No abstract available.
Erythroblastosis, Fetal* ; Infant, Newborn

No abstract available.
Humans

BACKGROUND: The risk of bleeding during extracorporeal membrane oxygenation (ECMO) is a potential deterrent in performing tracheostomy at many centers. To evaluate the safety of surgical tracheostomy (ST) in critically ill patients supported by ECMO, we reviewed the clinical correlation between preoperative coagulation status and bleeding complication-related ST during ECMO. METHODS: From April 1, 2012 to March 31, 2016, ST was performed on 38 patients supported by ECMO. We retrospectively reviewed and analyzed the medical records including complications related to ST. RESULTS: Heparin was administered to 23 patients (60.5%) for anticoagulation during ECMO, but 15 patients (39.5%) underwent ECMO without anticoagulation. Of the 23 patients administered anticoagulation therapy, heparin infusion was briefly paused in 13 prior to ST. The median platelet count, international normalized ratio, and activated partial thromboplastin time before ST were 126 ×109/L (range, 46 to 434 ×109/L), 1.2 (range, 1 to 2.3) and 62 seconds (27 to 114.2 seconds), respectively. No peri-procedural clotting complications related to ECMO were observed. Two patients (5.3%) suffering from ST-related major bleeding required surgical hemostasis. Minor bleeding after ST occurred in two cases (5.3%). No significant difference was found according to anticoagulation management (P = 0.723). No fatality was attributable to ST. CONCLUSIONS: The complication rates of ST in the patients supported by ECMO were low. Therefore, ST performed by an experienced operator, and with careful optimization of coagulation status, is a relatively safe procedure; the use of ST with ECMO should thus not be dismissed on account of the potential for bleeding caused by the administration of anticoagulants.
Anticoagulants ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Hemostasis, Surgical ; Heparin ; Humans ; International Normalized Ratio ; Medical Records ; Partial Thromboplastin Time ; Platelet Count ; Retrospective Studies ; Tracheostomy*

OBJECTIVES: The present study aims to investigate the effects of physical illness on depression in North Korean Defectors. METHODS: One hundred forty-four North Korean Defectors(20 males, 124 females) and 376 South Koreans 133 males, 243 females) in Incheon Metropolitan areas participated the present study. Face-to-face interview was conducted for demographic information including presence of physical illnesses. To investigate depressive symptoms, all participants were required to complete the Center for Epidemiologic Studies-Depression scale (CES-D). RESULTS: After controlling gender, age, marital status, educational year, employment status and physical illness, North Korean Defectors showed higher CES-D score than South Koreans(beta=0.449, p<0.001). Within North Korean Defectors, the presence of physical illnesses independently was related to higher CES-D score(beta=0.243, p<0.001). However, within South Koreans, the presence of physical illnesses did not significantly predict CES-D score. North Korean Defectors with physical illness have higher CES-D score than North Korean Defectors without physical illness(26.8+/-13.8 versus 19.7+/-12.7). However, there was no significant differences of CES-D score between South Koreans with physical illness and South Koreans without physical illness(10.3+/-9.8 versus 9.3+/-8.8). CONCLUSION: Compared to South Koreans, North Korean Defector showed higher depressive symptoms independently from gender, age, education, employment, marriage. In addition, only North Korean Defectors showed the relationship between depression and physical illness. Our study suggests that depression should be assessed when North Korean Defectors have physical illness.
Depression ; Employment ; Humans ; Male ; Marital Status ; Marriage

