OBJECTIVE: To evaluate the effect of neuromuscular electrical stimulation (NMES) therapy on swallowing dysfunction in patients with chronic (more than 6 months) dysphagia caused by stroke. METHOD: A total of 16 patients with stroke-caused swallowing disorders based on a videofluoroscopic swallowing study (VFSS) were treated with NMES for two weeks. NMES was applied to the skin over the anterior neck muscles for one hour a day. Swallowing function was evaluated by the functional dysphagia scale using the VFSS, clinical dysphagia scale and the American Speech-Language Hearing Association National Outcomes Measurements System Swallowing Scale (ASHA NOMS scale) before and after electrical stimulation. Follow up VFSS was performed one month after intervention. RESULTS: After completing ten treatment sessions, aspiration, reflex coughing and the total score in the clinical dysphagia scale were significantly decreased (p<0.05). There was also a significant improvement in the ASHA NOMS scale (p<0.05). Regarding the functional dysphagia scale, the residue in the valleculae and piriformis sinus, and total scores were significantly decreased (p<0.05). Specifically, the scores of the pharyngeal phase were mainly decreased as compared to that of the oral phase. In addition, these effects were maintained one month after the intervention as measured with functional dysphagia scale. CONCLUSION: After ten sessions of NMES, we found improvement in dysphagia parameters in chronic dysphagia patients. Specifically, residue in the valleculae and piriformis sinus, and a parameter of the pharyngeal phase were significantly improved.
Cough ; Deglutition ; Deglutition Disorders* ; Electric Stimulation Therapy* ; Electric Stimulation* ; Follow-Up Studies ; Hearing ; Humans ; Neck Muscles ; Reflex ; Skin ; Stroke*

The purpose of this study is to provide a fundamental basis for defining measures to prevent suicide by specifically examining the relationship between suicide and alcohol consumption, which is thought to be a key factor in suicide. This study reviewed 426 suicide autopsies diagnosed by the department of forensic medicine, National Forensic Service (2007-2009) and analyzed the preliminary data on variables such as gender, age, and cause of death, with particular focus on the relationship between these variables and blood alcohol concentration. The relationship between each variable and alcohol consumption was as follows. First, alcohol was present in 48.4% of suicides. Second, blood alcohol concentration wrere twice as high in women as in men. Third, the relationship between suicide and alcohol consumption was greater in people in their 30s and 40s. The correlation between suicide and alcohol intake was evident this age group. These results are more specific and practical than the results of previous studies on the correlation between suicide and alcohol intake. The results of this study will help define measures to facilitate suicide prevention as an important reference and may eventually help lower the suicide rate in Korea.
Alcohol Drinking ; Autopsy ; Cause of Death ; Drinking ; Female ; Forensic Medicine ; Humans ; Korea ; Male ; Suicide

In Sprague Dawley (SD) rats, antibodies against strains of Orinentia tsutsugamushi, Kato, Karp and Gilliam, were produced in order to investigate their longevity and cross-reactivities to their corresponding homologous and heterologous antigens. By immunofluorescence assay (IFA) of IgG and IgM, it was shown that the immunity to the homologous strains persisted at a higher level (longevity of at least 34 weeks with higher IFA titers). On the other hand, the immunity to the heterologous strains persisted at a lower level (longevity of 10 to 34 weeks with lower IFA titers). Since infection with one strain of O. tsutsugamushi does not preclude reinfection with other strains, understanding of the antigenic diversity of O. tsutsugamushi and duration of the immunity to both homologous and heterologous strain is very important in diagnosis of scrub typhus.
Animals ; Antibodies* ; Antigenic Variation ; Antigens, Heterophile ; Diagnosis ; Fluorescent Antibody Technique ; Hand ; Immunoglobulin G ; Immunoglobulin M ; Longevity* ; Orientia tsutsugamushi* ; Rats ; Rats, Sprague-Dawley* ; Scrub Typhus

