Utilization of End-of-Life Care Rooms by Patients Who Died in a Single Hospice Unit at a National University Hospital in South Korea / 한국호스피스완화의료학회지

Purpose@#For the dignity of patients nearing the end of their lives, it is essential to provide end-of-life (EoL) care in a separate, dedicated space. This study investigated the utilization of specialized rooms for dying patients within a hospice unit. @*Methods@#This retrospective study examined patients who died in a single hospice unit between January 1, 2017, and December 31, 2021. Utilizing medical records, we analyzed the circumstances surrounding death, the employment of specialized rooms for terminally ill patients, and the characteristics of those who received EoL care in a shared room. @*Results@#During the 1,825-day survey period, deaths occurred on 632 days, and 799 patients died. Of these patients, 496 (62.1%) received EoL care in a dedicated room. The average duration of using this dedicated space was 1.08 days. Meanwhile, 188 patients (23.5%) died in a shared room. Logistic regression analysis revealed that a longer stay in the hospice unit was associated with a lower risk of receiving EoL care in a shared room (odds ratio [OR]=0.98, 95% confidence interval [CI] 0.97~0.99; P=0.002). Furthermore, a higher number of deaths on the day a patient died was associated with a greater risk of receiving EoL care in a shared room (OR=1.66, 95% CI 1.33~2.08; P＜0.001). @*Conclusion@#To ensure that more patients receive EoL care for an adequate duration in a private setting, additional research is necessary to increase the number of dedicated rooms and incorporate them into the hospice unit at an early stage.

Association between Sleep Duration and Presbycusis in Korean Adults: Korea National Health and Nutrition Examination Survey / 가정의학회지

Background@#Sleep duration is associated with hearing loss, especially presbycusis, which is the most common type of hearing loss; however, there is limited evidence regarding this association among the Korean population. We aimed to determine the relationship between sleep duration and high-frequency hearing loss in Korean adults aged ≥40 years. @*Methods@#We examined 5,547 Korean adults aged ≥40 years who completed audiometric tests and questionnaires regarding sleep duration during the 2010–2012 cycle of the Korea National Health and Nutrition Examination Survey. Mild presbycusis was defined as >25 decibels (dB) and 40 dB pure tone averages at high frequencies (3,000, 4,000, and 6,000 Hz) for both ears. Additionally, the sleep duration was divided into quartiles. Odds ratios and 95% confidence intervals were estimated using multivariable logistic regression after adjusting for covariates. @*Results@#The prevalence of presbycusis in South Korean adults was 62.1%, of which 61.4% showed moderate to severe presbycusis. The incidence of moderate-to-severe, but not mild, presbycusis showed a significant positive correlation with sleep duration. @*Conclusion@#Our findings suggest that sleep duration is associated with the prevalence of presbycusis.

Thrower's Fracture on the Shaft of the Humerus: 4 Cases Report / 대한정형외과학회잡지

A fracture of the shaft of the humerus in young adults is known to occur as a result of high energy injuries such as traffic accidents and falls from a height. In baseball, which is one of the popular sports in the world, the incidence of a fracture of the shaft of the humerus during pitch motion is increasing even in non-professional players. Over the course of a year, we analyzed four cases of humeral shaft fractures that occurred during pitch motion through the pitch count, type of pitch, duration of playing, and prodromal pain. It was found that these fractures can easily occur through the torsion developed by the uncoordinated contraction of the muscle. The mechanism of the fracture should be recognized in order to prevent this type of fracture while playing baseball.

A Vertical Transmission, de novo, and Expansion of Y chromosome Microdeletion in Male Fetuses Pregnant after Intracytoplasmic Sperm Injection / 대한불임학회지

