No abstract available.
Kyphosis*

Tsutstugamushi disease is a major febrile disease that generally occurs in the fall in Korea with hemorrhagic fever with renal syndrome and leptospirosis. This disease is often accompanied by interstitial pneumonia, acute renal failure and liver failure. The causative agent, namely Orientia tsutsugamushi, is transmitted to humans through the bite of a laval trombiculid mite, which is commonly known as a chigger. A 78 year old man was admitted in October 2004 with intractable fever and a drowsy mentality. Two weeks earlier, he visited a private clinic complaining of a simple skin rash. He was treated with antihistamine and steroid, but his symptoms were aggravated and he was referred to our hospital. His physical examination and laboratory findings showed a septic shock status. The maculopapular rash had spread over his face, chest, abdomen and extremities. Eschar was observed in lower back area but it was too difficult to distinguish it from other skin rashes. His chest X-ray appeared as diffuse nodular patchy consolidations in the bilateral lung parenchyme. He was treated with a mechanical ventilator and doxycycline under th suspicion of Tsutstugamushi disease. However, he suffered multiorgan failure accompanied by acute respiratory distress syndrome, acute renal failure and acute hepatitis. He was treated in the intensive care unit for approximately 12 weeks and his general condition was recovered.
Abdomen ; Acute Kidney Injury ; Aged ; Doxycycline ; Exanthema ; Extremities ; Fever ; Hemorrhagic Fever with Renal Syndrome ; Hepatitis ; Humans ; Intensive Care Units ; Korea ; Leptospirosis ; Liver Failure ; Lung ; Lung Diseases, Interstitial ; Orientia tsutsugamushi ; Physical Examination ; Respiratory Distress Syndrome, Adult ; Scrub Typhus ; Shock, Septic ; Thorax ; Trombiculidae ; Ventilators, Mechanical

Extrarenal manifestations of hemolytic uremic syndrome (HUS) have increasingly been recognized and may be major determinants of mortality and morbidity. Although microthrombi are often found in the pulmonary and coronary circulation, apparent lung and cardiac involvement are clinically infrequent. We describe here a 10-month-old boy with HUS who developed pulmonary hemorrhage, acute respiratory distress syndrome and dilated cardiomyopathy. Complete renal as well as clinical recovery from these very uncommon complications was achieved by optimum supportive care.
Cardiomyopathies ; Cardiomyopathy, Dilated ; Coronary Circulation ; Hemolytic-Uremic Syndrome* ; Hemorrhage ; Humans ; Infant ; Lung ; Male ; Mortality ; Respiratory Distress Syndrome, Adult

Background: Clostridioides difficile infection (CDI) is one of the most common hospitalacquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. Methods: To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service–National Sample Cohort spanning a decade (2010–2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. Results: The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). Conclusion CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

Background: Clostridioides difficile infection (CDI) is one of the most common hospitalacquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. Methods: To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service–National Sample Cohort spanning a decade (2010–2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. Results: The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). Conclusion CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

Background: Clostridioides difficile infection (CDI) is one of the most common hospitalacquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. Methods: To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service–National Sample Cohort spanning a decade (2010–2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. Results: The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). Conclusion CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

Background: Clostridioides difficile infection (CDI) is one of the most common hospitalacquired infections, with its incidence and disease burden increasing markedly worldwide over the past decade. Methods: To assess the attributable costs of CDI in Korea, the expenses related to hospital management of CDI cases were computed. This analysis used data from the National Health Insurance Service–National Sample Cohort spanning a decade (2010–2019). The annual national burden of CDI was determined by combining the attributable cost per CDI case with the number of patients with CDI obtained from the Health Insurance Review and Assessment Service data. Results: The attributable costs of CDI were determined based on variations in the length of hospital stay and medical costs between patients with CDI and control patients. The mean length of hospital stay was significantly longer for patients with CDI than that for control patients: 43.06 vs. 14.76 days (a difference of 28.30 days, P < 0.001). The adjusted medical costs (2019 = 100) for cases of CDI and controls were 11,162 USD and 3,318 USD, respectively, with a significant difference of 7,843 USD (P < 0.001). The cost of CDI per case exhibited a noticeable annual increase from 2010 to 2019, despite an annual decreasing trend in length of hospital stay. The estimated national cost attributed to CDI was $28.9 million in 2010; however, it increased gradually each year, reaching $205.6 million in 2019 (a 600% increase over 10 years). Conclusion CDI is associated with substantial healthcare costs in Korea. The economic burden of CDI has gradually increased in South Korea.

