PURPOSE: Endoscopy has been recommended as a primary procedure for determining the extent of damage and prognosis in patients with caustic ingestions. Endoscopy within the first 24 hours has been suggested, however, such immediate endoscopy is not always possible. Therefore, we wanted to determine complications and possible delayed sequelae after the endoscopy performed dependent on time, including less than 24 hours and more than 24 hours, after ingestion of relatively high toxic caustic agents. METHODS: From January 2005 to May 2013, 105 consecutive patients were diagnosed with caustic poisoning in the emergency department of the Wonju Severance Christian Hospital. Out of 95 patients who underwent endoscopy, while excluding 49 patients who ingested sodium hypochlorite and 15 patients due to insufficient data, 41 patients were ultimately included. We compared general characteristics, complications related to endoscopy, late sequelae, total admission length, and mortality between two groups. RESULTS: Twenty eight patients (68.3%) were diagnosed with acid ingestion. Median endoscopy time was 17.8 (IQR 9.7-36.9) hours and performed in 16 patients (39%) after 24 hours. There were no complications, such as perforation and bleeding in either endoscopy within 24 hours group or endoscopy after 24 hours group. In addition, no difference in ingested materials, endoscopy grade, or late sequelae was observed between endoscopy within 24 hours group and endoscopy after 24 hours group. CONCLUSION: No difference in complications and late sequelae was observed between endoscopy within 24 hours group and endoscopy after 24 hours group when endoscopy was performed based on a clinician's assessment.
Caustics ; Eating ; Emergency Service, Hospital ; Endoscopy* ; Gangwon-do ; Hemorrhage ; Humans ; Mortality ; Poisoning ; Prognosis ; Sodium Hypochlorite

PURPOSE: Glufosinate poisoning can cause neurologic complications that may be difficult to treat due to delayed manifestation. Studies assessing possible predictors of complications are lacking. Although serum ammonia level is a potential predictor of severe neurotoxicity, it has only been assessed via case reports. Therefore, we investigated factors that predict neurologic complications in acute glufosinate-poisoned patients. MATERIALS AND METHODS: We conducted a retrospective review of 45 consecutive glufosinate-poisoning cases that were diagnosed in the emergency department (ED) of Wonju Severance Christian Hospital between May 2007 and July 2014. Patients with a Glasgow Coma Scale (GCS) score of <8, seizure, and/or amnesia were defined to a neurologic complication group. RESULTS: The neurologic complication group (29 patients, 64.4%) comprised patients with GCS<8 (27 patients, 60.0%), seizure (23 patients, 51.1%), and amnesia (5 patients, 11.1%). Non-neurologic complications included respiratory failure (14 patients, 31.1%), intubation and ventilator care (23 patients, 51.1%), shock (2 patients, 4.4%), pneumonia (16 patients, 35.6%), acute kidney injury (10 patients, 22.2%), and death (4 patients, 8.9%). Complications of GCS<8, seizure, respiratory failure, and intubation and ventilator care appeared during latent periods within 11 hrs, 34 hrs, 14 hrs, and 48 hrs, respectively. Initial serum ammonia was a predictor of neurologic complications [odds ratio 1.039, 95% confidence interval (1.001-1.078), p=0.046 and area under the curve 0.742]. CONCLUSION: Neurologic complications developed in 64.4% of patients with acute glufosinate poisoning. The most common complication was GCS<8. Initial serum ammonia level, which can be readily assessed in the ED, was a predictor of neurologic complications.
Adult ; Aged ; Aged, 80 and over ; Aminobutyrates/blood/*poisoning ; Ammonia/*blood ; *Emergency Service, Hospital ; Female ; Glasgow Coma Scale ; Humans ; Male ; Middle Aged ; Nausea/etiology ; Neurotoxicity Syndromes/blood/immunology/*physiopathology ; Respiratory Insufficiency/etiology ; Retrospective Studies ; Seizures/etiology ; Severity of Illness Index ; Vomiting/etiology

