The demineralized bone matrix (DBM) as the bone graft material to increase the fusion rate was widely used in spinal fusion. The current study aimed to compare the fusion rate of DBM to the fusion rate of autograft in lumbar spine fusion via meta-analysis of published literature. After systematic search, comparative studies were selected according to eligibility criteria. Checklist (risk of bias assessment tool for non-randomized study) was used to evaluate the risk of bias of the included nonrandomized controlled studies. The corresponding 95% confidence interval (95% CI) were calculated. We also used subgroup analysis to analyze the fusion rate of posterolateral lumbar fusion and lumbar interbody fusion. Eight studies were finally included in this meta-analysis. These eight studies included 581 patients. Among them, 337 patients underwent spinal fusion surgery using DBM (DBM group) and 204 patients underwent spinal fusion surgery with mainly autologous bone and without using DBM (control group). There was no significant differences of fusion rate between the two groups in posterolateral fusion analysis (risk ratio [RR], 1.03; 95% CI, 0.90–1.17; p=0.66) and interbody fusion analysis (RR, 1.13; 95% CI, 0.91–1.39; p=0.27). Based on the available evidence, the use of DBM with autograft in posterolateral lumbar spine fusion and lumbar interbody fusion showed a slightly higher fusion rate than that of autograft alone; however, there was no statistically different between two groups.

The purpose of this study was to investigate the immunomodulatory activity of ice plant (Mesembryanthemum crystallinum) extract (IPE) in vitro and in vivo. Raji (a human B cell line) and Jurkat (a human T cell line) cells were treated with various doses of IPE and cell proliferation was measured by WST assay. Results showed that IPE promoted the proliferation of both Raji and Jurkat cells in a dose-dependent manner. IPE also enhanced IL-6 and TNF-α production in macrophages in the presence of lipopolysaccharide (LPS), although IPE alone did not induce cytokine production. Moreover, IPE treatment upregulated iNOS gene expression in macrophages in a time- and dose-dependent manner and led to the production of nitric oxide in macrophages in the presence of IFNγ. In vivo studies revealed that oral administration of IPE for 2 weeks increased the differentiation of CD4+, CD8+, and CD19+ cells in splenocytes. These findings suggested that IPE has immunomodulatory effects and could be developed as an immunomodulatory supplement.
Administration, Oral ; Cell Proliferation ; Cytokines ; Ethanol* ; Gene Expression ; Humans ; Ice* ; In Vitro Techniques ; Interleukin-6 ; Jurkat Cells ; Lymphocytes ; Macrophages ; Mesembryanthemum* ; Nitric Oxide

PURPOSE: Although heart failure (HF) is recognized as a leading contributor to healthcare costs and a significant economic burden worldwide, studies of HF-related costs in South Korea are limited. This study aimed to estimate HF-related costs per Korean patient per year and per visit. MATERIALS AND METHODS: This retrospective cohort study analyzed data obtained from six hospitals in South Korea. Patients with HF who experienced ≥one hospitalization or ≥two outpatient visits between January 1, 2013 and December 31, 2013 were included. Patients were followed up for 1 year [in Korean won (KRW)]. RESULTS: Among a total of 500 patients (mean age, 66.1 years; male sex, 54.4%), the mean 1-year HF-related cost per patient was KRW 2,607,173, which included both, outpatient care (KRW 952,863) and inpatient care (KRW 1,654,309). During the post-index period, 22.2% of patients had at least one hospitalization, and their 1-year costs per patient (KRW 8,530,290) were higher than those of patients who had only visited a hospital over a 12-month period (77.8%; KRW 917,029). Among 111 hospitalized patients, the 1-year costs were 1.7-fold greater in patients (n=52) who were admitted to the hospital via the emergency department (ED) than in those (n=59) who were not (KRW 11,040,453 vs. KRW 6,317,942; p<0.001). CONCLUSION: The majority of healthcare costs for HF patients in South Korea was related to hospitalization, especially admissions via the ED. Appropriate treatment strategies including modification of risk factors to prevent or decrease hospitalization are needed to reduce the economic burden on HF patients.
Ambulatory Care ; Cohort Studies* ; Delivery of Health Care* ; Emergency Service, Hospital ; Health Care Costs* ; Heart Failure* ; Heart* ; Hospitalization ; Humans ; Inpatients ; Korea* ; Male ; Outpatients ; Retrospective Studies* ; Risk Factors

