Purpose: This study was conducted to assess the antidepressant effects of capsaicin in chronic depressive rats and elucidate the mechanism underlying its effects. Methods: Male Wistar rats (280~320 g, 8 weeks of age) were subjected to depression induced by chronic unpredictable mild stresses. The rats were exposed to 8 kinds of stresses for 8 weeks. In the last 2 weeks, fluoxetine or capsaicin was injected subcutaneously. The dose of fluoxetine was 10 mg/kg (body weight), while the doses of capsaicin consisted of low (1 mg/kg), middle (5 mg/kg), and high (10 mg/kg). The forced swim test (FST) was conducted to evaluate the immobility time of rats. The immobility time indicates despair, one of symptoms of depression. The change of tryptophan hydroxylase (TPH) in the dorsal raphe was investigated using immunohistochemistry. In the hippocampus cornu ammonis (CA) 1 and 3, glucocorticoid receptor (GR) expression was measured. Results: The immobility time in the FST was significantly lower (p < .05) in the low-dose (M = 32.40 ± 13.41 seconds) and middle-dose (M = 28.48 ± 19.57 seconds) groups than in the non-treated depressive rats (M = 90.19 ± 45.34 seconds). The amount of TPH in the dorsal raphe was significantly higher (p < .05) in the middle-dose (M = 249.17 ± 35.02) and high-dose (M = 251.0 ± 56.85) groups than in the non-treated depressive rats (M = 159.78 ± 41.16). However, GR expression in the hippocampus CA1 and CA3 did not show significant differences between the non-treated depressive rats and the capsaicin-injected rats. Conclusion This study suggests that capsaicin produces an antidepressant-like effect on chronic unpredictable mild stress-induced depression in rats via the serotonin biosynthesis pathway.

Objective To identify the source of infection and determine the clinical features and laboratory finding of measles infection. Methods In 27 measles patients, except for 3 adult patients, the rest of 24 pediatric measles cases were analyzed with regard to age, sex, immunization status, transmission routes and molecular genotyping of measles virus. Eighteen measles patients who admitted in isolation ward were set apart to investigate clinical findings and its correlation with laboratory characteristics. Retrospective analysis of cases was conducted in this study. Results Of the 24 pediatric patients, 23 (95.8%) had not received any measles-containing vaccine (MCV). Sixteen of the patients (66.7%) were aged <12 months. The suspicious index case of a girl aged 34 months was not vaccinated with MCV1 and got measles after a trip to Philippines, and molecular genotype was revealed as B3. Measles outbreaks in the community such as a restaurant were followed by this one imported case. According to analysis of 18 patients admitted in isolation ward, the median level of C-reactive protein (CRP) was 0.38 mg/dL and that of lactate dehydrogenase (LDH) was 1200 IU/L. All of the 18 patients had LDH levels above the normal range. Age correlated with CRP (ρ = 0.528, P = 0.024) and LDH (ρ = 0.501, P = 0.034). The duration of fever was correlated with the duration of fever before rash (ρ = 0.898, P < 0.01). The duration of hospitalization was correlated with CRP (ρ = 0.586, P = 0.011). The white blood cell counts were correlated with the levels of LDH (ρ = 0.505, P = 0.033), aspartate aminotransferase (ρ = 0.507, P = 0.032), and alanine aminotransferase (ρ = 0.481, P = 0.043). Conclusions Early weaning of maternally derived measles antibodies therefore vaccination of MCV1 at a young age from 9 months to 12 months should be considered in situations of early exposure. Furthermore, there is a call for consideration of scheduling an earlier age for the first dose of MMR vaccine in Europe. It is necessary for Korea to investigate the duration of the presence and quantitative analysis of maternal measles antibodies in infants and to reconsider the timing of MCV1.

This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2). Significantly fewer cases with ethical issues were reported in Period 2 than in Period 1 (89 cases [2.1%] of 4,291 ICU admissions vs. 51 [0.5%] of 9,302 ICU admissions, respectively; P < 0.001). The highest incidence of cases with identified ethical issues in both Periods occurred in MICU. The major source of ethical issues in Periods 1 and 2 was behavior-related. Among behavior-related issues, inappropriate healthcare professional behavior was predominant in both periods and mainly involved resident physicians. Ethical issue numbers regarding end-of-life (EOL) care significantly decreased in the proportion with respect to ethical issues during Period 2 (P = 0.044). In conclusion, the decreased incidence of cases with identified ethical issues in Period 2 might be associated with ethical enhancement related with EOL and improvements in the ICU care environment of the studied hospital. However, behavior-related issues involving resident physicians represent a considerable proportion of ethical issues encountered by critical care nurses. A systemic approach to solve behavior-related issues of resident physicians seems to be required to enhance an ethical environment in the studied ICU.
Critical Care Nursing/*ethics ; Humans ; *Intensive Care Units ; Nurses ; Retrospective Studies ; Terminal Care ; Tertiary Care Centers

