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1.
Article in English | WPRIM | ID: wpr-926787

ABSTRACT

Inflammatory myofibroblastic tumor (IMT) of the urinary bladder is an uncommon disease in young patients that presents with gross hematuria. However, IMT should be cautiously diagnosed because of its similarities with malignant spindle cell sarcoma. In this case, the tumor was successfully removed by transurethral resection of the bladder tumor and a final diagnosis of IMT was established conclusively.

2.
Article in English | WPRIM | ID: wpr-925904

ABSTRACT

Background@#We analyzed the differences between clinical characteristics and computed tomography (CT) findings in patients with coronavirus disease 2019 (COVID-19) to establish potential relationships with mediastinal lymphadenopathy and clinical outcomes. @*Methods@#We compared the clinical characteristics and CT findings of COVID-19 patients from a nationwide multicenter cohort who were grouped based on the presence or absence of mediastinal lymphadenopathy. Differences between clinical characteristics and CT findings in these groups were analyzed. Univariate and multivariate analyses were performed to determine the impact of mediastinal lymphadenopathy on clinical outcomes. @*Results@#Of the 344 patients included in this study, 53 (15.4%) presented with mediastinal lymphadenopathy. The rate of diffuse alveolar damage pattern pneumonia and the visual CT scores were significantly higher in patients with mediastinal lymphadenopathy than in those without (P < 0.05). A positive correlation between the number of enlarged mediastinal lymph nodes and visual CT scores was noted in patients with mediastinal lymphadenopathy (Spearman’s ρ = 0.334, P < 0.001). Multivariate analysis showed that mediastinal lymphadenopathy was independently associated with a higher risk of intensive care unit (ICU) admission (odds ratio, 95% confidence interval; 3.25, 1.06-9.95) but was not significantly associated with an increased risk of in-hospital death in patients with COVID-19. @*Conclusion@#COVID-19 patients with mediastinal lymphadenopathy had a larger extent of pneumonia than those without. Multivariate analysis adjusted for clinical characteristics and CT findings revealed that the presence of mediastinal lymphadenopathy was significantly associated with ICU admission.

3.
Article in English | WPRIM | ID: wpr-937236

ABSTRACT

Metabolic bone diseases are serious health issues worldwide, since several million individuals over the age of 50 are at risk of bone damage and should be worried about their bone health. One in every two women and one in every four men will break a bone during their lifetime due to a metabolic bone disease. Early detection, raising bone health awareness, and maintaining a balanced healthy diet may reduce the risk of skeletal fractures caused by metabolic bone diseases. This review compiles information on the most common metabolic bone diseases (osteoporosis, primary hyperparathyroidism, osteomalacia, and fluorosis disease) seen in the global population, including their symptoms, mechanisms, and causes, as well as discussing their prevention and the development of new drugs for treatment. A large amount of research literature suggests that balanced nutrition and balanced periodic supplementation of calcium, phosphate, and vitamin D can improve re-absorption and the regrowth of bones, and inhibit the formation of skeletal fractures, except in the case of hereditary bone diseases. Meanwhile, new and improved drug formulations, such as raloxifene, teriparatide, sclerostin, denosumab, and abaloparatide, have been successfully developed and administered as treatments for metabolic bone diseases, while others (romososumab and odanacatib) are in various stages of clinical trials.

4.
Article in English | WPRIM | ID: wpr-889599

ABSTRACT

Type 2 diabetes mellitus (T2DM) leads to many health problems like diabetic nephropathy (DN). One of the key factors for chronic kidney disease and end-stage renal disease (ESRD) is T2DM. Extensive work is being done to delineate the pathogenesis of DN and to extend possible remedies. This review is intended to understand the nature of DN risk factors, progression, effects of glycemic levels, and stages of DN. We also explored the novel diagnostic and therapeutic approaches for DN such as gene therapy and stem cell treatments.

