Septic shock is one of the leading cause of death in hospitalized patients and mortality rates of up to 50 % have been reported. Despite all efforts, no regimen today seems to be successful in the treatment of septic shock. The endogenous opioid system (EOS) includes three major families of peptides: dynorphins, endorphins and enkephalins. Several lines of evidence indicate that EOS is implicated in the pathophysiology of anaphylactic and endotoxic shock. An opioid receptor blocker naloxone has been used extensively in studies for the role of EOS or endogenous opiod peptides (EOP). However, there have been few, if any, detailed investigative studies regarding the effect of naloxone on TNF-a production and the lethality in response to endotoxin, and tumorigenesis. ...continue...
Carcinogenesis* ; Cause of Death ; Dynorphins ; Endorphins ; Enkephalins ; Humans ; Melanoma ; Mortality ; Naloxone* ; Nitric Oxide ; Peptides ; Receptors, Opioid* ; Shock, Septic*

Purpose: The purpose of this qualitative study is to explore the changed parenting experiences of mothers of elementary school kids living in the aftermath of the COVID-19 outbreak in Korea. Methods: From July to August in 2020, 10 mothers parenting elementary school students under the COVID-19 were interviewed in depth. For data analysis, a phenomenological research methodology suggested by Colaizzi was used. Results: According to the analysis, the experiences of mothers consisted of four categories: the ‘pain from the uncontrollable COVID-19’, ‘the problem of family relations due to the COVID-19 pandemic situation’, ‘standing firm against the drastic changes’, and ‘accepting the world changed by the COVID-19’. Conclusion The findings in this study vividly represent the parenting experiences of mothers of elementary school students after the outbreak of COVID-19. As the pandemic persists, mothers parenting elementary school students feel complex emotions and experience exhaustion, but in the process, they found family members growing positively and trying to adjust to each other to overcome the crisis. To support positive adaptation to catastrophic situations, an institutional and political foundation is needed to develop a systematic crisis management program customized for mothers and families of elementary school students. The results of this study can be used as basic data when establishing national policies and support systems so that mothers parenting elementary school students can better adapt to and overcome crisis situations.

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

BACKGROUND : A discussion of the chronologic trends of operative indications of breast masses for proper management of breast masses is desirable. METHODS : A retrospective analysis of 882 patients with breast masses who underwent operations at Kangnam General Hospital from January 1986 to December 1997 was done. All the lesions were classified according to for age, size of the mass, and the pathologic result. Concurrently, the distributions of the different masses were retrospectively analyzed for each one-year time period. RESULTS : The most prevalent age group was the third decade (28.6%) followed by the fourth decade (25.3%) and the fifth decade (24.4%). The most common lesion was fibroadenoma (38.7%), followed by mammary dysplasia (22.6%) and malignancy (18.3%). In fibroadenoma, the most common pathologic type was intracanalicular (34.9%), and the juvenile type occurred in significantly younger patients compared to other types (19.2 vs 29.2 years of age). In mammary dysplasia, the most common pathologic type was fibrous (74.4%), and the epithelial hyperplasia and adenosis types were occurred in older patients compared to the other types (39.1 and 41.0 vs 33.5 and 35.4 years of age). As the chronologically changing pattern of the pathologic types, the number of mammary dysplasia had a decreasing tendency and fibroadenoma had a relatively increasing one, and the reason may be the effect of fine-needle aspiration cytology. CONCLUSIONS : The result of this study shows that the distribution of the disease in terms of age and frequency is almost the same as that of other reported results. The trend of the disease types in terms of the time period shows that the operation rate for fibroadenomas is increasing while the rate for mammary dysplasia is decreasing. This tendency might come from the decreasing use of surgical biopsy for mammary dysplasia.
Biopsy* ; Biopsy, Fine-Needle ; Breast* ; Fibroadenoma ; Fibrocystic Breast Disease ; Hospitals, General ; Humans ; Hyperplasia ; Retrospective Studies

Thoracic aortic aneurysm (TAA) is the most common pathology of the thoracic aorta. The incidence of TAA is increasing and the true incidence of TAA is likely to be higher than currently reported because of its inherently silent nature. TAAs are an increasingly recognized condition that is diagnosed incidentally on imaging studies performed to evaluate unrelated conditions because most patients with TAA have no symptoms. TAAs normally grow in an indolent manner, but can become rapidly lethal once dissection or rupture occurs. Indeed, aortic aneurysms (both abdominal and thoracic) represent the 15th leading cause of death in individuals older than 55 years, and the 19th leading cause of death in individuals of all ages in the United States. The etiologies underlying TAAs are diverse. Therefore, the evaluation and management of TAAs are complex. The present review summarizes the knowledge of the pathophysiology, natural history and diagnostic modalities, as well as current treatment strategies of TAA on the basis of current literature.
Aorta, Thoracic ; Aortic Aneurysm ; Aortic Aneurysm, Thoracic* ; Cause of Death ; Diagnosis* ; Humans ; Incidence ; Natural History ; Pathology ; Prognosis ; Rupture ; United States

Background: This study aimed to investigate perceptions of Clostridioides difficile infection (CDI) diagnostic tests among physicians who prescribe CDI diagnostic tests as part of providing direct patient care. Methods: In August 2018, we provided a 12-question survey of gastroenterologists (the most common referral source for CDI testing) to 35 medical institutions in Korea, asking them about their perceptions of CDI diagnosis and testing. Results: A comparison of the perceptions of physicians and clinical pathologists (CPs) found that physicians had a lower perceived sensitivity of the toxin AB enzyme immunoassay test. For nucleic acid amplification tests, physicians exhibited a perception of higher assay sensitivity and specificity than CPs. The specificity of culture tests was generally perceived as high by physicians, whereas CPs regarding expressed mixed opinions. All but one physician and one CPs found the algorithmic test useful. Concerning the CDI isolation criteria, physicians commenced patient isolation by concurrently assessing both test results and clinical symptoms, rather than exclusively relying upon test results. Among CPs, 84.6% said they could rely on symptoms to determine when to release a patient from isolation, while 46.2% of physicians said they would rely on test results. Conclusion This study provides useful information on the status of laboratory diagnosis of CDI in Korea and what needs to be improved, which will help to standardize and improve laboratory diagnosis of CDI in Korea.

