PURPOSE: This study was done to examine the effects of Aroma inhalation therapy on test anxiety, stress and serum cortisol in nursing students. METHODS: The study design was a pre posttest randomized design with a pre-survey, a 5-day experimental treatment (2012.11.17-21) and a post survey. Participants were 65 students - 31 in the aromatic inhalation group and 34 in the control group. The pre-survey included general demographic characteristics and test anxiety, stress and serum cortisol levels for all students. The experimental group received the aromatic inhalation using aroma oil (mixed Maychang, lavender, rosewood essence - ratio of 3:5:2). RESULTS: The experimental group treated with aromatic inhalation scored significantly lower for test anxiety (t=-2.330 p=.023), physical stress (t=-2.910 p=.005) and psychological stress (t=-3.285 p=.002) compared to the control group. However, there were no differences in serum cortisol levels (t=0.228 p=.820). CONCLUSION: Results indicate that Aromatic inhalation, using maychang, lavender and rosewood essential oils, contributes significantly to reducing anxiety and stress among nursing students, and can therefore be an effective intervention for anxiety and stress.
Anxiety* ; Aromatherapy ; Humans ; Hydrocortisone* ; Inhalation* ; Lavandula ; Nursing* ; Oils, Volatile ; Respiratory Therapy ; Stress, Psychological ; Students, Nursing*

The CYP11A1 gene encodes for the cholesterol side-chain cleavage enzyme (P450scc), which initiates steroid hormone biosynthesis. Defective P450scc activity results in severe glucocorticoid and mineralocorticoid deficiencies. We describe a case of P450scc deficiency due to a novel homozygous CYP11A1 variant inherited from the mother with a possibility of uniparental disomy (UPD). The patient was a female, had no family history of endocrine disease, and showed adrenal insufficiency at 13 days of age. Hormonal analysis with an adrenocorticotropic hormone stimulation test showed both glucocorticoid and mineralocorticoid deficiencies, presumed to be a defect of the early stage of steroidogenesis. Exome sequencing reported a novel homozygous frameshift variant of CYP11A1 (c.284_285del, p.Asn95Serfs*10), which was inherited from the mother.Additionally, homozygosity in 15q22.31q26.2, which included CYP11A1, was identified using a chromosomal microarray. It was suggested that the possibility of maternal UPD was involved as the cause of a P450scc deficiency by unmasking the maternally derived affected allele. To our understanding, P450scc deficiency associated with UPD encompassing CYP11A1 had not been reported in Korea before. Genetic analysis can help diagnose rare causes of primary adrenal insufficiency, including P450scc deficiency.

BACKGROUND AND OBJECTIVES: Squamous cell carcinoma of head and neck (HNSCC) undergoes a generally poor hospital course, and response of radiotherapy remains in questionable status. For this carcinoma, the clinical courses, biological behaviors and responses to radiotherapy are variable among cases and difficult to predict accurately. MATERIALS AND METHODS: As a trial to elucidate the prognostic factors of HNSCC after radiotherapy, several responses following irradiation of HNSCC cell lines and the expressions of apoptosis-related markers, such as p53, bcl-2, and Bax, were evaluated in this study. RESULTS: Among the eight HNSCC cell lines, the AMC-HN 1 was considered to be radioresistant, the PCI-1 was radiosensitive, and the AMC-HN 8 showed intermediate response. In immunohistochemistry of p53, AMC-HN 1 was negative, PCI-1 was strongly positive, and AMC-HN 8 was weakly positive. However, the analysis of mRNA using RT-PCR implied different expressions of p53 in the mRNA level. All 3 cell lines showed the p53 mRNA expressions. After irradiation of 2 Gy (137Cs), changes in the expressions of apoptosis-related protein (p53, bcl-2, Bax) were analyzed with the Western blot assay. The p53 and bcl-2 did not show any difference in the expressions between the irradiation group and the non-irradiation group. However, there was a significant difference in the Bax expression in the radiosensitive cell line (PCI-1) after irradiation. CONCLUSION: Those results might imply some roles of Bax in apoptotic responses following radiotherapy. Therefore, further studies should look into finding other possible factors and markers of HNSCC after radiotherapy and the precise role of Bax.
Blotting, Western ; Carcinoma, Squamous Cell* ; Cell Line* ; Head* ; Immunohistochemistry ; Neck* ; Radiotherapy ; RNA, Messenger

