Transurethral resection is frequently performed urologic operation for benign prostate hypertrophy, prostate cancer, bladder cancer. During transurethral resection, urologists generally use room temperature irrigation fluid, and there is a chance that patients will run into hypothermia. Hypothermia may lead to arrhythmia, reduction of cardiac output, coagulation disorder, metabolic acidosis, and further serious life threatening complications. This case describes a sudden drop in core temperature due to bladder perforation and intraperitoneal leakage of irrigation fluid during transurethral resection of bladder tumor.
Acidosis ; Arrhythmias, Cardiac ; Cardiac Output ; Humans ; Hypertrophy ; Hypothermia ; Prostate ; Prostatic Neoplasms ; Urinary Bladder ; Urinary Bladder Neoplasms

Transurethral resection is frequently performed urologic operation for benign prostate hypertrophy, prostate cancer, bladder cancer. During transurethral resection, urologists generally use room temperature irrigation fluid, and there is a chance that patients will run into hypothermia. Hypothermia may lead to arrhythmia, reduction of cardiac output, coagulation disorder, metabolic acidosis, and further serious life threatening complications. This case describes a sudden drop in core temperature due to bladder perforation and intraperitoneal leakage of irrigation fluid during transurethral resection of bladder tumor.
Acidosis ; Arrhythmias, Cardiac ; Cardiac Output ; Humans ; Hypertrophy ; Hypothermia ; Prostate ; Prostatic Neoplasms ; Urinary Bladder ; Urinary Bladder Neoplasms

Dubowitz syndrome is a rare autosomal recessive disorder that leads to growth retardation (intrauterine, postnatal), mental retardation, a peculiar face, microcephaly, behavioral problems and eczema. The peculiar face of individuals with Dubowitz syndrome includes sparse hair and eyebrows, low-set ears, blepharophimosis, bilateral ptosis, a flat nasal bridge with a broad nasal root and micrognathia. Airway management of such individuals might be difficult due to craniofacial anomalies, such as micrognathia, cleft palate, tooth problems and craniocervical anomalies. In addition, anesthetic management may be complicated by other systemic illnesses. We report the uneventful anesthetic management of a 16-year-old girl with Dubowitz syndrome who underwent a total abdominal hysterectomy after a pelvic examination under general anesthesia. We report this case of Dubowitz syndrome with a review of the relevant literature.
Adolescent ; Airway Management ; Anesthesia ; Anesthesia, General ; Blepharophimosis ; Cleft Palate ; Ear ; Eczema ; Eyebrows ; Facies ; Growth Disorders ; Gynecological Examination ; Hair ; Humans ; Hysterectomy ; Intellectual Disability ; Microcephaly ; Tooth

Purpose: Histone deacetylase inhibitors (HDACis) are epigenetic regulators and used clinically for hematopoietic malignancies. Recently, HDACis have received attention as a factor that modulates the immune system. In this study, the role of histone deacetylase (HDAC) expression as a predictive marker in lung cancer patients who were treated with immune checkpoint inhibitors (ICIs) and the role of HDACi and ICI combination treatment in the mouse tumor model were analyzed. Materials and Methods: The overall response rate (ORR) and progression-free survival (PFS) were analyzed by the expression of HDAC. In vitro assay, the mRNA and protein expression levels of cytokines and programmed death-ligand 1 (PD-L1) were analyzed after HDACi treatment. In vivo assay, TC-1 tumor-bearing mice were treated with HDACi and mouse programmed cell death 1 (PD-1) inhibitor. Results: The HDAC6 low expression group showed high ORR and prolonged PFS. When the selective HDAC6 inhibitor was administered to the A549 cell line, the levels of interleukin-1β and interleukin-6 decreased and the expression of PD-L1 was reduced. Mice that received both the mouse PD-1 inhibitor and pan-HDACi had a smaller tumor size than that of the mice from the control group. Moreover, mice treated with the mouse PD-1 inhibitor and pan-HDACi generated greater numbers of E7-specific CD8+ T cells. Conclusion HDAC6 expression can predict the prognosis of non–small cell lung cancerpatients who were treated with ICIs. Furthermore, co-treatment with HDACi and PD-1 inhibitor was shown to decrease the tumor growth rate and create a favorable tumor microenvironment for cytotoxic T lymphocytes in the TC-1 mouse model.

