Mitochondrial injury in renal tubule has been recognized as a major contributor in acute kidney injury (AKI) pathogenesis. Ischemic insult, nephrotoxin, endotoxin and contrast medium destroy mitochondrial structure and function as well as their biogenesis and dynamics, especially in renal proximal tubule, to elicit ATP depletion. Mitochondrial fatty acid ${\beta}$-oxidation (FAO) is the preferred source of ATP in the kidney, and its impairment is a critical factor in AKI pathogenesis. This review explores current knowledge of mitochondrial dysfunction and energy depletion in AKI and prospective views on developing therapeutic strategies targeting mitochondrial dysfunction in AKI.

Colorectal cancer (CRC) is a third leading cause of cancer-related death in cancer patients. Sporadic and inflammation-related colon carcinogenesis are major mechanism of colorectal cancer. In vivo CRC models have been developed and implicated to understand their mechanisms upon a different type of CRC. Moreover, recently animal models have played important roles in chemopreventive and preclinical trials over the years. In this mini-review, the aim is to introduce various animal models of CRC and help the understanding to establish in vivo experimental plans according to the cancer type of CRC.

Cancer, a leading mortality disease following cardiovascular disease worldwide, has high incidence as one out of every four adults in Korea. It was known to be caused by several reasons including somatic mutation, activation of oncogene and chromosome aneuploidy. Cancer cells show a faster growth rate and have metastatic and heterogeneous cell populations compared to normal cells. Cancer stem cells, the most invested field in cancer biology, is a theory to explain heterogeneous cell populations of cancer cells among several characteristics of cancer cells, which is providing the theoretical background for incidence of cancer and treatment failure by drug resistance. Cancer stem cells initially explain heterogeneous cell populations of cancer cells based on the same markers of normal stem cells in cancer, in which only cancer stem cells showed heterogeneity of cancer cells and tumor initiating ability of leukemia. Based on these results, cancer stem cells were reported in various solid cancers such as breast cancer, liver cancer, and lung cancer. Breast cancer stem cells were first reported in solid cancer which had tumor initiating ability and further identified as anti-cancer drug resistance. There were several identification methods in breast cancer stem cells such as specific surface markers and culture methods. The discovery of cancer stem cells not only explains heterogeneity of cancer cells, but it also provides theoretical background for targeting cancer stem cells to complete elimination of cancer cells. Many institutes have been developing new anticancer drugs targeting cancer stem cells, but there have not been noticeable results yet. Many researchers also reported a necessity for improvement of current concepts and methods of research on cancer stem cells. Herein, we discuss the limitations and the perspectives of breast cancer stem cells based on the current concept and history.

Acceptance and Commitment Therapy (ACT) is a functional contextual intervention approach based on the behavioral theory on human language, which views human suffering as originating in psychological inflexibility fostered by cognitive fusion and experiential avoidance. Thus, the goal of ACT is to enhance psychological flexibility using six core processes including acceptance, cognitive defusion, self-as-context, contact with present moment, values clarification, and committed action. Recent clinical trials have suggested the efficacy for ACT in the treatment of various mental illness and psychological distress. The aim of this review is to offer more knowledge and better understanding of ACT by presenting its underlying principle and an overview of the research field.

NPWT는 90년대 이후 많은 연구가 이루어지며 발전해왔다. 이 기술은 사용하기에 간단하고 다양한 상처에 적용할 수 있고 효용성과 비용-효과가 뛰어나며 부작용이 적다. 따라서 NPWT를 일반적인 드레싱 대신에 사용하면 육아조직의 빠른 성장과 상처 수축을 통해 피부 이식이나 피판이 필요한 부위를 줄일 수 있고 봉합이 불가했던 부위를 가능하게 하므로 창상 환자에 대한 의료 비용을 감소시키고 만성 창상 환자가 입원하지 않고 움직이면서 창상 관리가 가능하도록 할 수 있는 유용한 방법이다.

A-type $K^+$ ($I_A$) channels are transiently activated in the suprathreshold membrane potential and then rapidly inactivated. These channels play roles to control the neuronal excitability in pyramidal neurons in hippocampi. We here electrophysiologically tested if regulatory functions of $I_A$ channels might be targeted by acute activation of glutamatergic synaptic transmission in cultured hippocampal neurons(DIV 6~8). The application of high KCl in recording solutions(10 mM, 2 min) to increase presynaptic glutamate release, significantly reduced the peak of somatic $I_A$ without changes of gating kinetics. This indicates that neuronal excitation induced by the enhancement of synaptic transmission may process with distinctive signaling cascades to affect voltage-dependent ion channels in hippocampal neurons. Therefore, it is possible that short-lasting enhancement of synaptic transmission is functionally restricted in local synapses without effects on intracellular signaling cascades affecting a whole neuron, efficiently and rapidly enhancing synaptic functions in hippocampal network.