Splenosis is defined as heterotopic autotransplantation of spleen tissue following traumatic rupture of the spleen, or surgery. It is a benign disease that is generally without any symptoms and is discovered incidentally. Surgical intervention is recommended if symptoms are present. We report the successful laparoscopic management of a 49-year-old Korean woman with splenosis-associated symptoms who had undergone splenectomy.
Autografts ; Female ; Humans ; Laparoscopy ; Middle Aged ; Rupture ; Spleen ; Splenectomy ; Splenosis*

Compartment syndrome is a clinical condition associated with decreased blood circulation that can lead to swelling of tissue in limited space. Several factors including lithotomy position, prolonged surgery, intermittent pneumatic compressor, and reperfusion after treatment of arterial thrombosis may contribute to compartment syndrome. However, compartment syndrome rarely occurs after gynecologic surgery. In this case, the patient was diagnosed as compartment syndrome due to reperfusion injury after treatment of arterial thrombosis, which occurred after laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer. Despite its rarity, prevention and identifying the risk factors of complication should be performed perioperatively; furthermore, gynecologist should be aware of the possibility of complications.
Blood Circulation ; Compartment Syndromes* ; Female ; Gynecologic Surgical Procedures ; Humans ; Hysterectomy* ; Lower Extremity* ; Lymph Node Excision* ; Lymph Nodes* ; Reperfusion Injury* ; Reperfusion* ; Risk Factors ; Thrombosis* ; Uterine Cervical Neoplasms*

Purpose: The aim of this study was to investigate the association between the changes in masticatory function and cognitive impairment by analyzing longitudinal data of older Korean patients. Materials and Methods: Patients aged over 60 years with dental records between 2005 to 2010 (baseline; T1) and 2014 to 2020 (follow-up; T2) were selected in a single medical center. Based on the dementia diagnosis after T2, the cohort was classified into two groups, the dementia group (n=122) and the control group (n=366). Changes in masticatory function were calculated using the total functional tooth unit (T-FTU) in both groups. The incidence of tooth extraction (%) and the subsequent rehabilitation during the observation period were also evaluated. Results: In the dementia group, T-FTU significantly decreased from T1 to T2 (9.81±2.78 to 9.11±3.16, respectively, p=0.008), while no significant change was observed in the control group. During the mean observation period of 9 years, significantly more teeth were extracted and neglected to be prosthetically restored in the dementia group than in the control group. Regression analysis revealed that the number of missing teeth neglected [odds ratio (OR)=1.195, 95% confidence interval (CI)=1.025–1.393, p=0.023] and previous alcohol consumption (OR=4.445, 95% CI=1.831–1.795, p=0.001) were the most significant risk factors of dementia. Conclusion There might be a causative relationship between the neglected missing dentition and the onset of dementia.

BACKGROUND: We performed the study on the changes of beta2-microglobulin(beta2M) clearance and urea reduction ratio after reuse of dialyzers with three different membranes. METHODS: 9 patients who had received regular hemodialysis more than five years were enrolled. Three kinds of dialyzer membrane were used; i.e. : Two of them were high-flux and the other was low-flux. Dialyzer reprocessing was performed by an automated machine using glutaraldehyde and bleach. Each dialyzer was reused 10 times. Solute clearance was determined for each dialyzer after the 1st, 5th, 8th and 10th reuse. RESULTS: Urea clearance was well maintained after reuse with both high-flux and low-flux membrane but beta2M clearance was significantly greater with high-flux dialyzers than low-flux dialyzer. Effects of each dialyzer reuse on beta2M clearance showed no significant decrease until the 10th reuse and no significant difference in beta2M clearance between the two high-flux dialyzers(polyamide vs PEPA membrane, p= 0.197). CONCLUSION: Reuse of dialyzers was cost-effective. After reuse of dialyzer, clearance of solute was maintained in both small and large solutes until the 10 th reuse. Further study is needed regarding the maintenance of solute clearance with increased number of reuses.
Blood Urea Nitrogen* ; Cellulose ; Glutaral ; Humans ; Membranes* ; Nylons ; Renal Dialysis ; Urea

