No abstract available.

No abstract available.
Nephrotic Syndrome*

Twenty-five cases of minimal change nephrotic syndrome(minimal change disease, MCD) with mesangial IgA deposition were evaluated electron microscopically. The thickness of the glomerular basement membrane(GBM) was 3875 +/- 1271 A and 3056 +/- 1201 A in adults and children, respectively. Alteration of the GBM was noted in 3 adults and eight children: splitting in 4, focal thinning in one, widening of the lamina rara interna in 10, and widening of the lamina rara externa in 4 cases. Minimal mesangial electron dense deposits were found in all but one adult, and an increase of the mesangial matrix and minimal mesangial proliferation were observed in 8 and 6 cases, respectively. Electron microscopic findings show representative findings of MCD in our cases. A relationship between the GBM alterations in these cases and frequent association of hematuria is suggested and discussed.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Glomerular Mesangium/*metabolism ; Human ; Immunoglobulin A/*metabolism

No abstract available.
Trichosporon*

Endoscopic injection sclerotheraphy(EIS) was an effective method for treatment of bleeding esophageal varices. However, it might be associated with some undesirable complications. Endoscopic variceal ligation(EVL) is a recently developed method for control of active variceal bleeding and eradicating esophageal varices with similar efficacy and minimal risk of complications compare to EIS. We performed EVL in 40 patients who had recently bled from esophageal varices. Total 198 variceal ligations were performed during 64 separate EVL session. Control rate of acute bleeding was 90%(36 of 40patients) and 4 patients died after EVL because of failure of bleeding control. Rebleeding following initiation of EVL occured in 5 patients-three patients were successfully controlled by EVL, one patient was controlled but eradication was impossible and one patient died. Varices were eradicated or reduced to grade I in 31(86.1%) of 36 survivors by 1-9 ligation(mean 5.0) in l-4 EVL sessions(mean 1.6). After EVL, there were mild complications-mild substernal discomfort in 4 patients, mild dysphagia in 2 patients and fever in 2 patients. These results suggest that EVL is a safe and effective method for treatment of bleeding and eradication of esophageal varices with less complication.
Deglutition Disorders ; Esophageal and Gastric Varices* ; Fever ; Hemorrhage* ; Humans ; Ligation* ; Survivors ; Varicose Veins

No abstract available.
Nephritis, Hereditary*

Background: Several studies have recently suggested that liver disease and cirrhosis were risk factors for poor outcomes in patients with coronavirus disease 2019 (COVID-19) infections.However, no large data study has reported the clinical course of COVID-19 patients with chronic hepatitis B virus (HBV) infections. This study investigated whether HBV infection had negative impacts on the clinical outcomes of COVID-19 patients. Methods: We performed a nationwide population-based cohort study with 19,160 COVID-19-infected patients in 2020 from the Korean Health Insurance Review and Assessment database. The clinical outcomes of COVID-19 patients with chronic HBV infections were assessed and compared to those of non-HBV-infected patients. Results: Of the 19,160 patients diagnosed with COVID-19, 675 (3.5%) patients had chronic HBV infections. The HBV-infected patients were older and had more commodities than the non-HBV infected COVID-19 patients. During the observation period, COVID-19-related mortality was seen in 1,524 (8.2%) of the non-HBV-infected 18,485 patients, whereas 91 (13.5%) in HBV-infected 675 patients died of COVID-19 infection. Compared to patients without HBV infections, a higher proportion of patients with chronic HBV infections required intensive care unit (ICU) admission and had organ failures. However, odds ratios for mortality, ICU admission, and organ failure were comparable between the two groups after adjusting for age, sex, and comorbid diseases including liver cirrhosis and hepatocellular carcinoma. Conclusion COVID-19-infected patients with HBV infections showed worse clinical courses than non-HBV-infected COVID-19 patients. However, after adjustment, chronic HBV infection itself does not seem to affect the clinical outcomes in COVID-19 patients.

