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1.
Article | WPRIM | ID: wpr-836740

ABSTRACT

After failed removal of common bile duct or intrahepatic bile duct (IHD) stones by endoscopic retrograde cholangiopancreatography (ERCP), percutaneous lithotripsy is well-known as an effective procedure. However, it is time-consuming because multiple sessions of transhepatic tract dilatation are required. Endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDS) has been recently used to approach IHD to remove difficult bile duct stones. We recently experienced EUS-guided CDS performed with metal stent. Common bile duct or IHD stones were removed by retrieval accessories after initial failed or inadequate ERCP in three patients. Serious complications including bleeding, infection, and perforation were not noted. The duration of hospital stay from EUS-guided procedure to discharge ranged from 10 to 14 days. Although this result is interim and ongoing, it suggests that EUS-guided CDS might be an effective and safe procedure after failed ERCP to remove difficult bile duct stones through the tract.

2.
Article | WPRIM | ID: wpr-834954

ABSTRACT

Diagnosis of renal transplant rejection is dependent on interpretation of renal allograft biopsies. The Banff Classification of Allograft Pathology, which was developed as a standardized working classification system in 1991, has contributed to the standardization of definitions for histologic injuries resulting from renal allograft rejections and provided a universal grading system for assessing these injuries. It has also helped to provide insight into the underlying pathogenic mechanisms that contribute to transplant rejection. In addition to histological and immunologic parameters, molecular tools are now being used to facilitate the diagnosis of rejection. In this review, I will discuss morphologic features of renal transplant rejections as well as major revisions and pitfalls of the Banff classification system, and provide future perspectives.

3.
Article | WPRIM | ID: wpr-834570

ABSTRACT

Herein, we describe the first case of renal intravascular large B cell lymphoma in Korea occurring in a 66-year-old female. She presented with mild fever and dyspnea. On physical and laboratory evaluations, hemophagocytic lymphohistiocytosis was suspected, but the bone marrow biopsy results were unremarkable. During the work-up, massive proteinuria developed, which led to a renal biopsy. The renal architecture was relatively well-preserved, but the glomeruli were hypercellular with the infiltration of atypical, large lymphoid cells with increased nucleus-cytoplasm ratio and clumped chromatin. Similar cells were also present in the peritubular capillaries. The tumor cells exhibited membranous staining for CD20 and CD79a. After the diagnosis of intravascular large B cell lymphoma, the patient received rituximab-based chemotherapy under close follow-up.

4.
Article in English | WPRIM | ID: wpr-832792

ABSTRACT

Inflammatory myofibroblastic tumor is a rare benign lesion that accounts for 0.04–1% of all lung tumors and usually appears as a solitary pulmonary nodule or mass. Here, we report the case of an endobronchial inflammatory myofibroblastic tumor in a 21-year-old man with a focus on the imaging findings and a review of previous literature.

5.
Article in English | WPRIM | ID: wpr-832791

ABSTRACT

Tracheal leiomyoma is a rare benign tumor, which is composed of transformed cells of mesenchymal origin. We describe a case in which digital tomosynthesis was useful to evaluate a tracheal tumor that was overlooked on initial chest radiographs.

6.
Article in English | WPRIM | ID: wpr-831565

ABSTRACT

Background@#The Korean Society of Thoracic Radiology (KSTR) recently constructed a nation-wide coronavirus disease 2019 (COVID-19) database and imaging repository, referred to the Korean imaging cohort of COVID-19 (KICC-19) based on the collaborative efforts of its members. The purpose of this study was to provide a summary of the clinico-epidemiological data and imaging data of the KICC-19. @*Methods@#The KSTR members at 17 COVID-19 referral centers retrospectively collected imaging data and clinical information of consecutive patients with reverse transcription polymerase chain reaction-proven COVID-19 in respiratory specimens from February 2020 through May 2020 who underwent diagnostic chest computed tomography (CT) or radiograph in each participating hospital. @*Results@#The cohort consisted of 239 men and 283 women (mean age, 52.3 years; age range, 11–97 years). Of the 522 subjects, 201 (38.5%) had an underlying disease. The most common symptoms were fever (n = 292) and cough (n = 245). The 151 patients (28.9%) had lymphocytopenia, 86 had (16.5%) thrombocytopenia, and 227 patients (43.5%) had an elevated CRP at admission. The 121 (23.4%) needed nasal oxygen therapy or mechanical ventilation (n = 38; 7.3%), and 49 patients (9.4%) were admitted to an intensive care unit.Although most patients had cured, 21 patients (4.0%) died. The 465 (89.1%) subjects underwent a low to standard-dose chest CT scan at least once during hospitalization, resulting in a total of 658 CT scans. The 497 subjects (95.2%) underwent chest radiography at least once during hospitalization, which resulted in a total of 1,475 chest radiographs. @*Conclusion@#The KICC-19 was successfully established and comprised of 658 CT scans and 1,475 chest radiographs of 522 hospitalized Korean COVID-19 patients. The KICC-19 will provide a more comprehensive understanding of the clinical, epidemiological, and radiologic characteristics of patients with COVID-19.

