The principal objective of this study was to assess the nutritional status and dietary quality in low-income elderly individuals residing at home (LH) or in health care facilities (LHCF) with dietitian. This study was conducted via anthropometric measurements, questionnaire interviews, and dietary surveys using a 24 hr recall method with 120 low-income elderly individuals (LHCF=46, LH=74). The average ages of the LH and LHCF group were 76.3 years and 78.6 years, respectively. The LH group evidenced a significantly higher frequency of skipping meals than the LHCF group. The average energy intakes of the LHCF and LH group were 1921.0 kcal and 1443.9 kcal, with a significant difference (p<0.001). Most of the nutrient intake and intake rates for recommended intake were significantly higher among the LHCF group as compared with the LH group. The LHCF group showed significantly higher values for the nutrient adequacy ratio (NAR), the mean adequacy ratio (MAR), nutrient density (ND), and the index of nutritional quality (INQ) by dietary qualitative estimation than in the LH group. The Korean diet diversity scores (KDDS) were 3.66 for LH group and 4.93 for the LHCF group, thus were significantly higher in the LHCF group than in the LH group. The results of the present study demonstrate that the LH group appeared to experience more dietary problems than the LHCF group. It was suggested that nutritional education is needed for low-income elderly individuals living at home, in order for them to learn proper dietary management. This can be achieved via educational programs in social welfare institutions, incentives toward employment as a dietitian, and implementation of community-based support.
Aged ; Delivery of Health Care ; Diet ; Employment ; Humans ; Meals ; Motivation ; Nutritional Status ; Nutritive Value ; Surveys and Questionnaires ; Social Welfare

PURPOSE: We report a case of acute dacryocystitis diagnosed with abscess and rupture of lacrimal sac and fistula to posterior orbit during the operation. CASE SUMMARY: A 71-year-old woman visited our clinic with edema and pain in the eyelid from three days ago. For past four months, there was viscous of the left eye and tears. The patient had severe conjunctival chemosis and hyperemia, compared with the left eyelid edema and redness. Orbital CT scan showed orbital cellulitis, which was followed by systemic antibiotics and steroid therapy. On the 4th day of therapy, orbital abscess formation was observed in orbit MRI and surgical drainage was planned. During surgery, we found rupture of the posterior part of lacrimal sac and fistula to posterior orbit. Pseudomonas aeruginosa was identified in the bacterial cultures, and after the administration of appropriate antibiotics, the disease showed improved progress, and then additional dacryocystorhinostomy was performed. CONCLUSIONS: In our case, acute dacryocystitis rarely spread in orbit, which may lead to delayed diagnosis, orbital cellulitis and abscess, resulting in serious complications of vision threat. So, we think that it is necessary to consider surgical treatment more actively in the stage of chronic dacryocysitis.
Abscess ; Aged ; Anti-Bacterial Agents ; Dacryocystitis ; Dacryocystorhinostomy ; Delayed Diagnosis ; Drainage ; Edema ; Eyelids ; Female ; Fistula ; Humans ; Hyperemia ; Magnetic Resonance Imaging ; Nasolacrimal Duct ; Orbit ; Orbital Cellulitis ; Pseudomonas aeruginosa ; Rupture ; Tears ; Tomography, X-Ray Computed

OBJECTIVE: The development of a dictionary of clinical terminology based on medical concepts is essential for understanding the precise meanings of the clinical terminologies used in EMR systems. For an unambiguous presentation and retrieval of the terminologies in practical data entry, this study propose a clinical terminology dictionary, which integrates and manages the wide range of data in EMR Systems. METHODS: The structure of the system and attributes were defined. The structures should satisfy the following: all terminologies should be consistent with the medical concepts, all concepts have multiple relationships, all concepts have many synonyms, all concepts can be mapped to concepts in an external medical terminology system, and all concepts can be grouped as value sets by setting the "domain". RESULTS: With the derived entity objects and attributes, the physical clinical terminology database was constructed and an editor was developed using MySQL 5.0.45 and JAVA Swing. To verify the structure and contents of the developed clinical terminology dictionary, the terminology experts used the editor to search and register the medical concepts. CONCLUSION: Although the contents refinement and complements are an unsolved problem, it is anticipated that the proposed research will provide unambiguous meanings of the clinical terminology and be applicable to many services in EMR systems.
Complement System Proteins ; Indonesia

