BACKGROUND: Aging can serve as an underlying mechanism of chronic obstructive pulmonary disease (COPD). Also, smoking, which is the most common cause of COPD, is responsible for the systemic manifestations of the disease, independently from the lung function alterations. The purpose of this study was to analyze the effect of aging on the occurrence of cigarette smoking induced COPD. METHODS: For this analysis, we evaluated smoking status by a lifestyle intervention program and measured the occurrence of COPD by the Korea National Health and Nutrition Examination Survey (KNHANES) from 2005 to 2015. RESULTS: Aging and smoking were significantly effected on the lung function of COPD patients. Especially, the smoking duration is exaggerated in the presence of old age for older COPD patients. CONCLUSION The result showed that COPD patients exhibit aging and smoking duration related severity. The prevalence of COPD kept increasing internationally. Knowing the risk factor of COPD quantitatively and finding out the interaction among risk factors could be valuable predictors for preventing COPD.

BACKGROUND: Reducing the gaps in health inequality at a regional level and improving health equity have been emphasized in Korea, it is essential to accurately measure the burden of disease by region. This study aimed to estimate years of life lost (YLLs) in 17 Si and Do of Korea from 1997 to 2015 and determine the trends of regional differences in health status and disease structure. METHODS: YLL was calculated by subtracting the age at death from the life expectancy. Data on the region, gender, and age-stratified cause-specific death were obtained from the Korean Statistical Information Service of Statistics Korea. RESULTS: Age-standardized YLLs per 100,000 population decreased by year in all regions from 1997 to 2015 by 27.4% (27.5% for men; 27.2% for women). Despite the decline in YLLs, the regions with the highest and lowest YLLs did not change between 1997 and 2015. The diseases showing regional differences were caused by injury, often classified as avoidable mortality. We also confirmed that YLLs were higher in the regions with a higher deprivation index. CONCLUSION The present study identified that YLLs differed by regions in Korea with specific causes. The findings of this study can be used by decision-makers to prioritize the reduction of regional gaps in premature deaths.

Objective: : Transvenous embolization (TVE) via an occluded inferior petrosal sinus (IPS) in a cavernous sinus dural arteriovenous fistula (CSDAVF) is challenging, often requiring navigation of a microcatheter through resistive obstacles between the occluded IPS and shunted pouch (SP), although the reopening technique was successfully performed. We report five cases of successful access to the cavernous sinus (CS) or SP using the rigid-tipped microguidewire such as chronic total occlusion (CTO) wire aiming to share our initial experience with this wire. Methods: : In this retrospective study, four patients with CSDAVF underwent five procedures using the CTO wire puncture during transfemoral transvenous coil embolization. Puncture success, shunt occlusion, and complications including any hemorrhage and cranial nerve palsy were evaluated. Results: : Despite successful access through the occluded IPS, further entry into the target area using neurointerventional devices was impossible due to a short-segment stricture before the CS (three cases) and a membranous barrier within the CS (two cases). However, puncturing these structures using the rigid-tipped microguidewire was successful in all cases. We could advance the microcatheter over the rigid-tipped microguidewire for the navigation to the SP and achieved complete occlusion of the SP without complications. Conclusion : The use of the rigid-tipped microguidewire in the TVE via the occluded IPS of the CSDAVF would be feasible and safe.

PURPOSE: Understanding changes in pathogen and pneumonia prevalence among pediatric pneumonia patients is important for the prevention of infectious diseases. METHODS: We retrospectively analyzed data of children younger than 18 years diagnosed with pneumonia at 117 Emergency Departments in Korea between 2007 and 2014. RESULTS: Over the study period, 329,380 pediatric cases of pneumonia were identified. The most frequent age group was 1–3 years old (48.6%) and the next was less than 12 months of age (17.4%). Based on International Classification of Diseases, 10th revision diagnostic codes, confirmed cases of viral pneumonia comprised 8.4% of all cases, pneumonia due to Mycoplasma pneumoniae comprised 3.8% and confirmed cases of bacterial pneumonia 1.3%. The prevalence of confirmed bacterial pneumonia decreased from 3.07% in 2007 and 4.01% in 2008 to 0.65% in 2014. The yearly rate of pneumococcal pneumonia also decreased from 0.47% in 2007 to 0.08% in 2014. A periodic prevalence of M. pneumoniae pneumonia (MP) was identified. CONCLUSION: The increased number of patients with pneumonia, bacterial pneumonia, pleural effusion, and empyema in 2011 and 2013–2014 resulted from an MP epidemic. We provide evidence that the frequency of confirmed cases of bacterial pneumonia and pneumococcal pneumonia has declined from 2007 to 2014, which can simultaneously reflect the effectiveness of the pneumococcal conjugate vaccine.
Child ; Communicable Diseases ; Community-Acquired Infections ; Emergencies* ; Emergency Service, Hospital* ; Empyema ; Humans ; Information Systems* ; International Classification of Diseases ; Interrupted Time Series Analysis ; Korea* ; Mycoplasma pneumoniae ; Pleural Effusion ; Pneumonia* ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma ; Pneumonia, Pneumococcal ; Pneumonia, Viral ; Prevalence* ; Retrospective Studies