The bronchopulmonary sequestration is a rare congenital malformation of the lung, concerning about the abnormal feeding systemic artery, needed for invasive angiography for definite diagnosis. This case report is described that patient diagnosed by multi-detectional computed tomography (MDCT) without angiography and combined with aspergillosis within an intralobar seqestration. He was 43-year old male patient with left submandibular mass. On chest PA, abnormal cystic lesion was shown in left lower lung field. There were multiple cysts with internal air-fluid level in left lower lobe on computed tomography. By useing MDCT, we could reconstruct internal structures and feeding artery, arising from thoracic aorta. We could confirm the intralobar bronchopulmonary sequestration. Lobectomy of the left lower lobe was done. On histologic finding, there was intralobar type pulmonary seqestration with chronic inflammation with hyphae of aspergillus species focally.
Adult ; Angiography ; Aorta, Thoracic ; Arteries ; Aspergillosis* ; Aspergillus ; Bronchopulmonary Sequestration* ; Diagnosis ; Humans ; Hyphae ; Inflammation ; Lung ; Male ; Thorax

To examine the effect of retinal branch vein occlusion (BRVO) on protein tyrosine phosphorylation, production of angiogenic growth factors, and activation of signal proteins in the tyrosine kinase pathways in the retina, BRVO was induced in cat retina by coagulation of retinal veins with diathermy. At 2 days, 1, 3, and 6 weeks after induction of BRVO, the retina was divided into 3 parts; a part within the distribution of the occluded vein [BRVO(IN)] or a part outside the distribution of the occluded vein [BRVO(OUT)], an prepared for western blot analysis. Overall, tyrosine-phosphorylated proteins were increased after BRVO, especially in BRVO(IN) at 2 days and 1 week. The vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were also increased in BRVO(IN) at 1 week and 2 days, respectively. The phospholipase Cgamma(PLCgamma) and mitogen-activated protein kinase (MAPK) were activated at these points. In this study, we concluded that the BRVO increased overall protein tyrosine phosphorylation in the cat retina in association with the increase of angiogenic growth factors (VEGF, bFGF) and activation of 2 signal proteins (PLCgamma and MAPK)in the tyrosine kinase pathways. These results suggest that the protein tyrosine phosphorylation may in part play an important role in mitogenesis of vascular endothelial cells and other retinal responses after BRVO.
Animals ; Blotting, Western ; Cats* ; Diathermy ; Endothelial Cells ; Fibroblast Growth Factor 2 ; Intercellular Signaling Peptides and Proteins ; Phospholipases ; Phosphorylation ; Protein Kinases ; Protein-Tyrosine Kinases* ; Retina ; Retinal Vein ; Retinaldehyde ; Tyrosine ; Vascular Endothelial Growth Factor A ; Veins

BACKGROUND: Since open Wiltse approach allows limited visualization for foraminal stenosis leading to an incomplete decompression, we report the short-term clinical and radiological results of unilateral biportal endoscopic foraminal decompression using 0° or 30° endoscopy with better visualization. METHODS: We examined 31 patients that underwent surgery for neurological symptoms due to lumbar foraminal stenosis which was refractory to 6 weeks of conservative treatment. All 31 patients underwent unilateral biportal endoscopic far-lateral decompression (UBEFLD). One portal was used for viewing purpose, and the other was for surgical instruments. Unilateral foraminotomy was performed under guidance of 0° or 30° endoscopy. Clinical outcomes were analyzed using the modified Macnab criteria, Oswestry disability index, and visual analogue scale. Plain radiographs obtained preoperatively and 1 year postoperatively were compared to analyze the intervertebral angle (IVA), dynamic IVA, percentage of slip, dynamic percentage of slip (gap between the percentage of slip on flexion and extension views), slip angle, disc height index (DHI), and foraminal height index (FHI). RESULTS: The IVA significantly increased from 6.24°± 4.27° to 6.96°± 3.58° at 1 year postoperatively (p = 0.306). The dynamic IVA slightly decreased from 6.27°± 3.12° to 6.04°± 2.41°, but the difference was not statistically significant (p = 0.375). The percentage of slip was 3.41% ± 5.24% preoperatively and 6.01% ± 1.43% at 1-year follow-up (p = 0.227), showing no significant difference. The preoperative dynamic percentage of slip was 2.90% ± 3.37%; at 1 year postoperatively, it was 3.13% ± 4.11% (p = 0.720), showing no significant difference. The DHI changed from 34.78% ± 9.54% preoperatively to 35.05% ± 8.83% postoperatively, which was not statistically significant (p = 0.837). In addition, the FHI slightly decreased from 55.15% ± 9.45% preoperatively to 54.56% ± 9.86% postoperatively, but the results were not statistically significant (p = 0.705). CONCLUSIONS: UBEFLD using endoscopy showed a satisfactory clinical outcome after 1-year follow-up and did not induce postoperative segmental spinal instability. It could be a feasible alternative to conventional open decompression or fusion surgery for lumbar foraminal stenosis.
Constriction, Pathologic* ; Decompression* ; Endoscopy ; Follow-Up Studies ; Foraminotomy ; Humans ; Minimally Invasive Surgical Procedures ; Spinal Stenosis ; Spine* ; Surgical Instruments