5.
Article in English | WPRIM | ID: wpr-889313

ABSTRACT

Purpose@#The study was aimed at assessing the prevalence of depression in individuals with fecal incontinence (FI) and the relationship between the symptoms of depression and the severity of objective test parameters. @*Methods@#Patients with FI for over 3 months were included in the study. The exclusion criteria were (1) diagnosis or treatment of the pelvic organ prolapse syndrome, (2) previous anorectal surgery, (3) inflammatory bowel disease, (4) previous diagnosis of psychiatric disorder, and (5) inability to read or understand the questionnaire themselves. The questionnaire included the Beck Depression Inventory-II (BDI-II) for measuring depression, and 142 patients were included for analysis. @*Results@#Of the 142 patients, 34 were males and 108 were females, with a mean age of 67.8 years. The mean duration of FI symptoms was 38.36 months (range, 3–600 months). The mean Cleveland Clinic Incontinence Score and BDI-II were 11.96 ± 4.76 and 12.46 ± 9.84, respectively. The Cleveland Clinic Incontinence Score showed a positive correlation with the BDI-II score (P = 0.005). Of the 142 patients, 99 showed minimal to mild BDI-II scores, and 43 showed moderate-to-severe BDI-II scores. The multivariable logistic regression analysis showed that health insurance status was related to the depression in FI patients. @*Conclusion@#Mood disorders related to FI are more affected by the severity of the subjective symptoms or the surrounding environment than the objective indicators derived from the test.

6.
Article in English | WPRIM | ID: wpr-918174

ABSTRACT

Objectives@#:This study aimed to investigate quality of life, severity of depression, suicidality, subjective health and subjective stress of depression with subjective cognitive decline in Korean adults. @*Methods@#:We used the 7th KNHANES data to enroll 415 participants with a score of 10 or higher on Patient Health Questionnaire-9 (PHQ-9), aged 20-64. Depression was divided into two groups based on the presence/absence of subjective cognitive decline. Demographic and psychological characteristics were compared between two groups. Correlation analysis of subjective cognitive decline, quality of life, depression, suicidal idea was car-ried out. To detect which variables influenced quality of life, a multiple regression analysis was carried out. @*Results@#:Among the 415 participants, 98 had depression with subjective cognitive decline. We identified sig-nificant differences in age, marital status, education, employment between the two groups. After adjusting for these variables, depression with subjective cognitive decline had lower EuroQol-5D index scores, more severe depressive symptoms without cognition and worse subjective health than depression without cognitive decline. There was a significant correlation between subjective cognitive decline and quality of life (r=-0.236, p<0.001), suicidal idea (r=0.182, p<0.001), depression score without cognition (r=0.108, p=0.028). Through multiple regression analysis, subjective cognitive decline was predictor of reduced quality of life (β=-0.178, p<0.001). @*Conclusions@#:Depression with subjective cognitive decline has poor quality of life and severe depression. Cognitive decline should be considered to improve treatment result in depression.

7.
Article in English | WPRIM | ID: wpr-918161

ABSTRACT

Objectives@#:This study aimed to compare the characteristics of suicide attempts among Korean patients with mixed and non-mixed depression. @*Methods@#:Patients who visited the emergency room due to a suicide attempt and participated in the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior study were included. Using the Montgomery-Asberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS), 111 patients were classified into the mixed depression (n=46) and non-mixed depression groups (n=65). The Koukopoulos Mixed Depression Rating Scale (KMDRS) score was calculated using the MADRS and YMRS scores. Suicide attempt characteristics were evaluated using the Columbia Suicidal Severity Rating Scale (C-SSRS) and Suicide Intent Scale (SIS). @*Results@#:In the mixed depression group, the reason item among the ideation intensity score of the C-SSRS was higher, and the deterrent item score was lower. Scores on the timing and suicide note items of the SIS were higher, and scores for overt communication items were lower in the mixed depression group. The KMDRS score was positively correlated with the C-SSRS ideation intensity and total SIS score. After adjusting for additional variables,the KMDRS scores had a significant effect on the C-SSRS ideation intensity and total SIS scores. @*Conclusions@#:The mixed depression group showed a difference in the intensity of suicidal ideation and suicidal intention compared to those in the non-mixed depression group. The overall suicidal ideation intensity and suicidal intention increased according to the degree of mixed depression.

8.
Article in English | WPRIM | ID: wpr-913692

ABSTRACT

Different lifestyles have an impact on useful metabolic functions, causing disorders. Different lipids are involved in the metabolic functions that play various vital roles in the body, such as structural components, storage of energy, in signaling, as biomarkers, in energy metabolism, and as hormones. Inter-related disorders are caused when these functions are affected, like diabetes, cancer, infections, and inflammatory and neurodegenerative conditions in humans. During the Covid-19 period, there has been a lot of focus on the effects of metabolic disorders all over the world. Hence, this review collectively reports on research concerning metabolic disorders, mainly cardiovascular and diabetes mellitus. In addition, drug research in lipid metabolism disorders have also been considered. This review explores lipids, metabolism, lipid metabolism disorders, and drugs used for these disorders.

