Background: s/Aims: The treatment landscape for hepatocellular carcinoma (HCC) has significantly evolved over the past decade. We aimed to analyze trends in treatment patterns for HCC using a nationwide claims database from the Korean Health Insurance Review and Assessment Service. Methods: This retrospective population-based cohort study analyzed 171,002 newly diagnosed HCC patients between 2008 and 2022. Etiologies and treatment modalities were categorized based on the ICD-10 codes and insurance data. Results: The annual incidence decreased from 11,814 in 2008 to 10,443 in 2022. However, patients aged ≥70 increased noticeably, with those aged ≥80 rising from 3.8% in 2008 to 13.1% in 2022. From 2008 to 2022, the predominant cause of hepatitis B virus decreased from 68.9% to 59.7%, whereas nonalcoholic fatty liver disease increased from 8.9% to 15.8%. The initial treatment trends shifted: surgical resection and systemic therapy increased from 12.2% to 21.3% and from 0.2% to 9.6%, whereas transarterial therapy decreased from 49.9% to 36.6%. Best supportive care decreased from 31.7% to 21.3%. In the subgroup analysis, laparoscopic resection rate increased from 10.6% to 60.6% among the surgical resections. Sorafenib initially accounted for 100%, lenvatinib peaked at 36.5% in 2021, and atezolizumab-bevacizumab became the most widely used (63.1%) by 2022 among the systemic therapies. Conclusions This study demonstrates the temporal changes in the treatment patterns of Korean HCC patients. Surgical resection, particularly laparoscopic liver resection, and systemic therapy has increased significantly. These changes may have been influenced by reimbursement policies and advances in clinical research.

Complications after a median sternotomy incision, which is used currently in most open heart surgery, are serious, although it is infrequent. Reconstruction of the sternal defect resulting from dehiscence of median sternotomy is still big challenge to the most plastic surgeons. Since vascularized greater omentum was transposed to eliminate mediastinal wound problems, many vascularized regional muscle flaps became mainstay in reconstruction of median sternotomy wound. We treated 13 patients with median sternotomy dehiscence between October of 1993 and March of 1998. In two patients, the wound problems were so confined to superficial tissue that debrided and closed primarily. Eleven patients with deep wound infection were managed with vigorous debridement of all necrotic tissues and resultant defects were covered with regional muscle flaps: rectus myocutaneous flap(3) and bilateral pectoralis advancement flap(8). We used the pectoralis major advancement flaps without counter incision at humeral insertion site and the dissections were limited only medial to the anterior axillary line to preserve the axillary fold. In five patients with larger defects, we elevated muscle and cutaneous flaps separately to make these flaps more mobile. Large portion of two rectus abdominis flaps could not survive, whereas pectoralis advancement flaps had mo special wound problems. Only one patient developed fistula due to remained wire, regardless to flap surgery.
Debridement ; Fistula ; Humans ; Omentum ; Rectus Abdominis ; Sternotomy* ; Thoracic Surgery ; Wound Infection ; Wounds and Injuries

Nutrition labels are helpful for chronic disease management in patients requiring balanced nutritional intake. This study aimed to investigate the association between the use of nutrition labels and chronic diseases (hypertension, diabetes mellitus, and hyperlipidemia) by using the 2008-2009 Korea National Health and Nutrition Examination Survey data. A total of 10,695 individuals aged 20 and over was included in the analysis. Using multiple logistic regressions, there was no difference in nutrition label use between the chronic disease and normal groups (men with hypertension OR, 0.97; 95% CI, 0.75-1.27; women with hypertension OR, 0.83; 95% CI, 0.67-1.03; men with diabetes OR, 0.70; 95% CI, 0.45-1.08; women with diabetes OR, 1.13; 95% CI, 0.84-1.53; men with hyperlipidemia OR, 0.85; 95% CI, 0.59-1.23; women with hyperlipidemia OR, 1.14; 95% CI, 0.91-1.44). In hyperlipidemia patients, awareness (OR, 1.55; 95% CI, 1.03-2.35) and control (OR, 2.19; 95% CI, 2.32-3.63) of disease were related to nutrition label use; however, no significant associations were found for the hypertension and diabetes mellitus patients. Considering the importance of dietary habits in the management of chronic diseases, an improvement in nutrition label use by patients with these diseases is required.
Adult ; Aged ; Chronic Disease ; Demography ; Diabetes Mellitus/pathology/*prevention & control ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hyperlipidemias/pathology/*prevention & control ; Hypertension/pathology/*prevention & control ; Logistic Models ; Male ; Middle Aged ; *Nutrition Surveys ; Nutritive Value ; Odds Ratio ; Republic of Korea