OBJECTIVE: Personality is defined as the trait-like qualities of a person. However, it has been recently suggested that the state effect of a situation leads to changes in scores on personality assessments. We predicted that traumatic experiences would induce changes not only in personality scores but also in the factor structures of personality assessments. METHODS: MethodsaaWe conducted a cross-sectional, case-controlled study using two data sets: a traumatized adolescent sample (n=71) and a non-traumatized adolescent sample (n=296). Personality factor structures were compared between the two samples using exploratory factor analyses for 25 lower-ordered subscales of the Temperament and Character Inventory (TCI). In the non-traumatized sample, evaluation of the scree plot suggested a five-factor solution supporting TCI's original seven-factor model. RESULTS: The traumatized sample showed a three-factor structure representing a biological factor, a social factor and an existential factor. This decrease in number of personality factors was caused by strengthened correlations among personality subscales related to coping with traumatic situations. Cloninger's psychobiological model of personality (i.e., temperament-character) was adequate in capturing personality traits of non-traumatized adolescents, but the tripartite view of existential psychology (i.e., body-mind-spirit) clearly corresponded to the factor structure of the traumatized adolescents. CONCLUSION: The three-factor solution of the present traumatized group is consistent with the tripartite model of personality (i.e., body-mind-spirit), while the five-factor solution of the non-traumatized group corresponds to Cloninger's seven-factor model. This is the first study to describe the state effects of traumatic experiences on personality structure.
Adolescent ; Biological Factors ; Case-Control Studies ; Existentialism ; Humans ; Personality Assessment ; Temperament

OBJECTIVE: Easy triggering of trauma-related episodic memory fragments caused by perceptual cues is tied to strong perceptual priming in the implicit memory system. And among benzodiazepines, only lorazepam has been consistently reported to have an atypical suppression effect on perceptual priming processes. The aim of this study was to investigate the effects of single doses of lorazepam, diazepam, and a placebo on intrusive memories after exposure to a distressing videotape and to explore whether the anti-intrusive effect of lorazepam is acquired as a result of the suppression of perceptual but not conceptual priming processes. METHODS: Under prospective, randomized, and double-blind conditions, we compared the anti-intrusion effect of a single dose of lorazepam (n=22) with that of diazepam (n=22) and a placebo (n=21) in young healthy Korean college students following exposure to a traumatic videotape. RESULTS: We present the first finding for an anti-intrusion effect of lorazepam. One day after the medication, lorazepam, rather than diazepam or the placebo, significantly reduced the extent of intrusion and data-driven processing of the traumatic information. There were no differences among the three conditions in state anxiety, depression, and an arousal scale throughout the experiment. CONCLUSION: Results from this study suggest the possibility of lorazepam as a candidate anti-intrusion drug, as well as the cautious use of diazepam in the treatment of PTSD patients. The anti-intrusive effect of lorazepam is directly related to its atypical inhibitory effect on implicit perceptual priming processes. The present study provides support for the enhanced perceptual priming hypothesis of PTSD.
Benzodiazepines ; Cues ; Diazepam ; Humans ; Lorazepam* ; Memory ; Memory, Episodic ; Prospective Studies ; Stress Disorders, Post-Traumatic ; Videotape Recording

PURPOSE: This report describes the results of a survey of the characteristics of pertussis in children from a single institution and compares it to data from the Korea Centers of Disease Control (KCDC). METHODS: We retrospectively evaluated the medical records of 17 and 6 patients diagnosed with pertussis and parapertussis, respectively, at Soonchunhyang University Bucheon Hospital from January 2005 to January 2017. RESULTS: Of the 17 patients with pertussis, 9 were under 1 year of age (52.9%), 3 were aged between 1 and 10 years (17.6%), and 5 were over 10 years of age (29.4%). Seven patients (41.2%) had never received diphtheria-tetanus-acellular pertussis vaccines, of which 5 were infants below 2 months of age and 2 were 10 years old and lived in China. Four patients showed the initial symptoms of cough in China. The sources of infection were the parents (2 cases) and the siblings (8 cases). All patients showed prolonged severe cough and the average duration of cough was 26 days. Severe symptoms, including dyspnea, cyanosis, apnea, and seizures, were observed in the children under 2 months of age. According to the recent 10-year KCDC data, the highest rate of pertussis diagnosis was noted in infants (47.8%), followed by adolescents (18.7%). Six patients with parapertussis also presented with prolonged severe cough without any other severe symptoms. Lymphocytosis was not found, unlike the patients with pertussis. CONCLUSION: The possibility of pertussis and parapertussis should be considered among patients with prolonged severe cough, especially in infants and adolescents.
Adolescent ; Apnea ; Bordetella parapertussis ; Bordetella pertussis ; Child ; China ; Cough ; Cyanosis ; Diagnosis ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Dyspnea ; Gyeonggi-do ; Humans ; Infant ; Korea ; Lymphocytosis ; Medical Records ; Parents ; Retrospective Studies ; Seizures ; Siblings ; Whooping Cough

