Time-restricted feeding (TRF), devoid of calorie restriction, is acknowledged for promoting metabolic health and mitigating various chronic metabolic diseases. While TRF exhibits widespread benefits across multiple tissues, there is limited exploration into its impact on kidney function. In this study, our aim was to investigate the potential ameliorative effects of TRF on kidney damage in a mouse model of cisplatin-induced acute kidney injury (AKI). Methods: Cisplatin-induced AKI was induced through intraperitoneal injection of cisplatin into C57BL/6 male mice. Mice undergoing TRF were provided unrestricted access to standard chow daily but were confined to an 8-hour feeding window during the dark cycle for 2 weeks before cisplatin injection. The mice were categorized into four groups: control, TRF, cisplatin, and TRF + cisplatin. Results: The tubular damage score and serum creatinine levels were significantly lower in the TRF + cisplatin group compared to the cisplatin group. The TRF + cisplatin group exhibited reduced expression of phosphorylated nuclear factor kappa B, inflammatory cytokines, and F4/80-positive macrophages compared to the cisplatin group. Furthermore, oxidative stress markers for DNA, protein, and lipid were markedly decreased in the TRF + cisplatin group compared to the cisplatin group. TUNEL-positive tubular cells, cleaved caspase-3 expression, and the Bax/Bcl-2 ratio in the TRF + cisplatin group were lower than those in the cisplatin group. Conclusion: TRF, without calorie restriction, effectively mitigated kidney damage by suppressing inflammatory reactions, oxidative stress, and tubular apoptosis in a mouse model of cisplatin-induced AKI. TRF holds promise as a novel dietary intervention for preventing cisplatin-induced AKI.

Objective: To develop an integrated and comprehensive community-based mental healthcare model, opinions were collected on various issues from practitioners in mental health service institutions currently offering mental healthcare services in Seoul through a focus group interview, qualitative research method, and Delphi survey. Methods: The focus group interview was conducted with six practitioners from mental health welfare centers and six hospital-based psychiatrists. A questionnaire of opinions on the mental healthcare model was filled by these practitioners and psychiatrists. A Delphi survey was additionally conducted with a panel of 20 experts from a community mental health welfare center and hospital-based psychiatrists. Results: The focus group interview results showed the need for integrated community-based mental healthcare service and the need to establish a system for managing mental and physical health in an integrated manner. Based on the survey results, the current status of community-based mental healthcare services was investigated, and the direction of the revised model was established. The Delphi survey was then conducted to refine the revised model. Conclusion The present study presents the Seoul-type community-based mental healthcare model with integrated services between a psychiatric hospital with a mental health welfare center as well as combined mental and physical health services. This is ultimately expected to help people with mental illnesses live healthy lives by meeting their needs as community members.

Purpose: Mycoplasma pneumoniae pneumonia (MP) is a major cause of community-acquired pneumonia (CAP) in children and is associated with extrapulmonary manifestations (EPM). The incidence and risk factors for EPM in children are unknown. Methods: This was a retrospective study involving 65,243 pediatric patients with CAP between 2010 and 2015 at 23 nationwide hospitals in South Korea. Medical records were reviewed to collect information regarding the clinical characteristics, radiological results, and laboratory findings. Logistic regression with multivariate analysis was performed to evaluate the risk factors associated with EPM in MP. Results: The incidence of EPM was 23.9%, including elevation of liver enzymes (18.1%), mucocutaneous manifestations (4.4%), proteinuria (4.1%), cardiovascular and neurological manifestations (0.4%), hematologic manifestations (0.2%), and arthritis (0.2%). Statistical analysis showed that mucocutaneous manifestations significantly increased with elevated alanine aminotransferase (adjusted odds ratio [aOR], 3.623; 95% confidence interval [CI], 1.933-6.790) and atopic sensitization (aOR, 2.973; 95% CI, 1.615–5.475) and decreased with respiratory virus coinfection (aOR, 0.273; 95% CI, 0.084–0.887). Elevated liver enzymes were significantly associated with elevated lactate dehydrogenase (aOR, 3.055; 95% CI, 2.257–4.137), presence of pleural effusion (aOR, 2.635; 95% CI, 1.767–3.930), and proteinuria with respiratory virus coinfection (aOR, 2.245; 95% CI, 1.113–4.527). Conclusion Approximately 24% of pediatric patients with MP had various EPM. As the risk factors associated with each EPM were different, it is necessary to evaluate the various clinical aspects and findings of MP to predict and prepare for the occurrence of EPM.

