PURPOSE: To date, the risk factors for central venous port-related bloodstream infection (CVP-BSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. MATERIALS AND METHODS: A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. RESULTS: CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). CONCLUSION: In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.
Case-Control Studies* ; Catheter-Related Infections ; Catheters ; Drug Therapy ; Fungi ; Gastrointestinal Neoplasms ; Gram-Positive Cocci ; Humans ; Mortality ; Multivariate Analysis ; Risk Factors*

OBJECTIVES: Previous studies suggest that the cannabinoid receptor 1 (CNR1) gene could be an important candidate gene for schizophrenia. According to linkage studies, this gene is located on chromosome 6q14-q15, which is known to harbor the schizophrenia susceptibility locus (locus 5, SCZ5, OMIM 803175). The pharmacological agent delta-9-tetrahydrocannabinol (Delta-9-THC) seems to elicit the symptoms of schizophrenia. The association between CNR1 polymorphisms and schizophrenia is actively being investigated, and some studies have linked the AAT-trinucleotide repeats in CNR1 to the onset of schizophrenia. In this study, we have investigated the association between the AAT-trinucleotide repeats in CNR1 and schizophrenia by studying schizophrenia patients and healthy individuals from Korea. METHODS: DNA was extracted from the blood samples of 394 control subjects and 337 patients diagnosed with schizophrenia (as per the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria). After polymerase chain reaction amplification, a logistic regression analysis, with age and gender as the covariates, was performed to study the variations in the AAT-repeat polymorphisms between the two groups. RESULTS: In total, 8 types of trinucleotide repeats were identified, each containing 7, 8, 10, 11, 12, 13, 14, and 15 repeats, respectively. (AAT)13 allele was most frequently observed, with a frequency of 33.6% and 31.6% in the patient and control groups, respectively. The frequency of the other repeat alleles in the patient group (in the decreasing order) was as follows : (AAT)13 33.6%, (AAT)14 21.6%, (AAT)12 18.5%, and (AAT)7 11.1%. The frequency of the repeat alleles in the control group (in the decreasing order) was as follows : (AAT)13 31.6%, (AAT)14 24.5%, (AAT)12 17.2%, and (AAT)7 11.6%. However, there were no significant differences in the AAT-repeat polymorphisms of the CNR1 gene between the patient group and the control group. CONCLUSIONS: Although our study revealed no significant association of the AAT-repeat polymorphism of the CNR1 gene with schizophrenia, it will serve as a good reference for future studies designed to examine the cannabinoid hypothesis of schizophrenia.

OBJECTIVES: Located on chromosome 10q22-q23, the human neuregulin 3 (NRG3) is suggested as a strong positional and functional candidate gene involved in the pathogenesis of schizophrenia. Several case-control studies examining the association between polymorphisms on NRG3 gene with schizophrenia and/or its traits (such as delusion) have been reported recently in cohorts of Han Chinese, Ashkenazi Jews, Australians, white Americans of Western European ancestry and Koreans. Thus, this study aimed to investigate the association of one SNP in exon 9 (rs2295933) of NRG3 gene with the risk of schizophrenia in a Korean population. METHODS: Using TaqMan assay, rs2295933 in the exon 9 of NRG3 was genotyped in 435 patients with schizophrenia as cases and 393 unrelated healthy individuals as controls. Differences in frequency distributions were analyzed using logistic regression models following various modes of genetic inheritance and controlling for age and sex as covariates. RESULTS: Subsequent analysis revealed that the frequency distribution of rs2295933 of NRG3 was not different between schizophrenia patients and healthy controls of Korean ethnicity. CONCLUSIONS: This study does not support the role of NRG3 in schizophrenia in a Korean population.
Asian Continental Ancestry Group ; Case-Control Studies ; Cohort Studies ; Exons ; Humans ; Jews ; Logistic Models ; Polymorphism, Single Nucleotide ; Schizophrenia ; Wills

