Purpose: This study aimed to evaluate the incidence and prognosis of second non-breast primary cancer (SNBPC) among Korean survivors of breast cancer. Materials and Methods: Data from the Korean National Health Insurance Service were searched to identify women who received curative surgery for initial breast cancer (IBC) between 2003 and 2008 (n=64,340). Among them, patients with the following characteristics were excluded: other cancer diagnosis before IBC (n=10,866), radiotherapy before IBC (n=349), absence of data on sex or age (n=371), or male (n=248). Accordingly, data of 52,506 women until December 2017 were analyzed. SNBPC was defined as a newly diagnosed SNBPC that occurred 5 years or more after IBC diagnosis. Results: The median follow-up time of all patients was 12.13 years. SNBPC was developed in 3,084 (5.87%) women after a median of 7.61 years following IBC diagnosis. The 10-year incidence of SNBPC was 5.78% (95% confidence interval [CI], 5.56 to 6.00). Higher SNBPC incidence was found in survivors with the following factors: old age at IBC diagnosis, low household income, and receiving combined chemotherapy with endocrine therapy, whereas receiving radiotherapy was related to a lower incidence of SNBPC (hazard ratio, 0.89; p < 0.01). Among the patients with SNBPC, the 5-year survival rate was 62.28% (95% CI, 65.53 to 69.02). Conclusion Approximately 5% of breast cancer survivors developed SNBPC within 10 years after IBC diagnosis. The risk of SNBPC was associated with patient’s age at IBC diagnosis, income level, and a receipt of systemic treatments.

The KOrean College of Rheumatology BIOlogics and targeted therapy (KOBIO) registry is a nationwide observational cohort that captures detailed data on exposure of patients to biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs). This registry was launched in December 2012 with an aim to prospectively investigate clinical manifestations and outcomes of patients with rheumatoid arthritis (RA), ankylosing spondylitis, and psoriatic arthritis who initiated a biologic or targeted synthetic DMARD or switched to another. Demographic data, disease activity, current treatment, adverse events, terms based on Medical Dictionary for Regulatory Activities, and so on are registered for patients who are then followed up annually in a web-based unified platform. The KOBIO registry also recruits and collects data of patients with RA on conventional DMARDs for comparison. As of today, more than 5,500 patients were enrolled from 47 academic and community Rheumatology centers across Korea. The KOBIO registry has evolved to become a powerful database for clinical research to improve clinical outcomes and quality of treatment.

The KOrean College of Rheumatology BIOlogics and targeted therapy (KOBIO) registry is a nationwide observational cohort that captures detailed data on exposure of patients to biologic and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs). This registry was launched in December 2012 with an aim to prospectively investigate clinical manifestations and outcomes of patients with rheumatoid arthritis (RA), ankylosing spondylitis, and psoriatic arthritis who initiated a biologic or targeted synthetic DMARD or switched to another. Demographic data, disease activity, current treatment, adverse events, terms based on Medical Dictionary for Regulatory Activities, and so on are registered for patients who are then followed up annually in a web-based unified platform. The KOBIO registry also recruits and collects data of patients with RA on conventional DMARDs for comparison. As of today, more than 5,500 patients were enrolled from 47 academic and community Rheumatology centers across Korea. The KOBIO registry has evolved to become a powerful database for clinical research to improve clinical outcomes and quality of treatment.

Coronavirus disease 2019 (COVID-19) is a global pandemic that had affected more than eight million people worldwide by June 2020. Given the importance of the presence of diabetes mellitus (DM) for host immunity, we retrospectively evaluated the clinical characteristics and outcomes of moderate-to-severe COVID-19 in patients with diabetes.

Background/Aims: Inflammatory bowel disease (IBD) is an autoimmune disease characterized by chronic inflammation mainly in the large intestine. The interleukin-10 knockout (IL-10 KO) mouse is a well-known animal model of IBD that develops spontaneous intestinal inflammation resembling Crohn’s disease. Oxidative stress is considered to be the leading cause of cell and tissue damage. Reactive oxygen species (ROS) can cause direct cell injury and/or indirect cell injury by inducing the secretion of cytokines from damaged cells. This study evaluated the effects of mesenchymal stem cell (MSC) on the progression of IBD. Methods: In this study, human bone marrow-derived MSCs were injected into IL-10 KO mice (MSC). Oxidative stress and inflammation levels were evaluated in the large intestine and compared with those in control IL-10 KO mice (CON) and normal wild-type control mice (Wild). Results: The levels of ROS (superoxide and hydrogen peroxidase) and a secondary end-product of lipid peroxidation (malondialdehyde) were considerably higher in the CON, while superoxide dismutase and catalase levels were lower in the MSC. Inflammation-related marker (interferon-γ, tumor necrosis factor-α, IL-4, and CD8) expression and inflammatory histological changes were much less pronounced in MSC than in CON. Conclusions MSCs affect the redox balance, leading to the suppression of IBD.

