Purpose: Studies have yielded contradictory results on whether donor sex and donor-recipient sex disparity affect hepatocellular carcinoma (HCC) recurrence after living donor liver transplantation (LDLT). The present study assessed whether donor sex or donor-recipient sex disparity affects HCC recurrence after LDLT at a high-volume center. Methods: This study included 772 HCC patients who underwent LDLT between January 2006 and December 2015 at Asan Medical Center. Patients were divided into 4 groups based on the sex of the donor and recipient: male-to-male (n = 490, 63.5%), male-to-female (n = 75, 9.7%), female-to-male (n = 170, 22.0%), and female-to-female (n = 37, 4.8%). Results: Disease-free survival (DFS; P = 0.372) and overall survival (OS; P = 0.591) did not differ significantly among the 4 groups. DFS also did not differ significantly between LDLT recipients with male and female donors (P = 0.792) or between male and female recipients (P = 0.084). After patient matching with an α-FP/des-γ-carboxy prothrombin/tumor volume score cutoff of 5logs, donor-recipient sex disparity did not significantly affect DFS (P = 0.598) or OS (P = 0.777). There were also no differences in DFS in matched LDLT recipients with male and female donors (P = 0.312) or between male and female recipients (P = 0.374). Conclusion Neither donor sex nor donor-recipient sex disparity significantly affected posttransplant HCC recurrence.

BACKGROUND AND OBJECTIVES: A risk prediction is needed even in the contemporary era of acute myocardial infarction (AMI). We sought to develop a risk scoring specific for patients with AMI being treated with guideline-adherent optimal therapies, including percutaneous coronary intervention and all 5 medications (aspirin, thienopyridine, β-blocker, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and statin). METHODS: From registries, 12,174 AMI patients were evaluated. The primary outcome was 1-year all-cause death or AMI. The Korea Working Group in Myocardial Infarction (KorMI) system was compared with the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX AMI), Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC), and Global Registry of Acute Coronary Events scores (GRACE) models. RESULTS: Ten predictors were identified: left ventricular dysfunction (hazard ratio [HR], 2.3), bare-metal stent (HR, 2.0), Killip class ≥II (HR, 1.9), renal insufficiency (HR, 1.8), previous stroke (HR, 1.6), regional wall-motion- score >20 on echocardiography (HR, 1.5), body mass index ≤24 kg/m2 (HR, 1.4), age ≥70 years (HR, 1.4), prior coronary heart disease (HR, 1.4), and diabetes (HR, 1.4). Compared with the previous models, the KorMI system had good discrimination (time-dependent C statistic, 0.759) and showed reasonable goodness-of-fit by Hosmer-Lemeshow test (p=0.84). Moreover, the continuous-net reclassification improvement varied from −27.3% to −19.1%, the integrated discrimination index varied from −2.1% to −0.9%, and the median improvement in risk score was from −1.0% to −0.4%. CONCLUSIONS: The KorMI system would be a useful tool for predicting outcomes in survivors treated with guideline-adherent optimal therapies after AMI.
Angioplasty ; Angiotensins ; Body Mass Index ; Coronary Disease ; Discrimination (Psychology) ; Drug Therapy ; Echocardiography ; Humans ; Korea ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Registries ; Renal Insufficiency ; Stents ; Stroke ; Survivors ; Ventricular Dysfunction, Left

BACKGROUND AND OBJECTIVES: A risk prediction is needed even in the contemporary era of acute myocardial infarction (AMI). We sought to develop a risk scoring specific for patients with AMI being treated with guideline-adherent optimal therapies, including percutaneous coronary intervention and all 5 medications (aspirin, thienopyridine, β-blocker, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and statin). METHODS: From registries, 12,174 AMI patients were evaluated. The primary outcome was 1-year all-cause death or AMI. The Korea Working Group in Myocardial Infarction (KorMI) system was compared with the Assessment of Pexelizumab in Acute Myocardial Infarction (APEX AMI), Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC), and Global Registry of Acute Coronary Events scores (GRACE) models. RESULTS: Ten predictors were identified: left ventricular dysfunction (hazard ratio [HR], 2.3), bare-metal stent (HR, 2.0), Killip class ≥II (HR, 1.9), renal insufficiency (HR, 1.8), previous stroke (HR, 1.6), regional wall-motion- score >20 on echocardiography (HR, 1.5), body mass index ≤24 kg/m2 (HR, 1.4), age ≥70 years (HR, 1.4), prior coronary heart disease (HR, 1.4), and diabetes (HR, 1.4). Compared with the previous models, the KorMI system had good discrimination (time-dependent C statistic, 0.759) and showed reasonable goodness-of-fit by Hosmer-Lemeshow test (p=0.84). Moreover, the continuous-net reclassification improvement varied from −27.3% to −19.1%, the integrated discrimination index varied from −2.1% to −0.9%, and the median improvement in risk score was from −1.0% to −0.4%. CONCLUSIONS The KorMI system would be a useful tool for predicting outcomes in survivors treated with guideline-adherent optimal therapies after AMI.

