Efficient management of human tissue samples is a critical issue; the supply of samples is unable to satisfy the current demands for research. Lack of informed consent is also an ethical problem. One of the goals of the 2012 revision of Korea's Bioethics and Safety Act was to implement regulations that govern the management of human tissue samples. To remain competitive, medical institutions must prepare for these future changes. In this report, we review two tissue management models that are currently in use; model 1 is the most common system utilized by hospitals in Korea and model 2 is implemented by some of the larger institutions. We also propose three alternative models that offer advantages over the systems currently in use. Model 3 is a multi-bank model that protects the independence of physicians and pathologists. Model 4 utilizes a comprehensive single bioresource bank; although in this case, the pathologists gain control of the samples, which may make it difficult to implement. Model 5, which employs a bioresource utilization steering committee (BUSC), is viable to implement and still maintains the advantages of Model 4. To comply with the upcoming law, we suggest that physicians and pathologists in an institution should collaborate to choose one of the improved models of tissue management system that best fits for their situation.
*Bioethics ; Biomedical Research/*legislation & jurisprudence ; Humans ; Models, Biological ; Republic of Korea

Estriol excreation was studied in 216 normal and 61 pathologic pregnancies. The 95% fiducial limits of the normal excretion of estriol, within which 95% out of 100 future determinations in normal pregnancies are expected to fall, were established. The estriol curve in normal pregnancy in this study agrees well in its general shape with those presented by previous investigators who used different chemical methods of determination. The estriol values in pathologic pregnancies with preeclampsia. intrauterine fetal death and antepartum hemorrage have been analyzed. The clinical significance of estriol determinations during pregnancy was discussed.
Estriol/urine* ; Female ; Fetal Death/urine ; Human ; Pre-Eclampsia/urine ; Pregnancy* ; Pregnancy Complications/urine* ; Uterine Hemorrhage/urine

PURPOSE: Diffusion-weighted magnetic resonance imaging (DWI) has been known to visualize hyperacute ischemic stroke. And it takes only a few minutes to do. Moreover only a small amount of time and little cost is required to add T2-weighted imaging (T2WI) to DWI. The purpose of this study is to determine the usefulness of T2WI in addition to DWI as a primary imaging modality for patients with suspected ischemic stroke. METHODS: DWI plus T2WI was performed from January to May 2001 on the patients with suspected ischemic stroke. Two emergency physicians reviewed the films and medical records. The sensitivity and the specificity of DWI and T2WI for acute ischemic stroke were calculated. The agreement between DWI and T2WI was calculated using kappa statistics. RESULTS: A total of 241 patients were enrolled. Acute ischemic stroke was confirmed in 86 (35.7%) patients. The sensitivity and the specificity of DWI for acute ischemic stroke were 94.2% and 98.7%, and those for T2WI were 60.5% and 94.2%, respectively. The kappa value was 0.721 (p<0.01). Among the 86 acute ischemic stroke patients, the number of cases who presented less than 6 hours after symptom onset was significantly lower in the T2WI positive group (31% vs. 68.7%, p<0.05). CONCLUSION: This study suggests that the addition of T2WI to DWI as a primary imaging modality for acute ischemic stroke has little benefit compared to DWI alone, especially, when the symptom duration has been less than 6 hours.
Emergencies ; Humans ; Magnetic Resonance Imaging* ; Medical Records ; Sensitivity and Specificity ; Stroke*

Congenital diverticula of the cardiac ventricle have been reported as arising either from the left ventricule or, rarely from both ventricules. A diverticulum arising from the right ventricle alone is very rare. Double chambered right ventricle(DCRV) was first described in 1962 by Lucas et al, and account for 1.5% of congenital heart disease. Right ventricular diverticulum are associated with right ventricle outlet obstructive disease, tetralogy of fallot, double outlet right ventricle, pulmonic stenosis, ventricular septal defect, left ventricule-right atrium communication, persistant truncus arteriosus. DCRV are freqently associated with ventricular septal defect(80%), pulmonic stenosis(33%), renal anormaly(43%). Treatment consist of suture of diverticulum and resection of septum. We report a case of double chambered right ventricle with congenital right ventricular true diverticulum in 62 years of female patients admitted due to anterior chest pain and mild exertional dyspnea.
Chest Pain ; Diverticulum* ; Double Outlet Right Ventricle ; Dyspnea ; Female ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Heart Ventricles* ; Humans ; Pulmonary Valve Stenosis ; Sutures ; Tetralogy of Fallot ; Truncus Arteriosus

Pyoderma gangrenosum is uncommon neutrophilic dermatosis characterized by richness of the mature neutrophilic polynuclear dermal infiltrate. Pyoderma gangrenosum is associated with variable diseases, most commonly inflammatory bowel disease, hematological diseases, malignancies, but it is reported rarely in rheumatoid arthritis. We report a case of pyoderma gangrenosum in rheumoid arthritis patient. A 50-year-old woman admitted to our hospital due to painful pretibial ulcerative skin lesions. She had been treated as rheumatoid arthritis for 8 years. At admission, body temperature was 36.5degrees C and other vital sign was unremarkable. Physical examination revealed right pretibial ulceration, multiple pustules on left pretibial area and both palms. Laboratory studies revealed WBC count 7,600/uL (neutrophils 60.3%, eosinophil 3.2%), hemoglobin 11.4 g/dL, platelet count 319,000/uL, ESR 65 mm/hour. Other lab findings were also unremarkable. Skin biopsy was done, which showed dense dermal infiltrate of neutrophils and wound culture were negative. By 8 weeks after systemic high dose corticosteroid (1 mg/kg/day), cyclosporine A (5 mg/kg/day), sulfasalazine 2 g therapy, symptoms and skin ulceration were being improved. Without skin relapse, she is followed up our hospital with low dose corticosteroid and sulfasalazine.
Arthritis* ; Arthritis, Rheumatoid ; Biopsy ; Body Temperature ; Cyclosporine ; Eosinophils ; Female ; Hematologic Diseases ; Humans ; Inflammatory Bowel Diseases ; Middle Aged ; Neutrophils ; Physical Examination ; Platelet Count ; Pyoderma Gangrenosum* ; Pyoderma* ; Recurrence ; Skin ; Skin Diseases ; Skin Ulcer ; Sulfasalazine ; Ulcer ; Vital Signs ; Wounds and Injuries