The percutaneous placement of a totally implantable vascular access port via the subclavian vein is commonly used in patients with a need for multiple intravenous infusions such as administration of chemotherapy. Unfortunately, the use of central venous ports have been associated with adverse events that are hazardous to patients. Here we report the case of a 5-year-old child who died of catastrophic hemothorax after several attempts at insertion of an implantable subclavian venous access device and removal of an infected port. Massive hemothorax occurred on the side contralateral to unsuccessful attempts at insertion of a new port and ipsilateral to the removal of an infected port. We could not confirm the cause of death and hemothorax without autopsy, but we discuss several possible causes of massive hemothorax.
Autopsy ; Cause of Death ; Child ; Hemothorax ; Humans ; Infusions, Intravenous ; Preschool Child ; Subclavian Vein ; Vascular Access Devices

The aim of this study was to investigate the effects of antidepressant treatment on serum cytokines and nutritional status in hemodialysis patients. Twenty-eight hemodialysis patients with a depressed mood were given 20 mg of fluoxetine for 8 weeks. The degree of depressive symptoms, the serum levels of interleukin-1beta, interleukin- 2, interleukin-6, tumor necrosis factor-alpha, c-reactive protein, and markers of nutritional status were assessed at baseline and after treatment. The outcome was assessed in terms of response to treatment (>50% reduction in the score of the Hamilton depression rating scale). Antidepressant treatment decreased the serum level of interleukin- 1 in both response and nonresponse groups, and increased the serum level of interleukin-6 only in the response group. At baseline, the level of interleukin-6 in the response group was lower than in the nonresponse group. Antidepressant treatment also increased fat distribution significantly in the response group which might have slightly improved the nutritional status. This study suggests that antidepressant treatment improve depressive symptoms and may affect immunological functions and nutritional status in chronic hemodialysis patients with depression.
Adult ; Antidepressive Agents, Second-Generation/*pharmacology ; C-Reactive Protein/biosynthesis ; Cytokines/*blood ; Depression/*drug therapy ; Electric Impedance ; Female ; Fluoxetine/*pharmacology ; Human ; Interleukin-1/blood ; Interleukin-2/blood ; Interleukin-6/blood ; Male ; Middle Aged ; Nutrition ; Renal Dialysis/*methods ; Support, Non-U.S. Gov't ; Treatment Outcome ; Tumor Necrosis Factor/biosynthesis

OBJECTIVE: The authors examined the genetic effect of DRD2 Taq I polymorphism to the smoking in the Korean schizophrenics. Also this study examined molecular heterosis and gender difference in the genetic effect to smoking in schizophrenics. METHODS: The study subjects were composed of 167 schizophrenic patients, 96 smokers and 71 non-smokers. DRD2 Taq I RFLP genotyping was carried out with DNA extracted from subjects' blood samples. RESULTS: Among the total schizophrenics, the smokers were not significantly different from the non-smokers in respect to the frequency and prevalence of A1 allele, the genotype distribution, or frequency of heterozygotes. In male schizophrenics, genotype distribution of smoking patients differed significantly from non-smoking patients(p=0.010), with a higher prevalence of A1 allele (p=0.020) and frequency of heterozygotes(p=0.005). In male schizophrenics, A1A2 heterozygotes showed significantly higher smoking rate than A1A1 or A2A2 homozygotes and non-smokers were deficient in heterozygotes. The deviation from Hardy-Weinberg expectations was observed in male and female non-smokers with opposite directions. Moreover, highly significant differences were seen between male and female non-smokers in A1 prevalence(p=0.001), genotype distribution(p<0.00011), and frequency of heterozygotes(p<0.00003). CONCLUSION: No significant difference between smokers and non-smokers in the genotype distributions of the total sample could be explained by the gender difference in the genetic effect of DRD2 A1 allele to the smoking with opposite directions. Our findings support molecular heterosis at the DRD2 gene.
Alleles ; DNA ; Dopamine* ; Female ; Genotype ; Heterozygote ; Homozygote ; Humans ; Hybrid Vigor ; Male ; Nicotine ; Polymorphism, Restriction Fragment Length ; Prevalence ; Receptors, Dopamine D2* ; Schizophrenia* ; Smoke* ; Smoking*