PURPOSE: Conventional indomethacin therapy(0.2mg/kg every 12 hours for three doses) has been used for closure of PDA. The effect of prolonged low dose of indomethacin therapy(0.1mg/kg daily for six days)had been reported in foreign country but, nothing had been reported in our country. So we attempted this study to examine effects of these two methods. METHODS: Forty one infants with PDA of prematurity from January 1992 to July 1995 who were admitted in NICU of Il Sin Christian Hospital were included. 27 of these infants received conventional dose of indomethacin therapy and 14 received prolonged low dose of indomethacin therapy, and we examined with closure rate and complication etc. RESULTS: 1) Closure of PDA was observed in 15(55.6%) and relapse was 3(11.1%) in conventional dose therapy group. In prolonged low dose therapy group, closure was 8(57.1%) and relapse was none. 2) Intraventricular hemorrhage was observed in 20(74.1%), 6(42.9%) and gastrointestinal tract bleeding was 6(22.2%), 13(92.2%) in each group. There was statistically significant between the two groups(p<0.05). 3) The rise of serum BUN, creatinine was observed in 9(33.3%), 6(46.2%), bleeding tendency was 9(33.3%), 8(57.1%), necrotizing enterocolitis was 2(7.4%), 0 and retinopathy of prematurity was 8(29.6%), 3(21.4%) in each group.But there was not statistically significant correlation between the two groups. 4) The development of sepsis and broncopulmonary dysplasia was slightly more in prolonged low dose therapy group. 5) The reduction of urine output was observed in 11(40.7%), 2(14.3%) in each group but, absolute oliguria was not observed in both groups. CONCLUSIONS: Though the closure rate of PDA was similar in both groups, prolonged low dose indomethacin therapy can be recommanded with its effectiveness on preventing the relapse of PDA and the accurrence of necrotizing enterocolitis.
Creatinine ; Enterocolitis, Necrotizing ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Indomethacin* ; Infant ; Oliguria ; Recurrence ; Retinopathy of Prematurity ; Sepsis

The incidence of multiple primary cancers is low than that of single primary cancer. In gastric cancer, incidence of occurrence of multiple primary cancer is 3 to 11.3%. Because stomach and lung are unrelated organs, the combination of gastric cancer and lung cancer is rare. Its estimated incidence is about 10% of all multiple primary cancers. The histologic types of secondary lung cancer in one series, squamous cell carcinomas were 49%; adenocarcinomas were 28%; large cell carcinomas were 14%; small cell carcinomas were 9%; others were 6%. This patient had been diagnosed as early gastric cancer 3 years ago, but he refused operation for cancer and wasnt followed up. After 3 years, he revisited us for dry coughing and diagnosed as small cell lung cancer. At this time, previous gastric cancer was remained as well differentiated, early gastric adenocarcinoma. For its rarity, we report this case with review of literatures.
Adenocarcinoma ; Carcinoma, Large Cell ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Cough ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Small Cell Lung Carcinoma* ; Stomach ; Stomach Neoplasms*

PURPOSE: The aim of this study was to achieve early detection, accurate diagnosis and adequate management of suspicious non-palpable breast lesions. METHODS: From January 1998 to March 2002, 86 cases of ultrasonoguided needle biopsies, 121 cases of mammographically guided needle localization biopsies and 75 cases of ultrasonographically guided needle localization biospsies were performed for a total of 282 cases of nonpalpable breast lesions. RESULTS: The age of patients ranged from 30 to 71 years with a mean age of 46.4 years. 56 cases out of a total 282 cases (20%) were found to be malignant (39.3% of those malignancies were carcinomas in situ, and 60.7% were invasive carcinomas). On a mammogram, 15.1% of the microcalcifications were found to be malignant. 31.6% of mass-like lesions and 20% of masses with microcalcifications were found to be malignant. On an ultrasonogram, 42.7% of the microcalcifications were found to be malignant. 21.1% of mass-like lesions, 30% of intraductal masses, and 31.6% of masses with microcalcifications were found to be malignant. 73.5% of all the cases of non-palpable breast cancer were found in stage 0 or 1. CONCLUSION: Non-palpable breast cancers are smaller in size and have lower chances of axillary lymph node involvement compared to palpable breast cancers. Because it is non-palpable, an early diagnosis is hard to achieve. However, once an early diagnosis is made, it could result in better prognosis. Therefore, the selection of adequate diagnostic modalities, the development of better localization methods, and training of precise surgical skill are important.
Biopsy ; Biopsy, Needle ; Breast Neoplasms ; Breast* ; Diagnosis ; Early Diagnosis ; Humans ; Lymph Nodes ; Needles ; Prognosis ; Ultrasonography

