The importance of the thyroid hormone axis in the regulation of skeletal growth and maintenance has been well established from clinical studies involving patients with mutations in proteins that regulate synthesis and...The importance of the thyroid hormone axis in the regulation of skeletal growth and maintenance has been well established from clinical studies involving patients with mutations in proteins that regulate synthesis and/or actions of thyroid hormone.Data from genetic mouse models involving disruption and overexpression of components of the thyroid hormone axis also provide direct support for a key role for thyroid hormone in the regulation of bone metabolism.Thyroid hormone regulates proliferation and/or differentiated actions of multiple cell types in bone including chondrocytes,osteoblasts and osteoclasts.Thyroid hormone effects on the target cells are mediated via ligand-inducible nuclear receptors/transcription factors,thyroid hormone receptor(TR) α and β,of which TRα seems to be critically important in regulating bone cell functions.In terms of mechanisms for thyroid hormone action,studies suggest that thyroid hormone regulates a number of key growth factor signaling pathways including insulin-like growth factor-I,parathyroid hormone related protein,fibroblast growth factor,Indian hedgehog and Wnt to influence skeletal growth.In this review we describe findings from various genetic mouse models and clinical mutations of thyroid hormone signaling related mutations in humans that pertain to the role and mechanism of action of thyroid hormone in the regulation of skeletal growth and maintenance.展开更多
Endoscopic submucosal dissection(ESD) is a widely accepted treatment for early gastric cancer(EGC),especially in Korea and Japan.The criteria for the therapeutic use of ESD for EGC have been expanded recently.However,...Endoscopic submucosal dissection(ESD) is a widely accepted treatment for early gastric cancer(EGC),especially in Korea and Japan.The criteria for the therapeutic use of ESD for EGC have been expanded recently.However,attention should be drawn to the technical feasibility of the ESD treatment which depends on a lesion's location,size or fibrosis level,or operator's experience.In the case of a lesion with a high level of difficulty,a more experienced operator is required.Thus,the treatment for a lesion with a high level of difficulty should be performed according to the degree of the operator's experience.In this paper,the authors describe the ESD procedure for lesions with a high level of difficulty.展开更多
AIM to evaluate gender differences in the aspect of ghrelin,nociception-related genes and psychological aspects and the quality of life(Qo L) in Korean functional dyspepsia(FD) patients.METHODS Total of 191 persons we...AIM to evaluate gender differences in the aspect of ghrelin,nociception-related genes and psychological aspects and the quality of life(Qo L) in Korean functional dyspepsia(FD) patients.METHODS Total of 191 persons were prospectively enrolled between March 2013 and May 2016 in Seoul National Bundang Hospital,and classified into control and FD group based on ROME Ⅲ criteria. Questionnaire included assessment for dyspepsia symptoms,Qo L and anxiety or depression. Preproghrelin and nociception genes in the gastric mucosa and plasma acyl/des-acyl ghrelin were measured. RESULTS Lower level of plasma acyl ghrelin in FD patients compared to control was significant only in male(15.9 fmol/m L vs 10.4 fmol/m L,P = 0.017). Significantly higher m RNA expressions of nerve growth factor and transient receptor potential vanilloid receptor 1 were observed in male(P = 0.002 and P = 0.014,respectively) than in female. In contrast,female FD patients had a higher anxiety and depression score than male FD(P = 0.029),and anxiety score was correlated with epigastric pain only in female FD patients(female: Spearman rho = 0.420,P = 0.037). The impairment of overall Qo L was more prominent in female FD patients than male patients(5.4 ± 0.3 vs 6.5 ± 0.3,P = 0.020). CONCLUSION Gender differences of ghrelin and nociception-related genes in male and psychological factors in female underlie FD symptoms. More careful assessment of psychological or emotional status is required particularly for the female FD patients.展开更多
