The Determination of the Duration of ElectroconvulsiveTherapy-Induced Seizure Using Local Standard Deviationof the Electroencephalogram Signal and the Changesof the RR Interval of Electrocardiogram

Objectives@#ZZIn electroconvulsive therapy (ECT) research and practice, the precise determination of seizure duration is importantin the evaluation of clinical relevance of the ECT-induced seizure. In this study, we have developed computerized algorithms to assessthe duration of ECT-induced seizure. @*Methods@#ZZSubjects included 5 males and 6 females, with the mean age of 33.1 years. Total 55 ECT sessions were included in theanalysis. We analyzed the standard deviation of a finite block of electroencephalography (EEG) data and the change in the local slope ofRR intervals in electrocardiography (ECG) signals during ECT-induced seizure. And then, we compared the calculated seizure durationsfrom EEG recording (EEG algorithm) and ECG recording (ECG algorithm) with values determined by consensus of clinicians basedon the recorded EEG (EEG consensus), as a gold standard criterion, in order to testify the computational validity of our algorithms. @*Results@#ZZThe mean seizure durations calculated by each method were not significantly different in sessions with abrupt flattenedpostictal suppression and in sessions with non-abrupt flattened postictal suppression. The intraclass correlation coefficients (95% confidenceinterval) of the three methods (EEG algorithm, ECG algorithm, EEG consensus) were significant in the total sessions [0.79(0.70–0.86)], the abrupt flattened postictal suppression sessions [0.84 (0.74–0.91)], and the non-abrupt flattened postictal suppressionsessions [0.67 (0.45–0.84)]. Correlations between three methods were also statistically significant, regardless of abruptness of transition. @*Conclusions@#ZZOur proposed algorithms could reliably measure the duration of ECT-induced seizure, even in sessions with nonabrupttransitions to flat postictal suppression, in which it is typically difficult to determine the seizure duration.

The Determination of the Duration of ElectroconvulsiveTherapy-Induced Seizure Using Local Standard Deviationof the Electroencephalogram Signal and the Changesof the RR Interval of Electrocardiogram

Objectives@#ZZIn electroconvulsive therapy (ECT) research and practice, the precise determination of seizure duration is importantin the evaluation of clinical relevance of the ECT-induced seizure. In this study, we have developed computerized algorithms to assessthe duration of ECT-induced seizure. @*Methods@#ZZSubjects included 5 males and 6 females, with the mean age of 33.1 years. Total 55 ECT sessions were included in theanalysis. We analyzed the standard deviation of a finite block of electroencephalography (EEG) data and the change in the local slope ofRR intervals in electrocardiography (ECG) signals during ECT-induced seizure. And then, we compared the calculated seizure durationsfrom EEG recording (EEG algorithm) and ECG recording (ECG algorithm) with values determined by consensus of clinicians basedon the recorded EEG (EEG consensus), as a gold standard criterion, in order to testify the computational validity of our algorithms. @*Results@#ZZThe mean seizure durations calculated by each method were not significantly different in sessions with abrupt flattenedpostictal suppression and in sessions with non-abrupt flattened postictal suppression. The intraclass correlation coefficients (95% confidenceinterval) of the three methods (EEG algorithm, ECG algorithm, EEG consensus) were significant in the total sessions [0.79(0.70–0.86)], the abrupt flattened postictal suppression sessions [0.84 (0.74–0.91)], and the non-abrupt flattened postictal suppressionsessions [0.67 (0.45–0.84)]. Correlations between three methods were also statistically significant, regardless of abruptness of transition. @*Conclusions@#ZZOur proposed algorithms could reliably measure the duration of ECT-induced seizure, even in sessions with nonabrupttransitions to flat postictal suppression, in which it is typically difficult to determine the seizure duration.

First Coccygeal Vertebra Dislocation Treated by Open Reduction and Internal Fixation

STUDY DESIGN: Case report. OBJECTIVES: To report the effectiveness of open reduction and internal (screw) fixation treatment performed to treat dislocation of the first coccygeal vertebra. SUMMARY OF LITERATURE REVIEW: Most treatment methods for coccygeal dislocation were conservative treatment for acute coccygodynia and coccygectomy for chronic coccygodynia. MATERIALS AND METHODS: A 18-year-old female presented with severe coccygodynia due to a fall down the stairs. Computed tomography showed dislocation of the first coccygeal vertebra. We performed open reduction and internal fixation with a 4.0-mm shortthread cancellous screw with a washer, with no additional procedure for bone union. RESULTS: Union was achieved 10 weeks postoperatively. CONCLUSIONS: Open reduction and internal (screw) fixation can be a useful method for coccygeal vertebra dislocation.

