OBJECTIVE: The retrospective study is undertaken to report clinical results of anterior cervical interbody fusion with an intradiscal cage with an integrated plate (PCB cervical plating system). METHODS: 38 patients underwent anterior cervical interbody fusion with PCB cervical plating system and followed 6~24 months. The authors investigated overall surgical results; clinical outcome, fusion rate, change of interspace height & lordotic angle, and complications. RESULTS: No complication was observed during the operation. Clinical improvement was identified in 34 cases (89.5%). Bone fusion observed in 44 out of 49 sites (90.7%). After operation, the interspace height increased from 5.4+/-1.3 mm to 7.8+/-1.5 mm and maintained 7.4+/-1.1 mm and, interspace angle went up from 4.2+/-0.7 degrees to 4.8+/-1.1 degrees and maintained 4.6+/-0.9 degrees. The loosening of screw was observed in 6 cases, one of which had reoperation because of the expulsion of the device accompanied. CONCLUSION: PCB cervical plating system could restore interbody height and lordosis in anterior cervical interbody fusion. But, if the insertion of the spacer is not precise, the frequencies of hardware failure are relatively high. It is considered necessary for the operator to be careful in the procedure.
Animals ; Humans ; Lordosis ; Reoperation ; Retrospective Studies

Hereditary angioedema (HAE) is a rare autosomal dominant disorder caused by genetic deficiency or decreased function of C1-esterase inhibitor. It is characterized by swelling of subcutaneous and submucosal tissues of the extremities, gastrointestinal tract, and upper airways which can be life-threatening. Thus, early recognition and treatment of the disease are important. Short- and longterm prophylaxes are used to decrease the severity and frequency of attacks. Icatibant is a selective bradykinin B2-receptor antagonist, earlier treatment of acute attacks and hospital admission. The authors present a case of 47-year-old woman who was diagnosed with type II HAE, danazol as a long term. Her symptoms improved dramatically after drug treatment. The unpredictability and recurrence of HAE attacks could have a negative impact on social life and quality of life. This case shows that timely and proper treatment could improve quality of life and reduce morbidity and mortality. (

BACKGROUND/AIMS: Depression and allergic diseases, including asthma, are frequently reported as comorbid conditions. However, their associations have been rarely examined in community-based elderly populations. METHODS: The analyses were performed using the baseline data set of the Korean Longitudinal Study of Health and Aging, which consists of 1,000 elderly participants (aged > 65 years) randomly recruited from an urban community. Depression was assessed using the Geriatric Depression Scale, Center for Epidemiologic Studies Depression Scale, and Hamilton Rating Scale for Depression. Major and minor depressive disorders were diagnosed by psychiatrists. Allergic conditions were assessed using structured questionnaires, lung function, and skin prick test. Quality of life and comorbidities were assessed using structured questionnaires. RESULTS: Prevalence of asthma and major depressive disorder were 5.4% and 5.3%, respectively. The rate of depression was not significantly different between the non-asthmatic and asthmatic groups. No correlation was observed between the scores obtained using the depression scales and self-reported asthma. However, chronic, frequent, and nocturnal cough were significantly associated with depression and scores obtained using the depression scales, which remained significant in multivariate logistic regression analyses (chronic cough: odds ratio [OR], 3.23; 95% confidence interval [CI], 2.57 to 12.74; p = 0.04). Rhinitis was independently associated with high Mini-Mental State Examination scores (OR, 1.11; 95% CI, 1.05 to 1.17; p < 0.001) and low 36-item short-form (OR, 0.96; 95% CI, 0.80 to 0.98; p = 0.002). CONCLUSIONS Depression may not be significantly associated with asthma and allergic diseases in elderly populations, but cough is a significant factor affecting depression.

Background/Aims: Teicoplanin can be used as an alternative to vancomycin when treating beta-lactam-resistant gram-positive bacterial infections. Both vancomycin and teicoplanin are associated with relatively high rates of adverse drug reactions (ADRs), including hypersensitivity reactions. There is limited data on teicoplanin-vancomycin cross-reactivity. This study examined the incidence of teicoplanin ADRs and risk factors for cross-reactivity between vancomycin and teicoplanin. Methods: We analyzed the incidence of teicoplanin ADRs in a retrospective study of 304 newly teicoplanin-exposed, immunocompetent, hospitalized patients at a single Korean Medical Center between January 1, 2006 and December 31, 2015. Results: Among 304 patients, 238 (78.3%) experienced vancomycin-associated ADRs prior to their teicoplanin exposure and 58 (19.1%) experienced teicoplanin- associated ADRs, which were mostly hypersensitivity reactions without acute kidney injury. The incidence of teicoplanin ADRs was higher in patients who previously experienced vancomycin-related ADRs (23.1% vs. 5.3%, p < 0.001). History of drug allergy was a statistically significant risk factor of teicoplanin ADRs. The incidence of teicoplanin ADRs significantly increased in patients with multiple organ involvement in vancomycin hypersensitivity reactions. Conclusions Teicoplanin should be administered with caution and clinicians must consider the risk factors of cross-reaction when prescribing teicoplanin to individuals with a history of vancomycin hypersensitivity.

