The aim of this study was to construct and test a structural equation model for the risk factors of metabolic syndrome in Korean adults. The structural equation model hypothesizes that eating alone and feeling depressed is a risk factor for metabolic syndrome. The data of this study were obtained from the Sixth Korea National Health and Nutrition Examination Survey which was cross-sectional data from the representative national survey. A total of 4,013 subjects replied to the survey item of lifestyle and completed the physical examinations among adults aged 19 years or older in South Korea was in 2015. The structural model in this study was composed of four latent variables: eating alone, depression, negative health behavior, and metabolic syndrome. Two variables, the rate of eating alone and depression, were exogenous variables. Negative health behavior was both a mediating variable and endogenous variable, and metabolic syndrome was the final endogenous variable. The data were analyzed using the Maximum Likelihood method and bootstrapping. The structural model was appropriate for the data based on the model fit indices. The results of this study can be summarized as follows: Eating alone is a direct risk factor of metabolic syndrome in Korean women. Depression can mediate metabolic syndrome through negative health behaviors. Negative health behavior had a direct impact on metabolic syndrome in both men and women. This study may be a guideline for interventions and strategies to reduce the incidence of metabolic syndrome in Korean adults.
Adult ; Depression ; Eating ; Female ; Health Behavior ; Humans ; Incidence ; Korea ; Life Style ; Male ; Methods ; Models, Structural ; Negotiating ; Nutrition Surveys ; Physical Examination ; Risk Factors

PURPOSE: The aim of this study was to verify the effects of daily 2% chlorhexidine gluconate (CHG) bathing on the acquisition of multidrug-resistant organisms (MDRO) and healthcare-associated infection (HAI) in a medical intensive care unit (MICU). METHODS: The study was a randomized controlled group posttest only design, involving 91 patients in MICU at a tertiary hospital (47 patients in the experimental group and 44 patients in the control group). The 2% CHG bathing was performed daily according to bathing protocol to the patients in the experimental group, and traditional bath was performed every three days to those in the control group. Fisher's exact test and χ² test were used to analyze the data. RESULTS: MDRO were found in 6 patients of the experimental group and in 15 patients of the control group. The difference was statistically significant (p=.016). HAI occurred in 2 patients of the experimental group and in 7 patients of the control group. The difference was not statistically significant (p=.084). CONCLUSION: The results confirmed that daily bathing with CHG was effective in reducing the incidence of MDRO acquisition. Therefore, it is expected that daily bathing with CHG will be used as an effective nursing intervention to reduce the incidence of MDRO acquisition.
Baths ; Chlorhexidine ; Critical Care ; Cross Infection ; Drug Resistance, Microbial ; Humans ; Incidence ; Intensive Care Units ; Nursing ; Tertiary Care Centers

BACKGROUND: Perioperative lidocaine infusion improves postoperative outcomes, mostly after abdominal and urologic surgeries. Knowledge of the effect of lidocaine on peripheral surgeries is limited. Presently, we investigated whether intraoperative lidocaine infusion reduced anesthetic consumption, duration of ileus, pain intensity, analgesic consumption and hospital stay after breast plastic surgeries. METHODS: Sixty female patients, aged 20-60 years, enrolled in this prospective study were randomly and equally divided to two groups. One group (n = 30) received a 1.5 mg/kg bolus of lidocaine approximately 30 min before incision followed by continuous infusion of lidocaine (1.5 mg/kg/h) until skin closure (lidocaine group). The other group (n = 30) was untreated (control group). Balanced inhalation (sevoflurane) anesthesia and multimodal postoperative analgesia were standardized. End tidal sevoflurane concentration during surgery, time to the first flatus and defecation, visual analog pain scale (0-10), analgesic consumption and associated side effects at 24, 48, and 72 h after surgery, hospital stay, and patient's general satisfaction were assessed. RESULTS: Compared to the control group, intraoperative lidocaine infusion reduced by 5% the amount of sevoflurane required at similar bispectral index (P = 0.014). However, there were no significant effects of lidocaine regarding the return of bowel function, postoperative pain intensity, analgesic sparing and side effects at all time points, hospital stay, and level of patient's satisfaction for pain control. CONCLUSIONS: Low dose intraoperative lidocaine infusion offered no beneficial effects on return of bowel function, opioid sparing, pain intensity and hospital stay after various breast plastic surgeries.
Aged ; Analgesia ; Anesthesia ; Breast ; Defecation ; Female ; Flatulence ; Humans ; Ileus ; Inhalation ; Length of Stay ; Lidocaine ; Methyl Ethers ; Pain Measurement ; Pain, Postoperative ; Prospective Studies ; Skin