OBJECTIVE: This study aimed to identify the characteristics of bicycle driver accidents, and investigate the factors related to the admission. METHODS: Adult patients (≥20 years old), who visited the emergency department (ED) after a bicycle driver accident registered in the Korean ED-based Injury In-Depth Surveillance (2011–2016) database, were included. The demographic characteristics, accident-related factors, and patients'disposition after the ED treatment were collected. All included cases were categorized into two groups according to the disposition: discharge versus admission. The characteristics of the two groups were compared, and the factors associated with admission were investigated. RESULTS: Among 25,070 ED visits, admissions were required in 5,963 patients (23.8%). The most frequent age group was the twenties (22.0%), and there were more males (74.7%) than females. Accidents occurred most in the summer (34.4%), and non-bicycle roads (73.5%) were the most common places. The most frequently injured body part was the headeck (43.0%), followed by the upper extremities (21.5%). The odds for admission were lower in females than males (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.78–0.96). The odds for admission were higher in the age group over 40 years than in their twenties. Non-bicycle roads had higher odds for admission than bicycle roads (OR, 1.60; 95% CI, 1.40–1.83). Torso (OR, 2.17; 95% CI, 1.92–2.47), upper extremities (OR, 1.20; 95% CI, 1.07–1.35), and lower extremities (OR, 1.48; 95% CI, 1.31–1.66) had higher odds for admission than the headeck. CONCLUSION Male sex, old age group, accidents on non-bicycle roads, and torso/extremities injuries were associated with the admission in bicycle driver accidents.

OBJECTIVE: Although middle cerebral artery (MCA) aneurysms are less amenable to coil embolization, an increasing number of studies support favorable endovascular treatment for them. The purpose of this study is to compare the outcomes of two different treatments (surgery versus coiling) and evaluate the benefits of surgical clipping for MCA aneurysms. METHODS: Here we retrospectively analyzed the outcomes of 178 ruptured and unruptured MCA aneurysms treated in patients between September 2008 and April 2012. Parameters assessing treatment outcomes include degree of aneurysm occlusion, presence of regrowth, clinical status, and complications. RESULTS: Among 178 MCA aneurysms, 153 were treated surgically. After a mean follow-up of 12 months, the surgery group showed a clinically significant complete occlusion rate (98%) compared with the coiling group (56%) (p<0.001). Follow-up radiologic evaluation showed a higher regrowth rate (four of 16 cases) in the coiling group than in the surgery group (one of 49 cases) (p=0.003). There was no statistically significant difference in favorable clinical outcome rate between the two groups. The procedure-related permanent morbidity and mortality rates were 2% (three of 153 cases) in the surgery group and 0% (0 of 25 cases) in the coiling group. CONCLUSION: Compared to endovascular treatment, surgical neck clipping for both ruptured and unruptured MCA aneurysms results in a significantly higher complete obliteration rate and less regrowth. Therefore, even in this endovascular era, we still recommend surgical clipping as the primary treatment option for MCA aneurysms rather than coil embolization.
Aneurysm* ; Embolization, Therapeutic ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Middle Cerebral Artery* ; Mortality ; Neck* ; Retrospective Studies ; Surgical Instruments

