No Abstract Available.
Chondrocytes* ; Phenotype*

Purpose: To report a case of extensive syphilitic punctate inner retinitis (SPIR) triggering bilateral macular ischemia after intravitreal triamcinolone injections, and the multimodal retinal imaging findings.Case summary: A 69-year-old male patient with nonproliferative diabetic retinopathy was transferred to our hospital because of bilateral visual deterioration (to counting fingers) after the first intravitreal triamcinolone injection. Fundus examination revealed numerous yellow punctate precipitates in the superficial retinae, retinal arteriolitis, and vitritis. The punctate lesions and surrounding retinal regions showed decreased vascular density on optical coherence tomography angiography, and focal hypofluorescence on fluorescein angiography. The patient was positive for all of the Venereal Disease Research Laboratory test, the fluorescent treponemal antibody-absorption test, and Treponema pallidum hemagglutination; we diagnosed bilateral SPIR. After treatment with aqueous crystalline penicillin solutions (24 million units per day for 14 days), the punctate lesions reduced but arteriolitis progressed to obliterative vasculitis. After 6 months, the bilateral SPIR and vitritis resolved, and the bilateral visual acuity improved to 20/100. However, inner retinal and macular ischemia persisted because of capillary nonperfusion attributable to obliterative vasculitis. Conclusions Extensive SPIR can develop after an initial intravitreal steroid injection; the inner retinal ischemia and visual loss may persist after treatment because obliterative vasculitis develops. Therefore, patients scheduled for intravitreal steroid injections should be screened for syphilis infection.

PURPOSE: Bone and cartilage were manufactured by using tissue engineering of mesenchymal stem cell (MSC) which can differentiate into variety of cell types. MATERIAL AND METHOD: MSC was isolated and cultured from the rabbit weighing 500g, and it was seeded into PGA mesh and pre-cultured for 1 week with different TGF- beta 3 treated conditions. It was implanted into nude mice and tissues generated were recovered from 1, 2, 3, 4, 8 ,and 12 weeks respectively. Degree of bone and cartilage formation was analyzed with histology and immunohistochemistry assay. RESULT: Pre-culture condition with TGF- beta 3 treatment showed early start of chondrogenic differentiation, and degree of bone and cartilage formation was promoted as time passed. But both of the cases differentiated into complete bone after 12 weeks. CONCLUSION: The results show that pretreatment of TGF- beta 3 promotes the differentiation process in vivo condition under the in vivo system where MSC differentiate into bone via cartilage formation.
Animals ; Cartilage ; Immunohistochemistry ; Mesenchymal Stromal Cells* ; Mice ; Mice, Nude ; Tissue Engineering

BACKGROUND: More than 90% of acute stroke patients have measurable cardiovascular sequelae, but we have been often overlooked in formal discussions of treatment. If we estimate the incidence of myocardial injury in patient with spontaneous SAH, we may figure the possibility of cardiac dysfunction in such patients. This study was designed to investigate the incidence of myocardial injury in patients with spontaneous SAH using cardiac troponin I(cTnI). METHODS: A prospective single emergency center study was performed to determined preoperative incidence of unrecognized cardiac injury in patients suffering spontaneous SAH. We include the spontaneous SAH patients who underwent serum measurements of the cardic troponin I immediately upon admission last six month period. ECG, CK, CK-MB and myoglobin were also performed at admission. We excluded the spontaneous SAH patients who had past history of myocardial ischemia and ECG abnormality. RESULTS: Fifty-two patients(34 females, 18 males) with spontaneous SAH were studied prospectively. 18 patients(34.6% of the total study population) had cTnI level above 0.5ng/ml. ECG was performed in 52 patients and was abnormal in 15 of the 52 patients(28.8%). CONCLUSION: The measurement of cTnI has provided physicians with a myocardial marker that has a cardiac sensitivity for cardiac injury equal to that of CK-MB yet with greater specificity. So, cardiac troponin I is useful to estimate the incidence of myocardial injury in patients with spontaneous SAH. And we may estimate the possibility of cardiac dysfunction in such patients. This knowledge will hopefully aid in the care and improve the outcome.
Electrocardiography ; Emergencies ; Female ; Humans ; Incidence* ; Myocardial Ischemia ; Myoglobin ; Prospective Studies ; Sensitivity and Specificity ; Stroke ; Troponin I* ; Troponin*

BACKGROUND: Quality-adjusted life expectancy (QALE) means life expectancy (LE) reflecting health-related quality of life and is one of the indicators of healthy LE. We determined the trends in QALE in Korea by age, gender, educational level, and subregion from 2005 to 2013. METHODS: We applied the Sullivan method to estimate QALE. We calculated QALE from 2005 to 2013 by gender and QALE for 2005 and 2010 by educational level at the national level. Furthermore, we estimated QALE for 2005, 2008, and 2011 by subregion according to metropolitan and provincial levels. RESULTS: Population health in Korea measured by LE and QALE at age 0 increased steadily from 2005 to 2013. Annual percent changes of LE and QALE in men were 0.52 and 0.73, respectively (P value < 0.05), and those in women were 0.47 and 0.71, respectively (P value < 0.05). Koreans with a higher educational level had longer LE and QALE than those with a lower educational level, but the differences in LE and QALE according to educational level narrowed from 2005 to 2010. The LE and QALE at age 0 for each of the 16 subnational regions in 2011 increased compared to 2005, but there was still a difference of up to 4.57 years in QALE between subnational regions. CONCLUSION We showed that QALE could be easily calculated and be an appropriate measure for tracking the overall population's health level. The results from this study are expected to aid the Ministry of Health of Republic of Korea in setting up a goal for the National Health Plan.

