The importance of tick-borne diseases is increasing because of climate change, with a lack of long-term studies on tick-borne pathogens in South Korea. To understand the epidemiological characteristics of tick-borne diseases, the monthly distribution of field ticks throughout the year was studied in South Korea between May 2014 and April 2018 in a cross sectional study.

Extrapleural hematoma results from blood accumulating between the parietal pleura and the endothoracic fascia, whereas hemothorax shows pooling in the pleural space. Extrapleural hematoma results from an intact parietal pleura that blocks blood from escaping the pleural cavity. Extrapleural fat, a fat layer outside the pleura in the chest wall between the parietal pleura and the endothoracic fascia, is pathognomonic on computed tomography. We diagnosed traumatic extrapleural hematoma and treated it with video-assisted thoracic surgery. We report here on this case along with a review of the literature.
Fascia ; Hematoma ; Hemothorax ; Pleura ; Pleural Cavity ; Thoracic Surgery, Video-Assisted ; Thoracic Wall ; Thoracoscopy ; United Nations

Kimura's disease is a rare benign disease characterized by subcutaneous or dermal tumors occurring predominantly on the head and the neck. It usually occurs in young adults without constitutional symptoms, except for peripheral blood eosinophilia. The histopathologic features of the tumor are characterized by dense lymphoid aggregates containing a prominent germinal center and by the proliferation of endothelial cells associated with varying degrees of lymphocytic, histiocytic, and eosinophilic infiltration. We report a case of Kimura's disease without peripheral blood eosinophilia in a 24-year-old male who had had a painless and slowly growing tumor-like swelling on his right groin for one year. The mass was excised, and the specimen was confirmed as Kimura's disease. After surgical excision, the lesion recurred, so 30 mg of oral prednisone was given daily for one month and then decreased gradually for another one month. Now, the lesion is completely healed.
Endothelial Cells ; Eosinophilia ; Eosinophils ; Germinal Center ; Groin* ; Head ; Humans ; Male ; Neck ; Prednisone ; Young Adult

Although the obstruction of the right colon is usually handled by primary anastomosis following resection, fear of the increased incidence of septic complication, especially anastomotic leakage with sepsis has turned surgeons away from doing anastomosis in the face of acute obstruction of the left colon. However, from recent reports, enough experiences have been accumulated to show that primary anastomosis is associated with minimum morbidity and mortality in the acute obstruction of the left colon. We experienced 54 cases of colon cancer obstruction at Holy Family Hospital from January 1988 to December 1997. Twenty six cases of them were right colon cancers, 24 cases were left colon cancers and 4 cases were rectal cancers. We reviewed these three groups for evaluation of the safety of one-stage resection and anastomosis of left colon cancer obstruction. The postoperative complication rate was 18% in right colon obstruction versus 38% in left colon obstruction. The most common complication was wound infection(43%). In using of primary resection and anastomosis, complication of right colon revealed 15% and left colon was 29%. But in a method of primary resection and anastomosis with decompression, complication of right colon was 17% and left colon was 13%. Especially on the left colon, primary resection and anastomosis with decompression revealed lower complication(13%) than that without decompression(67%). The mortality of colon cancer obstruction was 2% but this was a patient who had a poor general condition and took a primary resection and anastomosis without decompression. In cases of left colon cancer obstruction primary resection and anastomosis with decompression of left colon cancer obstruction can be a safe operation method with low morbidity and mortality.
Anastomotic Leak ; Colon* ; Colonic Neoplasms* ; Decompression ; Humans ; Incidence ; Mortality ; Postoperative Complications ; Rectal Neoplasms ; Sepsis ; Wounds and Injuries

Purpose: This literature review aimed to evaluate Cox’s interaction model of client health behavior (IMCHB) as used in studies on women’s health. Methods: Using keyword combinations of “women” and “IMCHB” or “interaction model of client health behavior,” we searched the PubMed, MEDLINE, Embase, and RISS databases for studies on the promotion of women’s health published from January 2009 to April 2019. Finally, 11 studies were selected and evaluated according to seven criteria for theory evaluation, which combined Fawcett’s theory evaluation criteria and Chinn and Kramer’s criteria. Results: We found that the IMCHB corresponds to a verifiable practical level of a middle-range theory, although it may be partially abstract. It contains all four concepts of the metaparadigm of nursing, in terms of a holistic philosophical approach. A theoretical evaluation demonstrated that the IMCHB has significance, generality, testability, empirical adequacy, and pragmatic adequacy for nursing practice and research. However, the lack of clear conceptual definitions and the presence of complex relationships among concepts resulted in a lack of internal consistency and parsimony. Conclusion According to an in-depth verification through a review of the literature, the IMCHB has been used as a health promotion intervention strategy for various populations of women and has led to useful results in nursing practice. The IMCHB was confirmed to be a suitable theory for experimental and clinical research. Future research can build on this middle-range theory for women’s health research and practice.

