OBJECTIVES: Recently, the number of adolescent criminals hospitalized for evaluation or treatment of mental illness is increasing. The aim of this study was to provide basic information for the evaluation and treatment of adolescent misconducts, based on their impulsivity. METHODS: Barrat's impulsivity test was done to 64 adolescent criminals under age of 18 who were admitted to a Juvenile School between Oct. 1, 2003 and June 30, 2004. According to their recognizing impulsivity scores, the upper 30% group (high impulsivity group: HIG) and the lower 30% group (low impulsivity group: LIG) were selected. The two groups were compared on socio-demographic data, crime characteristics, psychiatric diagnoses, Evoked Potential Latency and Amplitude, Cognitron and IQ. RESULTS: 1) The high impulsivity group had lower IQ than the low impulsivity group (p<0.01). 2) No difference was found in the seriousness of committed crimes, number of crimes and the age of first committed crimes. However, the high impulsivity group fended acting alone in committing crimes (p<0.05), and more frequently upeated same crimes (p<0.01). 3) Evoked potential latency was prolonged on FzN100 (p<0.05), CzN100 (p<0.05), PzN100 (p<0.01) and amplitude was increased on FzN100 (p<0.05), CzN100 (p<0.05), PzN100 (p<0.05) in high impulsivity group. 4) High impulsivity group showed lower scores on NOCR (p<0.01), NOCYR (p<0.01), NOCNR (p<0.01) in Cognitron. PzN100 (p<0.05) latency prolongation. CzN100 latency prolongation had positive correlation with PzN100 latency prolongation (p<0.05). 5) While the misconduct was most common problem in both groups, more ADHD diagnosis was identified in the high impulsivity group. The most frequent medical problem in low impulsivity group was with diseases of internal medicine (p<0.01) and anxiety disorders (p<0.01). CONCLUSION: The adolescent criminals with high impulsivity tend to have lower intelligence and commit crimes repeatedly. They are frequently diagnosed to have ADHD. When they are compared to low impulsivity group, big differences are found in prolonged evoked potential latency and increased amplitude on N100. Hence, in the treatment and rehabilitative programs for them, considering these characteristics may be helpful.
Adolescent* ; Anxiety Disorders ; Brain* ; Crime ; Criminals* ; Diagnosis ; Evoked Potentials ; Humans ; Impulsive Behavior* ; Intelligence ; Internal Medicine

OBJECTIVES: Recently, the number of adolescent criminals hospitalized for evaluation or treatment of mental illness is increasing. The aim of this study was to provide basic information for the evaluation and treatment of adolescent misconducts, based on their impulsivity. METHODS: Barrat's impulsivity test was done to 64 adolescent criminals under age of 18 who were admitted to a Juvenile School between Oct. 1, 2003 and June 30, 2004. According to their recognizing impulsivity scores, the upper 30% group (high impulsivity group: HIG) and the lower 30% group (low impulsivity group: LIG) were selected. The two groups were compared on socio-demographic data, crime characteristics, psychiatric diagnoses, Evoked Potential Latency and Amplitude, Cognitron and IQ. RESULTS: 1) The high impulsivity group had lower IQ than the low impulsivity group (p<0.01). 2) No difference was found in the seriousness of committed crimes, number of crimes and the age of first committed crimes. However, the high impulsivity group fended acting alone in committing crimes (p<0.05), and more frequently upeated same crimes (p<0.01). 3) Evoked potential latency was prolonged on FzN100 (p<0.05), CzN100 (p<0.05), PzN100 (p<0.01) and amplitude was increased on FzN100 (p<0.05), CzN100 (p<0.05), PzN100 (p<0.05) in high impulsivity group. 4) High impulsivity group showed lower scores on NOCR (p<0.01), NOCYR (p<0.01), NOCNR (p<0.01) in Cognitron. PzN100 (p<0.05) latency prolongation. CzN100 latency prolongation had positive correlation with PzN100 latency prolongation (p<0.05). 5) While the misconduct was most common problem in both groups, more ADHD diagnosis was identified in the high impulsivity group. The most frequent medical problem in low impulsivity group was with diseases of internal medicine (p<0.01) and anxiety disorders (p<0.01). CONCLUSION: The adolescent criminals with high impulsivity tend to have lower intelligence and commit crimes repeatedly. They are frequently diagnosed to have ADHD. When they are compared to low impulsivity group, big differences are found in prolonged evoked potential latency and increased amplitude on N100. Hence, in the treatment and rehabilitative programs for them, considering these characteristics may be helpful.
Adolescent* ; Anxiety Disorders ; Brain* ; Crime ; Criminals* ; Diagnosis ; Evoked Potentials ; Humans ; Impulsive Behavior* ; Intelligence ; Internal Medicine

