• The Korean Journal of Pharmacology
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• v.32 no.1
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• pp.23-29
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• 1996

According to the traditional receptor model, competitive antagonists share with agonists the ability to bind to a common site on receptors, but they are different from agonist in that they cannot trigger the biological response-i.e., they lack intrinsic efficacy. Recent findings extend the model by indicating that not all antagonists display an intrinsic efficacy of zero but that some display 'inverse agonism'. In the present study we studied the inverse agonism at $A_1$ adenosine receptors in membranes prepared from rat cerebral cortex. Eight commercially available $A_1$ adenosine receptor antagonists (CGS-15943, ADPX, CPT, DPCPX, DPX, N-0840, PACPX and 8-PT) were screened for inverse agonism by measuring the extent of $[^{35}S]guanosine-5'-({\gamma}-thio)$ triphosphate $([^{35}S]GTP_{\gamma}S)$ binding to G proteins. The agonist-induced stimulation of $[^{35}S]GTP_{\gamma}S$ bindings was completely blocked in the presence of $A_1$ adenosine receptor antagonists. Under optimal conditions, two types of antagonists could be distinguished. Seven antagonists including DPCPX decreased the basal $[^{35}S]GTP_{\gamma}S$ binding in the absence of agonist, displaying inverse agonist activity. One (CGS-15943) had no effect on the basal bindings. N-ethylmaleimide treatment reduced the basal bindings as well as agonist-mediated stimulation of $[^{35}S]GTP_{\gamma}S$ bindings, indicating that a substantial amount of this binding reflects an activated state of the C proteins. In good agreement with these findings, 0.1 mM GTP decreased the apparent affinity of the receptors for the agonist PIA, increased that for DPCPX, and had no effect on that for CGS-15943.

• Radiation Oncology Journal
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• v.27 no.3
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• pp.133-139
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• 2009

Purpose: This study was designed to analyze the outcome and toxicity of thoracic radiation therapy (TRT) and chemotherapy for patients who suffer with limited-stage small-cell lung cancer (LS-SCLC). Materials and Methods: We retrospectively studied 35 patients with LS-SCLC. TRT was administered once daily (1.8 to 2 Gy per fraction) and it was directed to the primary tumor for a total 50 to 66 Gy in 6 to 7 weeks. The patients received four cycles of etoposide plus cisplatin. TRT was begun on day 1 of the first cycle of chemotherapy in the concurrent arm and after the fourth cycle in the sequential arm. Results: The median progression-free survival time was 16.5 months (95% confidence interval [CI], 9.0 to 24.1 months) for the sequential arm, and 26.3 months (95% CI, 16.6 to 35.9 months) for the concurrent arm. The 2-year progression-free survival rate was 16.0 percent for the sequential arm and 50.0 percent for the concurrent arm (p=0.0950 by log-rank test). Leukopenia was more severe and more frequent in the concurrent arm than in the sequential arm. However, severe esophagitis was infrequent in both arms. The radiotherapy was interrupted more frequently in the concurrent arm than in the sequential arm due to hematologic toxicities (p=0.001). Conclusion: This study suggests that concurrent TRT with etoposide plus cisplatin is more effective for the treatment of LS-SCLC than sequential TRT. However, there is a significant increase in the risk of toxicities, and radiotherapy was frequently interrupted in the concurrent arm due to hematologic toxicities.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.58-65
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• 2010

Purpose: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features. Methods: A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January 1996 and June 2007. Results: Twenty males and 21 females (mean age, 8.7${\pm}$4.5 years) were included. In 22 patients (53.7%), no definitive causes were found. The most common etiologies were choledochal cysts (22.0%). Necrotizing pancreatitis was diagnosed in 5 patients (12.2%), and recurrent acute pancreatitis in 4 patients (9.8%). CT findings included pancreatic swelling (43.9%), peripancreatic fluid collection (29.3%), ascites (24.4%), and peripancreatic fat necrosis (12.2%). Serum amylase and lipase levels at diagnosis were 535.3${\pm}$553.2 and 766.2${\pm}$723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively. On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%), a surgical procedure was indicated. Major complications included ascites (32.3%), sepsis (16.1%), and pseudocyst and renal impairments (12.9%). Two patients died from multi-organ failure. Conclusion: The etiologies of AP in children are varied. Most children have a single episode and a self-limited course. However, AP of childhood still carries significant morbidity and mortality. Early diagnosis, appropriate treatment according to disease severity, and management of complications are important.