BACKGROUND: Methyl alcohol poisoning has been mainly reported in community. Two cases of methyl alcohol poisoning occurred in a small-sized subcontracted factory which manufactured smartphone parts in Korea. CASE PRESENTATION: One young female patient presented with dyspnea and visual disturbance. Another young male patient presented with visual disturbance and myalgia. They treated with sodium bicarbonate infusion and hemodialysis for metabolic acidosis. In addition, he received ethyl alcohol per oral treatment. Her and his urinary methyl alcohol concentration was detected as 7.632 mg/L, 46.8 mg/L, respectively, although they were treated hemodialysis. Results of the working environment measurement showed that the concentration of methyl alcohol (1030.1–2220.5 ppm) in the air exceeded the time weighted average (200 ppm). They were diagnosed with optic neuropathy due to methyl alcohol poisoning and still have visual impairment. CONCLUSIONS: Workers who hired as dispatched employees in a small-sized subcontracted factory were exposed to high concentrations of methyl alcohol. The workplace had poor ventilation system. In addition, workers did not wear proper personal protect equipment. Working environment measurement and annual chekups for workers were not performed. They were in a blind spot to occupational safety and health. More attention is needed to protect vulnerable workers’ health.
Acidosis ; Aluminum* ; Dyspnea ; Ethanol ; Female ; Humans ; Inhalation* ; Korea ; Male ; Methanol* ; Myalgia ; Occupational Health ; Optic Disk ; Optic Nerve Diseases ; Poisoning ; Renal Dialysis ; Smartphone ; Sodium Bicarbonate ; Ventilation ; Vision Disorders

PURPOSE: The impact of obesity on the surgical outcomes of Asian patients undergoing laparoscopic colon surgery is not clear. The purpose was to evaluate the outcome of laparoscopic surgery in obese Asian patients with colon cancer.METHODS: We retrospectively reviewed the prospectively collected data of 1,740 consecutive patients who underwent laparoscopic surgery for colon cancer between January 2008 and December 2010. Patients were classified according to the categories proposed by the International Obesity Task Force, Non-obese (body mass index [BMI]<25.0 kg/m2), Obese-I (BMI, 25.0–29.9 kg/m2), and Obese-II (BMI≥30 kg/m2). Surgical outcomes, including open conversion, operative time, and postoperative hospital stay, were compared in the Non-obese, Obese-I, and Obese-II patients.RESULTS: Of the 1,192 patients in the study, 812 (68.1%), 360 (30.2%), and 20 (1.7%), were classified as Non-obese, Obese-I, and Obese-II, respectively. The Obese-II group had higher conversion rates (10.0% vs. 3.6% and 1.6%, P=0.008) and, longer operative times (180.35 vs. 162.54 and 147.84 minutes, P<0.001) than the Obese-I and Non-obese group. However, the other postoperative outcomes were not significantly different. The overall survival and disease-free survival were not significantly different between groups (P=0.952). Multivariate analysis showed that the independent risk factor for conversion were BMI, total operative time, previous operative history, and cancer perforation.CONCLUSION: The outcomes of laparoscopic colon surgery in obese patients are similar to those of non-obese patients, offering all the benefits of a minimally invasive approach. However, the conversion rate was higher in obese patients. It is therefore very important for surgeons to be aware of these risks during laparoscopic colon surgery in obese patients.
Advisory Committees ; Asian Continental Ancestry Group ; Colectomy ; Colon ; Colonic Neoplasms ; Disease-Free Survival ; Humans ; Laparoscopy ; Length of Stay ; Multivariate Analysis ; Obesity ; Observational Study ; Operative Time ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Surgeons