Antiplatelet agents, such as aspirin, clopidogrel, and cilostazol, are essential for the treatment and prevention of cardiovascular, cerebrovascular, and peripheral vascular diseases. A 53-year-old male with aspirin hypersensitivity developed dizziness, which was caused by severe stenosis of the left vertebral artery. Clopidogrel was administerted, but discontinued due to generalized urticaria and angioedema. As an alternative drug, cilostazol was administered, but discontinued again because of the same adverse reactions. Desensitization was planned as other alternative antiplatelet agents were not available. Initially, aspirin desensitization was successfully performed. One day after aspirin desensitization, clopidogrel desensitization was sequentially done successfully. After a few months, cilostazole desensitization was performed. During the follow-up period, he had to stop aspirin and cilostazol twice to prevent the risk of bleeding after a procedure and an operation. After discontinuing medicines, sequential desensitization of aspirin and cilostazol was successfully performed. Physicians should be aware that drug hypersensitivity could be induced by various kinds of antiplatelet agents and that desensitization could be the treatment of choice unless alternative medicines are available.
Angioedema ; Aspirin ; Constriction, Pathologic ; Desensitization, Immunologic ; Dizziness ; Drug Hypersensitivity* ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypersensitivity ; Male ; Middle Aged ; Peripheral Vascular Diseases ; Platelet Aggregation Inhibitors* ; Urticaria ; Vertebral Artery

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) has recently been recognized to be one of the leading causes of chronic liver disease. Obesity and type 2 diabetes are associated strongly with NAFLD. Although often used to detect liver disease, sometimes the cause of elevated Alanine Transaminase (ALT) activity was unclear. In the absence of other causes, the author examined whether BMI and metabolic markers of NAFLD can explain the cause of abnormal ALT in Korean. METHODS: From April 2002 to November 2003, 9997 persons visited health promotion center of Kyungpook National University Hospital and took health screening. After excluding persons with excessive alcohol consumption, abnormal gamma-GTP, hepatitis B, hepatitis C, 8379 persons were included in this study. All patients underwent anthropometric measures, blood chemistry analysis and abdominal ultrasonographic exam. RESULTS: Elevated ALT levels were found in 10% (835 persons) of the all subjects. In univariate analysis, factors associated with elevated ALT levels (p<0.05) included male sex, younger age (20-40 years), higher Body Mass Index (BMI), higher blood pressure, higher fasting blood glucose, higher triglyceride, lower HDL and more fatty change in ultrasonography. The proportion of elevated ALT with fatty change in ultrasonography was 57% and with higher BMI (>or=23 kg/m2) was 79% in abnormal ALT group. In multivariate logistic regression study, total cholesterol and blood pressure were eleminated but sex, BMI, triglyceride level, ultrasonographic fatty change were strongly associated with elevated ALT level (p<0.01). CONCLUSION: In this study, unexplained ALT elevation was strongly associated with obesity, adiposity and other features of metabolic syndrome, and thus may represent nonalcoholic fatty liver disease. However, more research is needed for the definite clinical determinants of nonalcoholic fatty liver disease in Korean.
Adiposity ; Alanine Transaminase* ; Alanine* ; Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Chemistry ; Cholesterol ; Fasting ; Fatty Liver ; Gyeongsangbuk-do ; Health Promotion ; Hepatitis B ; Hepatitis C ; Humans ; Hypertension ; Liver Diseases ; Logistic Models ; Male ; Mass Screening ; Obesity* ; Triglycerides ; Ultrasonography