BACKGROUND/AIMS: The aim of the study was to evaluate the efficacy of i-scans for the diagnosis of gastroesophageal reflux disease, especially where only minimal change is involved. METHODS: The esophageal mucosa was inspected using an i-scan following conventional white light endoscopy. The examination with iscan was performed under tone enhancement (TE) esophagus (e) mode. Patients with subtle distal esophageal mucosal changes without definite mucosal breaks, such as blurring of Z-line (B), mucosal coarseness (C), hyperemic or purplish discoloration (D), erythema (E), ectopic gastric mucosal islet (I) and mixed type were classified as minimal change. RESULTS: A total of 156 patients were included. Using i-scan endoscopy, the number of minimal change was found to further increase from 94 (conventional endoscopy; 19B, 9C, 29D, 13E, 5I, 19 mixed type) to 109 (i-scan; 15B, 8C, 29D, 16E, 5I, 36 mixed type). And 14 patients who had single type by conventional endoscopy were converted to mixed type after i-scan. Therefore, 29 of 156 patients were upgraded after i-scan, they were account for 19% (p<0.0001; 95% confidence interval, 0.13 to 0.25). CONCLUSIONS: The use of i-scan endoscopy significantly improves the identification of minimal change and helps to identify more precisely the type of minimal change.
Endoscopy ; Erythema ; Esophagus ; Gastroesophageal Reflux ; Humans ; Light ; Mucous Membrane

BACKGROUND/AIMS: The aim of the study was to evaluate the efficacy of i-scans for the diagnosis of gastroesophageal reflux disease, especially where only minimal change is involved. METHODS: The esophageal mucosa was inspected using an i-scan following conventional white light endoscopy. The examination with iscan was performed under tone enhancement (TE) esophagus (e) mode. Patients with subtle distal esophageal mucosal changes without definite mucosal breaks, such as blurring of Z-line (B), mucosal coarseness (C), hyperemic or purplish discoloration (D), erythema (E), ectopic gastric mucosal islet (I) and mixed type were classified as minimal change. RESULTS: A total of 156 patients were included. Using i-scan endoscopy, the number of minimal change was found to further increase from 94 (conventional endoscopy; 19B, 9C, 29D, 13E, 5I, 19 mixed type) to 109 (i-scan; 15B, 8C, 29D, 16E, 5I, 36 mixed type). And 14 patients who had single type by conventional endoscopy were converted to mixed type after i-scan. Therefore, 29 of 156 patients were upgraded after i-scan, they were account for 19% (p<0.0001; 95% confidence interval, 0.13 to 0.25). CONCLUSIONS: The use of i-scan endoscopy significantly improves the identification of minimal change and helps to identify more precisely the type of minimal change.
Endoscopy ; Erythema ; Esophagus ; Gastroesophageal Reflux ; Humans ; Light ; Mucous Membrane

BACKGROUND: Several kinds of adverse reactions can occur during blood donation such as vasovagal reaction (VVR), hematoma, citrate toxicity, etc. These adverse reactions are not common, but they are important because they cause a decrease in re-donation. The cost for maintaining a repeat donation is very low compared to that for securing first-time donors. Whole blood donation differs from apheresis in some aspects, and this could have an influence on blood donor reactions. We compared whole blood donation with apheresis for blood donor reactions. METHODS: From January to December in 2007 at Busan Red Cross Blood Center, 109,004 donations were investigated for blood donor reactions. 76,098 (69.8%) donations were from male donors and 32,906 (30.2%) were from females. 77,813 (71.3%) donations were for whole blood, 25,224 (23.2%) were for plasmapheresis and 5,967 (5.5%) were for plateletpheresis. RESULTS: The frequencies of VVR were 0.10% (75/77,813) for the whole blood donations, 0.15% (37/25,224) for plasmapheresis and 0.03% (2/5,967) for plateletpheresis (P<0.05). The frequency of hematoma was 0.05% (37/77,813) for whole blood donation, 0.25% (62/25,224) for plasmapheresis and 0.27% (16/5,967) for plateletpheresis (P<0.05). Citrate toxicity was extremely rare. VVR was most common in plasmapheresis, and it was rare in plateletpheresis. CONCLUSION: The kinds of donated blood components had an influence on blood donor reactions. Understanding these characteristics helps to prevent adverse reaction. Having people re-donate is essential for keeping a large sized donor pool. So, appropriate management to prevent donor reactions is very important.
Blood Component Removal ; Blood Donors ; Citric Acid ; Female ; Hematoma ; Humans ; Male ; Plasmapheresis ; Plateletpheresis ; Red Cross ; Tissue Donors