OBJECTIVE: To investigate the efficacy of portable microcurrent therapy device (PMTD) of the hip internal rotators in the treatment of in-toeing gait caused by increased femoral anteversion in children over 8 years of age. METHODS: Eleven children (22 legs; 4 boys and 7 girls; mean age, 10.4±1.6 years) with in-toeing gait caused by increased femoral anteversion were included in the present study. All children received 60 minutes of PMTD (intensity, 25 µA; frequency, 8 Hz) applied to the hip internal rotators daily for 4 weeks. Hip internal rotation (IR) angle, external rotation (ER) angle, and midmalleolar-second toe angle (MSTA) measurement during stance phase at transverse plane and Family Satisfaction Questionnaire, frequency of tripping and fatigue like pains about the PMTD were performed before treatment and at 4 weeks after initial PMTD treatment. Paired t-test and Fisher exact test were used for statistical analysis. RESULTS: Hip IR/ER/MSTA was 70.3°±5.4°/20.1°±5.5°/–11.4°±2.7°, and 55.7°±7.8°/33.6°±8.2°/–2.6°±3.8° before treatment and at 4 weeks after initial PMTD treatment, respectively (p<0.01). Ten of 11 (91%) children's family stated that they were generally satisfied with the PMTD treatment. The frequency of tripping and fatigue like pains was significantly lower at 4 weeks after PMTD treatment (p<0.05). Excellent inter-rater and intra-rater reliability was observed for repeated MSTA measurements between the examiners (k=0.91–0.96 and k=0.93–0.99), respectively. CONCLUSION: PMTD of the hip internal rotators can be effective in improving the gait pattern of children with in-toeing gait caused by increased femoral anteversion.
Bone Anteversion ; Child* ; Electric Stimulation Therapy ; Fatigue ; Female ; Gait* ; Hip ; Humans ; Leg ; Pilot Projects* ; Toes

PURPOSE: Postpartum depression (PPD) is a common postnatal problem. PPD has a negative influence on maternal functioning and child development. We examined the result of Edinburgh Postnatal Depression Scale (EPDS) after delivery. METHODS: Three hundred two postpartum mothers were enrolled in the study. The Korean version of EPDS was completed and scored at postpartum visits. Mothers whose score was 10 or more were classified as an EPDS positive for PPD. We reviewed their medical records and determined risk factors for positive EPDS result. RESULTS: The positive rate of EPDS was 27.8% (84/302). Among various factors, a newborn's body weight more than 4.0 kg was statistically related to the positive result. The positive rate of EPDS was significantly higher when performed within postpartum 60 days than after postpartum 60 days. Among 84 positive women, only three mothers visited a psychiatric clinic for further evaluation and management of PPD. CONCLUSION: The EPDS was a useful tool for PPD screening. Obstetricians should consider an EPDS for effective screening of PPD. It would be the next important issue to encourage a screening positive mother to visit a psychiatric clinic.
Body Weight ; Child ; Child Development ; Depression, Postpartum* ; Female ; Humans ; Mass Screening ; Medical Records ; Mothers ; Postpartum Period ; Risk Factors

A 27-year-old man with bacterial endocarditis of the mitral valve and embolic episodes was bound to have a large right coronary artery fistula communicating with the left ventricle, immediately inferior to the posterior mitral annulus. The perforation of the posterior leaflet and coronary arteriovenous fistula was identified using two-dimensional Doppler echocardiography. The diagnosis was confirmed by coronary angiography, and the patient underwent a successful operation.
Arteriovenous Fistula ; Coronary Angiography ; Coronary Vessel Anomalies ; Coronary Vessels ; Echocardiography, Doppler ; Endocarditis ; Endocarditis, Bacterial ; Fistula ; Heart Ventricles ; Humans ; Mitral Valve

