摘要
Juvenile xanthogranuloma (JXG) is a histiocytic proliferative tumor that predominantly affects infants and young children. It is classified as a benign disease that comprises the majority of non-Langerhans cell histiocytes and is characterized by reddish-brown or yellow papules and nodules commonly found on the face and trunk. Although JXG presents with distinct clinical features, an exceedingly uncommon subset of JXG includes lesions that surpass 20 mm in diameter, referred to as giant JXG, which can occasionally be misdiagnosed as other tumors. Herein, we report a rare case of a giant JXG in a 1-month-old Korean boy, highlighting the significance of accurate diagnoses. Additionally, we provide a comprehensive literature review to enhance our understanding of this rare variant.
摘要
Ketamine is an anesthetic agent for diagnostic and surgical procedures. However, it can produce dissociative anesthesia and induce hallucinations. Therefore, it tends to be abused as a recreational drug. Chronic ketamine use can cause numerous adverse effects including ketamine-induced chlangiopathy and ulcerative cystitis. Ketamineinduced cholangiopathy has been reported since the 1980s and most cases were found in Western countries and South Asia. Here, we report the first case of ketamineinduced cholangiopathy in Korea. Owing to increasing recreational drug use among Koreans, ketamine-induced cholangiopathy should be considered in the differential diagnosis in young patients with cholangitis of unknown etiology.
摘要
Objective@#This study aimed to determine the incidence, characteristics, and outcomes of out-of-hospital cardiac arrests (OHCA) and to investigate the trends for the same in Changwon city, South Korea between 2012 and 2018. @*Methods@#We analyzed a list of adult cardiac arrest cases occurring between 2012 and 2018 from the OHCA surveillance registry and the Changwon Fire Department’s emergency medical services database. The trends in the incidence and resuscitation-related characteristics were assessed using nonparametric tests for trends across ordered groups. The predictors of the primary outcome were investigated using multivariable logistic regression. The primary outcome was a good neurological outcome at hospital discharge. @*Results@#A total of 2,951 OHCAs were attended by the emergency medical services and of these, 2,834 were included in this study. Overall, the proportion of patients discharged with a good neurologic outcome was 4.7% (133/2,834). Both OHCA survival and good neurologic outcomes improved significantly over time, from 4.9% and 2.1%, respectively, in 2012 to 10.3% and 7.4% in 2018 (P<0.001). The Utstein comparator (bystander-witnessed arrests presenting with initial shockable rhythm) increased over the study period (P-for-trend<0.001). Age, response time, scene time, in-hospital cardiopulmonary resuscitation (CPR) time, witness presence, cardiac origin, and shockable rhythm were associated with good neurologic outcomes. @*Conclusion@#With the gradual increase in the proportion of patients with witnessed cardiac arrests, bystander CPR, and initial shockable rhythm, the rate of survival and a good neurologic outcome at discharge also increased annually.
摘要
We present a case of delayed migration of an open-cell design carotid stent, which is a rare complication following carotid artery stenting (CAS). A 65-year-old patient with carotid artery stenosis underwent CAS with an open-cell stent, initially achieving successful deployment. However, 4 months later, the stent migrated and resulted in restenosis. The patient underwent balloon angioplasty and received an additional stent, leading to improved blood flow. The rarity of stent migration, particularly in the absence of risk factors, highlights the need for clinicians to be vigilant and consider early imaging follow-up for patients at risk of this complication after CAS.
摘要
Background@#The position of the eyebrows is critical when planning blepharoptosis surgery. However, insufficient scholarly attention has been paid to the details of postoperative eyebrow height changes at each anatomical landmark. This study investigated the effect of blepharoptosis surgery on brow height and evaluated the change in brow position. @*Methods@#After a retrospective review of 247 patients, this study analyzed 53 patients (106 eyelids) who underwent levator and Müller’s complex advancement between March 2010 and January 2022. Brow heights were measured from the distance between the upper brow margin of each landmark and horizontal line of pupillary center on a digital photograph. @*Results@#The mean change of eyebrow lowering was 1.54 mm (P<0.001) at the medial canthus, 1.29 mm (P<0.001) at the medial limbus, 1.44 mm (P<0.001) at the center of the pupil, 1.40 mm (P<0.001) at the lateral limbus, 1.15 mm (P=0.001) at the lateral canthus, and 0.75 mm (P=0.021) at the lateral eyebrow end. The brow change was most prominent at medial canthus and least prominent at the lateral brow end. The preoperative brow position was only statistically significant factor predicting brow height descent after surgery according to multiple linear regression analysis (R2=0.305, B=–0.375, P<0.001). @*Conclusions@#The eyebrows lowered in most patients after blepharoptosis surgery. The preoperative brow position is the most important factor in predicting the change in brow height after blepharoptosis surgery.