Epstein-Barr virus (EBV)-encoded small non-coding RNAs (EBERs) are abundantly expressed in various EBV-associated malignancies, and play critical roles in cell proliferation, tumorigenesis, and apoptosis resistance. However, the mechanism how EBERs regulate cell function awaits further clarification. In this study, we investigated the effect of EBERs on the expression of cellular microRNA (miRNA) and mRNA expression. To test the effect of EBERs while unaffected by other EBV genes, we used EBERs-deleted recombinant EBV infected Burkitt's lymphoma cell line (Akata(+)EBERs(-)) as well as EBV-infected (Akata(+)) and EBV uninfected (Akata(-)) cell lines. They all have the same genetic backgrounds. First, 15 different cellular miRNAs which have reverse complementary sequences to EBERs and have reported targets were selected by bioinformatics analysis. When RT-PCR was carried out for the 16 miRNAs using RNAs from Akata(+), Akata(-), and Akata(+)EBERs(-) cells, hsa-miR-7-5p was the only one showing down-regulated expression in Akata(+) than in Akata(-) and Akata(+)EBERs(-) cells. Bioinformatics and mRNA microarray analyses for Akata(+), Akata(-), and Akata(+)EBERs(-) cell lines were then carried out to predict putative targets of hsa-miR-7-5p. Among the 6 predicted targets of hsa-miR-7-5p, only low density lipoprotein receptor-related protein 6 (LRP6) was up-regulated in EBERs-expressing cells when tested by RT-PCR and Western blot. However, luciferase reporter assay showed that the 3'-UTR of LRP6 was not directly targeted by hsa-miR-7-5p. Our data suggest that both hsa-miR-7-5p and LRP6 are regulated by EBERs in Akata cells, and these genes may partly mediate the tumorigenic function of EBERs in Burkitt's lymphoma.
Apoptosis ; Blotting, Western ; Burkitt Lymphoma* ; Carcinogenesis ; Cell Line* ; Cell Proliferation ; Computational Biology ; Herpesvirus 4, Human ; Low Density Lipoprotein Receptor-Related Protein-6 ; Luciferases ; MicroRNAs ; RNA* ; RNA, Messenger ; RNA, Small Untranslated

PURPOSE: Among perinatal risk factors, neonatal seizures are one of the strongest independent discriminators of adverse outcome, representing high risks of mortality and neurologic morbidity. This study was undertaken to evaluate the neurologic outcome of neonatal status epilepticus according to underlying etiology, seizure pattern, onset time, and duration. METHODS: We reviewed retrospectively 36 neonates (19 males, 17 females) with status epilepticus who were admitted to the neonatal intensive care unit, Inha Hospital between July, 1988 and June, 2003. They were evaluated with neurologic examination, laboratory data, EEG findings, and neuroimaging studies etc. RESULTS: The mean gestational period of the patients was 37.0+/-3.6 weeks and birth weight was 2.70+/-0.82 kilogram. Fifty two point eight percent of the neonates were male and 66.7 percent were born at term. The most common cause of neonatal status epilepticus was hypoxic-ischemic encephalopathy. In preterm babies, intracranial hemorrhages showed an especially high frequency (P=0.034). Gestational age and birth weight did not show a correlation with neurologic complications. The incidence of neurological sequelae were significantly related to prolonged seizures lasting more than 1 hour (P=0.002). Neonates with seizures within the first 72 hours tended to be more frequent among those who developed adverse outcomes (P=0.016). Generalized tonic seizures had the worst prognosis, whereas those children who had subtle seizures had better outcomes than any other type (P< 0.05). Generalized tonic seizures were primarily represented on EEG by abnormal background, whereas subtle seizure showed a significantly more normal EEG than any other seizures (P< 0.05). CONCLUSION: Our results indicate that neonatal status epilepticus with early onsets, prolonged durations. And generalized tonic types can predict an increased risk for neurologic sequelae. So, those seizures must be perceived as medical emergencies and treated aggressively with antiepileptic drugs.
Child ; Male ; Female ; Infant, Newborn ; Humans ; Incidence ; Mortality ; Risk Factors

Aged ; Depression ; Follow-Up Studies ; Humans ; Korea ; Longitudinal Studies ; Odds Ratio ; Surveys and Questionnaires ; Weights and Measures

Purpose: This study aimed to examine the changes in stress, occupational stress, and subjective health problems of novice female nurses within the first 18 months of work. Methods: This was a longitudinal study conducted with a secondary data analysis based on the Shift Work Nurse’s Health and Turnover (SWNHT) study. The participants were 178 female novice nurses who participated in all 3 data collection activities (on the first day of orientation before ward placement [T0], 6 months after work [T1], and 18 months after work [T2]). The stress, occupational stress, 8 subjective health problems (upper musculoskeletal pain, leg/foot discomfort, depression, anxiety or emotional disorder, sleep disturbance, headache, gastrointestinal disorder, menstrual disorder, and others), and the greatest health problem during the study period were measured, respectively. Data were analyzed using SPSS 26.0 to obtain descriptive statistics. Results: The subjective health of novice female nurses were found to be poor at T1 compared to T0 on both physical (upper musculoskeletal pain, leg/foot discomfort, and sleep disturbance) and psychological health problems (depression and stress). However, the psychological health problems of the participants were alleviated at T2 whereas; physical health problems persisted until T2. Conclusion Novice nurses had poor health problems 6 months after work. Sleep disturbance and musculoskeletal pain persisted although other health problems such as depression and stress were alleviated over the period. Strategies to prevent and manage different health problems of novice female nurses at different work duration are urgently needed.

