A 15-year-old Schnauzer, showing right exophthalmos, was diagnosed as adenocarcinoma originated from the third eyelid gland. On computed tomography, a normal right third eyelid gland was not observed. Instead, a heterogeneous cystic mass invaded the retrobulbar space and displaced the eye globe dorsolaterally. In addition, lysis of the bony nasolacrimal duct was found, which was considered the tumor invasion. These findings indicated that third eyelid gland adenocarcinoma should be considered when a retrobulbar mass is found ventromedial to the globe without observation of the normal third eyelid and accompanies osteolysis of the bony nasolacrimal duct in dogs showing exophthalmos.

BACKGROUND/AIMS: Grape seed proanthocyanidin extract (GSPE) has been reported to have a beneficial effect on regulating inf lammation. However, the anti-inflammatory mechanism of GSPE remains unclear. The aim of this study was to verify the influence of GSPE on the Toll-like receptor 4 (TLR4)-mediated signaling pathway in the regulation of murine autoimmune arthritis. METHODS: Collagen-induced arthritis (CIA) was induced in dilute brown non-agouti (DBA)/1J mice. The mice were treated with GSPE (0 or 100 mg/kg) intraperitoneally. The severity of arthritis was assessed clinically, biochemically, and histologically. Immunostaining for TLR4 was performed. The expressions of TLR4 and downstream signaling molecules were analyzed by Western blot. The effect of GSPE on lipopolysaccharide (LPS)-induced TLR4 activation was also evaluated using RAW264.7 cells and fibroblast-like synoviocytes (FLSs) from patients with rheumatoid arthritis and from those with osteoarthritis. RESULTS: GSPE attenuated the clinical severity of arthritis and decreased histological damage. GSPE treatment reduced the number of TLR4-stained cells in the synovium of mice with CIA. GSPE also downregulated the expression of TLR4, myeloid differentiation factor 88 (MyD88) and phosphorylated IκBα synovial protein in CIA mice. Concurrently, GSPE inhibited the nuclear translocation of nuclear factor-κB (NF-κB) subunits (p65 and p50). LPS-induced TLR4 activation was suppressed by GSPE in human FLS as well as in murine macrophages in vitro. CONCLUSIONS: Our results demonstrated that GSPE ameliorated CIA by regulating the TLR4-MyD88-NF-κB signaling pathway.
Animals ; Arthritis* ; Arthritis, Experimental ; Arthritis, Rheumatoid ; Blotting, Western ; Humans ; In Vitro Techniques ; Macrophages ; Mice ; Myeloid Differentiation Factor 88 ; Osteoarthritis ; Synovial Membrane ; Toll-Like Receptor 4 ; Vitis*

Aorto-right ventricular fistula is a very rare complication of aortic dissection. We report a case of acute aortic dissection extending into the right ventricle as documented by echocardiography. The patient survived after successful surgical repair.
Aorta ; Echocardiography ; Fistula ; Heart Ventricles ; Humans

PURPOSE: There is a paucity of evidence about prognosis after a first febrile seizure in older children. We investigated the prognosis and potential risk factors associated with subsequent unprovoked seizures in children who had experienced a first febrile seizure over 6 years of age, which we termed as late-onset febrile seizure. METHODS: We included all patients six years or older who presented to the emergency department with a febrile seizure between 2009 and 2015. Clinical data was collected by chart review and parents were contacted for information on seizure progress. We used the Cox proportional-hazards model and Kaplan-Meier analysis for evaluating the risk factors for subsequent unprovoked seizures. RESULTS: Of 247 patients, we excluded 168 children who had a history of epilepsy, unprovoked, or febrile seizure and who were followed-up for period less than six months. Overall, 79 patients were classified as having had a first late-onset febrile seizure. During follow-up of 34.9±25.7(mean±SD) months, unprovoked seizure recurred in 7 of 79 patients (9%). The cumulative probability of seizure recurrence was 4% at 6 months, 6% at 1 year and 9% at 2 years. Clinical variables predictive of subsequent unprovoked seizures were not proved. CONCLUSION: This is the first multicenter study focusing on prognosis after a late-onset febrile seizure in children six years or older. The percentage of subsequent unprovoked seizure in patients with late-onset febrile seizure was 9% at 2 years of follow-up. Prospective follow-up study with longer duration is warranted.
Child ; Emergency Service, Hospital ; Epilepsy ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Parents ; Prognosis* ; Prospective Studies ; Recurrence ; Risk Factors ; Seizures ; Seizures, Febrile*