The extracellular calcium sensing receptor (CaSR) belongs to the type III family of G-protein-coupled receptors, a family that comprises the metabotropic glutamate receptor and the putative vomeronasal organ receptors. The CaSR plays an important role for calcium homeostasis in parathyroid cells, kidney cells and other cells to directly 'sense' changes in the extracellular calcium ion concentration ((Ca2+)o). The mesangial cells are known to be involved in many pathologic sequences through the mediation of altered glomerular hemodynamics, cell proliferation, and matrix production. In this study, we examined the expression of the CaSR in the mouse mesangial cell lines (MMC, ATCC number CRL-1927). Reverse transcription- polymerase chain reaction (RT-PCR) was perform with CaSR-specific primers, and this was followed by nucleotide sequencing of the amplified product; this process identified the CaSR transcript in the MMCs. Moreover, CaSR protein was present in the MMCs as assessed by Western blot and immunocytochemical analysis using a polyclonal antibody specific for the CaSR. Functionally, (Ca2+)o induced the increment of the intracellular calcium concentration ((Ca2+)i) in a dose-dependent manner. This (Ca2+)i increment by (Ca2+)o was attenuated by the pretreatment with a phospholipase C inhibitor (U73122) and also by a pretreatment with a CaSR antagonist (NPS 2390). The similar results were also obtained in IP3 accumulation by (Ca2+)o. To investigate the physiological effect of the CaSR, the effect of the (Ca2+)o on cell proliferation was studied. The increased (Ca2+)o (up to 10 mM) produced a significant increase in the cell numbers. This mitogenic effect of (Ca2+)o was inhibited by the co-treatment with a CaSR antagonist. From these results, the (Ca2+)o-induced (Ca2+)i elevation in the MMC is coupled with the extracellular calcium sensing receptor. Furthermore, (Ca2+)o produces a mitogenic effect in MMCs.
Animals ; Calcium/metabolism ; Cell Line ; Cell Proliferation ; Inositol 1,4,5-Trisphosphate/metabolism ; Mesangial Cells/*cytology/*metabolism ; Mice ; RNA, Messenger/genetics/metabolism ; Receptors, Calcium-Sensing/genetics/*metabolism ; Research Support, Non-U.S. Gov't

The necessary role of genital infection by specific types of human papillomavirus (HPV) in cervical cancer development provides an opportunity to reduce the risk of cervical cancer, a second leading cancer in women, through prophylactic vaccination. Two types of vaccines targeting HPV 16 and 18 which are responsible for about 70% of all cervical cancer worldwide have been developed: a quadrivalent vaccine (Gardasil?) and a bivalent vaccine (Cervarix?). Gardasil also targets HPV 6 and 11 causing 90% of genital wart. Both two vaccines contain virus-like particles composed of L1 protein of viral capsid and do not exert infectivity. HPV vaccines were highly effective in preventing persistent infection by vaccine specific type HPV in young women who have not been previously exposed to them. Randomized double-blind placebo-controlled clinical trials have provided evidence that HPV vaccines have high efficacy against cervical precancerous lesion in young women irrespective of baseline HPV infection status. However, HPV vaccines neither treat existing HPV infections nor provide protection against all types of HPV related with cervical cancer. Therefore, even vaccinated females should take cervical cancer screening as recommended. Gardasil has been tested mainly in 9~26 years old females and Cervarix in 15~25 years old. Current recommendation for vaccination age is 9~26 years for Gardasil and 10~25 years for Cervarix, considering sexual debut and previous clinical trials. There are plenty of remaining issues regarding HPV vaccination such as vaccine efficacy in older women and in males, cost-effectiveness, duration of protection, cross-protection, potential replacement infection, and vaccine compatibility.
Cancer Vaccines ; Capsid ; Condylomata Acuminata ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Human papillomavirus 6 ; Humans ; Male ; Mass Screening ; Papillomavirus Vaccines ; Uterine Cervical Neoplasms ; Vaccination ; Vaccines ; Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18

