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1.
Article in English | WPRIM | ID: wpr-926853

ABSTRACT

Objectives@#We described the trends and epidemiological characteristics of varicella outbreaks from 2016 to 2020 in the Republic of Korea. @*Methods@#We investigated variables such as the outbreak setting, age of patients, vaccination status, and lesion count. The collected data were analyzed with the Cochrane-Armitage trend test and Kruskal-Wallis test. These statistical tests were performed using R ver. 4.0.3. @*Results@#The number of varicella outbreaks increased from 2016 to 2018; however, after a slight decrease in the number of outbreaks in 2019, the number fell sharply in 2020. The median size of outbreaks decreased from 8 to 9 cases during 2016−2019 to 6 cases in 2020. The median duration of outbreaks was 18 days during 2016−2017, 28 days in 2018, 29 days in 2019, and 15 days in 2020. Varicella outbreaks occurred most frequently in elementary schools, and vaccination coverage of patients increased from 89.4% in 2016 to 97.2% in 2019. The median age of patients with outbreak-related varicella decreased from 8 years in 2016 to 6 years in 2020. @*Conclusion@#Significant changes were observed in the age of patients with outbreak-related varicella. Ongoing monitoring of varicella outbreaks should be conducted. Further research will be needed to measure the disease burden of varicella and enable evidence-based policy decisions.

2.
International Eye Science ; (12): 2026-2031, 2021.
Article in English | WPRIM | ID: wpr-904669

ABSTRACT

@#AIM: To evaluate the efficacy and safety of preoperative intravitreal injection of ranibizumab(IVR)and panretinal photocoagulation(PRP)combined with conventional trabeculectomy without drainage device in patients with neovascular glaucoma(NVG).<p>METHODS: The charts of 27 patients(27 eyes)who presented with NVG in our hospital between August 2015 and November 2018 were reviewed. All eyes were treated using the standard protocol of IVR accompanied by PRP, followed by conventional trabeculectomy without drainage device. The main outcomes were intraocular pressure(IOP)control, change in best-corrected visual acuity(BCVA), and surgical complications.<p>RESULTS: The postoperative follow-up periods for all patients were at least 18(mean 21.7±4.3)mo. The IOP significantly decreased from 45.7±5.1 mmHg(baseline)to 18.4±3.6 mmHg(last visit), and BCVA(LogMAR)improved from 2.42±0.68(baseline)to 1.77±0.93(last visit). The success rate was higher in eyes with peripheral anterior synechiae(PAS)≤50% than in those with PAS >50% after 3mo postoperatively. The main surgical complications were hyphema(11.1%)and hypotony with a shallow anterior chamber(14.8%)during the early postoperative stage, along with encapsulated bleb(37.0%)during the mid-late postoperative stage. Serious intraoperative or postoperative complications were not observed.<p>CONCLUSION: IVR and PRP combined with conventional trabeculectomy without drainage device is a safe and effective way in NVG treatment, especially for eyes with PAS ≤50%. Preoperative IVR and PRP appear to improve the success rate.

3.
Article in English | WPRIM | ID: wpr-903360

ABSTRACT

Background@#Traditional safety concept, which is called Safety-I, and its relevant methods and models have much contributed toward enhancing the safety of industrial systems. However, they have proved insufficient to be applied to complex socio-technical systems. As an alternative, Safety-II and resilience engineering have emerged and gained much attention for the last two decades. However, it seems that safety professionals have still difficulty understanding their fundamental concepts and methods. Accordingly, it is necessary to offer an introductory guide to them that helps safety professionals grasp them correctly in consideration of their current practices. @*Methods@#This article firstly explains the limitations of Safety-I and how Safety-II can resolve them from the four points of view. Next, the core concepts of resilience engineering and Functional Resonance Analysis Method are described. @*Results@#Workers' performance adjustment and performance variability due to it should be the basis for understanding human-related accidents in socio-technical systems. It should be acknowledged that successful and failed work performance have the same causes. However, they are not well considered in the traditional safety concept; in contrast, Safety-II and resilience engineering have conceptual bases and practical approaches to reflect them systematically. @*Conclusion@#It is necessary to move from a find-and-fix and reactive approach to a proactive approach to safety management. Safety-II and resilience engineering give a set of useful concepts and methods for proactive safety management. However, if necessary, Safety-I methods need to be properly used for situations where they can still be useful as well.