摘要
Objective@#The aim of this study was to examine the incidence and outcomes of pediatric out-of-hospital cardiac arrests (OHCA) in Changwon city, South Korea. @*Methods@#From the Out-of-Hospital Cardiac Arrest Surveillance registry and the Changwon Fire Department’s Emergency Medical Services data, we obtained a list of 119 assessed pediatric OHCAs occurred between January 2012 and December 2018. We analyzed basic demographic variables, the location of cardiac arrest, witnessed status, bystander cardiopulmonary resuscitation (CPR), time variables for CPR, dispatcher-assisted CPR, initial cardiac rhythm, automated defibrillator use, and clinical outcomes at hospital discharge. @*Results@#A total of 2,954 OHCAs occurred during the study period, of which 72 were pediatric OHCAs. The rate of witnessed cardiac arrest was 30.6% (22/72), and bystander CPR was performed in 29 patients (40.3%). The rate of cardiac arrest occurring in public places was 16.7% (12/72). The rate of shockable rhythm in the initial electrocardiogram rhythm was 8.3% (6/72). Twelve patients (16.7%) survived to admission. The proportion of survivors discharged was 4.3% (3/70), and the rate of discharge with a good prognosis was 2.8% (2/70). @*Conclusion@#The incidence rate of pediatric OHCA was low in Changwon city. The survival rate was also low. Thus, studies with larger sample sizes and continuous monitoring in the community are needed.
摘要
Erythema nodosum (EN) is the most common form of panniculitis and may be triggered by a variety of stimuli, including infections, drugs, pregnancy, sarcoidosis, inflammatory bowel disease, and malignancies. Rare cases of vaccination-related EN have been reported, but none due to the coronavirus disease 2019 (COVID-19) vaccine of Pfizer have been documented. We report a case of EN associated with the Pfizer vaccine. A 43-year-old woman presented with acute-onset painful nodular lesions that appeared bilaterally on the extensor surface of the lower legs. These lesions appeared 5 days after the first dose of Pfizer vaccination. The patient reported no recent infectious history other than fever for 3 days after vaccination. Skin biopsy revealed inflammation extending into the subcutaneous fat with a septal distribution. It is important for physicians to be aware of the side effects of the COVID-19 vaccine because more people are bound to be vaccinated.
摘要
Objective@#To investigate remineralizing effect of three fluoride regimens on artificially demineralized enamel around orthodontic bracket by analyzing mineral density (MD) acquired from micro-computed tomography (micro-CT). @*Methods@#Forty-eight bracket bonded bovine incisors were prepared to create demineralized enamel (DE) surface. The samples were divided into four groups according to the fluoride regimen: 1) no fluoridation, 2) 1.23% acidulated phosphate fluoride (APF) gel, 3) fluoridated toothpaste, and 4) 0.05% sodium fluoride mouthwash. Micro-CT was scanned after demineralization (T0), and 2 weeks (T1) and 4 weeks (T2) of fluoridation. @*Results@#APF gel showed highest remineralization of DE during T1–T0 interval among the groups (p < 0.05); followed by toothpaste, mouthwash and no fluoridation. APF gel and toothpaste demonstrated significant increase in MD after 4 weeks of application (p < 0.05). @*Conclusions@#Remineralization effects of three fluoride regimens were depicted through micro-CT analysis, of which APF gel was most effective.
