Reversible Burst-suppression Pattern of Acute Hyperammonemic Encephalopathy

Acute hyperammonemic encephalopathy is generally associated with severe liver disease, manifesting with neuropsychiatric symptoms including confusion, lethargy, seizure, coma, and even death. Electroencephalogram (EEG) is a proven diagnostic, prognostic, and therapeutic tool in patients with acute and chronic encephalopathies. EEG changes in acute hyperammonemic encephalopathy are associated with background slowing in theta to delta ranges, accompanied by presence of triphasic waves. We reported a patient with acute hyperammonemic encephalopathy showing an unusual burst-suppression pattern, which was reversible with proper treatment.

Two-Stage Operation Over a Period of 7 Years for a Patient with Macrodactyly: A Case Report / 대한족부족관절학회지

Macrodactyly of the toe is a rare congenital anomaly characterized by the overgrowth of a digit/digits in the foot and is one of the most difficult conditions to treat. Since the condition alters functionality and appearance, the treatment goal is to restore function and cosmetically enhance the appearance. Various surgical techniques are used for toe macrodactyly, including amputation, debulking, and epiphysiodesis. Herein, we present a case of a six-year-old patient with a second toe macrodactyly who was successfully treated with a twostage operation over a seven-year period. We initially performed an ostectomy of the middle phalanx with a fusion of the proximal and distal phalanges and then performed a soft tissue debulking procedure.

Clinical Characteristics of Campylobacter Enterocolitis in Korean Adults: A Retrospective Study at a Single Center / 대한소화기학회지

Background/Aims@#Although the diarrheal disease caused by Campylobacter bacteria has been continuously increasing in Korea, there has been limited study on the clinical aspects of Campylobacter enteritis in adults in Korea. The purpose of this study was to analyze the clinical features and characteristics of adult patients with Campylobacter enteritis. @*Methods@#This retrospective study included patients diagnosed with Campylobacter enterocolitis at Nowon Eulji University Hopsital between January 2016 and December 2017. Campylobacter enterocolitis was diagnosed through polymerase chain reaction of stools from patients with acute diarrhea. @*Results@#Among 630 hospitalized patients with acute diarrhea, Campylobacter enterocolitis was diagnosed in 88 patients (14.0%). The mean age was 37.9±19.1 years. Campylobacter enterocolitis was most prevalent in the summer (52 patients, 59.1%). Patients exhibited more than 10 times of diarrhea in 36 (40.9%), high fever above 39℃ in 19 (21.59%), and abdominal pain above 5 points on the numeric rating scale in 23 (26.14%) cases. In abdominal CT scan, pancolitis was found in 58 patients (65.9%). Small intestine was involved in 37 patients (42.4%). Mean CRP was 10.14 mg/dL (range 0.72-32.27 mg/dL). The duration of diarrhea after antibiotics treatment was 2.34±1.51 days in the ciprofloxacin treatment group and 2.26±1.71 days in the 3rd cephalosporin treatment group. @*Conclusions@#Campylobacter enterocolitis was common during summer. Commonly healthy young adults were hospitalized due to severe symptoms of Campylobacter enterocolitis. Whole colon and small bowel were frequently involved. Most patients were treated with antibiotics, and the efficacy of 3rd cephalosporin treatment was not inferior to that of ciprofloxacin treatment.

Ezetimibe decreased nonalcoholic fatty liver disease activity score but not hepatic steatosis

BACKGROUND/AIMS@#A number of clinical trials reported varying effects of cholesterol lowering agents in nonalcoholic fatty liver disease (NAFLD) patients. We, therefore, assessed the changes in hepatic steatosis and NAFLD activity score (NAS) after treatment with cholesterol lowering agents in NAFLD patients by metaanalysis.@*METHODS@#The Cochrane Library, the MEDLINE, and the Embase databases were searched until May 2015, without any language restrictions, for randomized controlled trials (RCTs) and nonrandomized studies (NRSs). Additional references were obtained from review of bibliography of relevant articles. The quality of evidence was assessed using the grading of recommendations assessment, development and evaluation guidelines.@*RESULTS@#Three RCTs (n = 98) and two NRSs (n = 101) met our study inclusion criteria (adult, NAFLD, liver biopsy). Liver biopsy was performed in all five studies, but only the three studies reported NAS. Ezetimibe significantly decreased NAS (standardized mean difference [SMD], –0.30; 95% confidence interval [CI], –0.57 to –0.03) but not hepatic steatosis in RCT (SMD, –0.1; 95% CI, –0.53 to 0.32), while the effect was significant for both NAS and intrahepatic content in NRSs (SMD, –3.0; 95% CI, –6.9 to 0.91).@*CONCLUSIONS@#Ezetimibe decreased NAS without improving hepatic steatosis.

