Background: Limited data are available on the mortality rates of patients receiving extracorporeal membrane oxygenation (ECMO) support for coronavirus disease 2019 (COVID-19). We aimed to analyze the relationship between COVID-19 and clinical outcomes for patients receiving ECMO. Methods: We retrospectively investigated patients with COVID-19 pneumonia requiring ECMO in 19 hospitals across Korea from January 1, 2020 to August 31, 2021. The primary outcome was the 90-day mortality after ECMO initiation. We performed multivariate analysis using a logistic regression model to estimate the odds ratio (OR) of 90-day mortality. Survival differences were analyzed using the Kaplan–Meier (KM) method. Results: Of 127 patients with COVID-19 pneumonia who received ECMO, 70 patients (55.1%) died within 90 days of ECMO initiation. The median age was 64 years, and 63% of patients were male. The incidence of ECMO was increased with age but was decreased after 70 years of age. However, the survival rate was decreased linearly with age. In multivariate analysis, age (OR, 1.048; 95% confidence interval [CI], 1.010–1.089; P = 0.014) and receipt of continuous renal replacement therapy (CRRT) (OR, 3.069; 95% CI, 1.312–7.180; P = 0.010) were significantly associated with an increased risk of 90-day mortality. KM curves showed significant differences in survival between groups according to age (65 years) (log-rank P = 0.021) and receipt of CRRT (log-rank P = 0.004). Conclusion Older age and receipt of CRRT were associated with higher mortality rates among patients with COVID-19 who received ECMO.

Objective: To investigate the effects of a herb complex extract (HCE) prepared from Cornus officinalis Sieb. Et Zucc., Eriobotrya japonica Lindley, and olive leaves on immune response of mouse spleen NK cells in vitro and in vivo analysis. Methods: The activity of natural killer (NK) cells was measured in splenocytes and YAC-1 cells. Mice were immunosuppressed using cyclophosphamide (5 mg/kg body weight). Three different doses of HCE (200, 400, and 800 mg/kg body weight) and red ginseng extract (800 mg/kg body weight) which was used as standard immunomodulatory herb were administered orally for 4 weeks. The body weight, dietary, water intake, organs (liver, thymus, and spleen) weight, completed blood count, and cytokines (tumor necrosis factor alpha, interferon gamma, and interleukin-2) production was measured. Results: At the maximum concentration of HCE, the activity of NK cells was increased by 48.5%. HCE increased liver, spleen, and thymus weights without altering numbers of white blood cells, lymphocytes, and neutrophils in a cyclophosphamide-induced immunosuppression rat model. However, HCE recovered the inhibited cytokine expression; HCE (800 mg/kg) increased cytokines levels. The results indicate the immune enhancement potential of this HCE. Conclusion: The HCE enhances immunity by increasing NK cell activity, regulating cytokine levels, and maintaining spleen weight. Therefore, it may be used as a potential immunity enhancer.

OBJECTIVES: The present study aimed to evaluate the validity of a set of self-reported questionnaires for periodontitis for estimating the prevalence of chronic adult periodontitis in the Korean population. METHODS: The questionnaire is comprised of a total of 14 questions with four summarized concepts including self-diagnosis of oral status, subjective signs related to oral health, smoking and drinking status, and use of auxiliary oral hygiene devices including scaling. The predictiveness of the measures from these self-reported questions was assessed by logistic regression modeling using receiver operating characteristic (ROC) statistics, sensitivity, and specificity. RESULTS: The sensitivity, specificity, and AUC including all questions were 0.571, 0.768, and 0.781, respectively; the sum of sensitivity and specificity was 1.34. To gain robustness, a simplified predictive model was built with six questions. Its results were 0.536, 0.817, and 0.762 for sensitivity, specificity, and AUC, respectively. The sum of sensitivity and specificity was found to be 1.35. CONCLUSIONS: The self-reported questionnaire for periodontitis showed considerable validity, but further study is required to provide optimal validity and predictability.
Area Under Curve ; Chronic Periodontitis ; Drinking ; Logistic Models ; Oral Health ; Oral Hygiene ; Periodontal Diseases ; Periodontitis* ; Prevalence ; Surveys and Questionnaires* ; ROC Curve ; Sensitivity and Specificity ; Smoke ; Smoking