Hepatocellular adenoma (HCA) is the most common type of benign liver tumor, and its major complication is malignant transformation to hepatocellular carcinoma (HCC). Here, we report a case of HCC arising in HCA with bone marrow metaplasia in a 24-year-old Korean woman who presented with abdominal discomfort. A huge liver mass was found on abdominal ultrasonography. She underwent surgical hepatic resection, and the resected specimen was entirely involved by a 20-cm-sized tumor. Histological review revealed a well differentiated HCC arising from inflammatory HCA with β-catenin nuclear positivity and bone marrow metaplasia that contained hematopoietic cells. This case was unique because malignant transformation, inflammatory type HCA, β-catenin nuclear staining, and bone marrow metaplasia were simultaneously observed. Additionally, it should be noted that a large HCA with β-catenin activation can undergo malignant transformation and should be surgically resected in a timely manner.
Adenoma, Liver Cell ; Bone Marrow ; Carcinoma, Hepatocellular ; Female ; Humans ; Liver ; Metaplasia ; Ultrasonography ; Young Adult

BACKGROUND: Rocuronium produces injection pain in 50-80% of treated patients. Therefore, a variety of pretreatments have been attempted to reduce this issue. We evaluated the efficacy of 3 different doses of magnesium on the rocuronium injection pain and following hemodynamic changes by laryngoscopy and tracheal intubation (LTI). METHODS: Two hundreds patients, ASA I and II, undergoing general anesthesia for elective surgery were randomly divided to 4 groups: group 1, 2, 3, 4 received saline 5 ml, magnesium 5, 10 and 20 mg/kg prior to 0.6 mg/kg of rocuronium, respectively. Then, group 1 only was treated with esmolol (20 mg) before LTI. Pain intensity with rocuronium injection was assessed using a four-point scale according to patient's movement. Cardiovascular responses at baseline, after induction, 1 minutes after LTI were determined. RESULTS: Compared to saline, 10 and 20 mg/kg of magnesium significantly reduced the incidence of overall movement after rocuronium injection (34% and 36% in group 3 and 4, respectively vs. 76% in the group 1) (P < 0.0001). Generalized movement was seen in 4% of patients in groups 3 and 4, respectively. Compared to baseline values, diastolic blood pressure (DBP) immediately after LTI significantly increased within groups 1 and 2 (P < 0.001), but not within groups 3 and 4. CONCLUSIONS: Magnesium (10 and 20 mg/kg) prior to rocuronium was effective in attenuating rocuronium associated injection pain and cardiovascular changes by LTI.
Androstanols ; Anesthesia, General ; Blood Pressure ; Hemodynamics ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Magnesium ; Magnesium Sulfate ; Propanolamines

PURPOSE: To report a case of bilateral posterior subcapsular cataract after taking oxcarbazepine (Trileptal®, Novartis, Basel, Swiss). CASE SUMMARY: A 19-year-old female visited our clinic with decreased vision in both eyes. Her best-corrected visual acuity was 0.3 in the right eye and 0.5 in the left eye, and slit-lamp examination revealed a bilateral cortical opacity and subcapsular cataract. She had been taking oxcarbazepine for epilepsy for 10 years, which was discontinued 3 years ago. Her mother had undergone cataract surgeries when she was approximately 46 years of age. No other risk factors for cataract were present. CONCLUSIONS: In the present case, bilateral cortical opacity and subcapsular cataract were assumed to be associated with the use of oxcarbazepine. We suggest that oxcarbazepine could induce a cataract and recommend a regular follow-up by a qualified ophthalmologist.
Cataract ; Epilepsy ; Female ; Follow-Up Studies ; Humans ; Mothers ; Risk Factors ; Visual Acuity ; Young Adult

The purpose of this study was to evaluate the influence of fabrication methods of lithium disilicate reinforced glass-ceramic crown on marginal and internal fit. Lithium disilicate reinforced glass-ceramic crowns were fabricated using ingots for heat press forming and blocks for CAD/CAM milling manufactured by Hass and Ivoclar/Vivadent. Dentiform of maxillary central incisor was prepared with a 6°taper and 1 mm deep chamfer margin and duplicated with silicone. Then the polyurethane resin was poured at silicone mold to produce working model. Marginal and internal fit were measured by the silicone replica technique. Each silicon replica was cut into labio-lingual and mesio-distal sections and the thickness of the light body silicon was measured. Fourteen reference points were determined and measured using a microscope. As a result of calculating and comparing the average value of 14 points in all groups, the measured value was within 120 µm, the clinically acceptable range suggested by previous literatures. In all groups, the marginal fit was smaller than the internal fit. At the margin area, significant differences were identified only between the ECM group and the EPM group, and there was no statistically significant difference between the remaining groups. At the deep chamfer area, the ECM and ABM group produced by the CAD system had excellent compatibility. In the axial wall and incisal area, ECM was superior to both EPC and EPM. Also, both ABM and APC groups were statistically significantly superior than APM.