• Journal of Hospice and Palliative Care
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• v.19 no.2
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• pp.170-179
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• 2016

Purpose: This study examined self-efficacy, self-care behavior, posttraumatic growth, and quality of life in cancer patients and their levels by disease characteristics groups to identify patient groups that require psychosocial intervention. Methods: We surveyed 107 patients using a structured questionnaire about the four factors and analyzed the factors by stratifying the patients by the period after the cancer diagnosis, by stage and by current treatment status. Results: The mean score for self-efficacy was 37.78, and that for self-care behavior 49.96. Patients who were diagnosed less than one year ago scored higher on medication, a sub-category of self-care behavior, than the post-diagnosis period of 1~2 year group. The score was higher in the currently-treated group than the follow-up and distant metastasis groups. For posttraumatic growth, the mean was 56.17, and the factor was higher in the 1~2 year post-diagnosis group after than the less than one year group. The score was higher in the follow-up group than the currently-treated group. With regard to quality of life, the mean score was 25.79, and no significant correlation was found with disease characteristics. Conclusion: A shorter post-diagnosis period increased self-care behavior, and the greatest posttraumatic growth was reported by the 1~2 year post-diagnosis group. It may be necessary to provide cancer patients with an education program and other strategies less than one year after the diagnosis to improve self-efficacy and self-care behavior. To promote post-traumatic growth, it may be helpful to provide patients with psychosocial intervention within two years after the diagnosis.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.4
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• pp.407-412
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• 2017

The aim of this study was to shorten the time required for subculture and bacterial identification and obtain a simple and rapid identification method for new test methods for bloodstream infections. The following results were obtained using a mass spectrometer. In Vitek 2, 208 (81.8%) cases were well-identified and 45 isolates were not identified in blood cultures. Among 208 cases, 146 (57.5%) were Gram positive bacteria and 108 (42.5%) were Gram negative bacteria. In total, 233 were identified to the species level and 21 were identified to the genus level. The identification error was found to be Propionibacterium acnes as Clostridium bifermentans. The accuracy of Enterobacteriaceae, glucose non-fermentative bacilli (GNFB), and staphylococci were 81/83 (97.6%), 12/15 (80.0%), and 72/85 (84.7%), respectively. The concordance rate of Vitek 2 and Vitek MS by the direct method was 81.8% and 45 isolates were not identified. Most of the unidentified bacteria were Gram positive bacteria (N=37). The Gram positive bacteria were streptococci (14), coagulase-negative staphylococci (CNS) (11), enterococci (3), Staphylococcus aureus (2), Micrococcus spp. (2), Bacillus spp. (2) and Actinomyces odontolyticus, Finegoldia magna, and Peptostreptococcus spp. The results reporting time was reduced to 24~72 hours compared to the conventional method. The rate of identification of the aerobic and anaerobic cultures was similar, but the use of an anaerobic culture did not require a dissolution process, which could shorten the sample preparation time. These results suggest that the method of direct identification in blood cultures is very useful for the treatment of patients. In further studies, it might be necessary to further improve the method for identifying streptococci and CNS, which were lacking in accuracy in this study.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.1
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• pp.51-59
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• 2007

