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1.
Epidemiology and Health ; : e2022024-2022.
Article in 0 | WPRIM | ID: wpr-937560

ABSTRACT

OBJECTIVES@#This study aimed to determine an effective survey method for the accurate calculation of obesity prevalence by comparing the self-reported and measured height, weight, and body mass index (BMI) using the 2018 Korea Community Healthy Survey (CHS) data. @*METHODS@#Raw data from the 2018 CHS were used to analyze the differences, correlation, and agreement between self-reported and measured height, weight, and BMI. @*RESULTS@#The self-reported height was over-reported than the measured height (0.59 cm greater for men and 0.71 cm greater for women), while the self-reported weight was under-reported than the measured weight (0.55 kg less for men and 0.67 kg less for women). Subsequently, the self-reported BMI was under-estimated (0.35 kg/m2 lower for men and 0.49 kg/m2 lower for women) compared with the measured BMI. The kappa statistic and agreement between measured and self-reported values per BMI category (underweight, normal, overweight, and obesity) were 0.82 and 79.6%, respectively. @*CONCLUSIONS@#The prevalence of obesity should be calculated using the measured values provided in the CHS in order to promote local health projects based on accurate evidence.

2.
Article in English | WPRIM | ID: wpr-937239

ABSTRACT

Neurodevelopmental disorders are complex conditions that pose difficulty in the modulation of proper motor, sensory and cognitive function due to dysregulated neuronal development. Previous studies have reported that an imbalance in the excitation/ inhibition (E/I) in the brain regulated by glutamatergic and/or GABAergic neurotransmission can cause neurodevelopmental and neuropsychiatric behavioral deficits such as autism spectrum disorder (ASD). NMDA acts as an agonist at the NMDA receptor and imitates the action of the glutamate on that receptor. NMDA however, unlike glutamate, only binds to and regulates the NMDA receptor subtypes and not the other glutamate receptors. This study seeks to determine whether NMDA administration in mice i.e., over-activation of the NMDA system would result in long-lasting behavioral deficits in the adolescent mice. Both gender mice were treated with NMDA or saline at early postnatal developmental period with significant synaptogenesis and synaptic maturation. On postnatal day 28, various behavioral experiments were conducted to assess and identify behavioral characteristics. NMDAtreated mice show social deficits, and repetitive behavior in both gender mice at adolescent periods. However, only the male mice but not female mice showed increased locomotor activity. This study implies that neonatal exposure to NMDA may illicit behavioral features similar to ASD. This study also confirms the validity of the E/I imbalance theory of ASD and that NMDA injection can be used as a pharmacologic model for ASD. Future studies may explore the mechanism behind the gender difference in locomotor activity as well as the human relevance and therapeutic significance of the present findings.

3.
Article in Korean | WPRIM | ID: wpr-938296

ABSTRACT

Purpose@#We report a case with bilateral, ocular inflammatory adverse reactions developing a few hours after COVID-19 vaccination.Case summary: A 70-year-old woman complained of headache and sudden visual impairment (both eyes) a few hours after COVID-19 vaccination (Astrazeneca). She had undergone bilateral cataract surgery 4 days before vaccination and her eyesight was good immediately after surgery. The best-corrected visual acuities (BCVA) were 0.2 and 0.1 in the right and left eyes, respectively. Diffuse corneal edema, anterior chamber reactions, inflammatory fibrinoid membranes on the anterior surfaces of the intraocular lenses (IOLs), and cystoid macular edema were observed in both eyes. The anterior chamber and IOL fibrinoid reactions much improved 7 days after the prescription of topical and oral corticosteroids. The aqueous humor polymerase chain reaction was positive for varicella zoster virus (VZV) in both eyes. The BCVA improved to 20/30 in the right eye and 20/50 in the left eye after 3 months of additional treatment. However, the cystoid macular edema did not improve. @*Conclusions@#In patients with a history of herpes zoster infection, adverse ocular inflammatory reactions associated with VZV may occur immediately after COVID-19 vaccination.

