PURPOSE: Co-morbidity is the presence of co-existing or additional diseases during the initial diagnosis. It may be used as a prognostic indicator for the postoperative outcomes in most cancers, including colorectal cancers. The impact of respective co-morbidities in colorectal cancer surgeries were evaluated to identify their outcomes regarding complications and hospital stay. METHODS: The medical records of 2,242 colorectal cancer patients, who had had curative operations between Jan. 1997 and Dec. 2001, were reviewed to evaluate the prevalence of co-morbidities. All co-morbidities were adequately evaluated and managed preoperatively. RESULTS: Co-morbidities were observed in 789 out of the 2,242 (35.2%) patients. Hypertension was the most frequent (340, 15.2%), with diabetes (210, 9.4%) and cardiovascular diseases (124, 5.5%) following. Early stages (0~II) were more frequently associated with co-morbidities, compared to late stages (III~IV) (P<0.001). Hypertension and cerebrovascular diseases were significantly associated with postoperative complications (P<0.05). Postoperative complications occurred in 578 out of the 2242 (25.8%) patients: e.g., ileus (10.2%), voiding difficulty (4.4%), wound problems (4.3%), etc. Pulmonary complications occurred more often in patients with cerebrovascular diseases, hypertension, and asthma. Wound complications were observed in patients with hypertension, cerebrovascular diseases, chronic obstructive pulmonary disease, and chronic renal failure (P<0.05). Patients with more than one co-morbidity were closely associated with frequent postoperative co-mplications (P<0.05). However, comorbidities did not seem to affect the duration of the postoperative hospital stay. CONCLUSIONS: Postoperative complications frequently occur in colorectal cancer patients with specific co- morbidities, especially in those with more than one. An adequate management of the co-morbidities preoperatively leads to a good outcome.
Asthma ; Cardiovascular Diseases ; Chronic Disease ; Colorectal Neoplasms* ; Comorbidity ; Diagnosis ; Humans ; Hypertension ; Ileus ; Kidney Failure, Chronic ; Length of Stay ; Lung Diseases, Obstructive ; Medical Records ; Postoperative Complications ; Prevalence ; Wounds and Injuries

Objectives: This study aimed to identify the effectiveness of treatment programs for children with reading (RD) or mathematics disorders (MD). Structured treatment programs were developed to improve phonological awareness and number sense among children and adolescents with RD or MD, respectively, and the effectiveness of the learning disorder treatment programs were evaluated. Methods: We used standardized, objective diagnostic, and evaluation tools not only to recruit participants with RD, MD, or comorbid attention deficit and hyperactivity disorder, but also to assess the effectiveness of the treatments regarding both improved core neurocognitive deficits of RD or MD and academic achievement. Forty children with RD or MD received one-on-one treatments from therapists. Results: In the RD group, treatment effects were observed in all subtests. In the word and paragraph reading tests, the accuracy rates and fluency improved. The results of the phonological working memory test, word–sound correspondence test, and rapid automatic naming tests also improved. In the MD group, the accuracy rate and fluency on the arithmetic test improved. An increase in the accuracy rate in the size and distance comparison tests and a decrease in the error rate in the estimation test were also observed. However, there were no improvements in reaction time in these subtests. Conclusion Learning disorder treatment programs that focus on improving phonological awareness or number sense in children with RD or MD improved achievement, phonological awareness, and number sense.

Purpose: In this study, we propose a deep learning (DL)–based voxel-based dosimetry method in which dose maps acquired using the multiple voxel S-value (VSV) approach were used for residual learning. Methods: Twenty-two SPECT/CT datasets from seven patients who underwent 177 Lu-DOTATATE treatment were used in this study. The dose maps generated from Monte Carlo (MC) simulations were used as the reference approach and target images for network training. The multiple VSV approach was used for residual learning and compared with dose maps generated from deep learning. The conventional 3D U-Net network was modified for residual learning. The absorbed doses in the organs were calculated as the mass-weighted average of the volume of interest (VOI). Results: The DL approach provided a slightly more accurate estimation than the multiple-VSV approach, but the results were not statistically significant. The single-VSV approach yielded a relatively inaccurate estimation. No significant difference was noted between the multiple VSV and DL approach on the dose maps. However, this difference was prominent in the error maps. The multiple VSV and DL approach showed a similar correlation. In contrast, the multiple VSV approach underestimated doses in the low-dose range, but it accounted for the underestimation when the DL approach was applied. Conclusion Dose estimation using the deep learning–based approach was approximately equal to that in the MC simulation. Accordingly, the proposed deep learning network is useful for accurate and fast dosimetry after radiation therapy using 177 Lu-labeled radiopharmaceuticals.