OBJECTIVES: Despite severe oligospermia, males with Y chromosome microdeletion can achieve conception through ICSI (Intracytoplasmic Sperm Injection). However, ICSI may not only result in the transmission of microdeletions but also the expansion of deletion to the offspring. The purpose of this study was to screen vertical transmission, expansion of microdeletions and de novo deletion in male fetuses conceived by ICSI. MATERIALS AND METHODS: A total of 32 ICSI treated patients with their 33 (a case of twin) male fetuses conceived by ICSI were used to make this study group. Sequence-tagged sites (STSs)-based PCR analyses were performed on genomic DNA isolated from peripheral blood of fathers and from the amniocytes of male fetuses. Ten primer pairs namely, sY134, sY138, MK5, sY152, sY147, sY254, sY255, SPGY1, sY269 and sY158 were used. The samples with deletions were verified at least three times. RESULTS: We detected a frequency of 12.5% (4 of the 32 patients) of microdeletions in ICSI patients. In 4 patients with detected deletions, two patients have proven deletions on single STS marker and their male fetuses have the identical deletion in this region. Another two patients have two and three deletions, but their male fetuses have more than 3 deletions which include deletions to their father's. Meanwhile, seven male fetuses, whose fathers were analyzed to have all 10 STS markers present, have deletions present in at least one or more of the markers. CONCLUSIONS: Although the majority of deletions on the Y chromosome are believed to arise de novo, in some cases a deletion has been transmitted from the fertile father to the infertile patient. In other cases the deletion was transmitted through ICSI treatment, it is likely that one sperm cell is injected through the oocyte's cytoplasm and fertilization can be obtained from spermatozoa. Our tests for deletion were determined by PCR and our results show that the ICSI treatment may lead to vertical transmission, expansion and de novo Y chromosome microdeletions in male fetuses. Because the sample group was relatively small, one should be cautious in analyzing these data. However, it is important to counsel infertile couples contemplating ICSI if the male carries Y chromosomal microdeletions.

A Case of Cutaneous Metastasis from Hepatocellular Carcinoma Manifested as Multiple Nodules on Whole Body / 대한간학회지

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. Frequent sites of extrahepatic metastasis are the lung, adrenal gland, bone, etc. But, cutaneous metastasis from HCC is rare event. Several cases of subcutaneous seeding after percutaneous transhepatic biopsy or aspiration of liver were reported, however, most of these cases had solitary nodular lesion which was located at the biopsy site. We experienced a case of multiple cutaneous metastasis on whole body from HCC which was not related to percutaneous transhepatic biopsy of liver in a 34-ear-ld male patient. Thus, we report a case of multiple cutaneous metastasis from HCC with brief review of related literature.

The Effects of Ethanol on Cholinesterase Inactivation by Organophosphorous / 영남의대학술지

BACKGROUND: In korea the agricultural community widely uses organophosphorous, and organophosphorous poisonings are increasing every year. We compared change in activity of acetylcholinesterase and pseudocholinesterase by organophosphorous and by the interaction of ethanol and organophosphorous. We also compared the effect of reversible anticholinesterase drugs, physostigmine and neostigmine. The object of this study is to investigate the effects of several anticholinesterase drugs and on how ethanol influences the activity of cholinesterase. MATERIALS AND METHODS: Fifteen male university students were randomly selected, and blood samples were taken from the antecubital vein. The acetylcholinesterase in the RBC and the pseudocholinesterase in the serum were extracted and separated. The enzyme activity change was measured by the electrometric method. After adding acetylcholine, the pH change was measured with a pH meter. RESULTS AND CONCLUSION: Our results indicated that reversible anticholinesterase drugs decreased the cholinesterase activity more efficiently than organophosphorous. The acetyl cholinesterase and pseudocholinosterase activity were decreased by ethanol. When ethanol was added, oxime a cholinesterase activator, increased acetylcholinesterase activity but dose not increased pseudocholinesterase activity.

Cytogenetic Analysis of 467 Cases of Amniocetesis / 대한주산의학회잡지

OBJECTIVE: The study of 467 cases of amniocentesis have been done at the department of Genetics, Taegu Cheil Hospital from Oct. 1997 to May 1999 for the purpose of analysis of abnormal karyotype according to the indication and age distribution, METHODS: We collected amniotic fluid using 22G spinal needle and measured amniotic alphafetoprotein and acetylcholine esterase in supematant and performed cytogenetic analysis. RESULTS: Positive Down screeing(positive triple test) was the most common indication of amniocentesis (61.5%) and abnormal karyotypes were 24 cases(5.1%) in 467 cases. Among 24 abnormal cases, 10 cases(2.1%) of 21 trisomy were observed. Abnormal karyotypes were most common in the group of abnormal ultrasonogram finding and the gmup of maternal age between 31 to 35 years old, which consists of 25% and 7.7% respectively. CONCLUSION: More attention for the abnormal karyotype should be paid to the group of abnormal ultrasonogram finding and the group of maternal age between 31 to 35 years old as well as above 35 years old.