Endobiliary radiofrequency ablation (RFA) is a procedure performed widely to induce locoregional tumor control by the transfer of thermal energy to the lesion and subsequent tumor necrosis. A 72-year-old male with a prior history of acute calculous cholangitis and perforated cholecystitis was admitted to the Kyungpook National University Hospital complaining of fever and nausea. He had an indwelling percutaneous transhepatic gallbladder drainage (PTGBD) catheter from the previous episode of perforated cholecystitis. An abdominal CT scan showed marked dilation of both the intrahepatic and extrahepatic bile ducts. Common bile duct cancer was confirmed histologically after an endobiliary biopsy. A surgical resection was considered to be the initial treatment option. During open surgery, multiple metastatic nodules were present in the small bowel mesentery and anterior abdominal wall. Resection of the tumor was not feasible, so endobiliary RFA was performed prior to biliary stenting. Cholecystectomy was required for the removal of the PTGBD catheter, but the surgical procedure could not be performed due to a cystic ductal invasion of the tumor. Instead, chemical ablation of the gallbladder (GB) with pure ethanol was performed to breakdown the GB mucosa. Palliative treatment for a biliary obstruction was achieved successfully using these procedures. In addition, a PTGBD catheter was removed successfully without significant side effects. As a result, an improvement in the patient's quality of life was accomplished.
Abdominal Wall ; Aged ; Bile Ducts, Extrahepatic ; Biopsy ; Catheter Ablation ; Catheters ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystectomy ; Cholecystitis ; Common Bile Duct ; Cystic Duct ; Drainage ; Ethanol ; Fever ; Gallbladder ; Gyeongsangbuk-do ; Humans ; Male ; Mesentery ; Mucous Membrane ; Nausea ; Necrosis ; Palliative Care ; Quality of Life ; Stents ; Tomography, X-Ray Computed

Gyeongsangbuk-do), mercury contents from shark meat distributed in this region have not been assessed yet. Thus, this study aims to identify the hazard by evaluating the mercury contents of the shark meat sold in the traditional market of Gyeongsangbuk-do.METHODS: The shark meat in the form of muscle meat was obtained from 15 traditional markets of Gyeongsangbuk-do in the summer and winter of 2013. Out of 105 samples in total, 49 were collected in the summer and 56 in the winter. The total mercury concentration was measured by the combustion-gold amalgamation method using an automatic mercury analyzer (Milestone DMA-80, Milestone).RESULTS: The average mercury concentration of shark meat was 2.29 ± 1.77 µg/g, ranging between 0.06–8.93 µg/g with a geometric mean of 1.44 µg/g, which is higher than those reported in many countries. The mercury concentration in 77 of 105 shark meat samples exceeded 1 µg/g. Mercury concentration ranged between 0.09–8.93 µg/g (geometric mean: 1.45) in the summer and 0.06–6.73 µg/g (geometric mean: 1.48) in the winter.CONCLUSIONS: Shark meat sold in the market contained a substantial amount of mercury. This suggests that it is difficult to reduce mercury intake by simply strengthening the standard level of mercury concentration in shark meat. Therefore, it is need to communication and awareness programs with consumers about hazardous effects of mercury inherent in shark meat.]]>
Gyeongsangbuk-do ; Korea ; Meat ; Methods ; Sharks

