Chronic kidney disease (CKD) is a common condition leading to renal dysfunction and is closely related to increased cardiovascular and mortality risk. CKD is an important public health issue, and recent genetic studies have verified common CKD susceptibility variants. This research examines the interrelationship between candidate genes polymorphisms of interferon lambda (IFNL) induction, its signaling pathway, and CKD. Methods: Seventy-five patients with advanced CKD and 312 healthy subjects (as controls) participated in this research. A replication set composed of 172 patients with advanced CKD and 365 controls was used for additional analysis. The genotype of single nucleotide polymorphisms (SNPs) was determined by the Axiom Genome-Wide Human Assay and SNaPshot assay. Results: The SNP of IFNL3 was significantly associated with CKD in the codominant (p = 0.02) and dominant models (p = 0.02). In addition, the SNPs of IFNL2 were significantly associated with CKD in the dominant model (p = 0.03), and the SNP of interferon alpha receptor 2 (IFNAR2) was significantly associated with CKD in the log-additive model (p = 0.03). Concerning rs148543092, in the IFNL3 gene, a significant association was observed after pooling the original and replication sets. Conclusion: These results indicate that SNPs in the IFNL induction and signal pathway may be associated with CKD risk in the Korean population. Finally, our results also show that the IFNL3 gene variant may be associated with CKD risk.

PURPOSE: The aim of this study was to compare the short- and long-term outcomes between stent placement as a bridge to surgery and emergency surgery for obstructive colon cancer. METHODS: Patients who underwent surgery for left colon cancer and rectal cancer with total obstruction from September 2006 to October 2014 were enrolled. Data for the stent placement and emergency surgery groups were compared. RESULTS: Of the 67 patients with total obstruction, 53 patients were treated with stent placement and 14 patients were treated with emergency surgery. Significant differences were observed for surgical approach, type of operation, and combined resection. Use of minimally invasive surgery (MIS) was higher (88.6 vs. 42.9%, p<0.001) in the stent placement (SP) group, and combined resection (5.9 vs. 37.5%, p<0.001) was higher in the emergency surgery (EM) group. In the SP group, resection and anastomosis accounted for the largest proportion (92.5%) and in the EM group, Hartmann's procedure was most common (57.1%) (p<0.001). There were no significant differences in other operative outcomes or in postoperative courses. Five-year overall survival was 96.0 and 77.8% (p=0.311) in the SP and EM groups, respectively. Five-year disease-free survival for local recurrence in the SP and EM groups was 90.0 and 88.9% (p=0.904). CONCLUSION: Stent placement as a bridge to surgery can be performed safely and represents an alternative to emergency surgery with good short-term results. Stent placement as a bridge to surgery is also comparable to emergency surgery in long-term outcomes.
Colonic Neoplasms ; Colorectal Neoplasms* ; Disease-Free Survival ; Emergencies* ; Humans ; Rectal Neoplasms ; Recurrence ; Stents* ; Surgical Procedures, Minimally Invasive

Proper seat belt use saves lives; however, the use rate decreased in Korea. This study aimed to measure the magnitude of the preventive effect of seat belt on case-fatality across drivers and passengers. We used the Emergency Department based Injury In-depth Surveillance (EDIIS) database from 17 EDs between 2011 and 2012. All of adult injured patients from road traffic injuries (RTI) in-vehicle of less than 10-seat van were eligible, excluding cases with unknown seat belt use and outcomes. Primary and secondary endpoints were in-hospital mortality and intracranial injury. We calculated adjusted odds ratios (AORs) of seat belt use and driving status for study outcomes adjusting for potential confounders. Among 23,698 eligible patients, 15,304 (64.6%) wore seat belts. Driver, middle aged (30-44 yr), male, daytime injured patients were more likely to use seat belts (all P < 0.001). In terms of clinical outcome, no seat belt group had higher proportions of case-fatality and intracranial injury compared to seat belt group (both P < 0.001). Compared to seat belt group, AORs (95% CIs) of no seat belt group were 10.43 (7.75-14.04) for case-fatality and 2.68 (2.25-3.19) for intracranial injury respectively. In the interaction model, AORs (95% CIs) of no seat belt use for case-fatality were 11.71 (8.45-16.22) in drivers and 5.52 (2.83-14.76) in non-driving passengers, respectively. Wearing seat belt has significantly preventive effects on case-fatality and intracranial injury. Public health efforts to increase seat belt use are needed to reduce health burden from RTIs.
Accidents, Traffic/mortality/*prevention & control ; Adult ; Aged ; Craniocerebral Trauma/prevention & control ; Databases, Factual ; Emergency Service, Hospital ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Motor Vehicles ; Odds Ratio ; Republic of Korea/epidemiology ; Seat Belts/*utilization ; Young Adult

