BACKGROUND/AIMS: To use serological and multiplex polymerase chain reaction (PCR) assays to examine sputum samples from patients experiencing acute exacerbation of chronic obstructive pulmonary disease (AECOPD) for the presence of atypical pathogens, including Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila. METHODS: From September 2012 to February 2014, 341 patients with AECOPD attending outpatient clinics were enrolled as part of a randomized, double-blind, multicenter study. A commercial enzyme-linked immunosorbent assay was used to measure serum immunoglobulin M (IgM) and IgG antibody titers on the first day of the study and at 36 days post-enrollment. Multiplex PCR was used to test sputum samples for the presence of atypical pathogens. A urinary antigen test for L. pneumophila was performed on the first day. RESULTS: Nineteen patients (5.6%) showed serological evidence of acute infection with M. pneumoniae. Also, one and seven patients (2%) showed serological evidence of acute infection with C. pneumoniae and L. pneumophila, respectively. All DNA samples were negative for M. pneumoniae, C. pneumoniae, and L. pneumophila according to PCR. Only one urine sample was positive for L. pneumophila antigen, but serologic evidence was lacking. CONCLUSIONS: Serological testing suggested that infection by atypical pathogens during AECOPD was relatively uncommon. In addition, PCR provided no direct evidence of infection by atypical pathogens. Thus, atypical pathogens may not be a major cause of AECOPD in South Korea.
Ambulatory Care Facilities ; Chlamydophila pneumoniae ; DNA ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Legionella pneumophila ; Multiplex Polymerase Chain Reaction ; Mycoplasma pneumoniae ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction* ; Pulmonary Disease, Chronic Obstructive* ; Serologic Tests ; Sputum

PURPOSE: This study aimed to identify factors affecting cognitive function in stomach cancer patients. METHODS: This was a cross-sectional study designed to obtain data from stomach cancer patients. The Global Assessment of Recent Stress, Hospital Anxiety-Depression Scale, Distress Thermometer, Korean version of the Montreal Cognitive Assessment, and electronic medical records were used to assess stress, anxiety, depression, psychological distress, and cognitive function, respectively. RESULTS: Among 182 total participants, there were statistically significant differences in sex between the group of patients who received chemotherapy and those who did not (χ2=5.32, p=.029). There were statistically significant differences in stress and cognitive function between the two groups. The factors affecting cognitive function in stomach cancer patients included distress, stress, anxiety, and depression. CONCLUSION: Cognitive function should be examined with consideration of the psychological distress, stress, anxiety, and depression in patients with stomach cancer. Moreover, an improved program to manage cognitive function is needed, which includes mediation between psychological and physiological factors including stress, anxiety, and cognitive level.
Anxiety ; Cognition* ; Cross-Sectional Studies ; Depression ; Drug Therapy ; Electronic Health Records ; Humans ; Negotiating ; Stomach Neoplasms* ; Stomach* ; Stress, Psychological ; Thermometers

OBJECTIVE: This study aimed to investigate the adolescent brain activation patterns in response to performance feedback (PF), social reward (SR) and monetary reward (MR) and their association with psychological factors. METHODS: Functional magnetic resonance imaging (fMRI) was performed while middle school boys (n=15) performed tests pertained to PF, SR and MR. The brain activation pattern in each condition was investigated, and the extent of brain activation in each of the three conditions was compared at once. RESULTS: The caudate and the dorsal prefrontal area were activated in all three conditions. Furthermore, the cuneus showed significantly greater activation in the PF condition than the SR or MR condition. And the self - related areas, such as the right precentral gyrus and paracenral lobule, were more activated in the SR condition than the PF or MR condition. The left middle frontal gyrus was more activated in the MR condition than the PF or SR condition. CONCLUSION: Not only various reward stimuli but also feedback stimulus might commonly activate dorsal prefrontal and subcortical area in adolescents. Moreover, several different brain activation patterns were also observed in each condition. The results of this study could be applied to planning of learning and teaching strategy for adolescents in various ways.
Adolescent ; Brain ; Humans ; Learning ; Magnetic Resonance Imaging ; Reward