Facial defect coverage is a common subject in the field of reconstructive surgery.There are many methods for facial defect reconstruction,and reconstructive surgeons should choose the most appropriate method on a case...Facial defect coverage is a common subject in the field of reconstructive surgery.There are many methods for facial defect reconstruction,and reconstructive surgeons should choose the most appropriate method on a case-by-case basis to achieve both functional and aesthetic improvement.Among various options for facial reconstruction,the local flap technique is considered the best reconstructive modality to provide good tissue matches of color and texture,which is consistent with the ideal goal of reconstruction(replacement of like-with-like).Keystone design perforator island flap(KDPIF),devised by Behan in 2003,has been applied to various fields of reconstructive surgery in the past decade due to its design simplicity,robust vascular supply,and reproducibility.Several studies have reported KDPIF reconstruction of facial defects,such as large parotid defects,small-to-moderate nasal defects,and eyelid defects.However,KDPIF has been used relatively less in facial defects than in other body regions,such as the trunk and extremities.The purpose of this review is to provide an organized overview of facial KDPIF reconstruction including the classification of KDPIF,modifications,physiology,mechanism of flap movement,consideration of facial relaxed skin tension lines and aesthetics,surgical techniques,clinical applications,and precautions for successful execution of KDPIF reconstruction.展开更多
Background:In 2014,an outbreak of adenoviral pneumonia occurred in the Korean military training center.However,there are limited data on the characteristics of the fever and its response to antipyretic therapy in immu...Background:In 2014,an outbreak of adenoviral pneumonia occurred in the Korean military training center.However,there are limited data on the characteristics of the fever and its response to antipyretic therapy in immunocompetent adults with adenovirus-positive community-acquired pneumonia(CAP).Methods:The medical records of the patients who were admitted to the Armed Forces Chuncheon Hospital for the treatment of CAP between January 2014 and December 2016 were retrospectively analyzed.The patients were divided into three groups,namely,the adenovirus-positive(Adv)group,the adenovirus-negative(Non-Adv)group and the unknown pathogen group,according to the results of a polymerase chain reaction(PCR)test and sputum culture used to measure adenovirus and other bacteria or viruses in respiratory specimens.We evaluated and compared the demographics,clinicolaboratory findings and radiological findings upon admission between the two groups.Results:Out of the 251 military personnel with CAP during the study periods,67 were classified into the Adv group,while 134 were classified into the Non-Adv group and 50 were classified into the unknown pathogen group.The patients in the Adv group had a longer duration of fever after admission((3.2±1.6)d vs.(1.9±1.2)d vs.(2.2±1.5)d,P=0.018)and symptom onset((5.8±2.2)d vs.(3.9±2.5)d vs.(3.7±2.0)d,P=0.006)than patients in the Non-Adv and unknown pathogen groups,respectively.The patients in the Adv group had a higher mean temperature at admission(37.8±0.3 vs.37.3±0.3 vs.37.3±0.3,P=0.005),and more patients were observed over 40 and 39 to 40(14.9%vs.2.2%vs.4.0%,35.8%vs.3.7%vs.6.0%,P<0.001)than those in the Non-Adv and unknown pathogen groups,respectively.The Adv group more commonly had no response or exhibited adverse events after antipyretic treatment compared to the Non-Adv group(17.9%vs.1.5%,35.0%vs.4.3%,P<0.001,P=0.05,respectively).In addition,the time from admission to overall clinical stabilization was significantly longer in the patients in the Adv group than in those in the Non-Adv group((4.3±2.8)d vs.(2.9±1.8)d,P=0.034,respectively).Furthermore,no significant difference in the length of hospital stay was observed between the two groups,and no patient died in either group.Conclusions:In this study,Adv-positive CAP in immunocompetent military personnel patients had distinct fever characteristics and responses to antipyretic treatment.展开更多