The pelvic ganglia provide autonomic innervations to the various urogenital organs, such as the urinary bladder, prostate, and penis. It is well established that both sympathetic and parasympathetic synaptic transmissions in autonomic ganglia are mediated mainly by acetylcholine (ACh). Until now, however, the properties of ACh-induced currents and its receptors in pelvic ganglia have not clearly been elucidated. In the present study, biophysical characteristics and molecular nature of nicotinic acetylcholine receptors (nAChRs) were studied in sympathetic and parasympathetic major pelvic ganglion (MPG) neurons. MPG neurons isolated from male rat were enzymatically dissociated, and ionic currents were recorded by using the whole cell variant patch clamp technique. Total RNA from MPG neuron was prepared, and RT-PCR analysis was performed with specific primers for subunits of nAChRs. ACh dose-dependently elicited fast inward currents in both sympathetic and parasympathetic MPG neurons (EC50; 41.4microliterM and 64.0microliterM, respectively). ACh-induced currents showed a strong inward rectification with a reversal potential near 0 mV in current-voltage relationship. Pharmacologically, mecamylamine as a selective antagonist for alpha3beta4 nAChR potently inhibited the ACh-induced currents in sympathetic and parasympathetic neurons (IC50; 0.53micrometer and 0.22micrometer, respectively). Conversely, alpha- bungarotoxin, alpha-methyllycaconitine, and dihydro-beta-erythroidine, which are known as potent and sensitive blockers for alpha7 or alpha4beta2 nAChRs, below micromolar concentrations showed negligible effect. RT-PCR analysis revealed that alpha3 and beta4 subunits were predominantly expressed in MPG neurons. We suggest that MPG neurons have nAChRs containing alpha3 and beta4 subunits, and that their activation induces fast inward currents, possibly mediating the excitatory synaptic transmission in pelvic autonomic ganglia.
Acetylcholine ; Animals ; Dihydro-beta-Erythroidine ; Ganglia ; Ganglia, Autonomic ; Ganglion Cysts* ; Humans ; Male* ; Mecamylamine ; Negotiating ; Neurons* ; Penis ; Prostate ; Rats* ; Receptors, Nicotinic ; Reverse Transcriptase Polymerase Chain Reaction ; RNA ; Synaptic Transmission ; Urinary Bladder

No abstract available.
Hepatitis C* ; Interferons* ; Polymyositis*

Krukenberg tumor of the ovary, originally described by Krukenberg as "Fibrosarcoma ovarii mucocellulare carcinomatodes", characterized as an infiltrative mucinous carcinoma of predominant signet-ring cell type, almost metastasize from gastrointestinal tract, is not common tumor. In recent years, we have experienced 2 cases of Krukenberg tumors on both ovaries metastasis from the stomach, and report these cases with brief review of the literatures.
Adenocarcinoma, Mucinous ; Female ; Gastrointestinal Tract ; Krukenberg Tumor* ; Neoplasm Metastasis ; Ovary ; Stomach ; Stomach Neoplasms

BACKGROUND: The emergence of multidrug-resistant, Gram-negative bacteria has resulted in reconsideration of colistimethate sodium (CMS) as a last resort for treatment of such infections. However, acute kidney injury (AKI) may represent a major limiting adverse effect of use of CMS. Early AKI detection in CMS-treated patients can help prevent progression to acute failure and reduce the need of renal replacement therapy. We hypothesized that plasma neutrophil gelatinase-associated lipocalin (NGAL) may be an early biomarker of AKI in CMS-treated patients. MATERIALS AND METHODS: This prospective cohort study included patients aged ≥20 years who received intravenous CMS between March 2014 and November 2015. AKI was defined according to Kidney Disease: Improving Global Outcomes criteria. The primary endpoint was the difference between the average time to AKI onset based on serum creatinine and empirically derived plasma NGAL levels. RESULTS: Among 109 CMS-treated patients, 23 patients (mean age, 61.3 ± 16.1 years; men, 65.2%) were evaluated. Thirteen (56.5%) patients fulfilled the AKI criteria. The mean time to AKI onset based on serum creatinine after CMS initiation was 78.15 ± 30.49 hours. AKI was detected approximately 22 hours earlier using plasma NGAL than when using serum creatinine as an indicator of AKI (P = 0.035). The baseline plasma NGAL level was 264.0 ± 167.3 ng/mL and 192.7 ± 65.3 ng/mL in patients with and without AKI, respectively (P = 0.218). The area under the curve for plasma NGAL level at 56 hours was 0.796 (95% confidence interval, 0.609–0.983; P = 0.017), with a sensitivity and specificity of 69.2% and 90.0%, respectively (cutoff value, 285 ng/mL). CONCLUSION: NGAL level was found to be a strong predictor of AKI. This study provides additional evidence of the utility of NGAL for AKI in patients with treated CMS. Plasma NGAL represent sensitive and specific predictive early biomarkers for AKI in patient treated CMS.
Acute Kidney Injury* ; Biomarkers ; Cohort Studies ; Creatinine ; Gram-Negative Bacteria ; Health Resorts ; Humans ; Kidney Diseases ; Lipocalins* ; Male ; Neutrophils* ; Plasma ; Prospective Studies ; Renal Replacement Therapy ; Sensitivity and Specificity ; Sodium*