OBJECTIVES: This study compared covert narcissistic propensity in adolescents with internet addiction tendency to normal adolescents. Further, we investigated the correlation between such propensities and anonymity in cyberspace, presence feeling and interactivity in internet gaming, and achievement motivation in adolescents with internet addiction tendencies. METHODS: Male middle school students with internet addiction tendencies (Addiction Tendency Group, N=27) and normal students (Control Group, N=29) were recruited. The scale of internet use, Covert Narcissism Scale, scale of achievement motivation, scale of anonymity in cyberspace, scale of presence feeling in internet games, and the scale of interactivity in internet games were administered. A comparison of the average scores and correlation analyses were performed. RESULTS: 1) Compared with Control Group, the Addiction Tendency Group showed significantly higher scores on all subscales of the Covert Narcissism Scale, and both the scale of presence feeling and that of interactivity in internet games. Further, the score on the scale of achievement motivation for the Addiction Tendency Group was significantly lower than that of the Control Group. 2) In the Addiction Tendency Group, the scores on several subscales of the Covert Narcissism Scale were significantly positively correlated with the scores on the scale of presence feeling in internet games, anonymity in cyberspace, and interactivity in internet games. However, in the Control Group, the scores of several subscales on the Covert Narcissism Scale were significantly negatively correlated with the score on the scale of achievement motivation, and was significantly positively correlated with the score on the scale of interactivity in internet games. There were no other significant correlations between the scores on the subscales of the Covert Narcissism Scale and the scores of either presence feeling in internet games or anonymity in cyberspace. CONCLUSION: These results suggested that adolescents with a tendency to be addicted to the internet exhibited higher covert narcissistic propensities than normal adolescents and that the covert narcissistic tendencies were related with presence feeling in cyber games as well as with anonymity in cyberspace.
Achievement ; Adolescent ; Anonyms and Pseudonyms ; Humans ; Internet ; Male ; Motivation ; Narcissism

OBJECTIVE: This preliminarily study was designed to determine and to compare the efficacy of two commercially available barium-based fecal tagging agents for CT colonography (CTC) (high-density [40% w/v] and low-density [4.6% w/v] barium suspensions) in a population in Korea. MATERIALS AND METHODS: In a population with an identified with an average-risk for colorectal cancer, 15 adults were administered three doses of 20 ml 40% w/v barium for fecal tagging (group I) and 15 adults were administered three doses of 200 ml 4.6% w/v barium (group II) for fecal tagging. Excluding five patients in group I and one patient in group II that left the study, ten patients in group I and 14 patients in group II were finally included in the analysis. Two experienced readers evaluated the CTC images in consensus regarding the degree of tagging of stool pieces 6 mm or larger. Stool pieces were confirmed with the use of standardized CTC criteria or the absence of matched lesions as seen on colonoscopy. The rates of complete fecal tagging were analyzed on a per-lesion and a per-segment basis and were compared between the patients in the two groups. RESULTS: Per-lesion rates of complete fecal tagging were 52% (22 of 42; 95% CI, 37.7-66.6%) in group I and 78% (28 of 36; 95% CI, 61.7-88.5%) in group II. The difference between the two groups did not reach statistical significance (p = 0.285). The per-segment rates of complete tagging were 33% (6 of 18; 95% CI, 16.1%-56.4%) in group I and 60% (9 of 15; 95% CI, 35.7%-80.3%) in group II; again, the difference between the two groups did not reach statistical significance (p = 0.171). CONCLUSION: Barium-based fecal tagging using both the 40% w/v and the 4.6% w/v barium suspensions showed moderate tagging efficacy. The preliminary comparison did not demonstrate a statistically significant difference in the tagging efficacy between the use of the two tagging agents, despite the tendency toward better tagging with the use of the 4.6% w/v barium suspension.
Administration, Oral ; Adult ; Barium/administration & dosage/*diagnostic use ; Colon/radiography ; *Colonography, Computed Tomographic/methods ; Colonoscopy ; Colorectal Neoplasms/diagnosis/radiography ; Contrast Media/*administration & dosage ; *Feces ; Female ; Humans ; Male ; Middle Aged ; Suspensions