Anti-proliferative effects of ginsenosides extracted from mountain ginseng on lung cancer / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of three major ginsenosides from mountain ginseng as anticancer substance and explore the underlying mechanism involved in lung cancer.</p><p><b>METHODS</b>The inhibitory proliferation of lung cancer by major five ginsenosides (Rb1, Rb2, Rg1, Rc, and Re) was examined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay. Calculated 50% inhibition (IC50) values of five ginsenosides were determined and compared each other. Apoptosis by the treatment of single ginsenoside was performed by fluorescence-assisted cytometric spectroscopy. The alterations of apoptosis-related proteins were evaluated by Western blot analysis.</p><p><b>RESULTS</b>The abundance of ginsenosides in butanol extract of mountain ginseng (BX-MG) was revealed in the order of Rb1, Rg1, Re, Rc and Rb2. Among them, Rb1 was the most effective to lung cancer cell, followed by Rb2 and Rg1 on the basis of relative IC50 values of IMR90 versus A549 cell. The alterations of apoptotic proteins were confirmed in lung cancer A549 cells according to the administration of Rb1, Rb2 and Rg1. The expression levels of caspase-3 and caspase-8 were increased upon the treatment of three ginsenosides, however, the levels of caspase-9 and anti-apoptotic protein Bax were not changed.</p><p><b>CONCLUSION</b>Major ginsenosides such as Rb1, Rb2 and Rg1 comprising BX-MG induced apoptosis in lung cancer cells via extrinsic apoptotic pathway rather than intrinsic mitochondrial pathway.</p>

Effect of Korean High School Students' Mental Health on Academic Achievement and School Dropout Rate

OBJECTIVES: The purpose of this study was to explore the influence of high school students' mental health on their academic achievement and school dropout rate by using longitudinal data. METHODS: For this study, 153 high schools were randomly sampled on a nationwide scale. The descriptive data was collected from a school information internet site which is organized by the Korean Ministry of Education. We used the schools' mean scores on the Adolescent Mental Health Problem-Behavior Questionnaire-II (AMPQ-II) scale which was used for estimating students' mental health in the 2013 school-based mental health screening test. The data analysis was conducted by using hierarchical regression analysis. RESULTS: The results of this study showed that the AMPQ-II scale's mean scores have significant effects on the following year's academic achievement and annual dropout rates. Especially, the AMPQ-II scale's mean scores tend to increase the school dropout rate in vocational schools. CONCLUSION: The finding of this study is that Korean high school students' mental health states significantly influence their academic achievement and school dropout rate.

Is Taking an Antiplatelet Agent a Contraindication for Early Surgery in Displaced Femur Neck Fracture? / 대한고관절학회지

PURPOSE: The purpose of this study was to evaluate whether we have to stop the antiplatelet agents prior to hemiarthroplasty surgery in patients with displaced femur neck fractures to reduce postoperative complications. MATERIALS AND METHODS: We enrolled forty-three patients with displaced femur neck fractures who were treated by bipolar hemiarthroplasty and were taking antiplatelet agents. Group I included 21 patients who discontinued antiplatelet agents and had delayed operations at an average 5.7 days and group II included 22 patients who had had early operations within 24 hours without stopping the antiplatelet agents. We compared the pre- and postoperative levels of hemoglobin, the volume of postoperative transfusion requirement and complications. Student's t-test and chi-square test were used for statistical analysis. RESULTS: The average differences between preoperative and postoperative hemoglobin was 1.4+/-0.4 g/dL decrease in group I and 2.1+/-0.5 g/dL decrease in group II (P<0.001). Patients who received a blood transfusion were 11 in group I and 13 in group II (P=0.66). Total number of blood transfusion was 13 pints in group I and 18 pints in group II (P=0.23). Pneumonia occurred in one patient in each group. Four pressure sores and three diaper rashes were developed in group I. But there were no patients requiring massive transfusion, reoperation due to hematoma and infection in each group. CONCLUSION: Although continuous taking of antiplatelet agents in displaced femur neck fracture is associated with an increased risk of postoperative bleeding, taking an antiplatelet agent itself is not a contraindication of early surgery.