Environment Factors Affecting Childhood Obesity: Voices from Students, Parents, and Teachers with Photograph

PURPOSE@#This study aimed to explore the environmental factors affecting childhood obesity using photovoice from the perspectives of students, parents, and teachers in the community.@*METHODS@#Six school students, seven parents, and seven school teachers completed an assignment requiring them to take 24 pictures and participate in group discussions. After training session, the participants were asked to take pictures associated with food and physical activity environments related to childhood obesity at home, school, and within their communities for two weeks and to submit the pictures with records. Each group had four sessions for discussion.@*RESULTS@#School cafeteria, convenience stores near schools, instant food and fast food joints, food delivery, and high-calorie snacks comprised the food environmental factors. Lack of physical activity classes at school, commuting by car, barriers to physical activity, and use of smart-phone were environmental factors that inhibited physical activity.@*CONCLUSION@#To reduce childhood obesity, the creation of a supportive environment for encouraging the consumption of healthy foods and enhancing physical activity should be considered. Modifications of and improvement to the obesogenic environment might be a good strategy to prevent and reduce childhood obesity.

Environment Factors Affecting Childhood Obesity: Voices from Students, Parents, and Teachers with Photograph

PURPOSE: This study aimed to explore the environmental factors affecting childhood obesity using photovoice from the perspectives of students, parents, and teachers in the community. METHODS: Six school students, seven parents, and seven school teachers completed an assignment requiring them to take 24 pictures and participate in group discussions. After training session, the participants were asked to take pictures associated with food and physical activity environments related to childhood obesity at home, school, and within their communities for two weeks and to submit the pictures with records. Each group had four sessions for discussion. RESULTS: School cafeteria, convenience stores near schools, instant food and fast food joints, food delivery, and high-calorie snacks comprised the food environmental factors. Lack of physical activity classes at school, commuting by car, barriers to physical activity, and use of smart-phone were environmental factors that inhibited physical activity. CONCLUSION: To reduce childhood obesity, the creation of a supportive environment for encouraging the consumption of healthy foods and enhancing physical activity should be considered. Modifications of and improvement to the obesogenic environment might be a good strategy to prevent and reduce childhood obesity.

Do Factors Associated Self-rated Good Health and Their Influences Differ between Males and Females across Different Age Groups in Korean and Australia?

OBJECTIVES: This was a comparative study between Australia and Korea that investigated whether and to what extent factors related to self-rated good health (SRGH) differ by gender among age groups. METHODS: This study was a secondary analysis of data that were collected in nationally representative, cross-sectional, and population-based surveys. We analyzed Australian and Korean participants > 20 years of age using 2011 data from the Australian National Nutritional Physical Activity Survey (n = 9,276) and the Korean National Health and Nutritional Examination Survey (n = 5,915). Analyses were based on multiple logistic regression after controlling for covariates. RESULTS: Factors associated with SRGH and the extent of their influence differed by gender among age groups within each nation. Australian SRGH was associated with more factors than Korean SRGH, except in participants > 65 years old. Many differences among adults aged 20–44 years were observed, particularly with regard to the influence of socioeconomic factors. Living with a spouse only influenced SRGH in men 20–44 years old in both countries, negatively for Korean men and positively for Australian men. In this same age group, SRGH was positively influenced by employment and attainment of a higher education level in Australian men but not among Korean men; among women, income, but not education, affected SRGH in Korea, whereas in Australia, women were more influenced by education than by income. Lack of chronic disease had a strong influence on SRGH in both countries and was influential in all Australians and Koreans except those ≥ 65 years old. CONCLUSION: Broad features of society should be considered when discussing health and differences in associated factors and their influences. For focused public health interventions of population groups, it is also necessary to consider gender and age groups within social environments.

