Purpose: To determine the prognostic role of muscle area and muscle radiation attenuation in the erector spinae (ES) and multifidus (MF) muscles in patients undergoing gastrectomy. Methods: Patients with stage I-III gastric cancer undergoing gastrectomy were retrospectively enrolled in this study. Clinicopathologic characteristics were collected and analyzed. Both paraspinal muscle index of ES/MF muscles (PMIEM) and paraspinal muscle radiation attenuation in the same muscles (PMRAEM) were analyzed at the 3rd lumbar level using axial computed tomographic images. Cox regression analysis was applied to estimate overall survival (OS) and diseasefree survival (DFS). Results: There was only a weak correlation between PMIEM and PMRAEM (r = 0.28). Multivariate Cox regression revealed that PMRAEM, but not PMIEM, was an important determinant of survival. PMRAEM along with age, tumor-node-metastasis (TNM) stage, perineural invasion, and serum albumin level were significant determinants of both OS and DFS that constituted Model 1. Harrell’s concordance index and integrated area under receiver operating characteristic curve were greater for Model 1 than for Model 2 (consisting of the same covariates as Model 1 except PMRAEM) or Model 3 (consisting of only TNM stage). Conclusion PMRAEM, but not PMIEM, was an important determinant of survival. Because there was only a weak correlation between PMIEM and PMRAEM in this study, it was presumed that they were mutually exclusive. Model 1 consisting of age, TNM stage, perineural invasion, serum albumin level, and PMRAEM was greater than nested models (i.e., Model 2 or Model 3) in predicting survival outcomes.

PURPOSE: To identify risk factors that affect the development of type 2 retinopathy of prematurity (ROP) and progression to type 1 or threshold ROP requiring treatment. METHODS: The medical records of premature infants born with a birth weight ≤1,500 g or a gestational age ≤32 weeks were retrospectively reviewed. Potential risk factors were divided into systemic and ophthalmic factors and analyzed by univariate and multivariate logistic regression analyses. RESULTS: Three hundred and twenty-four eyes met the screening criteria. Among them, 41 eyes (12.65%) progressed to type 2 ROP and 21 eyes (6.48%) received treatment after progression to type 1 or threshold ROP. The systemic risk factor associated with progression from type 2 ROP was periventricular leukomalacia and the ophthalmic factor was the existence of nasal ROP at the time of diagnosis of type 2 ROP. CONCLUSIONS: Careful examination was needed when type 2 ROP with periventricular leukomalacia or nasal ROP developed because there was a high probability of progression and treatment.
Birth Weight ; Diagnosis ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Leukomalacia, Periventricular ; Logistic Models ; Mass Screening ; Medical Records ; Retinopathy of Prematurity ; Retrospective Studies ; Risk Factors

PURPOSE: We aimed to investigate the clinical and phylogenetic characteristics of Escherichia coli Urinary Tract Infections (E. coli UTI). METHODS: We enrolled patients with culture-proven E. coli UTI, who were admitted at the study hospital from September 2008 to August 2009. We investigated clinical data of patients with E. coli UTI and characteristics of isolated E. coli strains. The phylogenetic groups were classified using triplex polymerase chain reaction (PCR), and the distribution of nine virulent genes was determined by multiplex PCR. RESULTS: A total of 47 patients have participated in this study. Thirty (63.8%) were under 6 months; eight (17.0%) were between 6-12 months; and nine (19.1%) were over 12 months. We compared two age groups between under 6-month and over 6-month. In the age group under 6-month, higher proportion of male (P=0.002) and group B2 strains (P=0.020) were observed. In contrast, higher proportion of female and group non-B2 strains were observed in age group over 6-month. Frequencies of papC, papGII, papGIII, sfa/foc, hlyC, cnf1, fyuA, iroN and iucC were estimated as 68.1%, 57.4%, 42.6%, 46.8%, 46.8%, 31.9%, 87.2%, 48.9% and 63.8%, respectively. In the comparison of phylogenetic groups, group B2 showed higher distribution of virulent genes, while group D included more strains resistant to trimethoprim/sulfamethoxazole (TMP/SMZ) than other groups. CONCLUSION: We showed the age group-specific difference in the distribution of sex ratios and phylogenetic groups; more male and group B2 strains in age group under 6-month, while more female and group non-B2 in age group over 6-month. However, further evaluation including larger number of patients will be necessary to confirm above thesis in future molecular epidemiological studies.
Epidemiologic Studies ; Escherichia ; Escherichia coli ; Female ; Humans ; Infant ; Iron ; Male ; Multiplex Polymerase Chain Reaction ; Sex Ratio ; Urinary Tract ; Urinary Tract Infections