The 1918 "Spanish Flu", cause of the largest causality rate ever recorded in human history with 50 million deaths, is genetically related to the current H5N1 virus, suggesting the potential emergence of H5N1 influenza as the next pandemic wave. In the process of co-infection and genetic reassortment of human and H5N1 avian influenza, the H5N1 strain could acquire human viral gene(s) to ignite the human to human spread, as occurred in 1957 and 1976 pandemics. All countries are vulnerable to infection as no effective vaccine has yet been developed for avian influenza. Once developed into a pandemic, the socio-economic impact of avian influenza would be enormous. In response to this danger, Korea recently proposed to establish an international consortium, the Pandemic Influenza Consortium, Korea (PICK), to emphasize close collaboration, especially among Pacific Rim countries. PICK proposes to support the following three areas: 1) international efforts in the implementation of national and regional preparedness plans through the development of epidemiological, microbiological and clinical tools and mechanisms for early detection of pandemic influenza epidemics, 2) the development and clinical evaluation of pandemic influenza candidate vaccine, and 3) the establishment of appropriate mechanisms to ensure the capacity to produce, the availability of supply, and the rational distribution of pandemic influenza vaccines to countries suffering from or at high risk of experiencing outbreaks. Finally, the effort is expected to serve as a basis for initiating, establishing and strengthening the international infrastructure for investigation of the infection mechanism and devising prophylactic and therapeutic responses to various infectious diseases.
Animals ; Coinfection ; Communicable Diseases ; Cooperative Behavior* ; Disease Outbreaks ; Humans ; Influenza A Virus, H5N1 Subtype ; Influenza in Birds* ; Influenza Vaccines ; Influenza, Human ; Korea ; Pandemics

PURPOSE: To examine the effect of unilateral otitis media and unilateral cerumen occlusion of the ear canal on thermometers. METHODS: One hundred eighty six children with unilateral otitis media, fifty children with unilateral cerumen occlusion, and fifty children with neither otitis media nor cerumen were enrolled. Temperature was measured in both ear canals using thermometers. After 15 minutes, second temperature was measured again in both ears. Unilateral otitis media was graded by video otoscope for 7 grades. Differences in temperatures between affected ears and unaffected ears were analyzed. RESULTS: No temperature difference between the normal and cerumen groups was observed. The mean temperature of the otitis media ear canal was 0.13+/-0.20degrees C higher than that of the intact ear canal (36.99+/-0.54degrees C vs 36.86+/-0.52degrees C; P<0.001). There was no statistically significant temperature difference between grades. CONCLUSION: Unilateral otits media can affect estimation of body temperature measured by thermometers.
Body Temperature ; Cerumen ; Child ; Ear ; Ear Canal ; Humans ; Otitis ; Otitis Media ; Otoscopes ; Thermometers

Syphilitic granulomatous pancreatitis is an extremely rare condition,and can occur in the generalized acquired syphilitic patient in tertiary or secondary phase. The most serious problem with granulomatous pancreatic lesion is clinical or radiological misdiagnosis as cancer. We experienced a case of syphilitic granulomatous pancreatitis arising in 54 year old female patient. She was treated for syphilis 20years ago. But she and her husband are still strong positive to VDRL and TPHA. On abdominal computed tomography and endoscopic pancreatico- duodenography, there was an obstructive mass of low density in the distal common bile duct or pancreatic head. Under the preoperative diagnosis of pancreatic head carcinoma, Whipple's operation was done. On gross examination, the pancreas was fibrotic, and the common bile duct was well preserved without tumor mass. Microscopically, numerous intralobular noncaseating epithelioid cell granulomas with multinucleated giant cells are identified. They surround thick-walled, small to medium sized arteries and involve vascular wall with luminal narrowing or obliteration, which are characteristic findings of the syphilitic granuloma. The remaining parenchyme shows fibrosis, acinar atrophy or destruction with dense infiltration of lymphohistiocytes, plasma cells with granuloma formation. Although the Warthin-Starry stain reveals no spirochetes, the serologic result and pathologic findings are compatible with syphilitic granulomatous pancreatitis.
Female ; Humans