PURPOSE: The prognostic value of p53 remains controversial in transitional cell carcinomas of the bladder. Survivin, an inhibitor of apoptosis, is expressed in many human cancers. Recent studies have reported increased expression of survivin in superficial transitional cell carcinomas of the bladder. We investigated the expression of survivin and p53 and the clinical implications of this expression in superficial transitional cell carcinomas of the bladder. MATERIALS AND METHODS: Immunohistochemical staining of paraffin sections using a monoclonal antibody for survivin and p53 was performed in 82 cases of superficial transitional cell carcinomas of the bladder. Correlations between the expression of survivin and p53 and clinicopathological features, such as age, multiplicity of tumor, size, recurrence, and progression, were examined. RESULTS: Among 82 cases, positive survivin expression (greater than 20%) was observed in 59 cases. Positive p53 expression (greater than 20%) was observed in 46 cases. There were no significant differences in age, gender, multiplicity, tumor size, tumor grade, pT stage, recurrence, or progression-free survival between p53-positive and p53-negative groups (p>0.05). Also, there were no significant differences in age, gender, multiplicity, tumor size, tumor grade, or pT stage between survivin-positive and survivin-negative groups (p>0.05). However, recurrent-free and progression-free survivals were significantly lower in the survivin-positive group than in the survivin-negative group (p<0.05). CONCLUSIONS: The expression of survivin can be recommended as a useful marker for predicting disease recurrence and progression. Survivin may be superior to p53 as a prognostic factor in superficial transitional cell carcinoma of bladder.
Apoptosis ; Carcinoma, Transitional Cell ; Disease-Free Survival ; Genes, p53 ; Humans ; Paraffin ; Recurrence ; Urinary Bladder ; Urinary Bladder Neoplasms

BACKGROUND: Acute liver failure either after liver resection or as part of underlying liver disease is still associated with high mortality. Various treatments have been tried to improve liver function during acute liver failure, including metabolic and nutritional support, hemodialysis, hemoperfusion, plasmapheresis, and hepatocyte and liver transplantation. Hepatocyte transplantation in various forms has attracted attention recently. We investigated whether allogeneic isolated hepatocytes transplanted in the spleen would prolong survival, facilitate liver regeneration, and improve biochemical parameters in rats with acute liver failure induced by a 90% hepatectomy. METHODS: Allogeneic male Sprague-Dawley rats were used. Group I rats (n=26) received an intrasplenic injection of 2 107 hepatocytes in 0.3 ml of Dulbecco's modified Eagle's medium (DMEM), and 1 days later acute liver failure was induced. Group II acute-liver-failure rats (n=24) received an intrasplenic injection of DMEM. The survival time was determined for 22 rats in Group I and for 20 rats in Group II. The remaining 8 (4/each group) acute liver failure rats were used to assess the liver function and regeneration. RESULTS: The survival was longer and the number of long-term survivors was greater for Group I rats than for the Group II controls. At 24 hour after the hepatectomy, Group I rats had lower ammonia, lower total bilirubin, lower activities of liver enzymes, and higher glucose levels than did Group II rats. In Group I, there was significant increase in the ratio of the weight of the remnant liver lobes to the body weight. CONCLUSION: Compared with the Control group intrasplenic hepatocyte transplantation in acute liver failure rats acts as a bridge to support experimental rats in going from acute or fulminant liver failureto liver regeneration or compensation, prolongs survival in rats with acute liver failure induced by a 90% hepatectomy, and improves the biochemical parameters, except for the albumin levels and prothrombin time. Transplantation of hepatocytes may be beneficial in supporting a liver which has been acutely devastated by a 90% hepatectomy.
Ammonia ; Animals ; Bilirubin ; Body Weight ; Compensation and Redress ; Glucose ; Hemoperfusion ; Hepatectomy* ; Hepatocytes* ; Humans ; Liver ; Liver Diseases ; Liver Failure, Acute* ; Liver Regeneration ; Liver Transplantation ; Male ; Mortality ; Nutritional Support ; Plasmapheresis ; Prothrombin Time ; Rats* ; Rats, Sprague-Dawley ; Regeneration ; Renal Dialysis ; Spleen ; Survivors

