Pyogenic liver abscess (PLA) is rare in healthy children. We report a case of PLA in an immunocompetent 12-year-old boy. Percutaneous catheter drainage was performed for the abscess. In addition, parenteral antibiotics were administered for 3 weeks. Klebsiella pneumoniae was detected in the culture of blood and drained fluid. Here, we present this case and a brief review of the literature on this subject.
Abscess ; Anti-Bacterial Agents ; Catheters ; Child* ; Drainage ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Male*

OBJECTIVES: Dry eye disease (DED) is an increasingly important public health problem in Korea. Previous studies conducted in Korea have reported inconsistent results regarding the protective effects of vitamin D on DED, and these discrepancies may be related to the relatively simple questionnaire that has been used. Thus, we evaluated the association of serum vitamin D levels with DED using the ocular surface disease index (OSDI). METHODS: The present study evaluated data from participants in the Study Group for Environmental Eye Disease (2014-2015). This group included data from 752 participants, and data from 740 participants (253 men and 487 women) were analyzed in the present study. DED severity was evaluated using the OSDI. RESULTS: Higher serum vitamin D levels were associated with a non-significantly reduced risk of DED in the crude analysis (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.971 to 1.011) and in the adjusted analysis (OR, 0.988; 95% CI, 0.966 to 1.010). In the crude analysis of no/mild DED vs. moderate/severe DED, men exhibited a decreased risk with increasing serum vitamin D levels (OR, 0.999; 95% CI, 0.950 to 1.051), while women exhibited an increased risk (OR, 1.003; 95% CI, 0.979 to 1.027). In these analyses, we found no significant associations. CONCLUSIONS: The findings of the present study support previous reports that serum vitamin D levels are not associated with DED.
25-Hydroxyvitamin D 2 ; Dry Eye Syndromes ; Eye Diseases* ; Female ; Humans ; Keratoconjunctivitis Sicca ; Korea ; Male ; Public Health ; Vitamin D* ; Vitamins*

Chylopericardium is a very rare, yet potentially fatal, complication following intrathoracic surgery, and can further lead to other life-threatening complications such as cardiac tamponade. A 54-year-old female underwent right upper lobectomy for lung cancer. Chylothorax developed on the 2nd postoperative day, and was managed conservatively with dietary modification. On the 9th postoperative day, the patient suddenly developed hypotension and severe cardiac dysfunction requiring cardiopulmonary resuscitation followed by VA ECMO. Transthoracic echocardiography revealed a large amount of pericardial effusion. Prompt pericardiocentesis was performed and the aspirated fluid showed features of chyle. Thoracic duct ligation with pericardial window operation was performed because the daily amount of chyle drained did not decrease after 3 weeks. Here, we review etiologies and therapeutic options of chylopericardial tamponade following intrathoracic surgery, which should not be underestimated even when the patient seems to demonstrate a good recovery.
Cardiac Tamponade ; Cardiopulmonary Resuscitation ; Chyle ; Chylothorax* ; Echocardiography ; Extracorporeal Membrane Oxygenation ; Female ; Food Habits ; Humans ; Hypotension ; Ligation ; Lung Neoplasms ; Middle Aged ; Pericardial Effusion ; Pericardiocentesis ; Thoracic Duct

PURPOSE: The purpose of this study was to evaluate the effects of oral stimulation interventions on the transition from tube to oral feeding in preterm infants through systematic review. METHODS: The randomized clinical trials published between 1980 and 2015 were searched using domestic and international databases, and five randomized studies were selected for this study. The quality of study was assessed by assessment tool from the SIGN and meta-analysis was performed using the Cochrane Review Manager software Version 5.3 (RevMan). RESULTS: Oral stimulation intervention in preterm infants decreased the transition time from tube to oral feeding (Post Menstrual Age, Day of life). Especially, a significant medium effect size was found in the number of days needed on the transition (ES=-4.95, p=.02). The oral stimulation intervention also had a significant large effect on the length of stay at hospital (ES=-8.33, p < .001). CONCLUSION: Based on the findings, oral stimulation interventions could be useful to facilitate the transition from tube to oral feeding in preterm infants in terms of reducing the length of stay at hospital and the number of days needed on transition.
Humans ; Infant, Newborn ; Infant, Premature ; Length of Stay ; Physical Stimulation ; Sucking Behavior