PURPOSE: The purpose of this study was to investigate the clinical significance of Bacille Calmette-Guérin (BCG) site reaction in terms of diagnosis and outcome prediction in young children with Kawasaki disease (KD). METHODS: The incidence of BCG site reaction in the respective age ranges was investigated in 1,058 patients who were admitted at Asan Medical Center between January 2006 and February 2017. The 416 patients under 18 months of age were enrolled as subjects for the analysis of the association between BCG site reaction and other laboratory and clinical findings. The analysis was performed separately in complete and incomplete KD groups. RESULTS: The incidence rate of BCG site reaction was peaked at 6–12 months (83%) and decreased with increasing age after 12 months in 1,058 patients (P < 0.001). The incidence rate was above 70% in KD aged less than 18 months and more frequent than those of cervical lymphadenopathy. The logistic regression analyses showed that the principal clinical findings including conjunctivitis (P=0.781), red lips/oral mucosa (P=0.963), rash (P=0.510), cervical lymphadenopathy (P=0.363), changes in extremities (P=0.283) and the coronary artery aneurysm (P=0.776) were not associated with the BCG site reaction. CONCLUSIONS: The BCG site reaction could be a useful diagnostic tool independent to principal clinical findings in KD developing in children aged < 18 months, who underwent BCG vaccination. Outcome of KD patients was not different between groups with or without the BCG site reaction in both complete KD and incomplete KD.
Aneurysm ; BCG Vaccine ; Child ; Chungcheongnam-do ; Conjunctivitis ; Coronary Vessels ; Diagnosis ; Erythema ; Exanthema ; Extremities ; Humans ; Incidence ; Logistic Models ; Lymphatic Diseases ; Mucocutaneous Lymph Node Syndrome ; Mucous Membrane ; Mycobacterium bovis ; Vaccination

This paper aims to introduce Korea’s total current health expenditure (CHE) and National Health Accounts of the year 2021 and their 2022 preliminary figures constructed on the basis of the System of Health Accounts 2011. As CHE includes expenditures for prevention, tracking, and treatment of coronavirus disease 2019 (COVID-19) and compensation for losses to medical institutions from 2020, the details are also introduced. Korea’s total CHE in 2021 is 193.3 trillion won, which is 9.3% of gross domestic product (GDP). The preliminary figure in 2022, 209.0 trillion won, exceeded the 200 trillion won line for the first time, and its “ratio to GDP” of 9.7% is expected to exceed the average of Organisation for Economic Co-Operation and Development member countries for the first time. Korea’s health expenditures, which were well controlled until the end of the 20th century, have increased at an alarming rate since the beginning of the 21st century, threatening the sustainability of national health insurance. The increase in health expenditure after 2020 is partly due to a temporary increase in response to COVID-19. However, when considering the structure of Korea’s health insurance price hike, where the ratchet effect of increased medical expenses works particularly strongly, it is unlikely that the accelerating growth trend that has lasted for more than 20 years will stop easily. More aggressive policies to control medical expenses are required in the national health insurance which not only constitutes the main financing sources of the Korean health system but also has the most powerful policy means in effect for changes in the health care provision.

Pancreatic cancer is one of the most lethal malignancies worldwide. The risk of developing pancreatic cancer increases with age. Pancreatic cancer is seen mostly in the elderly; patients under the age of 30 years are rare. Known risk factors for pancreatic cancer include genetic mutations, smoking, chronic pancreatitis, and diabetes mellitus. We report a case of pancreatic cancer in a 27-year-old man without the PRSS1 mutation. Chronic pancreatitis and smoking may have contributed to the development of pancreatic cancer in this patient. We also conducted a literature review on early onset pancreatic cancer.

Objective: To develop and validate a model using radiomics features from apparent diffusion coefficient (ADC) map to diagnose local tumor recurrence in head and neck squamous cell carcinoma (HNSCC). Materials and Methods: This retrospective study included 285 patients (mean age ± standard deviation, 62 ± 12 years; 220 male, 77.2%), including 215 for training (n = 161) and internal validation (n = 54) and 70 others for external validation, with newly developed contrast-enhancing lesions at the primary cancer site on the surveillance MRI following definitive treatment of HNSCC between January 2014 and October 2019. Of the 215 and 70 patients, 127 and 34, respectively, had local tumor recurrence. Radiomics models using radiomics scores were created separately for T2-weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE-T1WI), and ADC maps using non-zero coefficients from the least absolute shrinkage and selection operator in the training set. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of each radiomics score and known clinical parameter (age, sex, and clinical stage) in the internal and external validation sets. Results: Five radiomics features from T2WI, six from CE-T1WI, and nine from ADC maps were selected and used to develop the respective radiomics models. The area under ROC curve (AUROC) of ADC radiomics score was 0.76 (95% confidence interval [CI], 0.62–0.89) and 0.77 (95% CI, 0.65–0.88) in the internal and external validation sets, respectively. These were significantly higher than the AUROC values of T2WI (0.53 [95% CI, 0.40–0.67], p = 0.006), CE-T1WI (0.53 [95% CI, 0.40– 0.67], p = 0.012), and clinical parameters (0.53 [95% CI, 0.39–0.67], p = 0.021) in the external validation set. Conclusion The radiomics model using ADC maps exhibited higher diagnostic performance than those of the radiomics models using T2WI or CE-T1WI and clinical parameters in the diagnosis of local tumor recurrence in HNSCC following definitive treatment.

This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.

This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.