Background There are numerous but conflicting data regarding gender differences in outcomes following percutaneous coronary intervention(PCI). Furthermore, gender differences in clinical outcomes with acute myocardial...Background There are numerous but conflicting data regarding gender differences in outcomes following percutaneous coronary intervention(PCI). Furthermore, gender differences in clinical outcomes with acute myocardial infarction(AMI) following PCI in Asian population remain uncertain because of the under-representation of Asian in previous trials. Methods A total of 13,104 AMI patients from Korea Acute Myocardial Infarction Registry-National Institute of Health(KAMIR-NIH) between November 2011 and December 2015 were classified into male(n = 8021, 75.9%) and female(n = 2547, 24.1%). We compared the demographic, clinical and angiographic characteristics, 30-days and 1-year major adverse cardiac and cerebrovascular events(MACCE) in women with those in men after AMI by using propensity score(PS) matching. Results Compared with men, women were older, had more comorbidities and more often presented with non-ST segment elevation myocardial infarction(NSTEMI) and reduced left ventricular systolic function. Over the median follow-up of 363 days, gender differences in both 30-days and 1-year MACCE as well as thrombolysis in myocardial infarction minor bleeding risk were not observed in the PS matched population(30-days MACCE: 5.3% vs. 4.7%, log-rank P = 0.494, HR = 1.126, 95% CI: 0.800-1.585;1-year MACCE: 9.3% vs. 9.0%, log-rank P = 0.803, HR = 1.032, 95% CI: 0.802-1.328;TIMI minor bleeding: 4.9% vs. 3.9%, log-rank P = 0.215, HR = 1.255, 95% CI: 0.869-1.814). Conclusions Among Korean AMI population undergoing contemporary PCI, women, as compared with men, had different clinical and angiographic characteristics but showed similar 30-days and 1-year clinical outcomes. The risk of bleeding after PCI was comparable between men and women during one-year follow up.展开更多
BACKGROUND Endodermal sinus tumors(ESTs),which arise primarily in children and adolescents,account for 20%of malignant ovarian germ cell tumors,but constitute only 1%of all ovarian malignancies.Treatment of ESTs consi...BACKGROUND Endodermal sinus tumors(ESTs),which arise primarily in children and adolescents,account for 20%of malignant ovarian germ cell tumors,but constitute only 1%of all ovarian malignancies.Treatment of ESTs consists of surgical staging with fertility-sparing surgery and chemotherapy.CASE SUMMARY A 15-year-old nulliparous patient was diagnosed with disseminated ovarian ESTs after laparoscopic unilateral salpingo-oophorectomy using uncontained power morcellation for treatment of a ruptured solid adnexal mass in another hospital.Exploratory laparotomy;total abdominal hysterectomy,right salpingooophorectomy,and lymphadenectomy were performed with optimal debulking,and surgical stage 3C was assigned to the patient.CONCLUSION In 2014,the Food and Drug Administration noted that power morcellation was probably associated with a risk of disseminating suspected cancerous tissue.Furthermore,the use of power morcellation to remove solid adnexal mass is considered a contraindication because of the potential for a malignant tumor.This case report aims to warn of the dangers of using uncontained power morcellation to treat solid adnexal masses.展开更多
AIM:To investigate whether palatable sweet foods have a beneficial effect on chronic stress-induced colonic motility and inflammatory cytokines.METHODS:Adult male rats were divided into 3groups:control(CON,n=5),chroni...AIM:To investigate whether palatable sweet foods have a beneficial effect on chronic stress-induced colonic motility and inflammatory cytokines.METHODS:Adult male rats were divided into 3groups:control(CON,n=5),chronic variable stress with chow(CVS-A,n=6),and chronic variable stress with chow and sweet food(CVS-B,n=6).The rats were fed standard rodent chow as the chow food and/or AIN-76A as the sweet food.A food preference test for AIN-76A was performed in another group of normal rats(n=10)for twelve days.Fecal pellet output(FPO)was measured for 6 wk during water bedding stress in the CVS groups.The weight of the adrenal glands,adrenocorticotropic hormone(ACTH)and corticosterone levels in plasma were measured.The expression levels of transforming growth factor-β,interleukin(IL)-2,and interferon-gamma(IFN-γ)were measured in the distal part of colonic tissues and plasma using Western blot analysis.RESULTS:In sweet preference test,all rats initially preferred sweet food to chow food.However,the consumption rate of sweet food gradually decreased and reduced to below 50%of total intake eight days after sweet food feeding.Accumulated FPO was higher in the CVS-A group compared with the CVS-B group over time.All stress groups showed significant increases in the adrenal to body weight ratio(CVS-A,0.14±0.01;CVS-B,0.14±0.01)compared with the control group(0.12±0.01,P<0.05).The plasma