A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

Behavioral and psychological symptoms of dementia are major components of Alzheimer’s disease. In this study, we aimed at investigating the prevalence and severity of behavioral and psychological symptoms of dementia in very mild to mild Alzheimer’s disease. Forty-four patients with Alzheimer’s disease who visited the neurology outpatient clinic of Seoul Medical Center were included. A trained neurologist or a supervised test technician administered the neuropsychological test, the Seoul Neuropsychological Screening Battery including Mini Mental State Examination and Clinical Dementia Rating. The instrument used for assessing behavioral and psychological symptoms of dementia was Neuropsychiatric Inventory-Questionnaire. In order of prevalence, apathy, depression, irritability, anxiety, and agitation were the most common symptoms occurring in very mild-to-mild Alzheimer’s disease group. The prevalence and severity of behavioral and psychological symptoms of dementia were found to be in positive correlation with the Clinical Dementia Rating scores. Behavioral and psychological symptoms of dementia are found even in the very early stage of Alzheimer’s disease, apathy and depression being the most common symptoms. Physicians should be aware of this when managing dementia patients.

Lumbar puncture is a simple bedside procedure that is essential for the diagnosis and treatment of several neurologic diseases. Known complications include headache, backache, infection, and hemorrhage, with the most common being postpuncture headache. We report a case of postpuncture spinal subdural hematoma-which is extremely rare-in a 29-year-old female. Although most cases of postpuncture spinal hematomas are associated with coagulation abnormalities, this case shows that it can occur in the absence of predisposing factors.
Back Pain ; Female ; Headache ; Hematoma ; Hematoma, Subdural, Spinal ; Hemorrhage ; Humans ; Spinal Puncture

Purpose: We investigated the satisfaction of physical therapy course according to teaching ways after COVID-19. Methods: 336 students in major of physical therapy were recruited in this study. Based on the classification of subjects in the national examination, the questionnaire was divided into 6 subjects in the basic field of physical therapy, 2 subjects in the field of physical therapy diagnostic evaluation, 8 subjects in the field of physical therapy intervention, and 3 subjects in other fields. The Likert scale was used. Results: In the basic field of physical therapy, all subjects were shown the high score of the satisfactory in face-to-face classes except for the public health and medical law compared to the non-face-to-face classes and mixed classes. Regarding the field of physical therapy diagnostic evaluation, the principle of diagnostic evaluation was shown the high score of the satisfactory in face-to-face classes compared to the non-face-to-face classes and mixed classes. In the field of physical therapy intervention, all subjects were shown the high score of the satisfactory in face-to-face classes compared to the non-face-to-face classes and mixed classes. Conclusion We found that the face-to-face classes in most of subjects was shown the high score of satisfactory. We believed that our results can be used as basic data for physical therapy major learning methods.

Inflammatory bowel disease (IBD) is a chronic condition characterized by continuous inflam-mation of the gastrointestinal tract that varies in intensity over time. IBD is caused by several factors including aberrant gut flora, immunological dysregulation, altered environmental con-ditions, and genetic variations. However, the pathogenesis of IBD remains unclear. Studies have indicated that an imbalance between T helper 17 (Th17) and regulatory T (Treg) cells contributes significantly to the development of IBD. Intestinal Tregs suppress inflammation and are critical for maintaining tissue homeostasis. Th17 cells are known to play an import-ant role in the development and pathogenesis of IBD and provide non-inflammatory support for the integrity of the intestinal barrier against bacterial and fungal infections. Therefore, the Th17/Treg cell balance is crucial in the pathogenesis of IBD and gut integrity. The micro-environment of the intestinal mucosal immunity is regulated by the secretion of cytokines associated with Th17 cells and Tregs. Several studies have indicated that the gut bacteria contribute to the control of the immune milieu and play a key role in the regulation of Th17 cell development. Intestinal bacteria and cytokines control Th17 cell development. Th17 cells secrete cytokines that regulate the immune microenvironment in the gut mucosa. This review provides an overview of Th17 cells and examines the strategies for treating patients with IBD using Th17 cell-targeted drugs.

Inflammatory bowel disease (IBD) is a chronic condition characterized by continuous inflam-mation of the gastrointestinal tract that varies in intensity over time. IBD is caused by several factors including aberrant gut flora, immunological dysregulation, altered environmental con-ditions, and genetic variations. However, the pathogenesis of IBD remains unclear. Studies have indicated that an imbalance between T helper 17 (Th17) and regulatory T (Treg) cells contributes significantly to the development of IBD. Intestinal Tregs suppress inflammation and are critical for maintaining tissue homeostasis. Th17 cells are known to play an import-ant role in the development and pathogenesis of IBD and provide non-inflammatory support for the integrity of the intestinal barrier against bacterial and fungal infections. Therefore, the Th17/Treg cell balance is crucial in the pathogenesis of IBD and gut integrity. The micro-environment of the intestinal mucosal immunity is regulated by the secretion of cytokines associated with Th17 cells and Tregs. Several studies have indicated that the gut bacteria contribute to the control of the immune milieu and play a key role in the regulation of Th17 cell development. Intestinal bacteria and cytokines control Th17 cell development. Th17 cells secrete cytokines that regulate the immune microenvironment in the gut mucosa. This review provides an overview of Th17 cells and examines the strategies for treating patients with IBD using Th17 cell-targeted drugs.

