PURPOSE: To assess the nationwide rate of acute postoperative endophthalmitis (APE) after cataract extraction in Korea and to evaluate potential risk factors thereof. MATERIALS AND METHODS: Nationwide insurance claims data from July 2014 to June 2017 were reviewed. All patients with phacoemulsification or extracapsular/intracapsular cataract extraction were included. Exclusion criteria were combined glaucoma surgery or total vitrectomy or when the patient had a history of intraocular foreign body. RESULTS: In total, 1505103 cases (982203 patients) were included. APE developed in 953 cases (938 patients) with an overall incidence of 0.063%. After adjusting for possible confounding factors, male sex [odds ratio (OR) 1.42; 95% confidence interval (CI) 1.25–1.61; p<0.001], primary clinical setting, operations performed in non-major cities, usage of sutures (OR 2.82; 95% CI 2.13–3.74; p<0.001), anterior vitrectomy (OR 8.71; 95% CI 6.71–11.32; p<0.001), aphakic cataract surgery (OR 1.52; 95% CI 1.03–2.22; p=0.033), hypertension (OR 1.40; 95% CI 1.18–1.66; p<0.001), diabetes (OR 1.59; 95% CI 1.31–1.93; p<0.001), and chronic renal failure (OR 1.28; 95% CI 1.01–1.62; p=0.039) were found to be related to APE development. CONCLUSION: The incidence of APE after cataract extraction was consistent with reports from other studies. Additional research is needed to determine the relationship of newly found risk factors, such as hypertension, primary clinical setting, chronic renal failure, and usage of suturing, with APE development.
Cataract Extraction ; Cataract ; Endophthalmitis ; Foreign Bodies ; Glaucoma ; Hominidae ; Humans ; Hypertension ; Incidence ; Insurance ; Kidney Failure, Chronic ; Korea ; Male ; Phacoemulsification ; Risk Factors ; Sutures ; Vitrectomy

BACKGROUND: Atopic dermatitis (AD) is one of the most common skin disorders affecting infants and children. Food allergy is a strong risk factor for the development of AD. This study was designed to evaluate the improvement of symptoms among AD patients in the late childhood while they take the customized (organic, balanced, non-allergic, diverse vegetable, little saturated fat and trans fat free) diet. METHODS: Nineteen children with AD who agreed to the written consent were enrolled in the study from October to December, 2014. We supplied them with the customized diet for 8 weeks. Clinical evaluations, blood tests and nutritional status were conducted at baseline, at 4th and at 8th week. Eczema area and severity index (EASI) and Scoring atopic dermatitis (SCORAD) were used to determine the severity of AD. RESULTS: The mean age of 19 patients was 8.5±1.54 years. EASI and SCORD index were decreased after diet intervention (2.6±3.06 [standard deviation] vs. 2.0±2.93 P=0.026, 24.9±10.76 vs. 20.0±12.65 P=0.009). Pruritus scores using visual analogue scale, rated by patients and hemoglobin revealed statistically significant improvement after diet intervention. CONCLUSIONS: The customized diet helps to improve the symptoms of atopic dermatitis and the nutritional indicators. Additional long-term and large-scale studies are required as well as the development of various diets.
Child* ; Dermatitis ; Dermatitis, Atopic* ; Diet* ; Eczema ; Food Hypersensitivity ; Hematologic Tests ; Humans ; Infant ; Nutritional Status ; Pruritus ; Risk Factors ; Severity of Illness Index ; Skin ; Vegetables

