Ascites is the most common complication of liver cirrhosis, but its pharmacological management is unsatisfactory in some patients because of a lack of response to treatment with conventional diuretics. Patients with cirrhosis and ascites generally have increased non-osmotic secretion of vasopressin which participates in the pathogenesis of fluid retention. Vaptans are a new family of orally active drugs that increase urine volume by antagonizing specifically the vasopressin receptors in the principal cells of the collecting ducts that have been shown to correct dilutional hyponatremia effectively. They also seem to be promising in the management of ascites by reducing the increased extracellular fluid volume in conditions associated with water retention including liver cirrhosis. However, there is a paucity of information on whether vaptans might have beneficial effect in enhancing ascites reduction in patients with cirrhosis. This review addresses the pharmacological actions of vaptans, their clinical applications, and future potential roles in managing patients with liver cirrhosis and ascites.
Ascites ; Diuretics ; Extracellular Fluid ; Fibrosis ; Humans ; Hyponatremia ; Liver ; Liver Cirrhosis ; Receptors, Vasopressin ; Retention (Psychology) ; Vasopressins ; Water

Vertical transmission of hepatitis B virus (HBV) is the main source of chronic infection in Korea, an HBV-endemic area, and chronically infected people are at high risk of developing liver cirrhosis or hepatocellular carcinoma. Thus, preventing vertical transmission is an important step in eradicating or reducing the burden of chronic HBV infection. However, despite passive-active immunoprophylaxis provided to infants, up to 10% of infants born to highly viremic mothers still become infected with HBV. Therefore, antiviral treatments or management protocols to reduce vertical transmission should be considered for highly viremic mothers and infants born to these mothers. Additionally, in-depth discussions with the mothers about the risks, benefits, and limitations of the current published data are essential. This article reviews the potential mechanisms of vertical transmission and current intervention strategies to prevent vertical transmission of HBV.
Antiviral Agents ; Carcinoma, Hepatocellular ; Hepatitis B virus* ; Humans ; Infant ; Korea ; Liver Cirrhosis ; Mothers ; Pregnancy

Vertical transmission of hepatitis B virus (HBV) is the main source of chronic infection in Korea, an HBV-endemic area, and chronically infected people are at high risk of developing liver cirrhosis or hepatocellular carcinoma. Thus, preventing vertical transmission is an important step in eradicating or reducing the burden of chronic HBV infection. However, despite passive-active immunoprophylaxis provided to infants, up to 10% of infants born to highly viremic mothers still become infected with HBV. Therefore, antiviral treatments or management protocols to reduce vertical transmission should be considered for highly viremic mothers and infants born to these mothers. Additionally, in-depth discussions with the mothers about the risks, benefits, and limitations of the current published data are essential. This article reviews the potential mechanisms of vertical transmission and current intervention strategies to prevent vertical transmission of HBV.
Antiviral Agents ; Carcinoma, Hepatocellular ; Hepatitis B virus* ; Humans ; Infant ; Korea ; Liver Cirrhosis ; Mothers ; Pregnancy

No abstract available.

PURPOSE: To evaluate the usefulness of magnetic resonance imaging (MRI) for assessing fracture types and soft tissue injuries associated with tibial plateau fractures. MATERIALS AND METHODS: MRI was performed in 38 patients with tibial plateau fractures, each of which was classified according to the Schatzker system. We evaluated MR images and assessed the prevalence of each fracture type and accompanying soft tissue injuries. We also assessed whether ligamentous injury correlated with the extent of articular depression, splitting, and comminution. In 24 patients, diagnosis was based on MRI and operative or arthroscopic findings, and in 14 patients, on MRI alone. RESULTS: The totals of fracture types I, II, III, IV, V and VI were 4 (11 %), 15 (39 %), 6 (16 %), 4 (11 %), 4 (11%), and 5 cases (13 %), respectively. In 30 cases (79 %), there were associated ligamentous or meniscal injuries. Medial collateral ligaments and lateral menisci were injured in 17 (45 %) and 14 cases (37 %), respectively. Type II and IV fracture patterns were associated with soft tissue injuries in 14 of 15 cases (93 %) and 4 of 4 cases(100 %), respectively. As the extent of articular depression increased and the extent of bony comminution decreased, there was an increased prevalence of accompanying ligamentous injuries. CONCLUSION: In tibial plateau fractures, MR imaging is a useful diagnostic modality for the evaluation of both fracture type and accompanying ligamentous or meniscal injuries.
Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Soft Tissue Injuries*

OBJECTIVES: In the treatment of schizophrenia, treatment compliance is an important prognostic factor. As insight has a significant impact on treatment compliance, an appropriate assessment of insight is essential in the treatment of schizophrenia. This study examined the reliability and validity of the Korean version of Birchwood Insight Scale (BIS). METHODS: Fifty seven adult patients diagnosed with schizophrenia according to DSM-5 were recruited from a university hospital. They were evaluated using the Positive and Negative Syndrome Scale (PANSS), The Scale to Assessment Unawareness of Mental Disorder (SUMD) and BIS. Explorative factor analysis was performed to examine the construct validity of the Korean version of BIS. Concurrent validity was evaluated by a comparison with the PANSS G12 item and SUMD. The test-retest correlation was evaluated to examine the test-retest reliability. Multiple regression analysis was performed to examine the variables affecting insight. RESULTS: Explorative factor analysis showed that the Korean version of BIS was composed of 2 factors, which are ‘Awareness of symptoms’ and ‘Awareness of illness and need for treatment.’ The Korean version of BIS was reliable in terms of the internal consistency. Concurrent validity with the PANSS G 12 item and SUMD was statistically significant. The test-retest reliability was also statistically significant. Multiple regression analysis showed that the PANSS negative factor affects the BIS score, indicating that negative symptoms of schizophrenia may impair insight of the illness. CONCLUSION: This study suggests that the Korean version of BIS is a valid and reliable tool for assessing the insight of patients with schizophrenia.
Adult ; Compliance ; Humans ; Mental Disorders ; Psychopathology ; Reproducibility of Results ; Schizophrenia