Metformin (1,1-dimethylbiguanide hydrochloride), derived from French lilac (Galega officinalis), is a first-line anti-diabetic drug prescribed for patients with type 2 diabetes. However, the role of metformin in odontoblastic cell differentiation is still unclear. This study therefore undertook to examine the effect of metformin on regulating odontoblast differentiation in MDPC-23 mouse odontoblastic cells derived from mouse dental papilla cells. As compared to controls, metformin significantly accelerated the mineralization, significantly increased and accelerated the expressions of ALP and Col I mRNAs, and significantly increased the accelerated expressions of DSPP and DMP-1 mRNAs, during differentiation of MDPC-23 cells. There was no alteration in cell proliferation of MDPC-23 cells, on exposure to metformin. These results suggest that the effect of metformin on MDPC-23 mouse odontoblastic cells derived from mouse dental papilla cells, facilitates the odontoblast differentiation and mineralization, without altering the cell proliferation.
Animals ; Cell Differentiation ; Cell Proliferation ; Dental Papilla ; Humans ; Metformin* ; Mice ; Miners ; Odontoblasts* ; RNA, Messenger

BACKGROUND: Until recently, genome-wide association study (GWAS)-based findings have provided a substantial genetic contribution to type 2 diabetes mellitus (T2DM) or related glycemic traits. However, identification of allelic heterogeneity and population-specific genetic variants under consideration of potential confounding factors will be very valuable for clinical applicability. To identify novel susceptibility loci for T2DM and glycemic traits, we performed a two-stage genetic association study in a Korean population. METHODS: We performed a logistic analysis for T2DM, and the first discovery GWAS was analyzed for 1,042 cases and 2,943 controls recruited from a population-based cohort (KARE, n=8,842). The second stage, de novo replication analysis, was performed in 1,216 cases and 1,352 controls selected from an independent population-based cohort (Health 2, n=8,500). A multiple linear regression analysis for glycemic traits was further performed in a total of 14,232 nondiabetic individuals consisting of 7,696 GWAS and 6,536 replication study participants. A meta-analysis was performed on the combined results using effect size and standard errors estimated for stage 1 and 2, respectively. RESULTS: A combined meta-analysis for T2DM identified two new (rs11065756 and rs2074356) loci reaching genome-wide significance in CCDC63 and C12orf51 on the 12q24 region. In addition, these variants were significantly associated with fasting plasma glucose and homeostasis model assessment of beta-cell function. Interestingly, two independent single nucleotide polymorphisms were associated with sex-specific stratification in this study. CONCLUSION: Our study showed a strong association between T2DM and glycemic traits. We further observed that two novel loci with multiple diverse effects were highly specific to males. Taken together, these findings may provide additional insights into the clinical assessment or subclassification of disease risk in a Korean population.
Blood Glucose ; Cohort Studies ; Diabetes Mellitus, Type 2* ; Fasting ; Genetic Association Studies ; Genome-Wide Association Study* ; Homeostasis ; Humans ; Linear Models ; Male ; Polymorphism, Single Nucleotide ; Population Characteristics

OBJECTIVES: This study was designed to identify frontal lobe dysfunctions of schizophrenic group and to classify into subtypes accordingly. METHODS: Four neuropsychological tests (Wisconsin Card Sorting Test (WCST), Word Fluency Test, Ruff Figural Fluency Test and Grooved Pegboard Test) were administered to 93 schizophrenia or schizophreniform patients diagnosed with the Korean version of SCID. Ten measures (WCST Total Number of Errors, WCST Number of Categories Completed, WCST Conceptual Level Responses, WCST Trials to Complete First Category, WCST Perseverative Responses, GPT Dominant Hand RT, GPT Nondominant Hand RT, Letter Fluency raw score, Category Fluency raw score, RFFT Total Unique Designs) from the four tests were selected by statistical procedure. Latent factors embedded in the frontal lobe function of schizophrenic patients were extracted from the factor analysis, and hierarchical and K-means clustering procedures were used to identify subtypes. To examine the differences among the subtypes, demographic variables, K-WAIS and PANSS were used. RESULTS: (1) The subjects in this study showed significant impairments in the four neuropsychological tests. (2) Through factor analysis, three factors were extracted: Conceptualization, Motor and Fluency. (3) Three cluster solution was considered optimal by cluster analysis. The preserved cluster (n=42) comprised of patients who showed relatively high function in all three factors. This group showed relatively higher function than the other two clusters. However, even the performance of the preserved cluster was 1SD below the norm of the normal people. The conceptualization deficit cluster (n=25) comprised of patients with deficit in conceptualization function. This group was characterized by the clinical symptoms of poor impulse control and active social avoidance suggesting a deficit in the ability to actively organize stimuli utilizing the feedback from the external environment. And finally, the fluency deficit cluster (n=19) showed impairment in fluency. This group was characterized by impairments in the use of abstract-symbolic thinking and the ability to pay attention to relevant stimuli suggesting a severe deficit in the efficiency and flexibility of information withdrawal. These three subtypes didn't differ significantly in age, duration of illness and current dosage of antipsychotics. However, the three groups differed significantly in years of education, IQ and on five items of PANSS. CONCLUSION: This study shows that schizophrenia can be characterized by frontal lobe dysfunctions and divided into three subtypes according to the profile of the frontal lobe dysfunctions. These neurocognitive heterogeneity of schizophrenia, not related to age, duration of illness and dosage of antipsychotic, suggest that different strategies need to be developed in diagnosing and planning rehabilitation programs for schizophrenc patients.
Antipsychotic Agents ; Education ; Frontal Lobe* ; Hand ; Humans ; Neuropsychological Tests ; Pliability ; Population Characteristics ; Rehabilitation ; Schizophrenia* ; Thinking

