No abstract available.
Lymphocyte Subsets* ; Lymphocytes* ; Splenectomy*

BACKGROUND: Human metapneumovirus (hMPV) is a relatively recently identified respiratory virus that induces respiratory symptoms similar to those of respiratory syncytial virus infection in children. The characteristics of hMPV-infected adults are unclear because few cases have been reported. METHODS: We conducted a retrospective review of hospitalized adult patients with a positive multiplex real-time polymerase chain reaction assay result from 2012 to 2016 at a single tertiary referral hospital in South Korea. We analyzed clinical characteristics of the enrolled patients and divided patients into an acute respiratory distress syndrome (ARDS) group and a non-ARDS group. RESULTS: In total, 110 adults were reviewed in this study. Their mean age was 61.4 years, and the majority (n = 105, 95.5%) had comorbidities or were immunocompromised. Most of the patients had pneumonia on chest X-ray (n = 88, 93.6%), 22 (20.0%) had ARDS, and 12 (10.9%) expired during hospitalization. The mortality rate for patients with ARDS was higher than that of the other patients (36.4% vs. 5.7%, P = 0.001). The risk factor for hMPV-associated ARDS was heart failure (odds ratio, 5.24; P = 0.044) and laboratory values were increased blood urea nitrogen and increased C-reactive protein. The acquisition site of infection was divided into community vs. nosocomial; 43 patients (39.1%) had a nosocomial infection. The risk factors for nosocomial infection were an immunocompromised state, malignancy and immunosuppressive treatment. CONCLUSIONS: These data suggest that hMPV is one of the important respiratory pathogens important respiratory pathogen that causes pneumonia/ARDS in elderly, immunocompromised individuals and that it may be transmitted via the nosocomial route.
Adult* ; Aged ; Blood Urea Nitrogen ; C-Reactive Protein ; Child ; Comorbidity ; Cross Infection ; Heart Failure ; Hospitalization ; Humans* ; Korea ; Metapneumovirus* ; Mortality* ; Pneumonia ; Real-Time Polymerase Chain Reaction ; Respiratory Distress Syndrome, Adult* ; Respiratory Syncytial Viruses ; Retrospective Studies* ; Risk Factors ; Tertiary Care Centers ; Thorax

No abstract available.
Aneurysm* ; Humans ; Hydrocephalus*

No abstract available.

This study was conducted to identify the major dietary patterns of Korean adult men and to examine the relationship between subjective stress perception and these dietary patterns using data from the 2014∼2016 Korean National Health and Nutrition Examination Survey (KNHANES). Of the 23,080 total subjects, adult men between the ages of 19 and 64 who did not take the questionnaire or answer the questions relating to depression, and cases where the daily energy intake was less than 500 kcal or more than 5,000 kcal in the Food Frequency Questionnaire were excluded. This left a total of 3,464 subjects who were included in the final analysis. We performed a factor analysis based on the yearly mean intake frequency of 41 food groups to identify the major dietary patterns. Three major dietary patterns were identified (factor loading ＞0.3), including the ‘Healthy pattern’, ‘Processed meat pattern’, and the ‘Alcohol pattern’. The ‘Healthy pattern’ was characterized by higher intake of beans, tofu, vegetable, fish, and fruits. The ‘Processed meat pattern’ was characterized by high consumption of processed meats and instant foods. The ‘Alcohol pattern’ was characterized by a higher intake of alcohol. As a response to the subject's subjective perception of stress, the most answered 'a little' according to age, marital status, occupation, income, residential area, smoking status, drinking status, and exercise status. People whose diets followed the ‘Processed meat’ and ‘Alcohol’ patterns had significantly higher scores on subjective stress perception compared to people following the ’Healthy pattern’.To manage subjective stress, it is more effective to maintain health by relieving stress through a healthy method that combines healthy eating and exercise rather than following an unhealthy diet as characterized by the ‘processed meat’ and ‘alcohol’ dietary patterns.

BACKGROUND: There is concem about the rising incidence of skin cancer. However, few articles have reported the change in the clinical and epidemiological aspects of skin cancer. OBJECTIVE: We performed this study in order to clarifiy the recent changes in cutaneous premalignant and malignant lesions. METHODS: A statistical analysis was made using 101 cases of cutaneous premalignant lesions and 205 cases of ma]ignant tumors out of a total number of 20,175 new outpatients that visited the Department of Dermatology at the Seoul National University Hospital during a 6 year period(1990-1995). RESULTS: The frequency of premalignant lesions was 0.50% and that of malignant tumors was 1.02%. The frequency showed an increasing tendency compared to previous reports. In the premalignant lesion cases, actinic keratosis was most common and represented a figure of 82.2%. Among the malignant tumors, basal cell carcinoma was most frequent at 24.4%. Age, sex and anatomical site distribution of basal cell carcinoma, malignant melanoma was no different. The mean age of squamous cell carcinoma was greater than in previous reports and main preceding lesions were actinic keratosis and cheilitis. The frequency of lymphoma was markedly increased but the reason for this remains to be determined. CONCLUSION: Our findings showed the continous increasing incidence of skin cancers and emphasize the need for public eduacation, early diagnosis and proper treatment.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheilitis ; Dermatology ; Early Diagnosis ; Humans ; Incidence ; Keratosis, Actinic ; Lymphoma ; Melanoma ; Outpatients ; Seoul ; Skin Neoplasms ; Statistics as Topic*