OBJECTIVES: This study was conducted to analyze the effect that oral health literacy of adults has on perceived oral health state and to identify the factors that affect perceived oral health status. METHODS: A self-administered questionnaire survey was distributed to 554 adults who lived in the Daegu or Gyeongbuk areas and visited dental institutions located in the Daegu area. For adults who were 60 years old or older, direct interviews were conducted. Statistical analysis was performed with t-tests, analysis of variance, and multiple regression using SPSS RESULTS: Between oral health literacy and perceived oral health status, a significant positive correlation was revealed (r=0.142, P<0.01). A significant positive correlation was revealed between oral health literacy and knowledge (r=0.397, P<0.01). A significant but weakly positive correlation was revealed between oral health knowledge and perceived oral health status (r=0.086, P<0.05). To identify factors affecting perceived oral health status, multiple regression analysis was conducted, and the result showed that oral health literacy was a statistically significant factor (β=0.105, p<0.05). Among general characteristics, age was a statistically significant negatively affecting factor, as it showed a negative relationship with perceived oral health status (β=−0.140, P=0.001, adjusted R2=0.049). CONCLUSIONS: When these study results are taken into consideration, oral health literacy is a factor affecting perceived oral health status, and as such, oral health literacy of the research targets should be taken into consideration when implementing oral health education to promote oral health.
Adult ; Daegu ; Education ; Gyeongsangbuk-do ; Health Literacy ; Humans ; Literacy ; Oral Health

Wischnewski spots (WS) are multiple black spots observed in the gastric mucosa at autopsy that are considered a reliable and important feature of hypothermia. Nonetheless, the frequency of WS varies widely. WS were discovered in 20 cases out of 3,493 autopsies (0.57%) conducted between 2001 and 2017 in the Department of Forensic Medicine of the School of Medicine, Kyungpook National University in Korea. This study aimed to investigate the distribution and size of WS in these cases and analyze the respective causes of death. Nine cases that occurred in winter were the same as the nine cases with hypothermia as the cause of death or contributory cause. The post-mortem blood alcohol test was positive in eight cases, with acute or chronic alcoholism determined as the cause of death in two of these cases. There were two cases of acute poisoning by pesticides. Putrefaction was noted in six cases (30%). WS presented in various sizes ranging from pinpoint to more than 5 mm in diameter, and the number of WS varied from 5 to 100. WS distribution was diffuse in four cases (20%) and localized in 13 cases (65%). Microscopic examination showed brown to black pigmentation but no neutrophil infiltration or vital reactions in the WS. Thus, WS are associated with hypothermia and are considered post-mortem alterations with variable appearance, size, and distribution. Hypothermia is an exclusive diagnosis at autopsy that should result from a combined assessment of toxicological tests, circumstance of death, and autopsy findings.
Alcoholism ; Autopsy ; Cause of Death ; Diagnosis ; Forensic Medicine ; Gastric Mucosa ; Gyeongsangbuk-do ; Humans ; Hypothermia ; Korea ; Neutrophil Infiltration ; Pesticides ; Pigmentation ; Poisoning

Hesitation wounds are tentative, superficial incised wounds around the fatal wound(s). This study aimed to investigate the frequency and characteristic features of hesitation wounds including ordinary incised wounds and knife tip injuries as hesitation marks from the autopsy cases of suicides using sharp force instruments. The subjects were 478 cases out of 3,131 suicide cases autopsied at the Department of Forensic Medicine, School of Medicine, Kyungpook National University in Daegu, from August, 2001 to 2013. 48 cases (approximately 10%) were suicides using sharp force instruments. In 27 cases (56.3%), the sharp force was successfully applied causing suicide; 17 cases (35.4%) were so called complex suicide cases, in which two or more different methods including sharp force injury were used; and the 4 remaining cases were suicides caused by other reasons. Overall hesitation wounds had a high frequency of 33/48 cases (68.8%). The frequency of cases in which knife tip injuries were found was lower, appearing in 13/33 cases (39.3%). The most preferred sites of knife tip injuries were the abdomen (9 cases), neck (4 cases), chest (3 cases), and face (1 case) in these 13 cases, including several overlapped cases. The average number of knife tip injuries was 14.6. A total of 88.2% of knife tip injuries was found near the incised hesitation wounds or fatal wounds. In conclusion, knife tip injuries may be a significant factor in identifying hesitation wounds, and they should be precisely examined and evaluated during autopsies to determine the manner of death.
Abdomen ; Autopsy ; Daegu ; Forensic Medicine ; Gyeongsangbuk-do ; Humans ; Neck ; Suicide ; Thorax ; Wounds and Injuries