BACKGROUND/AIMS: Remission of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is difficult due to pleomorphic and multifocal endoscopic findings. We investigated the relationship between endoscopic appearances and histological findings of patients followed up after curative treatment for the tumor. MATERIALS AND METHODS: This retrospective study included 25 consecutive patients diagnosed with gastric MALT lymphoma, who were treated and underwent serial follow-up endoscopies with biopsies from June 2009 to March 2014 in Seoul St. Mary's Hospital. We reviewed the follow-up endoscopic findings at least 2 months after Helicobacter pylori eradication or chemoradiotherapy. Target biopsy sites were categorized according to their endoscopic appearance. RESULTS: The mean follow-up period was 17.6 months; 76 endoscopies and 238 biopsies were performed. Positive biopsies were observed in 50 cases (21.0%). Tumor positivity was high in ulcerated lesions (2/3, 66.7%), erosion (1/5, 20.0%), discoloration (32/89, 36.0%), mucosal thickening (10/41, 24.4%) and ulcer scars (3/21, 14.3%). Conversely, lesions appearing normal showed low positivity (1/68, 1.5%) and was significantly lower compared with the aforementioned lesions (P<0.001). CONCLUSIONS: Endoscopic appearances of depression, discoloration, mucosal thickening and ulcer scars were more likely to have tumor cells and should be targeted during follow up for gastric MALT lymphoma.
Biopsy* ; Chemoradiotherapy ; Cicatrix ; Depression ; Endoscopy* ; Endoscopy, Gastrointestinal ; Follow-Up Studies* ; Helicobacter pylori ; Humans ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Non-Hodgkin ; Retrospective Studies ; Seoul ; Ulcer

Testicular or scrotal involvement has been reported in children with Henoch-Schonlein purpura (HSP), but there are very few reports on penile involvement. We report the initial and follow-up ultrasonographic findings of scrotal and penile involvement of HSP in a 5-year-old boy. On ultrasonography, scrotal soft tissue thickening and epididymal swelling with increased vascularity were noted, and on the penis, a focal mass-like lesion appeared on the dorsal surface of the distal penis, having a hypoechoic mass-like appearance without visible vascular flow on a Doppler study. After 2 days of treatment, follow-up ultrasonography showed normal scrotum and penis with a resolved soft tissue mass-like lesion. Therefore, we think that HSP ultrasonographic findings involving the scrotum and penis might help to diagnose scrotal and penile involvement in a case of HSP and to avoid unnecessary medication and/or surgical procedures.
Child ; Child, Preschool ; Follow-Up Studies ; Humans ; Male ; Penis ; Purpura, Schoenlein-Henoch* ; Scrotum ; Ultrasonography*

BACKGROUND: Limited data on the incidence and clinical characteristics of adult pertussis infections are available in Korea. METHODS: Thirty-one hospitals and the Korean Centers for Disease Control and Prevention collaborated to investigate the incidence and clinical characteristics of pertussis infections among adults with a bothersome cough in non-outbreak, ordinary outpatient settings. Nasopharyngeal aspirates or nasopharyngeal swabs were collected for polymerase chain reaction (PCR) and culture tests. RESULTS: The study enrolled 934 patients between September 2009 and April 2011. Five patients were diagnosed as confirmed cases, satisfying both clinical and laboratory criteria (five positive PCR and one concurrent positive culture). Among 607 patients with cough duration of at least 2 weeks, 504 satisfied the clinical criteria of the US Centers for Disease Control and Prevention (i.e., probable case). The clinical pertussis cases (i.e., both probable and confirmed cases) had a wide age distribution (45.7+/-15.5 years) and cough duration (median, 30 days; interquartile range, 18.0~50.0 days). In addition, sputum, rhinorrhea, and myalgia were less common and dyspnea was more common in the clinical cases, compared to the others (p=0.037, p=0.006, p=0.005, and p=0.030, respectively). CONCLUSION: The positive rate of pertussis infection may be low in non-outbreak, ordinary clinical settings if a PCR-based method is used. However, further prospective, well-designed, multicenter studies are needed.
Adult ; Age Distribution ; Centers for Disease Control and Prevention (U.S.) ; Cough ; Dyspnea ; Humans ; Incidence ; Outpatients ; Polymerase Chain Reaction ; Sputum ; Whooping Cough