4.
Ultrasonography ; : 34-52, 2022.
Article in English | WPRIM | ID: wpr-919555

ABSTRACT

Musculoskeletal ultrasonography (US) has unique advantages, such as excellent spatial resolution for superficial structures, the capability for dynamic imaging, and the ability for direct correlation and provocation of symptoms. For these reasons, US is increasingly used to evaluate problems in small joints, such as the foot and ankle. However, it is almost impossible to evaluate every anatomic structure within a limited time. Therefore, US examinations can be faster and more efficient if radiologists know where to look and image patients with typical symptoms. In this review, common etiologies of heel pain are discussed in a problem-based manner. Knowing the common pain sources and being familiar with their US findings will help radiologists to perform accurate and effective US examinations.

5.
Article in English | WPRIM | ID: wpr-926607

ABSTRACT

Pembrolizumab is an immune checkpoint inhibitor that selectively blocks the programmed cell death (PD)-1 receptor. Although it has a dramatic effect on the treatment of advanced malignancies, instability of immune tolerance may cause immune-related adverse events in the skin. A 62-year-old male with a history of metastatic urothelial carcinoma was referred to the dermatology department and presented with a widespread mucocutaneous rash. Itching appeared 7 days after the first administration of pembrolizumab, and on the third day after the second administration, an erythematous maculopapular rash that coalesced into large flaccid bullae on the whole body with a positive Nikolsky’s sign developed. A biopsy revealed a subepidermal bulla with basal keratinocyte necrosis. Pembrolizumab was discontinued due to the diagnosis of toxic epidermal necrolysis (TEN), and intravenous methylprednisolone was started. Herein, we report a case of TEN induced by pembrolizumab to highlight immune-related cutaneous adverse events in patients receiving anti-PD-1 therapy.

6.
Article in English | WPRIM | ID: wpr-926419

ABSTRACT

Florid reactive periostitis (FRP) is a rare benign fibro-osseous proliferation, occurring mostly in the short tubular bones of hands and rarely in the long tubular bones. We report a surgically confirmed case of FRP involving the clavicle in a 26-year-old male. On MRI scans, a soft tissue mass with T2 high signal intensity was found that originated from the periosteum of the clavicle and included surrounding a periosteal elevation and perilesional soft tissue edema. Strong contrast enhancement was noted inside the mass and along the periosteum involving more than half of the circumference of the clavicle. Serial radiographs revealed a soft tissue mass without mineralization that turned into an ossified mass with a solid periosteal reaction within a month.

7.
Article in Korean | WPRIM | ID: wpr-926335

ABSTRACT

Purpose@#To investigate the pattern of Symptom Assessment in Dry Eye (SANDE) questionnaire symptom scores in dry eye disease (DED) patients and to assess the relationships with several dry eye signs. @*Methods@#The medical records of 173 patients with DED were analyzed retrospectively. Each patient’s SANDE score and history of autoimmune disease and ocular surgery were investigated, and Schirmer’s test, tear film breakup time (TBUT), ocular surface staining score (OSS), tear osmolarity, and tear MMP-9 test were assessed. The distribution of SANDE scores and relationships between the SANDE score and various dry eye signs were analyzed. The relationships between the SANDE scores of TBUT (< 5 / ≥ 5) and OSS (< 3 / ≥ 3) subgroups were compared. @*Results@#The average SANDE score was 52.6 ± 28.1. The SANDE scores were significantly higher in OSS ≥ 3 than in OSS < 3 (79.1 ± 21.6 vs. 51.1 ± 27.6, p = 0.030), and TBUT ≥ 5 had marginally significantly lower SANDE scores than TBUT < 5 (47.2 ± 25.6 vs. 55.6 ± 29.0, p = 0.050). TBUT was significantly negatively (R = -0.151, p = 0.024) correlated with the SANDE score, while OSS was marginally significantly positively (R = 0.111, p = 0.073) correlated. As OSS increased, the SANDE scores tended to increase (p for trend = 0.008). Other dry eye signs were not associated with the SANDE score. @*Conclusions@#The DED symptom score from the SANDE questionnaire was related to TBUT and OSS, but there was still a discrepancy between the symptoms and signs of DED.