During the first trimester of pregnancy, thyroid-stimulating hormone (TSH) >2.5 mIU/L has been suggested as the universal criterion for subclinical hypothyroidism. However, TSH levels change continuously during pregnancy, even in the first trimester. Therefore the use of a fixed cut-off value for TSH may result in a different diagnosis rate of subclinical hypothyroidism according to gestational age. The objective of this study was to obtain the normal reference range of TSH during the first trimester in Korean gravida and to determine the diagnosis rate of subclinical hypothyroidism using the fixed cut-off value (TSH >2.5 mIU/L). The study population consisted of pregnant women who were measured for TSH during the first trimester of pregnancy (n=492) and nonpregnant women (n=984). Median concentration of TSH in pregnant women was lower than in non-pregnant women. There was a continuous decrease of median TSH concentration during the first trimester of pregnancy (median TSH concentration: 1.82 mIU/L for 3+0 to 6+6 weeks; 1.53 mIU/L for 7+0 to 7+6 weeks; and 1.05 mIU/L for 8+0 to 13+6 weeks). Using the fixed cut-off value of TSH >2.5 mIU/L, the diagnosis rate of subclinical hypothyroidism decreased significantly according to the gestational age (GA) at TSH (25% in 3+0 to 6+6 weeks, 13% in 7+0 to 7+6 weeks, and 9% for 8+0 to 13+6 weeks, P<0.001), whereas the diagnosis rate was 5% in all GA with the use of a GA-specific cut-off value (P=0.995). Therefore, GA-specific criteria might be more appropriate for the diagnosis of subclinical hypothyroidism.
Adult ; *Algorithms ; Biomarkers/blood ; Diagnosis, Computer-Assisted/*methods ; *Diagnostic Techniques, Obstetrical and Gynecological ; Female ; *Gestational Age ; Humans ; Hypothyroidism/blood/*diagnosis ; Pregnancy ; Pregnancy Complications/blood/*diagnosis ; Reproducibility of Results ; Republic of Korea ; Sensitivity and Specificity ; Thyrotropin/*blood

Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a nulliparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.
Abdominal Pain ; Adenomyosis* ; Animals ; Diagnosis, Differential ; Female ; Fertilization in Vitro ; Fever ; Humans ; Hyperplasia ; Hypertrophy ; Infarction* ; Leiomyoma ; Magnetic Resonance Imaging ; Mice ; Myometrium ; Pelvic Pain ; Pregnancy* ; Uterine Artery Embolization ; Uterine Hemorrhage

OBJECTIVE: The purpose of this study was to estimate the effect of age on the risk of in-hospital surgical morbidity in patients with pelvic organ prolapse (POP). METHODS: Of the women aged 40 years and older who underwent surgical correction of POP at this institution from March 1999 to February 2006, 322 had medical records that could be analyzed. These patients were grouped according to decade of age and assessed according to a set of characteristics and postsurgical complications. RESULTS: There were 35 patients between 40 to 49 years of age, 97 between 50 to 59 years, 123 between 60 and 69 years, 64 between 70 to 79 years and 3 patients were 80 years or older. There were no differences between age groups regarding the following variables: stage, delivery history, BMI, previous surgical history, underlying medical disease, duration of hospital stay, operation time, type of operation and anesthesia, difference of preoperative and postoperative hemoglobin level. There were differences only for parity. Also, between each age group, no statistical differences were noted in postoperative complications. CONCLUSION: The risk of in-hospital surgical morbidity in patients with POP was not related to the age of the patients.
Anesthesia ; Female ; Humans ; Length of Stay ; Medical Records ; Parity ; Pelvic Organ Prolapse* ; Postoperative Complications