OBJECTIVE: We investigated the expression of chemokine receptors in human ovarian cancer to understand the role of chemokines in ovarian cancer development and metastasis. METHODS: Twenty-two cases of epithelial ovarian cancer were studied for expression of 13 chemokine receptors such as CXCR1-CXCR5 and CCR1-CCR8 by using semi- quantitative RT-PCR and immunohistochemistry. Moreover, we studied the relationship between the chemokine receptors expression and lymph nodes metastasis of ovarian cancers. RESULTS: As compared with normal ovarian tissues, ovarian cancer tissues showed higher mean expression levels of CCR1,3,4,5,7,8 and CXCR1,3,4. Of chemokine receptors, CCR7 revealed the significantly higher levels of expression in ovarian cancer tissues relative to normal tissues. In the cases of retroperitoneal lymph nodes metastasis, increased expression of CCR2,4 and CXCR 1,3,4 was observed although there was no statistical significance. CONCLUSION: These results suggest that there is a complex chemokine/chemokine receptor network in pathogenesis and the way of lymph node metastasis of ovarian cancer rather than a specific chemokine or chemokine receptor.
Chemokines ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Ovarian Neoplasms* ; Receptors, Chemokine*

Gastric stump cancer is defined as cancers that develop in the gastric remnant after the gastric resection of nonmalignant lesions or malignant lesions. The interval between gastrectomy and the detection of gastric stump cancer must be over 5 years in nonmaligant lesions and 10 years in malignant lesions. Symptoms of gastric stump cancer are not specific, so, diagnosis is often delayed. Early detection and curative operation is very important in gasric stump cancer and follow-up endoscopic examination is the most importaint diagnostic tool to detect gastric stump cancer. Recently we experienced a case of early gastric stump cancer. We report review of the literature to remind the important of gastric stump cancer and the important of follow-up endoscopic examination.
Diagnosis ; Esophagus* ; Follow-Up Studies ; Gastrectomy* ; Gastric Stump* ; Intestines* ; Stomach*

PURPOSE: We explored the performance of and pressure elevation caused by small-diameter microtubes used to reduce overfiltration. METHODS: Using a syringe pump-driven constant-flow setting (2 µL/min), pressures were measured for polytetrafluoroethylene (PTFE) microtubes 5 mm in length with inner diameters of 51, 64, and 76 µm and for polyether block amide (PEBAX) microtubes with an inner diameter of 76 µm. Experiments (using microtubes only) were initially performed in air, water, and enucleated pig eyes and were repeated under the same conditions using intraluminal 9/0 nylon stents. RESULTS: The pressures measured in air in 51-, 64-, and 76-µm-diameter PTFE microtubes differed significantly (22.1, 16.9, and 12.2 mmHg, respectively; p < 0.001), and that of the 76-µm-diameter PEBAX microtube was 15.8 mmHg (p < 0.001 compared to the 12.2 mmHg of the 76-µm-diameter PTFE microtube). The pressures measured in water also differed significantly among the three microtubes at 3.9, 3.0, and 1.4 mmHg, respectively, while that in the PEBAX microtube was 2.6 mmHg (all p < 0.001). Using the intraluminal stent, the pressure in water of the three different PTFE microtubes increased to 22.6, 18.0, and 4.1 mmHg, respectively, and that in the PEBAX microtube increased to 10.5 mmHg (all p < 0.001). Similar trends were evident when measurements were performed in pig eyes. CONCLUSIONS: Although microtubes of smaller diameter experienced higher pressure in air, reduction of the inner diameter to 51 µm did not adequately increase the pressure attained in water or pig eyes. Insertion of an intraluminal stent effectively elevated the latter pressures. PEBAX microtubes created higher pressures than did PTFE microtubes.
Animals ; Disease Models, Animal ; Glaucoma/physiopathology/*surgery ; *Glaucoma Drainage Implants ; Intraocular Pressure/*physiology ; Ophthalmologic Surgical Procedures/*instrumentation ; *Polytetrafluoroethylene ; Prosthesis Design ; Swine

The current emergence of the coronavirus disease 2019 (COVID-19) pandemic and the possible side effects of COVID-19 mRNA vaccination remain worrisome. Few cases of vaccination-related side effects, such as vasculitis, have been reported. Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome, is a type of vasculitis characterized by the histological richness of eosinophils, asthma, polyneuropathy, sinusitis, and skin or lung involvement. Here, we report the first case of new onset EGPA following COVID-19 vaccination in Korea. A 71-year old woman developed a skin rash and presented with progressive weakness of the upper and lower extremities after the BNT162b2 vaccination (Pfizer-BioNTech). She was diagnosed with EGPA and her symptoms improved after systemic steroid and immunosuppressant therapy. Although it is very rare, clinicians should be aware that EGPA may occur after COVID-19 vaccination.