OBJECTIVE: To investigate duration of the treatment effect of extracorporeal shockwave therapy (ESWT) on spasticity levels measured with Modified Ashworth Scale (MAS) regardless of the patient group (stroke, multiple sclerosis, and cerebral palsy) and evaluate its spasticity-reducing effect depending on the number of shocks and site of application. METHODS: PubMed, EMBASE, the Cochrane Library, and Scopus were searched from database inception to February 2018. Randomized controlled trials and cross-over trials were included. All participants had spasticity regardless of cause. ESWT was the main intervention and MAS score was the primary outcome. Among 122 screened articles, 9 trials met the inclusion criteria.
Ankle Joint ; Cross-Over Studies ; Elbow ; Fingers ; Humans ; Multiple Sclerosis ; Muscle Spasticity ; Shock ; Wrist

Purpose: To investigate the tomographic structural changes in the retinal layers after internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (ERM). Methods: Sixty-nine eyes treated with vitrectomy and ILM peeling for idiopathic ERM were analyzed. Parafoveal retinal thickness was measured at baseline and 6 months after surgery. Results: Total retinal thickness decreased significantly in the nasal and temporal subfields after surgery (p < 0.001), whereas the inner nuclear layer and outer nuclear layer showed nasal thickening (all, p < 0.001). The postoperative temporalasal subfield thickness ratio of each layer was significantly lower than that of fellow eyes. Eyes with larger ILM peeling showed a significantly lower temporalasal subfield thickness ratio (p = 0.033) than those with smaller sizes. Conclusions The retinal thickness of each layer showed anatomical changes from ILM peeling and ERM removal. Nasal parafoveal thickening and temporal thinning occurred in the inner retinal architecture, which might be affected by ILM peeling size.

Renal artery aneurysms and pseudoaneurysms are an uncommon clinical problem with a low incidence rate. They are abnormal dilatations of the vessel lumen with some different natures. However, the rupture of an aneurysm and pseudoaneurysm is the most dreaded complication because it causes death of the patient. There are many causes of renal artery aneurysm and pseudoaneurysm, including Behçet's disease; however, renal involvement in Behçet's disease is less frequent. We report a case of renal artery pseudoaneurysm induced by Behçet's disease and treated successfully with coil embolization. A 56-year-old woman with Behçet's disease presented with an incidental left renal artery pseudoaneurysm measuring 18 mm. We successfully performed endovascular treatment with coil embolization instead of surgical treatment.
Aneurysm ; Aneurysm, False* ; Dilatation ; Embolization, Therapeutic ; Female ; Humans ; Incidence ; Middle Aged ; Renal Artery* ; Rupture

