No abstract available.
Cataract* ; Nephrotic Syndrome*

Animals ; Dental Implants ; Female ; Hand ; Humans ; Intercellular Signaling Peptides and Proteins ; Male ; Osseointegration ; Osteogenesis ; Plants ; Polymerase Chain Reaction ; Titanium

BACKGROUND: Community-acquired pneumonia (CAP) is more frequent in the elderly and results in higher morbidity and mortality. Korea is undergoing extraordinary demographic change. Elderly patients constitute an even-increasing proportion of the population but there have been few studies on the epidemiological investigation of the CAP in the elderly. The purpose of this study was to characterize the background, etiology, clinical course and outcome of CAP in elderly compared with younger patients. METHODS: During the study period (from 1st January to 31th December 1997), 214 patients with CAP were reviewed with regard to epidemiological, clinical, laboratory and microbiological data. 119 elderly patients (> or =65 years-old of age) were compared with 95 younger patients (<65 years-old of age). The both groups were compared with each others in terms of variables related to CAP. RESULTS: Comparison of epidemiological data between older and younger patients revealed a high prevalence of alcoholics (40% vs 56%), current smoker (33% vs 56%), malignancy (8% vs 24%) in the elderly. In terms of complication and clinical manifestation, shock (1% vs 6%), intubation (6% vs 20%), mechanical ventilation apply (5% vs 18%), respiratory failure (2% vs 12%), dyspnea (26% vs 56%), altered consciousness (0% vs 13%), extrapulmonary symptom (11% vs 18%) and bilateral infiltration (8% vs 20%) showed higher incidence in the elderly than in the younger patients. Causative organisms are identified in 47% (56/119) of elderly patients: those identified most frequently were S. pneumoniae (25%), K. pneumoniae (20%), S. aureus (16%), other Gram-negative bacilli (13%) and H. influenzae (11%). The overall mortality were significantly higher in the elderly patients (24%) than younger patients (5%). Two independent risk factors, those were related to the mortality of the elderly:higher APACHE II score (RR:3.43, 95% CI=1.43~7.21) and requirement of endotracheal tube (RR:4.73; 95% CI=1.72~16.5). CONCLUSION: CAP in the elderly shows more serious clinical and abnormal laboratory features than younger patients. In elderly, S. pneumoniae was the most common causative organism for CAP but other agents, particularly K. pneumoniae was isolated frequently. The severity of illness at initial presentation such as high APACHE II score and requirement of endotracheal tube were the major variables affecting the outcome.
Aged* ; Alcoholics ; APACHE ; Consciousness ; Dyspnea ; Humans ; Incidence ; Influenza, Human ; Intubation ; Korea ; Mortality ; Pneumonia* ; Prevalence ; Respiration, Artificial ; Respiratory Insufficiency ; Risk Factors ; Shock

A 60-year-old man undergoing maintenance hemodialysis presented with periodic fever, which resembled Pel-Ebstein fever of Hodgkin's lymphoma. Despite scores of diagnostic evaluations, origin of the fever remained obscure. On positron emission tomography/computed tomography scan, focal hot uptakes were seen in the mediastinum and mediastinoscopic biopsy showed many acid-fast bacilli with chronic granulomatous inflammation and necrosis. After a week of anti-tuberculosis medication, the patient remained afebrile without recourse to antipyretics.
Antipyretics ; Biopsy ; Electrons ; Fever ; Fever of Unknown Origin ; Hodgkin Disease ; Humans ; Inflammation ; Mediastinum ; Middle Aged ; Necrosis ; Renal Dialysis ; Tuberculosis, Lymph Node

We found an error in our published article. Author name should be corrected.

A 60-year-old man undergoing maintenance hemodialysis presented with periodic fever, which resembled Pel-Ebstein fever of Hodgkin's lymphoma. Despite scores of diagnostic evaluations, origin of the fever remained obscure. On positron emission tomography/computed tomography scan, focal hot uptakes were seen in the mediastinum and mediastinoscopic biopsy showed many acid-fast bacilli with chronic granulomatous inflammation and necrosis. After a week of anti-tuberculosis medication, the patient remained afebrile without recourse to antipyretics.
Antipyretics ; Biopsy ; Electrons ; Fever ; Fever of Unknown Origin ; Hodgkin Disease ; Humans ; Inflammation ; Mediastinum ; Middle Aged ; Necrosis ; Renal Dialysis ; Tuberculosis, Lymph Node

Diffuse mesangial sclerosis (DMS) is one of the underlying pathology of congenital and infantile nephrotic syndrome. Infants with DMS develop nephrotic syndrome before 2 years of age and progress to end stage renal disease within 3 years of age. The authors experienced a case of isolated DMS in a 4-month-old male infant who had nephrotic syndrome for 1 month. The diagnosis was confirmed on the basis of clinical, laboratory, pathological and molecular genetic findings. This is the 3rd case report of DMS in our country and the 1st case report of isolated DMS confirmed by molecular genetic study.
Denys-Drash Syndrome ; Diagnosis ; Humans ; Infant ; Kidney Failure, Chronic ; Male ; Molecular Biology ; Nephrotic Syndrome* ; Pathology ; Sclerosis*

