Background: Denosumab (DMB) is a bone antiresorptive agent used to treat osteoporosis or metastatic cancer of the bones. However, denosumab-associated osteonecrosis of the jaw (DRONJ) has become a common complication in cancer patients. The prevalence of osteonecrosis of the jaw (ONJ) in cancer patients is estimated to be similar for both bisphosphonate-related cases (1.1 to 1.4%) and denosumab-related cases (0.8 to 2%), with the addition of adjunctive therapy with anti-angiogenic agents reportedly increasing its prevalence to 3%. (Spec Care Dentist 36(4):231–236, 2016). The aim of this study is to report on DRONJ in cancer patients treated with DMB (Xgeva ® , 120mg).Case presentation In this study, we identified four cases of ONJ among 74 patients receiving DMB therapy for meta‑ static cancer. Of the four patients, three had prostate cancer and one had breast cancer. Preceding tooth extraction within 2 months of the last DMB injection was found to be a risk factor for DRONJ. Pathological examination revealed that three patients had acute and chronic inflammation, including actinomycosis colonies. Among the four patients with DRONJ referred to us, three were successfully treated without complications and had no recurrence following surgical treatment, while one did not follow up. After healing, one patient experienced a recurrence at a different site.Sequestrectomy in conjunction with antibiotic therapy and cessation of DMB use proved to be effective in managing the condition, and the ONJ site healed after an average 5-month follow-up period. Conclusion Conservative surgery, along with antibiotic therapy and discontinuation of DMB, was found to be effec‑ tive in managing the condition. Additional studies are needed to investigate the contribution of steroids and antican‑ cer drugs to jaw bone necrosis, the prevalence of multicenter cases, and whether there is any drug interaction with DMB.

Purpose: The purpose of this study was to develop and validate a education nurse specialist-led educational satisfaction scale for nurses working at comprehensive nursing care service wards. Methods: A methodological study was conducted. A total of 237 nurses working at comprehensive nursing care service wards in a general hospital participated in this study. The scale was developed through literature reviews, in-depth interview, development of preliminary items, verification of content validity, development of secondary items, evaluation of construct validity, and extraction of final items. Analysis included exploratory factor analysis, pearson's analysis, and reliability analysis using cronbach's ⍺. Results: The education nurse specialist-led educational satisfaction scale for nurses working at comprehensive nursing care service ward consisted of 21 items. Two factors (critical thinking disposition and clinical competency) were identified which explained 63.5% of the total variance.Cronbach's ⍺ of each factors were >.95. Conclusion The results suggested that the education nurse specialist-led educational satisfaction scale for nurses working at comprehensive nursing care service wards demonstrated acceptable validity and reliability. Items of the instrument can assess the level of satisfaction with regards to education led by education nurse specialist among nurses working at comprehensive nursing care service wards.

Background: Recent studies have indicated that hyperuricemia is associated with metabolic syndrome and cardiovascular diseases. We aimed to examine the association between sitting time and hyperuricemia in Korean adults. Methods: This study included 16,535 adults aged ≥19 years who participated in the 2016–2018 Korea National Health and Nutrition Examination Survey. Hyperuricemia was defined as a serum uric acid level of ≥7.0 mg/dL in men and ≥6.0 mg/dL in women. The odds ratios and 95% confidence intervals of hyperuricemia according to sitting time were calculated using a multivariable logistic regression analysis. Results: The mean serum uric acid levels were significantly higher in participants with sitting times of ≥5 hours/day than those with sitting times of <5 hours/day in total participants, males, and females. The proportion of hyperuricemia was also significantly higher in participants with sitting times of ≥5 hours/day than those with sitting times of <5 hours/day in the total participants and males. Before and after adjusting for confounding variables, sitting times of ≥5 hours/day were associated with increased odds of hyperuricemia as compared with sitting times of <5 hours/day in total participants. Conclusion Our findings suggest that longer sitting time is associated with risk of hyperuricemia, and sitting time is an independent factor for hyperuricemia in Korean adults.