A 29-year-old man suffering from dyspnea and eosinophilic pleural effusion after being on warfarin for pulmonary thromboembolism for a period of one month, was readmitted to our hospital. Etiology of pleural effusion other than warfarin was excluded. To the best of our knowledge, this is the first case of warfarin-induced pleural effusion reported in Korea.
Adult ; Dyspnea ; Eosinophils ; Humans ; Korea ; Pleural Effusion ; Pulmonary Embolism ; Stress, Psychological ; Warfarin

A 29-year-old man suffering from dyspnea and eosinophilic pleural effusion after being on warfarin for pulmonary thromboembolism for a period of one month, was readmitted to our hospital. Etiology of pleural effusion other than warfarin was excluded. To the best of our knowledge, this is the first case of warfarin-induced pleural effusion reported in Korea.
Adult ; Dyspnea ; Eosinophils ; Humans ; Korea ; Pleural Effusion ; Pulmonary Embolism ; Stress, Psychological ; Warfarin

BACKGROUND: Little is known about the characteristics of tattoos on prisoners. OBJECTIVE: Our purpose was to investigate the clinical characteristics of tattooed prisoners and compare them with other previously reported data. METHODS: Between November 2006 and August 2010, we selected 98 tattooed men in a correctional institution in Seoul and investigated their personal and clinical information, including the average age of their first tattoo, sites of tattoos, contents of tattoos, motivations for getting tattooed, removal of tattoos, and occurrences of medical complications, etc. RESULTS: The most common educational level was the high school graduated group (39.8%). Most tattooed prisoners had a religion (83.7%). Thirty-three of the men (33.7%) had self-injuries. The average age of their first tattoo was 18.5 years, and the average number of tattoos was 2.7. Fifty-three of the tattooed prisoners (54.1%) were first-time offenders. There was a correlation between the number of tattoos and the rate of recidivism. Left arm was the most common site of tattoos (23.6%). Most of the tattoos were performed by others, especially friends (56.1%). Half of the prisoners received their tattoos in society. The most common tattoo material was Chinese ink (41.8%), and the most common motivation for getting tattoos was curiosity (48.0%). Among the various contents of the tattoos, letters were the most frequent (28.1%). Complications were observed in 16 cases (16.3%); hypertrophic scar, keloid, local skin infections, and allergic reactions such as itching. Most of the tattooed prisoners had regrets (80.6%) and requested tattoo removal. Embarrassment was the most common motivation for tattoo removal (35.4%). Removal of tattoos was attempted in 37 cases (37.8%). CONCLUSION: Most of the study results are compatible with those of previous studies. However, education level, religion, and contents of tattoos were slightly different. Further, we obtained new information regarding motivation for tattoo removal, correlation between the number of tattoos and number of crimes, and the attitudes toward their tattoos. We hope the obtained results will be helpful for understanding people with tattoos tattoo in a correctional institution.
Arm ; Asian Continental Ancestry Group ; Carbon ; Cicatrix, Hypertrophic ; Crime ; Criminals ; Exploratory Behavior ; Friends ; Humans ; Hypersensitivity ; Ink ; Keloid ; Male ; Motivation ; Prisoners ; Prisons ; Pruritus ; Skin

BACKGROUND/AIMS: Many previously published articles have reported poor outcomes for young patients with colorectal cancer as compared to that of older patients with colorectal cancer. However, these studies have tended to be small and have various biases. This study was retrospectively designed to determine the clinical course and survival rate of young patient with colorectal cancer. METHODS: All the patients who underwent surgery for colorectal cancer at Hanyang University Hospital between 1995 and 2001 were identified. These patients were assigned to two age groups: the 45 years old and below 45 years old group (123 patients) and the group over the age of 45 (421 patients). RESULTS: The size of the tumor mass was significantly larger in the young group. There were no significant differences between the two groups for the stage at the time of diagnosis, the differentiation, the degree of lymph node involvement, the cancer location and the gross finding. The median cancer specific survival time was worse for the old group as compared with that of the young group. Age, differentiation, lymph node involvement and the Duke stage were the significant prognostic factors on univariate analysis. Age and the Duke stage were the independent prognostic factors that were significantly correlated with survival on the multivariate analysis using the Cox proportional hazard model. CONCLUSIONS: Contrary to prior reports, younger patients with colorectal cancer appear to have a better survival rate than that of older patients with colorectal cancer.
Aged ; Bias (Epidemiology) ; Colorectal Neoplasms ; Humans ; Korea ; Lymph Nodes ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Survival Rate