Colon cancer treatment is on the way to evolution over several decades. The minimally invasive surgery has improved postoperative short-term outcomes. Adjuvant chemotherapy has prolonged the survival of advanced colon cancer patients. Hohenberger proposed the noble concept of complete mesocolic excision (CME) which consists of 3 components: plane surgery, sufficient longitudinal bowel resection, and central vascular ligation (CVL). Mesocolic plane surgery shares the same surgical principle of total mesorectal excision, which is maintaining the intact mesothelial envelope. However, there remain debates about the extent of bowel resection and the level of CVL for maximizing lymph node dissection. There is no solid clinical evidence for the oncological necessity and benefit of extended radical dissection in right hemicolectomy. CME with CVL based on open surgery has been adopted in laparoscopic surgery. So, it is also necessary to look at how the CME could be transformed and successfully implanted in the laparoscopic era. Recent rapid advances in surgical technology and cancer biology are preparing for fundamental changes in cancer surgery. In this study, we reviewed the history, oncological necessity, and compatibility of CME for the right hemicolectomy in the laparoscopic era and outline the new perspectives on the evolution of cancer surgery.

PURPOSE: Croup is known to have epidemics in seasonal and biennial trends, and to be strongly associated with epidemics of parainfluenza virus. However, seasonal and annual epidemics of croup have not been clearly reported in Korea. This study aimed to examine the seasonal/annual patterns and etiologies of childhood croup in Korea during a consecutive 6-year period. METHODS: Pediatric croup data were collected from 23 centers in Korea from 1 January 2010 to 31 December 2015. Electronic medical records, including multiplex reverse transcription polymerase chain reaction (RT-PCR) results, demographics and clinical information were cross-sectionally reviewed and analyzed. RESULTS: Overall, 2,598 childhood croup patients requiring hospitalization were identified during the study period. Among them, a total of 927 who underwent RT-PCR were included in the analysis. Males (61.5%) predominated, and most (63.0%) of them were younger than 2 years of age (median, 19 months; interquartile range, 11–31 months). Peak hospitalization occurred in 2010 and 2012 in even-numbered years, and parainfluenza virus (PIV, 39.7%) was the most common cause of childhood croup requiring hospitalization, followed by respiratory syncytial virus (14.9%), human rhinovirus (12.5%), Mycoplasma pneumonaie (10.6%), and human coronavirus (7.3%). CONCLUSION: It is concluded that croup hospitalization has a biennial pattern in even-numbered years. PIV may be the most common cause of childhood croup; however, croup epidemics could be attributed to other viruses.
Child ; Coronavirus ; Croup ; Demography ; Electronic Health Records ; Hospitalization ; Humans ; Korea ; Male ; Mycoplasma ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Reverse Transcription ; Rhinovirus ; Seasons

BACKGROUND: A 9-year-old male showed severe defects in midface structures, which resulted in maxillary hypoplasia, ocular hypertelorism, relative mandibular prognathism, and syndactyly. He had been diagnosed as having Apert syndrome and received a surgery of frontal calvaria distraction osteotomy to treat the steep forehead at 6 months old, and a surgery of digital separation to treat severe syndactyly of both hands at 6 years old. Nevertheless, he still showed a turribrachycephalic cranial profile with proptosis, a horizontal groove above supraorbital ridge, and a short nose with bulbous tip. METHODS: Fundamental aberrant growth may be associated with the cranial base structure in radiological observation. RESULTS: The Apert syndrome patient had a shorter and thinner nasal septum in panthomogram, PA view, and Waters’ view; shorter zygomatico-maxillary width (83.5 mm) in Waters’ view; shorter length between the sella and nasion (63.7 mm) on cephalogram; and bigger zygomatic axis angle of the cranial base (118.2°) in basal cranial view than a normal 9-year-old male (94.8 mm, 72.5 mm, 98.1°, respectively). On the other hand, the Apert syndrome patient showed interdigitating calcification of coronal suture similar to that of a normal 30-year-old male in a skull PA view. CONCLUSION: Taken together, the Apert syndrome patient, 9 years old, showed retarded growth of the anterior cranial base affecting severe midface hypoplasia, which resulted in a hypoplastic nasal septum axis, retruded zygomatic axes, and retarded growth of the maxilla and palate even after frontal calvaria distraction osteotomy 8 years ago. Therefore, it was suggested that the severe midface hypoplasia and dysostotic facial profile of the present Apert syndrome case are closely relevant to the aberrant growth of the anterior cranial base supporting the whole oro-facial and forebrain development.
Acrocephalosyndactylia ; Adult ; Child ; Exophthalmos ; Forehead ; Hand ; Humans ; Hypertelorism ; Male ; Maxilla ; Nasal Septum ; Nose ; Osteotomy ; Palate ; Prognathism ; Prosencephalon ; Skull ; Skull Base ; Sutures ; Syndactyly