9.
Article in English | WPRIM | ID: wpr-897303

ABSTRACT

Type 2 diabetes mellitus (T2DM) leads to many health problems like diabetic nephropathy (DN). One of the key factors for chronic kidney disease and end-stage renal disease (ESRD) is T2DM. Extensive work is being done to delineate the pathogenesis of DN and to extend possible remedies. This review is intended to understand the nature of DN risk factors, progression, effects of glycemic levels, and stages of DN. We also explored the novel diagnostic and therapeutic approaches for DN such as gene therapy and stem cell treatments.

10.
Article in English | WPRIM | ID: wpr-897017

ABSTRACT

Purpose@#The study was aimed at assessing the prevalence of depression in individuals with fecal incontinence (FI) and the relationship between the symptoms of depression and the severity of objective test parameters. @*Methods@#Patients with FI for over 3 months were included in the study. The exclusion criteria were (1) diagnosis or treatment of the pelvic organ prolapse syndrome, (2) previous anorectal surgery, (3) inflammatory bowel disease, (4) previous diagnosis of psychiatric disorder, and (5) inability to read or understand the questionnaire themselves. The questionnaire included the Beck Depression Inventory-II (BDI-II) for measuring depression, and 142 patients were included for analysis. @*Results@#Of the 142 patients, 34 were males and 108 were females, with a mean age of 67.8 years. The mean duration of FI symptoms was 38.36 months (range, 3–600 months). The mean Cleveland Clinic Incontinence Score and BDI-II were 11.96 ± 4.76 and 12.46 ± 9.84, respectively. The Cleveland Clinic Incontinence Score showed a positive correlation with the BDI-II score (P = 0.005). Of the 142 patients, 99 showed minimal to mild BDI-II scores, and 43 showed moderate-to-severe BDI-II scores. The multivariable logistic regression analysis showed that health insurance status was related to the depression in FI patients. @*Conclusion@#Mood disorders related to FI are more affected by the severity of the subjective symptoms or the surrounding environment than the objective indicators derived from the test.

11.
Article | WPRIM | ID: wpr-836781

ABSTRACT

Purpose@#We evaluated the clinical performance of Prostate Health Index (PHI) density with [-2]proPSA (p2PSA)and its derivatives in predicting the presence of prostate cancer (PCa) in Korean men. @*Materials and Methods@#A total of 706 men with total prostate-specific antigen (tPSA)≥2.5 ng/mL who underwenttheir first prostate biopsy were included in this prospective, multicenter, observational study. Diagnostic accuracyof tPSA, free-to-total PSA ratio (%fPSA), p2PSA, %p2PSA, the Beckman Coulter PHI, and PHI density wasassessed by receiver operating characteristic curve analyses and logistic regression analyses. PHI was calculatedas [(p2PSA/free PSA)×tPSA½], and density calculations were performed using prostate volume as determinedby transrectal ultrasonography. @*Results@#Overall, PCa was detected in 367 of all subjects (52%). In men with tPSA 2.5–10 ng/mL, the detectionrate of PCa was 41.1% (188 of 457). In this group, PHI and PHI density were the most accurate predictorsof PCa and significantly outperformed tPSA and %fPSA; area under the curve for tPSA, %fPSA, %p2PSA, PHI,and PHI density was 0.58, 0.68, 0.70, 0.75, 0.73 respectively. PHI and PHI density were also the strongestpredictor of PCa with Gleason score ≥7. @*Conclusions@#Based on the present prospective multicenter experience, PHI and PHI density demonstrate thesuperior clinical performance in predicting the presence of PCa in Korean men with tPSA 2.5–10 ng/mL.

12.
Article | WPRIM | ID: wpr-836413

ABSTRACT

Objectives@#:We aimed to evaluate the relationship between disability self-awareness and insight in patients with schizophrenia. @*Methods@#:We enrolled 58 clinically stable patients with schizophrenia. The World Health Organization Disability Assessment Schedule (WHODAS) self-report was used to identify self-awareness of functional ability. The Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Schizophrenia Scale (CGI-SCH), and Personal and Social Performance Scale (PSP) were utilized to evaluate clinical symptoms and global function. Whereas Insight Scale for Psychosis (ISP) was applied for insight. Statistical analyses were performed using correlation and linear regression. @*Results@#:The WHODAS had a significant correlation with the general psychopathology subscale and total score of PANSS, CGI-SCH, and PSP. Moreover, ISP had a strong correlation with the overall WHODAS score and all domains. In the linear regression analysis, ISP had significant effects on the overall WHODAS score after adjusting for additional variables. @*Conclusion@#:Disability self-awareness was significantly correlated with the level of insight in patients with schizophrenia. Clinicians need to consider patients’ insight during the discussion of functional ability.