PURPOSE: During oxidative stress, the levels of oxygen free radical increase dramatically, which plays a role in apoptosis, aging and is chemic injury, but also leads to positive effects such as induction of host defense genes and mobilization of ion transport systems. It has been suggested that the advantages of laparoscopic surgery are closely related to the reduced oxidative stress that occurs during laparoscopic cholecystectomy (LC) when compared to open cholecystectomy (OC). This study was conducted to compare oxidative stress markers including total antioxidant status (TAS), superoxide dismutase (SOD) and gluthathione reductase (GR) between the LC group and OC group to determine if these surgical procedures result in different patterns of oxidative stress. METHODS: Our prospective study included fifty patients with symptomatic cholelithiasis and cholecystitis, of whom 25 underwent LC and 25 underwent OC. The plasma levels of oxidative stress markers (TAS, SOD, and GR) were measured preoperatively and on the 1st, 2nd and 3rd postoperative days. RESULTS: The postoperative hospitalization days differed significantly between the two groups (p<0.01). The value of TAS decreased in the OC group in the immediate postoperative period (p=0.037), but this difference was not significant when analyzed by ANCOVA (analysis of covariance; p>0.05). An acceptable postoperative decrease in SOD was observed in the OC group, especially after the 2nd postoperative day (p<0.01), and this decrease was also significant when analyzed by ANCOVA (p=0.020). GR was decreased in the OC group on the 2nd postoperative day (p=0.022), and ANCOVA revealed a significant difference between groups (p=0.039). The length of postoperative hospital stay was significantly different between the two groups (p<0.01). The TAS value decreased in the OC group in the immediate postoperative period (p=0.037), but the serial change in the plasma level of TAS did not differ significantly among groups (p>0.05) upon analysis of covariance. A significant postoperative decrease in the level of SOD was observed in the OC group, especially after the 2nd postoperative day (p<0.01), and there was also a significant difference in the serial change in SOD between groups (p=0.020). The level of GR in the OC group decreased significantly on the 2nd postoperative day (p=0.022). Moreover, ANCOVA revealed a significant difference in the serial changes in thelevel of GR between the two groups (p=0.039). CONCLUSION: Our study compared oxidative stress between LC and OC groups based on the levels of TAS, SOD, and GR. We found that minimally invasive surgery, such as laparoscopic cholecystectomy, produced less oxidative stress than open surgery.
Aging ; Apoptosis ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholelithiasis ; Hospitalization ; Humans ; Ion Transport ; Laparoscopy ; Length of Stay ; Oxidative Stress ; Oxidoreductases ; Oxygen ; Plasma ; Postoperative Period ; Prospective Studies ; Superoxide Dismutase

PURPOSE: The development of postnatal pneumothorax and its common causes and clinical aspects were studied to promote early diagnosis and proper management. METHODS: A retrospective study of neonates who were hospitalized in the neonatal intensive care unit at Soonchunhyang University Bucheon Hospital from 2001 to 2010 was performed. Term neonates were divided into a spontaneous pneumothorax group and a secondary pneumothorax group. The secondary group was divided into term and preterm groups. RESULTS: Of 4,414 inpatients, 57 (1.3%) were diagnosed with pneumothorax. Of term newborn patients, 28 (80%) had a secondary pneumothorax, and seven (20%) had a spontaneous pneumothorax. No differences were observed for gender, birth weight, resuscitation, or duration of admission between the spontaneous and control groups. The duration of treatment with a thoracostomy (20 patients, 57%) was longer in the spontaneous group (5.4+/-2.9 days vs. 2.7+/-2.0 days) than that in the control group. Patients with respiratory distress syndrome (RDS) developed a pneumothorax 22.8 hours after surfactant treatment, whereas patients with transient tachypnea of the newborn (TTN), pneumonia, and meconium aspiration syndrome (MAS) developed pneumothorax after 16.6 hours. Of 50 patients with a secondary pneumothorax, 19 (38%) had RDS, 11 (22%) had MAS, 7 (14%) had TTN, and six (12%) had pneumonia. Among term newborns, 42.9% were treated only with 100% oxygen. Among preterm newborns, 72.6% and 27.3% needed a thoracostomy or ventilator care, respectively. CONCLUSION: A pneumothorax is likely to develop when pulmonary disease occurs in neonates. Therefore, it is important to carefully identify pneumothorax and provide appropriate treatment.
Birth Weight ; Early Diagnosis ; Humans ; Infant, Newborn ; Inpatients ; Intensive Care, Neonatal ; Lung Diseases ; Meconium Aspiration Syndrome ; Oxygen ; Pneumonia ; Pneumothorax ; Resuscitation ; Retrospective Studies ; Thoracostomy ; Transient Tachypnea of the Newborn ; Ventilators, Mechanical

