Background: The quality-of-life of patients with irritable bowel syndrome is low; incorrect diagnosis/treatment causes economic burden and inappropriate consumption of medical resources. This survey-based study aimed to analyze the current status of irritable bowel syndrome treatment to examine differences in doctors’ perceptions of the disease, and treatment patterns. Methods: From October 2019 to February 2020, the irritable bowel syndrome and Intestinal Function Research Study Group of the Korean Society of Neurogastroenterology and Motility conducted a survey on doctors working in primary, secondary, and tertiary healthcare institutions. The questionnaire included 37 items and was completed anonymously using the NAVER platform (a web-based platform), e-mails, and written forms. Results: A total of 272 doctors responded; respondents reported using the Rome IV diagnostic criteria (amended in 2016) for diagnosing and treating irritable bowel syndrome.Several differences were noted between the primary, secondary, and tertiary physicians’ groups. The rate of colonoscopy was high in tertiary healthcare institutions. During a colonoscopy, the necessity of random biopsy was higher among physicians who worked at tertiary institutions. ‘The patient did not adhere to the diet’ as a reason for ineffectiveness using low-fermentable oligo-, di-, and mono-saccharides, and polyols diet treatment was higher among physicians in primary/secondary institutions, and ‘There are individual differences in terms of effectiveness’ was higher among physicians in tertiary institutions. In irritable bowel syndrome constipation predominant subtype, the use of serotonin type 3 receptor antagonist (ramosetron) and probiotics was higher in primary/secondary institutions, while serotonin type 4 receptor agonist was used more in tertiary institutions. In irritable bowel syndrome diarrhea predominant subtype, the use of antispasmodics was higher in primary/secondary institutions, while the use of serotonin type 3 receptor antagonist (ramosetron) was higher in tertiary institutions. Conclusion Notable differences were observed between physicians in primary/secondary and tertiary institiutions regarding the rate of colonoscopy, necessity of random biopsy, the reason for the ineffectiveness of low-fermentable oligo-, di-, and mono-saccharides, and polyols diet, and use of drug therapy in irritable bowel syndrome. In South Korea, irritable bowel syndrome is diagnosed and treated according to the Rome IV diagnostic criteria, revised in 2016.

BACKGROUND: Hepatocellular carcinoma (HCC) recurrence and development of de novo malignancy (DNM) after liver transplantation (LT) are the major causes of late recipient death. METHODS: We analyzed the incidence of extrahepatic DNM following living donor LT according to the status of pretransplant hepatic malignancy. We selected 2,076 adult patients who underwent primary LDLT during 7 years from January 2010 to December 2016. RESULTS: The pretransplant hepatic malignancy group (n = 1,012) showed 45 cases (4.4%) of the following extrahepatic DNMs: posttransplant lymphoproliferative disease (PTLD) in 10; lung cancer in 10; stomach cancer in 6; colorectal cancer in 5; urinary bladder cancer in 3; and other cancers in 11. The pretransplant no hepatic malignancy group (n = 1,064) showed 25 cases (2.3%) of the following extrahepatic DNMs: colorectal cancer in 3; stomach cancer in 3; leukemia in 3; lung cancer in 3; PTLD in 2; prostate cancer in 2; and other cancers in 9. Incidences of extrahepatic DNM in the pretransplant hepatic malignancy and no hepatic malignancy groups were as follows: 1.1% and 0.5% at 1 year, 3.2% and 2.0% at 3 years, 4.6% and 2.5% at 5 years, and 5.4% and 2.8% at 8 years, respectively (P = 0.006). Their overall patient survival rates were as follows: 97.3% and 97.2% at 1 year, 91.6% and 95.9% at 3 years, 89.8% and 95.4% at 5 years, and 89.2% and 95.4% at 8 years, respectively (P < 0.001). Pretransplant hepatic malignancy was the only significant risk factor for posttransplant extrahepatic DNM. CONCLUSION Our results suggest that patients who had pretransplant hepatic malignancy be followed up more strictly because they have a potential risk of primary hepatic malignancy recurrence as well as a higher risk of extrahepatic DNM than patients without pretransplant hepatic malignancy.

PURPOSE: Hepatorenal syndrome (HRS) is a fatal complication in patients with end-stage liver disease awaiting liver transplantation (LT). HRS often develops in patients with high model for end-stage liver disease (MELD) score. This study investigated the outcomes of peritransplant management of HRS in a high-volume LT center in Korea for 2 years. METHODS: A total of 157 recipients that deceased donor liver transplantation (DDLT) from January 2017 to December 2018 were included. In-hospital mortality (IHM) was analyzed in relation to pre- and posttransplant application of renal replacement therapy (RRT). RESULTS: Primary diagnoses for DDLT were alcoholic liver disease (n = 61), HBV-associated liver cirrhosis (n = 48), retransplantation for chronic graft failure (n = 24), and others (n = 24). Mean MELD score was 34.6 ± 6.2 with 72 patients at Korean Network for Organ Sharing MELD status 2 (45.9%), 43 at status 3 (27.4%), 36 at status 4 (22.9%), and 6 at status 5 (3.8%). Pretransplant RRT was performed in 16 patients (10.2%) that did not show IHM. Posttransplant RRT was performed in 69 patients (44.0%), for whom IHM incidence was 15.9%. In 53 patients that had undergone de novo posttransplant RRT, IHM incidence increased to 20.8%. IHM in the 88 patients not requiring RRT was 2.3%. CONCLUSION The majority of adult DDLT recipients in Korean MELD score-based allocation system have very high MELD scores, which is often associated with HRS. Pretransplant RRT appears to improve posttransplant survival outcomes. We thereby recommend that, if indicated, pretransplant RRT be performed while awaiting DDLT.

BACKGROUND: Hepatocellular carcinoma (HCC) recurrence and development of de novo malignancy (DNM) after liver transplantation (LT) are the major causes of late recipient death.METHODS: We analyzed the incidence of extrahepatic DNM following living donor LT according to the status of pretransplant hepatic malignancy. We selected 2,076 adult patients who underwent primary LDLT during 7 years from January 2010 to December 2016.RESULTS: The pretransplant hepatic malignancy group (n = 1,012) showed 45 cases (4.4%) of the following extrahepatic DNMs: posttransplant lymphoproliferative disease (PTLD) in 10; lung cancer in 10; stomach cancer in 6; colorectal cancer in 5; urinary bladder cancer in 3; and other cancers in 11. The pretransplant no hepatic malignancy group (n = 1,064) showed 25 cases (2.3%) of the following extrahepatic DNMs: colorectal cancer in 3; stomach cancer in 3; leukemia in 3; lung cancer in 3; PTLD in 2; prostate cancer in 2; and other cancers in 9. Incidences of extrahepatic DNM in the pretransplant hepatic malignancy and no hepatic malignancy groups were as follows: 1.1% and 0.5% at 1 year, 3.2% and 2.0% at 3 years, 4.6% and 2.5% at 5 years, and 5.4% and 2.8% at 8 years, respectively (P = 0.006). Their overall patient survival rates were as follows: 97.3% and 97.2% at 1 year, 91.6% and 95.9% at 3 years, 89.8% and 95.4% at 5 years, and 89.2% and 95.4% at 8 years, respectively (P < 0.001). Pretransplant hepatic malignancy was the only significant risk factor for posttransplant extrahepatic DNM.CONCLUSION: Our results suggest that patients who had pretransplant hepatic malignancy be followed up more strictly because they have a potential risk of primary hepatic malignancy recurrence as well as a higher risk of extrahepatic DNM than patients without pretransplant hepatic malignancy.

No abstract available.
Anemia, Sideroblastic* ; High-Throughput Nucleotide Sequencing* ; Humans ; Infant* ; Male*

Extra ventricular neurocytoma (EVN) is a rare brain tumor with histologic features similar with a central neurocytoma, but located outside of the ventricular system. In this study, we present an unusual case of hypothalamic EVN in a 14-year-old patient. The patient underwent subtotal removal and had tumor relapse. The patient was then treated using intensity modulated radiation therapy, and the tumor remained stable for 24 months. This case report may be important in that this is the first pediatric case of EVN located in the hypothalamic region. EVN has similar radiologic features with pilocytic astrocytomas and therefore a hypothalamic EVN may be misdiagnosed as a hypothalamic glioma. Also, the pathologic-radiologic-clinical correlation of EVN located in the hypothalamic area may be different from that of EVNs originating from other usual sites.
Adolescent ; Astrocytoma ; Brain Neoplasms ; Glioma ; Humans ; Hypothalamic Neoplasms ; Neurocytoma* ; Radiotherapy, Adjuvant* ; Recurrence

