Association of coffee consumption with health-related quality of life and metabolic syndrome in Korean adults: based on 2013 ~ 2016 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study examined the association of the type and frequency of coffee consumption with the health-related quality of life and metabolic bio-markers in adult men and women from the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A total of 11,201 subjects (4,483 men and 6,718 women) were classified according to the type of coffee consumption (non-coffee, black coffee, 3-in-1 coffee) and type and frequency of coffee consumption (non-coffee, ≤2 times/day of black coffee, > 2 times/day of black coffee, ≤2 times/day of 3-in-1 coffee, > 2 times/day of 3-in-1 coffee) using food frequency questionnaires. Dietary nutrient intake data were assessed using food frequency questionnaires. The health-related quality of life was measured using the EuroQol-5 dimension (EQ-5D) and EQ-5D index score. Data on metabolic bio-markers were obtained from a health examination. RESULTS: Among men and women, the proportion of subjects with an energy intake below the estimated energy requirement (EER) was lower among the 3-in-1 coffee consumption group, and the proportion of subjects with iron intakes below the estimated average requirements (EAR) was lower among the 3-in-1 coffee consumption group. Women (OR: 0.810, 95% CI: 0.657 ~ 0.998) with the ≤2 times/day of 3-in-1 coffee had a lower risk of impaired health-related quality of life (lowest 20% level in the EQ-5D score) compared to the non-coffee consumers after a multivariable adjustment. In both men and women, the type and frequency of coffee consumption was not associated with metabolic bio-markers risk after multivariable adjustment. CONCLUSION: These results suggest that 3-in-1 coffee consumption may be associated with a lower risk of impaired health-related quality of life and may not be associated with the metabolic bio-markers risk in adult men and women.

A Pilot Study of Intralymphatic Immunotherapy for House Dust Mite, Cat, and Dog Allergies

Several recent clinical trials reported that intralymphatic immunotherapy (ILIT) for some allergens, such as cat dander and pollen, induce tolerance more rapidly than conventional subcutaneous or sublingual immunotherapy, have a comparable duration of effect after only 3 injections, and do not provoke serious local or systemic reactions. However, the efficacy and safety of ILIT are using Dermatophagoides farinae (Df), Dermatophagoides pteronyssinus (Dp), and dog, which are indoor allergens that are commonly found globally, need to be evaluated. Furthermore, use of multiple allergens in ILIT should be investigated. We assessed the clinical efficacy and adverse effects of ILIT using aqueous Df, Dp, dog, and cat allergens or mixtures thereof in patients with allergic rhinitis. A total of 11 subjects with AR sensitized to Df, Dp, cat, and/or dog allergens received 3 intralymphatic inguinal injections of sensitized allergen extract (HollisterStier, New Orleans, LA, USA). Clinical parameters were assessed before ILIT, and 4 months and 1 year after the first injection. Rhinitis symptoms were alleviated and quality of life was improved 4 months after ILIT (P=0.012 and P=0.007, respectively), and these improvements lasted for 1 year after ILIT (P=0.047 and P=0.009, respectively). However, we observed 2 cases of anaphylaxis, one case of a moderate-to-severe systemic hypersensitivity reaction and the other case of a severe local reaction at the injection site after ILIT. In conclusion, ILIT can rapidly improve allergy symptoms and quality of life, and this effect lasts for 1 year. In hypersensitized patients, however, ILIT can provoke severe systemic and/or local hypersensitivity reactions when performed using aqueous allergen extracts.

Long-term efficacy of tenofovir disoproxil fumarate therapy after multiple nucleos(t)ide analogue failure in chronic hepatitis B patients

BACKGROUND/AIMS: The efficacy of tenofovir disoproxil fumarate (TDF) for the treatment of chronic hepatitis B (CHB) patients following prior treatment failure with multiple nucleos(t)ide analogues (NAs) is not well defined, especially in Asian populations. In this study we investigated the efficacy and safety of TDF rescue therapy in CHB patients after multiple NA treatment failure. METHODS: The study retrospectively analyzed 52 CHB patients who experienced failure with two or more NAs and who were switched to regimens containing TDF. The efficacy and safety assessments included hepatitis B virus (HBV) DNA undetectability, hepatitis B envelop antigen (HBeAg) seroclearance, alanine transaminase (ALT) normalization and changes in serum creatinine and phosphorus levels. RESULTS: The mean HBV DNA level at baseline was 5.4 +/- 1.76 log10 IU/mL. At a median duration of 34.5 months of TDF treatment, the cumulative probabilities of achieving complete virological response (CVR) were 25.0%, 51.8%, 74.2%, and 96.7% at 6, 12, 24, and 48 months, respectively. HBeAg seroclearance occurred in seven of 48 patients (14.6%). ALT levels were normalized in 27 of 31 patients (87.1%) with elevated ALT at baseline. Lower levels of HBV DNA at baseline were significantly associated with increased CVR rates (p < 0.001). However, CVR rates did not differ between TDF monotherapy or combination therapy with other NAs, and were not affected by mutations associated with resistance to NAs. No significant adverse events were observed. CONCLUSIONS: TDF is an efficient and safe rescue therapy for CHB patients after treatment failure with multiple NAs.

