PURPOSE: Cardiovascular or respiratory complications of acute intoxication are the most common causes of mortality. Advanced cardiac life support (ACLS) or specific antidotes help manage these cardiac or respiratory complications in acute intoxication. On the other hand, some cases do not respond to ACLS or antidotes and they require some special treatment, such as extracorporeal life support (ECLS). ECLS will provide the chance of recovery from acute intoxication. This study examined the optimal timing of ECLS in acute intoxication cases. METHODS: This paper is a brief report of a case series about ECLS in acute poisoning. The cases of ECLS were reviewed and the effects of ECLS on the blood pressure and serum lactate level of the patients were analyzed. RESULTS: A total of four cases were reviewed; three of them were antihypertensive agent-induced shock, and one was respiratory failure after the inhalation of acid. The time range of ECLS application was 4.8-23.5 hours after toxic exposure. The causes of ECLS implementation were one for recurrent cardiac arrest, two for shock that did not respond to ACLS, and one for respiratory failure that did not respond to mechanical ventilator support. Three patients showed an improvement in blood pressure and serum lactate level and were discharged alive. In case 1, ECLS was stared at 23.5 hours post toxic exposure; the patient died due to refractory shock and multiple organ failure. CONCLUSION: The specific management of ECLS should be considered when a patient with acute intoxication does not recovery from shock or respiratory failure despite ACLS, antidote therapies, or mechanical ventilator support. ECLS improved the hemodynamic and ventilator condition in complicated poisoned patients. The early application of ECLS may improve the tissue perfusion state and outcomes of these patients before the toxic damage becomes irreversible.
Advanced Cardiac Life Support ; Antidotes ; Blood Pressure ; Hand ; Heart Arrest ; Hemodynamics ; Humans ; Inhalation ; Lactic Acid ; Mortality ; Multiple Organ Failure ; Perfusion ; Poisoning* ; Respiratory Insufficiency ; Shock ; Ventilators, Mechanical

BACKGROUND: The bacterium Chlamydia trachomatis is one of the leading causes of sexually transmitted diseases worldwide. Since no simple and effective tool exists to diagnose C. trachomatis infections, we evaluated a novel point-of-care (POC) test, aQcare Chlamydia TRF kit, which uses europium-chelated nanoparticles and a time-resolved fluorescence reader. METHODS: The test performance was evaluated by comparing the results obtained using the novel POC testing kit with those obtained using a nucleic acid amplification test (NAAT), using 114 NAAT-positive and 327 NAAT-negative samples. RESULTS: The cut-off value of the novel test was 20.8 with a detection limit of 0.27 ng/mL. No interference or cross-reactivity was observed. Diagnostic accuracy showed an overall sensitivity of 93.0% (106/114), specificity of 96.3% (315/327), positive predictive value (PPV) of 89.8% (106/118), and negative predictive value (NPV) of 97.5% (315/323). The sensitivity of the novel test was much higher than that of currently available POC tests. Furthermore, the relative ease and short turnaround time (30 min) of this assay enables C. trachomatis-infected individuals to be treated without a diagnostic delay. CONCLUSIONS: This simple and novel test is a potential tool to screen a larger population, especially those in areas with limited resources.
Adult ; Aged ; Aged, 80 and over ; Chlamydia Infections/*diagnosis ; Chlamydia trachomatis/*genetics/isolation & purification ; DNA, Bacterial/chemistry/metabolism ; Europium/*chemistry ; Female ; Humans ; Male ; Metal Nanoparticles/*chemistry ; Middle Aged ; Point-of-Care Systems ; Reagent Kits, Diagnostic ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity ; Young Adult