corticosterone and ACTH levels were significantly higher in the CVS-A(537.42±32.95,44.44±6.54 pg/mL)and CVS-B(655.07±30.82,65.46±4.44 pg/mL)groups than in the control group(46.96±13.29,8.51±1.35 pg/mL,P<0.05).Notably,the ratio of corticosterone to ACTH was significantly increased in the CVS-A group only.Rats exposed to CVS displayed significantly increased expression of IL-2 and IFN-γin the plasma and distal colon compared to the control group,whereas this effect was significantly attenuated in the CVS-B group.CONCLUSION:These results suggest that concurrent sweet food ingestion during CVS might have an effect on the reduction of stress-induced colonic hyper-motility and pro-inflammatory cytokine production in rats.展开更多
BACKGROUND Fexuprazan,a novel potassium-competitive acid blocker,reversibly suppresses the K+/H+-ATPase enzyme in proton pumps within gastric parietal cells.Fexuprazan’s suppression of gastric acid was maintained in ...BACKGROUND Fexuprazan,a novel potassium-competitive acid blocker,reversibly suppresses the K+/H+-ATPase enzyme in proton pumps within gastric parietal cells.Fexuprazan’s suppression of gastric acid was maintained in healthy individuals for 24 h in a dose-dependent manner.AIM To compare fexuprazan to esomeprazole and establish its efficacy and safety in patients with erosive esophagitis(EE).METHODS Korean adult patients with endoscopically confirmed EE were randomized 1:1 to receive fexuprazan 40 mg or esomeprazole 40 mg once daily for eight weeks.The primary endpoint was the proportion of patients with healed EE confirmed by endoscopy at week 8.The secondary endpoints included the healing rate of EE at week 4,symptom response,and quality of life assessment.Safety profiles and serum gastrin levels were compared between the groups.RESULTS Of the 263 randomized,218 completed the study per protocol(fexuprazan 40 mg,n=107;esomeprazole 40 mg,n=111).Fexuprazan was non-inferior to esomeprazole regarding the healing rate at week 8[99.1%(106/107)vs 99.1%(110/111)].There were no between-group differences in the EE healing rate at week 4[90.3%(93/103)vs 88.5%(92/104)],symptom responses,and quality of life assessments.Additionally,serum gastrin levels at weeks 4 and 8 and drug-related side effects did not significantly differ between the groups.CONCLUSION Fexuprazan 40 mg is non-inferior to esomeprazole 40 mg in EE healing at week 8.We suggest that fexuprazan is an alternative promising treatment option to PPIs for patients with EE.展开更多
We aimed to evaluate the current nationwide trend,efficacy,safety,and quality of life(QoL)profiles of hormone treatment in real-world practice settings for prostate cancer(PCa)patients in Korea.A total of 292 men with...We aimed to evaluate the current nationwide trend,efficacy,safety,and quality of life(QoL)profiles of hormone treatment in real-world practice settings for prostate cancer(PCa)patients in Korea.A total of 292 men with any biopsy-proven PCa(TanyNanyMany)from 12 institutions in Korea were included in this multi-institutional,observational study of prospectively collected data.All luteinizing hormone-releasing hormone(LHRH)agonists were allowed to be investigational drugs.Efficacy was defined as(1)the rate of castration(serum testosterone≤50 ng dl^-1)at 4-week visit and(2)breakthrough(serum testosterone>50 ng dl^-1 after castration).Safety assessments included routine examinations for potential adverse events,laboratory tests,blood pressure,body weight,and bone min era I density(BMD,at baseli ne and at the last follow-up visit).QoL was assessed using the Expa nded Prostate Cancer Index Composite-26(EPIC-26).The most comm on initial therapeutic regimen was LHRH agonist with an ti-androge n(78.0%),and the most commonly used LHRH agonist for combination and mono therapy was leuprolide(64.0%for combi natio n and 58.0%for monotherapy).The castration and breakthrough rates were 78.4%and 6.6%,respectively.The laboratory results related to dyslipidemia worsened after 4 weeks of hormone treatment.In addition,the mean BMD T-score was significantly lower at the last follow-up(mean:-1.950)compared to baseline(mean:-0.195).The mean total EPIC-26 score decreased from 84.8(standard deviation[s.d.]:12.2)to 78.3(s.d.:8.1),with significant deterioration only in the urinary domain(mean:23.5 at baseli ne and 21.9 at the 4-week visit).These findi ngs dem on strate the n ationwide trend of current practice setti ngs in hormone treatment for PCa in Korea.展开更多
