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1.
Article in English | WPRIM | ID: wpr-875445

ABSTRACT

Background/Aims@#To investigate whether visceral fat area (VFA) measured by bioelectric impedance analysis (BIA) was associated with metabolic syndrome in subjects with and without obesity. @*Methods@#A total 23,202 participants who underwent medical check-ups were assessed. Participants were stratified by body mass index (BMI) and VFA. We evaluated six different groups for metabolic syndrome: Group 1 (normal weight and low VFA), Group 2 (normal weight and high VFA), Group 3 (overweight and low VFA), Group 4 (overweight and high VFA), Group 5 (obesity and low VFA), and Group 6 (obesity and high VFA). @*Results@#Metabolic syndrome traits and metabolic syndrome were significantly more prevalent in the high-VFA (≥ 100 cm2 ) subgroup in each BMI group. Adjusted logistic regression analyses revealed that the odds ratio for metabolic syndrome compared with Group 1 was the highest in Group 6 (24.53; 95% confidence interval [CI], 21.77 to 27.64). Notably, the odds ratio of Group 2 was higher than that of Group 3 (2.92; 95% CI, 2.30 to 3.69 vs. 2.57; 95% CI, 2.23 to 2.97). @*Conclusions@#Our study demonstrates that the combination of BMI assessment and VFA determination by BIA may be a useful method for predicting the risk of metabolic syndrome. The VFA by BIA may be a useful target for interventions to improve metabolic syndrome.

2.
Article in English | WPRIM | ID: wpr-875195

ABSTRACT

Sarcoidosis is a chronic multi-organ disorder of unknown etiology, characterized by the development of non-caseating granulomas. Scar sarcoidosis is a cutaneous manifestation of sarcoidosis that originates in old cutaneous scars. Sarcoidosis may develop in scars that occur after surgery, vaccination, cosmetic tattoos, and herpes zoster infection. Upper eyelid blepharoplasty is the most popular aesthetic facial surgery performed in the Asian population. Despite the large number of blepharoplasty procedures performed over the last century, relatively few reports have described scar sarcoidosis involving a blepharoplasty scar. We report a rare case of sarcoidosis that originated in a post-blepharoplasty scar, together with a literature review. Scar sarcoidosis should be considered in the differential diagnosis in patients who present with post-blepharoplasty changes in an old scar.

3.
Article in English | WPRIM | ID: wpr-875187

ABSTRACT

Background@#Psoriasis is a chronic T17 cell-driven immune-mediated inflammatory disease. However, patients with psoriasis may have elevated total serum immunoglobulin E (IgE) levels, which is a hallmark of Th2 inflammation.In previous case reports, psoriasis patients with elevated total serum IgE levels did not respond well to treatment or had exacerbated eczema lesions. @*Objective@#We sought to investigate the clinical characteristics of psoriasis patients with elevated total serum IgE levels. @*Methods@#This is a retrospective chart review of 130 patients with psoriasis who were tested for total serum IgE levels from November 1, 2009, to October 31, 2019. We compared the demographics, clinical characteristics, disease severity, and treatment regimen for each elevated IgE group (>214 U/mL) and normal IgE group (≤214 U/mL). @*Results@#Among 130 patients with psoriasis, 41 (31.5%) had elevated total serum IgE levels. Elevated total serum IgE levels were positively associated with the severity of disease; psoriasis lesions including those on the scalp, hands, feet, and flexures, which are difficult to treat, were observed to be significantly higher in patients with elevated total serum IgE levels. There was no correlation between age, sex, disease duration, or presence of pruritus and total serum IgE levels. @*Conclusion@#This study identified the clinical characteristics of psoriasis patients with elevated total serum IgE levels in Korea.