No abstract available.
Adult ; Humans

Background: Legal regulations and fees have been established in Korea to provide visiting oral health care services to individuals with long-term care insurance (LTCI). However, beneficiaries of this service are very limited. Therefore, to improve the Korean system we propose a comparative analysis with the Japanese system. Methods: This study is a descriptive analysis based on secondary data, such as statistics, laws, and service record forms from Korea and Japan. The most recent institutional documents were obtained through a Google search. The variables investigated were financial resources of LTCI, co-payment structure, monthly limit of LTCI benefits, care levels of LTCI, service providers, service costs, contents of service, and the number of cases of service. Results: In both Korea and Japan, LTCI is financed through a combination of taxes and insurance premiums. However, the monthly limit for receiving LTCI services in Japan is about 2.4 times higher than in Korea. Visiting medical and dental treatment is also possible in Japan. Furthermore, nursing staff can provide daily oral health care services according to dental hygienists’ instruction unlike Korea. Oral health care services in Korea are focused on oral hygiene and prevention of oral diseases, while Japan additionally provides oral function screening, patient education for oral health management, and training for nursing staff to enhance oral function, eating, and swallowing of the patients. Conclusion We concluded that the possibility of visiting dental treatment, differences in monthly limit of LTCI benefits, oral function assessment and guidance, as well as collaboration with other healthcare professionals contributed to the difference in the frequency of utilization of visiting oral health care services between Korea and Japan.

Purpose: Surgeons can treat debilitating conditions of uncontrollable complex anorectal fistulas with sepsis, even after repeated fistula surgeries, for curative intention. Adipose-derived stem cells have shown good outcomes for refractory Crohn fistula. Unfortunately, cell therapy has some limitations, including high costs. We have therefore attempted immediate cell-assisted lipotransfer (CAL) in treating refractory complex anal fistulas and observed its outcomes. Methods: In a retrospective study, CAL, using a mixture of freshly extracted autologous stromal vascular fraction (SVF) and fat tissues, was used to treat 22 patients of refractory complex anal fistula from March 2018 to May 2021. Preoperative and postoperative assessments were performed with direct visual inspection, digital palpation, and endoanal ultrasonography. A fistula was considered completely healed if (1) the patient had no symptoms of discharge or inflammation; (2) there were no visible secondary openings of fistula tract inside and outside of the anorectal unit and even in the perineum; and (3) there was no primary opening in the anus. The endpoint of complete remission was wound healing without signs of inflammation 3 months after CAL treatment. Results: In a total of 22 patients who received CAL treatment, 19 patients showed complete remission, 1 patient showed partial improvement, and 2 patients showed no improvement. One of the 2 patients without improvement at primary endpoint showed complete remission 9 months after CAL. There were no significant adverse effects of the procedure. Conclusion We found that the immediately-collected CAL procedure for refractory complex anal fistula showed good outcomes without adverse side effects. It can be strongly recommended as an alternative surgical option for the treatment of complex anal fistula that is uncontrollable even after repeated surgical procedures. However, considering the unpredictable characteristics of SVF, long-term follow-up is necessary.

The authors have experienced 9 cases of postgastrectomy efferent loop obstruction during the past 16 months' period and analyzed the clinical features, radiological findings, causes, and types of obstruction. The incidence of efferent loop obstruction was 1.3%(9/673). Among the 9 cases, eight patients were male and one patient was female. Median age was 60 years and more than half(5 out of 9 cases) of the patients were obese(defined by more than 110% of ideal body weight). None of the cases showed signs of strangulation, including persistent pain, fever, focal abdominal tenderness, and/or leukocytosis. Gastrointestinal anastomoses were done using a GIA stapler in 6 cases, and manually in 3 cases. The diagnoses were made on the basis of clinical symptoms and signs, further supported by radiologic contrast studies. All the patients were initially treated with conservative measures, including nasogastric drainage and fluid therapy for about 2 weeks in average. 7 cases underwent re-laparotomy using separate left subcostal incisions as conservative management had failed. Among the relaparotomy cases, adhesiolysis and side to side jejunojejunostomy were performed in 5 patients, Roux-en-Y gastrojejunostomy in 1 patient, and gastrojejunostomy revision in 1 patient. Causes of the obstruction in the seven re-opened cases were confirmed as postoperative adhesion. The authors have analyzed the pattern of obstruction and classified the patterns into 4 types. One of the remaining two patients underwent balloon dilatation successfully and the other was managed with prolonged nasogastric decompression. The average hospital stay was 32 days. Adequate omentectomy, gentle tissue handling during dissection, avoidance of ischemia along the suture line of anastomosis, and the use of biologically inert suture material would prevent this kind of postoperative adhesive obstruction.
Adhesives ; Decompression ; Diagnosis ; Dilatation ; Drainage ; Female ; Fever ; Fluid Therapy ; Gastric Bypass ; Humans ; Incidence ; Ischemia ; Length of Stay ; Leukocytosis ; Male ; Stomach Neoplasms ; Sutures