Effect of Stress Level and Stress Vulnerability of Workers on Heart Rate Variability / 정신신체의학

Objectives@#: The purpose of this study is to identify the effect of office workers' stress level and stress vulnerability on heart rate variability (HRV), confirm the significance of objective stress indicators obtained through subjective stress and heart rate variability devices, and examine their effectiveness as an integrated stress measurement tool in community mental health projects. @*Methods@#: From June to July in 2020, 929 workers participated in the stress management and mental health promotion project carried out by K hospital, and their recorded database was used for study analysis with their agreements. Multiple linear regression analysis was performed to find out the effects of general stress level, and stress vulnerability on heart rate variability. @*Results@#: All general characteristics were found to have a significant effect on SDNN (ln), RMSSD (ln), LF (ln), and HF (ln), but work experience did not significantly affect RMSSD (ln). Stress level and stress vulnerability did not significantly affect heart rate variability, but stress perception, a sub-factor of stress level, was found to have a significant effect on RMSSD (ln) (β=0.118, p=0.023). @*Conclusions@#: In this study, stress perception, a sub-factor of stress level, was found to be a factor affecting RMSSD (ln). This indicates an association with the activity of parasympathetic nerves in stressful situations, and more follow-up studies are needed to use it as a direct indicator of chronic stress and integrated stress in the community mental health field.

Analysis of differential plaque depositions in the brains of Tg2576 and Tg-APPswe/PS1dE9 transgenic mouse models of Alzheimer disease

Adequate assessment of plaque deposition levels in the brain of mouse models of Alzheimer disease (AD) is required in many core issues of studies on AD, including studies on the mechanisms underlying plaque pathogenesis, identification of cellular factors modifying plaque pathology, and developments of anti-AD drugs. The present study was undertaken to quantitatively evaluate plaque deposition patterns in the brains of the two popular AD models, Tg2576 and Tg-APPswe/PS1dE9 mice. Coronally-cut brain sections of Tg2576 and Tg-APPswe/PS1dE9 mice were prepared and plaque depositions were visualized by staining with anti-amyloid beta peptides antibody. Microscopic images of plaque depositions in the prefrontal cortex, parietal cortex, piriform cortex and hippocampus were obtained and the number of plaques in each region was determined by a computer-aided image analysis method. A series of optical images representing a gradual increase of plaque deposition levels were selected in the four different brain regions and were assigned in each with a numerical grade of 1-6, where +1 was lowest and +6, highest, so that plaques per unit in mm2 increased "sigmoidally" over the grading scales. Analyzing plaque depositions using the photographic plaque reference panels and a computer-aid image analysis method, it was demonstrated that the brains of Tg2576 mice started to accumulate predominantly small plaques, while the brains of Tg-APPswe/PS1dE9 mice deposited relatively large plaques.

Cockayne syndrome: a case with hyperinsulinemia and growth hormone deficiency

Cockayne syndrome is a rare autosomal recessive disorder of childhood characterized by cachectic dwarfism with senile-like appearance, mental retardation, photosensitive dermatitis, loss of adipose tissue, pigmentary degeneration of retina, microcephaly, deafness, skeletal and neurologic abnormalities. We describe here an 18 year old boy with Cockayne syndrome who had, in addition to the typical features of the disorder, fasting hyperinsulinemia and growth hormone deficiency.

The Effect of Milk on the Bioavailability of 6-mercaptopurine

The purine antimetabolite 6-Mercaptopurine (6-MP) has been in clinical use for over 30 years and is still a widely used agent in the treatment of childhood acute lymphoblastic leukemia. The bioavailibility, clinical efficacy and toxicity of 6-MP administered orally for maintenance therapy of children with acute lymphoblastic leukemia are highly variable in many studies, as well as at differnt times in same patient. there are many factors affecting the bioavailibility of 6-MP. The most notably factor being that concomitantly administered drugs and foods might contribute to a decrease in the bioavailibity of this drug. In our sociocultural environment milk is a major constituent of child's foods. Cow's milk contains a high concentration of xanthine oxidase, which could potentially transform 6-TM into 6-thioxanthine (6-TX) and 6-thiouric acid (6-TUA) which have no more therapeutic effects. In this study, we evaluated the effect of various milk products on the bioavailability of 6-MP. Incubation at 37degrees C for 30 min raw or pasteurized milk resulted in transformation of a large quantity of clinically relevant concentration of 6-MP into 6-TUA. The concomitant adminstration of folic acid and allopurinol has markedly inhibitory effect on the 6-MP destroying activity of milk at clinically relevant concentrations. These observations may help to optimize modalities of administration of 6-MP for the treartment of patients with childhood leukemia.