BACKGROUND: The goal of this study was to analyze the relationship between exercise frequency and all-cause mortality for individuals diagnosed with and without diabetes mellitus (DM). METHODS: We analyzed data for 505,677 participants (53.9% men) in the National Health Insurance Service-National Health Screening (NHIS-HEALS) cohort. The study endpoint variable was all-cause mortality. RESULTS: Frequency of exercise and covariates including age, sex, smoking status, household income, blood pressure, fasting glucose, body mass index, total cholesterol, and Charlson comorbidity index were determined at baseline. Cox proportional hazard regression models were developed to assess the effects of exercise frequency (0, 1–2, 3–4, 5–6, and 7 days per week) on mortality, separately in individuals with and without DM. We found a U-shaped association between exercise frequency and mortality in individuals with and without DM. However, the frequency of exercise associated with the lowest risk of all-cause mortality was 3–4 times per week (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.65–0.73) in individuals without DM, and 5–6 times per week in those with DM (HR, 0.93; 95% CI, 0.78–1.10). CONCLUSION: A moderate frequency of exercise may reduce mortality regardless of the presence or absence of DM; however, when compared to those without the condition, people with DM may need to exercise more often.
Blood Pressure ; Body Mass Index ; Cholesterol ; Cohort Studies ; Comorbidity ; Diabetes Mellitus ; Family Characteristics ; Fasting ; Glucose ; Korea ; Mass Screening ; Mortality ; National Health Programs ; Smoke ; Smoking

Cypripedium japonicum is known to be the indigenous plant to Korea, Japan, and China. However, C. japonicum represents the most critically endangered plant species in South Korea. The plant is esthetically pleasing due to its flower, which is larger than any other orchidaceous species. Disease symptoms relating to gray mold were observed on C. japonicum in May 2019. The suspected pathogen was successfully isolated from the symptomatic leaf tissue and conducted a pure culture of the fungi. The conidia formed consisted of a colorless or light brown single cell, which was either egg or oval-shaped with a size of 7.1 to 13.4 × 5.2 to 8.6 μm. Molecular phylogenetic relationship analysis was also confirmed that the pathogen concerned belonging to the family of Botrytis cinerea. Therefore, the findings confirmed that the pathogen isolated from C. japonicum was consistent with the unique properties of B. cinerea.

Hepatocellular carcinoma (HCC) is the most common and lethal type of primary liver cancer, frequently arising from chronic liver injury and inflammation. Despite treatment advancements, HCC prognosis remains poor, emphasizing the need for effective preventive and therapeutic strategies. This study investigates the hepatoprotective and anti-tumor effects of Hongjam, a steamed freeze-dried silkworm powder, in a diethylnitrosamine (DEN) and thioacetamide (TAA)-induced HCC mouse model. Mice were administered DEN intraperitoneally for 8 weeks, followed by TAA in drinking water for 9 weeks, with Hongjam supplementation (0.01, 0.1, and 1 g/kg) provided daily through food. Hongjam markedly reduced the tumor incidence, the size, and the histological lesions compared to the DEN/TAA group. Serum biochemical analysis revealed reduction in liver damage markers, including alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, and total bilirubin, with a notable decrease in total bilirubin surpassing. Immunohistochemical and Western blot analyses demonstrated that Hongjam downregulated expression of proliferation markers, including Ki67, phosphorylation of protein kinase B, and proliferating cell nuclear antigen, while upregulating the pro-apoptotic protein Bcl-2-associated X protein, indicating its dual role in suppressing proliferation and promoting apoptosis. Furthermore, Hongjam inhibited angiogenesis by suppressing the expression of key markers, including interleukin 6, VEGF, hypoxia-inducible factor-1 subunit alpha, platelet-derived growth factor subunit beta, matrix metalloproteinase-2, and cluster of differentiation 31, thereby disrupting the tumor microenvironment. These findings suggest that Hongjam exerts multifaceted protective effects against HCC by targeting proliferation, apoptosis, and angiogenesis pathways, while also mitigating liver damage. This study highlights the potential of Hongjam as a functional food or a complementary therapeutic agent for HCC prevention and management.