The emerging pathogen, group C rotavirus (RVC) has been reported to cause acute diarrhea. But there was the limitation on the detection and monitoring for the absence of rapid sensitive diagnosis system. For the molecular biology study and diagnostic system development, we could detect porcine RVC by reverse transcriptase PCR (RT-PCR) analyses from 60 diarrheal disease porcine stool samples. VP6 full length RT-PCR product (CA-2 RVC, 1352 bp) was cloned and compared the nucleotide and deduced amino acid sequences with those of previously reported other porcine, human, and bovine rotavirus group A, B and C strains. Analyses data showed >82% homology on the nucleotide sequences and >90% homology on the deduced amino acid sequences with other RVCs. Recombinant baculovirus was prepared with cloned PCR product corresponding to VP6 coding sequence (CDS) (position 22~1206) into BaculoDirect(TM) C-term linear DNA, and used for the transfection of insect cells. The polyclonal antibody was produced from mice with purified recombinant VP6 and confirmed with western blot. Both of VP6 antigen and antibody, are useful for the development of rapid diagnostic system against RVC.
Amino Acid Sequence ; Animals ; Antibody Formation ; Baculoviridae ; Base Sequence ; Blotting, Western ; Clinical Coding ; Clone Cells ; Diarrhea ; DNA ; Humans ; Insects ; Mice ; Molecular Biology ; Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; Rotavirus ; Transfection

PURPOSE: To determine the prevalence of scoliosis in volleyball athletes and compare this with the prevalence in the general population. MATERIALS AND METHODS: One hundred and sixteen volleyball athletes who had been enrolled in the activity for more than one year were examined for prevalence of scoliosis. The Adams forward bending test was performed with a measurement of the truncal asymmetry using a scoliometer (Orthopaedic System, Inc, USA). Those atheletes who showed more than 5degreesof measurement were selected for an X-ray evaluation. Data from a randomized point prevalence survey of Korean Middle school students (46,428) in Seoul City, which had been performed by our department, was adopted for the control group. RESULTS: Among the 116 volleyball players, 60 (51.7%) showed more than a 5degreesof angle of trunk rotation, whereas controls of middle school students showed 2.5%. Cobb's angle more than 10degrees was 6 (5.17%) in athletes and the control group was 465 (1.0%). Despite higher frequency of prevalence, the Cobb' angle was below 15degrees whereas the control group showed a severe scoliosis which of Cobb's angle reaching to 45degrees. CONCLUSION: Volleyball athletes showed a higher incidence of truncal asymmetry and scoliotic spinal columns than the control group. However, we were able to conclude that asymmetrical muscle development can produce a mild scoliosis. However this doesn't have the potential for a severe progression as found in some cases of idiopathic scoliosis.
Athletes* ; Humans ; Incidence ; Muscle Development ; Prevalence ; Scoliosis* ; Seoul ; Spine ; Volleyball*

BACKGROUND AND OBJECTIVES: The increased risk of cardiovascular disease in patients with chronic renal failure (CRF) has been explained by accelerated atherosclerosis and impaired angiogenesis, where endothelial progenitor cells (EPC) may play key roles. It was hypothesized that : "an altered EPC biology may contribute to the pathophysiology of CRF". SUBJECTS AND METHODS: EPC were isolated from CRF patients on maintenance hemodialysis (n=44) and from a normal control group (n=30). After morphological and immunological characterization, the number and in vitro angiogenic function of the EPC were evaluated. RESULTS: CRF patients showed markedly decreased numbers of EPC (44.6%) and colonies (75.3%) compared to the controls (p<0.001). These findings were corroborated by a 30.5% decrease in the migratory function in response to vascular endothelial growth factor (VEGF)(p=0.040) and by a 48.8% decrease in EPC incorporation into human umbilical vein endothelial cells (HUVEC)(p<0.001). In addition, The Framingham's risk factor scores of both the CRF (r=-0.461, p=0.010) and normal groups (r=-0.367, p=0.016) were significantly correlated with the numbers of EPC. Indeed, under the same burden of risk factors the number of circulating EPC was significantly lower in CRF patients than in the normal group (p<0.001). A significant correlation was also observed between the dialysis dose (Kt/V) and EPC incorporation into the HUVEC (r=0.427, p=0.004). CONCLUSION: The EPC biology, which is critical for neovascularization and the maintenance of vascular function, was altered in CRF. Our data strongly suggest that dysfunction of circulating EPC has a role in the progression of cardiovascular disease in patients with CRF.
Atherosclerosis ; Biology ; Cardiovascular Diseases ; Coronary Artery Disease ; Dialysis ; Endothelial Cells ; Human Umbilical Vein Endothelial Cells ; Humans ; Kidney Failure, Chronic* ; Renal Dialysis ; Risk Factors ; Stem Cells* ; Vascular Endothelial Growth Factor A