Dear Editor,Despite the introduction of novel front-line therapies including rituximab plus high-dose cytarabine followed by consolidative autologous stem cell transplantation(ASCT)and salvage therapy with bendamustin...Dear Editor,Despite the introduction of novel front-line therapies including rituximab plus high-dose cytarabine followed by consolidative autologous stem cell transplantation(ASCT)and salvage therapy with bendamustine,lenalidomide or bortezomib,mantle cell lymphoma(MCL)is still considered incurable and most patients experience relapse or refractory(RR)disease.展开更多
基金Financial support was received from funding agencies in the United States (NIH grant AR048139 and VA merit review grant)
文摘The importance of the thyroid hormone axis in the regulation of skeletal growth and maintenance has been well established from clinical studies involving patients with mutations in proteins that regulate synthesis and/or actions of thyroid hormone.Data from genetic mouse models involving disruption and overexpression of components of the thyroid hormone axis also provide direct support for a key role for thyroid hormone in the regulation of bone metabolism.Thyroid hormone regulates proliferation and/or differentiated actions of multiple cell types in bone including chondrocytes,osteoblasts and osteoclasts.Thyroid hormone effects on the target cells are mediated via ligand-inducible nuclear receptors/transcription factors,thyroid hormone receptor(TR) α and β,of which TRα seems to be critically important in regulating bone cell functions.In terms of mechanisms for thyroid hormone action,studies suggest that thyroid hormone regulates a number of key growth factor signaling pathways including insulin-like growth factor-I,parathyroid hormone related protein,fibroblast growth factor,Indian hedgehog and Wnt to influence skeletal growth.In this review we describe findings from various genetic mouse models and clinical mutations of thyroid hormone signaling related mutations in humans that pertain to the role and mechanism of action of thyroid hormone in the regulation of skeletal growth and maintenance.
文摘Endoscopic submucosal dissection(ESD) is a widely accepted treatment for early gastric cancer(EGC),especially in Korea and Japan.The criteria for the therapeutic use of ESD for EGC have been expanded recently.However,attention should be drawn to the technical feasibility of the ESD treatment which depends on a lesion's location,size or fibrosis level,or operator's experience.In the case of a lesion with a high level of difficulty,a more experienced operator is required.Thus,the treatment for a lesion with a high level of difficulty should be performed according to the degree of the operator's experience.In this paper,the authors describe the ESD procedure for lesions with a high level of difficulty.
基金Supported by Support Program for Women in Science,Engineering and Technology through the National Research Foundation of Korea funded by the Ministry of Science,ICT and Future Planning,no.2016H1C3A1903202
文摘AIM to evaluate gender differences in the aspect of ghrelin,nociception-related genes and psychological aspects and the quality of life(Qo L) in Korean functional dyspepsia(FD) patients.METHODS Total of 191 persons were prospectively enrolled between March 2013 and May 2016 in Seoul National Bundang Hospital,and classified into control and FD group based on ROME Ⅲ criteria. Questionnaire included assessment for dyspepsia symptoms,Qo L and anxiety or depression. Preproghrelin and nociception genes in the gastric mucosa and plasma acyl/des-acyl ghrelin were measured. RESULTS Lower level of plasma acyl ghrelin in FD patients compared to control was significant only in male(15.9 fmol/m L vs 10.4 fmol/m L,P = 0.017). Significantly higher m RNA expressions of nerve growth factor and transient receptor potential vanilloid receptor 1 were observed in male(P = 0.002 and P = 0.014,respectively) than in female. In contrast,female FD patients had a higher anxiety and depression score than male FD(P = 0.029),and anxiety score was correlated with epigastric pain only in female FD patients(female: Spearman rho = 0.420,P = 0.037). The impairment of overall Qo L was more prominent in female FD patients than male patients(5.4 ± 0.3 vs 6.5 ± 0.3,P = 0.020). CONCLUSION Gender differences of ghrelin and nociception-related genes in male and psychological factors in female underlie FD symptoms. More careful assessment of psychological or emotional status is required particularly for the female FD patients.
