Background: Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO. Methods: We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan–Meier (KM) method. Results: Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010–1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312–7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004). Conclusion Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.

PURPOSE: The purpose of this study was to examine the effect of a group coaching program (GCP) on depression, anxiety, and hope in women breast cancer patients undergoing chemotherapy. METHODS: A total of 152 patients were enrolled and randomly assigned to an experimental group receiving the GCP (N=76) and an untreated control group (N=76). Data collection consisted of three measurements of depression, anxiety, and hope (pre, post, and 3weeks later). The intervention was a one-time GCP consisting of 5 subparts for 30~40 minutes for a group of 3~4 people, conducted by a single nurse. RESULTS: The scores of depression, anxiety, and hope changed significantly over time (p<.001, p<.001, p<.001). Depression, anxiety, and hope changes were significantly different between the experimental and control groups (p<.001, p<.001, p<.001). There was a difference in depression, anxiety, and hope among the groups according to the implementation of the GCP (p<.001, p<.001, p<.001). In the experimental group, depression, anxiety, and hope level were significantly different between the pre- and post-test (p<.001), pre- and 3weeks later-test (p<.001), but not in the control group. CONCLUSION: The GCP for women breast cancer patients receiving chemotherapy was effective in reducing depression and anxiety, and increasing hope.
Anxiety* ; Breast Neoplasms* ; Breast* ; Data Collection ; Depression* ; Drug Therapy* ; Female ; Hope* ; Humans

BACKGROUND: An oral glucose tolerance test (OGTT) is the current method used for screening and diagnosis of gestational diabetes mellitus (GDM). OGTT is a relatively complicated procedure and is expensive. Thus, new strategies that do not require fasting or more than a single blood draw may improve the diagnosis of GDM and increase the rate of GDM testing. We investigated the utility of monitoring glycosylated hemoglobin (HbA1c) levels for the diagnosis of GDM. METHODS: The data from 992 pregnant women with estimated gestational ages ranging from 24 to 28 weeks were retrospectively reviewed. There were 367 women with plasma glucose levels > or =140 mg/dL 1 hour after a 50-g OGTT. GDM was diagnosed according to the Carpenter-Coustan criteria for a 3-hour 100 g OGTT. A HbA1c assessment was performed at the same time. RESULTS: We enrolled 343 women in this study, and there were 109 women with GDM. The area under the curve the receiver operating characteristic curve for HbA1c detection of GDM was 0.852 (95% confidence interval, 0.808 to 0.897). A HbA1c cutoff value > or =5.35% had maximal points on the Youden index (0.581). The sensitivity was 87.2% and the specificity was 70.9% for diagnosing GDM. A threshold value > or =5.35% indicated that 163 patients had GDM and that 68 (41.7%) were false positive. The positive predictive value was 58.3% at this threshold value. CONCLUSION: Despite substantial progress in methodology, HbA1c values cannot replace OGTT for the diagnosis of GDM.
Blood Glucose ; Diabetes, Gestational* ; Diagnosis* ; Fasting ; Female ; Gestational Age ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Humans ; Mass Screening ; Pregnancy ; Pregnant Women ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity

Antidiabetic and beta cell-protection activities of purple corn anthocyanins (PCA) were examined in pancreatic beta cell culture and db/db mice. Only PCA among several plant anthocyanins and polyphenols showed insulin secretion activity in culture of HIT-T15 cells. PCA had excellent antihyperglycemic activity (in terms of blood glucose level and OGTT) and HbA1c-decreasing activity when compared with glimepiride, a sulfonylurea in db/db mice. In addition, PCA showed efficient protection activity of pancreatic beta cell from cell death in HIT-T15 cell culture and db/db mice. The result showed that PCA had antidiabetic and beta cell-protection activities in pancreatic beta cell culture and db/db mice.
Animals ; Anthocyanins* ; Blood Glucose ; Cell Culture Techniques ; Cell Death ; Insulin ; Insulin-Secreting Cells ; Mice ; Passive Cutaneous Anaphylaxis ; Plants ; Polyphenols ; Zea mays*

PURPOSE: This study was done to identify the effects of self-breast pumping on breastfeeding rates and, the degree of breast milk fullness among primiparous women giving birth by cesarean section. METHODS: The study design was a non-synchronized posttest control group experiment with repeated measures. The participants were 60 women, 31 in the experimental group who used a manual pump 5 times a day after exclusive breastfeeding and 29 in the control group who breastfed exclusively with no other interventions. RESULTS: While self-breast pumping did not improve breastfeeding rates or the degree of breast milk fullness at any of the time points studied, breastfeeding rates continued to remain high till 12 weeks postpartum in both groups. Conclusion: Although some modifications in research methods will be required to identify the effects of breast pumping and exclusive breastfeeding, both these approaches can be used as interventions to improve breastfeeding rates and breast milk quantity.
Breast Feeding ; Breast Milk Expression ; Cesarean Section ; Female ; Humans ; Lactation ; Milk, Human ; Parturition ; Postpartum Period ; Pregnancy