Extra ventricular neurocytoma (EVN) is a rare brain tumor with histologic features similar with a central neurocytoma, but located outside of the ventricular system. In this study, we present an unusual case of hypothalamic EVN in a 14-year-old patient. The patient underwent subtotal removal and had tumor relapse. The patient was then treated using intensity modulated radiation therapy, and the tumor remained stable for 24 months. This case report may be important in that this is the first pediatric case of EVN located in the hypothalamic region. EVN has similar radiologic features with pilocytic astrocytomas and therefore a hypothalamic EVN may be misdiagnosed as a hypothalamic glioma. Also, the pathologic-radiologic-clinical correlation of EVN located in the hypothalamic area may be different from that of EVNs originating from other usual sites.
Adolescent ; Astrocytoma ; Brain Neoplasms ; Glioma ; Humans ; Hypothalamic Neoplasms ; Neurocytoma* ; Radiotherapy, Adjuvant* ; Recurrence

PURPOSE: To evaluate the 12-month outcomes of anti-vascular endothelial growth factor (VEGF) treatment for patients with retinal angiomatous proliferation (RAP). METHODS: Retrospective review of medical records was performed for 33 patients (33 eyes) who were diagnosed with RAP. All patients were initially treated with three consecutive intravitreal anti-VEGF injections after diagnosis. Additional treatment was performed when the recurrence of exudation was noted. The best-corrected visual acuity (BCVA) was measured before the first injection and at 3, 6, and 12 months after the first injection. The value measured before the treatment was compared with those measured after treatment. RESULTS: The patients received an average of 4.2 +/- 1.7 intravitreal anti-VEGF injections during the 12-month follow-up period. The logarithm of minimal angle of resolution (log MAR) values of BCVA before the first injection and at 3, 6, and 12 months after the first injections were 0.76 +/- 0.49, 0.55 +/- 0.35, 0.67 +/- 0.41, and 0.70 +/- 0.50, respectively. BCVA was significantly improved at 3 and 6 months (p < 0.001 and p = 0.037) compared to that measured before the first injection. However, there was no significant difference between BCVA before the first injection and 12 months after the first injection (p = 0.590). At 12 months of follow-up, 29 eyes (87.9%) showed stable (<2 log MAR lines of change) or improved (> or =2 log MAR lines of improvement) BCVA. CONCLUSIONS: Anti-VEGF therapy was found to be beneficial in both normalizing macular thickness and in improving or maintaining visual acuity in the majority of patients with RAP.
Diagnosis ; Endothelial Growth Factors* ; Follow-Up Studies ; Humans ; Medical Records ; Recurrence ; Retinaldehyde* ; Retrospective Studies ; Visual Acuity

Adipose Tissue ; Adult ; Ascorbic Acid ; Bone Development ; Bone Marrow ; Cell Culture Techniques ; Cell Separation ; Collagen ; Collagenases ; Drug Combinations ; Durapatite ; Endothelial Cells ; Epidermal Growth Factor ; Flow Cytometry ; Heparin ; Humans ; Hydrocortisone ; Laminin ; Magnetics ; Magnets ; Mesenchymal Stromal Cells ; Microspheres ; Nylons ; Osteoblasts ; Osteotomy, Sagittal Split Ramus ; Prognathism ; Proteoglycans ; Skin ; Stem Cells ; Vascular Endothelial Growth Factor A

Use of electric pulp testing elicits painful response in vital teeth. In this study, we examined the excessive time from pain feeling to stimulation disconnection in clinical situation. D626D (Parkell Inc., USA.) scan type electric pulp tester was used in total of 23 young healthy individuals. Each of the right central incisors and first premolars were used as testing teeth. Stimulation disconnection was achieved by EMG in anterior belly of digastric muscle, finger span, and voice and the excessive stimulation time over the sensory threshold was recorded. As a result, we found that the short responses before the stimulation disconnection appeared following order; EMG, finger span, and voice. The EMG disconnection is suggested to be used to reduce the excessive stimulus time in electric pulp testing.
Bicuspid ; Fingers ; Incisor ; Sensory Thresholds* ; Tooth ; Voice