No abstract available.
Uterus*

No abstract available.
Iliac Artery* ; Nephrosis, Lipoid* ; Thrombosis*

Purpose: Regular aerobic exercise improves exercise capacity and quality of life in children with congenital heart disease (CHD), but it remains unclear whether aerobic exercise would improve vascular function in children with CHD. We tested the hypothesis that acute bout of virtual reality (VR) exergame would improve vascular function in children with CHD. Methods: In a single-arm study, eight children (age, 9±1 years; five males) with CHD participated in VR exergame (30 minutes at 40% of heart rate reserve) using a stationary cycle ergometer with a head mount display. Endothelial function and arterial stiffness as surrogate markers of vascular function were assessed via reactive hyperemia index (RHI) and augmentation index (AIx) using peripheral arterial tonometry at baseline and 30 minutes after VR exergame. Results: Compared to baseline, VR exergame improved in RHI (1.08 [0.96–1.30] to 1.16 [1.09–1.36], p＜ 0.05) and natural log transformed RHI (0.07 [−0.04–0.26] to 0.15 [0.09–0.31], p＜ 0.05). However, no significant changes were observed for decrease AIx (−1.00 [−9.00–9.50] to −7.00 [−14.00–8.75], p=0.547) and AIx@75 (−6.50 [9.75–3.50] to −4.50 [−13.00–4.50], p=0.735) (all index values are reported as median [interquartile range]). Conclusion These findings suggest that a single bout of VR exergame has the potential to improve vascular endothelial function in children with CHD.

Purpose: Numerous studies have reported the effects of interrupting prolonged sitting with aerobic exercise on vascular and postprandial function, but the effects of resistance exercise for interrupting prolonged sitting remain unclear. We tested the hypothesis that intermittent resistance activity breaks would attenuate prolonged sittinginduced vascular and postprandial metabolic dysfunction. Methods: Fourteen healthy adults (age, 24±2 years; body mass index, 22.0±2.4 kg/m2 ) completed two trials in a randomized cross-over design. During a 4-hour sitting after a high-fat meal, the participants underwent either resistance activity (RA) with 10 repetitions of five exercises every hour or uninterrupted sitting as a control trial (SIT). Plasma glucose, triglycerides, and brachial artery blood pressure, along with blood flow and shear rate in the superficial femoral artery and carotid artery were measured at baseline and every hour during the 4-hour sitting period. Brachial artery flow-mediated dilation (FMD) was measured at baseline, 2 hours, and 4 hours after the start of the sitting. Results: Plasma glucose and triglycerides increased after a high-fat meal in both RA and SIT groups without a significant interaction effect. In addition, while SIT group decreased brachial artery FMD (7.2%±2.0% to 6.5%±2.7% to 5.1%±2.6%), RA did not attenuate a decrease in FMD (7.6%±3.4% to 7.3%±3.1% to 6.7%±2.7%, interaction p=0.581). Conclusion Our findings indicate that interrupting prolonged sitting with intermittent RA did not attenuate the negative effects of sitting on vascular function and postprandial metabolism in young healthy adults.

Klebsiella pneumoniae has been reported to be the most common pathogen causing pyogenic liver abscess. K. pneumoniae liver abscess occurs fairly often in patients with diabetes mellitus, and is commonly associated with metastatic infections such as brain abscess, endophthalmitis, lung abscess, osteomyelitis, prostatitis, necrotizing fasciitis and infection in other sites. Although septic pulmonary embolism (SPE) is uncommon, it is a serious metastatic complication of K. pneumoniae liver abscess. Chest computed tomography (CT) scans are crucial in making the early diagnosis of SPE; however, it does not provide the basis for a definitive diagnosis. A 70-year-old man was referred to the Department of Pulmonology due to cough and an abnormal chest radiography. The chest CT scans revealed relatively well-demarcated, round multiple nodules with peripheral preponderance, cavitary mass in the right upper lobe of the lung and low-density hepatic cystic masses. Bronchoscopic examination and percutaneous needle aspiration of the lung were performed, but there was no evidence of malignancy. Finally, K. pneumoniae was grown from a bronchial washing specimen and blood culture. Intravenous carbapenem was administered over a 3-week period and follow-up CT scans showed improvement in both the lung and the liver. We report a case of K. pneumoniae liver abscess complicated with SPE requiring differential diagnosis of hematogenous metastatic malignancy on CT scans in an elderly patient.
Aged ; Brain Abscess ; Cough ; Diabetes Mellitus ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Endophthalmitis ; Fasciitis, Necrotizing ; Follow-Up Studies ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Lung ; Lung Abscess ; Needles ; Osteomyelitis ; Pneumonia ; Prostatitis ; Pulmonary Embolism* ; Pulmonary Medicine ; Radiography ; Thorax ; Tomography, X-Ray Computed

Background/Aims: Helicobacter pylori infection is presumably associated with iron deficiency and iron deficiency anemia (IDA). This study aimed to evaluate the relationship between H. pylori infection and the decline in iron stores in non-elderly adults during their health check-ups. Methods: We identified a total of 1,069 subjects who were tested for iron, ferritin, and total iron-binding capacity during their health check-ups, from January 2016 to May 2017. Of these, subjects who underwent endoscopy via rapid urease test and those aged 65 years or below were finally enrolled. Results: Overall, 281 subjects were enrolled, and 187 patients (66.5%) tested positive for H. pylori. The mean age was 36.1 years (range, 22 to 65), and 176 subjects (62.6%) were male. The mean levels of hemoglobin (14.1 ± 1.7 g/dL vs. 14.6 ± 1.4 g/dL, p = 0.019) and ferritin (121.7 ± 106.9 ng/mL vs. 151.8 ± 107.8 ng/mL, p = 0.027) in the H. pylori-positive group were significantly lower than those in the H. pylori-negative group. Iron deficiency (ferritin < 30 ng/mL) was more common in patients with H. pylori infection (p = 0.002). There was no significant difference in anemia (hemoglobin < 13 g/dL in men, < 12 g/dL in women) or IDA (anemia, ferritin < 10 ng/mL, and transferrin saturation < 16%) with H. pylori. Logistic regression analysis demonstrated that female sex (odds ratio, 197.559; 95% confidence interval, 26.461 to 1,475.015) and H. pylori infection (odds ratio, 3.033; 95% confidence interval, 1.216 to 7.567) were factors associated with iron deficiency. Conclusions H. pylori infection is associated with iron deficiency, suggesting a decline in iron stores among infected non-elderly adults.

Purpose: To analyze the change in the weekly incidence of epidemic keratoconjunctivitis (EKC) per 1,000 outpatients during the coronavirus disease 2019 (COVID-19) pandemic by comparing the mean weekly proportion of EKC of 2020 with that from 2016 to 2019. Methods: Using data from the Korea Disease Control and Prevention Agency for 2016-2020, we analyzed the weekly proportion of EKC per 1,000 outpatients. The data were also analyzed according to age, semester and vacation periods, region, and social distancing stages. For the Daegu data, we also analyzed the effects of social distancing in an area. Results: The mean weekly proportion of EKC per 1,000 outpatients in 2020 was lower than in previous years for all ages (2016-2019 19.77 ± 7.17‰, 2020 7.28 ± 2.97‰; p < 0.001). During the semester, the mean difference between 2016-2019 and 2020 was significant, particularly for preschool children. In Daegu, the weekly proportion of EKC per 1,000 outpatients during the extra 12-18 weeks of social distancing was significantly lower (2016-2019, 18.78 ± 6.61‰; 2020, 8.94 ± 2.92‰; p < 0.001). Conclusions The public health interventions implemented during the COVID-19 outbreak not only reduced the prevalence of COVID-19 but also reduced the prevalence of EKC. Therefore, maintaining hygiene principles and standard precautions may help prevent EKC.

PURPOSE: Adenotonsillar hypertrophy (ATH) that causes upper airway obstruction might lead to chronic hypoxemic pulmonary vasoconstriction and right ventricular (RV) dysfunction. We aimed to evaluate whether adenotonsillectomy (T&A) in children suffering from obstructive sleep apnea (OSA) due to severe ATH could improve RV function. METHODS: Thirty-seven children (boy:girl=21:16; mean age, 9.52±2.20 years), who underwent T&A forsleep apnea due to ATH, were included. We analyzedthe mean pulmonary artery pressure (mPAP), the presence and the maximal velocity of tricuspid regurgitation (TR), the tricuspid annular plane systolic excursion (TAPSE), and the right ventricular myocardial performance index (RVMPI) with tissue Doppler echocardiography (TDE) by transthoracic echocardiography pre- and post-T&A. The follow-up period was 1.78±0.27 years. RESULTS: Only the RVMPI using TDE improved after T&A (42.18±2.03 vs. 40±1.86, P=0.001). The absolute value of TAPSE increased (21.45±0.90 mm vs. 22.30±1.10 mm, P=0.001) but there was no change in the z score of TAPSE pre- and post-T&A (1.19±0.34 vs. 1.24±0.30, P=0.194). The mPAP was within normal range in children with ATH, and there was no significant difference between pre- and post-T&A (19.6±3.40 vs. 18.7±2.68, P=0.052). There was no difference in the presence and the maximal velocity of TR (P=0.058). CONCLUSION: RVMPI using TDE could be an early parameter of RV function in children with OSA due to ATH.
Airway Obstruction ; Apnea ; Child* ; Dichlorodiphenyldichloroethane ; Echocardiography ; Echocardiography, Doppler ; Follow-Up Studies ; Humans ; Hypertrophy ; Pulmonary Artery ; Reference Values ; Sleep Apnea, Obstructive* ; Tricuspid Valve Insufficiency ; Vasoconstriction ; Ventricular Function, Right*

PURPOSE: This study was conducted to confirm the necessity of lumbar puncture to identify the cause of fever in febrile infants aged less than 3 months who visited an emergency department. METHODS: This was a retrospective study conducted on 399 infants aged 31 days to 90 days who visited the emergency department with fever from March 2014 to February 2016. RESULTS: Of the 399 patients, 49 patients had serious bacterial infections (SBI), and were finally diagnosed with urinary tract infection (UTI), sepsis, and bacterial meningitis. Of these, only one case was diagnosed with bacterial meningitis, and this patient was accompanied by sepsis. UTIs were present in 47 patients, and only 1 case was diagnosed with sepsis without bacterial meningitis or UTI. The Boston criteria and Philadelphia criteria included the cerebrospinal fluid (CSF) results for predicting SBI. In this study, the modified Philadelphia criteria was used, which does not include the CSF results, and there was no factor that showed a significant correlation as a result of statistical analysis. Rather, a C-reactive protein ≥50 mg/L, procalcitonin ≥2 ng/mL, and fever over 39℃C showed statistical significance with SBI. In this study, the 1 patient diagnosed with bacterial meningitis also met all three factors (C-reactive protein, 106 mg/L; procalcitonin, 40.25 ng/mL; peak body temperature, >39℃). CONCLUSION: Because the incidence of bacterial meningitis has decreased recently, when an infant under 3 months of age visits the emergency room with fever, lumbar puncture should be performed selectively to identify the cause.
Bacterial Infections ; Body Temperature ; C-Reactive Protein ; Cerebrospinal Fluid ; Emergencies* ; Emergency Service, Hospital* ; Fever ; Humans ; Incidence ; Infant* ; Meningitis ; Meningitis, Bacterial ; Retrospective Studies ; Sepsis ; Spinal Puncture* ; Urinary Tract Infections

Dieulafoy's disease of the bronchus is rare but potentially life-threatening, and should be considered in patients with massive hemoptysis, especially from unknown etiology. We report a case of a patient with massive hemoptysis due to bronchial Dieulafoy's disease. He underwent bronchial artery embolization and surgical resection, and the post-operative specimen revealed dilated and tortuous arteries in the submucosa that presented as Dieulafoy's disease of the bronchus.
Arteries ; Bronchi ; Bronchial Arteries ; Hemoptysis ; Humans