PURPOSE: Spinocerebellar ataxias (SCAs) are progressive neurodegenerative disorders with diverse modes of inheritance. There are several subtypes of SCAs. SCA 8, SCA 12, and SCA 17 are the less common forms of SCAs with limited information available on their epidemiological profiles in Korea. The purpose of this study was to investigate the prevalence of SCA8, SCA12, and SCA17 in Korea. MATERIALS AND METHODS: Ninety-six unrelated Korean patients were enrolled and showed normal trinucleotide repeats through polymerase-chain reaction (PCR) for the genes ATXN1, ATXN2, ATXN3, CACNA1A , and ATXN7, which correspond to SCA1, SCA2, SCA3, SCA6, and SCA7, respectively. PCR products from patients were further analyzed by capillary electrophoresis using fluorescence labeled primers for the genes ATXN8OS, PPP2R2B, and TBP, which correspond to SCA8, SCA12, and SCA17. RESULTS: Three patients had 104, 97, and 75 abnormal expanded repeats in the ATXN8OS gene, the causative gene for SCA8. None of the patients exhibited abnormal repeats in SCA12 and SCA17. Normal trinucleotide repeat ranges of the cohort in this study were estimated to be 17-34 copies (average, 24+/-4 copies) for SCA8, 7-18 copies (average, 13+/-3 copies) for SCA12, and 26-43 copies (average, 35+/-2 copies) for SCA17. CONCLUSION: This study demonstrated that SCA8, SCA12, and SCA17 are rare in Korean patients with SCA, and further genetic studies are warranted to enhance the mutation detection rate in the Korean SCA population.
Asian Continental Ancestry Group ; Cohort Studies ; Electrophoresis, Capillary ; Fluorescence ; Humans ; Korea ; Neurodegenerative Diseases ; Polymerase Chain Reaction ; Prevalence ; Repetitive Sequences, Nucleic Acid* ; Spinocerebellar Ataxias* ; Trinucleotide Repeats ; Wills

PURPOSE: Some patients who undergo surgical resection of pancreatic cancer survive longer than other patients. The purpose of this study was to identify the factors that affect long-term survival after resection of histopathologically confirmed pancreatic ductal adenocarcinoma. METHODS: A single-center, retrospective study was conducted among 164 patients who underwent surgical resection of pancreatic cancer, between May 1995 and December 2004. The patient follow-up process was conducted via telephone survey and review of electronic medical records for at least 5 years or until death. RESULTS: We compared patients with long-term (> or =60 months, n = 19) and short-term survival (<60 months, n = 145). Resection margin status, differentiation of the tumor, tumor stage, pre-operative serum level of albumin, total bilirubin and carbohydrate antigen (CA) 19-9 level are related with survival difference (all factors, P < 0.05). Multivariate analysis revealed that a pre-operative serum total bilirubin level <7 mg/dL and a pre-operative serum CA19-9 level <37 U/mL is a statistically significant prognostic factor for long-term survival. CONCLUSION: The preoperative serum total bilirubin and serum CA19-9 levels are associated with long-term survival after surgical resection of pancreatic cancer.
Adenocarcinoma ; Bilirubin ; Electronic Health Records ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Pancreatic Ducts ; Pancreatic Neoplasms ; Retrospective Studies ; Telephone

