• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.2 no.2
• /
• pp.211-216
• /
• 1999

The esophageal hiatal hernia is a herniation of an abdominal organ, usually the stomach, through the esophageal hiatus into thoracic cavity. It is a rare disease, usually congenital and frequently associated with gastroesophageal reflux and other congenital malformations in children. It is classified according to their anatomic characteristics as type I (sliding hiatal hernia), type II (paraesophageal hiatal hernia), type III (combined hiatal hernia) and type IV (multiorgan hiatal hernia). We experienced a case of type III congenital esophageal hiatal hernia simulating chest mass on simple chest x-ray because of right intrathoracic stomach secondary to congenital esophageal hiatal hernia and organoaxial rotation in 10 months male. After the operation, he showed an improved general condition and was discharged at the 14th hospital day. We report the case with the brief review of the related literatures.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.6
• /
• pp.2901-2907
• /
• 2016

Background: Despite increasing debate about overdiagnosis and overtreatment of thyroid cancer in Korea, information to guide decisions on whether or not to undergo screening for and treatment of abnormal lesions of the thyroid is lacking. Moreover, studies have yet to outline what lay people know and want to know about thyroid cancer. The primary aim of this study was to explore general awareness of thyroid cancer among Korean women, their sources of information, and their satisfaction with the information they are provided. The secondary aim was to investigate information needs about thyroid cancer. Materials and Methods: A qualitative study using focus group interviews was conducted. Twenty-nine women were divided into four groups: (1) participants who had never undergone thyroid ultrasound screening; (2) those who had undergone screening, (3) those who continued to undergo regular check-ups with ultrasonography for benign nodules of the thyroid; and (4) participants who had undergone surgery for thyroid cancer. Results: A widespread lack of awareness of information on thyroid cancer was noted among participants in groups 1 and 2 who were not well aware of thyroid cancer and generally recognized it as a 'good cancer'. Surprisingly, instead of doctors and medical personnel, most participants reported obtaining information from acquaintances and media outlets. Moreover, most participants described dissatisfaction with their experience with screening and a lack of explanation on treatment and test results from medical personnel. Conclusions: Women in Korea seek reliable information on thyroid cancer that could help them to better understand the disease and make informed decisions regarding screening and treatment. More effort is needed from medical personnel to communicate the implications of thyroid cancer, screening results, and treatments thereof to lay people.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.14 no.2
• /
• pp.115-117
• /
• 2014

Septic pulmonary embolism is a rare disease entity that consists of pulmonary infection and embolism predominantly arising from endocarditis and thrombophlebitis. We report a rare case of candidal septic pulmonary embolism secondary to odontogenic infection in a previously healthy and immunocompetent man, who had a submandibular abscess with dyspnea and fever. The patient was not responsive to prolonged broad spectrum antibiotics and surgical drainage, however, antifungal therapy was successful after Candida albicans was confirmed by his blood culture. Since proper identification and the resolution of the septic origin is as important as the diagnosis of septic pulmonary embolism, in a patient with odontogenic infection, who shows definite respiratory complications despite antimicrobial therapy with surgical drainage, various culture examinations should be adopted.

• Journal of Oral Medicine and Pain
• /
• v.25 no.2
• /
• pp.159-165
• /
• 2000

Subsequent to an allogenic stem cell transplantation(ASCT) on patients with hematologic malignancy(AML, ALL, CML, multiple myeloma, lymphoma etc.), chronic GVHD(graft versus host disease), which is an immunological reaction, occurs. With treatment results from patients who were diagnosed with ALL(acute lymphocytic leukemia), undergone BMT(bone marrow transplantation) and showed oral and skin lesions due to GVHD, treatment of oral manifestations of leukemia and its general management were studied. 90% of patients with chronic GVHD show change in the oral mucosa causing oral manifestations such as leukoplakia, lichenoid change of the oral mucosa, mucosal atrophy, erythema, ulceration and xerostomia. In treating GVHD, extensive systemic immunosuppression cause bacterial, viral, fungal infection that are fatal, and even if the treatment is successful, the patient is already in a severe immunosuppressed state. Therefore, localized target therapy is preferred. In another words, topical application(rinse, cream, ointment etc.) of cyclosporin and steroid in treating oral chronic GVHD is highly recommended, and the use of PUVA(Psoralen Ultraviolet A) and thalidomide is reported to be effective. In treating such diseases, dental treatment to control pain and prevent secondary infection of oral manifestations is very important. To those patients with systemic diseases who show limited effect by general dental treatment, non-invasive treatment such as the dental laser, in addition to the use of drugs, may be necessary to actively treat pain and help the healing process. For greater results, new effective methods are to be developed for treatment.