BACKGROUND AND OBJECTIVES: Diffuse coronary artery disease presents physicians with a therapeutic challenge. The results after the use of bare metal stents (BMS) are limited by the high rate of restenosis. The introduction of drugeluting stent (DES) has prompted interventional cardiologists to treat long diffuse lesions with multiple overlapping stents. The purpose of this study is to determine the safety and efficacy of using multiple overlapping DESs for patients with diffuse coronary artery disease. SUBJECTS AND METHODS: From Jan. 2002 to Dec 2004, 83 consecutive patients suffering with diffuse coronary artery disease who underwent stent implantation with a minimum of 50 mm long BMSs or DESs were analyzed. The patients who had overlapping stents for dissection without diffuse lesion or they had BMS with overlapping DES were excluded from the study. The patients were divided into two group, the BMS group (group I: 29 patients, 63.0+/-8.2 years) and the DES group (group II: 56 patients, 60.6+/-9.3 years). The major adverse cardiac events (MACE), including death, myocardial infarction (MI), target vessel revascularization (TVR) and coronary artery bypass grafting (CABG), were examined. RESULTS: The mean number of stents implanted was 2.19+/-0.4 in group I and 2.08+/-0.2 in group II, whereas the total mean length of the stents was 61.5+/-9.3 mm in group I and 61.4+/-9.1 mm in group II (p=NS). Procedural success was achieved for 89.7% of the patients in group I and for 96.3% of the patients in group II. No acute stent thrombosis was observed in both groups. All the patients underwent clinical follow-up (mean follow-up: 15+/-8.9 months, range: 7-36 months), and 66.2 % had an angiographic follow-up done at six months. During the follow-up, MACE was the cause of two deaths; there were thirteen TVRs and one CABG in group I, and there was one MI and five TVRs in group II. The TVR rate was lower in group II compared with group I (44.8% vs. 9.3%, respectively; p<0.001). Late stent thrombosis developed for one patient in group II. CONCLUSION: The implantation of overlapping DESs in patients with diffuse coronary artery disease is safe and this treatment is associated with better clinical outcomes than that with using BMS.
Coronary Artery Bypass ; Coronary Artery Disease* ; Coronary Disease ; Coronary Restenosis ; Coronary Vessels* ; Drug-Eluting Stents* ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Stents ; Thrombosis