4.
Article in English | WPRIM | ID: wpr-902994

ABSTRACT

Objectives@#This study analyzed trends in foodborne and waterborne diseases in South Korea between 2015 and 2019. @*Methods@#The data consisted of information on outbreaks of waterborne and foodborne infectious diseases reported through the Korea Centers for Disease Control and Prevention(KCDC) system. We analyzed the trends and epidemiological aspects of outbreaks by month, place of occurrence, and causative pathogens in this observational study. @*Results@#The number of outbreaks has steadily increased over the last 5 years, but the number of cases per outbreak has followed a decreasing trend. Incidence at daycare centers and preschools has been steadily increasing over consecutive years. @*Conclusion@#The steady number of patients and decreasing number of cases per outbreak,even as the number of outbreaks has been increasing, suggest that the KCDC’s professional management system is operating effectively. It is necessary to continue improving the objectivity and efficiency of the management system and to carefully examine the increasing number of outbreaks in smaller-scale group catering facilities, such as daycare centers and preschools. Outbreaks can be prevented by closely examining those caused by unidentified pathogens and group outbreaks caused by other diseases, identifying problems, and supplementing the management system.

5.
Article in English | WPRIM | ID: wpr-895656

ABSTRACT

Background@#Traditional safety concept, which is called Safety-I, and its relevant methods and models have much contributed toward enhancing the safety of industrial systems. However, they have proved insufficient to be applied to complex socio-technical systems. As an alternative, Safety-II and resilience engineering have emerged and gained much attention for the last two decades. However, it seems that safety professionals have still difficulty understanding their fundamental concepts and methods. Accordingly, it is necessary to offer an introductory guide to them that helps safety professionals grasp them correctly in consideration of their current practices. @*Methods@#This article firstly explains the limitations of Safety-I and how Safety-II can resolve them from the four points of view. Next, the core concepts of resilience engineering and Functional Resonance Analysis Method are described. @*Results@#Workers' performance adjustment and performance variability due to it should be the basis for understanding human-related accidents in socio-technical systems. It should be acknowledged that successful and failed work performance have the same causes. However, they are not well considered in the traditional safety concept; in contrast, Safety-II and resilience engineering have conceptual bases and practical approaches to reflect them systematically. @*Conclusion@#It is necessary to move from a find-and-fix and reactive approach to a proactive approach to safety management. Safety-II and resilience engineering give a set of useful concepts and methods for proactive safety management. However, if necessary, Safety-I methods need to be properly used for situations where they can still be useful as well.

6.
Article in English | WPRIM | ID: wpr-895290

ABSTRACT

Objectives@#This study analyzed trends in foodborne and waterborne diseases in South Korea between 2015 and 2019. @*Methods@#The data consisted of information on outbreaks of waterborne and foodborne infectious diseases reported through the Korea Centers for Disease Control and Prevention(KCDC) system. We analyzed the trends and epidemiological aspects of outbreaks by month, place of occurrence, and causative pathogens in this observational study. @*Results@#The number of outbreaks has steadily increased over the last 5 years, but the number of cases per outbreak has followed a decreasing trend. Incidence at daycare centers and preschools has been steadily increasing over consecutive years. @*Conclusion@#The steady number of patients and decreasing number of cases per outbreak,even as the number of outbreaks has been increasing, suggest that the KCDC’s professional management system is operating effectively. It is necessary to continue improving the objectivity and efficiency of the management system and to carefully examine the increasing number of outbreaks in smaller-scale group catering facilities, such as daycare centers and preschools. Outbreaks can be prevented by closely examining those caused by unidentified pathogens and group outbreaks caused by other diseases, identifying problems, and supplementing the management system.

