The finding of extraluminal gas on plain abdominal radiogram is usually associated with a perforated viscus, and an emergency laparatomy is indicated. But we report herein an immature neonate with spontaneous pneumoperitoneum that was treated successfully with conservative management, although this infant she showed positive result in stool occult blood test. As this case shows, the finding of pneumoperitoneum is not of a surgical emergency, because there are many benign explanations for pneumoperitoneum. A through history taking and physical examination are most important in differentiating between surgical and nonsurgical pneumoperitonium.
Emergencies ; Humans ; Infant ; Infant, Newborn* ; Occult Blood ; Peritonitis ; Physical Examination ; Pneumoperitoneum*

No abstract available.
Holoprosencephaly*

Maternal diabetes is known to have teratogenic effects which increase the risk for congenital anomalies, such as caudal dysplasia, cardiac defects, hydronephrosis, and small left colon syndrome. Infants of diabetic mothers have a 10-fold higher frequency of anomalies in the central nervous system and a 5-fold higher frequency of congenital heart defects. However, jejunal atresia combined with multiple anomalies of the face, ears, and hands has rarely been reported. Herein we report a neonate born to a diabetic mother, who had hemifacial microsomia, displacement of the lacrimal ducts, polydactyly of the right hand, microtia of the right ear and proximal jejunal atresia presenting as bile regurgitation on the 1st day of life.
Bile ; Central Nervous System ; Colon ; Congenital Abnormalities ; Diabetes, Gestational ; Displacement (Psychology) ; Ear ; Facial Asymmetry ; Female ; Hand ; Heart Defects, Congenital ; Humans ; Hydronephrosis ; Infant ; Infant, Newborn ; Intestinal Atresia ; Mothers ; Polydactyly ; Pregnancy

The fourth author's name was misprinted.
Fibroblast Growth Factor 2* ; Humans ; Pilot Projects*

Background: and PurposeThis study aimed to determine the updated 10-year prevalence of Huntington’s disease (HD) in South Korea and the medical and economic burdens across the duration of the disease. Methods: Data from the National Health Insurance database during 2010–2019 were analyzed. We identified HD cases using predefined criteria. Information on age at diagnosis, sex, and common nonneurological comorbidities were collected. We analyzed individual patterns of the use of medical services and yearly medical expenditure. Incidence rates, 10-year prevalence rates, and longitudinal medical expenditure changes were assessed. Results: New patients with HD (average=152.10) were detected every year, with an annual incidence of 0.29 per 100,000. The estimated 10-year prevalence of HD was 2.2 per 100,000. The most common ages at the time of diagnosis were 50–59 years (23.3%). In 2019, 56.4% of patients with HD were followed-up at referral or general hospitals, and 32.2% were managed at long-term-care hospitals. The annual medical cost for an individual was KRW 6,569,341±895,097 (mean±SD) (mean≈USD 5,653). Medical expenditure was the highest in those aged 60–79 years, and lowest in those younger than 30 years. However, in all age groups, the annual medical expenditure was highest during the 9 years following a diagnosis. Conclusions This study found that the actual prevalence of HD in South Korea was higher than previously thought and that patients are in a situation with high medical expenditure that persists over time.

Purpose: To evaluate how a family history of prostate cancer influences the progression of the disease in individuals with prostate cancer undergoing active surveillance. Materials and Methods: We conducted a thorough literature search in PubMed/MEDLINE, Embase, and Cochrane Library up to June 2023. This systematic review was registered in PROSPERO (CRD42023441853). The study evaluated the effects of family history of prostate cancer (intervention) on disease progression (outcome) in prostate cancer patients undergoing active surveillance (population) and compared them to those without a family history (comparators). For time to disease progression outcomes, the extracted data were synthesized using the inverse variance method on the log hazard ratios scale. Results: A total of eight studies were incorporated into this systematic review and meta-analysis. The combined hazard ratio for unadjusted disease progression was 1.06 (95% confidential interval [CI] 0.66–1.69; p=0.82). The combined hazard ratio for adjusted disease progression was 1.31 (95% CI 1.16–1.48; p<0.0001). All the enlisted studies demonstrated high quality based on the Newcastle–Ottawa scale. The certainty of evidence for univariate and multivariate analysis of disease progression was very low and low, respectively. Publication bias for all studies was not significant. Conclusions For individuals with prostate cancer opting for active surveillance, a family history of prostate cancer may serve as an independent risk factor associated with an elevated risk of disease progression. Clinicians should be counseled about the increased risk of disease progression in patients with a family history of prostate cancer undergoing active surveillance.