PURPOSE: The adverse effects of obesity on short-term surgical outcomes after laparoscopic colorectal surgery have been reported. However, the influence of obesity on long-term oncological outcomes after laparoscopic surgery in Asian patients has not been well understood. The aim of this study was to evaluate the effect of obesity on long-term oncologic outcomes in patients who underwent laparoscopic surgery for colorectal cancer. METHODS: Overall, 424 consecutive patients who underwent laparoscopic resection for colorectal cancer between January 2005 and July 2012 were included in this retrospective study. Patients were classified as non-obese (body mass index [BMI] <25.0 kg/m²) and obese (BMI ≥25.0 kg/m²) according to the categories proposed by the International Obesity Task Force. A survival analysis was performed using clinicopathologic characteristics, including obesity. RESULTS: Of the 424 patients, 325 (76.7%) were classified as non-obese and 99 (23.3%) as obese. The clinicopathologic characteristics of the obese and non-obese groups were similar, except that there were more underlying comorbidities, a lower frequency of smoking, and fewer tumors in rectum in the obese group. Results of the multivariate analysis showed that older age, elevated serum carcinoembryonic antigen, high-grade histology, advanced tumor stage, and perineural invasion were associated with poorer disease-free survival and overall survival. Obesity was not significantly associated with disease-free survival (hazard ratio [HR], 1.196; 95% confidence interval [CI], 0.686~2.086; p=0.528) or overall survival (HR, 1.156; 95% CI, 0.584~2.289; p=0.677). CONCLUSION: Laparoscopic surgery for colorectal cancer seems to be safe and feasible for obese patients in terms of long-term oncologic outcomes.
Advisory Committees ; Asian Continental Ancestry Group* ; Body Mass Index ; Carcinoembryonic Antigen ; Colorectal Neoplasms* ; Colorectal Surgery ; Comorbidity ; Disease-Free Survival ; Humans ; Laparoscopy* ; Multivariate Analysis ; Obesity* ; Rectum ; Retrospective Studies ; Smoke ; Smoking

OBJECTIVE: The beneficial effect of decompressive craniectomy in the treatment of severe traumatic brain injury (TBI) is controversial, but there is no debate that decompression should be performed before irreversible neurological deficit occurs. The aim of our study was to assess the value of ultra-early decompressive craniectomy in patients with severe TBI. METHODS: Total of 127 patients who underwent decompressive craniectomy from January 2007 to December 2013 was included in this study. Among them, 60 patients had underwent ultra-early (within 4 hours from injury) emergent operation for relief of increased intracranial pressure. Initial Glasgow coma scale, brain computed tomography (CT) scan features by Marshall CT classification, and time interval between injury and craniectomy were evaluated retrospectively. Clinical outcome was evaluated, using the modified Rankin score. RESULTS: The outcomes of ultra-early decompressive craniectomy group were not better than those in the comparison group (p=0.809). The overall mortality rate was 68.5% (87 patients). Six of all patients (4.7%) showed good outcomes, and 34 patients (26.8%) remained in a severely disabled or vegetative state. Forty of sixty patients (66.7%) had died, and two patients (3.3%) showed good outcomes at last follow-up. CONCLUSION: Ultra-early decompressive craniectomy for intracranial hypertension did not improve patient outcome when compared with "early or late" decompressive craniectomy for managing severe TBI.
Brain Injuries ; Brain* ; Classification ; Decompression ; Decompressive Craniectomy* ; Follow-Up Studies ; Glasgow Coma Scale ; Humans ; Intracranial Hypertension ; Intracranial Pressure ; Mortality ; Persistent Vegetative State ; Retrospective Studies ; Treatment Outcome

Ascidian soft tunic syndrome (AsSTS) caused by Azumiobodo hoyamushi (A. hoyamushi) is a serious aquaculture problem that results in mass mortality of ascidians. Accordingly, the early and accurate detection of A. hoyamushi would contribute substantially to disease management and prevention of transmission. Recently, the loop-mediated isothermal amplification (LAMP) method was adopted for clinical diagnosis of a range of infectious diseases. Here, the authors describe a rapid and efficient LAMP-based method targeting the 18S rDNA gene for detection of A. hoyamushi using ascidian DNA for the diagnosis of AsSTS. A. hoyamushi LAMP assay amplified the DNA of 0.01 parasites per reaction and detected A. hoyamushi in 10 ng of ascidian DNA. To validate A. hoyamushi 18S rDNA LAMP assays, AsSTS-suspected and non-diseased ascidians were examined by microscopy, PCR, and by using the LAMP assay. When PCR was used as a gold standard, the LAMP assay showed good agreement in terms of sensitivity, positive predictive value (PPV), and negative predictive value (NPV). In the present study, a LAMP assay based on directly heat-treated samples was found to be as efficient as DNA extraction using a commercial kit for detecting A. hoyamushi. Taken together, this study shows the devised A. hoyamushi LAMP assay could be used to diagnose AsSTS in a straightforward, sensitive, and specific manner, that it could be used for forecasting, surveillance, and quarantine of AsSTS.
Animals ; Euglenozoa Infections/diagnosis/veterinary ; Kinetoplastida/*classification/genetics/*isolation & purification ; Nucleic Acid Amplification Techniques/*methods ; Predictive Value of Tests ; RNA, Ribosomal, 18S/*genetics ; Sensitivity and Specificity ; Urochordata