No abstract available.
Humans ; Intracranial Hemorrhages* ; Plasminogen Activators* ; Plasminogen* ; Rivaroxaban* ; Thrombolytic Therapy

PURPOSE: To analyze the incidence and prevalence of exudative age-related macular degeneration (AMD) and to predict the future AMD populations and health expenditures of intravitreal ranibizumab injection. METHODS: From 2010 to 2014, the National Health Insurance claims data were used to estimate the incidence and prevalence change of exudative AMD, according to demographic characteristics (year, sex, residence, and age). Based on the above results and changes in future population distribution, we estimated the AMD population by 2030. Considering the cost of Intravitreal ranibizumab injection from 2010 to 2014, we predicted the future health expenditure for AMD. RESULTS: The incidence and prevalence of exudative AMD increased from 14.04 and 295.11 per 100,000 populations in 2010 to 14.25 and 580.71 in 2014, respectively. The prevalence rate was higher in men and showed a large increase over 70 years of age. The ranibizumab was prescribed 13 times per person in average, and the amount consumed increased as the number of insurance coverage increased from 2013. Future AMD populations are predicted to reach 557,007 in 2030 from 146,871 in 2014. As a result, the cost of intravitreal ranibizumab injection is expected to increase from 83.6 billion won in 2014 to 171.7 billion won in 2030. CONCLUSIONS: The increase in medical expenses for AMD is expected due to social aging. Therefore, we need policies to secure medical resources and expand insurance indications.
Aging ; Demography ; Health Expenditures ; Humans ; Incidence ; Insurance ; Insurance Coverage ; Korea ; Macular Degeneration ; Male ; National Health Programs ; Prevalence ; Ranibizumab

No abstract available.
Humans ; Infarction, Middle Cerebral Artery ; Mechanical Thrombolysis ; Middle Cerebral Artery ; Stroke ; Thrombectomy

BACKGROUND/AIMS: Although colonoscopy is not indicated in patients with hematochezia, many surgeons, internists, and physicians are recommending colonoscopy for these patients in Korea. The aim of this study is to evaluate the diagnostic value of colonoscopy for patients with hematochezia. METHODS: We retrospectively reviewed the data of colonoscopy between January 2010 and December 2010. A total of 321 patients among 3,038 colonoscopies (10.6%) underwent colonoscopy to evaluate the cause of hematochezia. The patients with previous colorectal surgery (2) or polypectomy (5) were excluded. We analyzed endoscopic diagnoses. Advanced neoplastic polyps were defined as adenomas with villous histology or high grade dysplasia, or adenomas more than 10 mm in diameter. RESULTS: Hemorrhoid was the most common diagnosis (217 cases, 67.6%). Polyps were detected in 93 patients (29.0%), but advanced neoplastic polyps were found in only 14 cases (4.4%). Colorectal cancers were diagnosed in 18 patients (5.6%) including 14 rectal cancers. There was no cancer located above sigmoid-descending junction. Diverticuli were detected in 41 patients (12.8%) but there was only one case of suspected diverticular bleeding. Colitis was diagnosed in 24 patients (7.5%). Other lesions included acute anal fissure, rectal tumor, stercoral ulcer, and radiation proctitis. CONCLUSIONS: The colonoscopy had little value in patients with hematochezia because the most pathologic lesions were located below sigmoid colon. The first choice of diagnosis in patients with hematochezia is sigmoidoscopy.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Colitis/complications/diagnosis ; Colonic Neoplasms/complications/diagnosis ; Colonic Polyps ; *Colonoscopy ; Colorectal Neoplasms/complications/diagnosis ; Female ; Gastrointestinal Hemorrhage/diagnosis/*etiology ; Hemorrhoids/complications/diagnosis ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Esophagopericardial fistula (EPF) is a rare and serious medical condition induced by benign and malignant causes. Surgery is the main stay of treatment for benign EPF. However, there have been few reports of benign EPF treated by endoscopic stent insertion. We performed a laparoscopic total gastrectomy for treatment of a gastric cancer located at the cardia in a 62-year-old patient. A benign EPF occurred as a postoperative complication 14 days after surgery. We successfully managed the EPF through emergent laparoscopic pericardial window formation and insertion of a fully covered self-expendable metal stent during operation. The patient is being followed up without complications in the outpatient department after stent removal.
Cardia ; Fistula* ; Gastrectomy* ; Humans ; Middle Aged ; Outpatients ; Postoperative Complications ; Stents* ; Stomach Neoplasms*

OBJECTIVES: To identify the risk factors of cerebrovascular disorders(CVD) in Koreans using a nested case-control study. METHODS: The cohort consisted of beneficiaries who had taken health examinations of the Korea Medical Insurance Corporation (KMIC cohort: 115,600 persons) in 1990 and 1992 consecutively. Four hundred and twenty five (425) cases were selected following the validation of diagnosis among 2,026 reported CVD (I60-I68) inpatients during the year from 1993 to 1997. Controls were matched (1:1) with age and gender of the cases among inpatients without CVD during the same period. The source of data in this study were the files of the 1990 health examinations and the 1992 health questionnaires, as well as an additional telephone survey undertaken from March to November 1999. RESULTS: In a bivariate analysis and multiple logistic regression analysis, risk factors for total CVD were hyperglycemia and hypertension. Unrespectively, the odds ratio of ex-smoker was significantly lower than that of those who had never smoked. The risk factors for ischemic CVD also were hyperglycemia and hypertension. However, only blood pressure was found to be a risk factor for hemorrhagic CVD. Hypercholesterolemia was not a risk factor for total CVD, ischemic CVD, and hemorrhagic CVD. CONCLUSION: We concluded that the most important risk factor for CVD (including subtype) in Koreans was hypertension.
Blood Pressure ; Case-Control Studies ; Cerebrovascular Disorders* ; Cohort Studies ; Diagnosis ; Humans ; Hypercholesterolemia ; Hyperglycemia ; Hypertension ; Inpatients ; Insurance ; Insurance Benefits ; Korea ; Logistic Models ; Odds Ratio ; Questionnaires ; Risk Factors* ; Smoke ; Telephone