4.
Article in English | WPRIM | ID: wpr-787237

ABSTRACT

BACKGROUND/AIMS: This study aimed to identify the demographic and clinical factors associated with positive breath-test results and to assess the relationship between hydrogen and methane production in patients with suspected irritable bowel syndrome (IBS).METHODS: The demographic and clinical factors of 268 patients with suspected IBS, who had undergone a lactulose breath test, were analyzed.RESULTS: Of 268 patients included in this study, 143 (53.4%) were females. The median age and BMI of the patients was 58.0 years (range, 18.0–80.0 years) and 22.5 kg/m² (range, 14.4–34.3 kg/m²), respectively. A weak positive correlation was observed between the BMI and baseline hydrogen level (rho=0.134, p=0.031). Women were significantly more likely to show a ≥20 ppm increase in hydrogen within 90 min (early hydrogen increase, p=0.049), a ≥10 ppm increase in methane within 90 min (early methane increase, p=0.001), and a ≥10 ppm increase in methane between 90 min and 180 min (late methane increase, p=0.002) compared to men. The baseline hydrogen level was related to the baseline methane level (rho=0.592, p<0.001) and the maximal hydrogen level within 90 min was related to maximal methane level within 90 min (rho=0.721, p<0.001). Patients with an early hydrogen increase (43.8%) were more likely to show a positive result for an early methane increase compared to patients without an early increase in hydrogen (0%, p<0.001).CONCLUSIONS: Women were associated with high rates of positive lactulose breath-test results. In addition, methane production was correlated with hydrogen production.


Subject(s)
Breath Tests , Female , Humans , Hydrogen , Irritable Bowel Syndrome , Lactulose , Male , Methane , Sex Characteristics
6.
Article in English | WPRIM | ID: wpr-781333

ABSTRACT

OBJECTIVE@#To determine the effects of Hydrangeae Dulcis Folium (EHDF) on physical stress, changes in the whole-body cortisol level and behaviour in zebrafish (Danio rerio).@*METHODS@#One hundred and seventy-four fish were randomly divided into 4 [adrenocorticotropin hormone (ACTH) challenge test: 4 fish per group] or 6 groups (behavioural test: 10-12 fish per group, whole-body cortisol: 4 fish per group). Net handling stress (NHS) was used to induce physical stress. Fish were treated with vehicle or EHDF (5-20 mg/L) for 6 min before they were exposed to stress. And then, fish were sacrificed for collecting body fluid from whole-body or conducted behavioural tests, including novel tank test and open field test, and were evaluated to observe anxiety-like behaviours and locomotion. In addition, to elucidate the mode of action of the anti-stress effects of EHDF, ACTH (0.2 IU/g, i.p.) challenge test was performed.@*RESULTS@#The increased anxiety-like behaviours in novel tank test and open field test under stress were prevented by treatment with EHDF at 5-20 mg/L (P <0.05). Moreover, compared with the unstressed group, which was not treated with NHS, the whole-body cortisol level was significantly increased by treatment with NHS (P <0.05). Compared with the NHS-treated stressed control group, pre-treatment with EHDF at concentrations of 5-20 mg/L for 6 min significantly prevented the NHS-increased whole-body cortisol level (<0.05). In addition, ACTH challenge test showed that EHDF completely blocked the effects of ACTH on cortisol secretion (P <0.05).@*CONCLUSION@#EHDF may be a good antistress candidate and its mechanism of action may be related to its positive effects on cortisol release.