PURPOSE: This study was designed to allow a student at School of Medicine, Kyungpook National University (KNUSOM) to self-assess how well they had achieved competency and to analyze the differences and trends of the scores by year. Furthermore, students are asked to evaluate the need for curriculum improvement by competency, the tendency of the score is analyzed by year, and the results are reflected in the improvement of the curriculum. METHODS: We conducted a questionnaire survey for fourth-year students of KNUSOM who took medical education classes from 2015 to 2018. Questionnaire items were evaluated on the basis of their current achievement of 30 subordinate competencies of competency and the degree of necessity with respect to revising the curriculum. One-way analysis of variance was performed for the yearly difference analysis. RESULTS: The students' scores on the graduation competency were 2.03 to 4.06. In the yearly difference analysis, there was no significant difference in the average of 30 total competencies, but 16 of the sub-competencies showed significant year-to-year differences. The scores for the 30 graduation competencies were different for each year, but the competencies showing high scores and low scores were found to be similar each year. CONCLUSION: We found that the achievement level of the students was approximately 60% to 70%. We were able to confirm the contents of the education that the students continuously demand. The curriculum trend graphs for each year showed that the students' scores improved when the curriculum was being revised. We found that it is necessary to accept the students' self-evaluation reliable as the students indicated that the contents of the curriculum should be added to the areas where the contents were lacking in the present curriculum.
Curriculum ; Diagnostic Self Evaluation ; Education ; Education, Medical ; Gyeongsangbuk-do ; Humans ; Self-Assessment

PURPOSE: Nutritional markers, such as total protein, albumin, and vitamin D have been reportedly associated with neonatal outcomes. This study aimed to assess the correlation between nutritional markers at birth and the need for respiratory support on the first day of life. METHODS: This retrospective study included 94 newborns admitted to the neonatal intensive care unit of Kyungpook National University Children's Hospital between March and December 2017. We measured levels of nutritional markers, including serum total protein, albumin, ferritin, 25-hydroxyvitamin D (25-OHD), and prealbumin, from cord blood or blood sample within 24 hours after birth. Respiratory support was defined as the use of nasal continuous positive airway pressure, humidified high-flow nasal cannula, or mechanical ventilation on the first day of life. RESULTS: The mean gestational age and birth weight were 36.6±2.3 weeks and 2,714±575 g, respectively. Serum total protein, albumin, prealbumin, and ferritin levels at birth were significantly correlated with gestational age and birth weight. Total protein, albumin, ferritin, and 25-OHD levels were not correlated with the time to recover birth weight after adjusting for gestational age. Moreover, prealbumin levels at birth were significantly lower in small-for-gestational-age infants than in appropriate-for-gestational-age infants. The need for respiratory support on the first day of life decreased 0.058- and 0.001-fold for every 1 g/dL increase in serum total protein (95% confidence interval [CI], 0.004 to 0.833; P=0.036) and albumin (95% CI, 0.000 to 0.136; P=0.009) levels, respectively. CONCLUSION: Nutritional status at birth could be associated with the need for respiratory support on the first day of life, regardless of the Apgar score.
Apgar Score ; Birth Weight ; Catheters ; Continuous Positive Airway Pressure ; Ferritins ; Fetal Blood ; Gestational Age ; Gyeongsangbuk-do ; Humans ; Infant ; Infant, Newborn ; Intensive Care, Neonatal ; Nutritional Status ; Parturition ; Prealbumin ; Respiration, Artificial ; Respiratory Insufficiency ; Retrospective Studies ; Vitamin D