7.
Article in Chinese | WPRIM | ID: wpr-921941

ABSTRACT

OBJECTIVE@#To study the clinical efficacy and complications of Endobutton titanium plate and clavicle hook plate in the treatment of acromioclavicular dislocation.@*METHODS@#Total 48 patients with Rockwood Ⅲ to Ⅴ acromioclavicular joint dislocation from March 2015 to May 2019 were retrospectively divided into two groups according to different surgical methods. Among the patients, 23 patients were treated with Endobutton loop titanium plate fixation (observation group), including 15 males and 8 females, ranging in age from 23 to 59 years old, with an average of(36.2±8.1) years old;Rockwood type Ⅲ in 6 cases, type Ⅳ in 11 cases and type Ⅴ in 6 cases. Twenty-five patients were treated with clavicular hook plate(control group), including 17 males and 8 females, ranging in age from 22 to 54 years old, with an average of (34.7±6.4) years old; Rockwood type Ⅲ in 6 cases, type Ⅳ in 14 cases and type Ⅴ in 5 cases. The operation time, intraoperative bleeding, hospitalization time, visual analogue scale (VAS) of pain, Constant-Murley score of shoulder function and postoperative complications were compared between the two groups.@*RESULTS@#All the patients were followed up, and the duration ranged from 24 to 51 months, with a mean of (30.5±6.5) months. The amountof bleeding and hospitalization time in the observation group were (71.9±4.0) ml and(8.2±1.6) d respectively;and those in the control group were (97.6±13.4) ml and (12.8±1.2) d respectively. There was significant difference between the two groups (@*CONCLUSION@#Compared with clavicular hook plate internal fixation in the treatment of acromioclavicular joint dislocation, Endobutton loop titanium plate internal fixation technology has the advantages of less surgical bleeding, shorter hospitalization time, less postoperative pain, good recovery of shoulder joint function and less complications.


Subject(s)
Acromioclavicular Joint/surgery , Adult , Bone Plates , Case-Control Studies , Female , Humans , Joint Dislocations/surgery , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Young Adult
8.
Article in English | WPRIM | ID: wpr-918169

ABSTRACT

Objectives@#:The purpose of this study is to compare the psychosocial characteristics of patients diagnosed with functional gastrointestinal disorder (FGID) by classifying them into irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), functional heartburn (FH) groups, and overlap group (two or more functional diseases) and to examine the factors associated with the quality of life (QoL) of patients with FGID. @*Methods@#:A total of 144 patients who were diagnosed with FGID were selected as the subjects. The demographical factors were investigated; Korean-Beck Depression Inventory-II (K-BDI-II), Korean-Beck Anxiety Inventory (K-BAI), Korean version of Childhood Trauma Questionnaire (K-CTQ), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean Version of Connor-Davidson Resilience Scale (K-CD-RISC), and World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were used to evaluate the psychosocial factors. @*Results@#:TThe overlap group had a significantly higher K-BDI-II score (F=11.09, p<0.001) and K-BAI score (F=8.93, p<0.001) compared to other groups. In childhood trauma, the IBS patients had a difference in emotional neglect (F=2.54, p=0.04) than the FD patients. The QoL of FGID patients had a negative correlation with depression (r=-0.196, p<0.01), anxiety (r=-0.235, p<0.01), and childhood trauma (r=-0.222, p<0.01), and a positive correlation with social support (r=0.512, p<0.01) and resilience (r=0.581, p<0.01). @*Conclusions@#:Overlap group had a higher level of depression and anxiety, and the IBS patient group had a higher level of emotional neglect than the FD patient group in terms of childhood trauma.

9.
Article in Chinese | WPRIM | ID: wpr-912863

ABSTRACT

Objective: To observe the therapeutic effect of mild moxibustion on irritable bowel syndrome (IBS) visceral hyperalgesiamodel rats and its regulatory effect on P2X3 receptors in the spinal cord, anterior cingutate cortex (ACC) and thalamic ventral posterolateral nucleus (VPL). Methods: Thirty 8-day-old newborn rats were randomly divided into a normal group (n=6) and a modeling group (n=24) according to the completely random number table method. Rats in the normal group were bred routinely, and those in the modeling group were subjected to preparing IBS chronic visceral hyperalgesia model using colorectal distention (CRD) in stimulation method. Rats successfully modelled were re-divided into a model group, a mild moxibustion group, a P2X3 receptor antagonist group, and a normal saline group according to the completely random number table method with 6 rats in each group. Rats in each group received corresponding interventions from the 37-day old, once a day for 7 consecutive days. Immunohistochemistry and Western blot assays were used to detect P2X3 protein expressions in the spinal cord, ACC and VPL of rats. Results: Under different intensities of CRD stimulation, the abdominal withdrawal reflex (AWR) scores of the model group were significantly increased versus the normal group (all P<0.05); the AWR scores of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). The P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the model group were significantly increased versus the normal group (all P<0.01); the P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). Conclusion: Mild moxibustion can inhibit the P2X3 receptor expressions in the spinal cord, ACC, and VPL tissues of IBS visceral hyperalgesia model rats, which may be the mechanism of mild moxibustion in relieving the central sensitization of rats with IBS visceral hyperalgesia.