7.
Article in Korean | WPRIM | ID: wpr-811314

ABSTRACT

PURPOSE: To compare the accuracy of three intraocular lens (IOL) power calculation formulas (SRK/T, Barrett Universal II, and T2) in cataract surgery patients.METHODS: In total, 73 eyes of 73 patients who underwent uneventful cataract surgery were retrospectively reviewed. IOL power was determined using SRK/T, Barrett Universal II, and T2 preoperatively. The findings were compared with the actual refractive outcome to obtain the prediction error. The mean prediction error (ME) and mean absolute error (MAE) of each formula were compared. The MAE was defined as the difference between the postoperative spherical equivalence (SE) and the preoperatively predicted SE. The ME and MAE of each formula 3 months after surgery were compared with preoperatively predicted SE. Eyes were classified into subgroups based on axial length (AL) and average keratometry (K).RESULTS: The ME and MAE for the three formulas were SRK/T [−0.08 ± 0.45 diopters (D) and 0.35 ± 0.40 D, respectively], Barrett Universal II (−0.01 ± 0.44 D and 0.33 ± 0.30 D, respectively), and T2 (0.04 ± 0.45 D and −0.34 ± 0.30 D, respectively), but no statistically significant differences were detected. Similar results were obtained in groups with a long AL or a large average K. In groups with an AL ≥ 26 mm or with an average K ≥ 47 D, the Barrett Universal II formula yielded the smallest standard deviation and a ME closest to zero, but these differences were not statistically significant.CONCLUSIONS: No significant differences were observed between the three formulas regarding ME or MAE. However, recent formulas such as the Barrett Universal II could provide certain benefits in predicting IOL power for patients with a long AL (> 26 mm) or larger average K. Further research with a larger sample size is recommended for more evaluation.


Subject(s)
Cataract , Humans , Lenses, Intraocular , Retrospective Studies , Sample Size
8.
Article | WPRIM | ID: wpr-837396

ABSTRACT

Accurate diagnosis and management of a femoral vascular injury is important as it is a life-threatening injury with high morbidity and mortality. This is the case of a 75-year-old man admitted to the emergency room with trauma to the right groin due to a horse fall. Computed tomography showed active bleeding of the femoral artery without pelvic or femoral fracture. We inserted a stent-graft, but hypotension persisted. Exploration of the groin was completed, and the bleeding from the external iliac vein was identified and repaired. In conclusion, vascular injury is rare in groin trauma without associated fracture, however, arterial and venous injury should not be completely ruled out. Endovascular therapy is worth recommending as a quicker and safer management than surgery in patients with active bleeding in the femoral artery. However, the possibility of combined injury of the femoral vein should be suspected in case of ongoing hemodynamic instability.

9.
Article in English | WPRIM | ID: wpr-837323

ABSTRACT

Purpose@#The aim of current study is to verify the efficacy of extracorporeal shock wave therapy (ESWT) in neck and shoulder pain syndrome. @*Methods@#We enrolled 23 patients with neck and shoulder pain syndrome (mean age, 55±16 years; onset, 12.65±8.90 months) who underwent ESWT from July to December 2019. ESWT (4 to 5 bar or 0.23–0.45 mJ/mm 2 , 1,500 to 2,000 times/region, 7 Hz) was performed at least 4 consecutive times per week. Evaluated outcomes were visual analogue scale (VAS) of pain and tenderness, neck disability index (NDI), and shoulder passive range of motion (ROM; forward flexion [FF], external rotation at neutral [ER], internal rotation at back [IR]). Pain and tenderness VAS scores were assessed at every follow-up, while NDI and shoulder ROM were evaluated two times before treatment and at the final follw-up (at 4.52±0.73 weeks). @*Results@#The pain VAS score decreased from 5.5±2.4 at first visit to 4.0±1.8 (p=0.001), 3.3±2.1 (p=0.02), and 3.1±2.2 (p=0.29) at the first, second, and third follow-up visits. The tenderness VAS at first visit was 5.98±1.89, which decreased to 5.17±1.83 (p=0.005), 4.61±1.67 (p=0.05), and 4.09±1.92 (p=0.06) at the first, second, and third follow-up visits. NDI was significantly reduced from 18.04±8.86 to 10.04±6.94 at last follow-up (p=0.001) and shoulder ROM was significantly improved after treatment (FF: 159.6°±28.0° to 177.8°±8.5°, p=0.001; ER: 72.2±15.7° to 79.6±2.1°, p=0.02; IR: 10.2±3.49 [T 10] to 6.9±1.7 [T 7], p=0.001). @*Conclusion@#Consecutive ESWT was effective in treating neck and shoulder pain syndrome with functional improvement and pain reductio