Thrombotic thrombocytopenic purpura (TTP) can cause serious morbidity and mortality, and differentiating between this disease and systemic lupus erythematosus (SLE) can prove challenging. Although rare, TTP accompanied by SLE is linked to several complications and a higher mortality rate. Herein, we report a case of a 16-year-old boy who presented with systemic symptoms, such as petechiae, and was diagnosed with acquired TTP following a laboratory test. Steroid treatment was initiated and a diagnosis of SLE was reached after the symptoms had improved. Treatment with low-dose prednisone in addition to hydroxychloroquine was continued. The patient did not develop renal failure or neurologic deficit. No specific symptoms were observed after treatment and during the follow-up period. Early treatment of SLE is crucial, but it is difficult to reach an early diagnosis because the symptoms are similar to those of TTP. In the current study, an early diagnosis of TTP led to prompt treatment, thereby avoiding the fatal symptoms that could be caused by SLE.

Purpose: To compare the efficacy and safety of radiofrequency ablation (RFA) and ethanol ablation (EA) followed by RFA in treating mixed cystic and solid thyroid nodules. Materials and Methods: We included 243 nodules from 243 patients who underwent RFA for mixed cystic and solid benign nodules. The nodules were divided into two groups (RFA alone and EA + RFA). We evaluated volume reduction rate (VRR), therapeutic success rate, improvement in symptomatic and cosmetic issues, complications, and adverse effects. Results: The RFA group included 204 patients, and the EA + RFA group included 39 patients.The long-term success rates in the RFA only and EA + RFA groups were 90.2% and 97.4%, respectively. The mean VRR at the last follow-up in the RFA and EA + RFA groups were 81.6% and 87.2%, respectively. Therapeutic results were similar in both groups at the last followup. Cosmetic and symptomatic problems markedly improved in both groups. No major complications were observed. Conclusion Both RFA alone and EA + RA are safe and effective methods for treating mixed cystic and solid thyroid nodules, although EA + RFA is slightly more effective.

Purpose: To compare the efficacy and safety of radiofrequency ablation (RFA) and ethanol ablation (EA) followed by RFA in treating mixed cystic and solid thyroid nodules. Materials and Methods: We included 243 nodules from 243 patients who underwent RFA for mixed cystic and solid benign nodules. The nodules were divided into two groups (RFA alone and EA + RFA). We evaluated volume reduction rate (VRR), therapeutic success rate, improvement in symptomatic and cosmetic issues, complications, and adverse effects. Results: The RFA group included 204 patients, and the EA + RFA group included 39 patients.The long-term success rates in the RFA only and EA + RFA groups were 90.2% and 97.4%, respectively. The mean VRR at the last follow-up in the RFA and EA + RFA groups were 81.6% and 87.2%, respectively. Therapeutic results were similar in both groups at the last followup. Cosmetic and symptomatic problems markedly improved in both groups. No major complications were observed. Conclusion Both RFA alone and EA + RA are safe and effective methods for treating mixed cystic and solid thyroid nodules, although EA + RFA is slightly more effective.

Purpose: To compare the efficacy and safety of radiofrequency ablation (RFA) and ethanol ablation (EA) followed by RFA in treating mixed cystic and solid thyroid nodules. Materials and Methods: We included 243 nodules from 243 patients who underwent RFA for mixed cystic and solid benign nodules. The nodules were divided into two groups (RFA alone and EA + RFA). We evaluated volume reduction rate (VRR), therapeutic success rate, improvement in symptomatic and cosmetic issues, complications, and adverse effects. Results: The RFA group included 204 patients, and the EA + RFA group included 39 patients.The long-term success rates in the RFA only and EA + RFA groups were 90.2% and 97.4%, respectively. The mean VRR at the last follow-up in the RFA and EA + RFA groups were 81.6% and 87.2%, respectively. Therapeutic results were similar in both groups at the last followup. Cosmetic and symptomatic problems markedly improved in both groups. No major complications were observed. Conclusion Both RFA alone and EA + RA are safe and effective methods for treating mixed cystic and solid thyroid nodules, although EA + RFA is slightly more effective.

OBJECTIVES: We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI). METHODS: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them. RESULTS: There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI. CONCLUSIONS: The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required.
Disclosure* ; Education ; Guilt ; Humans ; Intention ; Mass Screening ; Medical Errors ; Patient Safety* ; Punishment