• Journal of Radiation Industry
• /
• v.10 no.4
• /
• pp.181-187
• /
• 2016

Selective ${\beta}_1$-agonist and antagonists are used for the treatment of cardiac diseases including congestive heart failure, angina pectoris and arrhythmia. Selective ${\beta}_1$-antagonists including nebivolol have high binding affinity on ${\beta}_1$-adrenergic receptor, not ${\beta}_2$-receptor mainly expressed in smooth muscle. Nebivolol is one of most selective ${\beta}_1$-blockers in clinically used ${\beta}_1$-blockers including atenolol and bisoprolol. We tried to develop clinically useful cardiac PET tracers using a selective ${\beta}_1$-blocker. Nebivolol is $C_2$-symmetric and has two chromane moiety with a secondary amino alcohol and aromatic fluorine. We adopted the general synthetic strategy using epoxide ring opening reaction. Unlike formal synthesis of nebivolol, we prepared two chromane building blocks with fluorine and iodine which was transformed to diaryliodonium salt for labelling of $^{18}F$. Two epoxide building blocks were readily prepared from commercially available chromene carboxylic acids (1, 8). Then, the amino alcohol building block (15) was prepared by ammonolysis of epoxide (14) followed by coupling reaction with the other building block, epoxide (7). Diaryliodonium salt, a precursor for $^{18}F$-aromatic substitution, was synthesized in moderate yield which was readily subjected to $^{18}F$-aromatic substitution to give $^{18}F$-labelled nebivolol.

• Experimental and Molecular Medicine
• /
• v.50 no.11
• /
• pp.14.1-14.14
• /
• 2018

The link between antibiotic treatment and IF-associated liver disease (IFALD) is unclear. Here, we study the effect of antibiotic treatment on bile acid (BA) metabolism and investigate the involved mechanisms. The results showed that pediatric IF patients with cholestasis had a significantly lower abundance of BA-biotransforming bacteria than patients without cholestasis. In addition, the BA composition was altered in the serum, feces, and liver of pediatric IF patients with cholestasis, as reflected by the increased proportion of primary BAs. In the ileum, farnesoid X receptor (FXR) expression was reduced in patients with cholestasis. Correspondingly, the serum FGF19 levels decreased significantly in patients with cholestasis. In the liver, the expression of the rate-limiting enzyme in bile salt synthesis, cytochrome P450 7a1 (CYP7A1), increased noticeably in IF patients with cholestasis. In mice, we showed that oral antibiotics (gentamicin, GM or vancomycin, VCM) reduced colonic microbial diversity, with a decrease in both Gram-negative bacteria (GM affected Eubacterium and Bacteroides) and Gram-positive bacteria (VCM affected Clostridium, Bifidobacterium and Lactobacillus). Concomitantly, treatment with GM or VCM decreased secondary BAs in the colonic contents, with a simultaneous increase in primary BAs in plasma. Moreover, the changes in the colonic BA profile especially that of tauro-beta-muricholic acid ($T{\beta}MCA$), were predominantly associated with the inhibition of the FXR and further altered BA synthesis and transport. In conclusion, the administration of antibiotics significantly decreased the intestinal microbiota diversity and subsequently altered the BA composition. The alterations in BA composition contributed to cholestasis in IF patients by regulating FXR signaling.

• Kidney Research and Clinical Practice
• /
• v.37 no.4
• /
• pp.347-355
• /
• 2018

Background: Nephrotic syndrome (NS) is the most common glomerulopathy in children. Acute kidney injury (AKI) is a common complication of NS, caused by severe intravascular volume depletion, acute tubular necrosis, interstitial nephritis, or progression of NS. However, the incidence and risk factors of childhood-onset NS in Korea are unclear. Therefore, we studied the incidence, causes, and risk factors of AKI in hospitalized Korean patients with childhood-onset NS. Methods: We conducted a retrospective review of patients with childhood-onset NS who were admitted to our center from January 2015 to July 2017. Patients with decreased renal function or hereditary/secondary NS, as well as those admitted for management of other conditions unrelated to NS, were excluded. Results: During the study period, 65 patients with idiopathic, childhood-onset NS were hospitalized 90 times for management of NS or its complications. Of these 90 cases, 29 met the Kidney Disease Improving Global Outcomes criteria for AKI (32.2%). They developed AKI in association with infection (n = 12), NS aggravation (n = 11), dehydration (n = 3), and intravenous methylprednisolone administration (n = 3). Age ${\geq}9$ years at admission and combined use of cyclosporine and renin-angiotensin system inhibitors were risk factors for AKI. Conclusion: AKI occurred in one-third of the total hospitalizations related to childhood-onset NS, owing to infection, aggravation of NS, dehydration, and possibly high-dose methylprednisolone treatment. Age at admission and use of nephrotoxic agents were associated with AKI. As the AKI incidence is high, AKI should be considered during management of high-risk patients.

