No abstract available.
Antiemetics* ; Drug Therapy, Combination* ; Humans ; Ondansetron*

BACKGROUND: The aim of this study is to evaluate whether the optimal vitamin D level is achieved after taking recommended dose in vitamin D deficient patients. METHODS: This was a retrospective study. Women (n=52) first diagnosed with osteoporosis were recruited in outpatient clinic. They were recommended to be exposed to sun light for more than 30 min a day. Subjects were divided into 3 groups according to serum 25-hydroxy-vitamin D3 (25-[OH]D3) status: deficiency (less than 20 ng/mL), insufficiency (20-30 ng/mL) and sufficiency (30 ng/mL or more). Insufficient and sufficient patients received the recommended dose (1,000 IU/day) but deficient patients received recommended or double dose (1,800-2,000 IU/day). We compared 25-(OH)D levels at baseline and after vitamin D supplementation for 3 months. RESULTS: Median (interquartile range) serum 25-(OH)D concentration at baseline was 15.10 (13.30-16.97) ng/mL and the proportion of deficient, insufficient and sufficient groups were 69.2%, 23.1%, and 7.7% respectively. The optimal 25-(OH)D level (30 ng/mL or more) was achieved in 83.3% of insufficient patients with the recommended dose and was did in 55.6% of deficient patients with recommended dose (P=0.117). However, 88.9% of the deficient patient with double dose achieved optimal level (P=0.030). CONCLUSIONS: About 44% of vitamin D deficient patients did not attain the optimal level of serum 25-(OH)D despite recommended daily intake of vitamin D to 1,000 IU in patients with osteoporosis. Follow-up of serum 25-(OH)D levels may be required for vitamin D supplementation in vitamin D deficient patients with osteoporosis.
Ambulatory Care Facilities ; Calcifediol ; Female ; Follow-Up Studies ; Humans ; Osteoporosis* ; Recommended Dietary Allowances ; Retrospective Studies ; Solar System ; Vitamin D*

Few surgeons have adopted pancreaticoduodenectomy (PD) for the treatment of advanced gastric cancer (AGC) invading the pancreas or duodenum because it remains controversial whether its prognostic benefits outweigh the high morbidity rates in such advanced cases. However, recent technical advances have revived diverse surgical procedures in minimally invasive approaches. Inspired by this trend, laparoscopic PD procedures have been performed for AGC in our institute since 2014. We recently performed a laparoscopic Whipple's operation in a case of cT4b gastric cancer with invasion of the pancreatic head and duodenum.
Duodenum ; Head ; Pancreas ; Pancreaticoduodenectomy ; Stomach Neoplasms ; Surgeons

Mediastinal inflammatory pseudotumor is a rare benign disease with its capability for local invasion and rapid growth. We present a case of middle-mediastinal inflammatory pseudotumor and report its contrast-enhanced chest computed tomography, 18F-fluorodeoxyglucose positron emission tomography/computed tomography and pathologic findings.
Adult ; Diagnosis, Differential ; Fluorodeoxyglucose F18/*diagnostic use ; Granuloma, Plasma Cell/*diagnosis ; Humans ; Male ; Mediastinal Diseases/*diagnosis ; Positron-Emission Tomography/*methods ; Radiopharmaceuticals/*diagnostic use ; Tomography, X-Ray Computed/*methods

The pulmonary interstitial emphysema (PIE) is a life-threatening illness in premature infants with mechanical ventilation. While most are managed conservatively, decompression would be necessary. Here, we report the first case of PIE treated by percutaneous catheter insertion in an extremely low birth weight (ELBW) infant in Korea. The patient, born with 660 g in 23+2 weeks of gestation, showed PIE in left lower lung on postnatal day 12. Percutaneous catheter insertion was performed on postnatal day 25. The size of PIE decreased, but didn't disappear completely. On postnatal day 42, we exchanged catheter and inserted additional catheter in pleural space. However, sudden desaturation and pneumothorax occurred on postnatal day 44. We changed catheter in pleural space, and pneumothorax and PIE improved. Finally, we successfully removed catheters, and weaned patient out. As in our case, percutaneous catheter insertion would be a useful option for ELBW infants with PIE.
Catheters* ; Catheters, Indwelling ; Decompression ; Emphysema* ; Humans ; Infant ; Infant, Extremely Low Birth Weight* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Korea ; Lung ; Pneumothorax ; Pregnancy ; Pulmonary Emphysema ; Respiration, Artificial