7.
Article | WPRIM | ID: wpr-831200

ABSTRACT

Purpose@#Hepatitis B virus (HBV) infection is among etiologies of secondarymembranousnephropathy (MN) in pediatric patients. We evaluated expressionof phospholipase A2 receptor (PLA2R), a specific target antigen of primary MN, inpediatric HBV-related MN. @*Methods@#We retrospectively reviewed patients with biopsy-proven HBV-relatedMN from the renal biopsy registry and electronic medical records of SeveranceHospital, Seoul, Korea, from 1993 to 2004. Paraffin-embedded human kidneytissues were retrieved and immunohistochemically stained for PLA2R. @*Results@#Ten pediatric patients with 13 biopsied specimens were reviewed. Thepredominant pathological stage was stage II–III, and second was stage II. Theintensity of staining for IgG was greatest, with less intense staining for IgM, IgA,C3, C4, and C1q. All the patients had angiotensin-converting enzyme inhibitorcombined with glucocorticoid, and four patients converted to cyclosporine treatmentfrom glucocorticoid monotherapy. Urinalysis of all the patients normalizedafter variable period. PLA2R staining was demonstrated in the outer glomerulus in3 out of 13 biopsies, 2 of which were obtained from the same patient over a 5-yearinterval. @*Conclusions@#PLA2R was expressed in a small number of cases diagnosed aspediatricHBV-related MN, indicating that some HBV-related MN cases may beprimary MN concurrent with HBV infection.

8.
Article in English | WPRIM | ID: wpr-785603

ABSTRACT

OBJECTIVE: Assessing the severity of injury and predicting outcomes are essential in traumatic brain injury (TBI). However, the respiratory rate and Glasgow Coma Scale (GCS) of the Revised Trauma Score (RTS) are difficult to use in the prehospital setting. This investigation aimed to develop a new prehospital trauma score for TBI (NTS-TBI) to predict mortality and disability.METHODS: We used a nationwide trauma database on severe trauma cases transported by fire departments across Korea in 2013 and 2015. NTS-TBI model 1 used systolic blood pressure < 90 mmHg, peripheral capillary oxygen saturation < 90% measured via pulse oximeter, and motor component of GCS. Model 2 comprised variables of model 1 and age >65 years. We assessed discriminative power via area under the curve (AUC) value for in-hospital mortality and disability defined according to the Glasgow Outcome Scale with scores of 2 or 3. We then compared AUC values of NTS-TBI with those of RTS.RESULTS: In total, 3,642 patients were enrolled. AUC values of NTS-TBI models 1 and 2 for mortality were 0.833 (95% confidence interval [CI], 0.815 to 0.852) and 0.852 (95% CI, 0.835 to 0.869), respectively, while AUC values for disability were 0.772 (95% CI, 0.749 to 0.796) and 0.784 (95% CI, 0.761 to 0.807), respectively. AUC values of NTS-TBI model 2 for mortality and disability were higher than those of RTS (0.819 and 0.761, respectively) (P < 0.01).CONCLUSION: Our NTS-TBI model using systolic blood pressure, motor component of GCS, oxygen saturation, and age was feasible for prehospital care and showed outstanding discriminative power for mortality.