BACKGROUND: Small cell lung cancer (SCLC) is an extremely aggressive tumor with a poor clinical course. Although many efforts have been made to improve patients' survival rates, patients who survive longer than 2 years after chemotherapy are still very rare. We examined the baseline characteristics of patients with long-term survival rates in order to identify the prognostic factors for overall survivals. METHODS: A total of 242 patients with cytologically or histologically diagnosed SCLC were enrolled into this study. The patients were categorized into long- and short-term survival groups by using a survival cut-off of 2 years after diagnosis. Cox's analyses were performed to identify the independent factors. RESULTS: The mean patient age was 65.66 years, and 85.5% were males; among the patients, 61 of them (25.2%) survived longer than 2 years. In the multivariate analyses, CRP (hazard ratio [HR], 2.75; 95% confidence interval [CI], 1.25-6.06; p=0.012), TNM staging (HR, 3.29; 95% CI, 1.59-6.80; p=0.001), and progression-free survival (PFS) (HR, 11.14; 95% CI, 2.98-41.73; p<0.001) were independent prognostic markers for poor survival rates. CONCLUSION: In addition to other well-known prognostic factors, this study discovered relationships between the long-term survival rates and serum CRP levels, TNM staging, and PFS. In situations with unfavorable conditions, the PFS would be particularly helpful for managing SCLC patients.
Diagnosis ; Disease-Free Survival* ; Drug Therapy ; Humans ; Male ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Small Cell Lung Carcinoma* ; Survival Rate

PURPOSE: The purpose of this study is to confirm the clinical usefulness of the Alvarado score's application and the differences in diagnostic values between male and female for patients who were diagnosed with acute appendicitis when they came to the hospital for pain in the right lower abdomen. METHODS: The subjects of this study were 211 patients who entered the surgical department of this hospital for doubtful acute appendicitis from June 2003 to May 2005. Using a retrospective method, we examined the patients' records and compared their ages, sex, symptoms, preoperative physical examinations, leukocyte and neutrophils figures, and the final postoperative pathological diagnosis. RESULTS: One hundred twelve patients were male, and 99 were female. A clinical Alvarado score of above 7 in sensitivity, specificity, positive predictive value, and negative predictive value was the standard for being judged positive. In this study, the sensitivity of the Alvarado score was 86.2%, its specificity was 61.6%, and the accuracy of diagnosis was 82.9%. The positive predictive value was 92.6%, and the negative predictive value was 51.0%. The accuracies were 83.9% and 81.8%, respectively, that for males being a little higher than that for female, but with no statistically significant differences. CONCLUSIONS: This study showed that the diagnosis of acute appendicitis was highly accurate for an Alvarado score above 7 (82.9%). The diagnosis of acute appendicitis by using the Alvarado score is simple, fast, reliable, and repeatable, and it can be used under any conditions without other expensive and complicated diagnostic tools.
Abdomen ; Appendicitis* ; Diagnosis* ; Female ; Humans ; Leukocytes ; Male ; Neutrophils ; Physical Examination ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND/AIMS: Helicobacter pylori (H. pylori) infection is the cause of peptic ulcer diseases, and gastric cancer. Hydrolysis of urea generating ammonia may cause cytotoxic effects on the gastric epithelium. The ammonia may induce the synthesis of epidermal growth factor (EGF) in gastric epithelium as an adaptive cytoprotective mechanism. The first aim was to examine the concentration of ammonia and EGF in gastric juice before and after H. pylori eradication in functional dyspepsia patients. The second aim was to examine the correlation among ammonia concentration, EGF concentration, and inflammatory score of gastritis. METHODS: The concentration of ammonia and EGF were measured by ELISA. The grade and severity of gastritis were measured according to the updated Sydney system. RESULTS: The concentration of ammonia in gastric juice was much higher in the H. pylori positive subjects (10,787 +/- 6,584 micro mol/L) than in the negative subjects (2,339 +/- 1,158 micro mol/L, p<0.0001). The concentrations of EGF in gastric juice was much higher in the positive subjects (1,462 +/- 393 pg/mL) than in the negative subjects (1,088 +/- 499 pg/mL, p<0.005). The concentration of ammonia and EGF in gastric juice showed significant correlation (r=0.63, p<0.0001). The concentrations of ammonia and histologic severities showed significant correlation (r=0.41, p<0.0001). Moreover, the level of EGF in gastric juice and histologic severities showed positive correlation (r=0.20, p<0.005). CONCLUSIONS: As the concentration of ammonia in gastric juices increased, the concentration of EGF was also increased in functional dyspepsia with H. pylori infection. The concentration of EGF in gastric juice may play a role in the adaptive cytoprotection in H. pylori- induced gastritis.
Adult ; Ammonia/*analysis ; English Abstract ; Epidermal Growth Factor/*analysis ; Female ; Gastric Juice/*chemistry ; Gastritis/drug therapy/*metabolism/microbiology/pathology ; Helicobacter Infections/drug therapy/*metabolism ; *Helicobacter pylori ; Humans ; Male ; Middle Aged