10.
Article in English | WPRIM | ID: wpr-837322

ABSTRACT

Purpose@#The purpose of this study was to investigate the effects of kartogenin (KGN) on the tendon-bone interface in a rat rotator cuff tear model. @*Methods@#Twenty male rats were divided into two equal groups; group 1 (repair only) and group 2 (KGN single injection). A rat rotator cuff rupture model was prepared, and KGN (500 μM) was injected into the repair site. The specimens were collected after 8 weeks, and biomechanical and histological analyses were performed. We assessed the healing quality of the tendon-to-bone repair site using six aspects of tendon tissue. The histological findings were classified semiquantitatively into four grades (grade 0, the poorest appearance; grade 1, poorer; grade 2, better; and grade 3, marked regeneration). @*Results@#Group 2 showed a higher mean ultimate load to failure than the control group (group 1: 25.78±31.38 N, group 2: 55.64±36.02 N; p=0.011). On histological analysis, group 2 exhibited a significantly greater total score (group 1: 7.20±2.14, group 2: 9.50±1.84; p=0.019), collagen fiber continuity (group 1: 1.20±0.42, group 2: 1.70±0.48; p=0.024), and collagen fiber density (group 1: 1.50±0.52, group 2: 2.20±0.63; p=0.080). Metachromasia were more intense in group 2 than in the control group. @*Conclusion@#A single injection of KGN reinforces biomechanical strength and the formation of collagen and fibrocartilage at the tendon-to-bone interface in a rat rotator cuff tear model.

11.
Article | WPRIM | ID: wpr-837081

ABSTRACT

Coronavirus disease 2019 (COVID-19), which started in Wuhan, China, in December 2019 and declared a worldwide pandemic on March 11, 2020, is a novel infectious disease that causes respiratory illness and death. Pediatric COVID-19 accounts for a small percentage of patients and is often milder than that in adults; however, it can progress to severe disease in some cases. Even neonates can suffer from COVID-19, and children may spread the disease in the community. This review summarizes what is currently known about COVID-19 in children and adolescents.

12.
Article | WPRIM | ID: wpr-837080

ABSTRACT

The Korean Society of Pediatric Infectious Diseases and the Korea Centers for Disease Control and Prevention issued the guidelines about coronavirus disease 2019 (COVID-19) for children and adolescents. Case definitions and management of COVID-19 in neonates, infants, children and adolescents are presented in this guideline. In addition, guidelines for caregiver management are also provided. In this review, we introduce the contents of the current guidelines for COVID-19 in children and adolescents in Korea.

13.
Article | WPRIM | ID: wpr-837073

ABSTRACT

Spinal cord lesions could mimic Guillain-Barré syndrome (GBS). Misdiagnosis as GBS can incur severe neurologic sequelae. We report the case of a previously healthy, 14-year-old boy with traumatic spinal epidural hematoma masquerading as GBS. He presented with sudden onset of tingling sensation on both hands and feet, which progressed into motor weakness of both legs. No abnormalities were found in brain magnetic resonance imaging and cerebrospinal fluid study. Despite intravenous immunoglobulin therapy for presumed GBS, the weakness progressed rapidly over 8 hours, resulting in complete loss of sensorimotor function below T4 level and loss of deep tendon reflexes. Whole spine magnetic resonance imaging showed a large epidural hematoma over the C5-T5 level. We found that he had experienced whiplash injury on an amusement ride about 3 weeks before. He underwent emergency decompressive laminectomy and hematoma removal, followed by vigorous rehabilitation treatment. On the fifth week of follow-up, he recovered from the complete loss of sensorimotor function. Thorough review of detailed history in emergency departments is required for children presenting with ascending paralysis. Also, rapid diagnostic and therapeutic interventions are crucial for maximum recovery of neurologic symptoms.

