OBJECTIVES: Idiopathic REM sleep behavior disorder (RBD) is by far the strongest clinical predictor of neurodegenerative disease available. Several potential early diagnostic markers of neurodegenerative disease including autonomic symptoms have been proposed, but they have generally not been tested in presymptomatic neurodegenerative disease. So the authors investigated autonomic symptoms and their associated factors in idiopathic RBD patients. METHODS: 52 idiopathic RBD patients and 52 controls participated in the study. Autonomic symptoms were evaluated by applying the unified multiple system atrophy rating scale (UMSARS) and measuring orthostatic systolic blood pressure drop. RESULTS: Idiopathic RBD patients showed significantly higher UMSARS subscale scores and sharper drop of orthostatic systolic blood pressure than controls. In multiple linear regression analysis, all autonomic symptoms and measured orthostatic systolic blood pressure drop were associated with RBD. In addition, orthostatic symptoms were associated with medication and age, urinary function was associated with benign prostatic hyperplasia, and measured orthostatic systolic blood pressure drop was associated with hypertension. CONCLUSION: In this study, idiopathic RBD patients showed more autonomic symptoms than controls. However, other autonomic symptoms-related factors also influenced some autonomic symptoms. Prospective studies should be performed to evaluate autonomic symptoms as a potential predictor of neurodegenerative diseases.
Aged* ; Blood Pressure ; Humans ; Hypertension ; Linear Models ; Multiple System Atrophy ; Neurodegenerative Diseases ; Prostatic Hyperplasia ; REM Sleep Behavior Disorder* ; Sleep, REM*

BACKGROUND: Interest in pharmacist participation in the multidisciplinary intensive care team is increasing. However, studies examining pharmacist interventions in the medical intensive care unit (MICU) are limited in Korea. The aim of this study was to describe the current status of pharmacist interventions and to identify common pharmacologic problems requiring pharmacist intervention in the MICU. METHODS: Between September 2013 and August 2014, a retrospective, observational study was conducted in the 22-bed MICU at a university hospital. Data were obtained from two trained pharmacists who participated in MICU rounds three times a week. In addition to patient characteristics, data on the cause, type, related drug, and acceptance rate of interventions were collected. RESULTS: In 340 patients, a total of 1211 pharmacologic interventions were performed. The majority of pharmacologic interventions were suggested by pharmacists at multidisciplinary rounds in the MICU. The most common pharmacologic interventions were adjustment of dosage and administration (n = 328, 26.0%), followed by parenteral/enteral nutritional support (n = 228, 18.1%), the provision of drug information (n = 228, 18.1%), and advice regarding pharmacokinetics (n = 118, 9.3%). Antimicrobial agents (n = 516, 42.6%) were the most frequent type of drug associated with pharmacist interventions. The acceptance rate of interventions was 84.1% with most accepted by physicians within 24 hours (n = 602, 92.8%). CONCLUSIONS: Medication and nutritional problems are frequently encountered pharmacotherapeutic problems in the MICU. Pharmacist interventions play an important role in the management of these problems.
Anti-Infective Agents ; Humans ; Critical Care ; Intensive Care Units* ; Korea ; Nutritional Support ; Observational Study ; Pharmacists* ; Pharmacokinetics ; Retrospective Studies

A 50-year-old man with bladder cancer had spinal anesthesia for transurethral resection of bladder. After he had spinal block at the T8 level, he developed a persistent penile erection, making it impossible to introduce the 24 French cystoscope. To treat a persistent penile erection, intravenous glycopyrrolate was incrementally given for a total of 0.4 mg. A persistent penile erection was markedly subsided 5 minutes after last 0.2 mg glycopyrrolate was given. Then corpus cavernosum blood was aspirated. The cystoscope was easily introduced, and transurethral resection of bladder proceeded without further complication.
Anesthesia, Spinal* ; Cystoscopes ; Glycopyrrolate ; Humans ; Male ; Middle Aged ; Penile Erection* ; Urinary Bladder ; Urinary Bladder Neoplasms

Objectives: This study aims to define the role of the local dental clinic for people with disabilities and the appropriate role of the dental hygienist to resolve oral health inequality with people with disabilities. Methods: From September 12, 2022 to November 11, 2022, 16 experts who voluntarily participated in the research, among the experts recommended by the related institutes, were selected through stratification analysis. The results of this study and improvement plans are as follows. Results: First, as a result of measuring the importance of the role of a regional oral care center for people with disabilities in the analytic hierarchy process (AHP) middle category, check-up was found to be the most important (0.364, C.I=0.01). For examination, a facility visit checkup and regular checkups were required. Second, as a result of measuring the importance of the role of a dedicated dental hygienist in the AHP middle category, the institutional-linked activity was found to be the most important (0.417, C.I=0.02). As for institutional-linked activities, linkage with local community organizations, patient management, and public relations activities were required. Conclusions Considering these results, the role of a regional oral care center for people with disabilities is to perform examinations and preventive treatments, primary treatments (simple), education and counseling, and establish a smooth medical return system to serve as a base for dental treatment for people with disabilities. Education and counseling are provided through professional patient response and the arrangement of a dedicated dental hygienist, and oral health care is provided to people with disabilities through professional treatment assistance for patients and treatment support and screening, linkage with local community institutions, and patient management. Specialized dental hygienists should play a role in supporting the operation of oral health care for people with disabilities.

Based on the rDNA ITS sequences data, specific primer set for PCR detection of wood-decaying fungus Phellinus linteus was designed. The length of PCR products using designed primer set(SHF and SHR) was about 540 bp. Among 11 species, 17 isolates of Phellinus spp. including Phellinus linteus, P. pomaceus, P. spiculosus, P. baumi, P. pini, P. igniarius, P. gilvus, P. biscuspidatus, P. weirii, P. johnsonianus, P. robutus, and P. igniarius, seven isolates of Phellinus linteus showed about 540 bp-sized single band. This molecular technique could offer a useful tool for detecting and identifying Phellinus linteus.
DNA, Ribosomal* ; Fungi* ; Polymerase Chain Reaction

Background: Accessory bones and tarsal coalitions are the most common developmental variations of the foot and ankle. However, their clinical implications are not well understood because there is no established prevalence data in the normal population and the reported prevalence varies widely. Therefore, we aimed to investigate the incidence of accessory ossicles and tarsal coalitions in a healthy, asymptomatic Korean population. Methods: A total of 448 healthy, asymptomatic participants (224 men and 224 women; 896 feet) were enrolled and stratified by age and sex. To investigate the presence of accessory bones and tarsal coalitions in the foot and ankle, we obtained the weight-bearing standing radiographs (anteroposterior and lateral views) from each participant. Results: Accessory ossicles were found in 49.2% of the healthy, asymptomatic Korean adults. The prevalence of accessory bones in adults was the highest with 34% for the accessory navicular, 5.8% for the os trigonum, 3.9% for the os peroneum, and 1.7% for the os subfibulare. The prevalence of tarsal coalitions in adults was 0.4% and that of symphalangism was 16% for the fourth toe and 80.6% for the fifth toe. The frequency of the accessory navicular and fifth toe symphalangism was significantly higher in women. Most of the accessory navicular and fourth and fifth toe symphalangism were bilateral, whereas the os subfibulare was mostly unilateral. Conclusions The prevalence of accessory bones and tarsal coalitions in the healthy, asymptomatic Korean population showed some variation according to age and sex.

BACKGROUND: Some types of human papillomavirus (HPV) play a major role in the pathogenesis of cervical cancer. Several dozens of studies on the association of HPV with cervical neoplasm have been done since the first detection of HPV 16 and 18 directly from cervical cancer patients in 1983. Approximately 90 types of HPV have been identified so far and the number of oncogenic HPV types is still growing. In this study, we examined the occurrence of oncogenic HPV infections in patients with cervical lesions. Method : Two hundred twenty cervical swab specimens were collected during a 3 year period (1996-1999). Processed specimens were tested for HPV type 16 and 18 by polymerase chain reaction. RESULTS: HPV type 16 was detected in the cervical swab specimens as follows: 19 (51.4%) of 37 cervical cancer patients, 19 (30.2%) of 63 high-grade squamous intraepithelial lesions, 5 (9.6%) of 52 low-grade squamous intraepithelial lesion, none in 6 atypical squamous cells of undetermined significance and 3 (4.8%) of 62 normal cervices. Conclusion : The positive rate for HPV type 16 increased according to the degree of cervical malignancy.
Human papillomavirus 16 ; Humans* ; Polymerase Chain Reaction* ; Uterine Cervical Neoplasms

Duchenne and Becker muscular dystrophies (DMD and BMD, respectively) are X-linked neuromuscular disorders characterized by progressive muscle weakness and severe skeletal muscle degeneration. BMD is a milder form with a later onset. Patients with BMD tend to survive much longer than those with DMD. The differentiation between DMD and BMD is important in the genetic counseling of affected patients and their families. Since muscle biopsies are invasive procedures, the differential diagnosis of BMD and DMD is often dependent on the mutation identified in the DMD gene in affected patients. However, when a novel DMD mutation is identified, the differential diagnosis should be based on muscle biopsy findings with other clinical findings. Here we describe two Korean patients with BMD confirmed by muscle biopsy and genetic testing. Two novel exonic deletions in the DMD gene were identified.
Biopsy ; Diagnosis, Differential ; Exons ; Genetic Counseling ; Genetic Testing ; Humans ; Muscle Weakness ; Muscle, Skeletal ; Muscular Dystrophies* ; Muscular Dystrophy, Duchenne*

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

BACKGROUND: To evaluate the efficacy and safety of paclitaxel and cisplatin against advanced non-small cell lung cancer (NSCLC) as a second-line chemotherapy. SUBJECTS AND METHODS: Twenty-five patients were enrolled. The patients received 200 mg/m2 paclitaxel as a 3-hour intravenous infusion and 60 mg/m2 cisplatin as 30-minute intravenous infusion with vigorous hydration on day 1 every 28 days. The response was assessed every 2 cycles. RESULTS: All 25 patients were assessed for their response and toxicity. Partial responses were observed in 5 patients. The overall response rate was 20% (95% confidence interval, 4%~36%) and the median response duration was 4.5 (range, 2-11) months. The median time to progression was 3.3 (range, 0-14) months. The median overall survival of all patients was 7.4 (range, 1.3-39) months. The hematologic toxicities were minor and easily controlled. CONCLUSION: The combination chemotherapy of paclitaxel and cisplatin as a second-line treatment has a moderate efficacy with an acceptable toxicity in patients with advanced NSCLC.
Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Humans ; Infusions, Intravenous ; Paclitaxel*