• Clinical and Experimental Reproductive Medicine
• /
• v.32 no.3
• /
• pp.223-230
• /
• 2005

Objective: This study was performed to evaluate the accuracy of hysterosalpingography (HSG) for evaluating female infertility patients by comparison with hysteroscopic and laparoscopic examination. Methods and Material: Total 219 infertile patients were retrospectively analyzed between January 1, 2002 and December 31, 2003. Ninety seven patients (44.3%) were primary infertility, 122 patients (55.7%) were secondary infertility. We performed hysteroscopic and laparoscopic examination on next cycle when HSG revealed any abnormal finding, and 3~6 cycles later if HSG was normal. Results: The accuracy of HSG was 65.2% compared with hysteroscopic examination (sensitivity 88.4%, specificity 46.4%, false positive rate 53.6%, false negative rate 11.6%). The most common abnormal finding of hysteroscopy was uterine synechia (67.4%) followed by endometrial polyp, uterine anomaly (e.g. uterine septum), endometrial hyperplasia. Compared with laparoscopic examination, the accuracy of HSG was 76.9% (sensitivity 98.9%, specificity 70.6%, +LR 3.36, -LR 0.02). The positive predictive value of normal patent tube was excellent (99.6%) but that of proximal tubal blockage was only 46.7%. The unilateral tubal obstruction of HSG was poor accuracy (+LR 3.85 -LR 0.68) and 70% of those was patent by laparoscopic examination. Laparoscopic examination also revealed that 53% of patients had peritubal adhesion and 37% of patients has additional pelvic findings, especially endometriosis. Among the patients had normal HSG, 53.5% patients with normal ultrasonography was diagnosed endometriosis (25.6% of them had endometriosis stage I-II). Conclusion: Normal HSG shows a high negative predictive value. Nevertheless, the incidence of associated pelvic disease in the normal HSG group is high enough to warrant diagnostic laparoscopy if nonsurgical treatment is unsuccessful. Because HSG has poor accuracy in predicting distal tubal blockage and peritubal adhesion, and poor positive predictive value of proximal tubal blockage, laparoscopic examination could be considered in abnormal HSG group.

• Tuberculosis and Respiratory Diseases
• /
• v.84 no.4
• /
• pp.299-316
• /
• 2021

Background: The lack of effective medications for coronavirus disease 2019 (COVID-19) has led to a trend of drug repurposing such as the case of azithromycin which shows immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results. It is currently unclear whether the available evidence is in favor or against the use of azithromycin in COVID-19 patients. Thus, the aim of this study was to investigate the efficacy and safety of azithromycin in COVID-19 patients. Methods: Four independent reviewers selected relevant studies from PubMed, ScienceDirect, EBSCO, and ProQuest published prior to March 2021. The protocol used in this study has been registered in PROSPERO (CRD42020224967). Results: We included 17 studies and found that the mortality rate (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.76-1.19), need of respiratory support (OR, 1.30; 95% CI, 0.98-1.73), hospitalization rate (standardized mean difference, 0.12; 95% CI, -0.02 to 0.27), and intensive care unit transfer (OR, 1.21; 95% CI, 0.79-1.86) of azithromycin-treated group did not differ significantly (p>0.05) from those of the control group. Azithromycin treatment did not significantly increase the risk of getting secondary infection (OR, 1.23; 95% CI, 0.83-1.82), hypoglycemia (OR, 0.73; 95% CI, 0.38-1.40), gastrointestinal problems (OR, 1.03; 95% CI, 0.73-1.45) or electrocardiogram abnormalities (OR, 1.16; 95% CI, 0.94-1.42). The overall quality of evidence ranged from low to very low. Conclusion: Azithromycin did not result in a superior clinical improvement in COVID-19 patients, although it was well-tolerated and safe to use.

• Journal of Convergence for Information Technology
• /
• v.11 no.11
• /
• pp.210-218
• /
• 2021

This study was conducted to provide a basis for developing strategies to improve the intention to quit smoking by identifying the factors affecting the smoking cessation intention of male smokers living in Seoul who have not tried to quit smoking in the past year. The components of the planned behavioral theory were used to identify the influencing factors. The research data were analysed secondary data used in the study performed by the Korea Centers for Disease Control and Prevention in 2020. As a result of the univariate analysis, the factors affecting the smoking cessation intention rate were the average daily smoking amount and the components of the TPB. As a result of multivariate logistic regression analysis, the subjective norm and the perceived behavior control factor among the components of the TPB had statistically significant differences. Therefore, in order to increase the intention to quit smoking, it would be effective to use strategies that strengthen the strong recommendations from significant others and the smoker's self control.