BACKGROUND: From May to July 2015, the Republic of Korea experienced the largest outbreak of Middle East respiratory syndrome (MERS) outside the Arabian Peninsula. A total of 186 patients, including 36 deaths, had been diagnosed with MERS-coronavirus (MERS-CoV) infection as of September 30th, 2015. MATERIALS AND METHODS: We obtained information of patients who were confirmed to have MERS-CoV infection. MERS-CoV infection was diagnosed using real-time reverse-transcriptase polymerase chain reaction assay. RESULTS: The median age of the patients was 55 years (range, 16 to 86). A total of 55.4% of the patients had one or more coexisting medical conditions. The most common symptom was fever (95.2%). At admission, leukopenia (42.6%), thrombocytopenia (46.6%), and elevation of aspartate aminotransferase (42.7%) were observed. Pneumonia was detected in 68.3% of patients at admission and developed in 80.8% during the disease course. Antiviral agents were used for 74.7% of patients. Mechanical ventilation, extracorporeal membrane oxygenation, and convalescent serum were employed for 24.5%, 7.1%, and 3.8% of patients, respectively. Older age, presence of coexisting medical conditions including diabetes or chronic lung disease, presence of dyspnea, hypotension, and leukocytosis at admission, and the use of mechanical ventilation were revealed to be independent predictors of death. CONCLUSION: The clinical features of MERS-CoV infection in the Republic of Korea were similar to those of previous outbreaks in the Middle East. However, the overall mortality rate (20.4%) was lower than that in previous reports. Enhanced surveillance and active management of patients during the outbreak may have resulted in improved outcomes.
Antiviral Agents ; Aspartate Aminotransferases ; Coronavirus Infections* ; Disease Outbreaks ; Dyspnea ; Extracorporeal Membrane Oxygenation ; Fever ; Humans ; Hypotension ; Leukocytosis ; Leukopenia ; Lung Diseases ; Middle East Respiratory Syndrome Coronavirus ; Middle East* ; Mortality ; Pneumonia ; Polymerase Chain Reaction ; Republic of Korea* ; Respiration, Artificial ; Thrombocytopenia

Thymidine phosphorylase (TP) has shown to be up-regulated in several cancers and to play a role in angiogenesis and invasion. Most studies regarding TP have focused on cancer cells. Recently, evidences suggest that TP in cancer-infiltrating inflammatory cells (CIICs) also affect the cancer cell behavior. To evaluate the significance of TP expression of CIICs in gastric cancer, we assessed TP expression of cancer cells and CIICs separately using immunohistochemical assay on 116 paraffin-embedded tissue samples from stomach cancer patients and investigated their clinical significance. When subjects were divided into 4 groups according to the TP expression: cancer/matrix (+/+), C/M (+/-), C/M (-/+), and C/M (-/-), intratumoral microvessel density scores were higher in the C/M (+/-) group than in the C/M (-/-) group (p=0.02). For lymph node metastasis and survival, there were no significant differences among the 4 groups. However, there were significant differences in survival (p=0.035) and LN metastasis (p=0.023) between the two groups divided by TP expression of CIICs alone irrespective of TP expression of cancer cells. Taken together, this study suggested the TP expression in CIICs could affect lymph node metastasis and patients' survival in gastric cancer.
Adult ; Aged ; Female ; Humans ; Immunohistochemistry ; Inflammation/*enzymology/pathology ; Kaplan-Meiers Estimate ; Lymphatic Metastasis ; Lymphocytes, Tumor-Infiltrating/*enzymology/pathology ; Male ; Microcirculation/pathology ; Middle Aged ; Neovascularization, Pathologic ; Prognosis ; Stomach Neoplasms/blood supply/*enzymology/mortality/pathology ; Thymidine Phosphorylase/*metabolism

The incidence of endobronchial tumor in the pediatric period is very rare and the symptoms are very close to those of respiratory tract infection. Diagnosis can be delayed because of low clinical suspicion and the many ways in which these tumors can present. We report the first case, in Korea, of a pulmonary carcinoid tumor that presented with recurrent pneumonia at the same location in adolescence. Treatment is surgical and geared towards complete resection while sparing healthy lung parenchyma. Long-term and careful follow up is recommended to detect local and distant metastasis.
Adolescent* ; Carcinoid Tumor* ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Lung ; Neoplasm Metastasis ; Pneumonia* ; Respiratory Tract Infections