13.
Article | WPRIM | ID: wpr-836240

ABSTRACT

Pain management is an important part of dental practice, and dentists frequently prescribe analgesics to improve clinical outcomes. Dentists should be aware of the pharmacological characteristics of the analgesics commonly used in dentistry and should choose appropriate analgesics to treat and prevent pain associated with inflammation or surgery. In this article, we review the potential benefits and risks of the analgesics frequently used in dental practice and provide a stepwise approach for pain management.

14.
Article | WPRIM | ID: wpr-836000

ABSTRACT

Objective@#:Older adults are at greater risk for malnutrition than younger adults, and malnutrition can be associated with a variety of mental problems. This study was undertaken to investigate differences in mental health indicators according to nutritional risk administered to elderly people living in the community. @*Methods@#:Nutritional risk score was assessed using the ‘Determine Your Nutrition Health’ checklist, developed by the Nutritional Screening Initiative. The study enrolled 400 elderly people living in the community. Study subjects were divided into 3 groups based on their nutritional risk score: good nutrition (score ≤2; n=275), moderate nutritional risk (score 3-5; n=63), and high nutritional risk (score ≥6; n=62). The General Health Questionnaire-12 (GHQ-12), suicide risk screening tool, memory decline awareness, sleep disorder questionnaire, and health-related quality of life (EuroQoL-5 dimension, EQ-5D) were used to assess mental health problems. Statistical analyses were performed using chi-square test, analysis of variance, and Pearson correlation analysis. @*Results@#:In the high nutrition risk group, GHQ-12 score was highest. In the good nutrition group, subjective memory impairment score and sleep difficulty were lowest, and EQ-5D index was highest. The risk of suicide tended to increase with increasing nutritional risk. Nutritional risk score was significantly correlated with GHQ-12, subjective memory impairment, sleep latency time, total sleep duration, sleep difficulty, and EQ-5D index. @*Conclusion@#:This study confirms that nutritional risk in the elderly is related to various psychological symptoms and low quality of life. High nutritional risk in the elderly warrants clinical attention to mental health and quality of life.

15.
Article | WPRIM | ID: wpr-833308

ABSTRACT

Purpose@#To compare the ocular pain scores and injection times of patients during 30 and 40-gauge intravitreal injection procedures. @*Methods@#This study was performed prospectively in patients who had not previously received intravitreal injection. Patients were randomly divided into two groups and intravitreal injections of bevacizumab, ranibizumab, and aflibercept were performed using a 30-gauge needle (30G Group) or a 40-gauge needle (40G group). The injection time defined as the time between conjunctival touching of the needle and finishing the hemostasis after needle removal was measured in each patient. Immediately after the injection, patients were asked to rate their pain level during the injection using a visual analogue scale (0, no pain; 10, unbearable pain). @*Results@#Sixty eyes of 60 patients were included in this study and 30 patients were assigned to each group. The mean injection times of the 30G and 40G groups were 42.00 ± 37.18 and 32.73 ± 14.58 seconds, respectively, with no significant difference (p = 0.212). The visual analogue scale, pain scores in the 30G and 40G groups were 3.50 ± 1.25 and 2.87 ± 1.01, respectively, with a significant difference (p = 0.035). @*Conclusions@#Intravitreal injection with a 40-gauge needle was less painful than that with a 30-gauge needle.

16.
Psychiatry Investigation ; : 1143-1148, 2020.
Article in English | WPRIM | ID: wpr-832581

ABSTRACT

Objective@#Cognition of peritoneal dialysis patients is influenced by various factors including dialysis adequacy such as fractional urea clearance (Kt/V) and relative overhydration (RelOH). This study aimed to discover the potential contribution of dialysis adequacy to cognitive function in patients undergoing peritoneal dialysis. @*Methods@#Fifty-nine patients undergoing peritoneal dialysis were recruited. Demographic information, comorbidities, and clinical lab findings were retrospectively collected, and dialysis adequacy was determined by the Kt/V and RelOH calculation. Cognition and depression were measured with Digit Symbol Substitution Test, Hopkins Verbal Learning Test, Wechsler memory scale (spatial span), Wisconsin Card Sorting Test, and Beck’s depression inventory. Partial correlation test was used to explore the correlation of dialysis adequacy with cognitive function. @*Results@#RelOH showed significant correlation with some of the Wisconsin Card Sorting test results. The categories achieved showed negative correlation (r=-0.32, p=0.02) and trials to complete first category showed positive correlation (r=0.31, p=0.02) with RelOH. Other tasks showed no significant correlation with RelOH. Kt/V. @*Conclusion@#Our study demonstrates that peritoneal dialysis adequacy, measured by RelOH, seems to be significantly correlated with the occurrence of cognitive impairment. The outcome suggests that RelOH may have the potential to clarify the role of cognitive impairment in peritoneal dialysis patients.