OBJECTIVES: This study determined the work schedules of public project workers who work an irregular shift and assessed the effect of these schedules on depression. METHODS: Study subjects were 2934 laborers who are members of seven labor unions. Each was given a questionnaire requesting basic personal information, habits, socioeconomic status, and work schedules. Information gathered on work schedules included daytime, nighttime, and weekend work hours. Depression was evaluated using the Beck Depression Inventory (BDI), with Laborers who checked "not depressed" and "slightly depressive" categorized to a low-risk group, whereas laborers who checked "depressed" and "severely depressed" were categorized to a high-risk group. We used the Chi-square test and multivariate logistic regression to examine associations between work schedules and depression. RESULTS: Laborers on an irregular work schedule averaged 47.8 hours/week and laborers who working over 48 hours/week comprised over half (54.5%) of the total population. Laborers performing night work, Sunday work, and Saturday work more than once in a month made up 25.7%, 30.8% and 33.5% of the examined population, respectively. A high-risk for depression was identified in 10.4% of laborers. Using logistic regression, depression was statistically associated with working : over 10 hours a day (OR=1.63, 95% CI 1.10~2.43), night work (OR=2.20, 95% CI 1.46~3.32), Sunday work (OR=1.81, 95% CI 1.15~2.85) and Saturday work (OR=1.82 95% CI 1.18~2.82). CONCLUSION: A significant number of laborers with irregular working shifts work long hours and on weekends. Depression was significantly associated with this type of work schedule.
Appointments and Schedules ; Depression ; Humans ; Labor Unions ; Logistic Models ; Public Sector ; Questionnaires ; Social Class

BACKGROUND: Helicobacter pylori (H. pylori) infection may cause systemic inflammation and increase the production of tumor necrosis factor-alpha, interleukin-1, and interleukin-6. Unfortunately, bone mineral density also may be affected by these cytokines. This study aimed to evaluate the association between bone mineral density and H. pylori infection. METHODS: A cross-sectional study evaluated 1,126 men undergoing a comprehensive health screening in a private Korean screening center. Subjects' sera were tested for H. pylori antibodies (immunoglobulin G) using an enzyme-linked immunosorbent assay, and bone mineral densities (g/cm2) of the lumbar spine, femoral neck, and total femur were obtained using dual-energy X-ray absorptiometry. To evaluate the difference in bone mineral density according to H. pylori infection status, the adjusted mean bone mineral densities at each site were compared after adjusting for potential confounders, including age, sex, body mass index, smoking, alcohol consumption, and exercise. RESULTS: H. pylori infection was associated with a significant decrease in mean lumbar bone mineral density (H. pylori-positive, 1.190 g/cm2; H. pylori-negative, 1.219 g/cm2; P=0.006), which was greatest among men who were > or =50 years old (H. pylori-positive, 1.193 g/cm2; H. pylori-negative, 1.233 g/cm2; P=0.006). However, no significant association was observed in the bone mineral densities of the total femur and femoral neck. CONCLUSION: In men, H. pylori infection was negatively associated with lumbar bone mineral density. This association may be useful in the early detection, prevention, and management of male osteoporosis.
Absorptiometry, Photon ; Alcohol Drinking ; Antibodies ; Body Mass Index ; Bone Density ; Cross-Sectional Studies ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Femur ; Femur Neck ; Helicobacter pylori* ; Helicobacter* ; Humans ; Inflammation ; Interleukin-1 ; Interleukin-6 ; Male ; Mass Screening ; Osteoporosis ; Risk Factors* ; Smoke ; Smoking ; Spine ; Tumor Necrosis Factor-alpha