Subject(s)
Hypoxia , Area Under Curve , Blood Pressure , Brain Injuries , Capillaries , Fires , Glasgow Coma Scale , Glasgow Outcome Scale , Hospital Mortality , Humans , Hypotension , Korea , Mortality , Observational Study , Oxygen , Quality Improvement , Respiratory Rate
9.
Article in English | WPRIM | ID: wpr-719594

ABSTRACT

OBJECTIVE: To investigate the efficacy of motion-correction algorithm (MCA) in improving coronary artery image quality and measurement accuracy using an anthropomorphic dynamic heart phantom and 256-detector row computed tomography (CT) scanner. MATERIALS AND METHODS: An anthropomorphic dynamic heart phantom was scanned under a static condition and under heart rate (HR) simulation of 50–120 beats per minute (bpm), and the obtained images were reconstructed using conventional algorithm (CA) and MCA. We compared the subjective image quality of coronary arteries using a four-point scale (1, excellent; 2, good; 3, fair; 4, poor) and measurement accuracy using measurement errors of the minimal luminal diameter (MLD) and minimal luminal area (MLA). RESULTS: Compared with CA, MCA significantly improved the subjective image quality at HRs of 110 bpm (1.3 ± 0.3 vs. 1.9 ± 0.8, p = 0.003) and 120 bpm (1.7 ± 0.7 vs. 2.3 ± 0.6, p = 0.006). The measurement error of MLD significantly decreased on using MCA at 110 bpm (11.7 ± 5.9% vs. 18.4 ± 9.4%, p = 0.013) and 120 bpm (10.0 ± 7.3% vs. 25.0 ± 16.5%, p = 0.013). The measurement error of the MLA was also reduced using MCA at 110 bpm (19.2 ± 28.1% vs. 26.4 ± 21.6%, p = 0.028) and 120 bpm (17.9 ± 17.7% vs. 34.8 ± 19.6%, p = 0.018). CONCLUSION: Motion-correction algorithm can improve the coronary artery image quality and measurement accuracy at a high HR using an anthropomorphic dynamic heart phantom and 256-detector row CT scanner.


Subject(s)
Coronary Vessels , Heart Rate , Heart , Phenobarbital
10.
Article in Korean | WPRIM | ID: wpr-714042

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the characteristics of the emergency medical services (EMS) response and clinical information on mass casualty chemical incidents in Korea. METHODS: This retrospective observational study analyzed the integrated data of the EMS rescue records and EMS-treated severe trauma registry from January 2012 to December 2013. Two databases were integrated using the unique accident identification number. Chemical incidents were defined by an in-depth review of the EMS rescue records according to a previous study. Mass casualty incidents were defined as more than 6 injured individuals. The rescue, EMS, and hospital variables of mass casualty chemical incidents were analyzed. RESULTS: A total of 8 mass casualty chemical incidents and 73 patients were included. The mean responded rescue vehicles and EMS vehicles were 2.4 and 3.5, respectively. The 4 incidents were an oil spill due to traffic accidents and most patients suffered minor trauma. A carbon monoxide leak caused the largest number of patients (23 people). The explosion caused by flammable polyethylene leaks showed the highest severity. In that explosion, the mortality rate was 40% and 8 patients had a disability at discharge. CONCLUSION: This study evaluated the characteristics of the EMS response and clinical information on mass casualty chemical incidents in Korea.


Subject(s)
Accidents, Traffic , Carbon Monoxide , Chemical Hazard Release , Emergency Medical Services , Explosions , Humans , Korea , Mass Casualty Incidents , Mortality , Observational Study , Petroleum Pollution , Polyethylene , Retrospective Studies
11.
Kosin Medical Journal ; : 245-251, 2018.
Article in English | WPRIM | ID: wpr-718459

ABSTRACT

Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.


Subject(s)
Anaphylaxis , Anesthesia , Anesthesia, General , Anti-Bacterial Agents , Bronchial Spasm , Cholecystectomy, Laparoscopic , Intradermal Tests , Shock , Skin Tests , Skin
12.
Article in English | WPRIM | ID: wpr-715759

ABSTRACT

BACKGROUND: This study evaluated the effect of decrease in loading dose administration rate of dexmedetomidine (DMT) on sedation and DMT requirement in elderly patients. METHODS: Fifty-eight patients over 65 years old with ASA I–II who were planned to receive DMT sedation during spinal anesthesia were randomly assigned to two groups. Group S (n = 29) received a 0.5 µg/kg DMT loading dose over 20 minutes, while group C (n = 29) received the DMT loading dose over 10 minutes. Then, both groups received a continuous infusion of 0.4 µg/kg/h. The sedative status was recorded before and at 5, 10, 15, 20, 25, and 30 minutes after administration of DMT and at the end of the anesthesia according to the Ramsay sedation scale (RSS). Also, the time to reach RSS-3 (patients asleep, responsive to commands) and the dose of DMT until reaching RSS-3 were recorded. RESULTS: The time to reach RSS-3 was similar between the two groups (group S = 16.0 ± 4.3 minutes vs. group C = 15.5 ± 4.2 minutes, P = 0.673). However, the DMT required to reach RSS-3 in group S was significantly lower than that in group C (23.3 ± 7.1 vs. 32.5 ± 6.0 µg, P < 0.001). There was no difference in RSS between the two groups from the administration of DMT to the end of the anesthesia (P = 0.927). CONCLUSIONS: Decreasing the administration rate of the DMT loading dose did not delay the onset of RSS-3 sedation and reduced the DMT requirement in elderly patients.