10.
Chinese Journal of School Health ; (12): 1152-1155, 2021.
Article in Chinese | WPRIM | ID: wpr-886607

ABSTRACT

Objective@#To investigate lunch supply of public primary school canteens in Zhejiang Province, and to provide a basis for the scientific guidance of school lunch.@*Methods@#During May to Jun. and Sept. to Oct. in 2019, lunch food supply was weighed and recorded and the number of diners in 44 public primary school canteens were summarized. Each investigation lasted for one week.@*Results@#Food was mainly based on the taste of the students (40.91%) in the school canteen. About 45.45% of the schools referred to the Nutrition Guidelines of School Meals for students meals when making recipes in the school canteen. The supplies of cereals, vegetables, fruits, livestock and poultry meat, fish and shrimp, eggs, milk, soybean nuts, vegetable oil and salt were 109.05, 118.01, 0, 63.96, 9.25, 11.31, 0, 10.68, 10.47, 2.54 g. The supply of vegetable oil was basically the same as the recommended amount ( P >0.05). The supplies of energy, protein, calcium, iron, zinc, vitamin A, vitamin B 1, vitamin B 2, vitamin C, dietary fiber were 820.84 kcal, 32.79 g, 164.18 mg, 7.84 mg, 4.71 mg, 23.07 μgRAE, 0.41 mg, 0.35 mg, 20.47 mg, 2.34 g, 37.56% of energy from fat and 48.47% of energy from carbohydrate. The supply of vitamin B 1 was basically the same as the recommended amount ( P >0.05). There were no significant differences in all kinds of food and nutrients between urban and rural primary schools ( P >0.05).@*Conclusion@#Lunch supply is not optimistic in public primary school canteens in Zhejiang Province, with unreasonable structure and fails to agree with current nutritional recommendations. It is suggested that the scientific guidance of students meals should be carried out according to the survey results combined with the characteristics of local diet.

11.
Article in English | WPRIM | ID: wpr-880856

ABSTRACT

The goal of this study was to identify MSX1 gene variants in multiple Chinese families with nonsyndromic oligodontia and analyse the functional influence of these variants. Whole-exome sequencing (WES) and Sanger sequencing were performed to identify the causal gene variants in five families with nonsyndromic oligodontia, and a series of bioinformatics databases were used for variant confirmation and functional prediction. Phenotypic characterization of the members of these families was described, and an in vitro analysis was performed for functional evaluation. Five novel MSX1 heterozygous variants were identified: three missense variants [c.662A>C (p.Q221P), c.670C>T (p.R224C), and c.809C>T (p.S270L)], one nonsense variant [c.364G>T (p.G122*)], and one frameshift variant [c.277delG (p.A93Rfs*67)]. Preliminary in vitro studies demonstrated that the subcellular localization of MSX1 was abnormal with the p.Q221P, p.R224C, p.G122*, and p.A93Rfs*67 variants compared to the wild type. Three variants (p.Q221P, p.G122*, and p.A93Rfs*67) were classified as pathogenic or likely pathogenic, while p.S270L and p.R224C were of uncertain significance in the current data. Moreover, we summarized and analysed the MSX1-related tooth agenesis positions and found that the type and variant locus were not related to the severity of tooth loss. Our results expand the variant spectrum of nonsyndromic oligodontia and provide valuable information for genetic counselling.


Subject(s)
Anodontia/genetics , Humans , MSX1 Transcription Factor/genetics , Pedigree , Whole Exome Sequencing
12.
Braz. j. med. biol. res ; 54(9): e10602, 2021. tab
Article in English | LILACS | ID: biblio-1278584