BACKGROUND: This study aimed to analyze the influence of the interruption of agitation and removal of leukocytes on platelet concentrates (PCs), and determine the maximum amount of time the agitation could be interrupted without impairing PCs' effectiveness during the storage period. METHODS: Four ABO-identical random donor platelets agitated for 24 hr were pooled, and divided into 4 units, and 2 units of them were leukoreduced. Then 52 pooled units were categorized into 4 groups, non-leukoreduced continuous agitation (Non-LRCA), non-leukoreduced interrupted agitation (Non-LRIA), leukoreduced continuous agitation (LRCA), and leukoreduced interrupted agitation (LRIA), and preserved for 6 days (total 7 days). Mean platelet volume (MPV), pH, HCO3-, pO2, pCO2, CD62P, CD61, glucose, lactate, ammonia and free fatty acid were measured during the period. RESULTS: Starting from the Day 4, the pH and HCO3- of Non-LRIA group begun to decrease while the amount of lactate production, glucose consumption, and MPV increased compared to the Non- LRCA group (P<0.01). An increase in pO2 level was observed in the interrupted agitation groups as the storage period prolonged (P<0.01). The pH levels of all the units in the agitation groups remained higher than 6.4 up to Day 7, while those of the non-leukoreduction group did so only up to Day 2, but those of leukoreduction in the interrupted agitation groups did so up to Day 4. CONCLUSIONS: The interruption of agitation reduced the platelet's capacity to utilize oxygen, increasing lactate amount and reducing pH level. However, the in vitro parameters of the Non-LRIA and Non-LRCA groups on Day 2 were similar to each other and the pH level remained at 6.4 or higher, making one day of agitation interruption possible after 24 hr of agitation. With leukocytes removed, the effective agitation interruption period may become longer.
*Blood Component Removal ; Blood Platelets/*cytology ; Blood Preservation/*standards ; Cell Separation ; Glucose/analysis ; Humans ; Hydrogen-Ion Concentration ; Lactic Acid/blood ; Oximetry ; P-Selectin/blood ; Time Factors ; Vibration

BACKGROUND AND PURPOSES: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and METHODS: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002- 2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Fortythree items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. RESULTS: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. CONCLUSION: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.
Chronic Disease ; Classification ; Climate ; Korea ; National Institute for Occupational Safety and Health (U.S.) ; Reward ; Risk Factors

BACKGROUND: Effects of storage period on platelet activation of random-donor platelets (RDP) prepared from whole blood units and single-donor platelets (SDP) prepared from single-donor apheresis collections have been investigated in this study. We also analyzed the correlation between amount of blood cells and platelet activation in random-donor platelets. METHODS: RDP and SDP were collected at 1 day, 3 day, or 5 day during storage. In case of SDP, whole blood was also collected just before apheresis. The platelet activation in RDP and SDP was measured by flowcytometry using monoclonal antibodies against CD41a, CD61 and CD62p. RESULTS: In SDP, MCFI against CD62p has been significantly increased during storage and any significant differences are not found according to the kinds of pheresis machines. In RDP, no significant differences in MCFI against CD62p were found with storage period and showed a increased MCFI dependent only on the number of platelets. CONCLUSION: Single-donor platelets should be used as soon as possible for transfusion due to progressive platelet activation with storage period. On the other hand, a proper number of platelets should be maintained under strict quality control system to minimize platelet activation in RDP.
Antibodies, Monoclonal ; Blood Cells ; Blood Component Removal ; Blood Platelets* ; Hand ; Platelet Activation* ; Quality Control

BACKGROUND: The purpose of this study is to examine whether the blood cells in the platelet concentrate (PC) and the PC arrangement method can affect the pH which is one of the important factors influencing the survival and function of the preserved PCs. METHOD: Two groups of CPDA-1 added PC were preserved at 20 ~ 24degrees C for 7 days. The PCs in group I were overlapped one another while those in group II were not overlapped and arranged separately during the preservation period. The number of RBC, WBC and platelets were measured at the first day of the preservation period while the pH was measured at the 1st, 3rd, 5th and 7th day. RESULTS: The number of blood cells in the PC was 0.6x109 for WBC, 1.6x109 for RBC and 800x109 for platelet. As for the average pH, the 1st day's average pH was 7.4 for group I and 7.3 for group II, while at the 7th day, both decreased by 0.6. According to the correlation analysis between the blood cells and the pH changes, as for group I, the more the number of platelets were, the lower the pH decreased, and as for group II, the more the WBC and platelets were, the lower the pH decreased. (p<0.01) CONCLUSION: This study indicates that the major parameter affecting the pH of the preserved PCs is the number of platelets. In addition to platelet, the number of WBCs affected the pH when PCs were overlapped during storage. Conclusionally the key factor which affects pH of stored PCs was the number of platelets. And the number of contaminated WBCs also were thought to be an important factor.
Blood Cells ; Blood Platelets* ; Hydrogen-Ion Concentration*