PURPOSE: To evaluate malignancy risk according to ultrasound (US) features and size change on follow-up US in mixed echoic thyroid nodules and to suggest management guidelines thereof. MATERIALS AND METHODS: Among patients who underwent US-guided fine needle aspiration biopsy, 316 mixed echoic nodules in 303 patients were included after excluding the patients with pure solid or cystic nodules or without further cytopathologic evaluation. We evaluated malignancy risk according to US features and changes in size and shape on follow-up US. RESULTS: The malignancy rate was 31.6% (6 of 19) for nodules with suspicious US features and 2.7% (8 of 297) for nodules without suspicious US features (p<0.001). Among 265 nodules with no suspicious US features and initial benign cytology, 15 nodules with suspicious US change and decreased size, 25 nodules with no suspicious US change and increased size, and 225 nodules with no suspicious US change and no change in size were observed on follow-up USs. The malignancy risk thereof was 0%, 0% and 0.4%, respectively (p=1.000). CONCLUSION: Mixed echoic nodules with no suspicious US features and benign cytology can be followed up using US, as they revealed very low malignancy rates, even if they showed growth on follow-up US.
Adult ; Biopsy, Fine-Needle/methods ; Female ; Humans ; Male ; Middle Aged ; Thyroid Neoplasms/diagnosis/ultrasonography ; Thyroid Nodule/*diagnosis/*ultrasonography

PURPOSE: The purpose was to compare the frequency of metastatic and nonmetastatic lymph nodes diagnosed by fine needle aspiration biopsy cytology (FNAC) and thyroglobulin concentration from fine needle aspiration biopsy washout fluid (FNAB-Tg) in an indeterminate range (0.2-100 ng/mL), and to evaluate the most appropriate threshold value of FNAB-Tg in an indeterminate range. MATERIALS AND METHODS: We performed ultrasound-guided FNAB and FNAB-Tg in suspicious metastatic cervical lymph nodes of papillary thyroid carcinoma and performed surgery. Ninety-five lymph nodes with indeterminate values of FNAB-Tg ranging from 0.2-100 ng/mL in ninety-two patients were included in this study. The diagnostic performances in multiple Tg levels (0.7, 1.0, 5.0, 10.0, 20.0, 50.0) were evaluated to compare with FNAB cytology using sensitivity, specificity, and accuracy with area under the curve (AUC) analysis. RESULTS: Forty-two were metastatic lymph nodes and fifty three were nonmetastatic lymph nodes. FNAB-Tg ranged from 0.22 to 90.9 ng/mL in metastatic lymph nodes (mean; 34.3+/-33.3 ng/mL) and 0.20 to 56.7 ng/mL in nonmetastatic lymph nodes (mean; 4.9+/-11.1 ng/mL) (p<0.001). The most excellent diagnostic performance was displayed in 5 ng/mL of FNAB-Tg with AUC of 0.76, sensitivity, specificity, accuracy, 69.0, 83.0, and 76.8, respectively. However, there was no significant difference from 10 ng/mL FNAB. CONCLUSION: We ascertained that 5 ng/mL yielded the most excellent diagnostic performance among FNAB-Tg levels in the present setting with a large series with the indeterminate range (0.2-100 ng/mL) of FNAB-Tg values. These results need additional confirmation under different laboratory conditions.
Biopsy, Fine-Needle/*methods/standards/statistics & numerical data ; Body Fluids/metabolism ; Carcinoma, Papillary/*metabolism/*secondary/ultrasonography ; Humans ; Lymph Nodes/metabolism/pathology/ultrasonography ; Lymphatic Metastasis ; Retrospective Studies ; Sensitivity and Specificity ; Thyroglobulin/*metabolism ; Thyroid Neoplasms/*metabolism/*secondary/ultrasonography ; Ultrasonography, Interventional

The iliopsoas bursa is a normal anatomical structure that lies deep to the iliopsoas tendon in the region of the hip joint. Iliopsoas bursitis is a relatively rare condition, so it is often overlooked as a cause of signs and symptoms involving the inguinal area and lower extremity. The clinical manifestation related to iliopsoas bursitis can vary due to compression of the adjacent structures such as the common and superficial femoral vessels, nerve, and bladder. We report here on rare cases of iliopsoas bursitis with compression of the superficial femoral artery and common femoral vein.
Bursitis* ; Femoral Artery ; Femoral Vein ; Hip Joint ; Lower Extremity ; Tendons ; Urinary Bladder

The iliopsoas bursa is a normal anatomical structure that lies deep to the iliopsoas tendon in the region of the hip joint. Iliopsoas bursitis is a relatively rare condition, so it is often overlooked as a cause of signs and symptoms involving the inguinal area and lower extremity. The clinical manifestation related to iliopsoas bursitis can vary due to compression of the adjacent structures such as the common and superficial femoral vessels, nerve, and bladder. We report here on rare cases of iliopsoas bursitis with compression of the superficial femoral artery and common femoral vein.
Bursitis* ; Femoral Artery ; Femoral Vein ; Hip Joint ; Lower Extremity ; Tendons ; Urinary Bladder