We investigated the seasonality of Anopheles mosquitoes, including its species composition, density, parity, and population densities of mosquitoes infected with the parasite in Ganghwa-do (Island), a vivax malaria endemic area in the Republic of Korea. Mosquitoes were collected periodically with a dry-ice-tent trap and a blacklight trap during the mosquito season (April-October) in 2008. Anopheles sinensis (94.9%) was the most abundant species collected, followed by Anopheles belenrae (3.8%), Anopheles pullus (1.2%), and Anopheles lesteri (0.1%). Hibernating Anopheles mosquitoes were also collected from December 2007 to March 2008. An. pullus (72.1%) was the most frequently collected, followed by An. sinensis (18.4%) and An. belenrae (9.5%). The composition of Anopheles species differed between the mosquito season and hibernation seasons. The parous rate fluctuated from 0% to 92.9%, and the highest rate was recorded on 10 September 2008. Sporozoite infections were detected by PCR in the head and thorax of female Anopheles mosquitoes. The annual sporozoite rate of mosquitoes was 0.11% (2 of 1,845 mosquitoes). The 2 mosquitoes that tested positive for sporozoites were An. sinensis. Malarial infections in anopheline mosquitoes from a population pool were also tried irrespective of the mosquito species. Nine of 2,331 pools of Anopheles mosquitoes were positive. From our study, it can be concluded that An. sinensis, which was the predominant vector species and confirmed as sporozoite-infected, plays an important role in malaria transmission in Ganghwa-do.
Animals ; Anopheles/*classification ; *Disease Vectors ; *Endemic Diseases ; Head/parasitology ; Malaria/*epidemiology/*transmission ; Plasmodium/isolation & purification ; Population Dynamics ; Republic of Korea/epidemiology ; Seasons ; Thorax/parasitology

Since sylvatic rabies was first identified in South Korea in 1993, over three million bait vaccine doses have been distributed to rabies risk regions in order to block transmission of rabies among wild animals. New progressive strategy is needed to eliminate sylvatic rabies completely in rabies risk regions. Before applying the preventive program related to eradication, immunogenicity of inactivated rabies vaccines available in Korea has to be evaluated in Korean raccoon dogs (Nyctereutes procyonoides koreensis). Six groups of raccoon dogs in wild rescue center of Gyeonggi-do were vaccinated intramuscularly with single dose of six inactivated commercial rabies vaccines (designated A to F). Serum samples at the time of vaccination, and two and four weeks post vaccination were obtained and analyzed by virus neutralizing assay (VNA). All raccoon dogs inoculated with vaccines C, D, E or F, showed VN antibody titers ranging from 0.5 to 13.77 IU/ml. Half of four raccoon dogs immunized with vaccine B revealed VN titer over 0.5 IU/ml, and one of four raccoon dogs inoculated with vaccine A showed protective antibody titer. This finding suggests that most of the commercially available inactivated rabies vaccines could induce protective immunity in Korean raccoon dogs and be applicable to new rabies control program.
Animals ; Animals, Wild ; Antibody Formation ; Korea ; Rabies ; Rabies Vaccines ; Raccoon Dogs ; Raccoons ; Republic of Korea ; Vaccination ; Vaccines ; Viruses