PURPOSE: There is limited data on the use of perampanel in children under 12 years of age. We evaluated the efficacy and tolerability of adjunctive perampanel treatment in children under 12 years of age with refractory epilepsy. METHODS: This retrospective observational study was performed in Kyungpook National University Hospital from July 2016 to March 2018. A responder was defined as a patient with ≥50% reduction in monthly seizure frequency compared with the baseline. Adverse events and discontinuation data were obtained to evaluate tolerability. RESULTS: Twenty-two patients (8 males, 14 females) aged 3.1–11.4 years (mean, 8.0±2.5 years) were included in this study. After an average of 9.2 months (range, 0.5–19 months) of follow-up, 15 patients (68%) showed a reduction in seizure frequency, including 5 patients (23%) with seizure freedom. The age at epilepsy onset was significantly lower (P=0.048), and the duration of epilepsy was significantly longer (P=0.019) in responders than in nonresponders. Nine patients (41%) experienced adverse events, including somnolence (23%), respiratory depression (9%), violence (4.5%), and seizure aggravation (4.5%). The most serious adverse event was respiratory depression, which required mechanical ventilation in 2 patients (9%). Eight patients (36%) discontinued perampanel due to lack of efficacy or adverse events. Three out of 4 patients (75%) who discontinued perampanel due to adverse events had an underlying medical condition. CONCLUSION: Perampanel offers a treatment option for refractory epilepsy in children. Adjunctive treatment with perampanel requires special consideration in those with underlying medical conditions to prevent serious adverse events.
Child ; Epilepsy ; Follow-Up Studies ; Freedom ; Gyeongsangbuk-do ; Humans ; Male ; Observational Study ; Respiration, Artificial ; Respiratory Insufficiency ; Retrospective Studies ; Seizures ; Violence

Adipsic hypernatremia is a rare disease where patients do not feel thirst even in the increased serum osmotic pressure and results in electrolyte imbalance, severely increased osmotic pressure and neurologic symptoms like nausea, vomiting, and seizures. We report a 12-year-old male patient who had underwent a trans-sphenoidal surgery for craniopharyngioma newly diagnosed with adipsic hypernatremia after having growth hormone replacement for growth hormone deficiency. The patient visited emergency room complaining of generalized weakness, tremor in both legs, and poor oral intake including water after starting growth hormone replacement therapy. Laboratory test revealed serum sodium 168 mmol/L and serum osmolality 329 mOsm/kg, despite the patient didn't feel any thirst at all. We treated him with scheduled water intake of 2.5 L a day with intranasal vasopressin. He admitted to Soonchunhyang University Gumi Hospital and Soonchunhyang University Seoul Hospital for 4 times during the following 8 months and serum sodium level and osmolality was controlled by scheduled water intake combined with intranasal vasopressin treatment. It is still unclear whether growth hormone replacement worked as a trigger of hypernatremia.
Child ; Craniopharyngioma ; Drinking ; Emergency Service, Hospital ; Growth Hormone ; Gyeongsangbuk-do ; Humans ; Hypernatremia ; Leg ; Male ; Nausea ; Neurologic Manifestations ; Osmolar Concentration ; Osmotic Pressure ; Rare Diseases ; Seizures ; Seoul ; Sodium ; Thirst ; Tremor ; Vasopressins ; Vomiting ; Water

PURPOSE: To evaluate the effect of periodontal and prosthodontic therapy on glycated hemoglobin A(HbA1c) level in patients with diabetes. MATERIALS AND METHODS: This is a retrospective study of 70 patients suffering from diabetes who visited the Kyungpook National University Hospital between January 2016 and May 2018. Patients underwent medical evaluation for their routine check-up, which includes laboratory test for HbA1c levels. Among the 70 patients, 35 patients also visited Kyungpook National University Dental Hospital during the same period to receive periodontal and prosthodontic therapy, while the other 35 patients did not receive such therapy. The HbA1c levels were compared before and after periodontal and prosthodontic therapy. Comparisons between groups and within groups were performed using independent t-test. RESULTS: The HbA1c levels in the group who have received periodontal and prosthodontic therapy decreased from 7.2 to 6.7 (P=.001). The HbA1c levels in the control group decreased from 7.2 to 7.1 (P=.580). The difference in changes between the two patient groups was statistically significant (P=.011). CONCLUSION: Periodontal and prosthodontic therapy can be effective on glycemic control in patients with diabetes.
Diabetes Mellitus ; Gyeongsangbuk-do ; Hemoglobin A, Glycosylated ; Humans ; Periodontal Diseases ; Prosthodontics ; Retrospective Studies