Congenital rubella syndrome is a transplacental fetal infection with rubella virus and shows a wide spectrum of clinical expression from severe malformation to asymptomatic in the neonatal period. For the confirmation of congenital rubella, one of the following laboratory criteria should be present: isolation of rubella virus, demonstration of rubella-specific IgM antibody, or a rubella IgG antibody that persists and fails to drop at a rate of twofold dilution per month. Recently a reverse transcription-nested polymerase chain reaction (RT-nPCR) method for the prenatal diagnosis of rubella virus infection has been used. We experienced a case of congenital rubella in a 15- month old male who had suffered from respiratory difficulty. He had low birth weight. Thrombocytopenia was noticed shortly after his birth. He was transferred to our hospital because persistent respiratory difficulty had been developing since the age of one month. His growth and development were delayed. Physical examination revealed micrognathia, hepatosplenomegly, lymphadenopathy, and petechiae. Laboratory examination revealed a rubella specific IgM antibody. Chest X-ray suggested a chronic lung change. Rubella virus RNA was detected in the serum by RT-nPCR. This is the first case of congenital rubella, which was confirmed by the detection of rubella virus RNA, in Korea.
Growth and Development ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Lung ; Lymphatic Diseases ; Male ; Parturition ; Physical Examination ; Polymerase Chain Reaction ; Prenatal Diagnosis ; Purpura ; RNA ; Rubella ; Rubella Syndrome, Congenital* ; Rubella virus ; Thorax ; Thrombocytopenia

Congenital rubella syndrome is a transplacental fetal infection with rubella virus and shows a wide spectrum of clinical expression from severe malformation to asymptomatic in the neonatal period. For the confirmation of congenital rubella, one of the following laboratory criteria should be present: isolation of rubella virus, demonstration of rubella-specific IgM antibody, or a rubella IgG antibody that persists and fails to drop at a rate of twofold dilution per month. Recently a reverse transcription-nested polymerase chain reaction (RT-nPCR) method for the prenatal diagnosis of rubella virus infection has been used. We experienced a case of congenital rubella in a 15- month old male who had suffered from respiratory difficulty. He had low birth weight. Thrombocytopenia was noticed shortly after his birth. He was transferred to our hospital because persistent respiratory difficulty had been developing since the age of one month. His growth and development were delayed. Physical examination revealed micrognathia, hepatosplenomegly, lymphadenopathy, and petechiae. Laboratory examination revealed a rubella specific IgM antibody. Chest X-ray suggested a chronic lung change. Rubella virus RNA was detected in the serum by RT-nPCR. This is the first case of congenital rubella, which was confirmed by the detection of rubella virus RNA, in Korea.
Growth and Development ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Lung ; Lymphatic Diseases ; Male ; Parturition ; Physical Examination ; Polymerase Chain Reaction ; Prenatal Diagnosis ; Purpura ; RNA ; Rubella ; Rubella Syndrome, Congenital* ; Rubella virus ; Thorax ; Thrombocytopenia

PURPOSE: Occult papillary thyroid carcinomas (OPC) are defined as tumors measuring < or =15 mm in size. They are believed to be a less aggressive subset of papillary cancers, which behave more like benign lesions, and are often treated more conservatively. However, some groups have reported a high incidence of metastases from papillary microcarcinomas and favor an aggressive surgical resection followed by radioiodine therapy. We review our experience in an attempt to characterize the biology and optimal treatment for OPCs. METHODS: From October 2001 to March 2006, among impalpable thyroid nodules detected incidentally during screening exams, 214 patients underwent surgery for occult papillary thyroid cancer (OPC) at Kangnam Cha University hospital. The data from these patients were analyzed retrospectively. The mean follow up period was 19.9+/-11.7 (max : 53, min : 1) months. RESULTS: The mean age of these patients was 41.4 year, and 188 (87.7%) were female. 41% of the patients underwent a total or neartotal thyroidectomy, 42% had a central lymph node dissection and 41% had radioiodine ablation therapy after surgery. Of the 214 patients, 40 (18.7%) had lymph node metastases. The LN metastases were associated with the tumor size (P=0.0007), extracapsular invasion (P=0.0268) and multifocality (P=0.0024), but there was no association with age and gender. The incidence of the LN metastases (20%) and extracapsular invasion (59.1%) were higher in the tumors between 0.5~1.0 cm in size. With a follow-up up to 53 months, 3 patients had a local recurrence (0.014%) but no patients currently has active disease. No patients with OPC died died during this period. CONCLUSION: In OPC patients, a progressively increasing frequency of signs of tumor aggressiveness with increasing tumor size was observed but a small size itself could not guarantee a low risk or low recurrence rate. The prevalence of LN metastases and extracapsular invasion were higher in tumors > 0.5 cm in size. Therefore, we prefer near-total or total thyroidectomy with central lymph node dissection. Early detection and treatment of OPC might be warranted by the routine use of thyroid USG and USG-guided FNA.
Biology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Mass Screening ; Neoplasm Metastasis ; Prevalence ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy