Background: Arsenic trioxide (ATO) is the standard treatment for relapsed acute promyelocytic leukemia (APL). However, consensus on post-remission therapies is still lacking. Methods: We evaluated 52 patients who experienced relapse following initial treatment of APL between 2000 and 2019 at Catholic Hematology Hospital. Among them, 41 patients received reinduction treatment, 30 with ATO-based regimen, whereas 11 with conventional intensive chemotherapy (IC). Results: The ATO reinduction group showed a significantly higher second molecular complete remission (mCR2) rate, superior neutrophil and platelet recovery, and a lower infection rate than the IC reinduction group. No significant differences were observed in survival outcomes after post-remission treatment among the ATO-based (N=19), autologous (N=12), and allogeneic (N=6) hematopoietic stem cell transplantation (HSCT) groups. In the ATO-based and autologous HSCT groups, among patients with mCR2 after ATO reinduction, nine and five patients experienced a second relapse, respectively (50.7% vs. 41.7%, P =0.878). Among these patients, seven received salvage allogeneic HSCT; six remained alive. The other seven patients received ATO without HSCT. Five died from disease progression, and two survived and have been in mCR2 since. Conclusion Post-remission treatment outcomes of patients with relapsed APL were not significantly different, regardless of the treatment option, suggesting the feasibility of ATO-based treatment without HSCT in mCR2. Allogeneic HSCT may be an effective salvage treatment modality for patients with a second relapse. Owing to a few cases of relapsed APL, multicenter prospective studies may help elucidate the efficacy of each post-remission treatment.

Purpose: In this study, a urinary management system was established to collect and analyze urinary time and interval data detected through patient-worn smart bands, and the results of the analysis were shown through a web-based visualization to enable monitoring and appropriate feedback for urological patients. Methods: We designed a device that can recognize urination time and spacing based on patient-specific posture and consistent posture changes, and we built a urination patient management system based on this device. The order of body movements during urination was consistent in terms of time characteristics; therefore, sequential data were analyzed and urinary activity was recognized using repeated neural networks and long-term short-term memory systems. The results were implemented as a web (HTML5) service program, enabling visual support for clinical diagnostic assistance. Results: Experiments were conducted to evaluate the performance of the proposed recognition techniques. The effectiveness of smart band monitoring urination was evaluated in 30 men (average age, 28.73 years; range, 26–34 years) without urination problems. The entire experiment lasted a total of 3 days. The final accuracy of the algorithm was calculated based on urological clinical guidelines. This experiment showed a high average accuracy of 95.8%, demonstrating the soundness of the proposed algorithm. Conclusions This urinary activity management system showed high accuracy and was applied in a clinical environment to characterize patients’ urinary patterns. As wearable devices are developed and generalized, algorithms capable of detecting certain sequential body motor patterns that reflect certain physiological behaviors can be a new methodology for studying human physiological behaviors. It is also thought that these systems will have a significant impact on diagnostic assistance for clinicians.

Purpose: In this study, a urinary management system was established to collect and analyze urinary time and interval data detected through patient-worn smart bands, and the results of the analysis were shown through a web-based visualization to enable monitoring and appropriate feedback for urological patients. Methods: We designed a device that can recognize urination time and spacing based on patient-specific posture and consistent posture changes, and we built a urination patient management system based on this device. The order of body movements during urination was consistent in terms of time characteristics; therefore, sequential data were analyzed and urinary activity was recognized using repeated neural networks and long-term short-term memory systems. The results were implemented as a web (HTML5) service program, enabling visual support for clinical diagnostic assistance. Results: Experiments were conducted to evaluate the performance of the proposed recognition techniques. The effectiveness of smart band monitoring urination was evaluated in 30 men (average age, 28.73 years; range, 26–34 years) without urination problems. The entire experiment lasted a total of 3 days. The final accuracy of the algorithm was calculated based on urological clinical guidelines. This experiment showed a high average accuracy of 95.8%, demonstrating the soundness of the proposed algorithm. Conclusions This urinary activity management system showed high accuracy and was applied in a clinical environment to characterize patients’ urinary patterns. As wearable devices are developed and generalized, algorithms capable of detecting certain sequential body motor patterns that reflect certain physiological behaviors can be a new methodology for studying human physiological behaviors. It is also thought that these systems will have a significant impact on diagnostic assistance for clinicians.

