Gastric adenocarcinoma is among the top causes of cancer-related death and is one of the most commonly diagnosed carcinomas worldwide. Benzyl isothiocyanate (BITC) has been reported to inhibit the gastric cancer metastasis. In our previous study, BITC induced apoptosis in AGS cells. The purpose of the present study was to investigate the effect of BITC on autophagy mechanism in AGS cells. First, the AGS cells were treated with 5, 10, or 15 μM BITC for 24 h, followed by an analysis of the autophagy mechanism. The expression level of autophagy proteins involved in different steps of autophagy, such as LC3B, p62/SQSTM1, Atg5-Atg12, Beclin1, p-mTOR/mTOR ratio, and class III PI3K was measured in the BITC-treated cells. Lysosomal function was investigated using cathepsin activity and Bafilomycin A1, an autophagy degradation stage inhibitor. Methods including qPCR, western blotting, and immunocytochemistry were employed to detect the protein expression levels. Acridine orange staining and omnicathepsin assay were conducted to analyze the lysosomal function. siRNA transfection was performed to knock down the LC3B gene. BITC reduced the level of autophagy protein such as Beclin 1, class III PI3K, and Atg5-Atg12. BITC also induced lysosomal dysfunction which was shown as reducing cathepsin activity, protein level of cathepsin, and enlargement of acidic vesicle. Overall, the results showed that the BITC-induced AGS cell death mechanism also comprises the inhibition of the cytoprotective autophagy at both initiation and degradation steps.

PURPOSE: This study was conducted to investigate the trend in functional changes over time and factors associated with the number of areas showing functional decline in older adults who had been discharged from acute care hospitals. METHODS: This longitudinal study involved 156 patients aged ≥ 65 years who were admitted to one tertiary hospital in Seoul and discharged home. Authors investigated patient demographic and health-care characteristics and the number of areas showing functional decline at 1 and 3 months after discharge. The data were analyzed using univariate and multivariate Poisson regression models. RESULTS: The number of areas showing functional decline increased between admission and 1 month after discharge and had declined slightly at 3 months after discharge. The factors associated with the number of areas showing functional decline at 3 months after discharge were age, education level, and length of hospitalization (p < .05); the factors associated at 1 month after discharge were medical department and caregiver relationship (p < .05). CONCLUSION: The results indicate that older patients with no spouse or those with their elderly spouse as their caregiver are at risk of functional decline in a greater number of areas after discharge. Therefore, a comprehensive health-care policy to ensure care continuity is required for functional health maintenance for older adults after hospital discharge.
Adult ; Aged ; Caregivers ; Continuity of Patient Care ; Education ; Hospitalization ; Humans ; Longitudinal Studies ; Seoul ; Socioeconomic Factors ; Spouses ; Tertiary Care Centers

OBJECTIVE: This study was performed to investigate the efficacy and tolerability of blonanserin in schizophrenic patients who were previously treated with other antipsychotics but, due to insufficient response, were switched to blonanserin. METHODS: A total of 52 patients with schizophrenia who were unresponsive to treatment with antipsychotic monotherapy or combination therapy were recruited into this 12-week, open-label, prospective, multicenter study. Patients were switched to blonanserin from their existing antipsychotics over a maximum 2-week tapering-off period. Efficacy was primarily evaluated using the 18-item Brief Psychiatric Rating Scale (BPRS). Assessments were performed at baseline, and at weeks 1, 2, 4, 8, and 12. RESULTS: Switching to blonanserin resulted in a significant decrease in the mean total score on the BPRS from baseline (56.8 ± 9.4) to week 12 (42.1 ± 13.8, p < 0.001). The most common adverse events were extrapyramidal symptoms (n = 12, 23.1%), insomnia (n = 10, 19.2%), and emotional arousal (n = 6, 11.5%). Overweight or obese patients (body mass index ≥ 23 kg/m2, n = 33) who switched to blonanserin exhibited significant weight loss from 75.2 ± 9.3 kg at baseline to 73.5 ± 9.2 kg at week 12 (p = 0.006). The total cholesterol (baseline, 236.1 ± 47.6 mg/dl; endpoint [week 12], 209.9 ± 28.0 mg/dl; p = 0.005) and prolactin levels (baseline, 80.0 ± 85.2 ng/ml; endpoint [week 12], 63.2 ± 88.9 ng/ml; p = 0.003) were also significantly improved in patients with hypercholesterolemia or hyperprolactinemia. CONCLUSION: The results of the present study suggest that switching to blonanserin may be an effective strategy for schizophrenic patients unresponsive to other antipsychotic treatments.
Antipsychotic Agents ; Arousal ; Body Weight ; Brief Psychiatric Rating Scale ; Cholesterol ; Humans ; Hypercholesterolemia ; Hyperprolactinemia ; Overweight ; Prolactin ; Prospective Studies ; Schizophrenia ; Sleep Initiation and Maintenance Disorders ; Treatment Outcome ; Weight Loss