8.
Annals of Dermatology ; : 515-521, 2021.
Article in English | WPRIM | ID: wpr-913455

ABSTRACT

Background@#A rifampicin (RF)-clindamycin (CL) combination therapy is recommended as the first-line treatment for moderate to severe hidradenitis suppurativa (HS). Although the long-term use of RF requires caution due to the possibility of developing resistant bacteria, only a few studies have investigated alternatives for this combination therapy. @*Objective@#To evaluate the efficacy of systemic CL mono-therapy and assess the prevalence and CL resistance of bacterial growth in HS patients. @*Methods@#A total of 53 HS patients treated with CL mono-therapy were included. The efficacy was evaluated by identifying the rate of HS Clinical Response (Hi-SCR) achievers and comparing HS Physician’s Global Assessment (HS-PGA) before (W0) and after (W8) the treatment. Purulent material from HS skin lesions was collected on the W0. Bacterial flora and antibiotic sensitivity were determined by bacterial cultures. @*Results@#Of 53 HS patients, 34 were eligible for evaluation of the efficacy of the therapy. Twenty-one patients (61.76%) achieved Hi-SCR. The mean scoring of HS-PGA had significantly decreased from 3.24 to 2.15 (p=0.001). The prevalence of CL resistance was 15.00%. No significant differences in the efficacy of the therapy according to the presence of CL-resistant bacteria on the W0 were observed (p=0.906). Adverse events occurred in 26.42% of patients. @*Conclusion@#Systemic CL mono-therapy may be a safe and useful alternative to RF-CL combination therapy, and no significant difference in the efficacy of the therapy depending on the presence of CL-resistant bacteria was observed.

9.
Article in English | WPRIM | ID: wpr-897974

ABSTRACT

Irreparable massive rotator cuff tears cause pain, loss of function, and a decrease in range of motion, which cause serious disturbances in daily life. Young patients, in particular, are active and have relatively high functional requirements, and their surgical options are limited. Superior capsular reconstruction (SCR) was first proposed for irreparable massive rotator cuff tears, good clinical results have been reported in short-term follow up. Since then, SCR has been used increasingly worldwide for irreparable massive rotator cuff tears, and various studies have been published on clinical outcomes, biomechanical outcomes, surgical techniques, and graft types. This article reviews the optimal graft and surgical options for improving clinical outcomes in SCR.

10.
Article in English | WPRIM | ID: wpr-896987

ABSTRACT

Purpose@#Drug-coated balloons have shown successful results in treating peripheral arterial occlusive disease. However, using multiple balloons for long femoropopliteal lesions (>15 cm) remains challenging; their safety and efficacy need to be explored. Therefore, we aimed to evaluate the outcomes of multiple drug-coated balloons for long femoropopliteal lesions in terms of the primary patency, freedom from clinically-driven target lesion revascularization, and mortality. @*Methods@#Between April 2015 and September 2018, 96 patients (117 limbs) who underwent balloon angioplasty using at least 2 drug-coated balloons for femoropopliteal lesions were retrospectively reviewed. Lesions were classified as TransAtlantic Inter-Society Consensus (TASC) classification C or D. The outcomes were analyzed using Kaplan-Meyer analysis. @*Results@#The mean age of 96 enrolled patients was 70.8 ± 9.8 years, and 83 patients were males (86.5%). Critical limbthreatening ischemia was found in 29 cases (24.8%). The mean lesion and drug-coated balloon lengths per limb were 292.3 ± 77.8 mm and 325.0 ± 70.2 mm, respectively. The technical success rate was 99.2%. A total of 82.1% were followedup for more than 6 months. The primary patency rates at 12 and 24 months were 71.4% and 41.7%, respectively; freedom from clinically-driven target lesion revascularization rates were 96.4% and 71.0% at 12 and 24 months, respectively. The Kaplan-Meier estimate of the 2-year overall cumulative mortality rate was 20.8%. All identified mortalities appeared to be less associated with paclitaxel. @*Conclusion@#Drug-coated balloons can be effectively used without drug-related mortality, even for long lesions, such as TASC classification C or D femoropopliteal lesions.