ABSTRACT

The outbreak of the 2019 novel coronavirus disease (COVID-19) has impacted the mental health of healthcare providers at the frontline. Therefore, we conducted this study to estimate the prevalence rate of anxiety and insomnia and identify associated risk factors among healthcare workers in Jilin, China, during the period from January 25 to February 25, 2020. Zung's Self-Reported Anxiety Scale (SAS) and the Insomnia Severity Index (ISI) scale were used to diagnose anxiety and insomnia, respectively. Associated risk factors were identified through a multivariate logistic regression model. A total of 300 healthcare workers were invited and 236 completed the study. Of them, 234 (99.15%) were medical workers, 197 (83.47%) were working at frontline departments, and 159 (67.37%) were fighting against COVID-19. Fifty-seven respondents (24.15%) had anxiety (SAS index score ≥45) and 94 (39.83%) had insomnia (ISI score ≥8). Based on the multivariate analysis, contact with people from Hubei province during work (no vs not clear) [OR=0.25, 95%CI: 0.10-0.61] and personal protective equipment (PPE) (not in place vs in place) [OR=6.22, 95%CI: 2.23-17.40] were significantly correlated with anxiety. PPE (not in place vs in place) was the only significant risk factor of insomnia [OR=10.56, 95%CI: 4.00-27.87]. The prevalence of anxiety and insomnia was high in our study, reflecting the psychological impact of COVID-19 on healthcare workers. The unavailability of PPE in place was a significant risk factor of both anxiety and insomnia.


Subject(s)
Humans , COVID-19 , Sleep Initiation and Maintenance Disorders/epidemiology , Anxiety/epidemiology , China/epidemiology , Prevalence , Cross-Sectional Studies , Health Personnel , Depression , Pandemics , SARS-CoV-2
13.
Article in Chinese | WPRIM | ID: wpr-873046

ABSTRACT

Objective:Potential targets and pathways of Qingfei Paidu decoction(QFPD)for treating coronavirus disease-2019(COVID-19) were analyzed based on the integrative pharmacology,the efficacy and material basis was predicted.This study provide a reference for the development and clinical application of QFPD. Method:Based on the integrative pharmacology of traditional Chinese medicine(TCMIP V2.0),the key targets and pathways of the intervention of QFPD on COVID-19 were enriched,the interaction network of "formula-herb-disease-targets-pathways" was constructed to explored the molecular mechanism of QFPD for the treatment of COVID-19. Result:The research results show that key-targets such as cell tumor antigen p53(tp53),protein kinase B1(Akt1),Nuclear factor nuclear transcription factor-κB(NF-κB)p105 subunit(NFKB1),nuclear factor p65 subunit(RELA),human NF-κB inhibited protein α(NFKBIA),ect.Closely associated with lung damage.The pathways such as interleukin signaling,adrenoceptors,7 members of the family of c-type lectin domains A(CLEC7A)/inflammasome pathway,phosphoinositide-3-kinase(PI3K)/protein kinase B(Akt)inflammatory signaling pathway,tp53 regulates transcription of DNA repair ect. may be the key pathways related with QFPD's effect on the treatment of COVID-19 accompany with lung injury, fever, cough and other symptoms.The results show that QFPD has many clinical effects, such as anti-inflammatory, anti-virus, strengthening immunity, inhibit the development of pulmonary fibrosis, protecting heart and lungs, treating asthma, regulating gastrointestinal tract, etc.In addition, there is a good synergism between the original prescription and the combined prescription, and each original prescription has its own emphasiscan prevention and treatment of COVID-19. Conclusion:QFPD plays a role in balancing immunity and eliminating inflammation,and it can treat COVID-19 by multi-pathway,multi-channel,multi-target and multi-link.This study also provides a new idea for the research of prevention and treatment of modern infectious diseases by use the traditional Chinese medicine.

14.
Article in Chinese | WPRIM | ID: wpr-872996

ABSTRACT

Objective::To established fingerprint of Acanthopanacix Cortex by UPLC method, in order to provide reference for quality control and evaluation. Method::UPLC method was performed on Waters BEH C18 (2.1 mm×100 mm, 1.7 μm), with acetonitrile-0.1% glacial acetic acid as the mobile phase for gradient elution.The detection wavelength was 282 nm, the flow rate was 0.3 mL·min-1, the column temperature was 25 ℃, and the injection volume was 2 μL.With syringin as reference substance, the fingerprint of 20 batches Acanthopanacix Cortex were analyzed under the same chromatographic conditions.The Similarity Evaluation System for Chromatographic Fingerprint of Chinese Materia Media (version 2012) was used to analyze the similarity of 20 batches of Acanthopanacix Cortex, and the SPSS 21.0 was applied for cluster analysis. Result::The UPLC fingerprint of the Acanthopanacix Cortex was established.The similarity results showed that the 7 batches of the 20 batches of Acanthopanacix Cortex was less than 0.800, and the remaining medicinal materials were similar within the range from 0.800 to 0.924.Besides, 12 common fingerprint peaks were calibrated and 4 components were identified, namely protocatechuic acid (peak 1), chlorogenic acid (peak 3), syringin (peak 4), and 4-methoxysalicylaldehyde (peak 12). The clustering results showed that the 20 batches of Acanthopanacix Cortex were divided into four groups.Among these batches, S1, S3, S9, S13 and S20 were clustered into one category, S11 was a category, S14 was a category, and the remaining samples belonged to a category. Conclusion::With a good precision, repeatability and stability, short analysis time as well as superior specificity, the method will provide a scientific basis to evaluate and control the quality of Acanthopanacix Cortex.