Subject(s)
Adrenergic alpha-2 Receptor Agonists , Aged , Anesthesia , Anesthesia, Spinal , Dexmedetomidine , Humans , Hypnotics and Sedatives
13.
Article in English | WPRIM | ID: wpr-770988

ABSTRACT

Acute cerebral infarctions are rare in children, however, they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient's survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokineinduced vascular inflammation.


Subject(s)
Brain , Cerebral Infarction , Child , Child, Preschool , Decompressive Craniectomy , Diagnosis , Enoxaparin , Humans , Immunoglobulins , Inflammation , Levofloxacin , Magnetic Resonance Imaging , Male , Mycoplasma pneumoniae , Mycoplasma , Pneumonia, Mycoplasma , Stroke , Thrombophilia , Thrombosis , Vasculitis
14.
Article in Korean | WPRIM | ID: wpr-222543

ABSTRACT

PURPOSE: Critical care transport (CCT) has been known to be beneficial for inter-hospital transport of critically ill patients. Seoul Mobile Intensive Care Unit (SMICU) has been established and provided CCT in Seoul Metropolitan City since 2015. We tested the association between SMICU transport and hospital outcome for critically ill patients. METHODS: This is a before and after intervention study. SMICU group with cardiac arrest, acute myocardial infarction, acute stroke, major trauma, respiratory failure, and shock who were transported by SMICU from January to July 2016 were collected as an intervention group. Non-SMICU group with the same above diagnosis criteria who were transported by private ambulance services during same period in 2015. By National Emergency Department Information System (NEDIS), demographics were compared for original data and sampling data. Multivariable logistic regression analysis was done to calculate the adjusted odds ratios (AORs) with 95% confidence intervals (95% CIs) adjusting for potential confounders. RESULTS: Total 1,837 patients (128 SMICU and 1,709 non-SMICU group) for original dataset and 180 patients (60 SMICU and 120 non-SMICU group) for sampling dataset were finally analyzed. Hospital mortality rates are 22.7% in SMICU and 11.8% in non-SMICU in original dataset (p<0.001), 26.7% in SMICU and 31.7% in non-SMICU in sampling dataset (p=0.490), respectively. AOR (95% CIs) for hospital mortality by SMICU in original and sampling dataset were 0.80 (0.48-1.35) and 0.71 (0.33-1.51), respectively. CONCLUSION: The CCT for critically ill patients did not show significantly better hospital mortality in the pilot study.


Subject(s)
Ambulances , Critical Care , Critical Illness , Dataset , Demography , Diagnosis , Emergency Medical Services , Emergency Service, Hospital , Heart Arrest , Hospital Mortality , Humans , Information Systems , Intensive Care Units , Logistic Models , Mortality , Myocardial Infarction , Odds Ratio , Pilot Projects , Respiratory Insufficiency , Seoul , Shock , Stroke , Transportation of Patients
15.
Article in English | WPRIM | ID: wpr-200975

ABSTRACT

Acute cerebral infarctions are rare in children, however, they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient's survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokineinduced vascular inflammation.


Subject(s)
Brain , Cerebral Infarction , Child , Child, Preschool , Decompressive Craniectomy , Diagnosis , Enoxaparin , Humans , Immunoglobulins , Inflammation , Levofloxacin , Magnetic Resonance Imaging , Male , Mycoplasma pneumoniae , Mycoplasma , Pneumonia, Mycoplasma , Stroke , Thrombophilia , Thrombosis , Vasculitis
16.
Article in English | WPRIM | ID: wpr-197567