文摘Facial defect coverage is a common subject in the field of reconstructive surgery.There are many methods for facial defect reconstruction,and reconstructive surgeons should choose the most appropriate method on a case-by-case basis to achieve both functional and aesthetic improvement.Among various options for facial reconstruction,the local flap technique is considered the best reconstructive modality to provide good tissue matches of color and texture,which is consistent with the ideal goal of reconstruction(replacement of like-with-like).Keystone design perforator island flap(KDPIF),devised by Behan in 2003,has been applied to various fields of reconstructive surgery in the past decade due to its design simplicity,robust vascular supply,and reproducibility.Several studies have reported KDPIF reconstruction of facial defects,such as large parotid defects,small-to-moderate nasal defects,and eyelid defects.However,KDPIF has been used relatively less in facial defects than in other body regions,such as the trunk and extremities.The purpose of this review is to provide an organized overview of facial KDPIF reconstruction including the classification of KDPIF,modifications,physiology,mechanism of flap movement,consideration of facial relaxed skin tension lines and aesthetics,surgical techniques,clinical applications,and precautions for successful execution of KDPIF reconstruction.
文摘Background:In 2014,an outbreak of adenoviral pneumonia occurred in the Korean military training center.However,there are limited data on the characteristics of the fever and its response to antipyretic therapy in immunocompetent adults with adenovirus-positive community-acquired pneumonia(CAP).Methods:The medical records of the patients who were admitted to the Armed Forces Chuncheon Hospital for the treatment of CAP between January 2014 and December 2016 were retrospectively analyzed.The patients were divided into three groups,namely,the adenovirus-positive(Adv)group,the adenovirus-negative(Non-Adv)group and the unknown pathogen group,according to the results of a polymerase chain reaction(PCR)test and sputum culture used to measure adenovirus and other bacteria or viruses in respiratory specimens.We evaluated and compared the demographics,clinicolaboratory findings and radiological findings upon admission between the two groups.Results:Out of the 251 military personnel with CAP during the study periods,67 were classified into the Adv group,while 134 were classified into the Non-Adv group and 50 were classified into the unknown pathogen group.The patients in the Adv group had a longer duration of fever after admission((3.2±1.6)d vs.(1.9±1.2)d vs.(2.2±1.5)d,P=0.018)and symptom onset((5.8±2.2)d vs.(3.9±2.5)d vs.(3.7±2.0)d,P=0.006)than patients in the Non-Adv and unknown pathogen groups,respectively.The patients in the Adv group had a higher mean temperature at admission(37.8±0.3 vs.37.3±0.3 vs.37.3±0.3,P=0.005),and more patients were observed over 40 and 39 to 40(14.9%vs.2.2%vs.4.0%,35.8%vs.3.7%vs.6.0%,P<0.001)than those in the Non-Adv and unknown pathogen groups,respectively.The Adv group more commonly had no response or exhibited adverse events after antipyretic treatment compared to the Non-Adv group(17.9%vs.1.5%,35.0%vs.4.3%,P<0.001,P=0.05,respectively).In addition,the time from admission to overall clinical stabilization was significantly longer in the patients in the Adv group than in those in the Non-Adv group((4.3±2.8)d vs.(2.9±1.8)d,P=0.034,respectively).Furthermore,no significant difference in the length of hospital stay was observed between the two groups,and no patient died in either group.Conclusions:In this study,Adv-positive CAP in immunocompetent military personnel patients had distinct fever characteristics and responses to antipyretic treatment.