The Efficacy and Safety of Ablative Fractional Resurfacing Using a 2,940-Nm Er:YAG Laser for Traumatic Scars in the Early Posttraumatic Period

BACKGROUND: Skin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR) for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG) laser for traumatic scars after primary repair during the early posttraumatic period. METHODS: Twelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Post-treatment evaluations were performed 1 month after the fourth treatment session. RESULTS: All 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves. CONCLUSIONS: This study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.

Pseudocyst of Auricle after Soft Tissue Filler Injection

A pseudocyst of the auricle is a rare disease with an unknown cause. We report a female patient who had auricular pseudocyst after a soft tissue filler injection in that area. The cyst was excised under local anesthesia. The entire cyst wall was removed and some portion of the surrounding cartilage was also resected. A silastic drain was inserted and the compressive dressing was maintained for 5 days. The swelling subsided gradually and no recurrence was noted after a 1-year follow up. Histopathology confirmed that the cyst has no epithelial lining on its inner surface. Patients and doctors should be aware that a soft tissue filler can cause a pseudocyst when injected into the auricle.

A Case of Respiratory Failure after Clean-up Work of the Hebei Spirit Crude Oil Spill in Taean / 결핵및호흡기질환

On 7 December 2007, the Hebei Spirit ran aground near Taean and released approximately 10,900 tons of oil into the sea. Crude oil on the coastal areas and fumes in the air increased the number of health problems among the local population. We report a case of respiratory failure after the oil spill clean-up work. A 66-year-old female was admitted to hospital with cough, sputum, and dyspnea of 1-month duration after the oil spill clean-up. She was diagnosed with community-acquired pneumonia and treated with empirical antibiotics. However, she had progressive respiratory failure without identification of the pathogen. Respiratory failure due to chronic inhalation of hydrocarbons from the crude oil spill clean-up was suspected. After mechanical ventilation care, she recovered from respiratory failure and was discharged. We report a case of severe respiratory toxic effects after an oil spill clean-up. We concluded that long-term hydrocarbon inhalation during the oil spill clean-up may have induced respiratory failure in this case.

Achalasia Combined with Esophageal Cancer Treated by Concurrent Chemoradiation Therapy

Achalasia is a rare neurological deficit of the esophagus that produces an impaired relaxation of the lower esophageal sphincter and decreased motility of the esophageal body. Achalasia is generally accepted to be a pre-malignant disorder, since, particularly in the mega-esophagus, chronic irritation by foods and bacterial overgrowth may contribute to the development of dysplasia and carcinoma. We present a case of a 51-year-old man with achalasia combined with esophageal cancer who has had dysphagia symptoms for more than 20 years. Since there was a clinically high possibility of supraclavicular lymph node metastasis, concurrent chemoradiation therapy was scheduled. After the third cycle of chemoradiation therapy, transthoracic esophageolymphadenectomy was performed. Histopathological examination of the main esophagus specimen revealed no residual carcinoma. And the entire regional lymph node areas were free of carcinoma except for one azygos metastatic lymph node. In summary, achalasia is a predisposing factor for esophageal squamous cell carcinoma. Although surveillance endoscopy in achalasia patients is still controversial, periodic screening for cancer development in long-standing achalasia patients might be advisable.

Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn / 소아과

PURPOSE: The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL. METHODS: Medical records of severe hyperbilirubiemia in newborns (serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants were grouped according to methodology of treatment: Group I (phototherapy only, n=42), Group II (exchange transfusion, n=6). And In addition, we evaluated the etiology and the difference of prognosis. RESULTS: A total of 48 documented cases of severe hyperbilirubinemia were identified. Birth weight was significantly lower in Group 2 (2, 852+/-1, 085 g) compared to Group 1 (3, 137+/-437 g) (P< 0.05). There were no significant differences in gestational age, sex, mode of delivery, inborn, age at presentation, and age at first examination and admission between the two study groups. Maximal bilirubin level was significantly higher in Group 2 (45+/-16 mg/dL) compared to Group 1 (29+/-6 mg/dL) (P< 0.05). But there were no significant differences in neurologic outcome. CONCLUSION: Our study suggests that the present guidelines for managing hyperbilirubinemia in newborns should be effective but follow-up with the first postnatal week would be necessary for each detection and treatment in the newborn infants with high risk of severe hyperbilirubinemia.

A clinical study of results after operation using Tension-free vaginal tape / 대한산부인과학회잡지

OBJECTIVE: The purpose of the study was to evaluate the safety and efficacy of tension-free vaginal tape (TVT) placement for surgical treatment of stress urinary incontinence (SUI) in women. METHODS: A retrospective study of 38 cases with SUI underwent the TVT procedure underlying local anesthesia at Daedong and Sewoong Hospital from March 2000 to December 2000, followed up more than six months who included in the study. RESULT: Operation times ranged from 20 to 53 minutes with a mean of 37.5 minutes. The mean blood loss was 90 mL. One major complication was encountered -bladder perforation (2.5%) and urinary retention was developed in 4 cases (10.5%). Length of hospital stay ranged from 0.8 to 11.3 days with a mean of 1.8 days. On postoperative follow-up from 6.1 to 17.5 months, thirty-three patients (87%) were cured, four (10.5%) were significantly improved and one was failed (2.5%). CONCLUSION: Althouth the follow-up period was short, the TVT procedure seemed to be a safe and effective method for the treatment of stress urinary incontience.