Disease outbreaks pose serious threats to humans, as highlighted by the recent pandemic, underscoring the need for an institutionalized multi-sectoral approach like One Health, encompassing human, animal, and environmental health. One Health has demonstrated efficacy in addressing emerging issues such as antimicrobial resistance and zoonotic disease spillover. While integrating the human-animal sector has yielded positive outcomes, the majority of zoonotic spillovers originate from wildlife, emphasizing the crucial role of environmental surveillance within global One Health systems. Additionally, climate change intensifies the frequency and emergence of infectious diseases and spillover events. Tackling the complexity and interconnectedness of health challenges necessitates integrated solutions that incorporate broader structural factors, aiding in the prevention, detection, and mitigation of disease outbreaks. Embracing One Health through multi-sectoral preparedness can effectively confront the escalating threats of pandemics and other emerging diseases.

Disease outbreaks pose serious threats to humans, as highlighted by the recent pandemic, underscoring the need for an institutionalized multi-sectoral approach like One Health, encompassing human, animal, and environmental health. One Health has demonstrated efficacy in addressing emerging issues such as antimicrobial resistance and zoonotic disease spillover. While integrating the human-animal sector has yielded positive outcomes, the majority of zoonotic spillovers originate from wildlife, emphasizing the crucial role of environmental surveillance within global One Health systems. Additionally, climate change intensifies the frequency and emergence of infectious diseases and spillover events. Tackling the complexity and interconnectedness of health challenges necessitates integrated solutions that incorporate broader structural factors, aiding in the prevention, detection, and mitigation of disease outbreaks. Embracing One Health through multi-sectoral preparedness can effectively confront the escalating threats of pandemics and other emerging diseases.

Disease outbreaks pose serious threats to humans, as highlighted by the recent pandemic, underscoring the need for an institutionalized multi-sectoral approach like One Health, encompassing human, animal, and environmental health. One Health has demonstrated efficacy in addressing emerging issues such as antimicrobial resistance and zoonotic disease spillover. While integrating the human-animal sector has yielded positive outcomes, the majority of zoonotic spillovers originate from wildlife, emphasizing the crucial role of environmental surveillance within global One Health systems. Additionally, climate change intensifies the frequency and emergence of infectious diseases and spillover events. Tackling the complexity and interconnectedness of health challenges necessitates integrated solutions that incorporate broader structural factors, aiding in the prevention, detection, and mitigation of disease outbreaks. Embracing One Health through multi-sectoral preparedness can effectively confront the escalating threats of pandemics and other emerging diseases.

Disease outbreaks pose serious threats to humans, as highlighted by the recent pandemic, underscoring the need for an institutionalized multi-sectoral approach like One Health, encompassing human, animal, and environmental health. One Health has demonstrated efficacy in addressing emerging issues such as antimicrobial resistance and zoonotic disease spillover. While integrating the human-animal sector has yielded positive outcomes, the majority of zoonotic spillovers originate from wildlife, emphasizing the crucial role of environmental surveillance within global One Health systems. Additionally, climate change intensifies the frequency and emergence of infectious diseases and spillover events. Tackling the complexity and interconnectedness of health challenges necessitates integrated solutions that incorporate broader structural factors, aiding in the prevention, detection, and mitigation of disease outbreaks. Embracing One Health through multi-sectoral preparedness can effectively confront the escalating threats of pandemics and other emerging diseases.

Disease outbreaks pose serious threats to humans, as highlighted by the recent pandemic, underscoring the need for an institutionalized multi-sectoral approach like One Health, encompassing human, animal, and environmental health. One Health has demonstrated efficacy in addressing emerging issues such as antimicrobial resistance and zoonotic disease spillover. While integrating the human-animal sector has yielded positive outcomes, the majority of zoonotic spillovers originate from wildlife, emphasizing the crucial role of environmental surveillance within global One Health systems. Additionally, climate change intensifies the frequency and emergence of infectious diseases and spillover events. Tackling the complexity and interconnectedness of health challenges necessitates integrated solutions that incorporate broader structural factors, aiding in the prevention, detection, and mitigation of disease outbreaks. Embracing One Health through multi-sectoral preparedness can effectively confront the escalating threats of pandemics and other emerging diseases.