基金funded by Research of Korea Centers for Disease Control and Prevention and the Korea Health Technology R & D Project (2016-ER6304-01)Ministry of Health & Welfare (HI13C1527)。
文摘Background There are numerous but conflicting data regarding gender differences in outcomes following percutaneous coronary intervention(PCI). Furthermore, gender differences in clinical outcomes with acute myocardial infarction(AMI) following PCI in Asian population remain uncertain because of the under-representation of Asian in previous trials. Methods A total of 13,104 AMI patients from Korea Acute Myocardial Infarction Registry-National Institute of Health(KAMIR-NIH) between November 2011 and December 2015 were classified into male(n = 8021, 75.9%) and female(n = 2547, 24.1%). We compared the demographic, clinical and angiographic characteristics, 30-days and 1-year major adverse cardiac and cerebrovascular events(MACCE) in women with those in men after AMI by using propensity score(PS) matching. Results Compared with men, women were older, had more comorbidities and more often presented with non-ST segment elevation myocardial infarction(NSTEMI) and reduced left ventricular systolic function. Over the median follow-up of 363 days, gender differences in both 30-days and 1-year MACCE as well as thrombolysis in myocardial infarction minor bleeding risk were not observed in the PS matched population(30-days MACCE: 5.3% vs. 4.7%, log-rank P = 0.494, HR = 1.126, 95% CI: 0.800-1.585;1-year MACCE: 9.3% vs. 9.0%, log-rank P = 0.803, HR = 1.032, 95% CI: 0.802-1.328;TIMI minor bleeding: 4.9% vs. 3.9%, log-rank P = 0.215, HR = 1.255, 95% CI: 0.869-1.814). Conclusions Among Korean AMI population undergoing contemporary PCI, women, as compared with men, had different clinical and angiographic characteristics but showed similar 30-days and 1-year clinical outcomes. The risk of bleeding after PCI was comparable between men and women during one-year follow up.
文摘BACKGROUND Endodermal sinus tumors(ESTs),which arise primarily in children and adolescents,account for 20%of malignant ovarian germ cell tumors,but constitute only 1%of all ovarian malignancies.Treatment of ESTs consists of surgical staging with fertility-sparing surgery and chemotherapy.CASE SUMMARY A 15-year-old nulliparous patient was diagnosed with disseminated ovarian ESTs after laparoscopic unilateral salpingo-oophorectomy using uncontained power morcellation for treatment of a ruptured solid adnexal mass in another hospital.Exploratory laparotomy;total abdominal hysterectomy,right salpingooophorectomy,and lymphadenectomy were performed with optimal debulking,and surgical stage 3C was assigned to the patient.CONCLUSION In 2014,the Food and Drug Administration noted that power morcellation was probably associated with a risk of disseminating suspected cancerous tissue.Furthermore,the use of power morcellation to remove solid adnexal mass is considered a contraindication because of the potential for a malignant tumor.This case report aims to warn of the dangers of using uncontained power morcellation to treat solid adnexal masses.
基金Supported by 2011 Sunmoon University in South Korea
文摘AIM:To investigate whether palatable sweet foods have a beneficial effect on chronic stress-induced colonic motility and inflammatory cytokines.METHODS:Adult male rats were divided into 3groups:control(CON,n=5),chronic variable stress with chow(CVS-A,n=6),and chronic variable stress with chow and sweet food(CVS-B,n=6).The rats were fed standard rodent chow as the chow food and/or AIN-76A as the sweet food.A food preference test for AIN-76A was performed in another group of normal rats(n=10)for twelve days.Fecal pellet output(FPO)was measured for 6 wk during water bedding stress in the CVS groups.The weight of the adrenal glands,adrenocorticotropic hormone(ACTH)and corticosterone levels in plasma were measured.The expression levels of transforming growth factor-β,interleukin(IL)-2,and interferon-gamma(IFN-γ)were measured in the distal part of colonic tissues and plasma using Western blot analysis.RESULTS:In sweet preference test,all rats initially preferred sweet food to chow food.However,the consumption rate of sweet food gradually decreased and reduced to below 50%of total intake eight days after sweet food feeding.Accumulated FPO was higher in the CVS-A group compared with the CVS-B group over time.All stress groups showed significant increases in the adrenal to body weight ratio(CVS-A,0.14±0.01;CVS-B,0.14±0.01)compared with the control group(0.12±0.01,P<0.05).The plasma corticosterone and ACTH levels were significantly higher in the CVS-A(537.42±32.95,44.44±6.54 pg/mL)and CVS-B(655.07±30.82,65.46±4.44 pg/mL)groups than in the control group(46.96±13.29,8.51±1.35 pg/mL,P<0.05).Notably,the ratio of corticosterone to ACTH was significantly increased in the CVS-A group only.Rats exposed to CVS displayed significantly increased expression of IL-2 and IFN-γin the plasma and distal colon compared to the control group,whereas this effect was significantly attenuated in the CVS-B group.CONCLUSION:These results suggest that concurrent sweet food ingestion during CVS might have an effect on the reduction of stress-induced colonic hyper-motility and pro-inflammatory cytokine production in rats.