Objective: This study was undertaken to assess the appropriateness of transfer of patients from a long-term care hospital to the emergency department (ED). Methods: We conducted a retrospective study in a Wide Regional Emergency Center in Gyeongsangnam-do between January 2019 and December 2019. The patients were divided into groups (direct visit, transferred from other hospitals, and transferred from long-term care hospitals [LTCHs]). The baseline characteristics, Korean Triage and Acuity Scale (KTAS), vital signs, length of stay, ED disposition, cost, clinical outcome, and instances of application of the “Act on decisions on life-sustaining treatment” were collected. Results: A total of 30,142 patients were enrolled during the study period. Twenty-one thousand, nine hundred and sixty-five patients were in the direct visit group, 7,057 patients were transferred from other hospitals, and 1,120 patients were transferred from LTCHs. Hospital admission was higher in cases of transfer from other hospitals and LTCHs (LTCHs, 63.8%; transferred from other hospitals, 64.1%, direct visit, 30.1%; P<0.001). Re-transfer and mortality in the ED were much higher (re-transfer: LTCHs, 11.0%; transferred from other hospitals 3.8%, direct visit 1.9%; P<0.001 and mortality in ED: 2.9%, 0.8%, 1.4%; respectively P<0.001). In the LCTH group after admission, mortality was higher (mortality: 16.2%, 5.4%, 7.1% for LTCH transfers and direct respectively; P<0.001). The implementation rate of the “Act on decisions on life-sustaining treatment”, the well-dying law, was higher in the LTCHs (26.6%, 12.5%, and 11.4% LTCH transfers, and direct respectively; P<0.001). Conclusion In the LTCH group, re-transfer, mortality, and the implementation rate of the “Act on decisions on life-sustaining treatment” were higher than in the other groups.

Purpose: This study aimed to explore the existing literature on frailty experienced by patients with prostate cancer (PC) receiving androgen deprivation therapy (ADT). Materials and Methods: Database and manual searches were conducted to identify relevant studies published in English, with no limitation on the year of publication, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. Four databases—PubMed, Cochrane Library, EMBASE, and CINAHL—were used for database searches and reference lists, related journals, and Google Scholar were used for manual searches. Results: A total of 12 studies were analyzed for this scoping review. Of these, only 2 were intervention studies, and 1 was a randomized controlled trial. Among the two intervention studies, the multidisciplinary intervention program, including psychological counseling, nutritional coaching, and supervised group physical exercise did not show significant improvement in frailty. In contrast, high-dose vitamin D supplementation significantly decreased frailty. The conceptual and operational definitions of frailty used in each study varied, and the most used one was mainly focused on physical functions. As a result of analyzing the other health-related variables associated with frailty in patients with PC receiving ADT, age, metastases, comorbidities, and incident falls were related to a high frailty level. As for the physiological index, high levels of C-reactive protein, and interleukin-6, and fibrinogen, low levels of total testosterone, lymphocyte count, and creatinine were associated with a high level of frailty. A few studies explored the relationship between psychological and cognitive variables and frailty. Conclusions Further research related to frailty in patients with PC receiving ADT should be conducted, and effective interventions to manage frailty should be developed. Additionally, research that considers not only the physical domain of frailty but also the psychological, cognitive, and social domains needs to be conducted.

PURPOSE: The aim of this study was to determine the allergenicity of soybean by fermentation. METHODS: Non-fermented soybean, fermented soybean by Bacillus subtilis KFCC 11293 and 3-step fermented soybean by Lactococcus lactis subsp. lactis IFO 12007 and Aspergillus oryzae and B. subtilis KFCC 11293 were extracted with phosphate buffered saline (PBS). In order to detect soybean-specific IgE, we performed SDS-PAGE and IgE immunoblot analysis by using 3 kinds of soybean extracts and sera from 9 patients with atopic dermatitis. All patients were sensitive to soybean, which were confirmed by CAP-FEIA. RESULTS: SDS-PAGE of non-fermented soybeans showed many bands, whereas only peptides of less than 15 kDa were found in fermented soybeans. IgE immunoblot analysis of fermented soybeans failed to detect specific IgE which were seen in non-fermented soybeans. CONCLUSION: Fermentation could reduce the allergenicity of soybeans by efficiently degrading antigenic proteins in soybeans. However, there was no significant difference between fermentation by B. subtilis and 3-step fermentation.
Aspergillus oryzae ; Bacillus subtilis ; Dermatitis, Atopic ; Electrophoresis, Polyacrylamide Gel ; Fermentation ; Humans ; Immunoglobulin E ; Lactococcus lactis ; Peptides ; Proteins ; Soybeans