BACKGROUND: Although several hospital-based stroke studies were published, there has not been any reliable data representing the clinical characteristics of stroke in Korea. We analyzed the clinical characteristics of patients with ischemic stroke registered in the Korean Stroke Registry (KSR), which is the largest prospective hospital-based nation-wide stroke registry in Korea. METHODS: The KSR provided standardized protocols for collecting data, which includes the data of demographics, subtypes of stroke, risk factors, and neurological outcome at discharge. The brain imaging studies, including CT or MRI, were performed in all cases. RESULTS: KSR registered 10,811 patients of acute ischemic stroke between Nov. 2002 and Jun. 2004. The large-artery atherosclerosis was the most common subtype (37.3%), followed by small vessel occlusion (30.8%). Hypertension (65.4%) was the most common risk factor, followed by smoking (34.5%) and diabetes (28.3%). Although most of the hypertensive and diabetic patients had been diagnosed before the stroke, less than 45.4% and 32.5% of them were under regular control. The steno-occlusive lesion of extracranial carotid artery was only 29.3% and the ratio of intra- to extracranial artery disease was more than 2 in KSR. Only 20.5% of patients were admitted within 3 hours after stroke onset and 2.1% were treated with intravenous thrombolysis. In-hospital case-fatality was 5.2%, which is relatively comparable to those of previous studies. CONCLUSIONS: The KSR provided informative data in understanding the clinical characteristics of ischemic stroke in Korea. Further analysis of KSR will facilitate clinical trials and development of guidelines for the management of stroke patients.
Arteries ; Atherosclerosis ; Carotid Arteries ; Cerebrovascular Disorders ; Demography ; Epidemiology ; Humans ; Hypertension ; Korea ; Magnetic Resonance Imaging ; Neuroimaging ; Prospective Studies* ; Registries ; Risk Factors ; Smoke ; Smoking ; Stroke*

PURPOSE: Heptaplatin (SKI-2053 R) is a new platinum analogue, with a better toxicity profile than cisplatin, and has antitumor activity even in cisplatin resistant cell lines. 5-fluoruracil (5-FU) has shown synergy with platinum compounds. This phase II trial was designed to determine the efficacy and toxicities of heptaplatin/ 5-FU (5-fluorouracil) for treating stomach cancer. MATERIALS AND METHODS: Thirty-two patients with advanced, measurable gastric adenocarcinomas were enrolled in this trial. The treatment consisted of heptaplatin, 400 mg/m2/day (1 hour IV infusion), on day 1 and 5-FU, 800 mg/m2/day (12 hours IV infusion), on days 1 to 5. The cycles were repeated every 3 weeks. RESULTS: Of the 26 evaluable patients, 9 had partial responses and 1a complete response (overall response rate, 38%; 95% confidence interval, 19~57%). The median response duration was 23 weeks (range: 4~60 weeks). The median time to progression was 26 weeks (range: 3~68 weeks). The grades III-IV toxicities were mostly hematological toxicities: leucopenia was observed in 11 patients (35%) and thrombocytopenia 4 (13%). No definite neuropathy was observed. Grade I-II nephropathy was also noted: grade I high BUN/creatinine levels occurred in 5 patients (16%), grade II proteinuria 2 (6%), grade I proteinuria 5 (16%). Neutropenic fever developed in 5 patients (16%) and 1 died of pneumonia in a neutropenic state. CONCLUSION: This study suggests that the regimen of Heptaplatin/5-FU should be effective and have a favorable toxicity profile for the patients suffering with advanced stomach cancer.
Adenocarcinoma ; Cell Line ; Cisplatin ; Drug Therapy ; Fever ; Fluorouracil ; Humans ; Leucovorin* ; Platinum ; Platinum Compounds ; Pneumonia ; Proteinuria ; Stomach Neoplasms* ; Stomach* ; Thrombocytopenia