摘要
Background@#and Purpose: Blood pressure (BP) control is strongly recommended, but BP control rate has not been well studied in patients with stroke. We evaluated the BP control rate with fimasartan-based antihypertensive therapy initiated in patients with recent cerebral ischemia. @*Methods@#This multicenter, prospective, single-arm trial involved 27 centers in South Korea. Key inclusion criteria were recent cerebral ischemia within 90 days and high BP [systolic blood pressure (SBP) >140 mm Hg or diastolic blood pressure (DBP) >90 mm Hg]. BP lowering was initiated with fimasartan. BP management during the follow-up was at the discretion of the responsible investigators. The primary endpoint was the target BP goal achievement rate (<140/90 mm Hg) at 24 weeks. Key secondary endpoints included achieved BP and BP changes at each visit, and clinical events (ClinicalTrials.gov Identifier: NCT03231293). @*Results@#Of 1,035 patients enrolled, 1,026 were included in the safety analysis, and 951 in the efficacy analysis. Their mean age was 64.1 years, 33% were female, the median time interval from onset to enrollment was 10 days, and the baseline SBP and DBP were 162.3±16.0 and 92.2±12.4 mm Hg (mean±SD). During the study period, 55.5% of patients were maintained on fimasartan monotherapy, and 44.5% received antihypertensive therapies other than fimasartan monotherapy at at least one visit. The target BP goal achievement rate at 24-week was 67.3% (48.6% at 4-week and 61.4% at 12-week). The mean BP was 139.0/81.8±18.3/11.7, 133.8/79.2±16.4/11.0, and 132.8/78.5±15.6/10.9 mm Hg at 4-, 12-, and 24-week. The treatment-emergent adverse event rate was 5.4%, including one serious adverse event. @*Conclusions@#Fimasartan-based BP lowering achieved the target BP in two-thirds of patients at 24 weeks, and was generally well tolerated.
摘要
Background@#and Purpose We aimed to develop a model predicting early recanalization after intravenous tissue plasminogen activator (t-PA) treatment in large-vessel occlusion. @*Methods@#Using data from two different multicenter prospective cohorts, we determined the factors associated with early recanalization immediately after t-PA in stroke patients with large-vessel occlusion, and developed and validated a prediction model for early recanalization. Clot volume was semiautomatically measured on thin-section computed tomography using software, and the degree of collaterals was determined using the Tan score. Follow-up angiographic studies were performed immediately after t-PA treatment to assess early recanalization. @*Results@#Early recanalization, assessed 61.0±44.7 minutes after t-PA bolus, was achieved in 15.5% (15/97) in the derivation cohort and in 10.5% (8/76) in the validation cohort. Clot volume (odds ratio [OR], 0.979; 95% confidence interval [CI], 0.961 to 0.997; P=0.020) and good collaterals (OR, 6.129; 95% CI, 1.592 to 23.594; P=0.008) were significant factors associated with early recanalization. The area under the curve (AUC) of the model including clot volume was 0.819 (95% CI, 0.720 to 0.917) and 0.842 (95% CI, 0.746 to 0.938) in the derivation and validation cohorts, respectively. The AUC improved when good collaterals were added (derivation cohort: AUC, 0.876; 95% CI, 0.802 to 0.950; P=0.164; validation cohort: AUC, 0.949; 95% CI, 0.886 to 1.000; P=0.036). The integrated discrimination improvement also showed significantly improved prediction (0.097; 95% CI, 0.009 to 0.185; P=0.032). @*Conclusions@#The model using clot volume and collaterals predicted early recanalization after intravenous t-PA and had a high performance. This model may aid in determining the recanalization treatment strategy in stroke patients with large-vessel occlusion.
摘要
Background and Objectives@#Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. @*Methods@#Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. @*Results@#mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). @*Conclusions@#Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.
摘要
Background@#Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal acute hypersensitivity reactions that involve the skin and mucous membranes. Because they are relatively rare diseases, it is difficult to obtain well-organized epidemiological data. The clinicodemographic characteristics, culprit drugs, and factors related to disease prognosis may vary. @*Objective@#To identify the characteristics of SJS/TEN by investigating patient clinicopathological characteristics, laboratory findings, suspected drugs, and mortality through a retrospective study using medical record data. @*Methods@#The clinical records of patients diagnosed with SJS/TEN between February 2009 and February 2019 at three medical institutions of Soonchunhyang University were retrospectively reviewed. Data pertaining to sex, age, history, suspected drugs, latent period, laboratory findings, and mortality were collected, and their correlations were analyzed. @*Results@#We identified SJS/TEN in 88 patients. Among the probable causative agents, antibiotics were the most common (29 cases, 33.0%), followed by nonsteroidal anti-inflammatory drugs (NSAIDs) in 20 cases (22.7%). The period between drug administration and symptom onset varied with the causative agent. Patients who died had high SCORTEN scores. In addition, hypertension, diabetes, renal failure, and cardiac disease had a statistically significant association with high SCORTEN. @*Conclusion@#Antibiotics, NSAIDs, antiepileptics and allopurinol were the most commonly implicated drugs in our retrospective study. There was a significant correlation between comorbidities. Because SJS/TEN is a life-threatening condition, early recognition of the suspected drug are important. The results of this study may provide insights that aid in the early diagnosis and prediction of disease outcomes of SJS/TEN in the Korean population.