BACKGROUND: CD43 is a sialoglycoprotein that is highly expressed on most leukocytes, except on B lymphocytes and dendritic cells. CD43 has been reported to be involved in the adhesion and apoptosis of lymphocytes. Although the aberrant expression of CD43 antigen in non-lymphoid tissues has been reported, the expression of the CD43 antigen in gastrointestinal malignancies is not well studied. Here, we studied the expression of CD43 in colon adenocarcinoma using the anti-CD43 monoclonal antibody developed in our laboratory. METHODS: Thirty patients who had undergone surgical resection for colorectal carcinoma were recruited. The expression of CD43 molecule was determined by analyzing the formalin-fixed, paraffin-embedded specimens immunohistochemically using our newly developed anti-CD43 mAb (K06). The results obtained by the immunohistochemical analysis correlated to the clinicopatho-logical parameters. RESULTS: The expression of CD43 were found in 20 out of 30 colorectal carcinoma cases. The expression of CD43 antigen is higher in well differentiated adenocarcinomas than poorly or moderately differentiated adenocarcinomas. CONCLUSIONS: The new anti-CD43 mAb might be helpful for the detection of the expression of CD43 on colorectal carcinoma cells. Further studies are required to assess the relationship between the CD43 expression and the colorectal carcinogenesis.
Adenocarcinoma ; Antigens, CD43 ; Apoptosis ; B-Lymphocytes ; Carcinogenesis ; Colon ; Colorectal Neoplasms ; Dendritic Cells ; Humans ; Immunohistochemistry ; Leukocytes ; Lymphocytes

BACKGROUND: At present, lamivudine-interferon combination therapy is being tried on chronic hepatitis B patients who had no significant response to interferon-alpha mono-therapy. The therapeutic effect of lamivudine-interferon combination therapy is showing various outcomes depending on the period of therapy and the status of the patient. Thus we conducted this study to compare the therapeutic effect of lamivudine-interferon combination therapy versus interferon-alpha monotherapy in korean patients with chronic hepatitis B. METHOD: Among the chronic hepatitis B patients, 138 patients who showed positive to HBeAg, and serum HBV DNA levels are over 5 pg/mL and serum ALT levels are over 40 IU/L were allocated to IFN-alpha monotherapy group (70 patients) and lamivudine-interferon combination therapy group (66 patients). We compared two groups on ALT normalization rate, HBeAg seroconversion rate, HBV DNA loss rate and HBeAg loss rate in both group. IFN-alpha was percutaneously injected three times a week. Mean administered dose was 27125 (+/-11841) MU and mean administered duration was 6.4 (+/-1.6) months. Lamivudine was concomitantly and continuously administered with IFN-alpha for over 6 months (mean 13.2 +/- 16.5). The lamivudine therapy was terminated at the point when HBeAg turned positive into negative. RESULTS: Mean follow-up period was 28 months. HBeAg loss rate was 40.9% in lamivudine- interferon combination therapy group and 28.6% in IFN-alpha monotherapy group on the 12th month of the therapy, showing there was no significant difference between the two groups (p=0.13). HBeAg seroconversion rate was 40.9% in lamivudine-interferon combination therapy group and 21.4% in IFN-alpha monotherapy group on the 12th month of the therapy (p=0.014). HBV DNA loss rate was 90.9% in lamivudine-interferon combination therapy group and 88.6% in IFN-alpha monotherapy group within 12months of the therapy, showing there was no significant difference between the two groups (p=0.35). Serum ALT normalization rate was 92.4% in lamivudine-interferon combination therapy group and 85.7% in IFN-alpha monotherapy group within 12months of the therapy, showing there was no significant difference between the two groups (p=0.11). CONCLUSION: The lamivudine-interferon combination therapy compared to the Interferon-alpha monotherapy showed a statistically significant higher HBeAg seroconversion rate.
DNA ; Follow-Up Studies ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons* ; Lamivudine