The formation of advanced glycation end products (AGEs), in various tissues has been known to enhance immunoinflammatory reactions and local oxidant stresses in long standing diabetes. Recently, AGEs have been reported to play a role in neointimal formation in animal models of arterial injury. We attempted to determine whether the serum levels of AGEs are associated with coronary restenosis in diabetic patients. Blood samples were collected from diabetic patients with coronary artery disease undergoing stent implantation and the serum levels of AGEs were analyzed by the fluorescent intensity method. The development of in-stent restenosis (ISR) was evaluated by a 6-month follow-up coronary angiography. A total of 263 target lesions were evaluated, in 203 patients. The ISR rate in the high-AGE (> 170 U/ml) group (40.1%) was significantly higher than in the low-AGE group (< or =170 U/ml) (19.6%) (p < 0.001). Furthermore, multivariate analysis revealed that a high level of serum AGEs is an independent risk factor for the development of ISR (odds ratio, 2.659; 95% CI, 1.431-4.940; p=0.002). The serum levels of AGEs constitute an excellent predictive factor for ISR, and should be one of the guidelines for medical therapy and interventional strategy to prevent ISR in diabetic patients.
Aged ; Coronary Arteriosclerosis/epidemiology/*metabolism/*therapy ; Coronary Restenosis/epidemiology/*metabolism ; Diabetes Mellitus, Type 2/epidemiology/*metabolism ; Female ; Glycosylation End Products, Advanced/*blood ; Humans ; Male ; Middle Aged ; Research Support, Non-U.S. Gov't ; Risk Factors ; *Stents

Stromal cell-derived factor 1 (SDF-1/CXCL12) is a multifunctional cytokine implicated in normal hematopoiesis. We previously reported that SDF-1alpha enhanced the survival of hematopoietic stem and progenitor cells in synergy with other cytokine such as GM-CSF, steel factor, or thrombopoietin. As adult stem cells are very rare, many investigators are trying to expand hematopoietic stem/progenitor cells in vitro. In this study, we constructed an adenoviral vector and produced high titer of recombinant adenoviruses directing robust expression of SDF-1alpha determined by ELISA. We also produced control empty adenoviruses and recombinant LacZ adenoviruses. In order to check the feasibility of SDF-1alpha in ex vivo expansion system, we compared HUVEC cells tranduced by a SDF-1alpha recombinant virus with HUVEC cells transduced by a LacZ recombinant virus in supporting activity of hematopoietic cells, and found that expression of SDF-1alpha in HUVEC cells increased viable blood cell population obtained from the same number of CD34+ cells. The SDF-1alpha recombinant adenovirus seems to be useful for future application in hematopoiesis studies.
Adenoviridae* ; Adult Stem Cells ; Blood Cells ; Chemokine CXCL12* ; Enzyme-Linked Immunosorbent Assay ; Granulocyte-Macrophage Colony-Stimulating Factor ; Hematopoiesis ; Hematopoietic Stem Cells* ; Human Umbilical Vein Endothelial Cells ; Humans ; Research Personnel ; Stem Cell Factor ; Stem Cells ; Thrombopoietin

With the widespread emergence of antimicrobial resistance, combination regimens of ceftriaxone and vancomycin (C+V) or ceftriaxone and rifampin (C+R) are recommended for empirical treatment of pneumococcal meningitis. To evaluate the therapeutic efficacy of meropenem (M), we compared various treatment regimens in arabbit model of meningitis caused by penicillin-resistant Streptococcus pneumoniae (PRSP). Therapeutic efficacy was also evaluated by the final bacterial concentration in the cerebrospinal fluid (CSF) at 24 hr. Each group consisted of six rabbits. C+V cleared the CSF at 10 hr, but regrowth was noted in 3 rabbits at 24 hr. Meropenem monotherapy resulted in sterilization at 10 hr, but regrowth was observed in all 6 rabbits at 24 hr. M+V also resulted in sterilization at 10 hr, but regrowth was observed in 2 rabbits at 24 hr. M+V was superior to the meropenem monotherapy at 24 hr (reduction of 4.8 vs. 1.8 log10 cfu/mL, respectively; p=0.003). The therapeutic efficacy of M+V was comparable to that of C+V (reduction of 4.8 vs. 4.0 log10 cfu/mL, respectively; p=0.054). The meropenem monotherapy may not be a suitable choice for PRSP meningitis, while combination of meropenem and vancomycin could be a possible alternative in the treatment of PRSP meningitis.
Animals ; Anti-Bacterial Agents/pharmacology ; Cerebrospinal Fluid ; Disease Models, Animal ; *Drug Resistance, Microbial ; Human ; Male ; Meningitis, Pneumococcal/*drug therapy ; Penicillins/*pharmacology ; Rabbits ; Streptococcus pneumoniae ; Support, Non-U.S. Gov't ; Thienamycins/*pharmacology ; Time Factors