11.
Yonsei Medical Journal ; : 969-980, 2021.
Article in English | WPRIM | ID: wpr-896576

ABSTRACT

The skin is the first line of defense of our body, and it is composed of the epidermis and dermis with diverse immune cells. Various in vitro models have been investigated to recapitulate the immunological functions of the skin and to model inflammatory skin diseases. The simplest model is a two-dimensional (2D) co-culture system, which helps understand the direct and indirect cellto-cell interactions between immune and structural cells; however, it has limitations when observing three-dimensional (3D) interactions or reproducing skin barriers. Conversely, 3D skin constructs can mimic the human skin characteristics in terms of epidermal and dermal structures, barrier functions, cell migration, and cell-to-cell interaction in the 3D space. Recently, as the importance of neuro-immune-cutaneous interactions in the inflammatory response is emerging, 3D skin constructs containing both immune cells and neurons are being developed. A microfluidic culture device called “skin-on-a-chip,” which simulates the structures and functions of the human skin with perfusion, was also developed to mimic immune cell migration through the vascular system. This review summarizes the in vitro skin models with immune components, focusing on two highly prevalent chronic inflammatory skin diseases: atopic dermatitis and psoriasis. The development of these models will be valuable in studying the pathophysiology of skin diseases and evaluating the efficacy and toxicity of new drugs.

12.
Article in English | WPRIM | ID: wpr-896398

ABSTRACT

BACKGROUND@#Decellularized nerve allografting is one of promising treatment options for nerve defect. As an effort to develop more efficient nerve graft, recently we have developed a new decellularization method for nerve allograft. The aim of this study was to evaluate the effectiveness and biocompatibility of nerve graft decellularized by our newly developed method. @*METHODS@#Forty-eight inbred male Lewis rats were divided into two groups, Group I (autograft group, n = 25), Group II (decellularized isograft group, n = 23). Decellularized nerve grafts were prepared with our newly developed methods using amphoteric detergent and nuclease treatment. Serum cytokine level measurements at 0, 2, and 4 weeks and histologic evaluation for inflammatory cell infiltration at 6 and 16 weeks after nerve graft. @*RESULTS@#There was no significant difference in mean maximum isometric tetanic force and weight of tibialis anterior muscle or ankle angle at toe-off phase between two groups at 6 and 16 weeks survival time points (p > 0.05). There was no inflammatory cell infiltration in either group and histomorphometric assessments of 6- and 16-week specimens of the isograft group did not differ from those in the autograft group with regard to number of fascicle, cross sectional area, fascicle area ratio, and number of regenerated nerve cells. @*CONCLUSION@#Based on inflammatory reaction, axonal regeneration, and functional outcomes, our newly developed decellularized nerve grafts were fairly biocompatible and had comparable effectiveness to autografts for nerve regeneration, which suggested it would be suitable for nerve reconstruction as an alternative to autograft.

13.
Article in English | WPRIM | ID: wpr-895935

ABSTRACT

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade lymphoma with a long median survival time because of its low proliferation rate. A 75-year-old man was referred to the hospital for hematemesis. Upper endoscopy revealed a 30-mm subepithelial tumor (SET). Abdominal CT and EUS revealed a homogeneously hypoechoic lesion arising from the second layer of the stomach, without distant metastasis. Laparoscopic wedge resection was performed. On microscopic examination, the tumor showed diffuse aggregation of small lymphoid cells with abnormal architecture. Neoplastic cells showed positive reactivity for CD20 and prominent lymphoepithelial lesions were observed. The urease breath test was also conducted, with a negative result. Our final diagnosis was Helicobacter pylori-negative MALT lymphoma (Ann Arbor classification IE2), which is a rapidly growing SET pattern. This case highlights the importance of including gastric MALT lymphoma as a differential diagnosis for rapidly growing gastric SETs.