Treatment of Clavicle Medial End Fracture Using Double-plate Fixation

Clavicle medial end fracture is rare, and it has not been studied extensively. Although there is debate regarding its treatment methods, because of the complications of conservative treatment, surgical treatment has been considered more than conservative treatment. This study describes a surgical method using double-plate fixation for treatment of clavicle medial end fractures in which plates were used on each anterior and superior border according to the anatomical structure of the clavicle. In addition, we report operative results of three patients treated by double-plate fixation.

Antifungal effect of electrolyzed hydrogen water on Candida albicans biofilm

PURPOSE: Candida albicans can cause mucosal disease in many vulnerable patients. Also they are associated with denture-related stomatitis. Electrolyzed water is generated by electric current passed via water using various metal electrodes and has antimicrobial activity. The aim of this study was to investigate antifungal activity of electrolyzed water on C. albicans biofilm. MATERIALS AND METHODS: C. albicans was cultured by sabouraud dextrose broth and F-12 nutrient medium in aerobic and 5% CO2 condition to form blastoconidia (yeast) and hyphae type, respectively. For formation of C. albicans biofilm, C. albicans was cultivated on rough surface 6-well plate by using F-12 nutrient medium in CO2 incubator for 48 hr. After electrolyzing tap water using various metal electrodes, the blastoconidia and hyphal type of C. albicans were treated with electrolyzed water. C. albicans formed blastoconidia and hyphae type when they were cultured by sabouraud dextrose broth and F-12 nutrient medium, respectively. RESULTS: The electrolyzed water using palladium electrode (EWP) exhibited antifungal effect on blastoconidia of C. albicans. Also, the EWP significantly has antifungal activity against C. albicans biofilm and hyphae. In the electrolyzed water using various metal electrodes, only the EWP have antifungal activity. CONCLUSION: The EWP may use a gargle solution and a soaking solution for prevention of oral candidiasis and denture-related stomatitis due to antifungal activity. (

Isolation and characterization of cellulose degrading ability in Paenibacillus isolates from landfill leachate

Aims: Cellulases are enzymes that convert cellulose into glucose molecules, and are produced by various microorganisms in the environment. Due to their importance to the biofuel industry, there is a need to screen for more efficient varieties of cellulases. In this study, leachate samples from a landfill site were screened for cellulolytic bacteria. Methodology and results: Leachate samples obtained from a landfill collection pond were cultured in an enriched cellulose medium. Two cellulolytic isolates, designated MAEPY1 and MAEPY2, were isolated and further characterized. Phenotypic profiles and phylogenetic analyses using sequences of 16S rRNA, gyrB and whole genome suggested that these isolates are new strains of the Paenibacillus genera. The crude enzyme extracts from both isolates have cellulose degradation activity at approximately 0.1-0.2 IU/mg under working conditions of pH 6 and 55 °C. Assays using other lignocellulosic substrates showed that the crude enzyme extracts also have high xylan degradation activity. Conclusion, significance and impact of study: Paenibacillus sp. are known to produce multiple enzymes for lignocellulolytic degradation and the present results suggest that isolates described in this study, MAEPY1 and MAEPY2, are excellent candidates deserving further study as potential producers of efficient cellulases for use in industries associated with cellulosic biomass.

Treatment of Clavicle Medial End Fracture Using Double-plate Fixation

Clavicle medial end fracture is rare, and it has not been studied extensively. Although there is debate regarding its treatment methods, because of the complications of conservative treatment, surgical treatment has been considered more than conservative treatment. This study describes a surgical method using double-plate fixation for treatment of clavicle medial end fractures in which plates were used on each anterior and superior border according to the anatomical structure of the clavicle. In addition, we report operative results of three patients treated by double-plate fixation.