Iatrogenic spinal epidermoid tumors are rare and implanted. Implanted skin fragment by trauma or lumbar puncture is thought to be a possible cause. Because of the lag in time between the lumbar puncture and the development of a symptomatic tumor, this relationship is usually overlooked and can cause a delay in diagnosis. We present a case of intraspinal epidermoid tumor developed 7 years after a lumbar puncture.
Diagnosis ; Skin ; Spinal Puncture

Background: Prevention of osteoporosis and bone fracture is one of the important issues for liver transplant recipients because a long history of liver disease and lifelong use of immunosuppressants, including corticosteroids, may cause these diseases. In this study, we aimed to analyze liver recipient bone status, 10-year fracture risk, and medication history. Methods: The electronic medical records of adult patients aged >40 years who received liver transplantation at Seoul National University Bundang Hospital between January 2009 and June 2017 were reviewed retrospectively. On the basis of their bone mineral density and fracture history, their fracture risks were analyzed using the Korean fracture risk assessment tool. Results: A total of 57 liver transplant recipients were treated with corticosteroids during a mean of 8.8 months after transplantation. 30 patients (52.6%) showed bone metabolism dysfunction such as osteopenia or osteoporosis. The 10-year femoral fracture risk was 2.1%, and dual-energy X-ray absorptiometry monitoring was performed, including right before liver transplantation every 27.5±19.2 months. The mean femoral bone mineral density decreased by −7.2%±7.3%. Four patients (7.0%) had a fracture after liver transplantation. Osteoporotic fracture occurred in 3 patients with osteoporosis (25.0%). Among the osteopenia patients with moderate fracture risk who were not treated with bisphosphonate, 1 patient (12.5%) had a history of bone fracture after liver transplantation. Conclusions Considering the deterioration of bone density and moderate fracture risk, medication for osteoporosis should be prescribed to liver transplant recipients with regular monitoring of bone density after transplantation.

Background: Prevention of osteoporosis and bone fracture is one of the important issues for liver transplant recipients because a long history of liver disease and lifelong use of immunosuppressants, including corticosteroids, may cause these diseases. In this study, we aimed to analyze liver recipient bone status, 10-year fracture risk, and medication history. Methods: The electronic medical records of adult patients aged >40 years who received liver transplantation at Seoul National University Bundang Hospital between January 2009 and June 2017 were reviewed retrospectively. On the basis of their bone mineral density and fracture history, their fracture risks were analyzed using the Korean fracture risk assessment tool. Results: A total of 57 liver transplant recipients were treated with corticosteroids during a mean of 8.8 months after transplantation. 30 patients (52.6%) showed bone metabolism dysfunction such as osteopenia or osteoporosis. The 10-year femoral fracture risk was 2.1%, and dual-energy X-ray absorptiometry monitoring was performed, including right before liver transplantation every 27.5±19.2 months. The mean femoral bone mineral density decreased by −7.2%±7.3%. Four patients (7.0%) had a fracture after liver transplantation. Osteoporotic fracture occurred in 3 patients with osteoporosis (25.0%). Among the osteopenia patients with moderate fracture risk who were not treated with bisphosphonate, 1 patient (12.5%) had a history of bone fracture after liver transplantation. Conclusions Considering the deterioration of bone density and moderate fracture risk, medication for osteoporosis should be prescribed to liver transplant recipients with regular monitoring of bone density after transplantation.

Purpose: The use of two adjacent radiation beams to treat a lesion that is larger than the maximum field of a machine may lead to higher or lower dose distribution at the junction than expected. Therefore, evaluation of the junction dose is crucial for radiotherapy. Volumetric modulated arc therapy (VMAT) can effectively protect surrounding normal tissues by implementing a complex dose distribution; therefore, two adjacent VMAT fields can effectively treat large lesions. However, VMAT can lead to significant errors in the junction dose between fields if setup errors occur due to its highly complex dose distributions. Methods: In this study, setup errors of ±1, ±3, and ±5 mm were assumed during radiotherapy for treating large lesions in the lower abdomen, and their effects on the treatment dose distribution and target coverage were analyzed using gamma pass rate (GP) and homogeneity index (HI). All studies were performed using a computational simulation method based on our radiation treatment planning software. Results: Consequently, when the setup error was more than ±3 mm, most GP values using a 3%/3-mm criterion decreased by <90%. GP was independent of the direction of the field gap (FG), whereas HI values were relatively more affected by negative values for FG. Conclusions Therefore, the size and direction of setup errors should be carefully managed when performing dual-isocentric VMATs for large targets.