BACKGROUND AND PURPOSE: This retrospective cross-sectional study included 18 patients from unrelated families harboring mutations of the transthyretin gene (TTR), and analyzed their characteristics and geographical distribution in South Korea. METHODS: The included patients had a diagnosis of systemic amyloidosis, clinical symptoms, such as amyloid neuropathy or cardiomyopathy, and confirmation of a TTR gene mutation using genetic analysis recorded between April 1995 and November 2014. RESULTS: The mean age at disease onset was 49.6 years, and the mean disease duration from symptom onset to diagnosis was 3.67 years. Fifteen of the 18 patients were classified as mixed phenotype, 2 as the neurological phenotype, and only 1 patient as the cardiac phenotype. The most-common mutation pattern in South Korea was Asp38Ala, which was detected in eight patients. Thirteen patients reported their family hometowns, and five of the eight harboring the Asp38Ala mutation were from the Gyeongsang province in southeast Korea. The other eight patients exhibited a widespread geographical distribution. A particularly noteworthy finding was that the valine at position 30 (Val30Met) mutation, which was previously reported as the most-common TTR mutation worldwide and also the most common in the Japanese population, was not detected in the present South Korean patients. CONCLUSIONS: South Korean patients with hereditary TTR amyloidosis exhibited heterogeneous TTR genotypes and clinical phenotypes. The findings of this study suggest that the distribution of TTR amyloidosis in South Korea is due to de novo mutations and/or related to the other countries in East Asia.
Amyloid Neuropathies ; Amyloidosis* ; Asian Continental Ancestry Group ; Cardiomyopathies ; Cross-Sectional Studies ; Diagnosis ; Far East ; Genotype ; Humans ; Korea ; Phenotype ; Prealbumin* ; Retrospective Studies ; Valine

Wolf's isotopic response is defined as the occurrence of a new skin disorder at the site of another unrelated skin disease that has already healed. In most cases of isotopic response, the initial dermatosis is herpes infection, and the most frequent second dermatoses are granulomatous reactions. Various interpretations of this phenomenon have been attempted. However, the exact mechanism has not been identified yet. Herein, we report a case in which the secondary disease was segmental vitiligo that appeared over the same dermatomes of herpes zoster. A 71-year-old woman presented with well-defined, depigmented patches on the left chest and back. She had been diagnosed with herpes zoster on the same dermatomes and treated with an antiviral agent 3 years ago. Histological examination showed decreased basal melanin pigments and melanocytes. Consequently, the patient was diagnosed with segmental vitiligo based on the clinical and histological findings.
Aged ; Female ; Herpes Zoster* ; Humans ; Melanins ; Melanocytes ; Skin ; Skin Diseases ; Thorax ; Vitiligo*

BACKGROUND: Skin types vary, making it difficult to identify them at a glance. To effectively understand skin type, analysis based on a questionnaire could be helpful. OBJECTIVE: The purpose of this study was to identify the accuracy and effectiveness of the Baumann skin type questionnaire (BSTQ) compared with an interview with a dermatologic specialist. In addition, we aimed to identify differences in skin type proportions according to age and develop a modified BSTQ. METHODS: Subjects included 202 women (19~64 years of age) who visited the dermatologic clinic of our hospital. They completed both the BSTQ and an interview with a dermatologic specialist. A modified BSTQ was developed by removing similar and racial questions and adjusting grading scores. RESULTS: The agreement between skin type proportions analyzed by the BSTQ and an interview was not reasonable (κ=0.428, 95% confidence interval [CI]: 0.363~0.493). There was a correlation between the proportion of dryness and age (R2=0.029, p<0.05). However, other skin type proportions (sensitivity, pigmentation, and wrinkles) were not significantly correlated with age. The modified BSTQ showed substantial agreement with the BSTQ in skin type proportions (κ=0.691, 95% CI: 0.641~0.740). CONCLUSION: We identified the skin types of Korean women of various ages using the BSTQ and an interview. Furthermore, the modified BSTQ might be helpful for accurately recognizing skin types.
Female ; Humans ; Pigmentation ; Skin* ; Specialization