14.
Yonsei Medical Journal ; : 969-980, 2021.
Article in English | WPRIM | ID: wpr-904280

ABSTRACT

The skin is the first line of defense of our body, and it is composed of the epidermis and dermis with diverse immune cells. Various in vitro models have been investigated to recapitulate the immunological functions of the skin and to model inflammatory skin diseases. The simplest model is a two-dimensional (2D) co-culture system, which helps understand the direct and indirect cellto-cell interactions between immune and structural cells; however, it has limitations when observing three-dimensional (3D) interactions or reproducing skin barriers. Conversely, 3D skin constructs can mimic the human skin characteristics in terms of epidermal and dermal structures, barrier functions, cell migration, and cell-to-cell interaction in the 3D space. Recently, as the importance of neuro-immune-cutaneous interactions in the inflammatory response is emerging, 3D skin constructs containing both immune cells and neurons are being developed. A microfluidic culture device called “skin-on-a-chip,” which simulates the structures and functions of the human skin with perfusion, was also developed to mimic immune cell migration through the vascular system. This review summarizes the in vitro skin models with immune components, focusing on two highly prevalent chronic inflammatory skin diseases: atopic dermatitis and psoriasis. The development of these models will be valuable in studying the pathophysiology of skin diseases and evaluating the efficacy and toxicity of new drugs.

15.
Article in English | WPRIM | ID: wpr-904102

ABSTRACT

BACKGROUND@#Decellularized nerve allografting is one of promising treatment options for nerve defect. As an effort to develop more efficient nerve graft, recently we have developed a new decellularization method for nerve allograft. The aim of this study was to evaluate the effectiveness and biocompatibility of nerve graft decellularized by our newly developed method. @*METHODS@#Forty-eight inbred male Lewis rats were divided into two groups, Group I (autograft group, n = 25), Group II (decellularized isograft group, n = 23). Decellularized nerve grafts were prepared with our newly developed methods using amphoteric detergent and nuclease treatment. Serum cytokine level measurements at 0, 2, and 4 weeks and histologic evaluation for inflammatory cell infiltration at 6 and 16 weeks after nerve graft. @*RESULTS@#There was no significant difference in mean maximum isometric tetanic force and weight of tibialis anterior muscle or ankle angle at toe-off phase between two groups at 6 and 16 weeks survival time points (p > 0.05). There was no inflammatory cell infiltration in either group and histomorphometric assessments of 6- and 16-week specimens of the isograft group did not differ from those in the autograft group with regard to number of fascicle, cross sectional area, fascicle area ratio, and number of regenerated nerve cells. @*CONCLUSION@#Based on inflammatory reaction, axonal regeneration, and functional outcomes, our newly developed decellularized nerve grafts were fairly biocompatible and had comparable effectiveness to autografts for nerve regeneration, which suggested it would be suitable for nerve reconstruction as an alternative to autograft.

16.
Article in English | WPRIM | ID: wpr-903639

ABSTRACT

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade lymphoma with a long median survival time because of its low proliferation rate. A 75-year-old man was referred to the hospital for hematemesis. Upper endoscopy revealed a 30-mm subepithelial tumor (SET). Abdominal CT and EUS revealed a homogeneously hypoechoic lesion arising from the second layer of the stomach, without distant metastasis. Laparoscopic wedge resection was performed. On microscopic examination, the tumor showed diffuse aggregation of small lymphoid cells with abnormal architecture. Neoplastic cells showed positive reactivity for CD20 and prominent lymphoepithelial lesions were observed. The urease breath test was also conducted, with a negative result. Our final diagnosis was Helicobacter pylori-negative MALT lymphoma (Ann Arbor classification IE2), which is a rapidly growing SET pattern. This case highlights the importance of including gastric MALT lymphoma as a differential diagnosis for rapidly growing gastric SETs.

