Rheumatoid arthritis (RA) is frequently associated with various extra-joint complications. Although rare, thromboembolic complications are associated with high morbidity and mortality. We experienced a very rare case of nonbacterial thrombotic endocarditis (NBTE) and subsequent embolic stroke in a patient with RA. A 72-year-old male with a 15-year history of RA suddenly developed neurologic symptoms of vomiting and dizziness. Brain magnetic resonance imaging revealed recently developed multiple cerebellar and cerebral lacunar infarctions. Echocardiography showed a pulsating mitral valve vegetation involving the posterior cusp of the mitral valve leaflet, which was confirmed as NBTE. Immediate anti-coagulation therapy was started. The NBTE lesion disappeared in follow-up echocardiography after 4 weeks of anti-coagulation treatment.
Aged ; Arthritis, Rheumatoid* ; Brain ; Dizziness ; Echocardiography ; Endocarditis ; Endocarditis, Non-Infective* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Mitral Valve ; Mortality ; Neurologic Manifestations ; Stroke ; Stroke, Lacunar ; Vomiting

Traumatic optic neuropathy is a complication resulting from facial trauma, with an incidence of 2% to 5%. The most widely accepted treatments include observation, high dose steroid, surgical decompression and combination therapy of steroid and surgical treatment. However, there has been no established mode of treatment and there are still debates about what the best treatment should be for the patients with optic canal fracture. We experienced two cases of traumatic optic neuropathies due to intracanalicular fracture of the optic canal after trauma. Surgical decompression was performed using an endoscope int-ranasally one day after injury as required for minimal invasive surgery. We report the results and progression of these two cases.
Decompression ; Decompression, Surgical ; Endoscopes ; Humans ; Incidence ; Optic Nerve ; Optic Nerve Injuries

Enophthalmos means displacement of the globe into the bony orbit backward, and usually downward. In post-traumatic enophthalmos, the mechanisms that determine the globe position can be the enlargement of the orbital cavity, the herniation of orbital fat into the maxillary sinus, fat atrophy, loss of ligament support, and scar contracture. It can be reconstructed through several approaches such as transconjunctival, canthotomy, lower eye lid, coronal approach, and by using bone, cartilage, and alloplastic materials. The authors report a case of postoperative enophthalmos reconstructed through subciliary and transnasal endoscopic approaches using porous polyethylene with embedded titanium.
Atrophy ; Cartilage ; Cicatrix ; Contracture ; Displacement (Psychology) ; Endoscopes ; Enophthalmos ; Eye ; Humans ; Ligaments ; Maxillary Sinus ; Orbit ; Polyethylene ; Polyethylenes ; Titanium

Combination treatment of antiplatelet drugs containing aspirin and clopidogrel reduces systemic ischemic events after percutaneous coronary intervention (PCI) in high risk patients. However, this combination treatment of antiplatelet drugs is associated with increased risk of nonfatal and fatal bleeding. Diffuse alveolar hemorrhage after PCI is a rare complication that has been mostly reported in association with glycoprotein IIb/IIIa inhibitors. We report the case of a 62-year-old man who presented with ST elevation myocardial infarction and suffered a diffuse alveolar hemorrhage after clopidogrel use following primary PCI.
Aspirin ; Glycoproteins ; Hemoptysis ; Hemorrhage ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors ; Ticlopidine

Objectives: Public health workers have been at the forefront of treating patients with coronavirus disease 2019 (COVID-19) and managing the pandemic. The redeployment of this workforce has limited or interrupted other public health services, including testing for humanimmunodeficiency virus (HIV). This study aims to examine the impact of COVID-19 on HIVtesting and diagnosis in the Republic of Korea from 2016 to 2021, comparing data before and after the onset of COVID-19. Methods: Annual HIV testing data were collected from each institution through direct communication or from open-source databases. The annual number of new HIV cases was obtained from the official report of the Korea Disease Control and Prevention Agency. Data on healthcare visits for HIV diagnosis or treatment were extracted from the open-source database of the National Insurance Health Service of Korea. Interrupted time series regression was conducted, stratified by institution type. Results: In 2020, HIV tests, diagnoses, and visits decreased. Notably, public health centers experienced a substantial reduction in 2020−2021 compared to previous years. The annual percentage change in HIV tests was −53.0%, while for HIV diagnoses, it was −31.6%. The decrease in visits for HIV was also most pronounced for public facilities: −33.3% in 2020 and −45.6% in 2021 relative to 2019. Conclusion The numbers of tests, diagnoses, and healthcare visits for HIV at public healthcenters in the Republic of Korea substantially decreased in 2020 and 2021. The impacts of thesechanges on the early diagnosis and treatment of HIV necessitate further monitoring.