Survival analysis of stage IV metastatic gastric cancer patients treated with HangAm-Plus / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of HangAm-Plus (HAP) on stage IV metastatic gastric cancer by analyzing the treated patients' overall survival outcome.</p><p><b>METHODS</b>Following the study eligibility, overall survival and one year survival rate of 44 stage IV metastatic gastric cancer patients who visited East-West Cancer Center (EWCC) were analyzed. The study consisted of two arms: HAP treatment only (n=18) and combined treatment of concurrent conventional chemotherapy and HAP (n=26). Patient characteristics by gender, age, surgical intervention, Eastern Cooperative Oncology Group (ECOG) score, treatment duration (< 4 weeks or [Symbol: see text]4 weeks), and lines of the chemotherapy received were assessed. Treatment related side effects were also assessed.</p><p><b>RESULTS</b>The median survival of combined group was longer (10.0 months) than that of HAP group (5.1 months). One-year survival rate of combined treatment group and HAP group was 38.5%±9.5% and 33.3%±11.1%, respectively (P>0.05). One-year survival rate of those received more and less than 4-week treatment was 57.1%±18.7% and 8.3%±8.0%, respectively (P=0.001).</p><p><b>CONCLUSIONS</b>The study supports the safety and potential efficacy of HAP treatment in prevention of chemo-related side effects for stage IV metastatic gastric cancer treated with conventional chemotherapy. Further studies are needed to investigate and confirm the results before applying the treatment in clinical settings.</p>

Erratum: Mesenchymal Stem Cell Lines Isolated by Different Isolation Methods Show Variations in the Regulation of Graft-versus-host Disease

Typographical error has been detected in acknowledgements.

Posterior Reversible Encephalopathy Syndrome as a Simultaneous Manifestation of Guillain-Barre Syndrome in an Elderly Female Patient

We report a 62-year-old woman with a simultaneous occurrence of posterior reversible encephalopathy syndrome (PRES) and Guillain-Barre syndrome (GBS). The simultaneous presence of PRES in GBS is unusual and can easily escape recognition, with potentially serious consequences for the patient. Previous reports showed that the simultaneous or initial manifestation of PRES in GBS is more common in elderly female. The preponderance of female in older age may be due to age and gender related difference in sympathetic nerve activity.

Mesenchymal Stem Cell Lines Isolated by Different Isolation Methods Show Variations in the Regulation of Graft-versus-host Disease

Since the discovery of the immunomodulation property of mesenchymal stem cells (MSCs) about a decade ago, it has been extensively investigated whether MSCs can be used for the treatment of immune-related diseases, such as graft-versus-host disease (GvHD). However, how to evaluate the efficacy of human MSCs for the clinical trial is still unclear. We used an MHC-mismatched model of GvHD (B6 into BALB/c). Surprisingly, the administration of the human MSCs (hMSCs) could reduce the GvHD-related mortality of the mouse recipients and xenogeneically inhibit mouse T-cell proliferation and IFN-gamma production in vitro. We recently established a new protocol for the isolation of a homogeneous population of MSCs called subfractionation culturing methods (SCM), and established a library of clonal MSC lines. Therefore, we also investigated whether MSCs isolated by the conventional gradient centrifugation method (GCM) and SCM show different efficacy in vivo. Intriguingly, clonal hMSCs (hcMSCs) isolated by SCM showed better efficacy than hMSCs isolated by GCM. Based on these results, the MHC-mismatched model of GvHD may be useful for evaluating the efficacy of human MSCs before the clinical trial. The results of this study suggest that different MSC lines may show different efficacy in vivo and in vitro.

Association of Heart Rate Variability with the Framingham Risk Score in Healthy Adults / 가정의학회지

BACKGROUND: The aim of this study was to investigate the relationship between heart rate variability (HRV), the Framingham risk score (FRS), and the 10-year risk of coronary heart disease (CHD) development among Korean adults. METHODS: The subjects were 85 healthy Korean adults recruited from a health check-up center. The FRS and 10-year risk of CHD development were calculated. RESULTS: The FRS in men was inversely correlated with the standard deviation of all normal to normal RR-intervals (SDNN); the root mean square successive difference (RMSSD); the percentage of successive normal cardiac inter-beat intervals greater than 20 ms, 30 ms, and 50 ms (pNN20, pNN30, pNN50); the low frequency (LF); and the high frequency (HF) (P or = 10%. CONCLUSION: This study therefore indicates that the HRV indices, particularly SDNN, RMSSD, pNN30, LF, and HF may be useful parameters for the assessment of CHD risk. Most notably, the usefulness of these HRV measures as indicators for CHD risk evaluation may be greater among men than among women.

Wearable Physiologic Monitoring System in Health Promotion

With the development of body sensor technology, wearable health monitoring systems have been an emerging information technology in the 'ubiquitous health care' system. Wearable sensors enable long-term continuous physiological monitoring important in health promotion and management of many chronic disorders. In this paper, we present several wearable health monitoring systems developed by different countries and discuss emerging opportunities, as well as, existing challenges such as standardization, administration, validation, and discrepancy issues between technology and clinical implication.