A case of congenital cystic adenomatoid malformation of the lung

The congenital cystic adenomatoid malformation (CCMA) of the lung is a rare variant of congenital cystic lung disease consisted of one or usually multiple interconnecting cysts in the pulmonary parenchyma lined by cuboidal and columnar epithelium. This diease present clinically in three ways: 1) stillborn or perinatal death, 2)progress respiratory distress in the newborn, and 3)acute and chronic pulmonary infections in the older infant and child. The onset of symptoms, which are cyanosis, tachypnea, and other forms of respiratory distress, usually occurs at or shortly after birth, This manifestations are related to compression of the remained normal ung by expansion of the cysts. We have experienced a case of congenital cystic adenomatoid malformation of the lung in a 1-day-old male infant who had tachypnea. A right upper lobectomy was done with satisfactory postoperative courses clinically and radiologically at 8 months of age. A brief review of the related literature is presented.

Changes of igG subclasses in the sera of the children with Kawasaki disease

Kawasaki disease is an acute vasculitis of infancy and early childhood characterized by high fever, rash, mucositis, lymphadenopathy and coronary artery damage. The failure to indentify a causative organism using convetional culture and serological techniques, and the lack of response to antibiotics indicate that the disorder is probably not due to any known bacterial or viral pathogens. During the acute phase of the disease, the alterations of T and B cell functions, changes of cytokine and immunoglobulin levels have been reported. This study was performed to investigate the changes of immunoglobulins levels in patients with Kawasaki disease. IgG, IgA, IgM and IgG subclasses were measured using immunoprecipitation and EIA in the sera of patients with Kawasaki disease. The results were as follows: 1) Acute phase reactants such as CRP and ESR were significantly increased in Kawasaki patients compared to those in control patients(p<0.01). 2) Serum IgG levels in Kawasaki disease were markedly increased than those in control patients, while serum IgA and IgM levels showed no significant changes (P: No Significance). 3) IgG1 and IgG4 were predominantly increased increased in the sera of Kawasaki patients, while IgG2 and IgG3 were not significantly increased (P: No Significance). With these results, unidentified infectious organism with abnormal immune response could be suggested as an etiologic factor of Kawasaki disease.

Changes of serum igG4 in allergic patients

This study was performed to evaluate the changes of serum IgG4 level in children with allergic diseases. Serum Ige, IgG and IgG4 level were measured using enyzme immunoassay (IgE) and radial immunodiffusion method (IgG and IgG4) in 21 children with bronchial asthma, allergic rhinitis or urticaria Eosinophil counts in peripheral blood and the values of serum IgE were significantly increased in allergic patients. The values of IgG4 in allergic patients were also increased compare to those in controls (24.23mg/dl versus 20.33mg/dl). But the values of IgG4 were not significantly correlated to either IgG or IgE levels. Further studies will be needed for measuring allergen specifie IgE and IgG4 levels considering the onset of diseases, methods and duration of treatment.

Fiberopitc Intervention of the Airway / 대한마취과학회지

To minimize morbidity arising from airway management related to anesthesia, the anesthesiologist performs a through history and physical examination and approaches all patients with well-through-out plans for various eventualities. Numerous anatomic and pathologic abnormalities may lead to difficult tracheal intubation. Failed tracheal intubation is frustrating, increase the risk of pulmonary aspiration, and may contribute to organ ischemia and then it imminently endangers the patients life and necessitates invasive approaches to ventilation. Use of the flexible fiberoptic bronchoscope has become an essential skill for anesthesiologists confronted with anatomic or physiologic abnormalities of the upper airway. The widespread availability of flexible fiberoptic bronchoscope has allowed anesthesiologists to use fiberoptic techniques eariler in airway instrumentation and, thereby, avoid failed intubation and trauma to the airway. This review will focus on practical information that will aid in successful utilization of fiberoptic bronchoscope.