OBJECTIVES: We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age. METHODS: Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status. RESULTS: The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women. CONCLUSIONS The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.

OBJECTIVES: We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age. METHODS: Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status. RESULTS: The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women. CONCLUSIONS The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.

OBJECTIVES: We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age. METHODS: Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status. RESULTS: The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women. CONCLUSIONS The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.

OBJECTIVES: We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age. METHODS: Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status. RESULTS: The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women. CONCLUSIONS The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.

Blotting, Western ; Conjunctival Diseases ; Dry Eye Syndromes ; Epithelial Cells ; Fluorescent Antibody Technique ; Humans ; Immunohistochemistry ; Inflammation ; Interleukin-6 ; Necrosis ; Phosphorylation ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Tears ; Tumor Necrosis Factor-alpha ; Wounds and Injuries

PURPOSE: The endoscopic management of a fully covered self-expandable metal stent (SEMS) has been suggested for the primary treatment of patients with anastomotic leaks after total gastrectomy. Embedded stents due to tissue ingrowth and migration are the main obstacles in endoscopic stent management. MATERIALS AND METHODS: The effectiveness and safety of endoscopic management were evaluated for anastomotic leaks when using a benign fully covered SEMS with an anchoring thread and thick silicone covering the membrane to prevent stent embedding and migration. We retrospectively reviewed the data of 14 consecutive patients with gastric cancer and anastomotic leaks after total gastrectomy treated from January 2009 to December 2016. RESULTS: The technical success rate of endoscopic stent replacement was 100%, and the rate of complete leaks closure was 85.7% (n=12). The mean size of leaks was 13.1 mm (range, 3–30 mm). The time interval from operation to stent replacement was 10.7 days (range, 3–35 days) and the interval from stent replacement to extraction was 32.3 days (range, 18–49 days). The complication rate was 14.1%, and included a single jejunal ulcer and delayed stricture at the site of leakage. No embedded stent or migration occurred. Two patients died due to progression of pneumonia and septic shock 2 weeks after stent replacement. CONCLUSIONS: A benign fully covered SEMS with an anchoring thread and thick membrane is an effective and safe stent in patients with anastomotic leaks after total gastrectomy. The novelty of this stent is that it provides complete prevention of stent migration and embedding, compared with conventional fully covered SEMS.
Anastomotic Leak* ; Constriction, Pathologic ; Gastrectomy* ; Humans ; Membranes* ; Pneumonia ; Retrospective Studies ; Self Expandable Metallic Stents ; Shock, Septic ; Silicon ; Silicones ; Stents* ; Stomach Neoplasms ; Ulcer

BACKGROUND/AIMS: The frequency of symptomatic acute HAV infections in adulthood are increasing in Korea. This study analyzes the clinical severity in patients with acute HAV infection and investigates risk factors associated with three severe complications: prolonged cholestasis, acute kidney injury, and acute liver failure. METHODS: We performed a retrospective analysis of 726 patients diagnosed from January 2006 to December 2010 at three tertiary hospitals in Jeonbuk Province, Republic of Korea with acute HAV infection. RESULTS: In the group of 726 patients, the mean age was 30.3 years, 426 (58.6%) were male, and 34 (4.7%) were HBsAg positive. Severe complications from acute HAV infection occurred as follows: prolonged cholestasis in 33 (4.6%), acute kidney injury in 17 (2.3%), and acute liver failure in 16 (2.2%). Through multivariate analysis, age > or =40 years (OR 2.63, p=0.024) and peak PT (INR) > or =1.5 (OR 5.81, p=0.035) were found to be significant risk factors for prolonged cholestasis. Age > or =40 years (OR 5.24, p=0.002) and female gender (OR 3.11, p=0.036) were significant risk factors for acute kidney injury. Age > or =40 years (OR 6.91, p=0.002), HBsAg positivity (OR 5.02, p=0.049), and peak total bilirubin (OR 1.11, p=0.001) were significant risk factors for acute liver failure. CONCLUSIONS: Age > or =40 years, female gender, HBsAg positivity, peak PT (INR) > or =1.5, and peak total bilirubin were significant risk factors for severe complications in acute HAV infections.
Acute Disease ; Acute Kidney Injury/complications ; Adult ; Cholestasis/complications ; Female ; Hepatitis A/complications/*diagnosis ; Hepatitis B Surface Antigens/blood ; Humans ; Liver Failure, Acute/complications ; Male ; Middle Aged ; Odds Ratio ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Tertiary Care Centers