Pneumatosis cystoides intestinalis (PCI) is a rare disease with intramural gas formation in the gastrointestinal tract. The causes of PCI are various, and are commonly associated with collagen vascular disease. We present a case of a 48-year-old female with dermatomyositis (DM) who also developed PCI. Her risk of PCI may have been increased by multiple factors such as gender, DM itself, and medications including corticosteroids, methotrexate, and azathioprine. While the cause of, and risk factors for PCI in DM patients are not well known on a global scale, outcomes range from benign to life threatening. Therefore, we present a case study and review the literature to identify candidate risk factors for PCI.
Adrenal Cortex Hormones ; Azathioprine ; Collagen ; Dermatomyositis* ; Female ; Gastrointestinal Tract ; Humans ; Methotrexate ; Middle Aged ; Pneumatosis Cystoides Intestinalis* ; Rare Diseases ; Risk Factors ; Vascular Diseases

BACKGROUND: Atelosteogenesis type I (AO-I) is a rare lethal skeletal dysplastic disorder characterized by severe short-limbed dwarfism and dislocated hips, knees, and elbows. AO-I is caused by mutations in the filamin B (FLNB) gene; however, several other genes can cause AO-like lethal skeletal dysplasias. METHODS: In order to screen all possible genes associated with AO-like lethal skeletal dysplasias simultaneously, we performed whole-exome sequencing in a female newborn having clinical features of AO-I. RESULTS: Exome sequencing identified a novel missense variant (c.517G>A; p.Ala173Thr) in exon 2 of the FLNB gene in the patient. Sanger sequencing validated this variant, and genetic analysis of the patient's parents suggested a de novo occurrence of the variant. CONCLUSIONS: This study shows that exome sequencing can be a useful tool for the identification of causative mutations in lethal skeletal dysplasia patients.
Exome ; Female ; Filamins/chemistry/*genetics ; Gene Frequency ; Heterozygote ; Humans ; Infant, Newborn ; Mutation, Missense ; Osteochondrodysplasias/*genetics/pathology/radiography ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA

PURPOSE: Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). METHODS: We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. RESULTS: The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. CONCLUSION: VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.
Anti-Bacterial Agents ; Birth Weight ; Central Venous Catheters ; Colon ; Heart Diseases ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Korea ; Medical Records ; Parturition ; Prevalence ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Thorax ; Vancomycin ; Vancomycin Resistance

PURPOSE: Pulmonary sequestration is characterized by a mass of non-functioning pulmonary tissue lacking normal communication with the tracheobronchial tree and receiving an aberrant systemic arterial blood supply. Two types have been described:intralobar and extralobar. Symptoms vary from the incidental finding of a mass to recurrent bronchitis or pneumonia, chest pain and hemoptysis. In this study, we evaluated clinical features and outcomes of pulmonary sequestration. METHODS: The records of the patients diagnosed with pulmonary sequestration by thoracic computerized tomography and aortography between January 1997 and July 2007 were retrospectively reviewed. RESULTS: Fourteen patients (6 males and 8 females) with an median age of 5.5 years in children, 35 years in adults were diagnosed with pulmonary sequestration. Nine patients had clinical symptoms including recurrent respiratory infections, chest pain and hemoptysis. Six patients were symptom free. The aberrant arteries originated from the descending thoracic aorta in 12 cases, abdominal aorta in 2 cases, inferior phrenic artery in 1 case. Thirteen patients received surgical operations with open thorax in 11 patients and with video-assisted thoracotomy surgery (VATs) in 2 cases recently diagnosed. Eleven cases (84.6%) were found to be of intralobar type and 2 cases (15.4%) were of extralobar type. One patient had bilateral pulmonary sequestration. All patients with preoperative symptoms improved after surgical treatment. CONCLUSION: The patients who presented with recurrent pneumonia in the same site, hemoptysis and chest pain should be studied to rule out pulmonary sequestration.
Adult ; Angiography ; Aorta, Abdominal ; Aorta, Thoracic ; Aortography ; Arteries ; Bronchitis ; Bronchopulmonary Sequestration ; Chest Pain ; Child ; Hemoptysis ; Humans ; Incidental Findings ; Male ; Pneumonia ; Respiratory Tract Infections ; Retrospective Studies ; Thoracotomy ; Thorax