The pulmonary interstitial emphysema (PIE) is a life-threatening illness in premature infants with mechanical ventilation. While most are managed conservatively, decompression would be necessary. Here, we report the first case of PIE treated by percutaneous catheter insertion in an extremely low birth weight (ELBW) infant in Korea. The patient, born with 660 g in 23+2 weeks of gestation, showed PIE in left lower lung on postnatal day 12. Percutaneous catheter insertion was performed on postnatal day 25. The size of PIE decreased, but didn't disappear completely. On postnatal day 42, we exchanged catheter and inserted additional catheter in pleural space. However, sudden desaturation and pneumothorax occurred on postnatal day 44. We changed catheter in pleural space, and pneumothorax and PIE improved. Finally, we successfully removed catheters, and weaned patient out. As in our case, percutaneous catheter insertion would be a useful option for ELBW infants with PIE.
Catheters* ; Catheters, Indwelling ; Decompression ; Emphysema* ; Humans ; Infant ; Infant, Extremely Low Birth Weight* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Korea ; Lung ; Pneumothorax ; Pregnancy ; Pulmonary Emphysema ; Respiration, Artificial

This study was performed to define the clinical spectrum and disease manifestations of ankylosing spondylitis (AS) in a referral hospital setting. We identified the differences in clinical manifestations according to the sex, the age at onset, the presence of peripheral arthritis and the presence of HLA B27. A total 412 patients (357 males, 55 females) were recruited. Eighty-seven percent were men and 155 out of 412 patients (35%) were juvenile-onset. HLA B27 was detected in 385 patients (93%). Peripheral joint involvement was noted in 287 of total AS cases (juvenile- onset ankylosing spondylitis (JOAS), 82%; adult-onset ankylosing spondylitis (AOAS), 61%), and was more common than those reported in other studies. A greater portion of patients with JOAS had peripheral arthritis and peripheral enthesitis than the patients with AOAS. The patients with peripheral arthritis showed a younger age at onset and an increased tendency of having enthesitis and trauma history. The natural history of Korean AS appears largely similar to those seen in Europe and North America, except a few differences. JOAS was quite common and AS was about nine times more common in men than in women. In addition, the HLA B27 antigen frequency was 93%, which is higher than those reported in other studies.
Adolescent ; Adult ; Age of Onset ; Arthritis/*etiology/immunology ; Female ; HLA-B27 Antigen ; Humans ; Korea ; Male ; Sex Characteristics ; Spondylitis, Ankylosing/*complications/immunology

Undifferentiated spondyloarthropathy (USpA) includes the forms that do not meet criteria for the established categories of spondyloarthropathy. The clinical spectrum of USpA is therefore wide and few studies have been published on USpA, especially peripheral arthritis. A total of 107 patients fulfilling the European Spondyloarthropathy Study Group criteria for SpA were studied retrospectively by a chart review and interview by a rheumatologist. Peripheral arthritis, excluding hip and shoulder involvement, occurred in 97 of the 107 patients (91%). Joint involvement tended to be monoarticular or pauciarticular, and most frequently developed in peripheral joints including the knee and ankle. Among the 97 patients with peripheral arthritis, only 37 (35%) had a persistent arthritis. HLA-B27 was detected in 80 patients (78%). Peripheral arthritis was found in the lower extremities regardless of symmetry or asymmetry and tended to run a benign course with only a few patients having persistent arthritis
Adult ; Arthritis/diagnosis/metabolism/*physiopathology ; Cartilage, Articular/physiopathology ; Female ; HLA-B27 Antigen/metabolism ; Humans ; Korea ; Male ; Prognosis ; Retrospective Studies ; Sex Factors