BACKGROUND/OBJECTIVES: Breast milk is the best available food for optimum growth and development of infants and the breastfeeding rate is increasing in Korea. The purpose of this study is to measure the concentrations of macronutrients and to evaluate their changes according to lactation period in breast milk from lactating Korean women. SUBJECTS/METHODS: Milk samples were obtained from 2,632 healthy lactating women (mean age; 32.0 +/- 3.3 years), where the lactating period was up to a period of 8 months, who also volunteered to participate in the Human Milk Macronutrient Analysis Research. Lactose, protein, fat and water content in the breast milk samples were analyzed with infrared spectrometry using MilkoScan FT-2. RESULTS: The mean macronutrient composition per 100 mL of mature breast milk was 7.1 g for lactose, 1.4 g for protein and 3.0 g for fat, and energy content was 61.1 kcal. The protein concentration was significantly lower in milk samples at 1-2 weeks (2.0 g/dL) to 2-3 months (1.4 g/dL) than those at 0-1 week (2.2 g/dL), but it was similar among samples from 3-4 months to 7-8 months (1.3 g/dL). Mean lipid levels varied among different lactational period groups (2.7-3.2 g/dL), but presented no significant difference. Lactose concentration in the milk samples did not differ with lactation period. Maternal body mass index was positively related to protein and lipid breast milk contents, but was negatively related to lactose content. General linear models examining the associations between maternal variables and milk macronutrient content revealed that lactation period had a major impact on protein and lipid, but not on lactose content in breast milk. CONCLUSIONS: These results warrant future studies to explore factors that may be associated with changes in macronutrient content in human milk.
Body Mass Index ; Breast Feeding ; Female ; Growth and Development ; Humans ; Infant* ; Korea ; Lactation ; Lactose ; Linear Models ; Milk ; Milk, Human* ; Mothers* ; Spectrum Analysis ; Water

Patients' insight has a critical role in the recovery from problematic behavior. The aim of this study was to evaluate the effects of a brief intervention to promote insight among alcohol-dependent patients. A total of 41 alcohol-dependent patients (30 males, 11 females) in an insight-deficient state who had been admitted to a community-based alcohol treatment center, were randomized into two groups based on their admission order: an intervention group (IG) (n = 20) and a control group (CG) (n = 21). Patients in both the IG and CG participated in an identical treatment program with one exception: patients in the IG were required to undergo five sessions of brief individual intervention focusing on insight enhancement. Changes in insight state were assessed after the intervention. The IG exhibited significant (P < 0.05) changes in the distribution of insight level, while the CG did not exhibit any significant changes in the distribution of insight level. The insight score after intervention was significantly (P < 0.05) greater for the IG than the CG with adjustment for the baseline characteristics. The results suggest that a brief individual intervention focused on insight enhancement may be an effective tool to improve insight among alcohol-dependent patients.
Adult ; Alcohol-Related Disorders/*therapy ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Patient Education as Topic

Patients' insight has a critical role in the recovery from problematic behavior. The aim of this study was to evaluate the effects of a brief intervention to promote insight among alcohol-dependent patients. A total of 41 alcohol-dependent patients (30 males, 11 females) in an insight-deficient state who had been admitted to a community-based alcohol treatment center, were randomized into two groups based on their admission order: an intervention group (IG) (n = 20) and a control group (CG) (n = 21). Patients in both the IG and CG participated in an identical treatment program with one exception: patients in the IG were required to undergo five sessions of brief individual intervention focusing on insight enhancement. Changes in insight state were assessed after the intervention. The IG exhibited significant (P < 0.05) changes in the distribution of insight level, while the CG did not exhibit any significant changes in the distribution of insight level. The insight score after intervention was significantly (P < 0.05) greater for the IG than the CG with adjustment for the baseline characteristics. The results suggest that a brief individual intervention focused on insight enhancement may be an effective tool to improve insight among alcohol-dependent patients.
Adult ; Alcohol-Related Disorders/*therapy ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Patient Education as Topic

TGF-beta-induced tolerogenic-antigen presenting cells (Tol-APCs) could induce suppression of autoimmune diseases such as collagen-induced arthritis (CIA) and allergic asthma. In contrast, many studies have shown that NKT cells are involved in the pathogenesis of Th1-mediated autoimmune joint inflammation and Th2-mediated allergic pulmonary inflammation. In this study, we investigated the effect of CD1d-restricted NKT cells in the Tol-APCs-mediated suppression of autoimmune disease using a murine CIA model. When CIA-induced mice were treated with Tol-APCs obtained from CD1d+/- or CD1d-/- mice, unlike CD1d+/- APCs, CD1d-/- Tol-APCs failed to suppress CIA. More specifically, CD1d-/- Tol-APCs failed to suppress the production of inflammatory cytokines and the induction of Th2 responses by antigen-specific CD4 T cells both in vitro and in vivo. Our results demonstrate that the presence of CD1d-restricted NKT cells is critical for the induction of Tol-APCs-mediated suppression of CIA.
Animals ; Antibodies/blood ; Antibody Formation/immunology ; Antibody Specificity/immunology ; Antigen-Presenting Cells/*immunology ; Antigens, CD1d/immunology ; Arthritis, Experimental/blood/*immunology/*prevention & control ; Collagen Type II/immunology ; Cytokines/blood ; Immune Tolerance/*immunology ; Inflammation Mediators/blood ; Mice ; Natural Killer T-Cells/*immunology ; Th1 Cells/immunology