No abstract available.
Anaphylaxis* ; Aprotinin* ; Thoracic Surgery*

PURPOSE: Ionizing radiations have been reported as an apoptosis initiating stimulus in various cells and it has established that sustained elevations in [Ca2+] can lead to DNA fragmentation by Ca2+-dependent endonucleases, ultimately resulting in apoptotic cell death. The previous experiments have been reported by using primarily thymocytes and lymphocytes and the change of [Ca2+] was measured only by minutes or hours respectively. We need to evaluate [Ca2+] in both several minutes and hours after irradiation of radiation of radiation therapy and verify the apoptotic cells. MATERIALS AND METHODS: We have measured [Ca2+] in human gingival epitheloid cancer cell with 10 Gy irradiation, at minutely intervals and hourly intervals using digitized video-intensified fluorescence microscopy and the fluorescent Ca2+ indicator dye, fura-2. In order to find out that the transient rise in [Ca2+] could induced apoptosis, cells were incubated for 1 hour at 37 degrees C with TdT enzyme, rinsed and resuspended containing fluorescence and observed under a confocal fluorescence microscope. MTT assay was done to determine cell activity and LDH assay was done to determine the amount of necrotic cells. RESULTS: After irradiation, the transient and temporal increasing of [Ca2+] in the KB cells was founded. Though, there was no change in the intracellular [Ca2+] at 30 minutes and 2 hours after irradiation. We could detect of DNA fragmented cells at 4 hours after 10 Gy irradiated cells. There were no significant differences between 4 hour, 1 day, 3 day cells. There were no significant differences in MTT and LDH assay between the irradiated group and the control group after 4 hours and 1 day. Though after 3 days there were differences in MTT and LDH assay between the irradiated group was significantly decreased than the control group, in LDH assay the number of necrotic cell death of the irradiated was higher than the control group. CONCLUSION: In KB cells there were incipient and temporal increasing of the [Ca2+] with 10 Gy irradiation and the apoptosis was founded from 4 hours later which was earlier than seeing of the change of the amount of the cellular ability and necrosis.
Apoptosis* ; Cell Death ; DNA ; DNA Fragmentation ; Endonucleases ; Fluorescence ; Fura-2 ; Humans ; KB Cells* ; Lymphocytes ; Microscopy, Fluorescence ; Necrosis ; Radiation, Ionizing ; Thymocytes

Protothecosis is an unusual human infection caused by the achlorophyllic algae Prototheca, and most commonly by Prototheca wickerhamii. A 65-year-old man presented with a 2-month history of a painful, erythematous, non-healing, ulcerative plaque on the extensor surface of his left forearm. He was previously diagnosed with diabetes and iatrogenic Cushing syndrome. A skin biopsy specimen revealed characteristic morula-like sporangia in the dermis by PAS positive staining. Prototheca wickerhamii was identified by culture and biochemical studies. Initially, itraconazole was administered for 8 weeks, followed by fluconazole, and the patient's condition was greatly improved.
Aged ; Biopsy ; Cushing Syndrome ; Dermis ; Fluconazole ; Forearm ; Humans ; Itraconazole ; Prototheca ; Skin ; Sporangia ; Ulcer

BACKGROUND/AIMS: For decades, thiopurines have been the mainstay of inflammatory bowel disease (IBD) treatment and will play an important role in the future. However, complex metabolism and various side effects limit the use of these potent drugs in clinical practice. The Korean Association for the Study of Intestinal Diseases developed a set of consensus statements with the aim of guiding clinicians on the appropriate use of thiopurines in the management of IBD. METHODS: Sixteen statements were initially drafted by five committee members. The quality of evidence and classification of recommendation were assessed according to the Grading of Recommendations Assessment, Development and Evaluation system. The statements were then circulated to IBD experts in Korea for review, feedback, and then finalized and accepted by voting at the consensus meeting. RESULTS: The consensus statements comprised four parts: (1) pre-treatment evaluation and management strategy, including value of thiopurine S-methyltransferase screening, dosing schedule, and novel biomarkers for predicting thiopurine-induced leukopenia; (2) treatment with thiopurines with regards to optimal duration of thiopurine treatment and long-term outcomes of combination therapy with anti-tumor necrosis factors; (3) safety of thiopurines, especially during pregnancy and lactation; and (4) monitoring side effects or efficacy of therapy using biomarkers. CONCLUSIONS: Thiopurines are an effective treatment option for patients with IBD. Management decisions should be individualized according to the risk of relapse and adverse events.
Appointments and Schedules ; Biomarkers ; Classification ; Committee Membership ; Consensus* ; Female ; Humans ; Inflammatory Bowel Diseases* ; Intestinal Diseases* ; Korea ; Lactation ; Leukopenia ; Mass Screening ; Metabolism ; Necrosis ; Politics ; Pregnancy ; Recurrence