Objective: This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia. Methods: Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed. Results: Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35–4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea. Conclusion Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.

Purpose: This study aimed to evaluate the usefulness of two-dimensional shear wave elastography (2D-SWE) in diagnosing hepatic veno-occlusive disease (VOD) in pediatric patients. Methods: This study retrospectively included pediatric patients who underwent hematopoietic stem cell transplantation (HSCT) between November 2019 and January 2021. All 34 patients (8.7±5.0 years) were examined using 2D-SWE for an initial diagnosis. A subgroup analysis was performed using the data from follow-up examinations of patients diagnosed with VOD. The characteristics of the initial VOD diagnosis were compared with the longitudinal changes observed in VOD patients who underwent multiple ultrasound examinations. Results: In total, 19 patients were diagnosed with VOD at 17.6±9.4 days after HSCT. All VOD patients showed hepatomegaly, ascites, and gallbladder wall thickening. Liver stiffness was higher in VOD patients than in non-VOD patients (12.4±1.1 vs. 6.3±0.8 kPa, P<0.001). Liver stiffness values above 7.2 kPa showed 84.2% sensitivity and 93.3% specificity in distinguishing VOD from non-VOD (area under the curve, 0.925; 95% confidence interval, 0.780 to 0.987; P<0.001). A subgroup analysis of 11 patients showed a linear decrease in liver stiffness values after VOD diagnosis with treatment (first, second, and third follow-ups; 13.5±1.7, 11.3±1.4, and 9.5±0.8 kPa, respectively), but without statistical significance in the pairwise analysis. Conclusion Liver stiffness measured using 2D-SWE increased in pediatric patients who develop VOD after HSCT. Therefore, liver stiffness can be a predictive and quantitative parameter for diagnosing VOD.

Objective: To evaluate the diagnostic performance of a deep learning algorithm for the automated detection of developmental dysplasia of the hip (DDH) on anteroposterior (AP) radiographs. Materials and Methods: Of 2601 hip AP radiographs, 5076 cropped unilateral hip joint images were used to construct a dataset that was further divided into training (80%), validation (10%), or test sets (10%). Three radiologists were asked to label the hip images as normal or DDH. To investigate the diagnostic performance of the deep learning algorithm, we calculated the receiver operating characteristics (ROC), precision-recall curve (PRC) plots, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and compared them with the performance of radiologists with different levels of experience. Results: The area under the ROC plot generated by the deep learning algorithm and radiologists was 0.988 and 0.988–0.919, respectively. The area under the PRC plot generated by the deep learning algorithm and radiologists was 0.973 and 0.618– 0.958, respectively. The sensitivity, specificity, PPV, and NPV of the proposed deep learning algorithm were 98.0, 98.1, 84.5, and 99.8%, respectively. There was no significant difference in the diagnosis of DDH by the algorithm and the radiologist with experience in pediatric radiology (p = 0.180). However, the proposed model showed higher sensitivity, specificity, and PPV, compared to the radiologist without experience in pediatric radiology (p < 0.001). Conclusion The proposed deep learning algorithm provided an accurate diagnosis of DDH on hip radiographs, which was comparable to the diagnosis by an experienced radiologist.

Objective: To evaluate the diagnostic performance of a deep learning algorithm for the automated detection of developmental dysplasia of the hip (DDH) on anteroposterior (AP) radiographs. Materials and Methods: Of 2601 hip AP radiographs, 5076 cropped unilateral hip joint images were used to construct a dataset that was further divided into training (80%), validation (10%), or test sets (10%). Three radiologists were asked to label the hip images as normal or DDH. To investigate the diagnostic performance of the deep learning algorithm, we calculated the receiver operating characteristics (ROC), precision-recall curve (PRC) plots, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and compared them with the performance of radiologists with different levels of experience. Results: The area under the ROC plot generated by the deep learning algorithm and radiologists was 0.988 and 0.988–0.919, respectively. The area under the PRC plot generated by the deep learning algorithm and radiologists was 0.973 and 0.618– 0.958, respectively. The sensitivity, specificity, PPV, and NPV of the proposed deep learning algorithm were 98.0, 98.1, 84.5, and 99.8%, respectively. There was no significant difference in the diagnosis of DDH by the algorithm and the radiologist with experience in pediatric radiology (p = 0.180). However, the proposed model showed higher sensitivity, specificity, and PPV, compared to the radiologist without experience in pediatric radiology (p < 0.001). Conclusion The proposed deep learning algorithm provided an accurate diagnosis of DDH on hip radiographs, which was comparable to the diagnosis by an experienced radiologist.