17.
Article in 0 | WPRIM | ID: wpr-901276

ABSTRACT

Current advances in CT techniques allow thorough evaluation of the beating heart. The strengths of cardiac CT relative to echocardiography and magnetic resonance imaging are its high availability in most institutions, rapid production of high-quality images, and outstanding delineation of the anatomy. For many normal variants and pathologic conditions, such as thrombi, masses, and congenital abnormalities of the left atrium, CT findings are sufficient to make a presumptive diagnosis. Assessments of the left atrium and left atrial appendage are particularly important for the management of atrial fibrillation, as various catheter-based procedures are aimed at the mechanical and electrical isolation of these structures. CT offers information crucial to a successful catheter-based procedure or surgery. Therefore, a comprehensive review of the geometry (shape, size, and relative position), along with various CT imaging features of pathologic states, should be provided in radiology reports to be of clinical value.

18.
Article in 0 | WPRIM | ID: wpr-893572

ABSTRACT

Current advances in CT techniques allow thorough evaluation of the beating heart. The strengths of cardiac CT relative to echocardiography and magnetic resonance imaging are its high availability in most institutions, rapid production of high-quality images, and outstanding delineation of the anatomy. For many normal variants and pathologic conditions, such as thrombi, masses, and congenital abnormalities of the left atrium, CT findings are sufficient to make a presumptive diagnosis. Assessments of the left atrium and left atrial appendage are particularly important for the management of atrial fibrillation, as various catheter-based procedures are aimed at the mechanical and electrical isolation of these structures. CT offers information crucial to a successful catheter-based procedure or surgery. Therefore, a comprehensive review of the geometry (shape, size, and relative position), along with various CT imaging features of pathologic states, should be provided in radiology reports to be of clinical value.

19.
Psychiatry Investigation ; : 695-701, 2020.
Article | WPRIM | ID: wpr-832527

ABSTRACT

Objective@#The Measurement and Treatment Research to improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) is used to measure the cognitive function of patients with schizophrenia. In some situations, interview-based measures such as the Schizophrenia Cognition Rating Scale (SCoRS) may be appropriate. In this study, we analyzed the correlation between performance- and interview-based measurements in patients with schizophrenia. @*Methods@#Fifty-six clinically stable patients were recruited. To evaluate cognitive function, we used the MCCB performance-based measure and the SCoRS interview-based measure. Measurements were taken at baseline, and 2 weeks and 3 months later. Spearman correlations were computed between each SCoRS item’s interviewer rating and each MCCB score. @*Results@#The correlation between the MCCB overall T score and the SCoRS global score was the strongest (r=-0.52), while the SCoRS total score and the MCCB Speed of Processing score also correlated (r=-0.48). The SCoRS global score showed statistically significant correlations with all seven MCCB domains and the overall T score. @*Conclusion@#This study reveals correlations between MCCB domains and SCoRS items. Since we find that interview-based measurements are highly correlated with performance-based measurements, we suggest them as a useful cognitive function evaluation tool that can easily be applied in clinical settings.

20.
Article | WPRIM | ID: wpr-830918

ABSTRACT

Probenecid is a representative drug used in the treatment of gout. A recent study showed that probenecid effectively inhibits oxidative stress in neural cells. In the present study, we investigated whether probenecid can affect osteoclast formation through the inhibition of reactive oxygen species (ROS) formation in RAW264.7 cells. Lipopolysaccharide (LPS)-induced ROS levels were dose-dependently reduced by probenecid. Fluorescence microscopy analysis clearly showed that probenecid inhibits the generation of ROS. Western blot analysis indicated that probenecid affects two downstream signaling molecules of ROS, cyclooxygen-ase 2 (COX-2) and c-Jun N-terminal kinase (JNK). These results indicate that probenecid inhibits ROS generation and exerts antiosteoclastogenic activity by inhibiting the COX-2 and JNK pathways. These results suggest that probenecid could potentially be used as a therapeutic agent to prevent bone resorption.

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