PURPOSE: The purpose of this study is to understand the level of fatigue and daily living activities and to confirm their relationship in patients with chronic liver disease. METHOD: The sample consisted of 182 patients with chronic liver disease with a mean age of 42.4 years, who visited the D University Hospital and a S clinic from February, 2004 to March in 2004. Data were collected by a self reporting questionnaire on the selected variables such as fatigue and daily life activities. Collected data were analyzed by using SPSS program for descriptive statistics, Pearson's correlation coefficients, t- test, ANOVA. RESULTS: Subjects showed the mild level of fatigue and slightly high level of daily living activities. They also showed a negative relationship between fatigue and daily living activities. CONCLUSION: It is necessary to develop nursing intervention program to reduce the level of fatigue for improving the level of daily living activities in patients with chronic liver disease.
Activities of Daily Living* ; Fatigue* ; Humans ; Liver Diseases* ; Liver* ; Nursing ; Surveys and Questionnaires ; Self Report

A 66-year-old woman was referred for treatment of incidental detection of two intracranial aneurysms. Time-of-flight MR angiography (TOF MRA) revealed two aneurysms at the M1 segment of the right middle cerebral artery, and clinoid segment of left internal carotid artery, respectively. On digital subtraction angiography, there was a saccular aneurysm on the left internal carotid artery, but the other aneurysm was not detected on the right middle cerebral artery. Based on comprehensive review of imaging findings, organized thrombosed aneurysm was judged as the most likely diagnosis. In the presented report, magnetization transfer (MT) pulse to TOF MRA was used, to differentiate aneurysm-mimicking lesion on TOF MRA. We report that MT technique could be effective in differentiating true aneurysm, from possible T1 high signal artifact on TOF MRA.
Aged ; Aneurysm ; Angiography ; Angiography, Digital Subtraction ; Artifacts ; Carotid Artery, Internal ; Diagnosis ; Female ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery

PURPOSE: To evaluate the clinical significance of T1 high signal intensity on the globus pallidus as a predictor of severe hepatic encephalopathy in patients with acute-on-chronic liver failure (ACLF), which is a distinct syndrome characterized by multi-organ dysfunction including cerebral failure. MATERIALS AND METHODS: From January 2002 to April 2014, we retrospectively reviewed the magnetic resonance imaging (MRI) findings and clinical and magnetic resonance (MR) features of 74 consecutive patients (44 men and 30 women; mean age, 59.5 years) with liver cirrhosis. The chronic liver failure-sequential organ failure assessment score was used to diagnose ACLF. The pallidal index (PI), calculated by dividing the mean signal intensity of the globus pallidus by that of the subcortical frontal white matter were compared according to ACLF. The PI was compared with the Model for End-Stage Liver Disease (MELD) score in predicting the development of ACLF. RESULTS: Fifteen patients who were diagnosed with ACLF had higher hepatic encephalopathy grades (initial, P = 0.024; follow-up, P = 0.002), MELD scores (P < 0.001), and PI (P = 0.048). In the ACLF group, the mean PI in patients with cerebral failure was significantly higher than that in the patients without cerebral failure (1.33 vs. 1.20, P = 0.039). In patients with ACLF, the area under the curve (AUC) for PI was 0.680 (95% confidence intervals [CI], 0.52–0.85), which was significantly lower than that for the MELD score (AUC, 0.88; 95% CI, 0.77–0.99) (P = 0.04). CONCLUSION: The PI can be an ancillary biomarker for predicting the development of ACLF and severe hepatic encephalopathy.
Acute-On-Chronic Liver Failure ; Female ; Follow-Up Studies ; Globus Pallidus ; Hepatic Encephalopathy* ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; White Matter