Background/Aims: Idiopathic multicentric Castleman disease (iMCD) comprises approximately 30% of all cases of Castleman disease. It is characterized by constitutional symptoms, enlarged lymph nodes at multiple anatomical sites, and laboratory test abnormalities, which are primarily related to the overproduction of interleukin 6 (IL-6). Siltuximab is a human-mouse chimeric immunoglobulin G1κ monoclonal antibody against human IL-6. In view of the limited treatment options for iMCD, this study aimed to evaluate the efficacy and safety of siltuximab in the management of this condition. Methods: In this real-world retrospective study, we administered siltuximab to 15 patients with iMCD who previously received conventional chemotherapy and/or steroid pulse therapy. The median time to a durable symptomatic response was 22 days (range, 17 to 56). The serum hemoglobin and albumin levels and erythrocyte sedimentation rates significantly normalized after the first 3 months of siltuximab treatment. Lymph node involution, assessed using imaging, was relatively gradual, demonstrating a complete or partial response at 6 months. Results: On an average, the improvements in clinical, laboratory, and radiologic parameters of iMCD in responders were observed after one, three, and eight cycles of siltuximab treatment, respectively. Siltuximab demonstrated a favorable safety profile, and prolonged treatment was well-tolerated. Conclusions Despite the small sample size of the present study, the results are encouraging and demonstrate the potential of siltuximab as the first-line treatment of iMCD. Further large multicenter studies are needed to evaluate the clinical outcomes and adverse events associated with siltuximab.

PURPOSE: Rotenone is the most widely used neurotoxin for the making Parkinson disease (PD) animal model. The neurodegenerative disorder PD shows symptoms, such as slowness of movements, tremor at resting, rigidity, disturbance of gait, and instability of posture. We investigated whether treadmill running improves motor ability using rotenone-caused PD rats. The effect of treadmill running on PD was also assessed in relation with apoptosis of cerebellar Purkinje cells. METHODS: Treadmill running was applied to the rats in the exercise groups for 30 minutes once a day for 4 weeks, starting 4 weeks after birth. We used rota-rod test for the determination of motor coordination and balance. In this experiment, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining, immunohistochemistry for calbindin, glial fibrillary acidic protein (GFAP), Iba-1, and western blot analysis for Bax and Bcl-2 were performed. RESULTS: Treadmill running enhanced motor balance and coordination by preventing the loss of Purkinje cells in the cerebellar vermis. Treadmill running suppressed PD-induced expression of GFAP-positive reactive astrocytes and Iba-1-positive microglia, showing that treadmill running suppressed reactive astrogliosis and microglia activation. Treadmill running suppressed TUNEL-positive cell number and Bax expression and enhanced Bcl-2 expression, demonstrating that treadmill running inhibited the progress of apoptosis in the cerebellum of rotenone-induced PD rats. CONCLUSIONS: Treadmill running improved motor ability of the rotenone-induced PD rats by inhibiting apoptosis in the cerebellum. Apoptosis suppressing effect of treadmill running on rotenone-induced PD was achieved via suppression of reactive astrocyte and inhibition of microglial activation.
Animals ; Apoptosis ; Astrocytes ; Blotting, Western ; Calbindins ; Cell Count ; Cerebellar Vermis ; Cerebellum ; Gait ; Glial Fibrillary Acidic Protein ; Immunohistochemistry ; Microglia ; Models, Animal ; Neurodegenerative Diseases ; Parkinson Disease* ; Parturition ; Posture ; Purkinje Cells* ; Rats* ; Rotenone ; Running ; Tremor

PURPOSE: The purpose of this study was to assess the current management status of patients with urological issues and to examine the level of knowledge and practice behaviors regarding urinary incontinence (UI) among Korean healthcare providers in long-term care hospitals. METHODS: This study used a cross-sectional descriptive design with a written questionnaire to assess knowledge and practice behaviors of 756 healthcare providers in 11 long-term care hospitals in Korean metropolitan areas. RESULTS: A total 42.6% of participants reported that more than 50% of patients had urologic issues, and that 68.1% of patients were regularly sent to urologists; no participants reported an on-site urologist in their facility. Participants identified collaboration with other hospitals and regular consultations by urologists as important factors in improving urologic care. Although the overall UI knowledge score was upper intermediate, a knowledge deficit was found for risk factors of UI. The knowledge level of physicians was significantly higher than that of other healthcare providers. Practice behaviors of nurses seemed to be better than those of other healthcare providers. CONCLUSIONS: Systematic collaboration between healthcare providers and urologic specialists, enhancing staff competence, and patient-tailored intervention should be recommended to improve quality of care for patients with urologic issues in long-term care hospitals.
Cooperative Behavior ; Delivery of Health Care* ; Health Personnel* ; Humans ; Long-Term Care* ; Mental Competency ; Professional Practice ; Referral and Consultation ; Risk Factors ; Specialization ; Urinary Incontinence*