Purpose: Recently well-developed anorectal function tests have revealed that there is an obvious pelvic floor dyssynergia (PFD) pattern in pediatric patients with constipation, as well as in adult's. The use of biofeedback therapy (BT) has been widely implemented in adult PFD patients; however, this approach has only rarely been considered for pediatric PFD patients. Therefore, we assessed the effectiveness of BT in children with PFD. Methods: We studied 70 children with PFD, who were referred to the department of pediatrics at the Asan Medical Center for the management of soiling or chronic constipation from September 2002 to February 2005. Diagnosis of PFD and assessment of the efficacy of BT for PFD treatment were carried out along with several ano-rectal function tests (cine-defecography, ano-rectal manometry, balloon expulsion test and intra-anal EMG); in addition, a questionnaire was administered. The BT based intra-anal EMG was performed. A follow-up telephone interview was performed more than 6 months later. Results: Most of the symptoms and results of the ano-rectal function tests were statistically improved after BT. In comparisons between the BT and control groups (BT refusal group due to poor compliance), the symptoms were statistically improved at follow-up. Therefore, for the shortterm improvement of symptoms, BT was better than conservative therapy alone. The negative feelings associated with ano-rectal function testing and BT were directly associated with failure or success of therapy. Conclusion: Pediatric patients with constipation or soiling that presented with an obvious PFD pattern showed that BT was a useful therapeutic tool for rapid improvement of symptoms.

• Childhood Kidney Diseases
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• v.14 no.2
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• pp.203-209
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• 2010

Purpose : It has been a common medical practice to use prophylactic antibiotics to prevent recurrent urinary tract infections (UTI) in high risk situations such as urinary tract obstruction, vesicoureteral reflux, neurogenic bladder, or urinary stones. But sometimes, we meet difficult situation of breakthrough infections (BI) which might cause new or progressive renal scarring. The clinical characteristics of children contracting breakthrough UTI experienced in a single center were studied. Methods : The study was done retrospectively through medical records of 150 pediatric patients who had been cared in pediatric and urologic clinics of Pusan National University Hospital from Jan. 2001 till June 2006 and had prophylactic antibiotics to prevent recurrent UTI. Results : The starting age of prophylactic antibiotics of 150 patient was 1-76 months, and median age was 5 months. The BI developed 61 times in 43 patients (28.7%), 1.5 times per 100 patient-months. The BI occurred more frequently in patients with higher grade of VUR, and in the cases with abnormal DMSA scan. Co-trimoxazole was more effective than 2nd and 3rd generation cephalosporins to prevent UTI. The distribution of causative organisms was more diverse than usual UTI. The causative organisms were sensitive to the antibiotics used for prophylaxis in 29.5%, and resistant in 59.1%. After experience of BI, 40 percents of patients went to the surgical treatment including endoscopic injection of Deflux, 35% to new antibiotics for prophylaxis, 26% remain on the same antibiotics as the previous one. Conclusion : Based on our study results, preexisting renal scar might be one of the factors which should be considered in favor of early surgical interventions of VUR. Poor compliance and wrong selection of antibiotics such as cephalosporins are important underlying causes of breakthrough UTIs.

• Radiation Oncology Journal
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• v.16 no.2
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• pp.195-202
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• 1998

Purpose : In order to obtain basic data for treatment plan in radiosurgery, we measured small fields of 6 MV X-rays and compared the measured data with our Monte Carlo simulations for the small fields. Materials and Methods : The small fields of 1.0, 2.0 and 3.0 cm in diameter were used in this study. Percentage depth dose (PDD) and beam Profiles of those fields were measured and calculated. A small semiconductor detector, water phantoms, and a remote control system were used for the measurement Monte Carlo simulations were Performed using the EGS4 code with the input data prepared for the energy distribution of 6 MV X-rays, beam divergence, circular fields and the geometry of the water phantoms. Results : In the case of PDD values, the calculated values were lower than the measured values for all fields and depths, with the differences being 0.3 to 5.7% at the depths of 20 to 20.0 cm and 0.0 to 8.9% at the surface regions. As a result of the analysis of beam profiles for all field sizes at a depth of loom in water phantom, the measured 90% dose widths were in good agreement with the calculated values, however, the calculated Penumbra radii were 0.1 cm shorter than measured values. Conclusion : The measured PDDs and beam profiles agreement with the Monte Carlo calculations approximately. However, it is different when it comes to calculations in the area of phantom surface and penumbra because the Monte Carlo calculations were performed under the simplified geometries. Therefore, we have to study how to include the actual geometries and more precise data for the field area in Monte Carlo calculations. The Monte Carlo calculations will be used as a useful tool for the very complicated conditions in measurement and verification.