17.
Article in English | WPRIM | ID: wpr-903138

ABSTRACT

There have been several reports on why the clinical course of coronavirus disease 2019 (COVID-19) in pediatric patients is milder than in adults. There are distinctive points in the immune system between children and adults, as well as in the angiotensin-converting enzyme 2 gene expression, the characteristics of the respiratory system, the effects of comorbidities and risk factors, and the effect of infection control. Even though children tend to have mild forms of COVID-19, this does not mean that we should not regard it as a matter of importance.

18.
Article in English | WPRIM | ID: wpr-902568

ABSTRACT

A 5-year-old neutered female Dachshund dog presented with a 3-month history of hyperthermia, skin lesions, and shifting lameness. Based on physical examination, blood tests, urinalysis, and radiographs, the dog was diagnosed with systemic lupus erythematosus. Clinical signs improved after administration of prednisolone and cyclosporine but relapsed after the prednisolone was reduced due to side effects. Oral levamisole was commenced and the other immunosuppressants were tapered over a period of 2 months and then stopped. Levamisole was retained as the sole therapy for an additional 2 months. Six months after discontinuation of all treatment, the patient remained in remission.

19.
Korean Journal of Radiology ; : 1332-1340, 2021.
Article in English | WPRIM | ID: wpr-902417

ABSTRACT

Objective@#To evaluate the feasibility of a new three-dimensional (3D) MR fingerprinting (MRF) technique for the prostate gland by conducting phantom and clinical studies. @*Materials and Methods@#The new 3D MRF technique used in this study enables quick data acquisition and has a high resolution. For the phantom study, the MRF T1 and T2 values in an in-house phantom were compared with those of goldstandard mapping methods using linear regression analysis. For the clinical study, we evaluated 90 patients who underwent prostate imaging with MRF for suspected prostate cancer between September 2019 and February 2020. The mean T1 and T2 values were compared in the peripheral zone, transition zone, and focal lesions using paired t tests. The differences in the T1 and T2 values according to cancer aggressiveness were evaluated using one-way analysis of variance. @*Results@#In the phantom study, the MRF T1 and T2 values showed a perfect correlation with the gold-standard T1 and T2 values (R > 0.99). In the clinical study, the T1 and T2 values in the peripheral zone were significantly higher than those in the transitional zone (p < 0.001, both). The T1 and T2 values in prostate cancer were significantly lower than those in the peripheral and transitional zones. The higher the grade of cancer, the lower the T2 values. @*Conclusion@#The T1 and T2 values obtained from the 3D MRF showed a perfect correlation with the gold standard values in the phantom study. Differences in the T1 and T2 values among the different zones of the prostate gland were identified using 3D MRF in patients.

20.
Article in English | WPRIM | ID: wpr-901986

ABSTRACT

Background@#Psoriasis is a chronic disease that can have accompanying comorbidities including arthritis, metabolic syndrome, and cardiovascular diseases. Patients with psoriasis tend to frequently visit medical institutions, and their economic burden for medical services is high. @*Objective@#To investigate the economic burden of psoriasis in Korea. @*Methods@#The Korean Society for Psoriasis conducted a multi-center field survey of the patients and analyzed the national insurance claim data. Also, we discussed the medical environment of psoriasis in Korea based on the results. @*Results@#The economic burden of psoriasis patients is substantial and varied by the type of medical institute. Patients also paid the indirect and intangible medical costs. Biological agents, which is used in patients with severe psoriasis, led to an increase in the cost. @*Conclusion@#This is the first study to estimate the economic burden of psoriasis in Korea comprehensively. To improve the medical environment of psoriasis and alleviate the burden of patients, discussion on the more efficient health policy and medical insurance criteria for psoriasis would be needed.

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