14.
Article | WPRIM | ID: wpr-836986

ABSTRACT

Flavonoids are mainly contained in the vegetables and medicinal herbs. Until now, over 5,000 kinds of flavonoid have been identified and their biological activities have been reported. Among them, we are interested in oroxylin A and spinosin because of their specific structures having bulky group at C-6 of ring A. Oroxylin A is contained in the Scutellaria baicalensis and exhibits cognitive enhancing activity as a GABAA receptor antagonist, which is different from those of mainly contained in the S. baicalenis, baicalein or wogonin. Spinosin is isolated from Zizyphus jujuba var. spinosa and mainly studied as a hypnotic or anxiolytic agent because of traditional knowledge about its original herb. As far as we know, the cognitive function of spinosin was first identified by our group. In this review, we discuss how such flavonoids exert their pharmacological activities associated with cognitive function based on the receptor binding study and behavioral studies. Traditional knowledge and reverse pharmacology may be addressed in the research field of phytochemical pharmacology and useful to unveil the secret of phytochemicals.

15.
Journal of Rhinology ; : 58-62, 2020.
Article | WPRIM | ID: wpr-836273

ABSTRACT

A 57-year-old male patient with nasal congestion and nasal congestion, which occurred 1 month prior to the hospital visited. PNS CT and MRI was performed and revealed right orbital cellulitis, sinusitis and brain abcess. Surgical drainage was determined by rhinology, ophthalmology and neurosurgery. The right sphenoid sinus was identified as an open mucosal mucosa, and blackish mucosa was found on the right sphenoid sinus. Eucleation was performed. Infected orbital tissue removal and orbital abscess drainage were performed. Neurosurgery performed dura incision, drainage and removal of a large amount of abscess pattern, and duroplasty with artificial dura. Actinomyces odontolyti was identified by pus culture, and postoperative antibiotic treatment and dressing were performed, but infection aggravation persisted, resulting in deterioration of general condition, multiple organ damage, and cerebral infarction.

16.
Article | WPRIM | ID: wpr-834069

ABSTRACT

Background/Aims@#Distinguishing gastric ectopic pancreas (GEP) from malignant tumors is relatively difficult. This study evaluated the endosonography findings of pathologically proven GEP. @*Methods@#Thirty-one patients diagnosed with GEP based on a histopathological analysis from January 2004 to July 2018 were enrolled in this study. All patients underwent EUS and an endoscopic resection. @*Results@#Seventeen patients were female, and the median age was 41.1 years (range, 14-74). The lesions were localized most commonly in the antrum. The mean size of the GEP was 10.6 mm (range, 7-15). Superficial type lesions, lesions with heterogeneous echogenicity, mixed pattern lesions, and lesions with indistinct borders were commonly observed on EUS. Calcification, anechoic duct-like structures, and thickening of the muscularis propria were observed in some patients. Endoscopic mucosal resection (41.9%) and endoscopic submucosal dissection (58.1%) were performed. The mean procedure time was 22.5 minutes. Complete resection was achieved for 71% of patients. No statistically significant results between the endosonography findings and complete resection rates were obtained. The mean follow-up esophagogastroduodenoscopy duration was 4.5 months. None of the patients presented with residual lesions on subsequent endoscopy. @*Conclusions@#EUS can help identify the features of GEP. Careful observations of the EUS findings can avoid unnecessary removal of GEP.