OBJECTIVE: To investigate the hepatic safety of methotrexate (MTX)and useful parameters to assess the risk of hepatotoxicity in rheumatoid arthritis (RA) patients with hepatitis B surface antigen (HBsAg). METHODS:19 HBsAg positive (B group)and 54 HBsAg negative (non-B group)RA patients taking MTX were prospectively followed up for 2 years. Aspartate aminotransferase (AST)and alanine aminotransferase (ALT)were checked at 2-month interval.In B group,HBeAg,HBeAb and levels of hepatitis B virus DNA (HBV DNA)were additionally checked,and liver biopsy was performed in seventeen of 19 patients.Change of AST or ALT to more than 1.5 times the upper limit of normal were considered as a hepatic event.The data were analyzed by stepwise linear and logistic regression method. RESULTS:The findings of liver biopsy in B group were classified as grade I (n=8),II (n=6),and IIIA (n=3)according to the Roenigk Classification Scale. Mean cumulative dose of MTX in B group was 2054mg in cases with hepatic event and 1780mg in cases who stopped taking MTX.The frequency of hepatic event (47.4%vs 7.4%,p=0.0001)and MTX withdrawal (26.3%vs 1.9%, p=0.0008)was higher in B group than in non-B group.HBV DNA (+)group (n=9)showed the increased tendency of hepatic event and MTX withdrawal compared with HBV DNA (-)group (n=10).Baseline HBV DNA was negative in all HBeAg (-)patients (n=14),but HBV DNA was positive during MTX therapy in 7 of 14 HBeAg (-)patients.Serum levels of AST and ALT returned to normal range within 2 months after MTX withdrawal in twelve of 13 patients with hepatic event. CONCLUSION:The use of MTX in HBsAg positive RA patients requires close monitoring of AST and ALT.HBV DNA seems to be a useful marker to predict hepatic event and viral replication,especially in HBeAg (-)patients.
Alanine Transaminase ; Arthritis, Rheumatoid* ; Aspartate Aminotransferases ; Biopsy ; Classification ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Liver ; Logistic Models ; Methotrexate* ; Prospective Studies ; Reference Values

The effects of unripe apple mask pack made from unripe apple extracts on the skin status of middle-aged women for 4 weeks were investigated. The subjects were divided into three groups: placebo mask pack as the control (PM, n = 8), apple mask pack (AM, n = 16), and apple mask pack + apple intake (AAM, n = 12). The study included a survey questionnaire, and evaluations of nutrients intakes and of skin status. Skin status was measured by Aramo-TS. After 4 weeks, facial moisture, elasticity, evenness, and wrinkle level were improved in AM and AAM. The facial moisture level (AM: +3.13 +/- 2.73, AAM: +2.25 +/- 2.93) and elasticity level (AM: +5.81 +/- 8.27, AAM: +5.50 +/- 6.13) of AM (p < 0.001) and AAM (p < 0.05) were increased. The facial evenness level (AM: -5.25 +/- 8.13, AAM: -9.17 +/- 4.26) and wrinkle level (AM: -10.88 +/- 11.74, AAM: -17.83 +/- 12.22) were significantly decreased. AAM was more effective in improving skin elasticity, evenness, and wrinkle. The skin status of PM was not changed. While the macronutrient intakes of all the subjects were not different before and after the study, the daily intakes of some vitamins (vitamins B6, C, and E and folic acid) during the study were significantly increased in AAM. These findings suggested that regular use of apple mask pack was effective in improving overall skin status. Furthermore, the consumption of apples with mask pack application was much better in improving skin status.
Elasticity ; Female ; Humans ; Malus ; Masks ; Surveys and Questionnaires ; Skin ; Vitamins