OBJECTIVES: It is increasingly thought that the human cerebellum plays an important role in emotion and cognition. Although recent evidence suggests that the cerebellum may also be implicated in fear learning, only a limited number of studies have investigated the cerebellar abnormalities in panic disorder. The aim of this study was to evaluate the cerebellar gray matter deficits and their clinical correlations among patients with panic disorder. METHODS: Using a voxel-based morphometry approach with a high-resolution spatially unbiased infratentorial template, regional cerebellar gray matter density was compared between 23 patients with panic disorder and 33 healthy individuals. RESULTS: The gray matter density in the right posterior-superior (lobule Crus I) and left posterior-inferior (lobules Crus II, VIIb, VIIIa) cerebellum was significantly reduced in the panic disorder group compared to healthy individuals (p < 0.05, false discovery rate corrected, extent threshold = 100 voxels). Additionally, the gray matter reduction in the left posterior-inferior cerebellum (lobule VIIIa) was significantly associated with greater panic symptom severity (r = -0.55, p = 0.007). CONCLUSIONS: Our findings suggest that the gray matter deficits in the posterior cerebellum may be involved in the pathogenesis of panic disorder. Further studies are needed to provide a comprehensive understanding of the cerebro-cerebellar network in panic disorder.
Cerebellum* ; Cognition ; Humans ; Learning ; Panic ; Panic Disorder*

OBJECTIVE: To evaluate the level of health-related quality of life (HRQoL), life satisfaction, and their present awareness of cardiac rehabilitation (CR) program in people with cardiovascular diseases. METHODS: A questionnaire survey was completed by 53 patients (mean age, 65.7±11.6 years; 33 men and 20 women) with unstable angina, myocardial infarction, or heart failure. The questionnaire included the Medical Outcome Study 36-item Short-Form Health Survey (MOS SF-36), life domain satisfaction measure (LDSM), and the awareness and degree of using CR program. RESULTS: The average scores of physical component summary (PCS) and mental component summary (MCS) were 47.7±18.5 and 56.5±19.5, respectively. There were significant differences in physical role (F=4.2, p=0.02), vitality (F=10.7, p<0.001), mental health (F=15.9, p<0.001), PCS (F=3.6, p=0.034), and MCS (F=11.9, p<0.001) between disease types. The average LDSM score was 4.7±1.5. Age and disease duration were negatively correlated with multiple HRQoL areas (p<0.05). Monthly income, ejection fraction, and LDSM were positively correlated with several MOS SF-36 factors (p<0.05). However, the number of modifiable risk factors had no significant correlation with medication. Thirty-seven subjects (69.8%) answered that they had not previously heard about CR program. Seventeen patients (32.1%) reported that they were actively participating in CR program. Most people said that a reasonable cost of CR was less than 100,000 Korean won per month. CONCLUSION: CR should focus on improving the physical components of quality of life. In addition, physicians should actively promote CR to cardiovascular disease patients to expand the reach of CR program.
Angina, Unstable ; Cardiovascular Diseases* ; Coronary Disease ; Health Surveys ; Heart Failure ; Humans ; Male ; Mental Health ; Myocardial Infarction ; Outcome Assessment (Health Care) ; Quality of Life* ; Rehabilitation* ; Risk Factors

Coxsackievirus B3 (CVB3) is a non-enveloped virus that has a single-stranded RNA genome. CVB3 induces myocarditis, and ultimately, dilated cardiomyopathy. A myocarditis variant of CVB3 (CVB3 H3) and its antibody-escape mutant (CVB3 10A1) were studied previously; H3 was found to induce myocarditis and 10A1 was found to be attenuated in infected mice. Although amino acid residue 165, located in a puff region of VP2, was found to be altered (i.e., the H3 asparagine was altered to aspartate in 10A1), the detailed mechanism of attenuation was not clearly elucidated. Here, DNA microarray technology was used to monitor changes in mRNA levels of infected mouse hearts after CVB3 H3 and 10A1 infection. This tool was used to elucidate the pathogenic mechanisms of viral infection by understanding virus-host interactions. We identified several genes, including protein tyrosine kinases, Ddr2 and Ptk2, as well as Clqb and Crry, involved in complement reactions, which may be involved in these viral processes. Thus, gene profiling can provide an opportunity to understand host immune responses to viral infection for gene therapy and may contribute to the identification of the target gene that is modified during treatment of viral myocarditis.
Animals ; Asparagine ; Aspartic Acid ; Cardiomyopathy, Dilated ; Complement System Proteins ; Genetic Therapy ; Genome ; Heart* ; Mice* ; Myocarditis ; Oligonucleotide Array Sequence Analysis ; Protein-Tyrosine Kinases ; RNA ; RNA, Messenger

Anticonvulsant hypersensitivity syndrome (AHS) is an uncommon, but potentially fatal and mutilsystemic disorder that occurs after exposure to the arene oxide-producing anticonvulsants-carbamzepine, phenobarbital and phenytoin. The multisystemic reactions include fever, skin eruptions, lymphadenopathy, hematologic abnormality and hepatitis. The diagnosis of AHS is made by history of drug exposure and clinical course. No specific treatments are proved as benefit except discontinuing the offending drug and trying the steroids in some severe cases. We report a case of carbamazepine induced anticonvulsant hypersensitivity syndrome characterized by skin rash, eosinophilia, subcarinal lymphadenopathy and eosinophilic pneumonia. The patient was resolved completely after only discontinuing carbamazepine.
Carbamazepine* ; Diagnosis ; Eosinophilia ; Eosinophils* ; Exanthema ; Fever ; Hepatitis ; Humans ; Hypersensitivity* ; Lymph Nodes* ; Lymphatic Diseases ; Phenobarbital ; Phenytoin ; Pulmonary Eosinophilia* ; Skin ; Steroids