An overview of current oriental medicine herbal cancer research in Korea / 中国结合医学杂志

Cancer is the number one cause of death in Korea with annual mortalities of 69 780. Research suggests one in every four Koreans will end up getting cancer at some point in their life time. With these persistent threats, strive for cancer cure is continued. Ten years of Korea's oriental medicine herbal research on cancer have been reviewed. Researches between the years of 2000 and 2010 are analyzed in terms of their published year, study types, tested subjects, testing measures, cancer types, and institutions. In the past ten years, cancer researches have blossomed from null to full in Korean peninsula, and further development is much anticipated in the next ten years to come.

A case of hydrothorax caused by peritoneal dialysate leakage diagnosed using the reaction between icodextrin and povidone-iodine / 대한내과학회지

Hydrothorax occurs as a complication of peritoneal dialysis in about 2% of cases. When a pleural effusion occurs, the effusion should be analyzed as part of the differential diagnosis. A hydrothorax due to peritoneal dialysate leakage can be suspected based on higher glucose and lower protein content compared with serum. Computed tomography (CT) peritoneography, peritoneal scintigraphy, and magnetic resonance peritoneography are safe, accurate, and reliable methods for diagnosing hydrothorax. Here, we report a case of hydrothorax associated with dialysate leakage that could not be confirmed using standard CT peritoneography. We confirmed the leakage by observing the change in color to black in a test that involved adding povidone-iodine to the pleural fluid obtained by thoracentesis after a cycle of peritoneal dialysis with icodextrin solution. We propose using the icodextrin-povidone reaction as a test for hydrothorax caused by dialysate leakage.

A case of hydrothorax caused by peritoneal dialysate leakage diagnosed using the reaction between icodextrin and povidone-iodine / 대한내과학회지

Hydrothorax occurs as a complication of peritoneal dialysis in about 2% of cases. When a pleural effusion occurs, the effusion should be analyzed as part of the differential diagnosis. A hydrothorax due to peritoneal dialysate leakage can be suspected based on higher glucose and lower protein content compared with serum. Computed tomography (CT) peritoneography, peritoneal scintigraphy, and magnetic resonance peritoneography are safe, accurate, and reliable methods for diagnosing hydrothorax. Here, we report a case of hydrothorax associated with dialysate leakage that could not be confirmed using standard CT peritoneography. We confirmed the leakage by observing the change in color to black in a test that involved adding povidone-iodine to the pleural fluid obtained by thoracentesis after a cycle of peritoneal dialysis with icodextrin solution. We propose using the icodextrin-povidone reaction as a test for hydrothorax caused by dialysate leakage.

The expression of TRAIL and its receptors in human osteoarthritic cartilages / 대한내과학회지

BACKGROUND/AIMS: The apoptosis of chondrocytes is assumed to be involved in the pathogenesis of osteoarthritis (OA), and the TNF related apoptosis inducing ligand (TRAIL) is thought to have a pivotal role in the apoptosis of chondrocytes. We investigated the expression of TRAIL and its receptors in human osteoarthritic cartilages. METHODS: Human OA cartilage tissues were obtained from the medial side of the cartilage in the knee joints of 25 patients who underwent total knee replacement surgery, and the normal human cartilages of the knee joint were obtained at autopsy from seven young adults who had no history of joint diseases. The expressions of TRAIL and the death receptor were analyzed by immunohistochemistry or immunofluorscent staining. The concentration of TRAIL in the synovial fluid was measured by enzyme linked immunosorbent assay. RESULTS: TRAIL and its receptors were expressed in the OA cartilage, but not in the normal cartilage. TUNEL staining and immunohistochemistry for TRAIL on the serial sections showed that most TRAIL positive cells were TUNEL positive. The OA joint fluid contained concentrations of TRAIL that were readily detectable (80 and 120 microgram/ppm in the synovial fluid of each, respectively). However, the synovial fluid of the knee joint obtained at autopsy from the seven young adults contained low concentrations of detectable TRAIL (0~2 microgram/ppm). CONCLUSIONS: These results support the notion that TRAIL and its receptors are involved in the pathogenesis of human OA. A better understanding of TRAIL induced apoptosis in chondrocytes might lead to the development of a new therapeutic strategy for OA.