PURPOSE: Simple and noninvasive methods for the diagnosis of transitional cell carcinoma of the bladder are needed for the prevention of invasive tumor. A proteomic technology has recently been developed to facilitate protein profiling of biological mixtures. We investigated the role of this proteomic approach as a possible tool to detect the marker protein during the initiation stages on BBN-induced bladder carcinogenesis in rats. MATERIALS AND METHODS: Ten rats group A were given 0.05% BBN in drinking water for 12 weeks. Ten rats in group B were designated as a control group and were not given BBN. Whole urinary bladders of all rats were excised at 12 weeks from the beginning of the experiment. Conventional proteomics was performed with high resolution 2-D gel electrophoresis followed by computational image analysis and protein identification using mass spectrometry. RESULTS: A comparison of urinary bladder hyperplasia tissue with control tissue showed that five proteins; actin gamma2 propeptide, cytokeratin-20, proapolipoprotein, alpha2 actin(alpha-cardiac actin) and heat shock 27kDa protein 1 were over-expressed in hyperplastic tissues. Three protein; transcription factors, seminal vesicle secretory protein VI precursor and hypothetical protein RMT-7 were under-expressed in hyperplastic tissues. CONCLUSIONS: In an animal model system, BBN-induced, urinary bladder mucosal hyperplasia resulted in an increase in five proteins and a decrease in three proteins. Of these altered proteins, CK-20 and SVS-VI seem to be important. The proteomic approach may be a simple and noninvasive method for monitoring and follow-up of bladder cancer patients. However more information is needed regarding CK-20 expression in nonmalignant urological disease and in human tumor tissue, and regarding SVS-VI expression in other organs, for clinical usage.
Actins ; Animals ; Carcinogenesis ; Carcinoma, Transitional Cell ; Diagnosis ; Drinking Water ; Electrophoresis, Gel, Two-Dimensional ; Follow-Up Studies ; Hot Temperature ; Humans ; Hyperplasia ; Keratin-20 ; Mass Spectrometry ; Models, Animal ; Precancerous Conditions* ; Proteomics ; Rats ; Seminal Vesicles ; Shock ; Transcription Factors ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urologic Diseases

No abstract available.
Cerebral Infarction* ; Humans ; Myxoma*

Hereditary hemorrhagic telangiectasia (HHT), also known as Osler–Weber–Rendu syndrome, is a rare autosomal dominant genetic disorder that results in vascular malformation in the skin, mucous membrane, and other internal organs, such as the gastrointestinal tract, lung, liver, and brain. A 49-year-old man presented with purpuric punctate, spider-like telangiectasia on the face, hands, and fingers. He had episodes of recurrent nasal bleeding. The family members of the patient had similar events of recurrent nasal bleeding and cutaneous telangiectasia. Abdominal computed tomography revealed multiple arteriovenous malformations and cysts in the liver. Gastroendoscopy and colonoscopy showed angiodysplasia of the fundus of the stomach and mucous membrane of the colon. Histopathologic examination revealed dilated vessels lined with flat endothelial cells in the dermis. We report herein the case of HTT because it is rare and significant for differential diagnosis.

Background: Tinea capitis, a superficial dermatomycosis, is caused by a dermatophyte infection on the scalp and hair. Recently, the number of adult patients with tinea capitis have been increasing; therefore, the clinical and mycological features of tinea capitis may be different from those of previous reports. However, only a few studies on adult tinea capitis have been conducted in Korea. Objective: This study aimed to analyze the clinical and mycological features of Korean adult patients with tinea capitis. Methods: A retrospective review of 61 adult patients with tinea capitis was conducted. Clinical features including age, sex, clinical type, and treatment outcome were obtained from medical records and images. The mycological features, including the result of KOH smear and fungal culture, were also analyzed. Results: The mean onset age was 61.3 years, and the male-to-female ratio was 1:4.1. Two patients (3.3%) had a family history of developing the same symptoms, and 17 (27.9%) had a history of close contact with animals. The most predilection site was the vertex, followed by the frontal and parietal areas. Microsporum canis was cultured in 66.7% patients, and Trichophyton rubrum was cultured in 28.6% patients. The number of adult patients with tinea capitis has been increasing constantly. The proportion of patients infected by T. rubrum has been increasing since 2000. Of the 51 patients who received treatments, 42 showed improvements. No significant difference was observed between patients treated with terbinafine and itraconazole. Conclusion This is the large-scale study that analyzed the clinical and mycological features of Korean adult patients with tinea capitis.