BACKGROUND: The emergence of multidrug-resistant, Gram-negative bacteria has resulted in reconsideration of colistimethate sodium (CMS) as a last resort for treatment of such infections. However, acute kidney injury (AKI) may represent a major limiting adverse effect of use of CMS. Early AKI detection in CMS-treated patients can help prevent progression to acute failure and reduce the need of renal replacement therapy. We hypothesized that plasma neutrophil gelatinase-associated lipocalin (NGAL) may be an early biomarker of AKI in CMS-treated patients. MATERIALS AND METHODS: This prospective cohort study included patients aged ≥20 years who received intravenous CMS between March 2014 and November 2015. AKI was defined according to Kidney Disease: Improving Global Outcomes criteria. The primary endpoint was the difference between the average time to AKI onset based on serum creatinine and empirically derived plasma NGAL levels. RESULTS: Among 109 CMS-treated patients, 23 patients (mean age, 61.3 ± 16.1 years; men, 65.2%) were evaluated. Thirteen (56.5%) patients fulfilled the AKI criteria. The mean time to AKI onset based on serum creatinine after CMS initiation was 78.15 ± 30.49 hours. AKI was detected approximately 22 hours earlier using plasma NGAL than when using serum creatinine as an indicator of AKI (P = 0.035). The baseline plasma NGAL level was 264.0 ± 167.3 ng/mL and 192.7 ± 65.3 ng/mL in patients with and without AKI, respectively (P = 0.218). The area under the curve for plasma NGAL level at 56 hours was 0.796 (95% confidence interval, 0.609–0.983; P = 0.017), with a sensitivity and specificity of 69.2% and 90.0%, respectively (cutoff value, 285 ng/mL). CONCLUSION: NGAL level was found to be a strong predictor of AKI. This study provides additional evidence of the utility of NGAL for AKI in patients with treated CMS. Plasma NGAL represent sensitive and specific predictive early biomarkers for AKI in patient treated CMS.
Acute Kidney Injury* ; Biomarkers ; Cohort Studies ; Creatinine ; Gram-Negative Bacteria ; Health Resorts ; Humans ; Kidney Diseases ; Lipocalins* ; Male ; Neutrophils* ; Plasma ; Prospective Studies ; Renal Replacement Therapy ; Sensitivity and Specificity ; Sodium*

Shigellosis may mimic acute appendicitis clinically, but Shigella species rarely cause appendicitis. We experienced acute appendicitis with perforation caused by Shigella sonnei in a 24-year-old woman who had traveled abroad.
Appendicitis ; Dysentery, Bacillary ; Female ; Humans ; Hydrazines ; Shigella ; Shigella sonnei ; Young Adult

We report on two cases of pericentric inversion of X chromosome. The cases were found in a 40-year- old man with azoospermia and in a family of a 38-year-old pregnant woman. The first case with 46,Y,inv(X)(p22.1q27) had concentrations of LH, prolactin, estradiol, and testosterone that were within normal ranges; however, FSH levels were elevated. Testis biopsy revealed maturation arrest at the primary and secondary spermatocytes without spermatozoa. There were no microdeletions in the 6 loci of chromosome Y. For the second case, the cytogenetic study of the pregnant woman referring for advanced maternal age and a family history of inversion X chromosome was 46,X,inv(X)(p22.11q27.2). The karyotype of her fetus was 46,X,inv(X)(p22.1q27). Among other family members, the karyotypes of an older sister in pregnancy and her fetus were 46,X,inv(X)(p22.11q27.2), and 46,Y,inv(X), respectively. The proband's father was 46,Y,inv(X)(p22.11q27.2). All carriers in the family discussed above were fertile and phenotypically normal. In addition, the ratio of inactivation of inv(X) by RBG-banding was discordant between the two sisters, with the older sister having only 4.1% of cells carrying inactivated inv(X) while the proband had a 69.5% incidence of late replicating inv(X). Therefore, we suggest that the cause of azoospermia in the first case might be related to inversion X chromosome with positional effect. Also, the family of the second case showing normal phenotype of the balanced inv(X) might be not affected any positional effect of genes.
Adult ; Azoospermia ; Biopsy ; Cytogenetics ; Estradiol ; Fathers ; Female ; Fetus ; Humans ; Incidence ; Karyotype ; Lifting ; Male ; Maternal Age ; Phenotype ; Pregnancy ; Pregnant Women ; Prenatal Diagnosis ; Prolactin ; Siblings ; Spermatocytes ; Spermatozoa ; Testis ; Testosterone ; X Chromosome