BACKGROUND: Natural moisturizing factors such as sodium pyrrolidone carboxylic acid and lactic acid may play an important role in increasing the moisture retention of isolated stratum corneum and reducing the incidence of dry and flaky skin in vivo. Although the precise mechanism of surfactant irritancy is not fully understood, it has been suggested that barrier dysfunction of stratum corneum by surfactants results in skin changes such as scaling, erythema, and even fissuring. OBJECTIVE: We evaluated the effect of sodium pyrrolidone carboxylic acid(NaPCA) and lactic acid(LA) with several non-invasive measuring methods in the irritated skin reaction induced by sodium lauryl sulphate (SLS) in normal persons and atopic dermatitis patients. METHODS: After skin irritation for 24 hours with patch test of 1% SLS on five volar sites of right forearm, we applied nothing(A), 3% LA+3% NaPCA(B), 3% LA(C), 3% NaPCA(D), and vehi cle(E) twice a day respectively. Visual score, transepidermal water loss(TEWL), water holding capa city(WHC), and erythema index were measured at 30 min, 24hr, 48hr and 72hr after patch removal. RESULTS: 1. After 72hr, the visual scores of B and C were significantly lower than that of A(control) in atopic dermatitis patients, and that of C in normal persons was significantly lower than that of A, D, and E. 2. TEWL values of B and C in both the normal (after 72hr) and atopic dermatitis group (after 48hr and 72hr) were significantly lower than that of A. 3. WHC values of B, C, D in both the normal and atopic dermatitis group were significantly higher than that of A after 48hr and 72hr. 4. After 72hr, erythema indices by Mexameter of B, C, and D in both the normal and atopic dermatitis group were significantly lower than that of A and values of C were significantly lower than that of E. In the atopic dermatitis group, values of D were also significantly lower than that of E. 5. The mean visual score was significantly correlated with TEWL value and erythema index of Mexameter (r=0.58, r=0.64) and the TEWL value was significantly correlated with erythema index of Mexameter (r=0.64). CONCLUSION: These results suggest that topical application of a moisturizing factor might improve the surfactant-induced disruption of permeability barrier with improvement of the water holding capacity of the stratum corneum.
Dermatitis, Atopic* ; Erythema ; Forearm ; Humans ; Incidence ; Lactic Acid* ; Patch Tests* ; Permeability ; Skin* ; Sodium* ; Surface-Active Agents

BACKGROUND/AIMS: Increasing evidence suggests that manganese deposition in globus pallidus is responsible for MRI signal hyperintensity and for extrapyramidal symptoms in cirrhotics. However, the relationships between blood manganese, the severity of liver dysfunction, the pallidal signal intensity, and neurological signs have not been well established. METHODS: Blood manganese concentrations were measured together with brain MRI and neurological evaluation in six controls, six patients with Parkinson's disease with normal liver function, and fourteen cirrhotic patients with hepatic encephalopathy including six cirrhotics with extrapyramidal symptoms. The neurological state was evaluated using the Columbia scale and the pallidal index (PI). The ratio of globus pallidus to frontal subcortical white-matter signal intensity was measured-multiplied by 100. RESULTS: Pallidal signal hyperintensity was observed in 85.7% of cirrhotics, and the PI was higher in cirrhotics with extrapyramidal signs or high grade varices than those without them, but there was no increase in the Parkinson's disease patients. No correlations were demonstrated between the blood manganese level and PI as well as the Child-Pugh score. The blood manganese level was not significantly different between cirrhotics and other groups. However, there was an overt increase only in two cirrhotic patients with extrapyramidal signs. The Columbia scale did not reveal any correlations with the blood manganese level and the Child-Pugh score. CONCLUSIONS: Cirrhotics with extrapyramidal signs showed a significant increase in PI, but there was no increase in the patients with Parkinson's disease. The PI was not significantly correlated with the blood manganese level. These findings suggest that extrapyramidal signs in cirrhotics might be caused by a different mechanism than those in Parkinson's disease, which could possibly be related with manganese.
Brain ; Globus Pallidus ; Hepatic Encephalopathy ; Humans ; Liver ; Liver Diseases ; Magnetic Resonance Imaging ; Manganese* ; Parkinson Disease ; Varicose Veins