BACKGROUND: Significant discrepancy exists between anatomical plate designs and the anatomy of the native distal radius, which may be attributable to considerable morphometric variations in the volar aspect of the distal radius. We aimed to evaluate the degree of variability in the morphometry of the distal radius and identify factors associated with this variability. METHODS: We measured the volar surface angle (VSA) of the intermediate and lateral columns and the volar surface width (VSW) in the distal radius from three-dimensional computed tomography scans acquired from 81 cadaveric forearms. These morphometric parameters were compared between the lateral and intermediate columns, between males and females, and between Koreans and Caucasians. Caucasian morphometric data were obtained and pooled from the previous studies. The coefficient of variation was used to assess the variability of the parameters and Cohen's d to estimate the effect size of the difference between groups. RESULTS: The average VSA of the lateral column was 22°± 6°, and that of the intermediate column was 29°± 8° in Koreans (p < 0.001). The variability was high for both VSAs. The VSA of the intermediate column was significantly larger in males than in females (p < 0.001) and in Caucasians than in Koreans (p < 0.001). The average VSW of distal radius was 30 ± 3 mm at the watershed line, and it became narrower proximally. The VSW was significantly larger in males than in females (p < 0.001) and in Koreans than in Caucasians (p < 0.001). The effect sizes of the difference for the VSA and VSW between sexes, races and columns were medium to large. CONCLUSIONS: Considerable variability exists in the morphometry of the volar distal radius, with sex, race, and column as contributing factors. These results suggest that surgeons should carefully choose an anatomical volar locking plate with appropriate angulation characteristics for each patient to achieve patient-specific alignment of the distal radius.
Bone Plates ; Cadaver ; Continental Population Groups ; Female ; Forearm ; Humans ; Male ; Radius* ; Surgeons

BACKGROUND: Cellular analysis of bronchoalveolar lavage fluid (BALF) is a useful diagnostic tool for interstitial lung diseases (ILDs). The lymphocytes in BALF consist of CD3+CD4+ T cells (T4), CD3+CD8+ T cells (T8), and a few B cells. However, sometimes, an increased number of CD3+CD4-CD8- T cells (double-negative T cells, DNTs) are noted in BALF. It is known that DNTs in the blood are associated with immunoregulation and autoimmune diseases. However, there are only few studies on DNTs in BALF. We evaluated the DNTs in BALF in patients with pulmonary diseases. METHODS: Immunophenotyping results of the BALF obtained from 122 pulmonary disease patients over an 8-yr period were reviewed. T-lymphocyte subsets (T4, T8, and DNT) and inflammatory markers were analyzed for each group of clinical diagnosis. T-lymphocyte percentage of more than 15% of the total cells was defined as BALF lymphocytosis, and DNT percentage of more than 5% of T lymphocytes was defined as high DNT. RESULTS: The most frequent diseases found in the patients were pneumonia (31.6%), autoimmune-related ILDs (18.0%), hypersensitivity pneumonitis (10.7%), and organizing pneumonia (10.7%). However, the occurrence of autoimmune-related ILDs was significantly high (40%) in patients with lymphocytosis and high DNT (P=0.002). All lung cancer patients showed lymphocytosis with high DNT. In addition, CD3-signal intensities of DNTs were significantly higher than those of other T-lymphocyte subtypes (P=0.003). CONCLUSION: The number of DNTs in BALF was increased in patients with autoimmune-related ILDs and lung cancer. High DNTs in BALF are useful as supportive diagnostic tools for autoimmune-related ILDs.
Alveolitis, Extrinsic Allergic ; Autoimmune Diseases ; B-Lymphocytes ; Bronchoalveolar Lavage Fluid* ; Diagnosis* ; Humans ; Immunophenotyping ; Lung Diseases* ; Lung Diseases, Interstitial ; Lung Neoplasms ; Lymphocytes ; Lymphocytosis ; Pneumonia ; T-Lymphocyte Subsets ; T-Lymphocytes*