• The Korean Society of Law and Medicine
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• v.17 no.1
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• pp.209-279
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• 2016

The Korean Mental Health Act was amended 2016 overall. This paper examines and evaluates the old Korean Mental Health Act since 1995 and the new Korean Mental Health Promotion Act 2016 from the Perspective of Human Rights and Inclusion of Persons with Psychosocial Disabilities. The persons with mental disabilities was separated and ruled out from society by the enactment of the Mental Health Act in 1995 and five times amendment. That has been justified and institutionally supported by medical viewpoint. The medical approach which reconsider the persons with mental disabilities as patients conceal that the aims of the involuntary admission in Mental Hospital are protection of society and the relief of the family member's duty of support for person with mental disabilities. This is institutionally supported in the 1995 Korean Mental Health Act by involuntary admission through the consent of family members as protectors. According to the old Act, the family members as protectors are authorized to consent to involuntary admission of persons with mental disabilities. Also, the psychiatrist that diagnoses the person with mental disabilities and evaluates the need for treatment by admission is not impartial in this decision. Family members as protectors may want to lighten their burden of support for the person with mental disabilities in their home by admitting them into a mental hospital, and the psychiatrist in the mental hospital can be improperly influenced by demand of hospital management. Additionally, Article 24 of the Korean Mental Health Act for the Involuntary Admission by the Consent of Family Members as Protector might violate personal liberty, as guaranteed in the Korean Constitution. The Mental Health Promotion Law was amended to reduce the scope of the persons with mental illness which are subject to forced hospitalization and to demand that a second diagnosis is made by another psychiatrist and screening by the committee concerning the legitimacy of admission in the process of the involuntary admission by the consent of family members as a method of protection. The amended Mental Health Promotion Law will contribute to reducing the number of the involuntary admissions and the inclusion of persons with mental disabilities. But if persons with mental disabilities are not providing some kind of service to the community, the amended Mental Health Promotion Law does not work for Inclusion of them.

• Journal of Life Science
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• v.14 no.4
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• pp.670-675
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• 2004

We have examined the effects of S-nitroso-N-acetylpenicillamine (SNAP), prostaglandin $E_2$ (PG $E_2$) and dibutric cyclic AMP (dbcAMP) on the methylation of interferon- ${\gamma}$ (IFN- ${\gamma}$ ) gene in human Jurkat T cells. The CpG dinucleotide which is critical for promoter function of IFN- ${\gamma}$ gene was methylated by treatment with SNAP, PG $E_2$ and dbcAMP, respectively. The DNA methylation induced by PG $E_2$ was suppressed by the addition of 2',5'-dideoxyadenosine (DDA), an inhibitor of adenylyl cyclase, but the suppression was not observed in SNAP treated cells. The NO production was not enhanced in PG $E_2$ or dbcAMP treated cells. The methylation induced by PG $E_2$ and dbcAMP was not suppressed by the addition of $N^{G}$-methyl-L-arginine (L-NMMA), NO synthase inhibitor. In conclusion, the inhibition of INF- ${\gamma}$ gene expression by PG $E_2$ was associated with the methylation of INF- ${\gamma}$ gene by elevation of intracellular cAMP in human Jurkat T cells. However, the methylation induced by PG $E_2$ might not be mediated through the NO production.rough the NO production.