BACKGROUND AND OBJECTIVES: Renal insufficiency (RI) has been reported to be associated with unfavorable clinical outcomes in patients undergoing percutaneous coronary interventions (PCI). However, little data is available regarding the impact of moderate to severe RI on clinical outcomes in patients with acute myocardial infarction (AMI) undergoing PCI. SUBJECTS AND METHODS: Between March 2003 and July 2007, 878 patients with AMI who underwent PCI were enrolled. Based on estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) equation, patients were divided into two groups: eGFR <60 mL/min.m2 (moderate to severe RI, group A) and eGFR > or =60 mL/min.m2 (normal to mild RI, group B). The primary endpoint was all-cause mortality at 1-year after successful PCI. The secondary endpoints were non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), stent thrombosis (ST) and major adverse cardiac events (MACE) at 1-year. RESULTS: In group A, patients were more often male and older, with diabetes and hypertension. Compared to patients in group B, group A showed significantly higher incidences of all-cause mortality, cardiac mortality, non-fatal MI and MACE. The needs of TLR and TVR, and the incidence of ST were not significantly different between the two groups. Independent predictors of 1-year mortality were eGFR <60 mL/min.m2, male gender, older age and a lower left ventricular ejection fraction. CONCLUSION: In patients with AMI, moderate to severe RI was associated with mortality and MACE at 1-year after successful PCI. In addition, eGFR <60 mL/min.m2 was a strong independent predictor of 1-year mortality.
Angioplasty, Balloon, Coronary ; Diet ; Glomerular Filtration Rate ; Glycosaminoglycans ; Humans ; Hypertension ; Incidence ; Male ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Renal Insufficiency ; Stents ; Thrombosis

OBJECTIVE: The aim of this study was to examine clinical characteristics of Korean rheumatoid arthritis (RA) patients with clinically indications for TNF-alpha blocker, and to compare their clinical parameters with the Korean National Health Insurance reimbursement criteria. METHODS: Data were obtained from a registry of RA patients who visited rheumatology clinics of Hallym University affiliated hospitals. Among patients who were previously prescribed DMARDs for more than three months, rheumatologists selected patients clinically indicated for TNF-alpha blocker. The clinical characteristics at the time TNF-alpha blocker use was deemed indicated were examined. Radiographic damage was quantified by Modified Sharp van der Heijde score in hand and foot simple AP radiograph. RESULTS: From August 2010 to January 2013, five rheumatologists in four hospitals selected 109 patients clinically indicated for TNF-alpha blocker. When TNF-alpha blocker was considered, mean DAS28 was 5.2 (range 2.1~8.05), mean swollen joint count was 6 (range 0~22), mean tender joint count was 10.6 (range 0~28), mean ESR was 43.2 mm/hr (range 1~140) and mean CRP was 2.5 mg/dL (range 0.1~18.3). The mean total modified Sharp van der Heijde score was 32.72 (range 0~240). Eighty one percent of subjects did not have enough active joints to satisfy the Korean National Health Insurance reimbursement standard. CONCLUSION: Our results show that patients with clinically indications for TNF-alpha blocker had a broad range of disease activity and clinical parameters, and the majority did not meet the Korean National Health Insurance reimbursement criteria.
Antirheumatic Agents ; Arthritis, Rheumatoid* ; Foot ; Hand ; Humans ; Joints ; National Health Programs ; Rheumatology ; Tumor Necrosis Factor-alpha*

PURPOSE: A limited number of studies have examined the link between F-wave abnormalities and clinical presentation in pediatric Guillain-Barré syndrome (GBS). Therefore, this study examined the importance of F-wave abnormalities as a prognostic factor in pediatric GBS patients. METHODS: The records and electrodiagnostic studies (EDS) of 70 GBS patients were retrospectively evaluated, and divided into 2 groups according to the results of EDS. Group A (n=33) presented with F-wave abnormalities, and group B (n=26) exhibited normal findings. We compared laboratory reports, clinical features, response to treatment, and prognosis between the 2 groups. RESULTS: Motor weakness was the most frequently observed symptom for either group. Clinically, the incidence of fever and upper respiratory symptoms differed between the 2 groups, while the prevalence of abnormal deep tendon reflex (DTR) was significantly higher in group A than B (P<0.05). Patients diagnosed with GBS had received intravenous immunoglobulin treatment: 94% in group A and 58% in group B. Furthermore, significantly greater numbers of patients in group A showed H-reflex abnormalities and poor prognosis compared with group B (P<0.05). CONCLUSION: This study demonstrated that F-waves are a clinically important prognostic factor in GBS. F-wave abnormalities were associated with abnormal DTR and poor prognosis in patients. Limited studies have examined the link between F-wave abnormalities and clinical results; therefore, further randomized controlled studies are needed to confirm the clinical characteristics and efficacy of treatments.
Child* ; Fever ; Guillain-Barre Syndrome* ; H-Reflex ; Humans ; Immunoglobulins ; Incidence ; Prevalence ; Prognosis ; Reflex, Abnormal ; Retrospective Studies