PURPOSE: To understand the structure and character of the right retroperitoneal space by analysis of the extension of retroperitoneal hematoma in patients with traumatic right renal injuries. MATERIALS AND METHODS: We retrospectively reviewed CT scans of 13 patients with right retroperitoneal hematomas caused by right renal injury. At the renal level, we analyzed the relation of a hematoma contacting psoas muscle with other retroperitoneal compartmental hematomas. At the suprarenal level, a perirenal hematoma and a hematoma contacting the diaphragm were analyzed according to their relation with intrahepatic IVC and pericaval hematoma. RESULTS: Below renal hilar level, all hematomas contacting psoas muscle, observed in eight cases, were connected with retrorenal extension of anterior pararenal hematoma. At the suprarenal level, intrahepatic pericaval hematomas were not, in all 13 cases, connected with a hematoma contacting the diaphragm, but with a perirenal hematoma. At the upper suprarenal level, the only pericaval hematomas containing a medial component of perirenal hematoma extended superiorly to the upper one third of the tenth thoracic vertebral body. CONCLUSION: The anterior renal fascia envelops perirenal space except in its medial aspect. In the upper suprarenal region, the anterior and posterior planes of the anterior renal fascia unite to fuse with diaphragmatic fascia, but along the medial aspect they fuse with intrahepatic pericaval connective tissue and posteromedial diaphragm, respectively.
Connective Tissue ; Diaphragm ; Fascia ; Hematoma* ; Humans ; Psoas Muscles ; Retroperitoneal Space* ; Retrospective Studies ; Tomography, X-Ray Computed

PURPOSE: Demand of specialized maternity ward is increasing as national income level rises. However, the National Health Insurance limits the number of hospital's non-standard room to less than 50% of total hospital beds. Therefore, this research was performed to investigate the utilization rate of non-standard room among the Korean women who recently delivered baby in medical facilities in order to examine the factors affecting their selection. METHODS: One hundred sixty six medical facilities which deliver a minimum of ten cases in 2011 were selected and categorized by type, region, and size. A cross-sectional survey was done in November 2012 by a professional research survey company. Eight hundred and two pregnant women answered the questionnaire through a face-to-face interview. RESULTS: Of the 802 expecting mothers, 690 (86%) occupied non-standard room and 684 (85.2%) preferred non-standard room to the standard room. Satisfaction levels were significantly higher in mothers occupying non-standard room [5.9+/-1.0 vs. 5.4+/-1.2 (0-7 scale), P<0.01] and high-income families used non-standard room more often. Reasons for using non-standard room included adequate convalescence (78%), separate place for breastfeeding (6.1%), and convenience on receiving visitors (5.4%). Preference for non-standard room on next visit was higher in case of delivery compared to other cause of hospitalization (81.8% vs. 44.9%, P<0.001). CONCLUSIONS: Preference and actual use of non-standard room after delivery were significant. In spite of concrete preference, there was certain barrier in use of non-standard room according to the income and types of hospitals. Therefore, changes of policy such as insurance support for room charge may be needed in case of delivery.
Breast Feeding ; Convalescence ; Cross-Sectional Studies ; Female ; Hospitalization ; Humans ; Insurance ; Maternal Health Services ; Mothers* ; National Health Programs ; Patients' Rooms ; Postpartum Period ; Pregnant Women ; Surveys and Questionnaires ; Maternal Health

No abstract available.
Bone Matrix* ; DNA* ; Gelatin* ; Osteoblasts*

Background: Contact immunotherapy with diphenylcyclopropenone is one of the first-line treatments for extensive alopecia areata, despite its adverse effects (AEs). Objective: This study aimed to investigate whether a modified contact immunotherapy treatment protocol can safely promote hair regrowth in children. Methods: Children with alopecia areata who were treated with modified contact immunotherapy with diphenylcyclopropenone were retrospectively reviewed. All patients were sensitized with 0.1% diphenylcyclopropenone and began treatment at subsequent increasing concentrations. The efficacy, AEs, and demographic factors were evaluated. Results: A total of 32 patients, aged 9 to 17 years (mean age, 14.6 years), were included in the study. The mean disease duration was 26.8 months. Ten (31.3%) and 11 patients (34.4%) showed complete and partial responses, respectively. No AEs were observed after the sensitization. During treatment, 13 patients (40.6%) did not experience any AEs. Sixteen patients (50.0%) showed mild to moderate pruritus, and only three patients (9.4%) had severe pruritus. However, all AEs were well controlled. Conclusion A modified diphenylcyclopropenone treatment protocol with subclinical sensitization could induce a favorable therapeutic response and fewer AEs in children.