Glutaric aciduria type 1(GA1) is an autosomal recessive disorder of the lysine, hydroxylysine and tryptophan metabolism caused by the deficiency of mitochondrial glutaryl-CoA dehydrogenase. This disease is characterized by macrocephaly at birth or shortly after birth and various neurologic symptoms. Between the first weeks and the 4-5th year of life, intercurrent illness such as viral infections, gastroenteritis, or even routine immunizations can trigger acute encephalopathy, causing injury to caudate nucleus and putamen. But intellectual functions are well preserved until late in the disease course. We report a one-month-old male infant with macrocephaly and hypotonia. In brain MRI, there was frontotemporal atrophy(widening of sylvian cistern). In metabolic investigation, there were high glutarylcarnitine level in tandem mass spectrometry and high glutarate in urine organic acid analysis, GA1 was confirmed by absent glutaryl-CoA dehydrogenase activity in fibroblast culture. He was managed with lysine free milk and carnitine and riboflavin. He developed well without a metabolic crisis. If there is macrocephaly in an infant with neuroradiologic sign of frontotemporal atrophy, GA1 should have a high priority in the differential diagnosis. Because current therapy can prevent brain degeneration in more than 90% of affected infants who are treated prospectively, recognition of this disorder before the brain has been injured is essential for treatment.
Atrophy ; Brain ; Carnitine ; Caudate Nucleus ; Diagnosis, Differential ; Fibroblasts ; Gastroenteritis ; Glutaryl-CoA Dehydrogenase ; Humans ; Hydroxylysine ; Immunization ; Infant ; Lysine ; Macrocephaly* ; Magnetic Resonance Imaging ; Male ; Metabolism ; Milk ; Muscle Hypotonia ; Neurologic Manifestations ; Parturition ; Putamen ; Riboflavin ; Tandem Mass Spectrometry ; Tryptophan

Kainic acid (KA) is a structural analogue of glutamate that interacts with specific presynaptic and postsynaptic receptors to potentiate the release and excitatory actions of glutamate. Systemic or intracerebroventricular (i.c.v.) administration of KA to experimental animals elicits multifocal seizures with a predominantly limbic localization, and results in neuronal death of cornu ammonia 1 (CA1), reactive gliosis and biochemical changes in the hippocampus and other limbic structures. Several lines of evidence suggest that reactive oxygen species (ROS) play a pivotal role in the pathogenesis of excitotoxic death by KA. Curcumin has been known to possess anti-oxidative and anti-inflammatory activities. In this study, the effects of curcumin on KA induced hippocampal cell death, reactive gliosis and biochemical changes in reactive glia were investigated by immunohistochemical methods. Our data demonstrated that curcumin attenuated KA-induced astroglial and microglial activation although it did not protect KA-induced hippocampal cell death.
Ammonia ; Animals ; Astrocytes ; Cell Death* ; Curcumin* ; Gliosis ; Glutamic Acid ; Hippocampus ; Kainic Acid ; Microglia ; Neuroglia* ; Neurons* ; Reactive Oxygen Species ; Seizures

Marshall-Smith syndrome is characterized by a triad of facial dysmorphism, failure to thrive and accelerated osseous maturation. We report a one-month-old male infant with of this rare syndrome, with laryngeal anomalies who died at 6 months of age with pneumonia. This is the first case of Marshall-Smith syndrome in Korea.
Failure to Thrive ; Humans ; Infant ; Korea ; Male ; Pneumonia

PURPOSE: The purpose of this study is to analyze the epidemiologic characteristics of sudden unexpected death in infancy and to evaluate the importance of postmortem autopsy. METHODS: We reviewed, retrospectively, medical records of 34 infants admitted to Kangnam General Hospital from January 1987 to December 2001 because of sudden unexpected death. We investigated the cause of death through medical history, death scene examination, autopsy findings, acylcarnitine and organic acid analysis. RESULTS: Among the total 34 infants, 18 were male(52.9%) and 16 were female(47.1%). Thirty infants(88%) were below the six months of age. Winter was the most affected season(38.2%). Eighteen infants(52.9%) died between 6 and 12AM. The prone sleeping position was observed more frequently than the supine position at death; nine cases in the prone position, six cases in the supine position. The cause of death of 23 cases could not be found by only history and death scene examination. Autopsy was done in 13 cases. Seven cases of them were thought to be SIDS. In six cases, we explained the cause of death with autosy findings. They were an endocardial fibroelastosis, a nesidioblastosis, a subdural hematoma, a bronchopneumonia and two fatty changes of liver. Metabolic screening tests performed in three cases to rule out metabolic disorder since 2000 were all normal. CONCLUSION: We concluded that autopsy and metabolic screening test should be performed to find out the cause of death in sudden unexpected death in infancy.
Autopsy* ; Bronchopneumonia ; Cause of Death ; Endocardial Fibroelastosis ; Hematoma, Subdural ; Hospitals, General ; Humans ; Infant ; Liver ; Mass Screening ; Medical Records ; Nesidioblastosis ; Prone Position ; Retrospective Studies ; Sudden Infant Death ; Supine Position

The purpose of this study was to describe the perceived burden of the stroke patient's caregiver and related factors to analyze relationships between perceived burden and social supports. A convenient sample of 225 caregivers who take care for a stroke patient at home participated in this study. Caregiver's perceived burden was measured by the objective and subjective burden scale developed by Montgomery (1985). Related factors of burden were studied in terms of the patient's instrumental activties of daily living, cognitive function, caregiver's demographic variables and caregiver's illness intrusiveness. The results were as follows: (1) The mean of objective burden score was 4.5, and subjective burden score was 3.1. These scores show that caregivers perceive moderate level of burden. (2) Caregivers' objective burden was significantly related to caregivers's illness intrusiveness (r=.62), patient's IADL (r=-.33), and patient's cognitive function (r=-.15). The subjective burden was related to the caregiver's illness intrusiveness (r=.29), the patient's IADL (r=.24), and the caregiver's age(r=.23). (3) The percentage of stroke caregivers who perceived physical support was 49.1%. The percentage of those who perceived emotional support was 61.0%, and those who perceived financial support totaled 37.6%. (4) Caregivers who received any type of social supports perceived lower subjective burden, and caregivers who received physical or psychological support perceived lower objective burden. These results emphasized the necessity of a rehabilitation programs for stroke patients and support program for family caregivers.
Caregivers* ; Financial Support ; Humans ; Rehabilitation ; Stroke*