PURPOSE: Cervical necrotizing fasciitis tends to involve the deep soft tissues and spread caudally to the anterior chest and mediastinum, often resulting in major complications and death. It may rapidly spread into the thorax along fascial planes, and the associated diagnostic delay results in this descending necrotizing mediastinitis. So, aggressive multidisciplinary therapy with surgical drainage is mandatory. We present a very rare case of descending necrotizing mediastinitis with literature review. METHODS: A 53 years old male visited our department 7 days after trauma in neck. His premorbid conditions and risk factors of necrotizing fasciitis were concealed hepatoma, trauma history, chronic liver disease, and nutrition deficit. Computed tomographic scans of the head and neck region were performed in this patient: signs of necrotizing fasciitis, were seen in the platysma, sternocleidomastoid, trapezius muscle and strap muscles of the neck. Fluid accumulations involved multiple neck spaces and mediastinum. At the time, he diagnosed as necrotizing fasciitis on his neck and anterior chest. Necrotic wound was excised serially and we treated this with the Vacuum-assisted closure (VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge and achieving additional 3 pieces drainage tubes in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was applied for a period of 12 days. RESULTS: We obtained satisfactory results from wide excision, abscess drainage with the VAC system, and then split thickness skin graft. The postoperative course was uneventful. CONCLUSION: The refined technique using the VAC system can provide a means of simple and effective management for the descending necrotizing mediastinitis, with better cosmetic and functional results. Finally, the VAC system has been adopted as the standard treatment for deep cervical and mediastinal wound infections as a result of the excellent clinical outcome.
Abscess ; Carcinoma, Hepatocellular ; Cosmetics ; Drainage ; Fasciitis, Necrotizing ; Head ; Humans ; Kinetics ; Liver Diseases ; Male ; Mediastinitis ; Mediastinum ; Muscles ; Neck ; Negative-Pressure Wound Therapy ; Porifera ; Risk Factors ; Skin ; Thorax ; Transplants ; Wound Infection

Recent reports have noted the increase of and questioned the justification for cesarean section rate in the past decade. This study was carried out retrospectively based on the clinical charts of 510 patients who had been performed cesarean section among 3,357 deliveries at Yeungnam University Hospital from May, 9, 1983 through Nov., 30, 1986. The results were as follows 1. Overall incidence of cesarean section was 15.7% of total deliveries. Of these, 10.9% were by primary cesarean section and 4.7% by repeat operation. There has been a gradual increase in the cesarean section rate. 2. In the distribution of age, the 26-30 aged group was the most prevalent (60.2%). 3. The most common indications for cesarean section were previous cesarean section (30.2%), CPD (26.9%), malpresentation (22.7%), and fetal distress (3.5%). In primipara, CPD was the most frequent and in multipara malpresentation. 4. A great proportion (31.6%) was done at 40th gestational week. 5. In the weight distribution of infants, the group of 3,000-3,499 gm was the most prevalent (39.8%), premature baby was 9.1%, and giant baby was 5.6%. 6. In the type of operation, lower segment transverse cesarean section was the most (97.5%). 7. In the combined surgery, sterilization was the most prevalent and the next was ovarian cystectomy, hysterectomy, and myomectomy in order. 8. In the type of the anesthesia, general anesthesia was 83.5%. 9. Maternal morbidity was 14.7. Among the cause of this morbidity, wound infection was the most and the next was urinary tract infection, fever of unknown origin. and atonic bleeding in order. 10. It was found that 18.4% was maternal morbidity in the patients below 10 gm Hb. In this group, maternal morbidity was markedly increased as the level of Hb was decreased. 11. Maternal morbidity was increased as the duration of ruptured membrane was prolonged. In the group of over 24 hours after rupture of membrane, it was markedly increased (44.4%). 12. Maternal morbidity was increased as the duration of labor was prolonged. In the group of over 12 hours after the onset of labor, it was 24.6%. 13. Maternal morbidity of lower segment transverse cesarean section was the least (14.1%). 14. Maternal morbidity of emergency cesarean section was about two times as much as elective cesarean section.
Anesthesia ; Anesthesia, General ; Cesarean Section* ; Cystectomy ; Emergencies ; Female ; Fetal Distress ; Fever of Unknown Origin ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Infant ; Membranes ; Pregnancy ; Retrospective Studies ; Rupture ; Sterilization ; Urinary Tract Infections ; Wound Infection