Objectives: Public health workers have been at the forefront of treating patients with coronavirus disease 2019 (COVID-19) and managing the pandemic. The redeployment of this workforce has limited or interrupted other public health services, including testing for humanimmunodeficiency virus (HIV). This study aims to examine the impact of COVID-19 on HIVtesting and diagnosis in the Republic of Korea from 2016 to 2021, comparing data before and after the onset of COVID-19. Methods: Annual HIV testing data were collected from each institution through direct communication or from open-source databases. The annual number of new HIV cases was obtained from the official report of the Korea Disease Control and Prevention Agency. Data on healthcare visits for HIV diagnosis or treatment were extracted from the open-source database of the National Insurance Health Service of Korea. Interrupted time series regression was conducted, stratified by institution type. Results: In 2020, HIV tests, diagnoses, and visits decreased. Notably, public health centers experienced a substantial reduction in 2020−2021 compared to previous years. The annual percentage change in HIV tests was −53.0%, while for HIV diagnoses, it was −31.6%. The decrease in visits for HIV was also most pronounced for public facilities: −33.3% in 2020 and −45.6% in 2021 relative to 2019. Conclusion The numbers of tests, diagnoses, and healthcare visits for HIV at public healthcenters in the Republic of Korea substantially decreased in 2020 and 2021. The impacts of thesechanges on the early diagnosis and treatment of HIV necessitate further monitoring.

Objectives: Public health workers have been at the forefront of treating patients with coronavirus disease 2019 (COVID-19) and managing the pandemic. The redeployment of this workforce has limited or interrupted other public health services, including testing for humanimmunodeficiency virus (HIV). This study aims to examine the impact of COVID-19 on HIVtesting and diagnosis in the Republic of Korea from 2016 to 2021, comparing data before and after the onset of COVID-19. Methods: Annual HIV testing data were collected from each institution through direct communication or from open-source databases. The annual number of new HIV cases was obtained from the official report of the Korea Disease Control and Prevention Agency. Data on healthcare visits for HIV diagnosis or treatment were extracted from the open-source database of the National Insurance Health Service of Korea. Interrupted time series regression was conducted, stratified by institution type. Results: In 2020, HIV tests, diagnoses, and visits decreased. Notably, public health centers experienced a substantial reduction in 2020−2021 compared to previous years. The annual percentage change in HIV tests was −53.0%, while for HIV diagnoses, it was −31.6%. The decrease in visits for HIV was also most pronounced for public facilities: −33.3% in 2020 and −45.6% in 2021 relative to 2019. Conclusion The numbers of tests, diagnoses, and healthcare visits for HIV at public healthcenters in the Republic of Korea substantially decreased in 2020 and 2021. The impacts of thesechanges on the early diagnosis and treatment of HIV necessitate further monitoring.

