PURPOSE: To determine if short term effects of intravitreal anti-vascular endothelial growth factor or steroid injection are correlated with fluid turbidity, as detected by spectral domain optical coherence tomography (SD-OCT) in diabetic macular edema (DME) patients. METHODS: A total of 583 medical records were reviewed and 104 cases were enrolled. Sixty eyes received a single intravitreal bevacizumab injection (IVB) on the first attack of DME and 44 eyes received triamcinolone acetonide treatment (IVTA). Intraretinal fluid turbidity in DME patients was estimated with initialintravitreal SD-OCT and analyzed with color histograms from a Photoshop program. Central macular thickness and visual acuity using a logarithm from the minimum angle of resolution chart, were assessed at the initial period and 2 months after injections. RESULTS: Visual acuity and central macular thickness improved after injections in both groups. In the IVB group, visual acuity and central macular thickness changed less as the intraretinal fluid became more turbid. In the IVTA group, visual acuity underwent less change while central macular thickness had a greater reduction (r = -0.675, p = 0.001) as the intraretinal fluid was more turbid. CONCLUSIONS: IVB and IVTA injections were effective in reducing central macular thickness and improving visual acuity in DME patients. Further, fluid turbidity, which was detected by SD-OCT may be one of the indexes that highlight the influence of the steroid-dependent pathogenetic mechanism.
Aged ; Angiogenesis Inhibitors/*therapeutic use ; Bevacizumab/*therapeutic use ; Diabetic Retinopathy/*drug therapy/physiopathology ; Female ; Glucocorticoids/*therapeutic use ; Humans ; Intravitreal Injections ; Macular Edema/*drug therapy/physiopathology ; Male ; Middle Aged ; Nephelometry and Turbidimetry ; Retina/pathology ; *Subretinal Fluid ; Tomography, Optical Coherence ; Treatment Outcome ; Triamcinolone Acetonide/*therapeutic use ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/physiology

PURPOSES: Resveratrol is a phenolic compound found in grapes and other food products. In order to assess the availability of resveratrol as an angio-inhibiting drug, we examined whether resveratrol plays an important role in bovine aortic endothelial cells (BAECs) for cell apoptosis and cell migration. METHODS AND MATERIALS: Endothelial cell apoptosis was observed as detected by the Hoechst staining and the caspase-3 activity. Additionally, Western blotting was performed for monitoring the activities of various cell signaling molecules. RESULTS: Resveratrol was shown to act as a pro-apoptotic agent. The pro-apoptotic effect of resveratrol was as great as that of etoposide, a well-known anti-cancer drug. In addition, resveratrol had an inhibitory effect on endothelial cell migration. The demonstrated efficacy of resveratrol suggests that resveratrol may be utilized as an anti-angiogenic drug. To determine the underlying mechanisms, we further investigated which signaling molecules are activated by resveratrol. Extracellular signal-regulated kinase (ERK) was activated by the treatment with resveratrol in BAECs, whereas endothelial nitric oxide synthetase (eNOS), Akt, and Jun N-terminal kinase (JNK) were inhibited. The pretreatment with PD compound, an ERK inhibitor, had no effect on the pro-apoptosis induced by resveratrol. CONCLUSION: Resveratrol plays an important role in endothelial cell apoptosis, indicating that resveratrol can be utilized as a potent anti-angiogenic drug.
Apoptosis ; Blotting, Western ; Caspase 3 ; Cell Movement ; Endothelial Cells* ; Etoposide ; Nitric Oxide Synthase ; Phenol ; Phosphotransferases ; Vitis

“Icteric type hepatoma” is a hepatocellular carcinoma (HCC) with tumor invasion to the bile duct (bile duct tumor thrombus, BDTT) causing obstructive jaundice. Effective and long-term decompression of the bile duct is essential for the palliative treatment for the patients. Percutaneous self-expandable metallic stent placement is a well-established treatment for palliating patients with an inoperative malignant biliary obstruction. This article reviews the treatment of percutaneous placement of self-expandable metallic stents for the management of obstructive jaundice caused by HCC.
Bile Ducts ; Carcinoma, Hepatocellular ; Decompression ; Humans ; Jaundice ; Jaundice, Obstructive ; Palliative Care ; Stents ; Thrombosis