摘要
Purpose@#The purpose of this study was to evaluate the prevalence and risk factors of unruptured intracranial aneurysms (UIAs), which can help establish guidelines of treatment for asymptomatic Korean adults using 3T magnetic resonance angiography (MRA). @*Materials and Methods@#Our Institutional Review Board approved this retrospective study, and informed consent was waived. All patients consisted of healthy individuals who underwent brain MRA using 3T magnetic resonance imaging between January 2011 and December 2012 as part of a routine health examination. Patient data and follow-up results were obtained from medical records. @*Results@#A total of 2,118 individuals (mean age=53.9±9.6 years, male:female=1,188:930) who had undergone brain MRA were enrolled in the study. UIAs were found in 80 patients with 105 UIAs (3.77%). Female predominance (55% in UIA vs. 43.47% in non-UIA, P=0.0416) and hypertension were more common in the UIA group (43.75% vs. 28.8%, P=0.004, respectively). The mean size of the aneurysms was 3.10±1.62 mm, and they were all saccular in shape and asymptomatic. The UIAs were most common in the internal carotid artery (59.1%), internal carotid-posterior communicating artery (15.2%), middle cerebral artery (9.5%), anterior communicating artery (8.6%), anterior cerebral artery (4.8%), and vertebral artery (2.9%). Twenty-eight of 80 patients (35%) had multiple aneurysms. The incidence of UIAs increased significantly with age (P=0.014). @*Conclusion@#In single center experience, we demonstrated the characteristics and prevalence of UIAs in asymptomatic adults, which may help establish guidelines or therapeutic standards for UIAs.
摘要
Background@#Data regarding the association between preexisting cardiovascular risk factors (CVRFs) and cardiovascular diseases (CVDs) and the outcomes of patients requiring hospitalization for coronavirus disease 2019 (COVID-19) are limited. Therefore, the aim of this study was to investigate the impact of preexisting CVRFs or CVDs on the outcomes of patients with COVID-19 hospitalized in a Korean healthcare system. @*Methods@#Patients with COVID-19 admitted to 10 hospitals in Daegu Metropolitan City, Korea, were examined. All sequentially hospitalized patients between February 15, 2020, and April 24, 2020, were enrolled in this study. All patients were confirmed to have COVID-19 based on the positive results on the polymerase chain reaction testing of nasopharyngeal samples. Clinical outcomes during hospitalization, such as requiring intensive care and invasive mechanical ventilation (MV) and death, were evaluated. Moreover, data on baseline comorbidities such as a history of diabetes, hypertension, dyslipidemia, current smoking, heart failure, coronary artery disease, cerebrovascular accidents, and other chronic cardiac diseases were obtained. @*Results@#Of all the patients enrolled, 954 (42.0%) had preexisting CVRFs or CVDs. Among the CVRFs, the most common were hypertension (28.8%) and diabetes mellitus (17.0%). The prevalence rates of preexisting CVRFs or CVDs increased with age (P < 0.001). The number of patients requiring intensive care (P < 0.001) and invasive MV (P < 0.001) increased with age.The in-hospital death rate increased with age (P < 0.001). Patients requiring intensive care (5.3% vs. 1.6%; P < 0.001) and invasive MV (4.3% vs. 1.7%; P < 0.001) were significantly greater in patients with preexisting CVRFs or CVDs. In-hospital mortality (12.9% vs. 3.1%; P < 0.001) was significantly higher in patients with preexisting CVRFs or CVDs. Among the CVRFs, diabetes mellitus and hypertension were associated with increased requirement of intensive care and invasive MV and in-hospital death. Among the known CVDs, coronary artery disease and congestive heart failure were associated with invasive MV and in-hospital death. In multivariate analysis, preexisting