Objectives: Public health workers have been at the forefront of treating patients with coronavirus disease 2019 (COVID-19) and managing the pandemic. The redeployment of this workforce has limited or interrupted other public health services, including testing for humanimmunodeficiency virus (HIV). This study aims to examine the impact of COVID-19 on HIVtesting and diagnosis in the Republic of Korea from 2016 to 2021, comparing data before and after the onset of COVID-19. Methods: Annual HIV testing data were collected from each institution through direct communication or from open-source databases. The annual number of new HIV cases was obtained from the official report of the Korea Disease Control and Prevention Agency. Data on healthcare visits for HIV diagnosis or treatment were extracted from the open-source database of the National Insurance Health Service of Korea. Interrupted time series regression was conducted, stratified by institution type. Results: In 2020, HIV tests, diagnoses, and visits decreased. Notably, public health centers experienced a substantial reduction in 2020−2021 compared to previous years. The annual percentage change in HIV tests was −53.0%, while for HIV diagnoses, it was −31.6%. The decrease in visits for HIV was also most pronounced for public facilities: −33.3% in 2020 and −45.6% in 2021 relative to 2019. Conclusion The numbers of tests, diagnoses, and healthcare visits for HIV at public healthcenters in the Republic of Korea substantially decreased in 2020 and 2021. The impacts of thesechanges on the early diagnosis and treatment of HIV necessitate further monitoring.

PURPOSE: Among the survivors of a ST elevation myocardial infarction (STEMI), higher platelet volume indices (mean platelet volume, MPV; platelet distribution width, PDW) are associated with impaired reperfusion and ventricular dysfunction. This study examined the relationship between the platelet volume indices and 30-day mortality with STEMI patients who underwent primary percutaneous coronary intervention (PCI). METHODS: This retrospective cohort study included patients presenting to the emergency department with STEMI between January 2011 and May 2016. The platelet volume indices were measured serially, using an automatic hematology analyzer, from admission to 24 hours after admission. The prognostic value of MPV, PDW for the 30-day mortality was determined by Cox proportional hazards model analysis. RESULTS: A total of 608 STEMI patients, who underwent reperfusion, were enrolled in this study. According to the multivariable Cox proportional hazard model, higher MPV (hazard ratio [HR], 1.414; 95% confidence interval [CI], 1.024-1.953; p=0.035) and PDW (HR, 1.043; 95% CI, 1.006-1.083; p=0.024) values at time-24 (24 hours after admission) were significant risk factors for the 30-day mortality. A MPV value >8.6 fL (HR, 5.953; 95% CI, 2.973-11.918; p<0.001) and PDW value >56.1% (HR, 5.117; 95% CI, 2.640-9.918; p<0.001) at time-24 were associated with an increased risk of 30-day mortality. CONCLUSION: The platelet volume indices without an additional burden of cost or time, can be measured rapidly and simply. Higher MPV and PDW levels predict independently the 30-day mortality in patients with STEMI after PCI.
Blood Platelets* ; Cohort Studies ; Emergency Service, Hospital ; Hematology ; Humans ; Mean Platelet Volume ; Mortality* ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Platelet Activation ; Prognosis ; Proportional Hazards Models ; Reperfusion ; Retrospective Studies ; Risk Factors ; Survivors ; Ventricular Dysfunction

Duodenal loop obstruction is an unusual cause of acute pancreatitis. Increased intraluminal pressure hinders pancreatic flow, causing dilatation of the pancreatic duct and inducing acute pancreatitis. We experienced three cases of acute pancreatitis that resulted from duodenal loop obstruction after (1) an esophagectomy with gastric pull-up procedure for esophageal cancer, (2) a gastrectomy with Billroth I reconstruction for gastric cancer, and (3) a gastrojejunostomy for abdominal trauma. An abdominal CT scan revealed a distended duodenal loop, dilated pancreatic duct, and inflamed pancreas with fluid collection. Acute pancreatitis with duodenal loop obstruction was diagnosed by abdominal pain, elevated serum amylase/lipase, and abdominal CT findings. Immediate decompression with a nasogastric tube was performed, and all patients showed improvement within one week after admission. Each patient was followed up for more than two years without recurrence. Our findings suggest the usefulness of nasogastric tube decompression as the first line of treatment for acute pancreatitis related to duodenal loop obstruction.
Abdominal Pain ; Decompression ; Dilatation ; Duodenal Obstruction ; Esophageal Neoplasms ; Esophagectomy ; Gastrectomy ; Gastric Bypass ; Gastroenterostomy ; Humans ; Pancreas ; Pancreatic Ducts ; Pancreatitis* ; Recurrence ; Stomach Neoplasms ; Tomography, X-Ray Computed