PURPOSE: We conducted this study in order to evaluate the question of whether a simple voice prompt, "push hard and fast", could improve the quality of chest compression performed by lay people. METHODS: Non-medical college students with no experience of cardiopulmonary resuscitation (CPR) education participated in this study. They were randomly divided into two groups-metronome prompt automated external defibrillator (AED) (M) group and metronome with intermittent "push hard and fast" voice prompt AED (V) group and performed two cycles of chest compression-only CPR. "Push hard and fast" voice was prompted every 10 seconds. The rate of metronome was fixed to 100/min in two groups. We measured compression depth, compression rate, and total compression frequency using ResusciAnne(R)SkillReporter(TM) (Laerdal, Korea). RESULTS: A total of 208 volunteers were enrolled. There were 120 (57.7%) females, and mean age was 21+/-2 years old. The compression depth was deeper in the V group (40.0+/-12 mm) than in the M group (35.9+/-13 mm) (p=0.02). The mean rate of chest compression was faster in the V group (98+/-20 cpm) than in the M group (88+/-31 cpm) (p=0.07) (*cpm: compressions per minute). Total frequency of chest compression during 2-cycle CPR was also higher in the V group (392+/-80) than in the M group (341+/-117) (p<0.001). CONCLUSION: A simple voice prompt, "push hard and fast", can improve the quality of chest compression performed by untrained lay people.
Cardiopulmonary Resuscitation ; Defibrillators ; Education ; Female ; Humans ; Thorax* ; Voice* ; Volunteers

Curcumin (diferuloylmethane), a constituent of turmeric powder derived from the rhizome of Curcuma longa, has been shown to inhibit the growth of various types of cancer cells by regulating cell proliferation and apoptosis. However, a need exists to design more effective analogs because of curcumin's poor intestinal absorption. EF-24 (diphenyl difluoroketone), the monoketone analog of curcumin, has shown good efficacy in anticancer screens. However, the effects of curcumin and EF-24 on salivary gland epidermoid carcinoma cells are not clearly established. The main goal of this study was to investigate the effects of curcumin and EF-24 on cell growth and induction of apoptosis in human salivary gland epidermoid carcinoma cells. Our studies showed that curcumin and EF-24 inhibited the growth of HTB-41 cells in a dose- and time-dependent manner, and the potency of EF-24 was > 34-fold that of curcumin. Treatment with curcumin or EF-24 resulted in nuclear condensation and fragmentation in HTB-41 cells, whereas the control HTB-41 cell nuclei retained their normal regular and oval shape. Curcumin and EF-24 promoted proteolytic cleavages of procaspase-3/-7/-9, resulting in an increase in the amount of cleaved caspase-3/-7/-9 in the HTB-41 cells. Caspase-3 and -7 activities were detected in viable HTB-41 cells treated with curcumin or EF-24. These results suggest that the curcumin and EF-24 inhibit cell proliferation and induce apoptosis in HTB-41 human salivary gland epidermoid carcinoma cells, and that they may have potential properties as an anti-cancer drug therapy.
Apoptosis ; Carcinoma, Squamous Cell* ; Caspase 3 ; Cell Death ; Cell Nucleus ; Cell Proliferation ; Curcuma ; Curcumin* ; Drug Therapy ; Humans ; Intestinal Absorption ; Rhizome ; Salivary Glands*

The etiology and pathogenesis of type 2 diabetes mellitus (T2DM) are not completely understood although it is often associated with other conditions such as obesity, hypertension, and dyslipidemia. Lipoprotein lipase (LPL) is a key enzyme in human lipid metabolism that facilitates the removal of triglyceride-rich lipoproteins from the bloodstream. LPL hydrolyzes the core of triglyceride-rich lipoproteins (chylomicrons and very low density lipoprotein) into free fatty acids and monoacylglycerol. To gain insight into the possible role of LPL in T2DM, nine single nucleotide polymorphisms (SNPs) of LPL were analyzed for the association with T2DM using 944 unrelated Koreans, including 474 T2DM subjects and 470 normal healthy controls. Of the nine LPL SNPs we analyzed, a significant association with multiple tests by the false discovery rate (FDR) was observed between T2DM and SNP rs343 (+13836C>A in intron 3). SNP rs343 was also marginally associated with some of T2DM-related phenotypes including total cholesterol, high density lipoprotein cholesterol (HDLc), and log transformed glycosylated hemoglobin in 470 normal controls, although no significant association was detected by multiple tests. In total, our results suggest that the control of lipid level by LPL in the bloodstream might be an important factor in T2DM pathogenesis in the Korean population.
Aged ; Asian Continental Ancestry Group ; Cohort Studies ; Databases, Genetic ; Diabetes Mellitus, Type 2/*genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Lipoprotein Lipase/*genetics ; Male ; Middle Aged ; *Polymorphism, Single Nucleotide