PURPOSE: To evaluate the clinical significance of T1 high signal intensity on the globus pallidus as a predictor of severe hepatic encephalopathy in patients with acute-on-chronic liver failure (ACLF), which is a distinct syndrome characterized by multi-organ dysfunction including cerebral failure. MATERIALS AND METHODS: From January 2002 to April 2014, we retrospectively reviewed the magnetic resonance imaging (MRI) findings and clinical and magnetic resonance (MR) features of 74 consecutive patients (44 men and 30 women; mean age, 59.5 years) with liver cirrhosis. The chronic liver failure-sequential organ failure assessment score was used to diagnose ACLF. The pallidal index (PI), calculated by dividing the mean signal intensity of the globus pallidus by that of the subcortical frontal white matter were compared according to ACLF. The PI was compared with the Model for End-Stage Liver Disease (MELD) score in predicting the development of ACLF. RESULTS: Fifteen patients who were diagnosed with ACLF had higher hepatic encephalopathy grades (initial, P = 0.024; follow-up, P = 0.002), MELD scores (P < 0.001), and PI (P = 0.048). In the ACLF group, the mean PI in patients with cerebral failure was significantly higher than that in the patients without cerebral failure (1.33 vs. 1.20, P = 0.039). In patients with ACLF, the area under the curve (AUC) for PI was 0.680 (95% confidence intervals [CI], 0.52–0.85), which was significantly lower than that for the MELD score (AUC, 0.88; 95% CI, 0.77–0.99) (P = 0.04). CONCLUSION: The PI can be an ancillary biomarker for predicting the development of ACLF and severe hepatic encephalopathy.
Acute-On-Chronic Liver Failure ; Female ; Follow-Up Studies ; Globus Pallidus ; Hepatic Encephalopathy* ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Magnetic Resonance Imaging ; Male ; Retrospective Studies ; White Matter

OBJECTIVES: To summarize the evidence regarding the association of parity and breast feeding duration with the risk of osteoporosis in postmenopausal Korean women. This was because studies have been inconsistent regarding the effect of parity and breast feeding duration on the risk of osteoporosis. METHODS: A systematic literature search of relevant studies published by December 26, 2018 was conducted in PubMed, EMBASE, the Cochrane Library, CINAHL, RISS, KISS, KMbase, and KoreaMed. Outcome estimates of odds ratio (OR) or standardized mean difference were pooled with fixed or random-effect model. In case of heterogeneity, subgroup analysis was conducted. RESULTS: Seven cross-sectional studies (with 3,813 subjects) were included in the analysis. OR for osteoporosis was 1.43 (95% confidence interval [CI] = 1.09–1.88, P = 0.010) in postmenopausal women with higher parity compared to those with less parity. Moreover, OR for osteoporosis was 1.93 (95% CI = 1.28–2.93, P = 0.002) in postmenopausal women with longer durations of breast feeding than in those with shorter durations of breast feeding. CONCLUSIONS: This study revealed that duration of breast feeding increased the risk of osteoporosis in postmenopausal Korean women. More cohort studies with high quality research designs are needed to confirm our results.
Bone Density ; Breast Feeding ; Breast ; Cohort Studies ; Cross-Sectional Studies ; Female ; Humans ; Odds Ratio ; Osteoporosis ; Parity ; Population Characteristics ; Postmenopause ; Research Design

PURPOSE: We wanted to evaluate the efficacy of MIPO (minimal invasive plate osteosynthesis) technique by LCP (locking compression plate) for treating proximal tibia fractures. MATERIALS AND METHODS: Twenty-three patients, who had operation due to proximal tibia fracture and available for follow up for more than 1 year were included in this study. Cause of injury and accompanied injuries were checked. Operation time, period to bone union, range of joint motion and alignment were evaluated with complications. RESULTS: Mean bone union time was 13.7 weeks (10~20). Twenty-one cases of the patients showed angulation of less than 5 degrees and 17 cases had normal range of motion. Five cases showed skin irritation by the plate and 2 cases had superficial infection. CONCLUSION: LCP by MIPO technique for treating proximal tibia fracture showed excellent results. Delicate technique is required for the proper adjustment of LCP and the alignment of the lower leg.
Follow-Up Studies ; Humans ; Joints ; Leg ; Reference Values ; Skin ; Tibia

