Clinical Characteristics and Disease Progression in Early-Stage COVID-19 Patients in South Korea.

A rapid increase in the number of patients with coronavirus disease 19 (COVID-19) may overwhelm the available medical resources. We aimed to evaluate risk factors for disease severity in the early stages of COVID-19. The cohort comprised 293 patients with COVID-19 from 5 March 2020, to 18 March 2020. The Korea Centers for Disease Control and Prevention (KCDC) classification system was used to triage patients. The clinical course was summarized, including the impact of drugs (angiotensin II receptor blockers [ARB], ibuprofen, and dipeptidyl peptidase-4 inhibitors [DPP4i]) and the therapeutic effect of lopinavir/ritonavir. After adjusting for confounding variables, prior history of drug use, including ARB, ibuprofen, and DPP4i was not a risk factor associated with disease progression. Patients treated with lopinavir/ritonavir had significantly shorter progression-free survival than those not receiving lopinavir/ritonavir. KCDC classification I clearly distinguished the improvement/stabilization group from the progression group of COVID-19 patients (AUC 0.817; 95% CI, 0.740-0.895).

Physiological and oxidative stress response of goldfish Carassius auratus induced by a light dimming system.

Light is an essential factor for organisms and affects the endocrine and stress regulation of fish in nature. However, sudden changes in light and dark conditions in artificial environments can negatively impact fish. In the present study, to evaluate the physiological and oxidative stress responses of goldfish (Carassius auratus) exposed to two different light conditions, sudden light changes and slowly dimming light changes for 24 h, we analyzed the mRNA expression and activity of stress indicators [corticotropin-releasing hormone (CRH) and pro-opiomelanocortin (POMC)], levels of plasma cortisol and glucose, mRNA expression of glucocorticoid receptor (GR), and activity of plasma oxidative stress indicators (superoxide dismutase and catalase). Consequently, the mRNA expressions and activities of CRH and POMC, plasma levels of cortisol and glucose, and mRNA expression of GR were found to be significantly increased during the light changes, particularly in the control group. Additionally, plasma levels of cortisol and glucose in the control group were significantly higher than those in the dimming group during the light changes. However, no significant differences in mRNA expression levels and activities of antioxidant enzymes both in the control and dimming groups were observed. These results indicate that dimming light induces less stress than sudden changes in light.

Non-neoplastic pathology results after endoscopic submucosal dissection for gastric epithelial dysplasia or early gastric cancer.

BACKGROUND AND STUDY AIMS: Endoscopists sometimes face paradoxical cases in which the endoscopic submucosal dissection (ESD) specimen reveals a non-neoplastic pathology result. The aims of the study were to determine the reasons for such results, and to compare the endoscopic characteristics of non-neoplastic and conventional neoplastic pathology groups after ESD. PATIENTS AND METHODS: A total of 1186 gastric ESDs performed between February 2005 and December 2011 were retrospectively reviewed. The ESD specimens included 52 (4.4 %) that were confirmed as negative or indefinite for neoplasia. Patient characteristics and endoscopic and pathological data were reviewed and compared. RESULTS: Non-neoplastic pathology after ESD was due to complete removal of the lesion at biopsy in 45 cases (86.5 %), pathology overestimation in 5 (9.6 %), and incorrect localization of the original tumor with subsequent ESD performed at the wrong site in 2 (3.8 %). The mean length and surface area of the non-neoplastic lesions were 9.2 ±â€Š2.6 mm and 49.6 ±â€Š23.6 mm (2), respectively. Mean sampling ratios were 3.0 ±â€Š1.5 mm/fragment and 16.3 ±â€Š10.0 mm(2)/fragment. Compared with 1134 cases confirmed as neoplastic on the final ESD specimen, non-neoplastic cases showed a significantly smaller tumor size and surface area, and lower sampling ratios in a logistic regression analysis adjusted for potential confounders (P < 0.001 for all). CONCLUSIONS: Complete lesion removal by biopsy, pathology overestimation, and incorrect localization of the original tumor with subsequent ESD at the wrong site were the main reasons for non-neoplastic results after ESD. Small tumor size and surface area, and low sampling ratios were associated with non-neoplastic pathology results after ESD.