17.
Article | WPRIM | ID: wpr-833300

ABSTRACT

Purpose@#We report a patient with acquired Brown syndrome, secondary to trochleitis, who improved after intra-trochlear steroid injection.Case summary: An 8-year-old boy presented to the hospital with an abnormal chin-up head posture that had onset suddenly three days prior. Ductions and versions showed elevation limitation, particularly during adduction of the left eye. Prism and alternate cover tests revealed 16-18 prism diopters (PD) of left hypotropia, and 6 PD of left exotropia, in the primary position. Pain in the left eye was exacerbated by looking up or looking inward, or with palpation of the left trochlear region. Brain magnetic resonance imaging revealed bilateral pansinusitis and focal swelling with peripheral enhancement in the left trochlear area, leading to a diagnosis of acquired Brown syndrome associated with trochleitis in the left eye. Symptoms were partially relieved by one month of oral steroid therapy; however, the elevation limitation during adduction persisted in the left eye. Intra-trochlear steroid injection was performed in the left trochlear region and the limitation in eye movement gradually improved thereafter. @*Conclusions@#Intra-trochlear steroid injection facilitates the recovery of eye movement in acquired Brown syndrome secondary to trochleitis.

18.
Article | WPRIM | ID: wpr-833215

ABSTRACT

Purpose@#To determine the efficacy of tear varicella zoster virus polymerase chain reaction (VZV PCR) results for the occurrenceof ocular symptoms in patients diagnosed with herpes zoster ophthalmicus (HZO), as compared to Hutchinson’s sign, and to determinethe relationship between recurrence of HZO and VZV PCR results. @*Methods@#We conducted a retrospective analysis using medical records from 69 patients diagnosed with HZO from February2015 to June 2018. We investigated whether Hutchinson’s sign and VZV PCR results were correlated with the occurrence of ocularsymptoms and recurrence of HZO. @*Results@#Of the 69 patients, 51 patients (73%) had ocular symptoms and 45 patients (65.2%) had conjunctivitis as the most commonocular symptom. There were correlations between Hutchinson’s sign and the occurrence of ocular symptoms, and betweenVZV PCR and the occurrence of ocular symptoms (p = 0.047 and p = 0.005, respectively). The receiver operating characteristiccurve of Hutchinson’s sign and VZV PCR in ocular involvement of the area under the curve of the tear VZV PCR was larger thanHutchinson’s sign (VZV PCR = 0.72; Hutchinson’s sign = 0.63). Only keratouveitis was identified as a risk factor for recurrenceof HZO (odds ratio = 30.53; p = 0.033). There was no correlation between keratouveitis and recurrence of HZO (p > 0.05). @*Conclusions@#In patients with HZO, the tear VZV PCR may be as effective a predictor of ocular involvement as Hutchinson’s sign,and keratouveitis diagnosed at the initial visit was associated with the recurrence of HZO.

19.
Article | WPRIM | ID: wpr-832727

ABSTRACT

Adenoid cystic carcinoma (ACC) is a malignant glandular neoplasm that commonly occurs in the salivary glands. Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare form of ACC that primarily presents on the skin. A diagnosis of a primary tumor arising in the skin can be made only after excluding metastatic deposits from other, more common sites. PCACC tends to infiltrate and recur locally but rarely metastasizes to distant organs and lymph nodes. To our knowledge, this is the first reported case of a PCACC of the chest wall in Korea. We report this case and literature review to raise awareness of this rare tumor.

20.
Article | WPRIM | ID: wpr-832627

ABSTRACT

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. A range of factors including tuberculous infection, beryllium exposure, and cold climate have been implicated in the pathogenesis of the condition. A 45-year-old woman presented with a 4-month history of an asymptomatic eyelid swelling and multiple erythematous papules on the neck. Histological examination of the neck, orbital soft tissue, and lacrimal gland was consistent with sarcoidosis. Ziehl−Neelsen stains and polymerase chain reactions (PCRs) for tuberculosis on the skin biopsy specimens were negative. However, the orbital soft tissue specimen was positive for non-tuberculous mycobacteria (NTM) PCR. The patient was finally diagnosed with sarcoidosis associated with NTM. Treatment with systemic steroid and hydroxychloroquine was started, resulting in an improvement of skin lesions. We herein report a case of sarcoidosis associated with NTM infection with review of the literature, as only little is known regarding the role of mycobacteria in sarcoidosis.

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