Background: The Korean Society of Thoracic Radiology (KSTR) recently constructed a nation-wide coronavirus disease 2019 (COVID-19) database and imaging repository, referred to the Korean imaging cohort of COVID-19 (KICC-19) based on the collaborative efforts of its members. The purpose of this study was to provide a summary of the clinico-epidemiological data and imaging data of the KICC-19. Methods: The KSTR members at 17 COVID-19 referral centers retrospectively collected imaging data and clinical information of consecutive patients with reverse transcription polymerase chain reaction-proven COVID-19 in respiratory specimens from February 2020 through May 2020 who underwent diagnostic chest computed tomography (CT) or radiograph in each participating hospital. Results: The cohort consisted of 239 men and 283 women (mean age, 52.3 years; age range, 11–97 years). Of the 522 subjects, 201 (38.5%) had an underlying disease. The most common symptoms were fever (n = 292) and cough (n = 245). The 151 patients (28.9%) had lymphocytopenia, 86 had (16.5%) thrombocytopenia, and 227 patients (43.5%) had an elevated CRP at admission. The 121 (23.4%) needed nasal oxygen therapy or mechanical ventilation (n = 38; 7.3%), and 49 patients (9.4%) were admitted to an intensive care unit.Although most patients had cured, 21 patients (4.0%) died. The 465 (89.1%) subjects underwent a low to standard-dose chest CT scan at least once during hospitalization, resulting in a total of 658 CT scans. The 497 subjects (95.2%) underwent chest radiography at least once during hospitalization, which resulted in a total of 1,475 chest radiographs. Conclusion The KICC-19 was successfully established and comprised of 658 CT scans and 1,475 chest radiographs of 522 hospitalized Korean COVID-19 patients. The KICC-19 will provide a more comprehensive understanding of the clinical, epidemiological, and radiologic characteristics of patients with COVID-19.

The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate (MTA) was studied by scanning electron microscopy (SEM). Single-rooted human premolars (n=60) were instrumented to an apical size #50/0.06 using ProFile and treated as follows: Group 1 (n=10) was filled with phosphate buffered saline (PBS); Group 2 (n=10) was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS; Group 3 (n=20) was obturated orthograde with a paste of OrthoMTA (BioMTA, Seoul, Korea) and PBS; and Group 4 (n=20) was incubated with E. faecalis for 3 weeks and then obturated with OrthoMTA-PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material (IRM), and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoMTA-filled roots (Groups 3 and 4). Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots (Group 4). Therefore, the orthograde obturation of root canals with OrthoMTA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.
Aluminum Compounds ; therapeutic use ; Calcification, Physiologic ; physiology ; Calcium Compounds ; therapeutic use ; Crystallization ; Dental Pulp Cavity ; microbiology ; Dentin ; microbiology ; Drug Combinations ; Enterococcus faecalis ; ultrastructure ; Humans ; Methylmethacrylates ; therapeutic use ; Microscopy, Electron, Scanning ; Oxides ; therapeutic use ; Root Canal Filling Materials ; therapeutic use ; Root Canal Obturation ; methods ; Root Canal Preparation ; instrumentation ; Silicates ; therapeutic use ; Time Factors ; Zinc Oxide-Eugenol Cement ; therapeutic use

PURPOSE: To report the results of stereotactic body radiotherapy (SBRT) for unresectable primary or recurrent cholangiocarcinoma. MATERIALS AND METHODS: From January 2005 through August 2013, 58 patients with unresectable primary (n = 28) or recurrent (n = 30) cholangiocarcinoma treated by SBRT were retrospectively analyzed. The median prescribed dose was 45 Gy in 3 fractions (range, 15 to 60 Gy in 1-5 fractions). Patients were treated by SBRT only (n = 53) or EBRT + SBRT boost (n = 5). The median tumor volume was 40 mL (range, 5 to 1,287 mL). RESULTS: The median follow-up duration was 10 months (range, 1 to 97 months). The 1-year, 2-year overall survival rates, and median survival were 45%, 20%, and 10 months, respectively. The median survival for primary group and recurrent group were 5 and 13 months, respectively. Local control rate at 1-year and 2-year were 85% and 72%, respectively. Disease progression-free survival rates at 1-year and 2-year were 26% and 23%, respectively. In univariate analysis, ECOG performance score (0-1 vs. 2-3), treatment volume (<50 vs. > or =50 mL), and pre-SBRT CEA level (<5 vs. > or =5 ng/mL) were significant in overall survival rate. In multivariate analysis, ECOG score (p = 0.037) and tumor volume (p = 0.030) were statistically significant. In the recurrent tumor group, patients with >12 months interval from surgery to recurrence showed statistically significant higher overall survival rate than those with < or =12 months (p = 0.026). Six patients (10%) experienced > or =grade 3 complications. CONCLUSION: SBRT can be considered as an effective local modality for unresectable primary or recurrent cholangiocarcinoma.
Cholangiocarcinoma* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Radiosurgery* ; Recurrence ; Retrospective Studies ; Survival Rate ; Tumor Burden