Hemorrhagic radiation-induced gastritis is a rare but serious complication of upper gastrointestinal radiation treatment, and no simple and effective treatment method has yet been developed. Studies on effective treatment methods for achieving hemostasis in patients with hemorrhagic radiation-induced gastritis are necessary, because the new indications for upper gastrointestinal radiotherapy in the field digestive oncology can potentially lead to an increased incidence of radiation-induced gastric vasculopathy. For the first time in Korea and to the best of our knowledge, we report here on a 59-years-old male patient with hemorrhagic gastritis that was induced by external radiotherapy for ampullary adenocarcinoma. This was all well-treated using Argon plasma coagulation (APC).
Adenocarcinoma ; Argon ; Argon Plasma Coagulation ; Gastritis ; Hemostasis ; Humans ; Incidence ; Korea ; Male

Foreign body ingestion is common in children, but magnet ingestion is rare. Ingestion of one magnet does not creat a serious problem; however, ingesting multiple magnet can lead to hazardous complications such as pressure necrosis, intestinal perforation, fistula formation, obstruction and intestinal volvulus. Most cases with complications after multiple magnet ingestion require surgical intervention. We report a case of a fistula following the ingestion of seven small, flat and round magnets that were removed successfully by endoscopic submucosal dissection without surgery.
Child ; Eating ; Fistula ; Foreign Bodies ; Humans ; Intestinal Perforation ; Intestinal Volvulus ; Magnets ; Necrosis

PURPOSE: The aim of this study was to find the dose of agonistic 4-1BB monoclonal antibody (mAb) that results in optimal T cell activation. METHODS: Cancer was induced in mice by an intrahepatic parenchymal injection of 1x10(5) cells of CT26 cells. Cancer-carrying mice (n=84) were divided into seven groups and treated with either rat IgG or agonistic 4-1BB monoclonal antibody (mAb) (5microgram, 10microgram, 20microgram, 100microgram, 200microgram, or 300microgram). All treatments were administered intraperitoneally on days 7, 9, and 11. Mice from each group were sacrificed on days 14, 28, and 42. Harvested livers were weighed and the numbers of T cells in the splenocytes were analyzed with a FACS Vantage flow cytometer. RESULTS: Liver weights increased when 5microgram of agonistic 4-1BB mAb was administered, but showed no additional weight increase for doses greater than 10microgram. The absolute numbers of CD4+ and CD8+ T cells increased in groups treated with low doses of agonistic 4-1BB mAb (5microgram, 10microgram, or 20microgram), but did not increase in the groups treated with high doses of mAb (100microgram, 200microgram, or 300microgram). The levels of CD4/annexin V and CD8/annexin V increased as the dose increased, and the absolute cell numbers of CD4/annexin V were greater than those of CD8/annexin V. CONCLUSION: Liver weight, including the cancer mass, failed to increase at agonistic 4-1BB mAb doses greater than 10microgram. A high dose (> or =100microgram) of agonistic 4-1BB mAb resulted in lower counts of absolute T cells. This study suggests that a low dose (20microgram) of agonistic 4-1BB mAb can be used for optimal T cell activation in combination with other anti-cancer treatments.
Animals ; Cell Count ; Colon ; Colonic Neoplasms ; Immunoglobulin G ; Liver ; Mice ; Neoplasm Metastasis ; Rats ; T-Lymphocytes ; Weights and Measures