BACKGROUND: Recently, the prevalence of obesity and socioeconomic costs stemming from obesity are increasing steeply. Obesity, in particular, has a highly polarization caused by income levels. Obesity in low-income patients is expected to become a serious social problem in the future. This study aims to observe the effects of consistent consultation and drug therapy during a six months period, and to develop the treatment process of obesity for low-income people. METHODS: The body weight, waist circumference, body mass index (BMI), and blood pressure (BP) was measured every 2 weeks, and laboratory blood tests with a survey including Beck Depression Inventory (BDI) and eating behavior index was checked at 0, 3, and 6 months. Paired t-test and linear mixed model was done to evaluate the difference between pre-treatment data and post-treatment data. RESULTS: Twenty-one patients (2 males, median age [interquartile range] of 39 years [29-46]) were analyzed. There were statistically significant reductions of body weight (P<0.01), BMI (P<0.01), waist circumference (P<0.01), low-density lipoprotein (P=0.01), BDI-I (P<0.01), eating behavior index (P<0.01). There was no statistically significant difference of safety outcome of the BP and blood tests. CONCLUSIONS: Proper obesity treatment of obese patients of low socioeconomic status was meaningful enough to affect depression and eating patterns as well as reducing body weight and decreased waist circumference.
Blood Pressure ; Body Mass Index ; Body Weight ; Depression ; Drug Therapy ; Eating ; Feeding Behavior ; Hematologic Tests ; Humans ; Korea* ; Lipoproteins ; Male ; Obesity ; Prevalence ; Prospective Studies* ; Social Class* ; Social Problems ; Socioeconomic Factors ; Waist Circumference

BACKGROUND: Pilomatricoma is a benign, appendageal tumor differentiating towards the normal hair follicles and is characterized by basaloid, transitional, and shadow cells. It is most frequently seen in children; however, a bimodal onset distribution is observed in the first and sixth decades. OBJECTIVE: The purpose of this study was to analyze the clinical and histopathological features of pilomatricomas in patients over 50 years of age, and to compare these features with those occurring in patients under 20 years of age. METHODS: We retrospectively reviewed the medical records and histopathological findings of 73 patients under 20 years and above 50 years of age. The morphological stages of the tumors were analyzed through histopathological findings. RESULTS: The age of patients in the over 50-year age group ranged from 50 to 82 years, with a mean age of 60 years. The male-to-female ratio was 1.1:1. The duration of lesions was from 1 month to several years, with half of the patients having the tumors for over 12 months. The predilection sites were the head (51%), followed by the upper extremities (21%), neck (15%), trunk (6%), and lower extremities (6%). In 73% of the patients over 50 years of age, pilomatricoma was less likely the suspected diagnosis compared with that in the under 20-year age group. Epidermal cysts were most likely suspected in patients over 50 years of age. Histopathologically, half of the tumors were located in the subcutis, which was not significantly different when compared with pilomatricomas in the under 20-year age group. The most common evolutional stage of tumors was early regressive (52%), followed by late regressive (27%), fully developed (15%), and early stage (6%). Capsulation (9%), inflammatory cell infiltration (60%), multinucleated giant cells (36%), calcification (33%), and ossification (12%) were observed. With the exception of capsulation, there were no significant differences in these histopathological features in pilomatricomas in patients over 50 years of age compared with those in patients under 20 years of age. CONCLUSION: Pilomatrichomas in patients over 50 years of age show no pain, are located in the head and neck, are present for a long duration, and have various clinical presentations when compared with those in patients under 20 years of age. However, they are not rare tumors in adults. Accordingly, pilomatricomas should be included in the clinical differential diagnosis of a solitary, deep skin tumors presenting in adults, especially when they occur on the head.
Adult ; Child ; Diagnosis ; Diagnosis, Differential ; Epidermal Cyst ; Giant Cells ; Hair Follicle ; Head ; Humans ; Lower Extremity ; Medical Records ; Neck ; Pilomatrixoma* ; Retrospective Studies ; Skin ; Upper Extremity

OBJECTIVES: This study compared cognitive-behavioral traits related to eating behaviors, obsessive-compulsive traits, and depression levels in bulimic subjects with and without a history of anorexia nervosa according to the perspective that there are common diagnostic transitions over time in subgroups of eating disorders (anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified). METHODS: We compared EDI-2, MOCI, and BDI scores between the bulimic group with a history of anorexia (n=98), the bulimic group without a history of anorexia (n=99), and the non-clinic group (n=100) by ANOVA. RESULTS: The bulimic group with a history of anorexia showed significantly higher scores on four of the EDI-2 subscales (Ineffectiveness, Interoceptive Awareness, Impulse Regulation and Social Insecurity) than the other two groups. They also indicated significantly higher scores on both the MOCI subscale 'rumination' and BDI than both the other groups. CONCLUSION: These findings suggest that it is important to consider a prior history of anorexia nervosa in order to understand symptom severity in patients with bulimia. Psychological variables such as ineffectiveness, impulse regulation, social insecurity, rumination, and depression are crucial to consider while treating bulimics with a history of anorexia.
Anorexia ; Anorexia Nervosa ; Bulimia ; Bulimia Nervosa ; Depression ; Feeding and Eating Disorders ; Feeding Behavior ; Female ; Humans