PURPOSE: Although infants with bronchopulmonary dysplasia (BPD) are at risk of developing secondary pulmonary hypertension (PH), which is associated with significant morbidity and mortality, little has been reported about the incidence, clinical course and prognosis of PH secondary to BPD in premature infants. This study was done to investigate the incidence, risk factors, clinical course, and the ultimate prognosis of PH developed secondary to BPD in very low birth weight infants (<1,500 g). METHODS: Medical records of very low birth weight infant (VLBWI) admitted to Samsung Medical Center NICU from January 2000 to July 2007 were reviewed retrospectively. BPD was defined by Jobe's classification. The diagnosis of pulmonary hypertension was established as velocity of tricuspid valve regurgitation (TR) > or =3 m/s and a flattening of the intraventricular septum by conducting Doppler echocardiography. RESULTS: The incidence of pulmonary hypertension was 6% in VLBWI with BPD and it developed in moderate to severe BPD. The diagnosis of pulmonary hypertension was made on postnatal 133 days (range 40-224 days) and the risk factors related to developing pulmonary hypertension were severe BPD, small for gestational age and outborn infants. The mortality rate was 57% and especially higher in severe BPD (70%). The time to recovery spent 3 months (range 1-10 months) in survived patients. CONCLUSION: Based on the results of this research, pulmonary hypertension secondary to BPD in VLBWI related to severity of BPD and had a poor prognosis. We expect that regular long-term echocardiography may be helpful in treating reversible in VLBWI with moderate to severe BPD.
Bronchopulmonary Dysplasia ; Echocardiography ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Medical Records ; Prognosis ; Retrospective Studies ; Risk Factors ; Tricuspid Valve Insufficiency

OBJECTIVE: This study was performed to compare the efficiency of slow freezing and vitrification based on survival, development to blastocysts, and cell numbers of blastocysts. Changes in embryonic gene expression in fresh and frozen-thawed embryos were also examined. METHODS: Eight-cell stage embryos were collected from superovulated female BDF1 mice. The collected embryos were randomly divided into three groups. One group was maintained as fresh controls (n=42), one was frozen by slow freezing (n=43), and one was cooled by vitrification (n=43). After thawing or cooling, survival rates, development to blastocyst, and cell numbers and inner cell mass (ICM) cell numbers of blastocysts were compared with those of the control group. The expressions of eight genes (Rbm3, Birc5, Sod1, Sod2, Cirbp, Caspase3, Trp53, Hsp70.1) were examined by real time-quantitative polymerase chain reaction in the fresh and frozen-thawed embryos. RESULTS: There were no significant differences in the slow freezing and vitrification groups' survival rate after thawing (88.4% vs. 88.4%), development to blastocyst (100% vs. 97.4%), cell numbers (107.0+/-21.0 vs. 115.0+/-19.7), or ICM cell numbers of blastocysts (11.3+/-5.2 vs. 11.1+/-3.7). Cell numbers of blastocysts were significantly (p<0.05) lower in the frozen-thawed embryos than the fresh embryos. There were no significant differences in the slow freezing and the vitrification groups' expressions of the eight genes. The expressions of CirbP and Hsp70.1 were higher in the frozen-thawed embryos than in the fresh embryos but there were no significant differences. CONCLUSION: These results suggest that there were no significant differences between embryos that underwent slow freezing and vitrification.
Animals ; Blastocyst ; Cell Count ; Cryopreservation ; Embryonic Structures ; Female ; Freezing ; Gene Expression ; HSP70 Heat-Shock Proteins ; Humans ; Mice ; Polymerase Chain Reaction ; Survival Rate ; Vitrification