基金This study is registered at ClinicalTrials.gov.The registration identification number is NCT03736369。
文摘BACKGROUND Fexuprazan,a novel potassium-competitive acid blocker,reversibly suppresses the K+/H+-ATPase enzyme in proton pumps within gastric parietal cells.Fexuprazan’s suppression of gastric acid was maintained in healthy individuals for 24 h in a dose-dependent manner.AIM To compare fexuprazan to esomeprazole and establish its efficacy and safety in patients with erosive esophagitis(EE).METHODS Korean adult patients with endoscopically confirmed EE were randomized 1:1 to receive fexuprazan 40 mg or esomeprazole 40 mg once daily for eight weeks.The primary endpoint was the proportion of patients with healed EE confirmed by endoscopy at week 8.The secondary endpoints included the healing rate of EE at week 4,symptom response,and quality of life assessment.Safety profiles and serum gastrin levels were compared between the groups.RESULTS Of the 263 randomized,218 completed the study per protocol(fexuprazan 40 mg,n=107;esomeprazole 40 mg,n=111).Fexuprazan was non-inferior to esomeprazole regarding the healing rate at week 8[99.1%(106/107)vs 99.1%(110/111)].There were no between-group differences in the EE healing rate at week 4[90.3%(93/103)vs 88.5%(92/104)],symptom responses,and quality of life assessments.Additionally,serum gastrin levels at weeks 4 and 8 and drug-related side effects did not significantly differ between the groups.CONCLUSION Fexuprazan 40 mg is non-inferior to esomeprazole 40 mg in EE healing at week 8.We suggest that fexuprazan is an alternative promising treatment option to PPIs for patients with EE.
文摘We aimed to evaluate the current nationwide trend,efficacy,safety,and quality of life(QoL)profiles of hormone treatment in real-world practice settings for prostate cancer(PCa)patients in Korea.A total of 292 men with any biopsy-proven PCa(TanyNanyMany)from 12 institutions in Korea were included in this multi-institutional,observational study of prospectively collected data.All luteinizing hormone-releasing hormone(LHRH)agonists were allowed to be investigational drugs.Efficacy was defined as(1)the rate of castration(serum testosterone≤50 ng dl^-1)at 4-week visit and(2)breakthrough(serum testosterone>50 ng dl^-1 after castration).Safety assessments included routine examinations for potential adverse events,laboratory tests,blood pressure,body weight,and bone min era I density(BMD,at baseli ne and at the last follow-up visit).QoL was assessed using the Expa nded Prostate Cancer Index Composite-26(EPIC-26).The most comm on initial therapeutic regimen was LHRH agonist with an ti-androge n(78.0%),and the most commonly used LHRH agonist for combination and mono therapy was leuprolide(64.0%for combi natio n and 58.0%for monotherapy).The castration and breakthrough rates were 78.4%and 6.6%,respectively.The laboratory results related to dyslipidemia worsened after 4 weeks of hormone treatment.In addition,the mean BMD T-score was significantly lower at the last follow-up(mean:-1.950)compared to baseline(mean:-0.195).The mean total EPIC-26 score decreased from 84.8(standard deviation[s.d.]:12.2)to 78.3(s.d.:8.1),with significant deterioration only in the urinary domain(mean:23.5 at baseli ne and 21.9 at the 4-week visit).These findi ngs dem on strate the n ationwide trend of current practice setti ngs in hormone treatment for PCa in Korea.
基金Janssen Korea Ltd.provided funding for data collection but was not involved in data analysis and manuscript writing.(Fund number:54179060MCL4008)。
文摘Dear Editor,Despite the introduction of novel front-line therapies including rituximab plus high-dose cytarabine followed by consolidative autologous stem cell transplantation(ASCT)and salvage therapy with bendamustine,lenalidomide or bortezomib,mantle cell lymphoma(MCL)is still considered incurable and most patients experience relapse or refractory(RR)disease.