15.
Clinical Pain ; (2): 80-89, 2020.
Article in Korean | WPRIM | ID: wpr-897846

ABSTRACT

Objective@#We compared the regenerative effects of microcurrent therapy (MT) according to the type of electric current, which were direct current microcurrent therapy (DCMT) and alternating current microcurrent therapy (ACMT) on atrophied calf muscle in cast-immobilized rabbit. @*Methods@#Rabbits were allocated into control group (sham MT), ACMT group, and DCMT group.Before starting treatment, right gastrocnemius (GCM) muscle was immobilized by cast for 2 weeks. Compound muscle action potential of tibial nerve in nerve conduction study, circumference of calf muscle using a ruler, and thickness of medial and lateral GCM muscle measured by ultrasound, cross sectional area (CSA), and proliferating cell nuclear antigen (PCNA) ratios (%) of muscle fibers were measured on the immunohistochemical analysis. @*Results@#The mean atrophic changes (%) in right medial and lateral GCM muscle thickness, right calf circumference, and amplitude of CMAP of the right tibial nerve in ACMT group and DCMT group were significantly lower than those in control group, respectively (p<0.05). The mean CSA (μm 2 ) of type I and type II and PCNA ratios (%) of medial and lateral GCM muscle fibers in ACMT group and DCMT group were significantly greater than those in control group, respectively (p<0.05). There were no significant differences between the ACMT group and DCMT group at all parameters. @*Conclusion@#This study demonstrated that ACMT and DCMT showed better regeneration effect than sham MT. Microcurrent may be effective in regeneration of atrophied muscle regardless of the type of current.

16.
Article | WPRIM | ID: wpr-837307

ABSTRACT

Achalasia is a rare primary esophageal motility disorder characterized by the loss of enteric neurons leading to an absence of peristalsis and impaired relaxation of the lower esophageal sphincter. The subsequent stasis of ingested food not only leads to symptoms of dysphagia, regurgitation, chest pain, and weight loss, but also results in an increased risk of esophageal carcinoma. Structural or functional pulmonary abnormalities occur in more than half of patients and may be due to recurrent aspiration or tracheal compression from a dilated esophagus. Delayed diagnosis or ineffective intervention may lead to progressive dilation of the esophagus and the development of a megaesophagus. Respiratory distress and cardiopulmonary arrest from tracheal or left atrial compression secondary to a megaesophagus are rare complications of achalasia. There is only limited evidence that pneumatic dilation may be used as a first-line therapy for a megaesophagus. The choice of definitive treatment will depend on many factors including achalasia type, patient wishes, performance status, and surgical expertise.

17.
Article | WPRIM | ID: wpr-837295

ABSTRACT

Esophageal diverticula are uncommon lesions that are usually classified according to location, layers of the wall, and underlying pathogenesis. A true traction esophageal diverticulum, which is commonly seen in the middle one-third of the thoracic esophagus, occurs secondary to mediastinal inflammatory lesions, such as those caused by tuberculosis. Esophageal tuberculosis usually develops secondary to tuberculous lymphadenitis or lung lesion; it manifests with various endoscopic findings such as single or multiple ulcers, elevated lesions with ulcers at the center, extrinsic compressions, fistulas, and rarely, anthracosis. Its shape can vary greatly depending on disease progression and treatment. Herein, we report sequential endoscopic findings of a tuberculous esophageal ulcer that turned into a depressed lesion with black-pigmentation, finally developing into a typical traction esophageal diverticulum in a patient with mediastinal lymphadenitis.