PURPOSE: To compare the effect of breast milk containing fortifier with preterm formula on bone mineral metabolism in premature infants, we evaluated the state of bone mineralization, biochemical alteration and the frequency of rickets during the first five months of life. METHODS: Fourteen fortified breast milk-fed infants and eleven preterm formula-fed infants who were born at Il-Sin Christian Hospital from August, 1996 through July, 1997, were studied. The breast milk-fed group received human milk fortifier. The intake of Ca, P, Mg, protein, and fat was calculated at one month of age. Birth weight and weight at one, two and five months of age were measured. Serum Ca, P, alkaline phosphatase and 25-hydroxyvitamine D were measured at one month of age, and the wrist received X-ray examinations monthly. Total body bone mineral content was measured by Dual energy X-ray absorptiometry (Lunar WI) at two and five months of age. RESULTS: The two groups were similar in birth weight, gestational age, and weight at one, two and five months of age. Enteral Ca, P, protein, Mg, and fat intake, and urinary excretion of Ca, P were similar among the two groups. Serum Ca, P, ALP and 25-hydroxyvitamin D were not different. Occurrence of rickets and bone mineral content were similar among the two groups. CONCLUSION: Fortified breast milk-fed infants and preterm formula-fed infants showed no difference in total body bone mineral content and occurrence of rickets. Ultimately, we could enhance the advantage of breast milk fed to premature infants by adding fortifier.
Absorptiometry, Photon ; Alkaline Phosphatase ; Birth Weight ; Bone Density ; Breast ; Calcification, Physiologic ; Gestational Age ; Humans* ; Infant ; Infant, Newborn ; Infant, Premature ; Metabolism* ; Milk, Human* ; Rickets* ; Wrist

OBJECTIVE: To evaluate the discrepancies between initial STO and final STO in Class III malocclusions and to find which factors are related to the discrepancies. METHODS: Twenty patients were selected for the extraction group and 20 patients for the non-extraction group. They were diagnosed as skeletal Class III and received presurgical orthodontic treatment and mandibular set-back surgery at Pusan National University Hospital. The lateral cephalograms were analyzed for initial STO (T1s) at pretreatment and final STO (T2s) after presurgical orthodontic treatment, and specified the landmarks as coordinates of the X and Y axes. RESULTS: Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, upper first molar mesial end surface, lower central incisor apex, lower first molar mesial end surface and mesio-buccal cusp and Y coordinates of upper central incisor edge, upper central incisor apex, upper first molar mesio-buccal cusp were statistically significant in the extraction group. Differences in hard tissue points (T1s-T2s) in the X coordinates of upper central incisor edge, lower central incisor apex, lower first molar mesial end surface and Y coordinates of lower central incisor apex were statistically significant in the non-extraction group. In the extraction group, the upper arch length discrepancy (UALD) had a statistically significant effect on maxillary incisor and first molar estimation. Lower arch length discrepancy and IMPA had statistically significant effects on mandibular incisor estimation in both groups. CONCLUSIONS: Discrepancies between initial STO and final STO and factors contributing to the accuracy of initial STO must be considered in treatment planning of Class III surgical patients to increase the accuracy of prediction.
Humans ; Incisor ; Malocclusion ; Molar ; Organophosphorus Compounds ; Orthodontics

Objective: Dizziness is a common symptom in the emergency department. Identifying central causes, such as acute ischemic stroke (AIS), is essential in patients with dizziness. This study examined the usefulness of computed tomographic angiography (CTA) for the safe disposition of patients with dizziness when brain magnetic resonance imaging (MRI) is difficult to perform. Methods: This study was a retrospective observational study. Patients who underwent CTA and MRI to determine the cause of dizziness were included in this study between January 2019 and December 2019. Clinical and radiological characteristics, including the CTA findings, were compared in groups with and without AIS in MRI. Univariate and multivariate logistic regression analyses were performed. The area under the receiver operating characteristic curve (AUROC) was assessed. Results: Three hundred and fifty patients were included in the study. Of these patients, 63 patients had AIS in MRI. The group with AIS was more frequently male (65.1% vs. 44.3%, P=0.003), had dysarthria (9.5% vs. 2.4%, P=0.016), and relevant vertebral or basilar artery stenosis or occlusion on CTA (66.7% vs. 3.5%, P<0.001). In logistic regression, relevant vertebral or basilar artery stenosis or occlusion was significantly associated with AIS in MRI (odds ratio, 47.941; 95% confidence interval, 20.857-110.195; P<0.001). In the receiver operating characteristic curve, the relevant vertebral or basilar artery stenosis or occlusion on CTA was a feasible predictive value for diagnosing AIS (AUROC, 0.816). Conclusion This study showed that the CTA findings were feasible for predicting the safety disposition of patients with dizziness when MRI is difficult to perform.