PURPOSE: Methylphenidate is the most widely used central nervous system stimulant in patients with attention deficit hyperactivity disorder. However, few studies have assessed its effects on voiding. Various doses of methylphenidate were investigated for their effects on cystometric parameters in conscious mice. METHODS: Ten male C57BL/6 mice, weighing between 20 and 23 g, were used in this study. To compare the acute drug responses before and after the oral medication was administered in the awake condition, we injected the solution through a catheter inserted into the stomach. Methylphenidate (1.25, 2.5, and 5 mg/kg) in an injection volume of 0.05 mL was administered. RESULTS: Four mice that received high doses of methylphenidate (2.5 and 5 mg/kg) showed no voiding contraction, with urine leakage. Six mice that received a low dose of methylphenidate (1.25 mg/kg) showed typical micturition cycles before and after administration. The micturition pressure decreased and bladder capacity increased without an increased residual volume after administration. CONCLUSIONS: Methylphenidate has differential, dose-dependent effects on the function of the lower urinary tract, due to the dependent relationship between the brain and lower urinary tract. Especially at higher doses, this drug may interfere with normal micturition. Therefore, more detailed clinical or experimental studies are warranted in the future.
Animals ; Attention Deficit Disorder with Hyperactivity ; Brain ; Catheters ; Central Nervous System ; Humans ; Male ; Methylphenidate* ; Mice ; Residual Volume ; Stomach ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Tract ; Urination ; Urodynamics

BACKGROUND: The sleep quality of subway drivers who work in the dark underground with an rotating shift system is generally poor, which can degrade the quality of a worker's life. This study examined the relationship between the sleep quality of subway worker and shift work by comparing three shift systems (rotating shift system, a three day shift system, and no-shift system). METHOD: Questionnaires including The short form of the Korean Occupational Stress Scale (KOSS), Pittsburgh Sleep Questionnaire (PSQI), the worker's age, gender, job type, accident, near miss and shift system were given to a total of 1010 workers. The results of 759 qualified questionnaires (75.15 %) were analyzed using the SPSS (ver 12.0) program. RESULT: The highest level of job stress was found among those working a rotating shift system followed by three shift system and no-shift system. The mean sleep quality score in the rotating shift workers was 5.1 (SD+/-3.2), which was greater than the sleep symptom score (5). 34.8% of rotating shift workers suffered from sleep symptoms. The sleep quality score by shift-work was significantly different. High job demand, strong external locus control, the experience of a near miss or an accident in the workplace during previous year has an adverse affect on the sleep quality. The sleep quality improved in case of a change into a no-shift system or a strong internal locus control. CONCLUSION: A rotating shift system is more harmful to the quality of sleep in subway workers than a 3 shift system or no-shift system. In addition, job stress, personality, near miss and the experience of an accident affect the sleep quality of subway workers.
Questionnaires ; Railroads

Objective: The purpose of this study was to evaluate and compare the association of job stress and working with video display terminal (VDT) to musculoskeletal symptoms of the neck-shoulder which were most common in white-collar workers. METHODS: From 122 workplaces, 1,790 white-collar workers with no trauma, and no history of musculoskeletal disease were selected for the study. The questionnaire survey included general characteristics, work related characteristics, Job Content Questionnaire (JCQ) and musculoskeletal symptoms. Multiple logistic regression, adjusted for age, smoking status, drinking habit, housekeeping, work time, job tenure, and work-load change, were used to evaluate the effects of job stress and VDT-work on the symptoms. RESULTS: The prevalence of neck-shoulder symptoms was overall 24.3% overall. The prevalence odds ratio of job demand (high/low) to neck-shoulder symptoms, adjusted for general and work-related factors, was 1.56 (95% confidence interval 1.12~2.17), and that of job strain (high strain/low strain) was 1.72 (1.07~2.79). However, VDT-work was not associated with neck-shoulder symptoms in the multiple logistic regression model. CONCLUSIONS: To prevent musculoskeletal disorders in white-collar workers, it is important to consider psychosocial factors such as job demand and job strain, as well as VDT-work.
Computer Terminals ; Drinking ; Housekeeping ; Logistic Models ; Musculoskeletal Diseases ; Neck* ; Odds Ratio ; Prevalence ; Psychology ; Questionnaires ; Shoulder* ; Smoke ; Smoking

OBJECTIVE: This study was performed to evaluate relationship of burdened work and musculoskeletal symptoms in small-to-medium sized enterprises. METHOD: After a questionnaire survey was administered to 9,950 workers in 122 workplace, 7,626 workers(76.6%) were finally selected for the study analysis. Industrial hygienists visited 122 small-to-medium sized enterprises to investigate the presence of burdened works within the workplace. The selection of jobs with significant burden was based on the Ministry of Labor's recent notification in 11 types of job description associated with musculoskeletal disorders. The subjects of this study were then divided into three categories. 1) non-burdened white collar workers, 2) non-burdened blue collar workers, and 3) burdened workers (include some VDT workers). Multiple logistic regression was used to evaluate the relationship between burdened work and musculoskeletal symptoms. RESULTS: The burdened workers reported significantly more musculoskeletal symptoms than non-burdened white collar workers and non-burdened blue collar workers(OR:1.57, 95% CI: 1.314-1.875). There was no significant difference in reports of musculoskeletal symptoms between non-burdened white and blue collar workers. CONCLUSION: To prevent or diminish musculoskeletal disorders in small-to-medium sized enterprises, we need to better manage burdened works.
Job Description ; Logistic Models ; Questionnaires