The present study investigated the prognostic factors predicting survival of patients with sepsis and acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT). This retrospective observational study included 165 sepsis patients treated with CRRT. The patients were divided into two groups; the survivor group (n=73, 44.2%) vs. the nonsurvivor group (n=92, 55.8%). AKI was defined by the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines. We analyzed medical histories, clinical characteristics and laboratory findings of the enrolled patients when they started CRRT. In addition, we performed binary logistic regression and cox regression analysis. In the survivor group, urine output during the first day was significantly higher compared with the nonsurvivor group (55.7±66.3 vs. 26.6±46.4, p=0.001). Patients with urine output <30 mL/hour during the 1st day showed worse outcomes than ≥30 mL/hour in the logistic regression (hazard ratio 2.464, 95% confidence interval 1.152-5.271, p=0.020) and the cox regression analysis (hazard ratio 1.935, 95% confidence interval 1.147-3.263, p=0.013). In conclusion, urine output may predict survival of septic AKI patients undergoing CRRT. In these patients, urine output <30 mL/hour during the first day was the strongest risk factor for in-hospital mortality.
Acute Kidney Injury ; Biomarkers ; Hospital Mortality ; Humans ; Kidney Diseases ; Logistic Models ; Observational Study ; Renal Replacement Therapy ; Retrospective Studies ; Risk Factors ; Sepsis ; Survivors

The purpose of this study was to evaluate the influence of fabrication methods of lithium disilicate reinforced glass-ceramic crown on marginal and internal fit. Lithium disilicate reinforced glass-ceramic crowns were fabricated using ingots for heat press forming and blocks for CAD/CAM milling manufactured by Hass and Ivoclar/Vivadent. Dentiform of maxillary central incisor was prepared with a 6°taper and 1 mm deep chamfer margin and duplicated with silicone. Then the polyurethane resin was poured at silicone mold to produce working model. Marginal and internal fit were measured by the silicone replica technique. Each silicon replica was cut into labio-lingual and mesio-distal sections and the thickness of the light body silicon was measured. Fourteen reference points were determined and measured using a microscope. As a result of calculating and comparing the average value of 14 points in all groups, the measured value was within 120 µm, the clinically acceptable range suggested by previous literatures. In all groups, the marginal fit was smaller than the internal fit. At the margin area, significant differences were identified only between the ECM group and the EPM group, and there was no statistically significant difference between the remaining groups. At the deep chamfer area, the ECM and ABM group produced by the CAD system had excellent compatibility. In the axial wall and incisal area, ECM was superior to both EPC and EPM. Also, both ABM and APC groups were statistically significantly superior than APM.

Purpose: This study investigated the anti-inflammatory effects of Evodiae Fructus (EF) on hydrochloric acid (HCl)/ethanol-induced gastritis, focusing on its impact on oxidative stress by analyzing inflammatory cytokines and inflammation-related factors. The total polyphenol and flavonoid contents were determined through in vitro experiments, while the radical scavenging activity was confirmed using 2,2-diphenyl-1-picrylhydrazyl and 2,2’-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) assays. Methods: In vivo experiments were conducted on rats divided into 5 groups (n = 7/in each group): normal group (Normal), 150 mM HCl/60% ethanol-induced gastritis group (Control), 150 mM HCl/60% ethanol-induced gastritis group administered 10 mg/kg sucralfate (SC), 150 mM HCl/60% ethanol-induced gastritis group administered EF at the doses of 100 mg/kg or 200 mg/kg (EF100 or EF200). The mice were pretreated with the extract (EF) or drug (SC), and after 1 hour, 150 mM HCl/60% ethanol (v/v) mixture was administered orally. Reactive oxygen species (ROS) levels, peroxynitrite (ONOO − ), and pro-inflammatory cytokines including tumor necrosis factor-α and interleukin-1 beta were assessed in serum. Additionally, western blotting of the gastric tissues confirmed the expression of inflammation-related proteins. Results: EF alleviated the gastric mucosal damage caused by 150 mM HCl/60% ethanol.The assessment of oxidative stress in the serum showed that EF significantly reduced ROS and ONOO − levels and significantly decreased the levels of pro-inflammatory cytokines. Western blot analysis revealed that EF reduced ROS-generating nicotinamide adenine dinucleotide phosphate oxidase subunits, including gp91phox , p22phox , and p47phox . Additionally, EF mitigated the inflammation by inhibiting the mitogen-activated protein kinase signaling pathway. Conclusion These results indicate that EF is a potential herbal medicine candidate for the treatment of oxidative stress-induced gastritis.