Surgical decompression for cervical radiculopathy includes anterior cervical discectomy and fusion, anterior or posterior cervical foraminotomy, and cervical arthroplasty after decompression. The aim of this study was to evaluate the usefulness of a CO2 laser in posterior-approach surgery for unilateral cervical radiculopathy. From January 2006 to December 2008, 12 consecutive patients with unilateral cervical radiculopathy from either foraminal stenosis or disc herniation, which was confirmed with imaging studies, underwent posterior foraminotomy and discectomy with the use of a microscope and CO2 laser. For annulotomy and discectomy, we used about 300 joules of CO2 laser energy. Magnetic resonance imaging (MRI) was used to evaluate the extent of disc removal or foraminal decompression. Clinical outcome was evaluated by using visual analogue scale scores for radicular pain and Odom's criteria. For evaluation of spinal stability, cervical flexion and extension radiographs were obtained. Single-level foraminotomy was performed in 10 patients and two-level foraminotomies were performed in 2 patients. Preoperative radicular symptoms were improved immediately after surgery in all patients. No surgery-related complications developed in our cases. Postoperative MRI demonstrated effective decompression of ventral lesions and widened foraminal spaces in all cases. There was no development of cervical instability during the follow-up period. Posterior foraminotomy and discectomy using a microscope and CO2 laser is an effective surgical tool for unilateral cervical radiculopathy caused by lateral or foraminal disc herniations or spondylotic stenosis. Long-term follow-up with radiographs showed no significant kyphotic changes or spinal instability.
Arthroplasty ; Constriction, Pathologic ; Decompression ; Decompression, Surgical ; Diskectomy ; Follow-Up Studies ; Foraminotomy ; Humans ; Lasers, Gas ; Magnetic Resonance Imaging ; Radiculopathy

BACKGROUND: The distribution of ABO and Rhesus D (RhD) blood group antigens differs according to race and region. Previous studies have reported that blood group type was associated with not only transfusion-related diseases but also various diseases, such as malignancy and infectious disease. However, true relationship of blood groups and many diseases remained controversial. The aim of this study was to determine whether ABO and RhD blood groups are correlated with several infectious diseases. METHODS: From January 2003 to December 2012, we retrospectively reviewed results for HBsAg, HCV Ab, HIV Ab, VDRL, HAV IgM, CMV IgM, EBV VCA IgM, and Clostridium difficile toxin A and B (CD toxin). We also reviewed ABO and RhD results of these patients. Data were analyzed using chi-square test and binary logistic regression test. Odds ratio and 95% confidence intervals were determined. RESULTS: A total of 109,898 medical records of ABO and HBsAg results were reviewed. Blood group type-A was more prone to have positive results with HBsAg, while blood group type-O was less affected (odds ratio 1.086, P=0.003, odds ratio 0.935, P=0.029, respectively). With 3,171 records of CD toxin, blood group type-O was more affected (odds ratio 1.247, P=0.027). The relationship of the other serologic results and blood groups was not statistically significant. CONCLUSION: Seroprevalence of HBsAg and CD toxin showed an association with blood group type. Blood group type-A had higher HBsAg seroprevalence than the other group. Blood group type-O was more prone to have CD toxin.
Blood Group Antigens ; Clostridium difficile ; Communicable Diseases* ; Continental Population Groups ; Hepatitis B Surface Antigens ; Herpesvirus 4, Human ; HIV ; Humans ; Immunoglobulin M ; Korea ; Logistic Models ; Medical Records ; Odds Ratio ; Phenotype* ; Retrospective Studies ; Seroepidemiologic Studies*