Objective: Lipopolysaccharide (LPS) from Gram-negative bacteria causes poor uterine receptivity by inducing excessive inflammation at the maternal-fetal interface. This study aimed to investigate the detrimental effects of LPS on the attachment and outgrowth of various types of trophoblastic spheroids on endometrial epithelial cells (ECC-1 cells) in an in vitro model of implantation. Methods: Three types of spheroids with JAr, JEG-3, and JAr mixed JEG-3 (JmJ) cells were used to evaluate the effect of LPS on early implantation events. ECC-1 cells were treated with LPS to mimic endometrial infection, and the expression of inflammatory cytokines and adhesion molecules was analyzed by quantitative real-time polymerase chain reaction and western blotting. The attachment rates and outgrowth areas were evaluated in the various trophoblastic spheroids and ECC-1 cells treated with LPS. Results: LPS treatment significantly increased the mRNA expression of inflammatory cytokines (CXCL1, IL-8, and IL-33) and decreased the protein expression of adhesion molecules (ITGβ3 and ITGβ5) in ECC-1 cells. The attachment rates of JAr and JmJ spheroids on ECC-1 cells significantly decreased after treating the ECC-1 cells with 1 and 10 μg/mL LPS. In the outgrowth assay, JAr spheroids did not show any outgrowth areas. However, the outgrowth areas of JEG-3 spheroids were similar regardless of LPS treatment. LPS treatment of JmJ spheroids significantly decreased the outgrowth area after 72 hours of coincubation. Conclusion An in vitro implantation model using novel JmJ spheroids was established, and the inhibitory effects of LPS on ECC-1 endometrial epithelial cells were confirmed in the early implantation process.

Objective: Lipopolysaccharide (LPS) from Gram-negative bacteria causes poor uterine receptivity by inducing excessive inflammation at the maternal-fetal interface. This study aimed to investigate the detrimental effects of LPS on the attachment and outgrowth of various types of trophoblastic spheroids on endometrial epithelial cells (ECC-1 cells) in an in vitro model of implantation. Methods: Three types of spheroids with JAr, JEG-3, and JAr mixed JEG-3 (JmJ) cells were used to evaluate the effect of LPS on early implantation events. ECC-1 cells were treated with LPS to mimic endometrial infection, and the expression of inflammatory cytokines and adhesion molecules was analyzed by quantitative real-time polymerase chain reaction and western blotting. The attachment rates and outgrowth areas were evaluated in the various trophoblastic spheroids and ECC-1 cells treated with LPS. Results: LPS treatment significantly increased the mRNA expression of inflammatory cytokines (CXCL1, IL-8, and IL-33) and decreased the protein expression of adhesion molecules (ITGβ3 and ITGβ5) in ECC-1 cells. The attachment rates of JAr and JmJ spheroids on ECC-1 cells significantly decreased after treating the ECC-1 cells with 1 and 10 μg/mL LPS. In the outgrowth assay, JAr spheroids did not show any outgrowth areas. However, the outgrowth areas of JEG-3 spheroids were similar regardless of LPS treatment. LPS treatment of JmJ spheroids significantly decreased the outgrowth area after 72 hours of coincubation. Conclusion An in vitro implantation model using novel JmJ spheroids was established, and the inhibitory effects of LPS on ECC-1 endometrial epithelial cells were confirmed in the early implantation process.