Adult ; Aneurysm ; Arteries ; Carotid Artery, Internal ; Embolization, Therapeutic ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Angiography ; Parents ; Prospective Studies ; Recurrence ; Retinal Artery ; Retreatment ; Stents ; Stroke, Lacunar ; Thromboembolism

BACKBROUND AND PURPOSE: The flow diverting effect of a low-wall coverage stent remains controversial. We evaluted patients who underwent stenting for small aneurysms with a low but potential risk of growth and reviewed related literature. MATERIALS AND METHODS: We evaluated 9 small aneurysms among 19 unruptured intracranial aneurysms from eight patients who underwent stenting. The patients had unexplainable severe headache (n = 8), aneurysm originating from the anterior choroidal artery (n = 3), potential growth or rupture risks including hypertension (n = 5), and multiple aneurysms (n = 6). Stents with a relatively low-wall coverage ratio (8-10%) were used. Clinical and angiographic outcomes were assessed. RESULTS: One (n = 8) or two stents (n = 1) were used without any procedural difficulties or complications. Although no immediate changes of aneurysm morphology were observed, aneurysms decreased in size (n = 8) when examined by DSA (n = 8) or MRA (n = 1) during a median 28.9-month follow-up. There were no adverse events, including thromboembolism, aneurysm rupture, or stent movement during a median 31.9-month clinical follow-up (range: 17-69 months). CONCLUSION: Although a variable degree of aneurysm size decrease may not prevent further growth or rupture of small aneurysms, stenting with a low-wall coverage ratio may have some advantageous hemodynamic effect. Flow modification of stent architecture vs. aneurysm characteristics, including size and location, on long-term outcome, requires further clarification.
Aneurysm* ; Arteries ; Choroid ; Follow-Up Studies ; Headache ; Hemodynamics ; Humans ; Hypertension ; Intracranial Aneurysm ; Rupture ; Stents* ; Thromboembolism

Objective: To assess the feasibility, efficacy, and safety of targeted embolization for cavernous sinus dural arteriovenous fistulas (CSDAVF). Materials and Methods: This retrospective study investigated patients with CSDAVF who underwent endovascular treatment at a tertiary hospital between October 1991 and March 2023. Treatment strategies were determined based on clinical symptoms and shunt characteristics. Targeted or non-targeted curative embolization was performed to achieve complete shunt occlusion.Initially, targeted embolization, selective occlusion of the shunted pouch while preserving the normal cavernous sinus lumen, was conducted, should that fail, non-targeted embolization was performed. In contrast, palliative embolization solely reduced shunt flow. Clinical signs, imaging characteristics, and outcomes were evaluated according to the agreed treatment strategy. Results: In total, 198 patients with CSDAVF (mean age 59.0 ± 12.1 years, 23.2% male) participated in this study. Of which, 94 patients (47.5%) were treated with targeted embolization, 75 (37.9%) with non-targeted embolization, and 29 (14.6%) with palliative treatment. For patients undergoing curative embolization, 55.7% (94/169) successfully achieved targeted embolization; this procedure was usually used to treat focal fistulas (restrictive or late-restrictive types), whereas diffuse fistulas (proliferative type) often underwent non-targeted or palliative embolization. For patients that underwent targeted embolization, the rate of complete or near-complete occlusion on immediate post-treatment digital subtraction angiography was 93.6% (88/94), with a complication rate of 2.1% (2/94), symptom improvement rate of 96.8% (91/94), and retreatment rate of 5.3% (5/94). No serious complications were reported during follow-up. Conclusion When successful, targeted embolization of CSDAVF causes low rates of cranial nerve palsy, retreatment, and good clinical outcomes.