ABSTRACT

PURPOSE: To evaluate the clinical spectrum of posttransplantation lymphoproliferative disorder (PTLD) after solid organ transplantation (SOT) in children. METHODS: We retrospectively reviewed the medical records of 18 patients with PTLD who underwent liver (LT) or kidney transplantation (KT) between January 1995 and December 2014 in Seoul National University Children's Hospital. RESULTS: Eighteen patients (3.9% of pediatric SOTs; LT:KT, 11:7; male to female, 9:9) were diagnosed as having PTLD over the last 2 decades (4.8% for LT and 2.9% for KT). PTLD usually presented with fever or gastrointestinal symptoms in a median period of 7 months after SOT. Eight cases had malignant lesions, and all the patients except one had evidence of Epstein-Barr virus (EBV) involvement, assessed by using in situ hybridization of tumor tissue or EBV viral load quantitation of blood. Remission was achieved in all patients with reduction of immunosuppression and/or rituximab therapy or chemotherapy, although 1 patient had allograft kidney loss and another died from complications of chemotherapy. The first case of PTLD was encountered after the introduction of tacrolimus for pediatric SOT in 2003. The recent increase in PTLD incidence in KT coincided with modification of clinical practice since 2012 to increase the tacrolimus trough level. CONCLUSION: While the outcome was favorable in that all patients achieved complete remission, some patients still had allograft loss or mortality. To prevent PTLD and improve its outcome, monitoring for EBV infection is essential, which would lead to appropriate modification of immunosuppression and enhanced surveillance for PTLD.


Subject(s)
Allografts , Child , Drug Therapy , Epstein-Barr Virus Infections , Female , Fever , Herpesvirus 4, Human , Humans , Immunosuppression , In Situ Hybridization , Incidence , Kidney , Kidney Transplantation , Liver , Lymphoproliferative Disorders , Male , Medical Records , Mortality , Organ Transplantation , Retrospective Studies , Rituximab , Seoul , Tacrolimus , Transplants , Viral Load
17.
Article in English | WPRIM | ID: wpr-118258

ABSTRACT

OBJECTIVE: To evaluate the utility of cardiovascular magnetic resonance (CMR)-derived myocardial strain measurement for the prediction of poor outcomes in patients with acute myocarditis. MATERIALS AND METHODS: We retrospectively analyzed data from 37 patients with acute myocarditis who underwent CMR. Left ventricular (LV) size, LV mass index, ejection fraction and presence of myocardial late gadolinium enhancement (LGE) were analyzed. LV circumferential strain (Ecc(SAX)), radial strain (Err(SAX)) from mid-ventricular level short-axis cine views and LV longitudinal strain (Ell(LV)), radial strain (Err(Lax)) measurements from 2-chamber long-axis views were obtained. In total, 31 of 37 patients (83.8%) underwent follow-up echocardiography. The primary outcome was major adverse cardiovascular event (MACE). Incomplete LV functional recovery was a secondary outcome. RESULTS: During an average follow-up of 41 months, 11 of 37 patients (29.7%) experienced MACE. Multivariable Cox proportional hazard regression analysis, which included LV mass index, LV ejection fraction, the presence of LGE, Ecc(SAX), Err(SAX), Ell(LV), and Err(Lax) values, indicated that the presence of LGE (hazard ratio, 42.88; p = 0.014), together with ErrLax (hazard ratio, 0.77 per 1%, p = 0.004), was a significant predictor of MACE. Kaplan-Meier analysis demonstrated worse outcomes in patient with LGE and an Err(Lax) value ≤ 9.48%. Multivariable backward regression analysis revealed that Err(Lax) values were the only significant predictors of LV functional recovery (hazard ratio, 0.54 per 1%; p = 0.042). CONCLUSION: CMR-derived Err(Lax) values can predict poor outcomes, both MACE and incomplete LV functional recovery, in patients with acute myocarditis, while LGE is only a predictor of MACE.


Subject(s)
Echocardiography , Follow-Up Studies , Gadolinium , Heart Ventricles , Humans , Kaplan-Meier Estimate , Magnetic Resonance Imaging , Myocarditis , Retrospective Studies , Ventricular Dysfunction
18.
Article in English | WPRIM | ID: wpr-147985

ABSTRACT

Benzylideneacetophenone derivative (1E)-1-(4-hydroxy-3-methoxyphenyl) hept-1-en-3-one (JC3) elicited cytotoxic effects on MDA-MB 231 human breast cancer cells-radiation resistant cells (MDA-MB 231-RR), in a dose-dependent manner, with an IC₅₀ value of 6 μM JC3. JC3-mediated apoptosis was confirmed by increase in sub-G1 cell population. JC3 disrupted the mitochondrial membrane potential, and reduced expression of anti-apoptotic B cell lymphoma-2 protein, whereas it increased expression of pro-apoptotic Bcl-2-associated X protein, leading to the cleavage of caspase-9, caspase-3 and poly (ADP-ribose) polymerase. In addition, JC3 activated mitogen-activated protein kinases, and specific inhibitors of these kinases abrogated the JC3-induced increase in apoptotic bodies. JC3 increased the level of intracellular reactive oxygen species and enhanced oxidative macromolecular damage via lipid peroxidation, protein carbonylation, and DNA strand breakage. Considering these findings, JC3 is an effective therapy against radiation-resistant human breast cancer cells.


