No abstract available.
Porokeratosis*

No abstract available.
Chickenpox ; Polymerase Chain Reaction ; Pregnancy

Background: Limited access to medical services causes problems in patients’ health and life. Also, hospital closures cause concentration towards general hospitals, which leads to worsening National Health Insurance finance. Therefore, hospital closure is an important topic to be analyzed. Methods: This paper analyzed the factors that affect hospital closures using survival analysis with the data of 970 hospitals opened between 2010 and 2019 in Korea. The number of medical personnel, hospital rooms, sickbeds, and medical departments were used as explanatory variables. Results: The number of medical personnel and hospital rooms increased the survival probability while the number of sickbeds and medical departments decrease the survival probability. Conclusion The results suggest that hospitals have economies of scale and diseconomies of scope in management.

The therapeutic strategy for relapsed and refractory multiple myeloma (RRMM) integrates a holistic approach regarding patient, disease, and drug-related factors. Patient-related factors include age, frailty status, and underlying comorbidities, especially cardiovascular and renal diseases and peripheral neuropathies that affect tolerability to multiple drug combinations or transplantations. Disease-related factors encompass these multiple patient-related factors, particularly the aggressiveness of the disease and cytogenetics. Regarding drug-related factors, the approval of novel proteasome inhibitors (such as carfilzomib and ixazomib), immunomodulatory agents (such as pomalidomide), monoclonal antibodies (such as daratumumab and elotuzumab), and new classes of drugs increasingly makes the choice treatment more complex and necessitates a comprehensive summary and an update of the efficacy and toxicities of each antimyeloma drug and its combinations. Further, careful monitoring of the side effects and supportive care throughout the course of treatment are important to achieve better outcomes for patients with RRMM.

This study examined the relations between degree of posterior dental compensation and skeletal discrepancy in Class III malocclusion. The pretreatment lateral cephalograms and dental casts of 87 skeletal Class III adults were selected to provide a random sampling of skeletal Class III malocclusion. Skeletal discrepancy was described with ANB angle, Wits appraisal, SN-Mn plane angle, FMA and ratios of basal arch width. Degree of posterior dental compensation was described with maxillary intermolar angle, mandibular intermolar angle and sum of intermoloar angle. The relationships between skeletal discrepancy and degree of posterior dental compensation were analyzed with simple correlation analysis, stepwise multiple regression analysis. The results were as follows : 1. A strong association was found between the variation in the anteroposterior measure, ANB angle and the variation of posterior dental compensation measures, sum of intermolar angle and mandibular intermolar angle in skeletal Class III malocclusion. 2. There was no statistically significant relationship between the variation in the vertical measures and the variation of posterior dental compensation measures in skeletal Class III malocclusion. 3. There was no statistically significant relationship between the variation in the anteroposterior and vertical measures and degree of basal arch width discrepancy.
Adult ; Compensation and Redress* ; Humans ; Malocclusion*

PURPOSE: Because carbon monoxide (CO)-intoxicated patients with an alert mental status and only mild cognitive dysfunction may be inadequately assessed by traditional bedside neurologic examination in the emergency department (ED), they may not receive appropriate treatment. METHODS: We retrospectively investigated the incidence and features of cognitive dysfunction using the Korean version of the Mini-Mental State Examination (MMSE-K) in ED patients with CO poisoning with alert mental status. We conducted a retrospective review of 43 consecutive mild CO poisoned patients with a Glasgow Coma Scale score of 15 based on documentation by the treating emergency physician in the ED between July 2014 and August 2015. RESULTS: Cognitive dysfunction, defined as a score of less than 24 in the MMSE-K, was diagnosed in six patients (14%) in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed greater impairments. The mean age was significantly older in the cognitive dysfunction group than the non-cognitive dysfunction group (45.3 yrs vs. 66.5 yrs, p<0.001). Among the initial symptoms, experience of a transient change in mental status before ED arrival was significantly more common in the cognitive dysfunction group (32.4% vs. 100%, p=0.003). CONCLUSION: Patients with CO poisoning and an alert mental status may experience cognitive dysfunction as assessed using the MMSE-K during the early stages of evaluation in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed the greatest impairment.
Carbon Monoxide ; Carbon* ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Glasgow Coma Scale ; Humans ; Incidence* ; Memory ; Neurologic Examination ; Poisoning ; Retrospective Studies

No abstract available.
Child* ; Humans ; Lung*

Myasthenia gravis is a autoimmune neuromuscular disorder characterized by weakness and fatigability of skeletal muscles. The underlying defect is a decrease in the number of available acetylcholine receptors at neuromuscular junction due to an antibody-mediated autoimmune attacks. The course of myasthenia gravis during pregnancy is not predictable. We experienced a patient of myasthenia gravis associated with pregnancy who underwent cesarean section and transient neonatal myasthenia gravis of the newborn. We present this case with brief review of the concerned literatures.
Cesarean Section ; Female ; Humans ; Infant, Newborn ; Muscle, Skeletal ; Myasthenia Gravis* ; Myasthenia Gravis, Neonatal ; Neuromuscular Junction ; Pregnancy* ; Receptors, Cholinergic

Superficial siderosis (SS) is a rare disorder characterized by deposition of hemosiderin in the leptomeninges and subpial layer of the central nervous system. Recently SS suggested a subtype of cerebral amyloid angiopathy which is an important cause of lobar intracerebral hemorrhage (ICH). We present a patient with cortical SS had seizure and cognitive dysfunction as symptom and lobar ICH in the existed area of cortical SS 4 years later. This case suggested cortical SS could be a warning sign of lobar ICH.
Central Nervous System ; Cerebral Amyloid Angiopathy ; Cerebral Hemorrhage ; Hemosiderin ; Humans ; Seizures ; Siderosis

Ulcerative colitis, one of the inflammatory bowel disease, is primarily managed medically with combinations of 5-ASA and steroids. However, this chronic disease requires surgical management if symptoms persist or complications develop despite medical management. The clinical course, the indications and outcome for surgical management of pediatric ulcerative colitis patients were studied from medical records retrospectively. Twenty-one patients under the age of 15 who were endoscopically diagnosed with ulcerative colitis at the Seoul National University Children's Hospital between January, 1988 and January, 2003 were subjected to the study. Mean follow up period was 3 years and 10 months. The mean age was 10.3 years old. All patients received medical management primarily after diagnosis and 8 patients (38%) eventually required surgical management. Of 13 patients who received medical management only, 7 patients (53%) showed remission, 4 patients are still on medical management, and 2 patients expired due to congenital immune deficiency and hepatic failure owing to sclerosing cholangitis respectively. In 8 patients who received surgical management, 1 patient underwent surgery due to sigmoid colon perforation and 7 patients due to intractability of medical management. The perforated case received colon segmental resection and the other 7 patients recieved total protocolectomy with ileal pouch-anal anastomosis. One patient expired postoperatively due to pneumonia and sepsis. One patient is still on medical management because of mild persistent hematochezia after surgery. The other operated patients are showing good prognosis without any management. Pediatric ulcerative colitis patients can be surgically managed if the patient is intractable to medical management or if complications such as perforation is present. Total protocolectomy & ileal pouch-anal anastomosis is thought to be the adequate surgical method.
Child* ; Cholangitis, Sclerosing ; Chronic Disease ; Colitis, Ulcerative* ; Colon ; Colon, Sigmoid ; Diagnosis ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Liver Failure ; Medical Records ; Pneumonia ; Prognosis ; Retrospective Studies ; Seoul ; Sepsis ; Steroids ; Ulcer*