Objective: To assess the feasibility, efficacy, and safety of targeted embolization for cavernous sinus dural arteriovenous fistulas (CSDAVF). Materials and Methods: This retrospective study investigated patients with CSDAVF who underwent endovascular treatment at a tertiary hospital between October 1991 and March 2023. Treatment strategies were determined based on clinical symptoms and shunt characteristics. Targeted or non-targeted curative embolization was performed to achieve complete shunt occlusion.Initially, targeted embolization, selective occlusion of the shunted pouch while preserving the normal cavernous sinus lumen, was conducted, should that fail, non-targeted embolization was performed. In contrast, palliative embolization solely reduced shunt flow. Clinical signs, imaging characteristics, and outcomes were evaluated according to the agreed treatment strategy. Results: In total, 198 patients with CSDAVF (mean age 59.0 ± 12.1 years, 23.2% male) participated in this study. Of which, 94 patients (47.5%) were treated with targeted embolization, 75 (37.9%) with non-targeted embolization, and 29 (14.6%) with palliative treatment. For patients undergoing curative embolization, 55.7% (94/169) successfully achieved targeted embolization; this procedure was usually used to treat focal fistulas (restrictive or late-restrictive types), whereas diffuse fistulas (proliferative type) often underwent non-targeted or palliative embolization. For patients that underwent targeted embolization, the rate of complete or near-complete occlusion on immediate post-treatment digital subtraction angiography was 93.6% (88/94), with a complication rate of 2.1% (2/94), symptom improvement rate of 96.8% (91/94), and retreatment rate of 5.3% (5/94). No serious complications were reported during follow-up. Conclusion When successful, targeted embolization of CSDAVF causes low rates of cranial nerve palsy, retreatment, and good clinical outcomes.

Objective: To assess the feasibility, efficacy, and safety of targeted embolization for cavernous sinus dural arteriovenous fistulas (CSDAVF). Materials and Methods: This retrospective study investigated patients with CSDAVF who underwent endovascular treatment at a tertiary hospital between October 1991 and March 2023. Treatment strategies were determined based on clinical symptoms and shunt characteristics. Targeted or non-targeted curative embolization was performed to achieve complete shunt occlusion.Initially, targeted embolization, selective occlusion of the shunted pouch while preserving the normal cavernous sinus lumen, was conducted, should that fail, non-targeted embolization was performed. In contrast, palliative embolization solely reduced shunt flow. Clinical signs, imaging characteristics, and outcomes were evaluated according to the agreed treatment strategy. Results: In total, 198 patients with CSDAVF (mean age 59.0 ± 12.1 years, 23.2% male) participated in this study. Of which, 94 patients (47.5%) were treated with targeted embolization, 75 (37.9%) with non-targeted embolization, and 29 (14.6%) with palliative treatment. For patients undergoing curative embolization, 55.7% (94/169) successfully achieved targeted embolization; this procedure was usually used to treat focal fistulas (restrictive or late-restrictive types), whereas diffuse fistulas (proliferative type) often underwent non-targeted or palliative embolization. For patients that underwent targeted embolization, the rate of complete or near-complete occlusion on immediate post-treatment digital subtraction angiography was 93.6% (88/94), with a complication rate of 2.1% (2/94), symptom improvement rate of 96.8% (91/94), and retreatment rate of 5.3% (5/94). No serious complications were reported during follow-up. Conclusion When successful, targeted embolization of CSDAVF causes low rates of cranial nerve palsy, retreatment, and good clinical outcomes.

Objective: To assess the feasibility, efficacy, and safety of targeted embolization for cavernous sinus dural arteriovenous fistulas (CSDAVF). Materials and Methods: This retrospective study investigated patients with CSDAVF who underwent endovascular treatment at a tertiary hospital between October 1991 and March 2023. Treatment strategies were determined based on clinical symptoms and shunt characteristics. Targeted or non-targeted curative embolization was performed to achieve complete shunt occlusion.Initially, targeted embolization, selective occlusion of the shunted pouch while preserving the normal cavernous sinus lumen, was conducted, should that fail, non-targeted embolization was performed. In contrast, palliative embolization solely reduced shunt flow. Clinical signs, imaging characteristics, and outcomes were evaluated according to the agreed treatment strategy. Results: In total, 198 patients with CSDAVF (mean age 59.0 ± 12.1 years, 23.2% male) participated in this study. Of which, 94 patients (47.5%) were treated with targeted embolization, 75 (37.9%) with non-targeted embolization, and 29 (14.6%) with palliative treatment. For patients undergoing curative embolization, 55.7% (94/169) successfully achieved targeted embolization; this procedure was usually used to treat focal fistulas (restrictive or late-restrictive types), whereas diffuse fistulas (proliferative type) often underwent non-targeted or palliative embolization. For patients that underwent targeted embolization, the rate of complete or near-complete occlusion on immediate post-treatment digital subtraction angiography was 93.6% (88/94), with a complication rate of 2.1% (2/94), symptom improvement rate of 96.8% (91/94), and retreatment rate of 5.3% (5/94). No serious complications were reported during follow-up. Conclusion When successful, targeted embolization of CSDAVF causes low rates of cranial nerve palsy, retreatment, and good clinical outcomes.