Subject(s)
Apoptosis , bcl-2-Associated X Protein , Breast Neoplasms , Breast , Caspase 3 , Caspase 9 , Chalcone , DNA , Extracellular Vesicles , Humans , Lipid Peroxidation , Membrane Potential, Mitochondrial , Mitogen-Activated Protein Kinases , Oxidative Stress , Phosphotransferases , Protein Carbonylation , Reactive Oxygen Species
19.
Article in English | WPRIM | ID: wpr-165874

ABSTRACT

Following natural disasters, rapid health needs assessments are required to quickly assess health status and help decision making during the recovery phase. The Korean Centers for Disease Control and Prevention (KCDC) developed the Public Health Assessment for Emergency Response (PHASER) Toolkit which was optimized for a weather disaster in Korea. The goal of this study is to assess public health needs following the 2012 typhoons Bolaven and Tembin in both urban and rural areas in Korea. We conducted pilot trials using the PHASER toolkit to assess health needs following typhoons Bolaven and Tembin in Paju and Jeju during summer 2012. We sampled 400 households in Jeju and 200 households in Paju using a multistage cluster sampling design method. We used a standardized household tracking sheet and household survey sheet to collect data on the availability of resource for daily life, required health needs, clinical results and accessibility of medical services. The primary outcomes were clinical results and accessibility of medical service after the typhoons. We completed surveys for 190 households in Paju and 386 households in Jeju. Sleeping disorders were identified in 6.8% (95% confidence interval [CI], 2.8%–10.8%) surveyed in Paju and 17.4% (95% CI, 12.8%–22.0%) in Jeju. We used the PHASER toolkit to assess healthcare needs rapidly after 2 typhoons in Korea. Sleeping disorders were frequently identified in both Paju and Jeju following the 2 typhoons.


Subject(s)
Cyclonic Storms , Decision Making , Delivery of Health Care , Disasters , Emergencies , Family Characteristics , Korea , Mental Health Services , Methods , Needs Assessment , Public Health , Weather
20.
Yonsei Medical Journal ; : 209-216, 2016.
Article in English | WPRIM | ID: wpr-220780

ABSTRACT

PURPOSE: Smoking reportedly exerts deleterious effects on renal function; however, its effects on histology have not been clarified in patients with IgA nephropathy (IgAN). MATERIALS AND METHODS: Renal histology was evaluated in a cohort of 397 patients diagnosed with IgAN according to smoking status and dose in relation to renal function. RESULTS: Among the study cohort, which was predominantly male (88.5%), 52 patients (13%) were current smokers. These current smokers demonstrated more frequent hypertension and higher serum creatinine levels than non/ex-smokers at the time of diagnosis, which was apparent with increased smoking dose. The percentages of global glomerulosclerosis and arteriolar hyalinosis increased with increased smoking dose, whereas tubulointerstitial fibrosis or arterial intimal thickening did not. Glomerular mesangial alpha-smooth muscle actin expression were similar between current and non/ex-smokers matched for age, gender, hypertension, and histologic severity, although the number of glomerular CD68+ cells was significantly fewer in smokers. Initial serum creatinine level, estimated glomerular filtration rate (eGFR), and global glomerulosclerosis were found to be risk factors of serum creatinine doubling in both smokers and non/ex-smokers by univariate analysis during a mean follow-up of 3.8 years. CONCLUSION: In addition to dose dependent renal functional decline and hypertension, smoking contributes to renal disease progression by eliciting microvascular injury in IgAN patients.


Subject(s)
Adult , Aged , Case-Control Studies , Cohort Studies , Creatinine/blood , Disease Progression , Female , Glomerulonephritis, IGA/blood , Humans , Immunohistochemistry , Kidney/pathology , Kidney Function Tests , Kidney Glomerulus/pathology , Male , Middle Aged , Risk Factors , Smoking/adverse effects
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