Purpose: Paclitaxel is an anticancer drug that blocks cell division by stabilizing microtubules. Even though paclitaxel has been shown to be effective in killing bladder cancer cell lines in vitro, the in vivo absorption was extremely low. A paclitaxel formulation was prepared in solution only, which was bioadhesive, and its effects evaluated in the MBT-2 cell line and in C3H2 bladder cancer mice. In addition, the toxicity of the paclitaxel formulation was also evaluated. Materials and Methods: A muco-adhesive oily paclitaxel formulation was made by the combining of monoolein, tricaprylin, Tween 80 and paclitaxel. MBT-2 cells were cultivated in different concentration of taxol, and the tumoricidal activity measured by the indirect methylthiazol-2-yl-2, 5-diphenyl tetrazolium bromide (MTT) assay. In an in vivo study, the treatment regimen for the s.c. C3H2 mice was five consecutive once daily administrations, beginning on day 4 post tumor implant. The length and width of the tumors were measured twice a week, and the tumor volume calculated. On day 21, the tumor volume change and toxicity were evaluated. Results: The average particle size of paclitaxel-loaded lipid nanoparticle was about 600nm, with a polydispersity of 1,000. Only 2.6% of the MBT-2 cells were viable after 24 hour of treatment with the formulation at a paclitaxel concentration of 10mug/ml, while showing minimal toxicity of the formulation without paclitaxel. Paclitaxel-loaded lipid nanoparticles, administered orally, allowed significant antitumor activity in C3H2 mice (p<0.05). Conclusions: Paclitaxel-loaded lipid nanoparticles have a remarkable cytotoxic effect against MBT-2 cells, in a dose dependent manner, and the oral paclitaxel-loaded lipid nanoparticle therapy had an inhibitory effect on bladder tumors in a MBT-2 model, but without systemic toxicity. Therefore, oral paclitaxel-loaded lipid nanoparticles may be used for advanced bladder cancer patients.
Absorption ; Animals ; Cell Division ; Cell Line ; Homicide ; Humans ; Mice* ; Microtubules ; Nanoparticles* ; Paclitaxel ; Particle Size ; Polysorbates ; Tumor Burden ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: To evaluate the genetic factor in development of comitant strabismus. METHODS: We retrospectively reviewed 48 patients of 24 twins classified into monozygotic or dizygotic twin and analyzed gestational period and birth weight, refraction, phenotype and age of onset, amount of deviation, surgical history, and associated systemic or other ocular anomaly except strabismus. RESULTS: Seventeen of the 24 twins (70.8%) showed phenotypic concordance. The concordance was significantly higher in monozygotic twins (15 of the 18 pairs, 83.3%) than in dizygotic twins (2 of the 6 pairs, 33.3%) (p=0.038). Out of 15 twins with monozygosity who showed concordance, the predominant phenotype was intermittent exotropia (9 pairs, 60.0%). Concordance rate according to phenotype was high in refractive or nonrefractive accommodative esotropia (3 of the 3 pairs, 100.0%) and intermittent exotropia (9 of the 10 pairs, 90.0%). Most of concordant pairs showed similarity in age of onset and amount of deviation between first and second child. CONCLUSIONS: The concordance rate in monozygotic twin was high, especially in refractive or nonrefractive accommodative esotropia and intermittent exotropia, and therefore genetic factor can be responsible for the development of these types of strabismus.
Age of Onset ; Birth Weight ; Child ; Esotropia ; Exotropia ; Humans ; Phenotype ; Retrospective Studies ; Strabismus* ; Twins* ; Twins, Dizygotic ; Twins, Monozygotic

PURPOSE: Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. METHODS: We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. RESULTS: Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. CONCLUSION: Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.
Continuous Positive Airway Pressure ; Gestational Age ; Humans ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Intubation, Intratracheal ; Mortality ; Parturition ; Retrospective Studies ; Ventilation ; Ventilators, Mechanical*

PURPOSE: This study was conducted for the use of nasal continuous positive airway pressure (CPAP), by comparing the early use of non-invasive nasal CPAP with low intermittent mandatory ventilation(low IMV) and endotracheal CPAP in weaning a mechanical ventilator from infants with moderate respiratory distress syndrome(RDS). METHODS: Thirty infants in the study group, with moderate RDS from November 2001 to June 2002, were administered surfactants and treated with the mechanical ventilator, and applied the nasal CPAP in weaning. Thirty infants of the control group, from January 1999 to September 2001, were applied low IMV and endoctracheal CPAP in weaning. RESULTS: There were no significant differences in the characteristics, the severity of clinical symptoms, the initial laboratory findings and settings of the mechanical ventilator. After weaning, the study group showed no significant changes in PaCO2. However, the control group showed a slight CO2 retension after one and 12 hours. Twenty eight infants(93.3%) of the study group and 24 infants(80%) of the control group were successfully extubated. The primary cause of failure was apnea. There were no significant differences in the duration of weaning and the mechanical ventilator treatment between the groups. Complications in weaning were related to the fixation of nasal CPAP and the mechanical problems caused by endotracheal tube. CONCLUSIONS: Aggressive weaning is possible for moderate RDS, in which the nasal CPAP was used without the low IMV and the endotracheal CPAP process. It had no difficulties. In conclusion, the nasal CPAP is an adequate weaning method for moderate RDS.
Apnea ; Continuous Positive Airway Pressure ; Humans ; Infant ; Surface-Active Agents ; Ventilators, Mechanical* ; Weaning*