In two female siblings, growth and developmental retardation, poor sucking, anorexia, floppiness and respiratory difficulty developed around 2 and 4 monthes of age in each, and the respiratory symptoms rapidly aggravated to comatose states and finally into death one month later. On admission at emergency room, severe acidosis and high lactate and pyruvate levels in serum and cerebrospinal fluid were revealed in one. Brain computed tomography and magnetic resonance imaging revealed identical bilateral involvement of putamen in both of the sibs, which made the diagnosis of Leigh disease(subacute necrotizing encephalomyelopathy) possible. There is also a family history of early death in infancy period; an elder sister and a brother of mother died with unknown cause at their 5 and 10 months of age. Mitochondrial enzyme functions could not be assayed.
Acidosis ; Anorexia ; Brain ; Cerebrospinal Fluid ; Coma ; Diagnosis ; Emergency Service, Hospital ; Female ; Growth and Development ; Humans ; Lactic Acid ; Leigh Disease* ; Magnetic Resonance Imaging ; Mothers ; Putamen ; Pyruvic Acid ; Siblings

No abstract available.
Animals ; Congenital Abnormalities* ; Rats*

Purpose: The purpose of this study was to investigate the effect of assistance tools such as gym balls, wedges, and straps on lower extremity muscle activity and the increase in the range of motion made possible by the use of these tools. The subjects were divided into two groups: a group capable of deep-squatting (PS) and the second finding it impossible or having difficulty in performing such squats (IS). Methods: Twenty-three subjects participated in this study. Surface electromyography was used to measure the muscle activation of the rectus femoris (RF), vastus medialis (VM), and tibialis anterior (TA) muscles during deep squats, normal squats (NS), gym ball squats (GS), wedge squats (WS), and strap squats (SS). A motion analysis system was used to measure the range of motion of the knee joint during each of these exercises. Results: There was a significant difference in the RF muscle activity between the possible squat (PS) and the impossible squat (IS) groups in the GS, and there were significant differences in the RF and TA muscle activity between the groups in the WS. Both the PS group and the IS group showed a significant difference in the TA muscle activity depending on the tool used. There were also significant differences in the range of motion of the knee joints between the intervention methods using NS and those using the tools. Conclusion In both groups, the muscle activity of the TA muscles was lower when GS, WS, and SS were performed compared to NS. In addition, compared to NS, the range of motion of the knee joint increased when the three tools were used. This study shows that the activity of the RF, VM, and TA muscles decreased and the range of motion of the knee joint increased during deep squats for both the PS and IS groups when tools were used.

No abstract available.
Humans ; Listeria* ; Meningitis, Listeria*

BACKGROUND: The nationwide statistical analysis of hematologic malignancies in Korea has not been reported yet. METHODS: The Korea Central Cancer Registry and the Korean Society of Hematology jointly investigated domestic incidence rates and prevalence of hematologic malignancies occurred between 1999 and 2008, and analyzed survival rates of patients who were diagnosed between 1993 and 2008. Data of hematologic malignancies from 1993 to 2008 were obtained from the Korean National Cancer Incidence Data base. The crude incidence rates, age-specific incidence rates, age-standardized incidence rates, annual percentage change of incidence, and prevalence from 1999-2008 were calculated. Survival rates for patients diagnosed in 1993-2008 were estimated. RESULTS: In 2008, a total of 8,006 cases of hematologic malignancies were occurred, which comprised 4.5% of all malignancies. In all genders, non-Hodgkin lymphoma, myeloid leukemia, and multiple myeloma were most frequent diseases. In terms of age, ages between 60 and 69 were most prevalent. From 1999 to 2008, the age-standardized incidence rates increased from 10.2 to 13.7, and the annual percentage change was 3.9%. The 5-year survival rate increased from 38.2% during 1993-1995 to 55.2% during 2004-2008. As of January 2009, number of patients with 10-year prevalence was 33,130, and with 5- to 10-year prevalence was 10,515. CONCLUSION: This is the first nationwide statistical report of hematologic malignancies in Korea. It could be used as the basic information to help investigate epidemiologic characteristics, evaluate progress during the past years, and establish future strategies for hematologic malignancies. Periodic statistical analysis of hematologic malignancies in Korea should be continued.
Hematologic Neoplasms ; Hematology ; Humans ; Incidence ; Korea ; Leukemia, Myeloid ; Lymphoma, Non-Hodgkin ; Multiple Myeloma ; Prevalence ; Survival Rate