CVRFs or CVDs (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.07–3.01; P = 0.027) were independent predictors of in-hospital death adjusting for confounding variables. Among individual preexisting CVRF or CVD components, diabetes mellitus (OR, 2.43; 95% CI, 1.51–3.90; P < 0.001) and congestive heart failure (OR, 2.43; 95% CI, 1.06–5.87; P = 0.049) were independent predictors of in-hospital death. @*Conclusion@#Based on the findings of this study, the patients with confirmed COVID-19 with preexisting CVRFs or CVDs had worse clinical outcomes. Caution is required in dealing with these patients at triage.after
摘要
Purpose@#Endoscopic breast surgery for patients with breast cancer was introduced for its superior cosmetic outcomes; it was initially studied in the field of breast-conserving surgery and, more recently, in robotic-assisted nipple-sparing mastectomy (NSM). The main purpose of this study was to investigate the feasibility and safety of endoscopic NSM (E-NSM) in patients with breast cancer by comparing E-NSM and conventional NSM (C-NSM). @*Methods@#Between May 2017 and October 2020, we retrieved the records of 45 patients who underwent NSM with permanent silicone implants and divided them into the E-NSM group (20 patients) and the C-NSM group (25 patients), depending on the use of the endoscopic device.We also analyzed demographic information, pathology, operative time, and complications. @*Results@#No significant differences were observed between the 2 groups based on demographic information, postoperative pathological data, mean length of hospital stay, and total number of complications. The mean preparation time for surgery was comparable between both groups. Compared to the C-NSM group, the E-NSM group had a significantly longer mean operative time and, subsequently, a significantly longer mean total operative time and number of complications. @*Conclusion@#The results showed that E-NSM was feasible and safe with a more inconspicuous incision in patients with breast cancer.
摘要
Background@#and Purpose: Blood pressure (BP) control is strongly recommended, but BP control rate has not been well studied in patients with stroke. We evaluated the BP control rate with fimasartan-based antihypertensive therapy initiated in patients with recent cerebral ischemia. @*Methods@#This multicenter, prospective, single-arm trial involved 27 centers in South Korea. Key inclusion criteria were recent cerebral ischemia within 90 days and high BP [systolic blood pressure (SBP) >140 mm Hg or diastolic blood pressure (DBP) >90 mm Hg]. BP lowering was initiated with fimasartan. BP management during the follow-up was at the discretion of the responsible investigators. The primary endpoint was the target BP goal achievement rate (<140/90 mm Hg) at 24 weeks. Key secondary endpoints included achieved BP and BP changes at each visit, and clinical events (ClinicalTrials.gov Identifier: NCT03231293). @*Results@#Of 1,035 patients enrolled, 1,026 were included in the safety analysis, and 951 in the efficacy analysis. Their mean age was 64.1 years, 33% were female, the median time interval from onset to enrollment was 10 days, and the baseline SBP and DBP were 162.3±16.0 and 92.2±12.4 mm Hg (mean±SD). During the study period, 55.5% of patients were maintained on fimasartan monotherapy, and 44.5% received antihypertensive therapies other than fimasartan monotherapy at at least one visit. The target BP goal achievement rate at 24-week was 67.3% (48.6% at 4-week and 61.4% at 12-week). The mean BP was 139.0/81.8±18.3/11.7, 133.8/79.2±16.4/11.0, and 132.8/78.5±15.6/10.9 mm Hg at 4-, 12-, and 24-week. The treatment-emergent adverse event rate was 5.4%, including one serious adverse event. @*Conclusions@#Fimasartan-based BP lowering achieved the target BP in two-thirds of patients at 24 weeks, and was generally well tolerated.