Microscopic polyangiitis (MPA) is a distinct type of systemic small vessel vasculitis affecting small sized vessels with few or no immune deposit and no granulomatous inflammation. Cause or pathogenetic mechanism of MPA has been unknown but association with silicon or silica exposure or pulmonary silicosis has been reported rarely and supports hypothesis that environmental factors are important modulating or triggering factors of the vasculitis in the indivisual who may be genetically predisposed. We report a case of microscopic polyangiitis with underlying pulmonary silicosis in 43 year-old male. He was admitted due to hemoptysis, dyspnea, fever and bilateral pulmonary infiltration with underlying small nodular densities in whole lung field and egg-shell calcification of both hilar areas. Laboratory findings showed hematuria, proteinuria and rapid deterioration of renal function. Renal biopsy revealed focal segmental necrotizing glomerulonephritis with early cellular crescents accompanied with membranous glomerulonephropathy and perinuclear-antineutrophil cytoplasmic antibody was positive. Under the diagnosis of MPA, he has been managed with high dose steroid, cyclophosphamide and hemodialysis. Chest infiltration decreased and hemoptysis and hypoxia was improved but renal function was not recoverd and he needed regular hemodialysis continuously.
Adult ; Anoxia ; Biopsy ; Cyclophosphamide ; Cytoplasm ; Diagnosis ; Dyspnea ; Fever ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Hematuria ; Hemoptysis ; Humans ; Inflammation ; Lung ; Male ; Microscopic Polyangiitis* ; Proteinuria ; Renal Dialysis ; Silicon ; Silicon Dioxide ; Silicosis* ; Thorax ; Vasculitis

BACKGROUND: Interleukin-7 receptor (IL-7R) alpha-deficient mice have small numbers of B cells and alpha beta T cells in periphery, they totally lack gamma sigma T cells. In addition, the V-J recombination and transcription of TCRgamma genes is also severely impaired in IL-7Ralpha-deficient mice. Stat5, a signaling molecule of the IL-7R, induces germline transcription in the TCRgamma locus, and promotes V-J recombination and gamma sigma T cell development. However, the roles for IL-7R signaling pathway in thymic or extrathymic gamma sigma T cell development are largely unknown. METHODS: To clarify the role of the IL-7 receptor in proliferation and survival of gamma sigma T cells, we introduced the TCR gamma sigma transgene, Vgamma2/ Vsigma5, into IL-7Ralpha-deficient mice, and investigated the development of gamma sigma T cells. RESULTS: We found that Vgamma2/Vsigma5 transgene restored gamma sigma T cells in the epithelium of the small intestine (IEL) but not in the thymus and the spleen. Further addition of a bcl-2 transgene resulted in partial recovery of gamma sigma T cells in the thymus and the spleen of these mice. CONCLUSION: Taken together, this study revealed that the IL-7Ralpha is indispensable for proliferation and survival mainly in thymic gamma sigma T cell development.
Animals ; B-Lymphocytes ; Epithelium ; Interleukin-7* ; Intestine, Small ; Mice ; Receptors, Interleukin-7 ; Recombination, Genetic ; Spleen ; T-Lymphocytes ; Thymus Gland ; Transgenes

Traumatic diaphragmatic rupture (TDR) is uncommon, and may be associated with other severe life-threatening injuries after blunt trauma. Recently, we experienced a right-sided TDR patient with other multiple life-threatening injuries. A 59-year-old female inflicted with a right-sided TDR accompanied by herniated liver was treated with thoracoscopic exploration. We successfully managed associated life-threatening injuries such as traumatic brain injury and pelvic bone fractures with bleeding, simultaneously.
Brain Injuries ; Diaphragm ; Female ; Hemorrhage ; Humans ; Liver ; Middle Aged ; Pelvic Bones ; Rupture* ; Thoracoscopes