This study was performed to investigate the effect of insight on the readiness to change in alcoholism. The subjects were 131 Korean male patients with alcohol dependence who were being hospitalized in a community-based alcohol treatment center. The patients' readiness to change was classified into precontemplation, contemplation, and action stage through the readiness to change questionnaire. The state of the patients' insight was measured through the Hanil alcohol insight scale. Fourteen patients (10.7%) were in the stage of precontemplation, 65 (49.6%) in contemplation and 52 (39.7%) in action stage. The insight score of the patients in precontemplation stage was significantly lower (p<0.001) than that of others. On the basis of the precontemplation stage, multinomial logistic regression analysis for the control of the differences in the patients' characteristics among each stage of the readiness to change showed that the possibility of contemplation and action stage went up 1.231 (p<0.01) and 1.249 (p<0.01) times higher as the insight score increased.
Adaptation, Psychological ; Adult ; Alcohol Drinking ; Alcoholism/*psychology/*therapy ; Awareness ; Health Behavior ; Humans ; Korea ; Male ; Middle Aged ; Motivation ; Psychometrics ; Questionnaires ; Regression Analysis ; Self Care

This study was performed to examine the relationship between the abstinence results of alcohol dependents after discharge and the level of insight at the time of discharge. 117 male Korean alcohol dependents discharged from a community-based alcohol treatment center were followed up to determine the initial months of abstinence on a successive basis (IMA), total months of abstinence during 12-month period (TMA), and complete abstinence for one full year after discharge. Analyses of abstinence results with adjustment for the differences in baseline characteristics were performed for subjects' insight levels (poor, fair and good). The mean IMA of patients with good insight was significantly (p<0.01) longer than that of patients with poor insight and TMA of patients with good insight was significantly (p<0.001) longer than that of others. Using patients with good insight as the reference, patients with poor insight showed an adjusted odds ratio (OR) of 0.07 (95% confidence interval [CI]=0.01-0.75, p<0.05) for complete abstinence for one full year after discharge and patients with fair insight, adjusted OR of 0.17 (95% CI=0.03-0.81, p<0.05). These results suggest that alcohol dependents' insight could be regarded as a factor related with abstinence.
Temperance/*psychology ; Middle Aged ; Male ; Humans ; Alcoholism/*psychology ; Adult

The incidence of intussusception in adults is quite low. A preoperative diagnosis was quite difficult due to the atypical clinical features, but the success rate of preoperative diagnosis of intussusception has improved with the advances in abdominal US and CT. However, the value of colonoscopy in making a preoperative diagnosis is unclear. The incidence of multiple primary cancer of the colon and rectum can vary widely. We report a case of intussusception in a patient who had synchronous cecal and sigmoid colonic cancer. A 71-year-old man was visited our hospital for diarrhea and general weakness. The abdominal US and CT revealed a mass lesion in the cecal area. Preoperative colonoscopy confirmed the lesion to be cecal cancer with a synchronous sigmoid colon cancer. In conclusion, the rarity of these synchronous cancers may result in a misdiagnosis. Therefore, a preoperative colonoscopy or postoperative colonoscopy might be useful.
Adult ; Aged ; Cecal Neoplasms ; Colon* ; Colon, Sigmoid* ; Colonic Neoplasms* ; Colonoscopy ; Diagnosis ; Diagnostic Errors ; Diarrhea ; Humans ; Incidence ; Intussusception* ; Rectum ; Sigmoid Neoplasms*

Gastritis cystica profunda (GCP) is a rare disease in which mature glandular epithelium extends into the muscularis mucosae or below. GCP lesions mainly develop at the gastroenterostomy stomas. These lesions show malignant histologic features such as metaplastic and even dysplastic alteration, however they usually exhibit benign behavior. We report a case of a patient with GCP who had not previously undergone gastric surgery. A 63-year-old woman visited our hospital for anorexia and epigastric discomfort. The esophagogastroduodenoscopy revealed two polyps on the anterior wall of the greater curvature, antrum. The polyps were removed by snare polypectomy and the histology findings showed the character of a tubular adenoma and a hyperplastic polyp with an associated GCP.
Adenoma* ; Anorexia ; Endoscopy, Digestive System ; Epithelium ; Female ; Gastritis* ; Gastroenterostomy ; Humans ; Middle Aged ; Mucous Membrane ; Polyps ; Rare Diseases ; SNARE Proteins