BACKGROUND: 'Masked Hypertension' is a phenomenon of blood pressure that is normotensive by clinic measurement but proves to be hypertensive by 24 hour-AMBP and is associated with many cardiovascular complications and its clinical importance has become the center of public interest. However, in Korea no study concerning masked hypertension has ever been published so far. We investigated the frequency and the related factors of masked hypertension among Koreans. METHODS: Overall, 53 volunteers from Incheon and Seoul, Korea, who were 40 years old and abov were enrolled from August 2003 to August 2004. We checked their blood pressure and pulse rate every hour using an ambulatory blood pressure monitoring device [SpaceLabs 90207] for 24 hours. Masked hypertension was defined as office mean BP less than 140/90 mmHg and daytime mean BP over 135/85 mmHg. RESULTS: Among the total, 15 subjects met the criteria of masked hypertension (28.3%) Current smoking (P=0.021), higher clinic mean SBP (P=0.011) and DBP (P=0.027), and prehypertension (P=0.04) were identified as related factors. And when adjusted for sex by logistic regression, only current smoking was statistically significant (P=0.039) and prehypertension showed borderline significance (P=0.092) (CI=95%). Additionally, mean pulse pressures and mean standard deviation of individual mean SBP were higher in the masked hypertension group. CONCLUSION: The frequency of masked hypertension was 28.3% the and related factors were current smoking and higher office BP, especially prehypertension that was introduced in JNC-7. The fact that the pulse pressure and the variability of individual SBP were higher in the masked hypertension group remains thought-provoking.
Adult ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Heart Rate ; Humans ; Incheon ; Korea ; Logistic Models ; Masked Hypertension* ; Masks* ; Prehypertension ; Seoul ; Smoke ; Smoking ; Volunteers*

PURPOSE: To present a rare case of tear drainage since birth from a lacrimal ductule fistula, which is the first report in the Republic of Korea. CASE SUMMARY: 3-month-old female who presented with discharge of clear fluid from a small skin opening lateral to the right upper eyelid since birth visited the outpatient clinic. The patient was healthy and was receiving no medication. She was born on gestation age 35 weeks and 3 days. No other specific history or other ophthalmic abnormality was found. On examination, a small skin orifice approximately 2 mm diameter and no sign of infection or discoloration was observed. To relieve this symptom, the patient underwent a fistulectomy under general anesthesia. Histopathological examination of the surgical specimen was performed. The patient's symptom subsided postoperatively without recurrence. CONCLUSIONS: This is the first report in the Republic of Korea of tears draining from a lacrimal ductule fistula since birth and the subsequent clinical treatment procedures.
Ambulatory Care Facilities ; Anesthesia, General ; Congenital Abnormalities ; Drainage ; Eyelids ; Female ; Fistula ; Humans ; Infant ; Lacrimal Apparatus ; Parturition ; Pregnancy ; Recurrence ; Republic of Korea ; Skin ; Tears

Hemorrhagic cystitis is defined as diffuse mucosal inflammation of the urinary bladder that presents with gross hematuria. A variety of factors, including chemotherapeutic agents, radiation therapy and infection, can cause hemorrhagic cystitis. Among them, BK virus-associated hemorrhagic cystitis is common in patients who have undergone stem cell transplantation but relatively rare in kidney transplantation patients. Here, we present the case of a kidney-transplant patient with BK virus-associated hemorrhagic cystitis and interstitial nephritis who was successfully treated with leflunomide and ciprofloxacin.
BK Virus ; Ciprofloxacin ; Cystitis* ; Hematuria ; Humans ; Inflammation ; Kidney Transplantation ; Kidney* ; Nephritis, Interstitial ; Stem Cell Transplantation ; Urinary Bladder

Idiopathic pulmonary hemosiderosis (IPH) is a rare disease affecting mostly children. This disorder is characterized by recurrent episodes of hemoptysis, bilateral diffuse pulmonary infiltrates, and iron-deficiency anemia. An acute fulminant alveolar hemorrhage can be fatal due to respiratory failure, while chronic hemorrhage leads to hemosiderin-laden macrophages and pulmonary fibrosis. Genetic, autoimmune, allergic, environmental, and metabolic mechanisms of pathogenesis have been suggested, but the etiology of IPH remains unknown. We report on a 9-year-old girl with idiopathic pulmonary hemosiderosis who showed seasonal recurrences without cause.
Anemia, Iron-Deficiency ; Child ; Hemoptysis ; Hemorrhage ; Hemosiderosis ; Humans ; Lung Diseases ; Macrophages ; Pulmonary Fibrosis ; Rare Diseases ; Recurrence ; Respiratory Insufficiency ; Seasons