Objective: : Anterior cervical spine surgery (ACSS) is a common surgical procedure used to treat cervical spinal degenerative diseases. One of the complications associated with ACSS is prevertebral soft tissue swelling (PSTS), which can result in airway obstruction, dysphagia, and other adverse outcomes. This study aims to investigate the correlation between various cervical sagittal parameters and PSTS following single-level ACSS, as well as to identify independent risk factors for PSTS. Methods: : A retrospective study conducted at a single institution. The study population included all patients who underwent single-level ACSS between January 2014 and December 2022. Patients with a history of cervical spine surgery or trauma were excluded from the study. The presence and severity of PSTS was assessed by reviewing pre- and postoperative imaging studies. The potential risk factors for PSTS that were examined include patient age, sex, body mass index, tobacco use, comorbidities, serum albumin levels, operative time, implant type, implanted level, and various cervical spine sagittal parameters. Multivariate linear regression analysis was performed to identify the independent risk factors for PSTS. Results: : A total of 62 consecutive patients who underwent single-level ACSS over a 8-year period at a single institution were enrolled in this study. Only preoperative segmental angle showed positive correlation with PSTS among various cervical spine sagittal parameters (r=0.36, p=0.005). Artificial disc replacement showed a negative correlation with PSTS (β=-0.38, p=0.002), whereas the use of demineralized bone matrix (DBM) had a positive impact on PSTS (β=0.33, p=0.009). We found that male sex, lower preoperative serum albumin, and implantation of upper cervical level (above C5) were independent predictors for PSTS after single-level ACSS (β=1.21; 95% confidence interval [CI], 0.27 to 2.15; p=0.012; β=-1.63; 95% CI, -2.91 to -0.34; p=0.014; β=1.44; 95% CI, 0.38 to 2.49; p=0.008, respectively). Conclusion : Our study identified male sex, lower preoperative serum albumin levels, and upper cervical level involvement as independent risk factors for PSTS after single-level ACSS. These findings can help clinicians monitor high-risk patients and take preventive measures to reduce complications. Further research with larger sample sizes and prospective designs is needed to validate these findings.

PURPOSE: To investigate the relationship between trans-lamina cribrosa pressure difference (TLCPD) and morphologic parameters of optic disc (OD) in normal tension glaucoma (NTG) patients. METHODS: Data from 31 NTG patients (31 eyes) and 29 controls (29 eyes) were analyzed retrospectively. Their cerebrospinal fluid pressure was estimated using diastolic pressure (DBP), body mass index (BMI) and age. TLCPD was defined as the difference of intraocular pressure (IOP) and the estimated cerebrospinal fluid pressure (ECSFP). Measurements of the rim area (RA), disc area (DA), average and vertical cup/disc (C/D) ratio, retinal nerve fiber layer thickness (RNFLT) and cup volume (CV) were taken for all patients using optical coherence tomography. The correlation between TLCPD and morphologic parameters of OD were assessed. RESULTS: There were no significant differences between the two groups in terms of age, DBP, IOP and spherical equivalent (SE) and BMI. The mean ECSFP was significantly higher in the controls (10.7 ± 2.8 vs. 12.2 ± 2.2 mm Hg, p = 0.031) and TLCPD was significantly higher in patients (2.4 ± 2.1 vs. 4.9 ± 3.7 mm Hg, p = 0.002). In the NTG group, there was a negative correlation between TLCPD and RA (r = -0.595) and positive correlations between TLCPD and the average C/D ratio (r = 0.504), vertical C/D ratio (r = 0.434) and CV (r = 0.420). Average RNLFT was also significantly correlated with TLCPD (r = -0.500) and RNFLT for four quadrants, except the nasal quadrant, in NTG patients. CONCLUSIONS: NTG patients had higher TLCPD. A higher TLCPD was associated with a narrower RA, larger C/D ratio, and thinner RNFLT.
Blood Pressure ; Body Mass Index ; Cerebrospinal Fluid Pressure ; Humans ; Intraocular Pressure ; Low Tension Glaucoma* ; Nerve Fibers ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence

OBJECTIVE: The authors report a retrospective analysis of the clinical effect of dorsal root entry zone (DREZ) lesioning for neuropathic intractable pain. METHODS: Fourteen patients who underwent dorsal root entry zone lesioning for various types of pain between September 1995 and August 2001 were evaluated retrospectively. Eleven male and three female patients whose ages ranging from 35 to 70 were studied. According to causes of intractable pain, patients were divided into paraplegic pain(7 patients), peripheral nerve injury pain(3), cancer pain(3), phantom limb pain(1) and root avulsion pain(1). Other preoperative pain managements showed no benificial effects. The changes in painful symtoms were closely observed during follow up period. The mean follow period after operation was 32.4 months. RESULTS: Postoperatively, the decrease in level of pain was classified into four groups : excellent, good, fair, poor. Excellent represented no pain without medication : Good, pain tolerable with non-opiate medicine ; Fair, pain tolerable with opiate medicine ; Poor, pain sustained. After operation, three patients were in excellent group, eight in good, one in fair, and two in poor. Twelve patients were in medically tolerable pain group accounting for 85.7%. There were no serious operation releated side effects. CONCLUSION: DREZ lesioning, in our series, provided substantial pain relief and this may be considered an option in management of these types of intractable neuropathic pain.
Female ; Follow-Up Studies ; Humans ; Male ; Neuralgia ; Pain Management ; Pain, Intractable* ; Peripheral Nerve Injuries ; Phantom Limb ; Retrospective Studies ; Spinal Nerve Roots*