PURPOSE: We evaluated the risk factors for late complications and functional outcome after total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC). METHODS: Pre- and postoperative clinical status and follow-up data were obtained for 55 patients who underwent TPC with IPAA between 1999 and 2010. The median follow-up duration was 4.17 years. Late complications were defined as those that appeared at least one month after surgery. For a functional assessment, telephone interviews were conducted using the Global Assessment of Functioning Scale. Twenty-eight patients completed the interview. RESULTS: Late complications were found in 20 cases (36.3%), comprising pouchitis (n = 8), bowel obstruction (n = 5), ileitis (n = 3), pouch associated fistula (n = 2), and intra-abdominal infection (n = 2). The preoperative serum albumin level for patients with late complications was lower than for patients without (2.4 +/- 0.5 vs. 2.9 +/- 0.7, P = 0.04). Functional outcomes were not significantly associated with clinical characteristics, follow-up duration, operation indication, or late complications. CONCLUSION: This study demonstrated that a low preoperative albumin level could be a risk factor for late complications of TPC with IPAA. Preoperative nutritional support, especially albumin, could reduce late complications. Functional outcomes are not related to late complications.
Colitis, Ulcerative ; Fistula ; Follow-Up Studies ; Humans ; Ileitis ; Interviews as Topic ; Intraabdominal Infections ; Nutritional Support ; Pouchitis ; Risk Factors ; Serum Albumin ; Ulcer

Serous cystic neoplasms of the pancreas are almost always benign lesions. However, there are some case reports of malignant serous neoplasms of the pancreas. It is very difficult to distinguish malignant and benign tumors. Indeed, only clinicopathologic findings of locoregional invasion and metastasis represent a malignancy. We report a serous cystadenocarcinoma of the pancreas that was initially considered to be colon cancer. Post-operatively, the tumor was confirmed to be a malignant serous cystic tumor of the pancreas. One year later, the patient remains disease-free.
Colon ; Colonic Neoplasms ; Cystadenocarcinoma ; Cystadenocarcinoma, Serous ; Humans ; Neoplasm Metastasis ; Pancreas ; Spleen

PURPOSE: Herpes zoster (HZ) is caused by reactivation of the varicella zoster virus, which occurs frequently in liver transplant recipients with impaired cellular immunity. The purpose of this study was to evaluate the incidence and risk factors for HZ after adult liver transplantation (LT). METHODS: In our institution, 993 patients underwent adult LT from January 1997 to December 2013. We retrospectively analyzed the incidence rate of HZ and risk factors for HZ after LT. RESULTS: Of 993 LT recipients, 101 (10.2%) were diagnosed with HZ. The incidence of HZ at 1, 3, 5, and 10 years was 6.6%, 9.1%, 10.0%, and 11.9%, respectively. Therefore, we observed that the incidence of HZ after LT was 16.3 per 1,000 person-years. Older age (≥50 years) at LT and mycophenolate mofetil (MMF) exposure were independent risk factors of HZ infection after adult LT. CONCLUSION: Patients older than 50 years or with MMF exposure are considered to be at high risk for HZ. Therefore, adult liver recipients with such factors should not be given strong immunosuppression treatments.
Adult ; Herpes Zoster ; Herpesvirus 3, Human ; Humans ; Immunity, Cellular ; Immunosuppression ; Incidence ; Liver Transplantation ; Liver ; Retrospective Studies ; Risk Factors ; Transplant Recipients