Purpose: To evaluate outcomes and complications after traumatic posterior hip fractures and dislocations classified according to the Thompson-Epstein system. Materials and Methods: Thirty-five cases were selected from among the patients we treated between January 2000 and December 2005. According to Thompson-Epstein classification, 5 cases were type I, 7 cases were type II, 5 cases were type III, 8 cases were type IV, and 10 cases were type V. The mean age at the time of injury was 41 years (range: 19~72 years). Twenty-six patients were men, and 9 patients were women. The mechanisms of injury included traffic accidents in 30 cases and falls in 5 cases. The mean follow-up period was 31 months (range: 13~86 months). Fracture reduction was achieved within 6 hours in 32 cases. Thirty-four patients underwent closed reduction, and 22 of these patients were treated using Allis'method. Results: All Thompson-Epstein type I fractures were managed with closed reduction. Two type II fractures were treated conservatively, and 4 were treated with open reduction and internal fixation. All 13 type III and IV fractures were treated using open reduction and internal fixation. Six type V fractures were treated conservatively, 4 were treated with open reduction and internal fixation, and 1 was treated using total hip arthroplasty. Posttraumatic arthritis was observed in 9 cases, 7 of which were Thompson-Epstein type IV. Avascular necrosis (AVN) of the femoral head and deep vein thrombosis were observed in 1 case. Sciatic nerve injury was seen in 5 cases. Conclusion: Complications often occur in Thompson-Epstein type IV fractures. We believe that early, appropriate anatomical reduction helps to improve outcomes.
Arthritis ; Arthroplasty ; Dislocations ; Female ; Follow-Up Studies ; Head ; Hip ; Hip Fractures ; Humans ; Male ; Necrosis ; Sciatic Nerve ; Venous Thrombosis

Background: The Wnt signaling pathway regulates crucial cellular processes, including stem cell development and tissue repair. Dysregulation of this pathway, particularly β-catenin stabilization, is linked to colorectal carcinoma and other tumors. Axin2, a critical component in the pathway, plays a role in β-catenin regulation. This study examines Axin2 expression in normal gastric mucosa and various gastric pathologies. Methods: Formalin-fixed and paraffin-embedded tissue samples from normal stomach, gastritis, intestinal metaplasia (IM), and gastric carcinoma were collected. Axin2 and β-catenin expression were evaluated using RNA in situ hybridization and immunohistochemistry, respectively. Histo-scores (H-scores) were calculated to quantify expression levels of Axin2. Associations between Axin2 expression and clinicopathological variables were examined. Results: Axin2 expression was examined in normal stomach, gastritis, and IM tissues. Axin2 expression was mainly observed in the surface and isthmus areas in the normal stomach and gastritis, whereas Axin2 expression was markedly higher at the bases of IM. Axin2 H-scores were significantly elevated in IM (mean ± standard deviation [SD], 87.0 ± 38.9) compared to normal (mean ± SD, 18.0 ± 4.5) and gastritis tissues (mean ± SD, 33.0 ± 18.6). In total, 30% of gastric carcinomas showed higher Axin2 expression. Axin2 expression did not have significant associations with age, sex, Lauren classification, histological differentiation, invasion depth, and lymph node metastasis. However, a strong positive correlation was observed between Axin2 and nuclear β-catenin in gastric carcinomas (p < .001). Conclusions Axin2 expression was significantly increased in IM compared to normal and gastritis cases. In addition, Axin2 showed a strong positive association with nuclear β-catenin expression in gastric carcinomas, demonstrating a close relationship with abnormal Wnt/β-catenin signaling pathway.

Acquired perforating dermatosis (APD) triggers severe itching, and is observed most often in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). Various treatments, such as topical steroids, topical and oral retinoids, allopurinol, and ultraviolet B (UVB) phototherapy, have been used. However, as the precise etiology is unknown, there are a lack of well-established treatment guidelines. We report a peritoneal dialysis patient with a diagnosis of APD who was resistant to topical steroids, phototherapy, allopurinol, and topical retinoids. Severe pruritus persisted, which compromised his ability to lead a normal life. As a final treatment option, we used oral isotretinoin and the patient experienced a dramatic improvement.