18.
Article | WPRIM | ID: wpr-835499

ABSTRACT

The transformation of papillary thyroid carcinoma (PTC) to anaplastic thyroid carcinoma (ATC) is well documented in the literature but is an exceptionally rare occurrence in metastatic foci outside the primary thyroid lesion. Even rarer is the simultaneous occurrence of PTC and ATC in the cervical lymph nodes. We report the case of an 85–year–old man who presented with a rapidly growing neck mass diagnosed as PTC. Following surgery, multiple ATC foci in the metastatic cervical lymph node were found coexisting with PTC, whereas in the thyroid, only PTC was found. This case is of high clinical significance because transformation of PTC to ATC outside the thyroid gland per se is very rare and because it suggests rapidly growing tumors in an elderly patient. The use of core needle biopsies in cases with suspected rapid tumor growth can aid in proper diagnosis, surgical decision making, and patient counselling.

19.
Article | WPRIM | ID: wpr-833959

ABSTRACT

Background@#Depression is suggested to be associated with cardiovascular disease, including ischemic heart disease and cerebrovascular disease. This study investigated the impact of depression on cardiovascular disease in the elderly population in Korea. @*Methods@#This retrospective cohort study was performed using the Senior Cohort database released by the Korean National Health Insurance Services from January 1, 2008 to December 31, 2012, or January 1, 2009 to December 31, 2013. The study group constituted participants newly diagnosed with depression, but not cardiovascular disease. The control group constituted participants with no past history of depression or cardiovascular disease, and were not diagnosed with depression during the follow-up period. During the 5-year follow-up period, development of ischemic heart disease or cerebrovascular disease was assessed. Depression and cardiovascular disease were identified using the International Classification of Diseases, 10th revision, Clinical Modification codes. The data was analyzed using Cox proportional hazards model. @*Results@#The hazard ratio (HR) between depression and ischemic heart disease was 1.38 (95% confidence interval [CI], 1.23 to 1.55) and the HR between depression and cerebrovascular disease was 1.46 (95% CI, 1.32 to 1.62), after adjusting all confounding variables. @*Conclusion@#Independent of other cardiovascular risk factors, depression increased the risk of ischemic heart disease by 38% and cerebrovascular disease by 46% among older adults in Korea. Since depression may increase the risk of cardiovascular disease, future research should focus on the diagnosis and prevention of cardiovascular disease in people with depression.

20.
Article in English | WPRIM | ID: wpr-831682

ABSTRACT

Background@#Hearing loss (HL) in children may adversely affect their development. HL is more prevalent in patients with chronic kidney disease (CKD) than in the general population.This study evaluated the prevalence of HL and its underlying diseases in patients with childhood-onset in CKD. @*Methods@#In this retrospective study of a tertiary referral center, childhood-onset CKD patients (stage 2–5, age at onset of renal symptom < 18 years) were recruited. We referred to the “renal” syndromic HL as cases with genetic or syndromic diseases, or extra-renal anomalies in addition to HL and CKD. @*Results@#A total of 421 patients (male:female = 279:142) were reviewed according to the causes of CKD: congenital anomalies of the kidney and urinary tract (CAKUT; n = 184, 43.7%), glomerulopathies (GP; n = 105, 24.9%), cystic kidney diseases (CYST; n = 39, 9.3%), perinatal problems (PP; n = 29, 6.9%), and others (n = 64, 15.2%). HL was detected in 82 (19.5%) patients, including 51 (12.1%) patients with sensorineural hearing loss (SNHL), 30 (7.1%) with conductive hearing loss (CHL), and 1 patient with mixed HL. The prevalence of HL in each group was as follows: 16.8% in the CAKUT group, 28.6% in the GP group, 12.8% in the CYST group, 24.1% in the PP group, and 14.1% in the others group. HL was more common in higher CKD stages, especially CHL in end-stage renal disease. SNHL was more prevalent in CKD from GP. Of the 82 patients with HL, 50% had renal syndromic HL: 58.8% of SNHL and one-third of CHL were renal syndromic HL. @*Conclusion@#One-fifth of the childhood-onset CKD had HL. Collectively, renal syndromic HL comprised half of the HL in this study. To improve the quality of life in patients with childhood-onset CKD, we suggest that HL should be considered, requiring surveillance, and if necessary, early intervention.

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