BACKGROUNDS/AIMS: Hepatocellular carcinoma (HCC) is uncommon in young adults and the prognosis of these patients is still unclear. In this retrospective study, we compared the clinicopathological characteristics and outcomes of young patients with HCC with those of older patients with HCC. METHODS: We retrospectively reviewed the clinicopathological characteristics of a total of 1,124 patients with HCC who underwent hepatectomy at our institution between 2006 and 2010. Patients < or =40 years of age at the time of HCC diagnosis were classified in the younger group. RESULTS: One hundred and three patients (9.2%) were classified in the younger group. whereas, 1021 patients were classified in the older group. The incidences of hepatitis B virus infection, alpha-fetoprotein (AFP) levels, and indocyanine green retention test were all higher in younger patients than in older patients (p<0.05). Disease-free survival and overall survival were longer in older patients than in younger patients, without statistical significance. In younger patients, increased levels of protein induced by vitamin K antagonist-II (PIVKA-II) and alkaline phosphatase, portal vein tumor thrombosis, and intrahepatic metastasis were all predisposing factors for tumor recurrence after hepatectomy. CONCLUSIONS: Although the AFP levels were higher in younger patients with HCC than in older patients with HCC, disease-free survival and overall survival after liver resection were not significantly different between the two groups.
Alkaline Phosphatase ; alpha-Fetoproteins ; Carcinoma, Hepatocellular* ; Causality ; Diagnosis ; Disease-Free Survival ; Hepatectomy* ; Hepatitis B virus ; Humans ; Incidence ; Indocyanine Green ; Liver ; Neoplasm Metastasis ; Portal Vein ; Prognosis* ; Recurrence ; Retrospective Studies ; Thrombosis ; Vitamin K ; Young Adult

This study aimed to compare the pharmacokinetic (PK) and safety profiles of 2 fenofibric acid formulations under fasting and fed conditions. The reference was a 135 mg capsule, while the test was a 110 mg enteric-coated tablet. This randomized, open-label, two-sequence, two-period crossover phase 1 clinical trial was conducted in healthy Korean men. Sixty participants were enrolled in each of the fasting and feeding groups. Blood samples were collected 72 hours after drug administration. PK parameters were calculated using a noncompartmental method with Phoenix WinNonlin ® . A total of 53 and 51 participants from the fasting and feeding groups, respectively, completed the study. The geometric mean ratio and 90% confidence intervals of the maximum concentration (C max ) and area under the concentration-time curve to the last measurable plasma concentration were 0.9195 (0.8795–0.9614) and 0.8630 (0.8472–0.8791) in the fasting study and 1.0926 (1.0102–1.1818) and 0.9998 (0.9675–1.0332) in the fed study, respectively. The time to reach C max of the enteric-coated tablet compared to that of the capsule was extended by 1 and 3 hours under fasting and fed conditions, respectively. In conclusion, enteric-coated tablets have a higher bioavailability than capsules. In addition, the enteric-coated tablet was smaller than the capsule, making it easier for patients to swallow.

PURPOSE: Laparoscopic major liver resection (major LLR) remains a challenging procedure because of the technical difficulty. Several significant technical innovations have been applied in our center since 2012. They include routine application of bipolar electrocautery, initiation of temporary increase of intra-abdominal pressure during bleeding events from veins to balance the central venous pressure, and use of temporary inflow control of the Glissonean pedicle. This study evaluated the impact of these technique modifications in patients with major LLR. METHODS: Between January 2004 and February 2015, a total of 606 patients underwent LLR at Samsung Medical Center in Seoul, Korea. Major LLR was employed in 233 cases. All major LLR procedures were anatomical resections performed with a totally laparoscopic approach. We compared surgical parameters of right hepatectomy (RH), left hepatectomy (LH), and right posterior sectionectomy (RPS) before and after 2012. RESULTS: Open conversion rates of RH and LH and estimated blood loss in RPS significantly decreased after 2012. The postoperative complication rate of major LLR was 12.7% and was similar before and after 2012. Bile leakage was the most common complication (3.2%). CONCLUSION: The modifications of surgical techniques resulted in good outcomes for laparoscopic major LLR. We recommend routine application of these techniques to improve outcomes, especially in patients requiring major liver resection.
Bile ; Central Venous Pressure ; Electrocoagulation ; Hemorrhage ; Hepatectomy ; Humans ; Korea ; Laparoscopy ; Learning Curve ; Liver* ; Minimally Invasive Surgical Procedures ; Postoperative Complications ; Seoul ; Veins