To investigate potential health risks associated with exposure to metals from an abandoned metal mine, the authors studied people living near an abandoned mine (n=102) and control groups (n=149). Levels of cadmium, copper, arsenic, lead, and zinc were measured in the air, soil, drinking water, and agricultural products. To assess individual exposure, biomarkers of each metal in blood and urine were measured. beta2-microglobulin, alpha1-microglobulin, and N-acetyl-beta-glucosaminidase and bone mineral density were measured. Surface soil in the study area showed 2-10 times higher levels of metals compared to that of the control area. Metal concentrations in the groundwater and air did not show any notable differences between groups. Mean concentrations of cadmium and copper in rice and barley from the study area were significantly higher than those of the control area (p<0.05). Geometric means of blood and urine cadmium in the study area were 2.9 microgram/L and 1.5 microgram/g Cr, respectively, significantly higher than those in the control area (p<0.05). There were no differences in the levels of urinary markers of early kidney dysfunction and bone mineral density. The authors conclude that the residents near the abandoned mine were exposed to higher levels of metals through various routes.
Aged ; Cadmium/*blood/*urine ; Copper/blood/urine ; Environmental Exposure ; *Environmental Monitoring ; Female ; *Food Contamination ; Hordeum ; Humans ; Korea ; Lead/blood/urine ; Male ; Middle Aged ; *Mining ; Oryza sativa ; Risk Factors ; Soil Pollutants/analysis ; Water Pollutants, Chemical/analysis ; Zinc/blood/urine

A system to non-invasively fix and monitor eye by a head mounted display (HMD) with a CCD camera for stereotactic radiotherapy (SRS) of uveal melanoma has been developed and implemented clinically. The eye fixing and monitoring system consists of a HMD showing patient a screen for fixing eyeball, a CCD camera monitoring patient' s eyeball, and an immobilization mask. At first, patient' s head was immobilized with a mask. Then, patient was instructed to wear HMD, to which CCD camera was attached, on the mask and see the given reference point on its screen. While patient stared at the given point in order to fix eyeball, the camera monitored its motion. Four volunteers and one patient of uveal melanoma for SRS came into this study. For the volunteers, setup errors and the motion of eyeball were analyzed. For the patient, CT scans were performed, with patient' s wearing HMD and fixing the eye to the given point. To treat patient under the same condition, daily CT scans were also performed before every treatment and the motion of lens was compared to the planning CT. Setup errors for four volunteers were within 1 mm and the motion of eyeball was fixed within the clinically acceptable ranges. For the patient with uveal melanoma, the motion of lens was fixed within 2 mm from daily CT scans. An eye fixing and monitoring system allowed immobilizing patient as well as monitoring eyeball and was successfully implemented in the treatment of uveal melanoma for SRS.
Head* ; Humans ; Immobilization ; Masks ; Melanoma ; Radiotherapy ; Tomography, X-Ray Computed ; Volunteers

A 39-year-old man with a history of hypertension for 10 years and 10 pack-years smoking, was admitted with dyspnea and generalized edema. On admission, renal insufficiency accompanied with nephrotic syndrome was diagnosed. Even on careful examination including history, blood chemistry test, and fundoscopic examination, no clinical evidence of diabetes was found. Renal biopsy findings, which strongly resembled that of diabetic nodular glomerulosclerosis in microscopic features, showed glomerular hypertrophy and nodular mesangeal sclerosis. Additional immunohistochemistry and ultrastructural investigations excluded other possible diseases that should be differentiated; membranoproliferative glomerulonephritis, thrombotic microangiopathy, amyloidosis, monoclonal immunoglobulin deposition disease, fibrillary glomerulonephritis, and immunotactoid glomerulopathy. Idiopathic nodular glomerulosclerosis is histopathologically similar to nodular diabetic glomerulosclerosis but is unusually developed in persons with hypertension and smoking history. Though there were three reports about cases of nodular glomerulosclerosis in the Korean literature, the cases were related to hepatitis B virus or diabetic retinopathy without overt diabetes. We report a rare case of idiopathic nodular glomerulosclerosis that was related to hypertension and smoking without other medical history.
Adult ; Amyloidosis ; Biopsy ; Chemistry ; Diabetic Nephropathies* ; Diabetic Retinopathy ; Dyspnea ; Edema ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative ; Hepatitis B virus ; Humans ; Hypertension* ; Hypertrophy ; Immunoglobulins ; Immunohistochemistry ; Nephrotic Syndrome ; Renal Insufficiency ; Sclerosis ; Smoke* ; Smoking* ; Thrombotic Microangiopathies