OBJECTIVE: This study was performed to evaluate testicular sperm chromatin condensation using aniline blue-eosin (AB-E) staining and its effects on IVF-ET. METHODS: Chromatin condensation was analyzed using AB-E staining in 27 cases of testicular sperm extraction. There were 19 cases of obstructive azoospermia (OA) and 8 cases of non-obstructive azoospermia (NOA) in IVF-ET. Mature sperm heads were stained red-pink whereas immature sperm heads were stained dark blue. The percentage of sperm chromatin condensation was calculated from the ratio of the number of red-pink sperm to the total number of sperm analyzed. RESULTS: The overall percentages of chromatin condensation in OA and NOA were 31.1+/-11.2% and 26.3+/-14.4%, respectively. The fertilization rate was significant higher in OA than NOA (p<0.05); however, the rates of good embryos and clinical pregnancy did not show statistical differences. In OA and NOA, statistical differences were not observed in the rate of chromatin condensation, fertilization, good embryos, and clinical pregnancy between the pregnant group and non-pregnant group. CONCLUSION: Chromatin condensation is less stable than OA and showed a low fertilization rate in NOA. While there were no significant differences in chromatin condensation results between NOA and OA, we propose that a pattern of decreased chromatin condensation in NOA is one of the factors of low fertilization results requiring further study.
Aniline Compounds ; Azoospermia ; Chromatin ; Embryonic Structures ; Eosine Yellowish-(YS) ; Fertilization ; Humans ; Pregnancy ; Sperm Head ; Spermatozoa

PURPOSE: The aim of this study was to determine the efficacy of Synagis(R) (palivizumab) in reducing the respiratory syncytial virus (RSV) readmission rate in very low birth weight infants (VLBWI ) and the subgroup that showed the most effective vaccination. METHODS: We enrolled 350 VLBWI who had been discharged alive from the neonatal intensive care unit of Samsung Medical Center from January 2005 to December 2007 and were followed up for at least one year. A retrospective study based on medical records was performed for a period of one year after discharge. RSV readmission rate was investigated according to BPD (bronchopulmonary dysplasia, requiring oxygen at postnatal day 28) and Synagis(R) prophylaxis. We categorized the subgroups by the severity of BPD gestational age, and birth weight and compared the RSV readmission rates between subgroups. RESULTS: Eleven VLBWI were readmitted. Synagis(R) prophylaxis resulted in a 86% reduction in the rate of readmission due to RSV infection (prophylaxis group, 0.7% and no prophylaxis group, 5.0%; P=0.02). Readmission rate in BPD patients was also reduced in the prophylaxis group (0.7% in the prophylaxis group vs. 5.2% in the no prophylaxis group, P=0.03). The readmission rate in patients without BPD was reduced in the prophylaxis group (0% in the prophylaxis group vs. 4.9% in the no prophylaxis group, P=1.00), but this was not statistically significant. CONCLUSION: Synagis(R) prophylaxis was effective at reducing RSV readmission in VLBWI. Its efficacy was verified irrespective of BPD, gestational age, or birth weight.
Antibodies, Monoclonal, Humanized ; Birth Weight ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Medical Records ; Oxygen ; Respiratory Syncytial Viruses ; Retrospective Studies ; Vaccination ; Palivizumab

PURPOSE: With improved survival of extremely low birth weight infants (ELBWI), there is an increase in the incidence of necrotizing enterocolitis (NEC) requiring laparotomy, and the risk of morbidity and mortality in these ELBWI is increased. Thus, we determined the prognostic factors in ELBWI who underwent laparotomy for NEC. METHODS: We retrospectively reviewed the medical records of 35 ELBWI who underwent laparotomy for NEC from January 2001 to December 2008 at Samsung Medical Center. RESULTS: Of 480 ELBWI, 35 required laparotomy for NEC; the mortality rate was 20% (Alive group n=28, Dead group n=7). The values of preoperative score for neonatal acute physiology-II (P=0.022) and fraction of inspired oxygen (P<0.001) were significantly higher in the dead group and values of base excess (P=0.004) were significantly lower in the dead group. Values of preoperative heart rate, respiration rate, mean blood pressure, pH, CO2, and potassium ion were not significantly different between the study groups. Intraoperative fluid volume was significantly higher in the alive group than in the dead group (P=0.045). Postoperative infusion rate was significantly lower in the alive group than in the dead group (P=0.022). CONCLUSION: Good preoperative condition, more intraoperative fluid infusion, and stable postoperative hemodynamic condition were factors associated with favorable prognosis of laparotomy for NEC in ELBWI.
Blood Pressure ; Enterocolitis, Necrotizing ; Heart Rate ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Laparotomy ; Medical Records ; Oxygen ; Potassium ; Prognosis ; Respiratory Rate ; Retrospective Studies

OBJECTIVE: This study was carried out to know whether cryopreservation of sibling 2PN zygotes could increase the cumulative delivery rates in the patients who had less than 10 fertilized zygotes. METHODS: A retrospective analysis was performed in 138 in vitro fertilization-embryo transfer (IVF-ET) cycles with less than 10 fertilized zygotes during January 2003 to December 2007 in Cheil General Hospital. These cycles were divided into two groups. In Group I (n=86), all fertilized embryos were cultured to transfer on day 3 without cryopreserved embryos at the 2PN stage. In Group II (n=52), among fertilized zygotes, some sibling zygotes were frozen at the 2PN stage, the remainder were cultured to transfer. Clinical outcomes in fresh ET cycles and cumulative ongoing pregnancy rates after subsequent frozen-thawed (FT)-ET cycles were compared. RESULTS: There were no significant differences in female mean age, number of retrieved oocytes and total fertilized embryos between two groups. Number of cultured embryos was significantly lower in Group II (5.2+/-0.5) than in Group I (8.4+/-0.7) (p<0.01). Also, number of transferred embryos was significantly lower in Group II (3.3+/-0.6) compared with Group I (3.6+/-0.6) (p<0.01). beta-hCG positive rates and delivery rates (51.2 vs. 46.2% and 41.9 vs. 34.6%, respectively) after fresh ET were slightly higher in Group I than in Group II. However, the differences were not statistically significant. Also, the cumulative delivery rates after subsequent FT-ET cycles were not significantly different between Group I (48.8%) and Group II (50.0%). CONCLUSION: This study showed that cryopreservation of sibling 2PN zygotes from patients who had less than 10 zygotes in the fresh ET cycles did not increase cumulative delivery outcomes. But, it could provide an alternative choice for patients due to offering more chance for embryo transfers if pregnancy was failed in fresh IVF-ET cycles.
Cryopreservation ; Embryo Transfer ; Embryonic Structures ; Female ; Hospitals, General ; Humans ; Oocytes ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Siblings ; Zygote

OBJECTIVES: Mindfulness-base cognitive therapy (MBCT) has been used to treat patients with depression to prevent relapse. The purpose of this study was to examine the effectiveness of Mindfulness- Base Cognitive Therapy for patients who suffer with generalized anxiety disorder or panic disorder for 1 year. METHODS: 19 patients with generalized anxiety disorder or panic disorder were assigned to receive MBCT for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used at 0 weeks, 8 weeks and 1 year to assess the results. RESULTS: MBCT demonstrated significantly decreases on all the anxiety scale scores (HAM-A, p=0.00 ; BAI, p=0.00) and depressive scale scores (HAM-D, p=0.00 ; BDI, p=0.00). The patients who received 8-week of MBCT showed a higher remission rate (15/19, 78%) during the 1-year followup period. CONCLUSION: MBCT may be effective at relieving the anxiety and depressive symptoms of patients who suffer with generalized anxiety disorder or panic disorder for 1 year. However, further well-designed controlled trials are needed to assess the value of MBCT.
Anxiety ; Anxiety Disorders ; Cognitive Therapy ; Depression ; Follow-Up Studies ; Humans ; Panic ; Panic Disorder ; Recurrence