BACKGROUND: Previously, cutaneous lymphomas were classified according to either the European Organization for the Research and Treatment of Cancer (EORTC) or the World Health Organization (WHO) classification paradigms. The aim of this study was to determine the relative frequency of Korean cutaneous lymphoma according to the new WHO-EORTC classification system. METHODS: A total of 517 patients were recruited during a recent 5 year-period (2006-2010) from 21 institutes and classified according to the WHO-EORTC criteria. RESULTS: The patients included 298 males and 219 females, and the mean age at diagnosis was 49 years. The lesions preferentially affected the trunk area (40.2%). The most frequent subtypes in order of decreasing prevalence were mycosis fungoides (22.2%), peripheral T-cell lymphoma (17.2%), CD30+ T-cell lymphoproliferative disorder (13.7%), and extranodal natural killer/T (NK/T) cell lymphoma, nasal type (12.0%). Diffuse large B-cell lymphoma accounted for 11.2% of cases, half of which were secondary cutaneous involvement; other types of B-cell lymphoma accounted for less than 1% of cases. CONCLUSIONS: In comparison with data from Western countries, this study revealed relatively lower rates of mycosis fungoides and B-cell lymphoma in Korean patients, as well as higher rates of subcutaneous panniculitis-like T-cell lymphoma and NK/T cell lymphoma.
Academies and Institutes ; Classification* ; Diagnosis ; Female ; Humans ; Korea ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Lymphoproliferative Disorders ; Male ; Mycosis Fungoides ; Prevalence ; T-Lymphocytes ; World Health Organization

Gastrointestinal bleeding from small bowel lesions is uncommon but it is the most common cause of obscure gastrointestinal bleeding that can go undiagnosed using traditional upper endoscopy and colonoscopy. Recently, various new methods, including wireless capsule endoscopy and double-balloon enteroscopy have been used to detect and manage small bowel lesions. A 51-year-old man was admitted with hematochezia. The source of bleeding could not be identified using conventional upper endoscopy and colonoscopy. Wireless capsule endoscopy revealed a mass-like lesion with active blood spurting in the proximal jejunum. Finally, a tumor with central ulceration was detected at the proximal jejunum using a clean colonoscope through the oral approach. This lesion was surgically resected, and the histology findings were consistent with a gastrointestinal stromal tumor. We report a case of gastrointestinal bleeding from a proximal jejunal GIST diagnosed by clean colonoscopy through the oral approach with a review of the relevant literature.
Capsule Endoscopy ; Colonoscopes ; Colonoscopy* ; Double-Balloon Enteroscopy ; Endoscopy ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors ; Hemorrhage* ; Humans ; Jejunum ; Middle Aged ; Ulcer

Vaccination against hepatitis A virus (HAV) is recommended for patients with chronic liver disease (CLD), but this has been deemed unnecessary in Korea since the immunity against HAV was almost universal in adults. However, this practice has never been reevaluated with respect to the changing incidence of adult acute hepatitis A. We retrospectively reviewed the medical records of 278 patients with acute hepatitis A diagnosed from January 1995 to November 2005 and prospectively tested 419 consecutive CLD patients from July to December 2005 for the presence of IgG anti-HAV. The number of patients with acute hepatitis A has markedly increased recently, and the proportion of adult patients older than 30 yr has been growing from 15.2% during 1995-1999, to 28.4% during 2000-2005 (p=0.019). Among 419 CLD patients, the seroprevalences of IgG anti-HAV were 23.1% for those between 26 and 30 yr, 64% between 31 and 35 yr, and 85.0% between 36 and 40 yr. These data demonstrate that immunity against HAV is no more universal in adult and substantial proportion of adult CLD patients are now at risk of HAV infection in Korea. Therefore, further study on seeking proper strategy of active immunization against HAV is warranted in these populations.
Risk Factors ; Risk Assessment/methods ; Middle Aged ; Male ; Liver Diseases/*epidemiology/*prevention & control ; Korea/epidemiology ; Infant, Newborn ; Infant ; Incidence ; Humans ; Hepatitis A Vaccines/*therapeutic use ; Hepatitis A/*epidemiology/*prevention & control ; Female ; Disease Outbreaks/*prevention & control/*statistics & numerical data ; Comorbidity ; Communicable Diseases, Emerging/epidemiology/prevention & control ; Chronic Disease ; Child, Preschool ; Child ; Aged, 80 and over ; Aged ; Adult ; Adolescent