PURPOSE: The purpose of this study was to identify ultrasonographic features that can be used to differentiate between thyroglossal duct cysts (TGDCs) and dermoid cysts (DCs). METHODS: We searched surgical pathology reports completed between January 2004 and October 2015 and identified 66 patients with TGDCs or DCs who had undergone preoperative ultrasonography. The ultrasound images were reviewed by two radiologists who were blinded to the pathological diagnosis. They evaluated the following parameters: dimensions, shape, margin, location in relation to the midline, level in relation to the hyoid bone, attachment to the hyoid bone, the depth of the lesion in relation to the strap muscles, internal echogenicity, internal echogenic dots, multilocularity, the presence of a longitudinal extension into the tongue base, posterior acoustic enhancement, the presence of internal septae, and intralesional vascularity. RESULTS: There were 50 TGDCs and 16 DCs. TGDCs were significantly more likely than DCs to have an irregular shape, an ill-defined margin, attachment to the hyoid bone, an intramuscular location, heterogeneous internal echogenicity, multilocularity, and longitudinal extension into the tongue base. CONCLUSION: Ultrasound findings may inform the differential diagnosis between TGDCs and DCs.
Acoustics ; Dermoid Cyst* ; Diagnosis ; Diagnosis, Differential ; Humans ; Hyoid Bone ; Muscles ; Pathology, Surgical ; Pediatrics ; Thyroglossal Cyst* ; Tongue ; Ultrasonography

This nationwide, prospective cohort study evaluated pulmonary function and radiological sequelae according to infection severity in 73 survivors from the 2015 Middle East respiratory syndrome (MERS) outbreak in Korea. Patients with severe pneumonia in MERS-coronavirus infection had more impaired pulmonary function than those with no or mild pneumonia at the 1-year follow-up, which was compatible with the radiological sequelae. Severe pneumonia significantly impairs pulmonary function and makes long radiological sequelae in MERS.
Cohort Studies ; Coronavirus ; Coronavirus Infections* ; Follow-Up Studies ; Humans ; Korea ; Middle East* ; Pneumonia* ; Prospective Studies ; Survivors

BACKGROUND/AIMS: Acute pancreatitis is a common complication of endoscopic retrograde cholangiopancreatography (ERCP). Combination therapy w ith ora l udenafil and aceclofenac may reduce the occurrence of post-ERCP pancreatitis by targeting different pathophysiological mechanisms. We investigated whether combining udenafil and aceclofenac reduced the rates of post-ERCP pancreatitis. METHODS: A prospective, randomized, double-blind, placebo-controlled, multicenter study was conducted in four academic medical centers. Between January 2012 and June 2013, a total of 216 patients who underwent ERCP were analyzed for the occurrence of post-ERCP pancreatitis. Patients were determined to be at high risk for pancreatitis based on validated patient and procedure-related risk factors. RESULTS: Demographic features, indications for ERCP, and therapeutic procedures were similar in each group. There were no significant differences in the rate (15.8% [17/107] vs. 16.5% [18/109], p = 0.901) and severity of post-ERCP pancreatitis between the udenafil/aceclofenac and placebo groups. One patient in each group developed severe pancreatitis. Multivariate analyses indicated that suspected dysfunction of the sphincter of Oddi and endoscopic papillary balloon dilation without sphincterotomy were associated with post-ERCP pancreatitis. CONCLUSIONS: Combination therapy with udenafil and aceclofenac is not effective for the prevention of post-ERCP pancreatitis.
Acute Disease ; Administration, Oral ; Adult ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage/adverse effects ; Cholangiopancreatography, Endoscopic Retrograde/*adverse effects ; Diclofenac/administration & dosage/adverse effects/*analogs & derivatives ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Pancreatitis/diagnosis/etiology/*prevention & control ; Phosphodiesterase 5 Inhibitors/*administration & dosage/adverse effects ; Prospective Studies ; Pyrimidines/*administration & dosage/adverse effects ; Republic of Korea ; Risk Factors ; Sulfonamides/*administration & dosage/adverse effects ; Treatment Outcome ; Young Adult

PURPOSE: To investigate the causes, clinical features and characteristics of food-dependent exercise-induced anaphylaxis (FDEIA) in Korea. METHODS: A retrospective medical chart review was performed on the patients diagnosed with anaphylaxis between 2007 and 2011 in 14 hospitals in Korea. Cases with FDEIA were subsequently identified among anaphylaxis patients, and subgroup analyses were done to assess clinical characteristics of FDEIA. RESULTS: A total of 62 subjects with FDEIA (male, 72.6%; aged 16 to 70 years) were enrolled in 10 hospitals. Wheat (69.3%) was the most common cause of FDEIA, followed by meat (8.1%), seafood (6.5%), and vegetables (6.5%). The clinical manifestations were cutaneous (100%), respiratory (64.5%), cardiovascular (61.3%), and gastrointestinal (9.7%), respectively. In severity assessment, approximately 40% of FDEIA were classified as severe anaphylaxis. Portable epinephrine auto-injector was prescribed to 17.2% of patients, and about one fifth of the patients experienced redevelopment of anaphylactic symptoms during follow-up period. There was no significant difference of age, gender, latent period, total immunoglobulin E, and past history of allergic disease between patients with severe anaphylaxis group and patients with mild-to-moderate group. CONCLUSION: Wheat is the most common cause of FDEIA in Korea. Because significant number of patients with FDEIA experienced anaphylactic symptoms after diagnosis of FDEIA, more comprehensive therapeutic and educational approaches will be required to prevent recurrent development of anaphylaxis.
Aged ; Anaphylaxis ; Epinephrine ; Follow-Up Studies ; Food Hypersensitivity ; Humans ; Immunoglobulin E ; Immunoglobulins ; Korea ; Meat ; Retrospective Studies ; Seafood ; Triticum ; Vegetables

PURPOSE: The present study explored novel methods in visual field tests that actively induce the gaze of the examinee to the fixation target in the center vision and compared their effectiveness. METHODS: Four gaze induction methods (dot-on, dot-off, number-on, and number-off) were prepared by combining 2 types of fixation targets (dot and number) and 2 conditions of sound presence (on and off). The gaze induction methods were implemented to a PC-based visual field testing system and the 24-2 visual field testing protocol was administered to 14 participants without glaucoma. The performance of the gaze induction method was evaluated in terms of fixation error rate, target detection rate, and subjective satisfaction (7-point scale, 1 for least satisfied and 7 for most satisfied). RESULTS: The fixation error rates of dot-on (5.7%) and number-on (6.4%) were relatively lower than the other methods; the target detection rates of the induction methods were very high (95-96%) without significant differences, and the subjective satisfaction levels of dot-on (5.7) and number-on (5.4) were significantly higher than the other methods. CONCLUSIONS: In the present study we determined number-on as the preferred effective gaze induction method compared to the conventional dot-off method when fixation error rates and subjective satisfaction were considered.
Glaucoma ; Vision, Ocular ; Visual Field Tests ; Visual Fields

BACKGROUND: From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. METHODS: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. RESULTS: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3+/-13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56+/-0.68 L/min at rest, 2.08+/-0.91 L/min during exercise or 1.51+/-0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18+/-10.48% and 91.64+/-7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85+/-6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414+/-15,618 won/month and 40,352+/-36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). CONCLUSION: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.
Blood Gas Analysis ; Compliance ; Dyspnea ; Electricity ; Equipment and Supplies ; Fees and Charges ; Hospitals, University ; Humans ; Insurance, Health ; Korea ; Male ; Medical Records ; National Health Programs ; Noise ; Oxygen ; Pulmonary Disease, Chronic Obstructive ; Republic of Korea ; Respiratory Function Tests ; Respiratory Insufficiency ; Thorax