PURPOSE: We aimed to evaluate the clinical characteristics and etiological organisms associated with lobar/lobular pneumonia in Korean children. METHODS: Children hospitalized due to radiographically confirmed lobar/lobular pneumonia were evaluated prospectively between June 2006 and May 2008. Anti-Mycoplasma pneumoniae IgM/IgG (at admission and follow-up), blood cultures, throat swabs for bacterial detection or sputum culture, respiratory viruses (Respiratory syncytial virus, Adenovirus and Influenza A/B) antigen testing, and urinary antigen testing for S. pneumoniae were performed. RESULTS: Two hundred eighty-eight immunocompetent children (mean age, 5.9 years) were enrolled. The age distribution showed a peak frequency at 2-6 years of age (<2 years, 8.7%; 2-6 years, 60.8%; 7-10 years, 22.6%; 11-15 years, 8.0%). Typical respiratory organisms were identified in 64.9% of cases. Identified organisms were Mycoplasma pneumoniae (50.7%), bacteria in (5.9%), viruses (2.1%) and mixed infection (5.9%). Mycoplasma pneumoniae was the most commonly identified organism in all age groups. The majority (88.9%) of bacterial pneumonias including mixed infection were caused by Streptococcus pneumoniae. Mycoplasma pneumonia was the most frequent at 5-6 years of age, but bacterial pneumonia was most frequent at 1-2 years of age. Lobar/lobular pneumonia began to increase from August and showed peak incidence in November and December. The levels of WBC, ESR, and CRP more significantly elevated in those with bacterial pneumonia than in children with mycoplasma pneumonia. Pleural effusion was present in 18.1% of cases. In these cases, the duration of fever and hospitalization was prolonged, and the ESR and CRP levels were significantly higher, than those without pleural effusion. CONCLUSION: Mycoplasma pneumoniae was the most common organism causing lobar/lobular pneumonia in children. Mycoplasma pneumoniae was the most frequent causative organism at 5-6 years of age. On the other hand, bacterial pneumonia was more common at 1-2 years of age. Thus, age may be a significant factor for the diagnosis and treatment of lobar/lobular pneumonia in children.
Adenoviridae ; Age Distribution ; Bacteria ; Child ; Coinfection ; Fever ; Hand ; Hospitalization ; Humans ; Incidence ; Influenza, Human ; Mycoplasma ; Mycoplasma pneumoniae ; Pharynx ; Pleural Effusion ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma ; Prospective Studies ; Sputum ; Streptococcus pneumoniae ; Viruses

In this study, we evaluated accuracy and usefulness of CyberKnife Respiratory Tracking System (SynchronyTM, Accuray, USA) about a moving during stereotactic radiosurgery. For this study, we used moving phantom that can move the target. We also used Respiratory Tracking System called Synchrony of the Cyberknife in order to track the moving target. For treatment planning of the moving target, we obtained an image using 4D-CT. To measure dose distribution and point dose at the moving target, ion chamber (0.62 cc) and gafchromic EBT film were used. We compared dose distribution (80% isodose line of prescription dose) of static target to that of moving target in order to evaluate the accuracy of Respiratory Tracking System. We also measured the point dose at the target. The mean difference of synchronization for TLS (target localization system) and Synchrony were 11.5+/-3.09 mm for desynchronization and 0.14+/-0.08 mm for synchronization. The mean difference between static target plan and moving target plan using 4D CT images was 0.18+/-0.06 mm. And, the accuracy of Respiratory Tracking System was less 1 mm. Estimation of usefulness in Respiratory Tracking System was 17.39+/-0.14 mm for inactivity and 1.37+/-0.11 mm for activity. The mean difference of absolute dose was 0.68+/-0.38% in static target and 1.31+/-0.81% in moving target. As a conclusion, when we treat about the moving target, we consider that it is important to use 4D-CT and the Respiratory Tracking System. In this study, we confirmed the accuracy and usefulness of Respiratory Tracking System in the Cyberknife.
Four-Dimensional Computed Tomography ; Prescriptions ; Radiosurgery ; Track and Field