Giant duodenal ulcer can be defined as a variant of peptic ulceration that exceeds 2 cm at the greatest diameter. The high mortality and morbidity of giant duodenal ulcer are directly related to the resultant perforation, obstruction and massive hemorrhage. The patient usually has a long history of an inadequately treated or neglected peptic ulcer, but this malady is rarely induced by nonsteroidal anti-inflammatory drugs (NSAIDs). A 60-year-old man was referred to us due to epigastric pain. He underwent appendectomy 1 week ago, and he was administered ketorolac (tarasyn(R)) for 5 days to control the postoperative pain. Esophagogastroduodenos copy (EGD) revealed a giant duodenal ulcer encircling the lumen from the pylorus to the postbulbar portion of the duodenum, and he was then treated with proton pump inhibitor. Two weeks later, the follow-up EGD showed complete duodenal obstruction at the bulb. He was treated by laparoscopic gastrojejunostomy. We report here on this case of duodenal obstruction that was induced by the short-term use of NSAIDs.
Anti-Inflammatory Agents, Non-Steroidal ; Appendectomy ; Duodenal Obstruction* ; Duodenal Ulcer ; Duodenum ; Follow-Up Studies ; Gastric Bypass ; Hemorrhage ; Humans ; Ketorolac ; Middle Aged ; Mortality ; Pain, Postoperative ; Peptic Ulcer ; Proton Pumps ; Pylorus

BACKGROUND/AIMS: The clinical significance of serum CA 125 levels in patients with chronic liver disease has not been widely appreciated in relation to the severity of the disease. We examined serum CA 125 levels in patients with chronic liver disease according to the severity of liver disease and the presence of ascites. METHODS: Fasting serum CA 125 levels were measured by a commercial RIA kit in 92 patients with chronic liver disease: 22 with chronic hepatitis and 70 with liver cirrhosis (Child class A, 19; B, 28; C, 23). Forty-one patients (45%) had ascites. RESULTS: The patients with Child class C liver cirrhosis had significantly higher mean serum CA 125 level than those with class A (p<0.05). In Child class B patients, the mean serum CA 125 level was significantly higher in patients with ascites than in those without (p<0.05). A multiple regression analysis showed that the presence of ascites, serum albumin, and prothrombin time were independent factors related to the increase of serum CA 125 levels. CONCLUSIONS: The presence of ascites is more closely related to the increase of CA125 levels in patients with liver cirrhosis than the severity of liver disease.
Adult ; Aged ; Ascites/blood ; CA-125 Antigen/*blood ; Chronic Disease ; Female ; Hepatitis B, Chronic/*blood ; Humans ; Liver Cirrhosis/*blood ; Male ; Middle Aged

PURPOSE: TPN has been widely used to treat nutritional depletion since the late 1960s. However, many metabolic complications may occur as a result of parenteral feeding. Among these, hepatic complications has received increasing attention. A retrospective review of liver function abnormalities in adult patients who underwent TPN was done to determine the frequency and magnitude of the abnormalities in a liver function test. METHODS: From January 2001 to Jun 2001, 160 adult patient receiving TPN were reviewed. Of these, 111 had a malignant disease and 49 had a benign disease. The duration of TPN therapy ranged from 5 days to 52 days, with a mean duration of 14 days. Abnormalities of liver function test were defined as a value greater than the upper normal limit. Forty cases of gastric cancer were analyzed to determine the risk factors that contribute to abnormal liver function in individual patients receiving TPN. RESULTS: Abnormalities of the liver function test appeared after 6~7 days of therapy. Increases in the ALP levels were noted in 34 out of 93 patients (37.6%), in the AST levels in 42 out of 116 patients (36.2%), in the ALT levels in 54 out of 125 patients (43.2%), in the LDH levels in 20 out of 72 patients (27.8%), in the gamma-GTP levels in 44 out of 81 patients (54.3%), and in the bilirubin levels in 30 out of 126 patients (23.8%). The serum ALP level rose to 1.6 times upper the limit of normal; AST, 1.7 times; ALT, 2.0 times; LDH, 1.2 times; gamma-GTP, 2.4 times; bilirubin, 2.4 times. gamma-GTP value was most sensitive. In 40 gastric cancers, factors as age, the amount of TPN solution, the duration of TPN, intraoperative chemotherapy, transfusion, and postoperative infection were investigated. However, no association with TPN-associated liver function abnormalities was found. CONCLUSION: The incidences of an abnormal liver function during TPN were 23.8~54.3%. However, the liver function abnormalities that developed during short term-TPN were reversible and not serious.
Adult ; Bilirubin ; Drug Therapy ; Humans ; Incidence ; Liver Function Tests ; Liver* ; Parenteral Nutrition ; Parenteral Nutrition, Total* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms