Objective: Striatal dopamine dysfunction caused by cortical abnormalities is a leading hypothesis of schizophrenia. Although prefrontal cortical pathology is negatively correlated with striatal dopamine synthesis, the relationship between structural frontostriatal connectivity and striatal dopamine synthesis has not been proved in patients with schizophrenia with different treatment response. We therefore investigated the relationship between frontostriatal connectivity and striatal dopamine synthesis in treatment-responsive schizophrenia (non-TRS) and compared them to treatment-resistant schizophrenia (TRS) and healthy controls (HC). Methods: Twenty-four patients with schizophrenia and twelve HC underwent [18F] DOPA PET scans to measure dopamine synthesis capacity (the influx rate constant Kicer) and diffusion 3T MRI to measure structural connectivity (fractional anisotropy, FA). Connectivity was assessed in 2 major frontostriatal tracts. Associations between Kicer and FA in each group were evaluated using Spearman’s rho correlation coefficients. Results: Non-TRS showed a negative correlation (r=-0.629, p=0.028) between connectivity of dorsolateral prefrontal cortex-associative striatum (DLPFC-AST) and dopamine synthesis capacity of associative striatum but this was not evident in TRS (r=-0.07, p=0.829) and HC (r=-0.277, p=0.384). Conclusion Our findings are consistent with the hypothesis of dysregulation of the striatal dopaminergic system being related to prefrontal cortex pathology localized to connectivity of DLPFC-AST in non-TRS, and also extend the hypothesis to suggest that different mechanisms underlie the pathophysiology of non-TRS and TRS.

Coronavirus disease 2019 vaccinations for healthcare workers (HCWs) have begun in South Korea. To investigate adverse events (AEs) of the first dose of each vaccine, any symptom was collected daily for seven days after vaccination in a tertiary hospital. We found that 1,301 of 1,403 ChAdOx1 nCoV-19 recipients and 38 of 80 BNT162b2 recipients reported AEs respectively (90.9% vs. 52.5%): injection-site pain (77.7% vs. 51.2%), myalgia (60.5% vs.11.2%), fatigue (50.7% vs. 7.5%), headache (47.4% vs. 7.5%), and fever (36.1% vs. 5%; P < 0.001 for all). Young HCWs reported more AEs with ChAdOx1 nCoV-19 than with BNT162b2.No incidences of anaphylaxis were observed. Only one serious AE required hospitalization for serious vomiting, and completely recovered. In conclusion, reported AEs were more common in recipients with ChAdOx1 nCoV-19 than in those with BNT162b2. However, most of the reported AEs were mild to moderate in severity. Sufficient explanation and preparation for expected AEs required to promote widespread vaccination.

Coronavirus disease 2019 vaccinations for healthcare workers (HCWs) have begun in South Korea. To investigate adverse events (AEs) of the first dose of each vaccine, any symptom was collected daily for seven days after vaccination in a tertiary hospital. We found that 1,301 of 1,403 ChAdOx1 nCoV-19 recipients and 38 of 80 BNT162b2 recipients reported AEs respectively (90.9% vs. 52.5%): injection-site pain (77.7% vs. 51.2%), myalgia (60.5% vs.11.2%), fatigue (50.7% vs. 7.5%), headache (47.4% vs. 7.5%), and fever (36.1% vs. 5%; P < 0.001 for all). Young HCWs reported more AEs with ChAdOx1 nCoV-19 than with BNT162b2.No incidences of anaphylaxis were observed. Only one serious AE required hospitalization for serious vomiting, and completely recovered. In conclusion, reported AEs were more common in recipients with ChAdOx1 nCoV-19 than in those with BNT162b2. However, most of the reported AEs were mild to moderate in severity. Sufficient explanation and preparation for expected AEs required to promote widespread vaccination.

Objective To evaluate the effect of oxycodone preconditioning on mitochondrion-dependent apoptosis in liver ceils during intestinal ischemia-reperfusion (I/R) in rats.Methods Fifty-four healthy male Sprague-Dawley rats,weighing 200-300 g,were divided into 9 groups (n=6 each) using a random number table:sham operation group (group S),I/R group,oxycodone preconditioning group (group OP),μ receptor blocker CTOP group (group CTOP),δ receptor blocker naltrindole (NTD) group (group NTD),κ receptor blocker nor-binaltorphimne (BNI) group (group BNI),CTOP plus oxycodone preconditioning group (group CTOP+OP),NTD plus oxycodone preconditioning group (group NTD+ OP),and BN1 plus oxycodone preconditioning group (group BNI+OP).The model of intestinal I/R was established by occluding the superior mesenteric artery for 45 min followed by 2 h reperfusion.Oxycodone 0.5 mg/kg was injected intravenously at 10 min prior to ischemia in OP,COTP+OP,NTD+OP and BNI+ OP groups.COTP 1 mg/kg and NTD 5 mg/kg were injected intravenously at 20 min prior to ischemia in COTP+OP and NTD+OP groups,respectively.BNI 5 mg/kg was injected intravenously at 25 min prior to ischemia in group BNI+OP.CTOP 1 mg/kg and NTD 5 mg/kg were injected intravenously at 10 min prior to ischemia in CTOP and NTD groups,respectively.BNI 5 mg/kg was injected intravenously at 15 min prior to ischemia in group BNI.The superior mesenteric artery was only exposed but not occluded in group S.The rats were sacrificed at 2 h of reperfusion,and livers were removed for determination of apoptosis in liver cells (using TUNEL) and expression of Bcl-2 and caspase-3 in liver tissues (by immunohistochemistry).The apoptosis index (AI) was calculated.Results Compared with group S,AI was significantly increased,the expression of Bcl-2 was down-regulated and the expression of caspase-3 was up-regulated in the other eight groups (P＜0.05).Compared with group I/R,AI was significantly decreased,the expression of Bcl-2 was up-regulated,and the expression of caspase-3 was down-regulated in group OP (P＜0.05).Compared with group OP,AI was significantly increased,Bcl-2 expression was down-regulated,and caspase-3 expression was up-regulated in COTP+OP,NTD+OP and BNI+OP groups (P＜0.05).Conclusion The mechanism by which oxycodone preconditioning activates μ,δ and κ receptors and reduces intestinal I/R injury may be related to inhibiting mitochondrion-dependent apoptosis in rats.

OBJECTIVE: Executive dysfunction might be an important determinant for response to pharmacotherapy in obsessive-compulsive disorder (OCD), and could be sustained independently of symptom relief. The anterior cingulate cortex (ACC) has been indicated as a potential neural correlate of executive functioning in OCD. The present study examined the brain-executive function relationships in OCD from the ACC-based resting state functional connectivity networks (rs-FCNs), which reflect information processing mechanisms during task performance. METHODS: For a total of 58 subjects [OCD, n=24; healthy controls (HCs), n=34], four subdomains of executive functioning were measured using the Rey-Osterrieth Complex Figure Test (RCFT), the Stroop Color-Word Test (SCWT), the Wisconsin Card Sorting Test (WCST), and the Trail Making Test part B (TMT-B). To probe for differential patterns of the brain-cognition relationship in OCD compared to HC, the ACC-centered rs-FCN were calculated using five seed regions systemically placed throughout the ACC. RESULTS: Significant differences between the OCD group and the HCs with respect to the WCST perseverative errors, SCWT interference scores, and TMT-B reaction times (p<0.05) were observed. Moreover, significant interactions between diagnosis×dorsal ACC [S3]-based rs-FCN strength in the right dorsolateral prefrontal cortex for RCFT organization summary scores as well as between diagnosis×perigenual ACC [S7]-based rs-FCN strength in the left frontal eye field for SCWT color-word interference scores were unveiled. CONCLUSION: These network-based neural foundations for executive dysfunction in OCD could become a potential target of future treatment, which could improve global domains of functioning broader than symptomatic relief.
Automatic Data Processing ; Drug Therapy ; Executive Function ; Foundations ; Frontal Lobe ; Gyrus Cinguli ; Obsessive-Compulsive Disorder* ; Prefrontal Cortex ; Reaction Time ; Task Performance and Analysis ; Trail Making Test ; Wisconsin

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization has been known as a predictor of intensive care unit (ICU)-acquired MRSA infections. We performed this study to survey the nasal colonization of MRSA among the patients admitted to an ICU and analyze risk factors associated with the colonization. METHODS: A retrospective 1:1 matched case-control study was conducted with patients admitted to the ICU from March to December 2010 at Samsung Changwon Hospital. RESULTS: A total of 602 patients among 846 patients admitted to the ICU during the study period were evaluated. The prevalence of nasal MRSA colonization was 67 (11.1%) of 602. Other factors, including underlying renal disease (odds ratio [OR]=12.37, 95% confidence interval [CI] 3.60-42.54; P<0.001), MRSA infection within the previous 3 months (OR=7.43, 95% CI 1.31-42.05; P=0.023), nursing home resident within the previous 1 month (OR=6.25, 95% CI 1.82-21.53; P=0.004), surgical procedure within the previous 1 month (OR=5.93, 95% CI 1.86-18.85; P=0.003), and current use of nasogastric tube (OR=4.98, 95% CI 1.84-13.45; P=0.002) were independently associated with nasal MRSA colonization in patients admitted to ICU. CONCLUSION: A significant number of patients admitted to the ICU in a secondary hospital were colonized with MRSA. The present study showed the possible impact of the presence of a nasogastric tube on the nasal colonization by MRSA. More effective infection control procedures must be developed for patients with nasogastric tube use.
Case-Control Studies ; Colon* ; Gyeongsangnam-do ; Humans ; Infection Control ; Intensive Care Units* ; Methicillin-Resistant Staphylococcus aureus* ; Nursing Homes ; Prevalence ; Retrospective Studies ; Risk Factors