Neuronal excitotoxicity induces mitochondrial dysfunction and the release of proapoptotic proteins. Excitotoxicity, the process by which the overactivation of excitatory neurotransmitter receptors leads to neuronal cell death. Neuronal death by excitotoxicity was related to neuronal degenerative disorders and hypoxia, results from excessive exposure to excitatory neurotransmitters, such as glutamate. Glutamate acts at NMDA receptors in cultured neurons to increase the intracellular free calcium concentration. Therefore endogenous glutamate may be a key factor to regulate neuronal cell death via activating $Ca^{2+}$ signaling. For this issue, we tested some conditions to alter intracellular $Ca^{2+}$ level in dissociated hippocampal neurons of rats. Cultured hippocampal neuron were treated by KCl (20 mM), $CaCl_2$ (3.8 mM) and glutamate ($5{\mu}M$) for 24 hrs. Interestingly, The Optical Density of hippocampal neurons was increased by high KCl application in MTT assay data. This enhanced response by high KCl was dependent on synaptic $Ca^{2+}$ influx but not on intracellular $Ca^{2+}$ level. However, the number of neurons seemed to be not changed in Hoechst 33342 staining data. These results suggest that enhancement of synaptic activity plays a key role to increase mitochondrial signaling in hippocampal neurons.

We investigated the effect of KIOM-79, 80% ethanolic extract of herbal prescription isolated from Magnolia officinalis, Pueraria lobate, Glycyrrhiza uralensis, and Euphorbia pekinensis, on streptozotocin-induced diabetes in Sprague-Dawley rats. The rats were treated orally with KIOM-79 (500 mg/kg/day) 1) for 3 days prior to streptozotocin (60 mg/kg, intraperitoneal) injection or 2) for 9 weeks after establishing diabetes model to examine acute and chronic effects on hyperglycemia and biochemical variables, respectively. As a result, KIOM-79 had little effects on hyperglycemic changes in acute model. Sexual comparison, however, showed reduced hyperglycemia in female rats, especially 24 hours after streptozotocin injection with or without KIOM-79 pretreatment. In chronic model, streptozotocin-induced hyperglycemia was well established, but KIOM-79 treatment showed no statistically significant effects on all variables. Thus, based on our findings KIOM-79 might have little effects on streptozotocin-induced insulin-dependent diabetes although it has been known to have hypoglycemic and antidiabetic effects on non-insulin-dependent diabetes models.

Jejudo has unique geographical and climatologic characteristics compared with other areas in Korea. The aim was to evaluate differences of the nationwide notifiable infectious diseases (NND) occurred in Jejudo, 2011~2018. The source of data was on the Infectious Disease Statistics System operated by Centers for Diseases Control & Prevention in Korea between 1 January 2001 and 30 September 2018. After calculating the proportion of sum of years showing a higher incidence in Jejudo than nationwide divided by sum of comparing years(PSYH), authors defined the infectious diseases for control in Jejudo (IDCJ) with PSYH over 75%. In addition, the infectious diseases showing increasing trends during recent 2 years(2015~2018) were defined as sudden increase Infectious diseases for control (SIDCJ). IDCJ in 2001~2018 included 3 NNDs such as chicken pox, syphilis, and Streptococcus pneumoniae. The results support main evidences to plan strategies and distribute community resources for control and prevention of NNDs in Jejudo, Korea.

The aim was to evaluate different results from using crude incidence rate (CIR) instead of agestandardized incidence rate (AIR) when comparing groups having different age structures. After selecting a report using CIRs, AIRs and their 95% confidence intervals(CI) was calculated from the raw data. The statistically significant difference between CIR and AIR was decided based on AIR's 95% CI. Comparing with CIRs, AIRs were under-estimated. In addition, there were no statistical significance of annual trends(P=0.59). These findings are an additional evidence using AIR when comparing level of occurring infectious diseases on groups with different age structures.

Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is inherited microangiopathy caused by mutations in the Notch3 gene. Typical findings from brain magnetic resonance imaging (MRI) include subcortical lacunes, extensive white matter change and cerebral microbleeds(CMBs). CMBs are indicative of bleeding-prone microangiopathy. Despite some studies investigating the association between lacunes and cognitive dysfunction in CADASIL, few studies have examined the relationship between cognitive dysfunction and CMBs. We sought to assess whether CMBs are associated with cognitive dysfunction in CADASIL. This study enrolled 83 consecutive patients with CADASIL between April 2012 and January 2014. Their degree of cognitive dysfunction was assessed by the Korean version of the CERAD neuropsychological assessment battery, digit span test, and the Stroop test. A 3.0-T MRI was used to obtain T1-weighted, fluid-attenuated inversion recovery, and susceptibility weighted images. In multiple logistic regression analysis, the grade of CMBs influenced tests of memory dysfunction (p=0.003). Three or more lacunes correlated with dysfunction in the executive domain (p=0.013) and attention domain (p=0.005). White matter hyperintensity (WMH) was an independent predictor of executive dysfunction (p=0.001). These findings suggest that in addition to lacunes, CMBs and WMHs may be useful imaging markers to associated with cognitive dysfunction in CADASIL.

We conduct this study to compare the difference in duration of labor in nulliparous women received epidural analgesia or non-epidural analgesia for labor pain. This retrospective, observational study based on the review of the medical records from February 2014 to July 2017. Epidural analgesia was initiated with a 10 mL epidural bolus of 1% lidocaine and was maintained with a 0.1% mixture of ropivacaine with fentanyl. Non-epidural analgesia was initiated with pethidine 12.5 mg bolus, followed by additional boluses as needed. The primary outcome was the duration of the labor. 149 healthy nulliparous women at term pregnancies with no evidence of fetal distress were enrolled in this study. 92 women received non-epidural analgesia (Group NE) and 57 women received epidural analgesia (Group E). There were no significant differences between the two groups in maternal demographic characteristics. Using a Kaplan-Meier survival analysis, there was no significant difference in the overall duration of the labor(P=0.233). The duration of the first stage of labor was $187.6{\pm}167.3min$ in Group NE, $248.6{\pm}168.7min$ in Group E (Mean${\pm}$SD, P=0.032). The duration of the second stage of labor was $67.1{\pm}57.8min$ in Group NE, $64.1{\pm}47.5min$ in Group E (Mean${\pm}$SD, P=0.693). Epidural analgesia delayed the first stage of labor in this study. But there were no significant differences between the two groups in the duration of the second stage and the total duration of labor.

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by focal compression of the median nerve in the carpal tunnel. However, many patients with CTS, who are diagnosed clinically and confirmed with electrophysiological studies, complain of the sensory symptoms extends to the ulnar nerve territory. The aim of this study was to evaluate whether a dysfunction in sensory fibers of the ulnar nerve was present or not in hands with CTS patients who had extramedian spread of sensory symptoms over the hand. We retrospectively analyzed the recording of the subjects who were diagnosed with CTS within a one-year-period of time. After exclusions, 136 hands recordings of 87 patient were included. We compared the results of median and ulnar nerve sensory conduction studies between normal hands and hands with CTS. We did not detect statistically significant difference on all parameters of ulnar nerve sensory conduction studies between the normal hands and the hands with CTS. The parameters of the obtained in median nerve sensory conduction studies were statistically different between the healthy control and CTS patients. The hands with CTS showed similar rate of ulnar sensory conduction abnormalities compared with the normal hands. In conclusion, our study showed that none of the parameters in ulnar sensory nerve conduction studies differ between two groups. Accordingly, our study revealed that ulnar nerve involvement does not contribute in CTS patients underlying the spread of paresthesia extends to the ulnar nerve territory.

The reconstruction method of nasal area can be used differently depending on the location, size, age. In this elderly female patient case, without using the forehead medial flap, good results can be obtained by using an advancement flap considering the nasal aesthetic unit.

Extra-corporeal membrane oxygenation (ECMO) has the potential to rescue patients in cardiac arrest or respiratory failure. ECMO has two systems such as veno-arterial and veno-venous circulation. In cardiac arrest resulting from acute myocardial infarction, veno-arterial ECMO is mandatory for systemic circulation and oxygenation. A 75-year old female patient underwent primary coronary intervention for acute myocardial infarction. Despite successful revascularization, recurrent ventricular tachycardia and heart failure were progressing. We performed a veno-arterial ECMO through the femoral artery and vein, then the patient seemed to be stable clinically. However, laboratory studies, echocardiography, and vital signs indicated multi-organ failure and decreasing cardiac function. We found out an error that we performed veno-venous ECMO instead of veno-arterial ECMO. We added a femoral artery cannula and exchange the circuit system to veno-arterial ECMO. While the systemic circulation seemed to be recovered, the left ventricular function was decreased persistently. A hypovolemia resulting from pulmonary hemorrhage was occurred, which lead to ECMO failure. The patient died of cardiac arrest and multi-organ failure 23 hours after ECMO. Because the color of arterial and venous circuits represent the position and efficacy of ECMO, if unexpected or abnormal circuit colors are detected, prompt and aggressive evaluation for ECMO function is mandatory.