epitope for gp41 protein of Korean anti-HIV1 positive sera, multiple antigenic peptides (MAPs) for the sequences corresponding to 584-604, 590-612, 604-623 and 584-618 of HIV1 gp41 were synthesized by solid phase method using Fmoc-Lys (Fmoc)-OH and used as coating antigens for ELISA. The reactivities of the synthetic peptides with Korean HIV1 positive (21 samples) and anti-HIV1 negative sera (22 samples) obtained from healthy blood doner were estimated by an indirect ELISA. MAPs for 584-604, 590-612 and 604-623 of gp41 reacted with 62 %, 100 % and 81 % of Korean anti-HIV1 positive sera tested, respectively. The results suggest that the epitope for HIV1 gp 41 for Korean anti-HIV1 positive sera is located in the region of amino acid 590-612 of gp41. MAP for gp41 (584-618) reacted with all (100 %) of anti-HIV1 positive sera tested, but did not react with anti-HlV1 negative sera. In addition, this MAP reacted stronger with seven samples of anti-HIV1 positive sera of anti-HIV1/2 combo performance panel than the mixture of 584-604, 590-612 and 604-623 of gp41, but did not react with anti-HIV negative serum. The high sensitivity and selectivity of MAP of gp41 (584-618) suggest that this peptide as a coating antigen in an ELISA system will be useful for antibody detection of HIV1.
Enzyme-Linked Immunosorbent Assay ; Epitope Mapping* ; Immune Sera* ; Peptides*

The brachial plexus block by interscalene approach is useful for any procedure on upper extremity, including the shoulder. Complications such as phrenic nerve block, Horner's syndrome, permanent neurologic damage, high epidural block, total spinal anesthesia, pneumothorax and cardiac arrest etc. were reported. We experienced a case of 56-year old male patient with ankylosing spondylitis who developed cervical spinal cord injury following the turning of head for brachial plexus block by interscalene approach. The patient developed quadriplegia and finally died after 28 days.
Anesthesia, Spinal ; Brachial Plexus* ; Head ; Heart Arrest ; Horner Syndrome ; Humans ; Male ; Middle Aged ; Phrenic Nerve ; Pneumothorax ; Quadriplegia ; Shoulder ; Spinal Cord Injuries* ; Spinal Cord* ; Spondylitis, Ankylosing ; Upper Extremity

PURPOSE: This study investigated major dietary patterns among healthy Korean adults using cluster analysis and analyzed the relationship between energy intake and skeletal muscle mass.METHODS: This study was conducted using the data from the 2008 ~ 2010 Korea National Health and Nutrition Survey. The data of 7,922 subjects aged 30 years and over, without any missing values, were included in the final analysis. K-means cluster analyses were conducted to identify the dietary patterns of the study subjects, which were based on the energy intake from 21 food groups using a 24-h recall method. The changes in energy intake with each dietary pattern, according to quartiles of skeletal muscle mass, were investigated.RESULTS: Three dietary patterns were identified for both men and women: ‘Flour, Animal fat’, ‘White rice’ and ‘Healthy mixed diet’. The association between energy intake and skeletal muscle mass for both men and women was significant only in the ‘White rice’ dietary pattern. In the ‘White rice’ pattern, the energy intake increased up to > 300 kcal from the lowest to the highest quartile of skeletal muscle mass after adjustment for covariates. Within the ‘White rice’ pattern, skeletal muscle mass was linearly associated with energy intake in all the age groups in men.CONCLUSION: Energy intake was significantly associated with changes in skeletal muscle mass only in the ‘White rice’ pattern. Furthermore, the degree of association between the change in skeletal muscle mass and energy intake differed according to gender. These results indicate that the association between skeletal muscle mass and energy intake may be specific to Korean people who are accustomed to a traditional Korean diet.
Adult ; Animals ; Cluster Analysis ; Diet ; Energy Intake ; Female ; Humans ; Korea ; Male ; Methods ; Muscle, Skeletal ; Nutrition Surveys

After publication of the article (Jang & Bu, 2019), the authors recognized clerical errors on page 3 and 4.

Isolating the effects of a single nutrient or food in relation to health outcomes including increased skeletal muscle mass is a challenging task because dietary constituents are highly correlated and synergistic. Hence, diet pattern analysis may be used to investigate the role of certain diets in health outcomes. The present study investigated the dietary patterns and their relationship to skeletal muscle mass in Korean adults. Data were extracted from the 2008–2011 Korea National Health and Nutrition Examination Surveys. To explore the dietary patterns of the study subjects, factor analysis was performed using data obtained from a 24-hour recall. The skeletal muscle index according to dietary pattern scores was then investigated to estimate the changes in skeletal muscle mass. Three patterns were initially identified from the factor analysis. Of these vegetables and fish (VF) pattern was the primary factor with high reliability and was a common factor in sex-separated analyses. The VF pattern scores were positively associated with increased skeletal muscle mass in both men and women. Further analysis according to quartile levels of VF pattern scores showed a positive association between skeletal muscle mass and VF pattern in men but not in women. These results suggest that dietary patterns focused on vegetables and seafoods may contribute to increased skeletal muscle mass in Korean men but that sex difference should be considered in nutrition care for skeletal muscle health.
Adult ; Diet ; Factor Analysis, Statistical ; Female ; Fishes ; Food Habits ; Humans ; Korea ; Male ; Muscle, Skeletal* ; Seafood ; Sex Characteristics ; Vegetables*

The authors made a mistake in presenting an equation for SI calculation on page 223.