The infantile skull is malleable, and its sutures are tightly adhering to the underlying dura and venous sinus. These characteristics, in association with the small amount of total blood volume, can result in a specific fatal type of skull fracture, which is unique to infancy. The authors report a case of this injury, and stress the need to pay attention to the possibility of massive bleeding during operation in infants. A 23-month-old female baby presented with semicomatose mentality after sustaining injuries by falling from a second-floor. Plain skull films showed bi-frontal skull fracture crossing the midline. Computed tomography revealed an acute subdural hematoma along the right convexity with severe brain edema. In the emergency operation, the scalp incision exposed massive bleeding from the fracture site. The bleeding was identified as arising from the lacerated and widely separated sagittal sinus beneath the fracture. The patient entered hypovolemic shock immediately after the scalp incision, and died from severe brain edema two days after the trauma and surgery. This case implies that special care should be paid during the operation of patients that have skull fracture overlying the venous sinus, especially when the fracture line is separated.
Blood Volume ; Brain Edema ; Brain Injuries ; Craniocerebral Trauma* ; Emergencies ; Female ; Hematoma, Subdural, Acute ; Hemorrhage ; Humans ; Infant ; Sagittal Sinus Thrombosis ; Scalp ; Shock ; Skull ; Skull Fractures* ; Sutures

The aim of this study was to develop and validate a new radiographic damage scoring method (DAmagE index of GoUt; DAEGU) in chronic gout using plain radiography. Two independent observers scored foot x-rays from 15 patients with chronic gout according to the DAEGU method and the modified Sharp/van der Heijde (SvdH) method. The 10 metatarsophalangeal (MTP) and 2 interphalangeal (IP) joints of the first toes of both feet were scored to assess the degrees of erosion and joint space narrowing (JSN). The intraobserver and interobserver reliabilities were analyzed by calculating the intraclass correlation coefficient (ICC) and minimal detectable change (MDC). The correlation between the DAEGU and SvdH methods was analyzed by calculating the Spearman's rho correlation coefficients and Kappa coefficients. The DAEGU method was found to be highly reproducible (0.945-0.987 for the intraobserver and 0.993-0.996 for the interobserver ICC values). The erosion, JSN, and total scores exhibited strong positive correlations between the DAEGU and SvdH methods and also within each method (r = 0.860-0.969, P < 0.001 for all parameters). The DAEGU and SvdH methods were in very good agreement as determined by Kappa coefficient analysis [0.732 (0.387-1.000) for erosion and 1.000 (1.000-1.000) for JSN]. In conclusion, this study revealed that DAEGU method was a reliable and feasible tool in the assessment of radiographic damage in chronic gout. The DAEGU method may provide a more easy assessment of structural damage in chronic gout in the real clinical practice.
Adult ; Arthritis, Gouty/*diagnostic imaging/pathology ; Chronic Disease ; Female ; Humans ; Joints/*diagnostic imaging/pathology ; Male ; Middle Aged ; Severity of Illness Index ; *Tomography, X-Ray Computed

Background: Depression is increasing among college students in general. Moreover, almost one-third of college students have been reported to suffer from depression. Thus, this study aimed to assess differences in stress coping strategies and resilience between depressed and normal-mood groups among college students. Methods: A total of 3,306 college students participated in this study. The students responded to a questionnaire that included questions of the Center for Epidemiologic Studies Depression (CES-D) scale, stress coping scale (SCS), and brief resilience scale. Logistic regression analysis was conducted to evaluate the impact of variables on depression. Results: Using the CES-D (cutoff score ≥21), 423 (12.8%) college students were classified as depressed. Adjusting for individual demographic factors, the SCS results of the students with depression showed significantly higher scores in emotion-focused coping (p<0.001), wishful thinking (p<0.001), and lower problem-focused coping (p<0.001) than the normal-mood group. Moreover, they presented lower resilience scores. Students who had emotion-focused coping (odds ratio [OR], 1.11; p<0.001) and lower resilience scores (OR, 0.76; p<0.001) were associated with higher CES-D scores. Conclusion The study findings revealed significant differences between the depressed and normal-mood groups in terms of stress coping skills and resilience, suggesting the need for promoting stress coping strategies and resilience to lower depression-related problems among college students.