OBJECTIVE: Genetic imaging is used to investigate the mechanism by which genetic variants influence brain structure. In a previous study, a structural change of the dorsolateral prefrontal cortex was associated with symptom modulation in post-traumatic stress disorder patients. This study examined the effect of a polymorphism in the gene encoding brain-derived neurotrophic factor (BDNF) on regional gray matter (GM) volumes and the correlations between the dorsolateral prefrontal GM volume and the stress level in healthy volunteers. METHODS: Sixty-one volunteers underwent genotyping for the BDNF Val66Met single nucleotide polymorphism (SNP) and completed the Stress Response Inventory (SRI). Magnetic resonance images were also acquired, and the effect of each subject's BDNF genotype and SRI subscore on his or her dorsolateral prefrontal GM volume was evaluated. RESULTS: The Val/Val homozygotes had significantly larger GM volumes in the prefrontal cortex and the precuneus, the uncus, and the superior temporal and occipital cortices than Met carriers. The Met homozygotes demonstrated a higher stress response in depression domain than Val/Val and Val/Met groups. A negative correlation between the middle frontal cortex GM volume and the SRI depression subscore was found. CONCLUSION: These findings indicate an interaction between genes and brain structure, and they suggest that differences in dorsolateral prefrontal GM volume related to the BDNF Val66Met SNP are associated with resilience to stressful life events, particularly in the dimension of emotion.
Brain ; Brain-Derived Neurotrophic Factor ; Depression ; Genotype ; Homozygote ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Prefrontal Cortex ; Stress Disorders, Post-Traumatic

Generalized granuloma annulare (GGA) is a rare variant of granuloma annulare, presenting with diffuse papules and annular patches on the trunk and extremities. Though the pathogenesis of GGA has not been totally understood, recent studies have shown the relationship between malignancy and GGA. A 74-year-old man developed a generalized, mildly pruritic erythematous papules, which slowly coalesced into annular patch with elevated rim. Punch biopsy showed palisading and interstitial granuloma with giant cells. A complete blood cell count with differential revealed leukopenia and subsequent findings of the bone marrow biopsy were compatible with myelodysplastic syndrome (MDS). As there was no more progression of MDS, only the skin lesions were treated with hydroxychloroquine, isotretinoin and phototherapy, and improved after 14 months of treatment. We recommend that careful evaluation of the underlying solid tumor, as well as hematologic malignancy, should be done when the dermatologists encounter with the patient presenting generalized granuloma annulare.
Aged ; Biopsy ; Blood Cell Count ; Bone Marrow ; Extremities ; Giant Cells ; Granuloma ; Granuloma Annulare ; Hematologic Neoplasms ; Humans ; Hydroxychloroquine ; Isotretinoin ; Leukopenia ; Myelodysplastic Syndromes ; Phototherapy ; Skin

Kissing or divided nevi are similar in shape to congenital melanocytic nevi located on an adjacent part of the body that are separated during embryogenesis. Kissing nevi of the upper and lower eyelids have been reported infrequently since the first report in 1908. Kissing nevi of the penis are very rare, with only 12 cases being reported until now, and this is the first case report in the Korean dermatological literature. A previously healthy 27-year-old man presented with asymptomatic black colored patches, which were detected 10 years ago, on the glans penis and the prepuce with growth in size. We report here a case of kissing nevus of the penis, which showed an obvious mirror-image symmetry relative to the coronal sulcus.
Adult ; Embryonic Development ; Eyelids ; Female ; Humans ; Male ; Nevus ; Nevus, Pigmented ; Penis ; Pregnancy

PURPOSE: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. METHODS: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. RESULTS: The inter-rater reliability of items was high (Kappa range: 0.66-0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. CONCLUSION: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Female ; Health Services for the Aged/standards ; Hospitals ; Humans ; Long-Term Care/*standards ; Male ; Outcome Assessment (Health Care) ; Prevalence ; *Quality of Health Care ; Urinary Incontinence/*therapy