A Case of Hepatocellular Carcinoma with Recurrent Peritoneal Metastasis after Hepatectomy Who Showed Complete Response by Surgical Resection

Recurrence of hepatocellular carcinoma (HCC) after hepatic resection is quite common. Peritoneal recurrence has been considered incurable status and related to poor prognosis. Although peritoneal metastasectomy is a therapeutic option for some selected patients with a few peritoneal metastasis, the indication and therapeutic effect has not been clear. We report a case of a 61-year-old man achieving complete remission of recurrent peritoneal metastasis after repeated surgical resection by a multidisciplinary approach. Peritoneal metastasectomy might be a therapeutic option for selected patients with localized oligonodular peritoneal metastasis.

Low Salt Diet and Insulin Resistance

It is well known that high sodium intake is closely associated with the risk of cardiovascular disease, but the effect of low sodium intake on insulin resistance is not clear. In this article, we summarize findings from previous studies focusing on the association between low sodium intake and insulin resistance. While many investigations on this topic have been conducted actively, their major findings are inconsistent, partly due to different study designs. Thus, additional randomized controlled trials with an adequate study period and reasonable levels of low sodium intake are needed.

Two Cases of Treatment with Thrombolysis and an Extracorporeal Membrane Oxygenator in Patients with Pulmonary Embolism and Cardiac Arrest / 대한내과학회지

Massive pulmonary embolism (PE) is associated with poor prognosis and high mortality. Moreover, patients with massive PE who present with shock have mortality rates ranging from 30% to 50%. Thrombolysis should be administered to patients with massive PE unless there are absolute contraindications to its use. However, treatment failure still occurs, and there is no consensus for the management of massive PE with cardiopulmonary arrest with regard to thrombolysis. In this study, two cases of massive PE with cardiopulmonary arrest are described, both of which were successfully treated with thrombolysis and hemodynamic support, which was administered by extracorporeal membrane oxygenation (ECMO). This report suggests that ECMO may provide safe and adequate cardiopulmonary support in patients with massive PE with refractory thrombolysis and cardiopulmonary arrest.

Effects of Hypertension, Diabetes, and/or Cardiovascular Disease on Health-related Quality of Life in Elderly Korean Individuals: A Population-based Cross-sectional Survey

PURPOSE: This study explored health-related quality of life (QoL) in Korean elderly individuals with hypertension, diabetes, and/or cardiovascular disease (CVD). METHODS: This study used a population-based cross-sectional design. Data were obtained from the Fourth Korean National Health and Nutrition Examination Survey 2008, which involved a nationally representative sample. Data on health-related QoL were collected using the EuroQoL-5 Dimension instrument and via health interviews. The sample consisted of 1,467 Korean individuals aged 60 years and older. A multiple linear regression model was used to analyze health-related QoL. RESULTS: After controlling for sociodemographic and lifestyle variables, individuals with one of the aforementioned chronic diseases had lower EuroQoL-5 Dimension scores, ranging from 0.186 among those with only hypertension to 0.469 among those with hypertension plus CVD, compared with those without a chronic disease (higher scores are indicative of more limitations). The impact of comorbid diseases was greater than that of any single disease except diabetes. CVD had a stronger negative impact on QoL than did any other single disease studied. Whereas the physical elements of QoL were influenced by all diseases, the psychological components were influenced only by hypertension plus diabetes and hypertension plus CVD. CONCLUSION: We found that both the number and the type of diseases affected QoL scores. Efforts to prevent or manage diabetes, CVD, and related risk factors should include psychological support.