The purpose of this study was to determine the expression and distribution of band 3 in the collecting duct and connecting tubules of the kidney of the marmoset monkey (Callithrix jacchus), and to establish whether band 3 is expressed in type A intercalated cells. The intracellular localization of band 3 in the different populations of intercalated cells was determined by double-labeling immunohistochemistry. Immunohistochemical microscopy demonstrated that band 3 is located in the basolateral plasma membranes of all type A intercalated cells in the connecting tubule (CNT), cortical collecting duct (CCD), and outer medullary collecting duct (OMCD) of the marmoset. However, type B intercalated cells and non-A/ non-B intercalated cells did not show band 3 labeling. Electron microscopy of the CNT, CCD and OMCD confirmed the light microscopic observation of the basolateral plasma membrane staining for band 3 in a subpopulation of interacted cells. Basolateral staining was seen on the plasma membrane and small coated vesicles in the perinuclear structure, some of which were located in the Golgi region. In addition, there was no labeling of band 3 in the mitochondria of the CNT, CCD and in OMCD cells. The intensity of the immunostaining of the basolateral membrane was less in the CNT than in the CCD and OMCD. In contrast, band 3 immunoreactivity was greater in the intracellular vesicles of the CNT. From these results, we suggest that the basolateral Cl-/HCO3- exchanger in the monkey kidney is in a more active state in the collecting duct than in the CNT.
Animals ; Anion Exchange Protein 1, Erythrocyte/*metabolism ; Callithrix/*metabolism ; Gene Expression Profiling/veterinary ; *Gene Expression Regulation ; Immunohistochemistry/veterinary ; Kidney Tubules/cytology/physiology/ultrastructure ; Kidney Tubules, Collecting/cytology/*metabolism/ultrastructure ; Male ; Microscopy, Electron, Transmission/veterinary

Chronic urticaria (CU) is defined by the presence of urticaria that has been continuously or intermittently for a period of 6 weeks or longer. The prevalence of CU in the general population has been estimated to range from 0.5% to 5%. Correct diagnosis and proper management for CU is essential to improve the quality of care. To date, several practical guidelines have been available for practitioners. In this article, we reviewed and summarized the epidemiology, pathogenesis, diagnosis, and management based on case reports and studies of CU from Korea and the other part of world, and recently published guidelines. Although there are many controversies, this report for CU would provide a clinical guidance for healthcare professionals in Korea.
Delivery of Health Care ; Diagnosis ; Epidemiology ; Korea ; Prevalence ; Urticaria*

Background: Patient-centered management is becoming increasingly important in gout, but there are limited studies exploring patients' perspectives and preferences. We aimed to investigate patients' perspectives and preferences regarding gout and gout management, and their impacts on adherence to urate lowering therapy (ULT). Methods: A paper-based survey was performed in patients with gout seen at the rheumatology outpatient clinics of 16 tertiary hospitals. The survey included questions regarding demographics, comorbidities, gout attacks, current treatment and adherence, and patients' perspectives and preferences regarding gout and gout management. Multivariate regression analysis was performed to determine the factors associated with ULT adherence. Results: Of 809 surveyed patients with gout, 755 (94.5%) were using ULT. Among those using ULT, 89.1% had ≥ 80% adherence to ULT. Majority of the patients knew management strategies to some extent (94.8%), perceived gout as a life-long disease (91.2%), and were making efforts toward practicing at least one lifestyle modification (89.2%). Most patients (71.9%) obtained information about gout management during their clinic visits.Approximately half of the patients (53.6%) preferred managing their disease with both ULT and lifestyle modification, 28.4% preferred ULT only, and 17.4% preferred lifestyle modification only. Adherence was better in patients with older age (odds ratio [OR], 1.03), those with better knowledge of gout management strategies (OR, 3.56), and those who had preference for ULT (OR, 2.07). Conclusion Patients' perspectives and management preferences had high impacts on adherence to ULT in gout. Consideration of patients' perspectives and preferences is important for achieving the desired clinical outcome in gout.

Background: Patient-centered management is becoming increasingly important in gout, but there are limited studies exploring patients' perspectives and preferences. We aimed to investigate patients' perspectives and preferences regarding gout and gout management, and their impacts on adherence to urate lowering therapy (ULT). Methods: A paper-based survey was performed in patients with gout seen at the rheumatology outpatient clinics of 16 tertiary hospitals. The survey included questions regarding demographics, comorbidities, gout attacks, current treatment and adherence, and patients' perspectives and preferences regarding gout and gout management. Multivariate regression analysis was performed to determine the factors associated with ULT adherence. Results: Of 809 surveyed patients with gout, 755 (94.5%) were using ULT. Among those using ULT, 89.1% had ≥ 80% adherence to ULT. Majority of the patients knew management strategies to some extent (94.8%), perceived gout as a life-long disease (91.2%), and were making efforts toward practicing at least one lifestyle modification (89.2%). Most patients (71.9%) obtained information about gout management during their clinic visits.Approximately half of the patients (53.6%) preferred managing their disease with both ULT and lifestyle modification, 28.4% preferred ULT only, and 17.4% preferred lifestyle modification only. Adherence was better in patients with older age (odds ratio [OR], 1.03), those with better knowledge of gout management strategies (OR, 3.56), and those who had preference for ULT (OR, 2.07). Conclusion Patients' perspectives and management preferences had high impacts on adherence to ULT in gout. Consideration of patients' perspectives and preferences is important for achieving the desired clinical outcome in gout.