Purpose: To determine the clinical manifestations and maternal and perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19). Methods: We conducted a retrospective observational study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to National Health Insurance Service (NHIS) Ilsan Hospital between August 2020 and October 2021. The maternal and perinatal outcomes were investigated. Results: Among 184 pregnant women infected with SARS-CoV-2, 79 women delivered. Of the women who delivered, with 36 women giving birth during the quarantine period. At delivery, 45 women were positive for SARS-CoV-2 by polymerase chain reaction (PCR), whereas 34 women were negative. The most common clinical manifestations were cough (65.2%), fever (38.0%), and myalgia (33.2%). Regarding perinatal outcomes, none of the babies had an Apgar score <7 at 5 minutes, and none were intubated following the delivery. The preterm birth rate and small-for-gestational-age (SGA) rate were 15.2% and 16.5%, respectively. All babies who was delivered at NHIS Ilsan Hospital were negative for SARS-CoV-2 infection by PCR, which was evaluated using amniotic fluid, cord blood, neonatal nasopharyngeal and oropharyngeal swabs in the 1st and 2nd days following delivery, although 45 women were positive for SARS-CoV-2 infection by PCR at the time of delivery. Conclusion Most pregnant women with COVID-19 in South Korea were unlikely to manifest symptoms or present with a severe disease progression. The observed preterm birth rate and SGA rate were higher in women with COVID-19 than in those without COVID-19. However, there was no evidence of vertical transmission, and all babies were negative for SARS-CoV-2 infection during pregnancy.

Inflammatory bowel disease (IBD) is a chronic condition characterized by continuous inflam-mation of the gastrointestinal tract that varies in intensity over time. IBD is caused by several factors including aberrant gut flora, immunological dysregulation, altered environmental con-ditions, and genetic variations. However, the pathogenesis of IBD remains unclear. Studies have indicated that an imbalance between T helper 17 (Th17) and regulatory T (Treg) cells contributes significantly to the development of IBD. Intestinal Tregs suppress inflammation and are critical for maintaining tissue homeostasis. Th17 cells are known to play an import-ant role in the development and pathogenesis of IBD and provide non-inflammatory support for the integrity of the intestinal barrier against bacterial and fungal infections. Therefore, the Th17/Treg cell balance is crucial in the pathogenesis of IBD and gut integrity. The micro-environment of the intestinal mucosal immunity is regulated by the secretion of cytokines associated with Th17 cells and Tregs. Several studies have indicated that the gut bacteria contribute to the control of the immune milieu and play a key role in the regulation of Th17 cell development. Intestinal bacteria and cytokines control Th17 cell development. Th17 cells secrete cytokines that regulate the immune microenvironment in the gut mucosa. This review provides an overview of Th17 cells and examines the strategies for treating patients with IBD using Th17 cell-targeted drugs.

Inflammatory bowel disease (IBD) is a chronic condition characterized by continuous inflam-mation of the gastrointestinal tract that varies in intensity over time. IBD is caused by several factors including aberrant gut flora, immunological dysregulation, altered environmental con-ditions, and genetic variations. However, the pathogenesis of IBD remains unclear. Studies have indicated that an imbalance between T helper 17 (Th17) and regulatory T (Treg) cells contributes significantly to the development of IBD. Intestinal Tregs suppress inflammation and are critical for maintaining tissue homeostasis. Th17 cells are known to play an import-ant role in the development and pathogenesis of IBD and provide non-inflammatory support for the integrity of the intestinal barrier against bacterial and fungal infections. Therefore, the Th17/Treg cell balance is crucial in the pathogenesis of IBD and gut integrity. The micro-environment of the intestinal mucosal immunity is regulated by the secretion of cytokines associated with Th17 cells and Tregs. Several studies have indicated that the gut bacteria contribute to the control of the immune milieu and play a key role in the regulation of Th17 cell development. Intestinal bacteria and cytokines control Th17 cell development. Th17 cells secrete cytokines that regulate the immune microenvironment in the gut mucosa. This review provides an overview of Th17 cells and examines the strategies for treating patients with IBD using Th17 cell-targeted drugs.

Mature cystic teratomas of the ovary are one of the most common ovarian neoplasms found in reproductive age women. Malignant transformation is an uncommon complication in a mature cystic teratoma of the ovary, usually being reported in about 1-3% of cases. Of malignant transformations, squamous cell carcimona is the most common type and sarcomatous transformation is rare, its prognosis is poor. Adenocarcinoma occurs with less frequency. We experienced a case of squamous cell carcinoma and adenocarcinoma arising in mature cystic teratoma of the ovary, so we present this case with brief review of the literature.
Adenocarcinoma* ; Carcinoma, Squamous Cell* ; Female ; Humans ; Ovarian Neoplasms ; Ovary* ; Prognosis ; Teratoma*