PURPOSE: Cost-effectiveness of myocardial SPECT f'or the diagniosis of coronary artery disease was investigated considering the present and amended costs of myocardial SPECT and exercise ECG in Korea. MATERIALS AND METHODS: Four diagnostic tactics such as 1) coronary angiography (CAG) after exercise ECG, 2) CAG after myocardial SPECT, 3) direct CAG, and 4) CAG after myocardial SPECT following exercise ECG were chosen. Costs were calculated using the present costs of various tests and effects represented by Quality Adjusted Life Year (QALY) were estimated. Difference of QALY (deltaQALY) was calculated by subtracting QALY of diagnosed/treated cases from QALY of undiagnosed cases, Cost/delta QALY was calculated and compared between four different tactics according to pre-test probability, RESULTS: When pre-test probability was equal to or larger than 0.6, direct CAG was the most cost-effective. When pre-test probability was between 0.2 and 0.6, CAG after myocardial SPECT following exercise ECG was the most cost-effective. CAG after myocardial SPECT was the second most cost-effective. Cost-effectiveness was similar when the costs of exercise ECG were doubled or quadrupled. CAG after exercise ECG was always the least cost-effective, CONCLUSION: Myocardial SPECT with or without preceding exercise ECG was the most cost-effective method to diagnose coronary artery disease in the present or expected amended cost system.
Coronary Angiography* ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Electrocardiography* ; Korea* ; Perfusion* ; Quality-Adjusted Life Years ; Tomography, Emission-Computed, Single-Photon*

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology. Non-steroidal anti-inflammatory drugs (NSAIDs), steroids, disease modifying anti-rheumatic drugs (DMARDs), immunosuppressives and intravenous immunoglobulin (IVIG) have been used to control the disease. It was suggested that several pro-inflammatory cytokines, such as interleukin (IL)-6, IL-8, IL-18, and tumor necrosis factor (TNF)-alpha, play an important role in its pathogenesis. Recent reports showed the clinical effectiveness of TNF-alpha blockers (infliximab and etanercept) in refractory AOSD. We report a case successfully treated with etanercept in the early AOSD refractory to the combination therapy of high-dose prednisolone and cyclosporine (CSA).
Antirheumatic Agents ; Cyclosporine ; Cytokines ; Etanercept ; Humans ; Immunoglobulins ; Interleukin-18 ; Interleukin-8 ; Interleukins ; Prednisolone ; Steroids ; Still's Disease, Adult-Onset* ; Tumor Necrosis Factor-alpha

PURPOSE: The lack of identified mammalian target of rapamycin (mTOR) pathway downstream genes that overcome cross-talk in nonmuscle invasive low grade (LG)-urothelial carcinoma (UC) of the bladder is a clinical limitation in the use of mTOR inhibitor for the treatment of UC. MATERIALS AND METHODS: Presently, gene expression patterns, gene ontology, and gene clustering by dual (p70S6K and S6K) siRNAs or rapamycin in 253J and TR4 cell lines were investigated by microarray analysis. mTOR/S6K pathway downstream genes suppressed to siRNAs, and rapamycin up-regulated or rapamycin down-regulated genes were identified. The mTOR downstream genes examined using a tissue microarray of 90 nonmuscle invasive LG-UC patients to assess whether any of these genes predicted clinical outcomes. A knockout study evaluated the synergistic effect with rapamycin. RESULTS: In the microarray analysis, mTOR pathway downstream genes selected consisted of 4 rapamycin down-regulated (FOXM1, KIF14, MYBL2, and UHRF1), and 4 rapamycin up-regulated (GPR87, NBR1, VASH1, and PRIMA1). In the tissue microarray, FOXM1, KIF14, and NBR1 were more expressed at T1, and MYBL2, and PRIMA1 were more expressed in tumors exceeding 3 cm. In a multivariate Cox regression model, KIF14 and NBR1 were significant predictors of recurrence in nonmuscle invasive LG-UC of the bladder. In a NBR1 knock out model, rapamycin treatment synergistically inhibited cell viability and colony forming ability compared to rapamycin only. CONCLUSIONS: The results implicate KIF14 and NBR1 as mTOR/S6K pathway downstream genes that predict recurrence in nonmuscle invasive LG-UC of the bladder and demonstrate that NBR1 knockout overcomes rapamycin cross-talk.
Biomarkers ; Cell Line ; Cell Survival ; Gene Expression ; Gene Ontology ; Humans ; Microarray Analysis ; Recurrence* ; RNA, Small Interfering ; Sirolimus* ; Urinary Bladder Neoplasms ; Urinary Bladder*