The Prevalence of Metabolic Syndrome and Related Risk Factors Based on the KNHANES V 2010 / 農村醫學 地域保健

OBJECTIVES: This study is to investigate the prevalence and related factors of metabolic syndrome among Korean adults aged 20 years and above. METHODS: From the database of the 5th Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands. RESULTS: The prevalence rate of metabolic syndrome based on the criteria proposed by International Diabetes Federation (IDF) was 18.8%. The prevalence of metabolic syndrome in each group was: 20.7% of women, 43.1% among elderly over 70 years old, 40.6% of the divorced or the separated, 27.6% of recipients of economic support from the government, 23.6% of people who had alcohol dependency problem, and 43.7% of overweight or obese adults. Independent risk factors based on the multiple logistic regression analysis revealed that prevalence of metabolic syndrome was associated with female (odds ratio 1.59 [95% confidence interval 1.20-2.11]), age (50s 3.95 [2.11-7.37], 60s 5.62 [2.98-10.61], 70s 10.56 [5.25-21.25]), high school education (0.52 [0.37-0.74]), clerk occupation (2.14 [1.27-3.60]), divorced marital status (1.72 [1.15-2.59]), alcohol dependency (1.86 [1.16-2.98]), higher BMI (14.08 [10.60-18.70]). CONCLUSIONS: The metabolic syndrome is prevalent among Korean adult population according to IDF criteria. Several demographic characteristics and potentially modifiable factors are associated with metabolic syndrome. Identification of this high-risk group and management of these modifiable factors are warranted to reduce the prevalence of metabolic syndrome.

The Prevalence of the Metabolic Syndrome in Korean Children and Adolescents: Comparisons of the Criteria of Cook et al., Cruz and Goran, and Ferranti et al

PURPOSE: Although the metabolic syndrome (MS), which can lead to the development of cardiovascular disease (CVD) or diabetes mellitus (DM), is increasing in children and adolescents, no unified criteria have been established, and little attention has been paid to its occurrence in Korean children and adolescents. In this study, we compared the prevalence of the MS in Korean children and adolescents using the criteria which were modified for children and adolescents by Cook et al., Cruz and Goran, and Ferranti et al. MATERIALS and METHODS: The study population was a nationwide representative sample of 3,431 children and adolescents (1,828 boys and 1,603 girls) from the 2001 Korean National Health and Nutrition Examination Survey (KNHANES), who were aged 10-19 years (mean 14.1 +/- 2.8), underwent a physical examination, and fasted for 8 hours before collecting blood samples. RESULTS: The rates of the MS were 6.1, 5.3, and 14.0% according to the criteria of Cruz and Goran, Cook et al., and Ferranti et al., respectively, and the agreement rate of the three sets of criteria was 88.7%. CONCLUSION: Unified criteria for the MS and a strategy for reducing obesity in children and adolescents will be necessary to prevent the occurrence of this syndrome.

Outcomes of an Community-based Intervention Program for Obese Children / 대한소아내분비학회지

PURPOSE: Childhood obesity is global public health issue and early intervention is essential because the long-term consequences of childhood obesity are well documented. We studied the effects of community-based intervention program for obese children in regard to regulating excess body weight and improving their lifestyle. METHODS: The study population were 101 obese children (age 6-12) who lived in Ansan during year 2003. The Program consists of exercise and nutritional education, and was conducted for 20 weeks (during the first 8 weeks program was performed once every week and once every month after that). We evaluated the changes of weight, body mass index, obesity index, lipid profiles and their lifestyle during the program. RESULTS: After the intensive course during 8 weeks, body mass index, obesity index, LDL-cholesterol decreased significantly. However, those results increased again after 20 weeks program comparable to initial levels. There are no significant differences in total cholesterol, triglyceride and HDL-cholesterol during program. The lifestyle for exercise and eating improved after initial 8 weeks intensive course, but returned to previous state after 20 weeks program finished. CONCLUSION: Our 20 weeks obesity program did not influence body mass index significantly although it showed transient improvement during early intensive course. These results suggest that the importance of long-term intensive programs to maintain educated healthy lifestyle. Hereafter, well-controlled and long term followed clinical researches in larger group will be necessary.

A clinical, epidemiologic and laboratory investigation of aseptic menigitis in Taejeon area on 1993 / 대한소아신경학회지

No abstract available.