Background: Alcohol drinking among college students is socially permissible in Korea. However, this population’s tendency to consume alcohol excessively results in many alcohol-related problems, including psychiatric problems.This study aimed to identify the sociodemographic characteristics and psychiatric comorbidities associated with hazardous alcohol drinking among college students. Methods: In total, 2,571 college students participated in the study. Data were collected using the Korean version of the Alcohol Use Disorders Identification Test (AUDIT-K), the Mood Disorder Questionnaire, the Center for Epidemiologic Studies Depression Scale, a modified Korean version of the 16-item Prodromal Questionnaire, the Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale-Version 1.1, and a stress-coping scale. Logistic regression analysis was performed on variables significantly correlated with hazardous alcohol drinking. Results: In total, 633 students were grouped into the hazardous alcohol drinking group (AUDIT-K, ≥12). The associ-ated variables were age (odds ratio [OR], 0.95; p<0.05), smoking (OR, 4.00; p<0.001), bipolar disorder (OR, 2.45; p<0.05), depressive disorder (OR, 1.35; p<0.05), attention-deficit/hyperactivity disorder (ADHD; OR, 1.44; p<0.05), and problem-focused stress coping (OR, 0.97; p<0.05). Conclusion In this study, hazardous alcohol drinking was associated with smoking, mood disorders, and ADHD. We suggest that alcohol use among college students be carefully monitored and managed in terms of its psychiatric comorbidities.

The number of reported varicella cases is continuously increasing in Korea; however, associated medical utilization is declining. The ratio between varicella insurance claims and reports of passive infectious disease surveillance has gradually increased to > 80% since the second half of 2017. The recent increase in reported varicella cases is influenced by improved reporting. We calculated the varicella incidence and cumulative incidence in each birth cohort according to age. The cumulative incidence rate among children aged < 6 years in the birth cohort born after the National Immunization Program introduced the varicella vaccine was about 60% lower than among children born before
Chickenpox Vaccine ; Chickenpox ; Child ; Cohort Studies ; Communicable Diseases ; Humans ; Immunization Programs ; Immunization ; Incidence ; Insurance ; Korea ; Parturition

Various vaccines have been developed to fight severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the coronavirus disease 2019 pandemic.However, new variants of SARS-CoV-2 undermine the effort to fight SARS-CoV-2. Here, we produced S proteins harboring the receptor-binding domain (RBD) of the Omicron variant in plants. Plant-produced S proteins together with adjuvant CIA09A triggered strong immune responses in mice. Antibodies in serum inhibited interaction of recombinant human angiotensinconverting enzyme 2 with RBD of the Omicron variant, but not RBD of other variants. These results suggest that antibodies induced by RBD of the Omicron variant are highly specific for the Omicron RBD, but not for that of other variants.

Background: Human adenovirus (HAdV) is a common cause of acute respiratory disease (ARD) and has raised significant concerns within the Korean military. Here, we conducted a comprehensive epidemiological analysis of HAdV-associated ARD by evaluating its prevalence, clinical outcomes, and prognosis. Methods: We reviewed data from multiple sources, including the New Defense Medical Information System, Defense Medical Statistical Information System, Ministry of National Defense, Army Headquarters, Navy Headquarters, Air Force Headquarters, and Armed Forces Medical Command. We analyzed data of patients who underwent polymerase chain reaction (PCR) testing for respiratory viruses between January 2013 and July 2022 in all 14 Korean military hospitals. The analysis included the PCR test results, demographic characteristics, health care utilization, and prognosis including types of treatments received, incidence of pneumonia, and mortality. Results: Among the 23,830 individuals who underwent PCR testing at Korean military hospitals, 44.78% (10,670 cases) tested positive for respiratory viruses. Across all military types and ranks, HAdV was the most prevalent virus, with a total of 8,580 patients diagnosed, among HAdV, influenza virus, human metapneumovirus, human parainfluenza virus, and human respiratory syncytial virus. HAdV-infected patients exhibited higher rates of healthcare use compared to non-HAdV-infected patients, including a greater number of emergency visits (1.04 vs. 1.02) and outpatient visits (1.31 vs. 1.27), longer hospitalizations (8.14 days vs. 6.84 days), and extended stays in the intensive care unit (5.21 days vs. 3.38 days).Furthermore, HAdV-infected patients had a higher proportion of pneumonia cases (65.79%vs. 48.33%) and greater likelihood of receiving advanced treatments such as high flow nasal cannula or continuous renal replacement therapy. Conclusion Our findings indicate that HAdV posed a significant public health concern within the Korean military prior to the coronavirus disease 2019 (COVID-19) pandemic. Given the potential for a resurgence of outbreaks in the post-COVID-19 era, proactive measures, such as education, environmental improvements, and the development of HAdV vaccines, are crucial for effectively preventing future outbreaks.