摘要
Background@#and Purpose We aimed to develop a model predicting early recanalization after intravenous tissue plasminogen activator (t-PA) treatment in large-vessel occlusion. @*Methods@#Using data from two different multicenter prospective cohorts, we determined the factors associated with early recanalization immediately after t-PA in stroke patients with large-vessel occlusion, and developed and validated a prediction model for early recanalization. Clot volume was semiautomatically measured on thin-section computed tomography using software, and the degree of collaterals was determined using the Tan score. Follow-up angiographic studies were performed immediately after t-PA treatment to assess early recanalization. @*Results@#Early recanalization, assessed 61.0±44.7 minutes after t-PA bolus, was achieved in 15.5% (15/97) in the derivation cohort and in 10.5% (8/76) in the validation cohort. Clot volume (odds ratio [OR], 0.979; 95% confidence interval [CI], 0.961 to 0.997; P=0.020) and good collaterals (OR, 6.129; 95% CI, 1.592 to 23.594; P=0.008) were significant factors associated with early recanalization. The area under the curve (AUC) of the model including clot volume was 0.819 (95% CI, 0.720 to 0.917) and 0.842 (95% CI, 0.746 to 0.938) in the derivation and validation cohorts, respectively. The AUC improved when good collaterals were added (derivation cohort: AUC, 0.876; 95% CI, 0.802 to 0.950; P=0.164; validation cohort: AUC, 0.949; 95% CI, 0.886 to 1.000; P=0.036). The integrated discrimination improvement also showed significantly improved prediction (0.097; 95% CI, 0.009 to 0.185; P=0.032). @*Conclusions@#The model using clot volume and collaterals predicted early recanalization after intravenous t-PA and had a high performance. This model may aid in determining the recanalization treatment strategy in stroke patients with large-vessel occlusion.
摘要
Background and Objectives@#Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. @*Methods@#Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. @*Results@#mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). @*Conclusions@#Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.
摘要
Background@#Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal acute hypersensitivity reactions that involve the skin and mucous membranes. Because they are relatively rare diseases, it is difficult to obtain well-organized epidemiological data. The clinicodemographic characteristics, culprit drugs, and factors related to disease prognosis may vary. @*Objective@#To identify the characteristics of SJS/TEN by investigating patient clinicopathological characteristics, laboratory findings, suspected drugs, and mortality through a retrospective study using medical record data. @*Methods@#The clinical records of patients diagnosed with SJS/TEN between February 2009 and February 2019 at three medical institutions of Soonchunhyang University were retrospectively reviewed. Data pertaining to sex, age, history, suspected drugs, latent period, laboratory findings, and mortality were collected, and their correlations were analyzed. @*Results@#We identified SJS/TEN in 88 patients. Among the probable causative agents, antibiotics were the most common (29 cases, 33.0%), followed by nonsteroidal anti-inflammatory drugs (NSAIDs) in 20 cases (22.7%). The period between drug administration and symptom onset varied with the causative agent. Patients who died had high SCORTEN scores. In addition, hypertension, diabetes, renal failure, and cardiac disease had a statistically significant association with high SCORTEN. @*Conclusion@#Antibiotics, NSAIDs, antiepileptics and allopurinol were the most commonly implicated drugs in our retrospective study. There was a significant correlation between comorbidities. Because SJS/TEN is a life-threatening condition, early recognition of the suspected drug are important. The results of this study may provide insights that aid in the early diagnosis and prediction of disease outcomes of SJS/TEN in the Korean population.
摘要
Purpose@#The purpose of this study was to evaluate the prevalence and risk factors of unruptured intracranial aneurysms (UIAs), which can help establish guidelines of treatment for asymptomatic Korean adults using 3T magnetic resonance angiography (MRA). @*Materials and Methods@#Our Institutional Review Board approved this retrospective study, and informed consent was waived. All patients consisted of healthy individuals who underwent brain MRA using 3T magnetic resonance imaging between January 2011 and December 2012 as part of a routine health examination. Patient data and follow-up results were obtained from medical records. @*Results@#A total of 2,118 individuals (mean age=53.9±9.6 years, male:female=1,188:930) who had undergone brain MRA were enrolled in the study. UIAs were found in 80 patients with 105 UIAs (3.77%). Female predominance (55% in UIA vs. 43.47% in non-UIA, P=0.0416) and hypertension were more common in the UIA group (43.75% vs. 28.8%, P=0.004, respectively). The mean size of the aneurysms was 3.10±1.62 mm, and they were all saccular in shape and asymptomatic. The UIAs were most common in the internal carotid artery (59.1%), internal carotid-posterior communicating artery (15.2%), middle cerebral artery (9.5%), anterior communicating artery (8.6%), anterior cerebral artery (4.8%), and vertebral artery (2.9%). Twenty-eight of 80 patients (35%) had multiple aneurysms. The incidence of UIAs increased significantly with age (P=0.014). @*Conclusion@#In single center experience, we demonstrated the characteristics and prevalence of UIAs in asymptomatic adults, which may help establish guidelines or therapeutic standards for UIAs.