We observed the gastric varices in l89 variceal patients with liver cirrhosis and in 129 patients with UGI bleeding by endoscopy. Gastric varices was found in 27 cases(14.2%) amoag 189 variceal cases. There was variceal bleeding in 74 cases(57.4%) beieg the toy cause of UGI: bleeding among l29 cases with UGI bleeding and 6(4.7%) had endoscopically proved gastric Variceal bleeding. Cardiac and fundic varices were observed in l8 and 12 cases, respectively end 12 cases of cardiac varices were mainly observed on the lesser curvature side. The incidence of isolated gastric varices being 30 % amoag gastric varices was far less than that of esophagogastric varices. There was no significant relations between the severity of liver cirrhosis and the kinds of varices These results suggest that gastric varices are not infrequent cause of UGI bleeding cases. Therefore all must have attention in gastric intestinal fiberscopic examination in portal hypertensive patients.
Endoscopy ; Esophageal and Gastric Varices* ; Hemorrhage ; Humans ; Incidence ; Liver Cirrhosis ; Play and Playthings ; Varicose Veins

BACKGROUND: Graves' disease (GD) is an autoimmune thyroid disorder caused by antibodies stimulating the thyrotropin (TSH) receptor. TSH receptor antibody (TRAb) measurement is useful for predicting GD relapse after antithyroid drug (ATD) treatment. However, the association of other thyroid autoantibodies with GD relapse remains obscure. METHODS: This retrospective study enrolled patients with GD who were initially treated with ATD. TRAb, thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured at the initial diagnosis and at the time of ATD discontinuation. RESULTS: A total of 55 patients were enrolled. The mean age was 49.7 years, and 39 patients (70.9%) were female. Antibody positivity at diagnosis was 90.9%, 69.1%, and 61.9% for TRAb, TPOAb, TgAb, respectively. Median ATD treatment period was 15.1 months. At the time of ATD withdrawal, TRAb titers decreased uniformly overall. Conversely, TPOAb and TgAb showed various changes. After withdrawal of ATD, 19 patients (34.5%) experienced relapse. No clinical features or laboratory results were significantly related to relapse in the overall patient group. However, in the TPOAb positive group at diagnosis, increasing titer of TPOAb or TgAb after ATD treatment was significantly and independently related to relapse free survival (TPOAb: hazard ratio [HR], 17.99; 95% confidence interval [CI], 1.66 to 195.43; P=0.02) (TgAb: HR, 5.73; 95% CI, 1.21 to 27.26; P=0.03). CONCLUSION: Changes in TPOAb or TgAb titers during treatment might be useful for predicting relapse after ATD treatment in patients with positive TPOAb at diagnosis.
Antibodies ; Autoantibodies ; Diagnosis ; Drug Therapy ; Female ; Graves Disease ; Humans ; Iodide Peroxidase ; Receptors, Thyrotropin ; Recurrence ; Retrospective Studies ; Thyroglobulin ; Thyroid Gland ; Thyrotropin

Background: Thyroid cancer mortality has been largely overlooked as relatively stable given the large gap between thyroid cancer incidence and mortality. This study evaluated long-term trends in age-standardized mortality rates (ASMRs) throughout Korea and compared them with mortality data reported by the Surveillance, Epidemiology, and End Results (SEER). Methods: Cancer-specific mortality data from 1985 to 2020 were obtained from Statistics Korea. ASMRs from thyroid cancer were calculated based on the Korean mid-year resident registration population of 2005. We assessed SEER*Explorer and downloaded the mortality data. Results: The ASMR increased from 0.19 to 0.77/100,000 between 1985 and 2002 but decreased continuously to 0.36/100,000 in 2020. The annual percent change (APC) in the ASMR between 1985 and 2003 and between 2003 and 2020 was 6.204 and −4.218, respectively, with similar patterns observed in both men and women. The ASMR of the SEER showed a modest increase from 1988 to 2016 and then stabilized. In subgroup analysis, the ASMR of the old age group (≥55 years) increased significantly from 0.82 in 1985 to 3.92/100,000 in 2002 (APC 6.917) but then decreased again to 1.86/100,000 in 2020 (APC −4.136). ASMRs according to the age group in the SEER showed a relatively stable trend even in the elderly group. Conclusion The ASMR of thyroid cancer in Korea had increased from 1985 to 2002 but has since been steadily decreasing. This trend was mainly attributed to elderly people aged 55 or over. The absolute APC value of Korea was much higher than that of the SEER.