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1.
Dis Colon Rectum ; 57(4): 522-8, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24608310

RESUMO

BACKGROUND: Reduced-volume bowel preparation with a low-residue diet prior to colonoscopy would result in better patient compliance and sufficient bowel preparation. OBJECTIVE: To compare the clinical efficacy of reduced-volume sodium picosulfate and a prepackaged low-residue diet with that of the standard bowel preparation using 4 L of PEG solution. DESIGN: Prospective, single center, single blind, active control, randomized study (NCCCTS-12-619, KCT0000470). SETTING: Ambulatory outpatient clinic at the National Cancer Center, Republic of Korea. PATIENTS: A total of 194 subjects were randomly assigned for this study, 97 in each group. After exclusions, 94 subjects in the Picolight group and 90 in the PEG group completed the study and were analyzed. INTERVENTIONS: Sodium picosulfate with a prepackaged low-residue, one-day diet or 4-L PEG for bowel preparation. MAIN OUTCOME MEASURES: Success rate of the bowel preparation, tolerability, adverse events, cecal intubation time, polyp detection rate and adenoma detection rate. RESULTS: The bowel preparation success rate was significantly higher (91.5% vs. 81.1%, p = 0.04) and the rates of adverse events, including abdominal distension, pain, nausea, vomiting and abdominal discomfort, were significantly lower in the picosulfate group than the PEG group. Cecal intubation times and the polyp and adenoma detection rates were similar in the 2 groups. LIMITATIONS: Single center, limited population, all colonoscopies were performed in the morning. CONCLUSIONS: Bowel preparation with low-volume oral picosulfate and a prepackaged low-residue diet enhances colon cleansing and is better tolerated than the standard bowel preparation.


Assuntos
Catárticos , Citratos , Colonoscopia , Dieta , Compostos Organometálicos , Picolinas , Polietilenoglicóis , Administração Oral , Adulto , Catárticos/administração & dosagem , Catárticos/efeitos adversos , Citratos/administração & dosagem , Citratos/efeitos adversos , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Compostos Organometálicos/administração & dosagem , Compostos Organometálicos/efeitos adversos , Avaliação de Resultados em Cuidados de Saúde , Cooperação do Paciente , Picolinas/administração & dosagem , Picolinas/efeitos adversos , Polietilenoglicóis/administração & dosagem , Polietilenoglicóis/efeitos adversos , Estudos Prospectivos , Método Simples-Cego
2.
Int Immunopharmacol ; 105: 108567, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35114442

RESUMO

Basophils and mast cells are characteristic effector cells in allergic reactions. Sargahydorquinoic acid (SHQA), a compound isolated from Sargassum serratifolium (marine alga), possesses various biochemical properties, including potent antioxidant activities. The objective of the present study was to investigate inhibitory effects of SHQA on the activation of human basophilic KU812F cells induced by phorbol myristate acetate and A23187 (PMACI), a calcium ionophore. Furthermore, we confirmed the inhibitory effects of SHQA on the activation of rat basophilic leukemia (RBL)-2H3 cells induced by compound 48/80 (com 48/80), bone marrow-derived mast cells (BMCMCs) induced by anti-dinitrophenyl(DNP)-immunoglobulin E (IgE)/DNP-bovine serum albumin (BSA), DNP/IgE and on the reaction of passive cutaneous anaphylaxis (PCA) mediated by IgE. SHQA reduced PMACI-induced intracellular reactive oxygen species (ROS) and calcium levels. Western blot analysis revealed that SHQA downregulated the activation of ERK, p38, and NF-κB in a dose-dependent manner. Moreover, SHQA suppressed the production and gene expression of various cytokines, including interleukin (IL)-1 ß, IL-4, IL-6, and IL-8 in PMACI-induced KU812F cells and IL-4 and tumor necrosis factor (TNF)- α in com 48/80-induced RBL-2H3 cells. It also determined the inhibition of PMACI, com 48/80- and IgE/DNP-induced degranulation by reducing the release of ß -hexosaminidase. Furthermore, it attenuated the IgE/DNP-induced PCA reaction in the ears of BALB/c mice. These results suggest that SHQA isolated from S. serratifolium is a potential therapeutic functional food material for inhibiting effector cell activation in allergic reactions and anaphylaxis in animal model.


Assuntos
Anafilaxia , Sargassum , Alcenos , Anafilaxia/metabolismo , Animais , Basófilos , Benzoquinonas , Mastócitos , Camundongos , Camundongos Endogâmicos BALB C , Anafilaxia Cutânea Passiva , Ratos
3.
Artigo em Coreano | WPRIM | ID: wpr-1001678

RESUMO

Patellofemoral instability, by definition, is a condition where the patella bone pathologically disarticulates out from the patellofemoral joint, either through subluxation or complete dislocation. The overall incidence of patellofemoral instability ranges between 5.8 and 29 per 100,000. Over time, patients with patellar instability can have debilitating pain, limitations in basic function, and long-term arthritis.Current Concepts: Risk factors for patellofemoral instability include trochlear dysplasia, patella alta, increased tibial tubercle-to-trochlear groove distance, abnormal patella lateral tilt, and coronal and torsional malalignment. The proper treatment is often debatable. Conservative treatment is suitable for acute dislocation but has a high failure rate for chronic instability, which usually necessitates surgical treatment. Today’s common surgical treatments focus on fixing anatomical defects, relieving symptoms of instability, and allowing patients to return to a suitable level of activity.Discussion and Conclusion: In this review, we summarize the relevant pathophysiology, categorization, clinical features, physical examination, imaging, and treatment options for patellofemoral instability.

4.
Artigo em Inglês | WPRIM | ID: wpr-999443

RESUMO

Purpose@#This study aimed to assess the performance of ChatGPT, specifically the GPT-3.5 and GPT-4 models, in understanding complex surgical clinical information and its potential implications for surgical education and training. @*Methods@#The dataset comprised 280 questions from the Korean general surgery board exams conducted between 2020 and 2022. Both GPT-3.5 and GPT-4 models were evaluated, and their performances were compared using McNemar test. @*Results@#GPT-3.5 achieved an overall accuracy of 46.8%, while GPT-4 demonstrated a significant improvement with an overall accuracy of 76.4%, indicating a notable difference in performance between the models (P < 0.001). GPT-4 also exhibited consistent performance across all subspecialties, with accuracy rates ranging from 63.6% to 83.3%. @*Conclusion@#ChatGPT, particularly GPT-4, demonstrates a remarkable ability to understand complex surgical clinical information, achieving an accuracy rate of 76.4% on the Korean general surgery board exam. However, it is important to recognize the limitations of large language models and ensure that they are used in conjunction with human expertise and judgment.

5.
Artigo em Inglês | WPRIM | ID: wpr-976943

RESUMO

Background@#Liver transplant (LT) recipients were considered a vulnerable population during the coronavirus disease 2019 (COVID-19) pandemic. The clinical efficacy of the COVID-19 vaccine is unknown in immunocompromised patients. The purpose of this study was to provide evidence of antibody responses after COVID-19 vaccination in LT recipients. @*Methods@#This study enrolled 46 patients who underwent LT at Samsung Medical Center (Seoul, Korea) before implementation of the one-dose vaccine in Korea. Those who completed the two-dose COVID-19 vaccine between August 2021 and September 2021 were included and followed through December 2021. Semiquantitative anti-spike serologic testing was performed using the Roche Elecsys anti-SARS-CoV-2 S enzyme immunoassay (Roche Diagnostics, Rotkereuz, Switzerland) with a positive cutoff of at least 0.8 U/mL. @*Results@#Among all 46 participants, 40 (87%) demonstrated an antibody response after the second dose of a COVID-19 vaccine, while six (13%) had no antibody response after the second dose. Upon univariate analysis, patients with higher antibody titer had longer years since LT (2.3 ± 2.8 vs. 9.4 ± 5.0, P < 0.001). A lower median tacrolimus (TAC) level before vaccination and after the second dose of COVID-19 vaccine indicated a significantly higher antibody response (2.3 [1.6–3.2] vs. 7.0 [3.7–7.8], P = 0.006, 2.5 [1.6–3.3] vs. 5.7 [4.2–7.2], P = 0.003). Period between 2nd vaccination and serologic testing was significantly higher in the antibody-response group compared to the no-antibody-response group (30.2 ± 24.0 vs. 65.9 ± 35.0, P = 0.012). A multivariate analysis of antibody responses revealed TAC level before vaccination as a statistically significant factor. @*Conclusion@#A higher TAC level before vaccination resulted in less effective vaccination in LT patients. Booster vaccinations are required, especially for patients in the early stage after LT who have compromised immune function.

6.
Annals of Dermatology ; : S88-S92, 2023.
Artigo em Inglês | WPRIM | ID: wpr-976637

RESUMO

PELVIS syndrome describes the constellation of perineal hemangioma, external genitalia malformations, lipomyelomeningocele, vesicorenal abnormalities, imperforate anus, and skin tag. A 2-month-old girl presented with infantile hemangioma on her perineum and genitalia with imperforate anus, rectovaginal fistula and perineal skin tag at birth. Under the impression of PELVIS syndrome, consequential spinal sonography was conducted and revealed an intrasacral meningocele without clinical neurologic deficit. The anorectal malformation was surgically corrected, she was taking oral propranolol for the cutaneous lesion, and she showed improvement and no complications.

7.
Artigo em Inglês | WPRIM | ID: wpr-999433

RESUMO

Purpose@#This study evaluated the clinical implication of hepatic venous territory mapping in living donor liver transplantation. @*Methods@#Living donor liver transplantations performed using right graft since 2017 were included. Hepatic venous volume mapping was started in 2019. Risk factors for graft failure and overall survival were analyzed. Analysis for factors related to occlusion of reconstructed vein was performed. @*Results@#Among 445 patients included, 213 underwent hepatic venous mapping. Hepatic venous mapping itself was not a significant factor for graft (hazard ratio [HR], 0.958; 95% confidence interval [CI], 0.441–2.082; P = 0.913) and overall survival (HR, 0.627; 95% CI, 0.315–1.247; P = 0.183). Inferior hepatic vein occlusion was a significant risk factor for both graft survival (HR, 8.795; 95% CI, 1.628–47.523; P = 0.012) and overall survival (HR, 11.13; 95% CI, 2.460–50.300; P = 0.002). In a subgroup with middle hepatic vein reconstruction, occlusion was a significant risk factor for overall survival (HR, 3.289;95% CI, 1.304–8.296; P = 0.012). In patients with middle hepatic vein reconstruction whose venous territory volumes were measured, right anterior volume of ≥300 cm 3 was protective for vein occlusion (OR, 0.317; 95% CI, 0.152–0.662; P = 0.002). In patients with V5 reconstruction, V5 volume of ≥150 cm 3 was protective for vein occlusion (OR, 0.253; 95% CI, 0.087–0.734; P = 0.011). @*Conclusion@#Inferior and middle hepatic vein reconstruction has significant impact on clinical outcome. Hepatic venous territory mapping can provide an objective measure for successful reconstruction of venous branches.

8.
Artigo em Inglês | WPRIM | ID: wpr-999415

RESUMO

Purpose@#Liver fibrosis plays an important role in the development of hepatocellular carcinoma (HCC) and determining its prognosis. Although many staging systems and liver reserve models have been developed without the intention of predicting prognosis of HCC, some studies have investigated their prognostic values in HCC after curative liver resection (LR). The aim of this study is to evaluate prognostic value of non-invasive biomarkers after curative LR. @*Methods@#Between 2006 and 2013, HCC patients underwent LR were included and total 962 patients were enrolled. All non-invasive biomarkers (fibrosis 4 index (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), AAR-to-platelet ratio index (AARPRI), and albumin-bilirubin (ALBI) score) were measured at the time of HCC diagnosis. To binarize each biomarker, an optimal cut-off value for fibrosis stage was selected using the value of minimum distance from the left-upper corner of the receiver operating characteristic curve with a specificity >60%. We performed Cox regression analysis on 2-year recurrence-free survival (RFS) and overall survival (OS). @*Results@#The area under curve values for FIB-4 and APRI were the largest for fibrosis stage compared to other biomarkers, 0.669 (95% confidential interval (CI), 0.610–0.719) and 0.748 (95% CI, 0.692–0.800), respectively. Between those two indices, FIB-4 is considered a statistically significant prognostic factor of RFS in HCC patients after LR. The HR for 2-year RFS and OS were 1.81 (95% CI, 1.18–2.77; P = 0.007) and 2.36 (95% CI, 0.99–5.65; P = 0.054), respectively. @*Conclusion@#FIB-4 is identified as a statistically significant predictor of HCC prognosis after curative LR even in HBV dominant populations.

9.
Artigo em Inglês | WPRIM | ID: wpr-1002458

RESUMO

Bovine viral diarrhea virus (BVDV), which is prevalent worldwide, is one of the most important viral pathogens and causes substantial economic loss to the livestock industry. Despite its importance, BVDV is largely unnoticed in the Republic of Korea (ROK). In this study, we report the case of a steer with BVDV that died suddenly due to severe enteritis. Two 1-year-old Korean indigenous cattle in the same herd presented severe hemorrhagic diarrhea. Case 1 had severe dehydration and died after 3 days, whereas case 2 had anorexia, depression, and severe diarrhea with mucus and blood. Only case 2 was necropsied, and BVDV2a was detected in the tissues of its alimentary tract. Gross lesions, including erosion, ulceration, and extensive hemorrhage, were observed in the digestive tract mucosa. Immunohistochemistry revealed marked positive staining for BVDV2a antigen in the large intestine. This report describes the first case of hemorrhagic disease caused by acute BVDV2a infection, which is characterized by high mortality in Korean indigenous cattle. This study will help establish vaccination and control strategies for BVDV in the ROK.

10.
Artigo em Inglês | WPRIM | ID: wpr-1002218

RESUMO

For all suspected, clinical, or confirmed cases of scabies, treatment should be initiated. Affected patients should be adequately isolated, and high-risk groups with close contact histories should be treated irrespective of their symptoms. Optimal treatment strategies can be selected based on age, clinical subtype, and patient’s health status. In Korea, commercially available preparations for scabies treatment include topical 5% permethrin, topical 10% crotamiton, and oral ivermectin. Topical 5% permethrin is the first-line selective treatment for both classic and crusted scabies. Alternative treatments are topical 10% crotamiton and oral ivermectin. Following treatment completion, a follow-up visit at 2 and 4 weeks is recommended to monitor therapeutic response. Treatment failure is considered when scabies mites or burrows are detected, upon development of new clinical characteristics, or upon aggravation of pruritus. Scabies itch should be adequately managed with emollients, oral antihistamines, and topical corticosteroids. Preventive measures, including personal hygiene, patient education, and environmental control should be rendered to reduce the transmission of scabies.

11.
Artigo em Inglês | WPRIM | ID: wpr-1002166

RESUMO

Scabies is a skin disease caused by the parasite Sarcoptes scabiei var. hominis, primarily transmitted via direct skin or sexual contact or, less commonly, via contact with infested fomites. In Korea, the incidence of scabies has decreased from approximately 50,000 people/yr in 2010 to approximately 30,000 people/yr in 2021. However, outbreaks have been consistently observed in residential facilities, such as nursing facilities, particularly among the older population. The clinical manifestations of scabies vary depending on a patient’s age, health status, number of mites, and transmission route. Typical clinical presentations of classic scabies include intense nocturnal pruritus and characteristic skin rashes (burrows and erythematous papules), with a predilection for the interdigital web spaces, inner wrists, periumbilical areas, axillae, and genital areas. Unlike classic scabies, older adults with immunodeficiency or neurological disorders exhibit hyperkeratotic scaly lesions or an atypical distribution with mild-to-non pruritus (crusted scabies). Diagnosis of scabies is based on clinical symptoms and results of diagnostic tests aimed at identifying the presence of the parasite. Although a close contact history and characteristic clinical findings are suggestive of scabies, confirmation of diagnosis requires detection of scabies mites, eggs, or scybala.This can be achieved through light microscopy of skin samples, non-invasive dermoscopy, and other high-resolution in vivo imaging techniques.

12.
Artigo em Inglês | WPRIM | ID: wpr-977205

RESUMO

Merkel cell carcinoma (MCC), a rare cutaneous neuroendocrine carcinoma, is most common in sun-exposed areas of aged individuals. Merkel cell polyomavirus (MCPyV) is one causative agent of MCC. Cases of MCC concurrent with other skin tumors, especially squamous cell carcinoma, are rarely reported. Immunohistochemical staining is performed using antibodies to the MCPyV large-T antigen (CM2B4) only in select cases. To date, no cases of MCPyV have been reported in Korea. Here we report a case of MCC concurrent with squamous cell carcinoma in an aged man and discuss the pathogenesis of the case through CM2B4 staining.

13.
Artigo em Inglês | WPRIM | ID: wpr-976979

RESUMO

Background@#This study aimed to 1) assess the effect of total hip arthroplasty (THA) on coronal limb alignment, namely, the hip–knee–ankle angle (HKA), 2) identify factors that determine changes in the HKA, and 3) determine whether alignment changes influence the knee joint space width. @*Methods@#We retrospectively evaluated 266 limbs of patients who underwent THA. Three types of prostheses with neck shaft angles (NSAs) of 132°, 135°, and 138° were used. Several radiographic parameters were measured in the preoperative and final radiographs (at least 5 years after THA). A paired t-test was used to confirm the effect of THA on HKA change.Multiple regression analysis was performed to identify radiographic parameters related to HKA changes following THA and changes in knee joint space width. Subgroup analyses were performed to reveal the effect of NSA change on the HKA change, and the proportion of total knee arthroplasty usage and changes in radiographic parameters between maintained joint space and narrowed joint space groups were compared. @*Results@#The preoperative mean HKA was 1.4° varus and increased to 2.7° varus after THA.This change was related to changes in the NSA, lateral distal femoral angle, and femoral bowing angle. In particular, in the group with a decrease in NSA of > 5°, the preoperative mean HKA was largely changed from 1.4° varus to 4.6° varus after THA. The prostheses with NSA of 132° and 135° also led to greater varus HKA changes than those with an NSA of 138°. Narrowing of the medial knee joint space was related to changes in the varus direction of the HKA, decrease in NSA, increase in femoral offset. @*Conclusion@#A large reduction in NSA can lead to considerable varus limb alignment after THA, which can have adverse effects on the medial compartment of the ipsilateral knee.

14.
Artigo em Inglês | WPRIM | ID: wpr-999783

RESUMO

Purpose@#In the latest staging system of the American Joint Committee on Cancer for intrahepatic cholangiocarcinoma (IHCCC), solitary tumors with vascular invasion and multiple tumors are grouped together as T2. However, recent studies report that multifocal IHCCC has a worse prognosis than a single lesion. This study aimed to investigate the risk factors for IHCCC and explore the prognostic significance of multiplicity after surgical resection. @*Materials and Methods@#A total of 257 patients underwent surgery for IHCCC from 2010 to 2019 and the clinicopathological data were retrospectively reviewed. Risk factor analysis was performed to identify variables associated with survival after resection. Survival outcomes were compared between patients with solitary and multiple tumors. @*Results@#In multivariable analysis, the presence of preoperative symptoms, tumor size, lymph node ratio, multiplicity, and tumor differentiation were identified as risk factors for survival. Among 82 patients with T2, overall survival was significantly longer in patients with solitary tumors (sT2) than in those with multiple tumors (mT2) (p=0.017). Survival was compared among patients with stage II-sT2, stage II-mT2, and stage III. The stage II-sT2 group showed prolonged survival when compared with stage II-mT2 or stage III. Survivals of stage II-mT2 and stage III patients were not statistically different. @*Conclusion@#Tumor multiplicity was an independent risk factor for overall survival of IHCCC after surgical resection. Patients with multiple tumors showed poorer survival than patients with a single tumor. The oncologic significance of multiplicity in IHCCC should be reappraised and reflected in the next staging system update.

15.
Artigo em Inglês | WPRIM | ID: wpr-999466

RESUMO

Purpose@#Deceased donor liver transplantation (DDLT) recipients in Korea are generally sicker due to an increasing organ shortage. In the present study, the risk factors for early 30-day liver graft failure after DDLT were identified. @*Methods@#From August 2017 to February 2021, 265 adult DDLTs were performed. The characteristics of patients with and without 30-day graft failure were compared. @*Results@#Liver graft failure occurred in 11 patients (17.7%) after DDLT. Baseline and perioperative characteristics of donors and recipients were not statistically significantly different between the 2 groups. The cumulative graft and overall survival rates at 6 months were 83.9% and 88.7%, respectively. Multivariate analysis showed ventilator support in the pretransplant period was a predisposing factor for 30-day graft failure after DDLT. @*Conclusion@#Present study indicates that cautious decision is required when allocating DDLT in critically ill patients on mechanical ventilatory support.

16.
Artigo em Inglês | WPRIM | ID: wpr-999457

RESUMO

Purpose@#The skeletal muscle index (SMI) at the L3 level is widely used to diagnose sarcopenia. The upper thigh (UT) also reflects changes in whole-body muscle mass, but no study has examined this using the UT to diagnose sarcopenia in liver transplantation (LT). This study aimed to determine an optimal cut-off value for UT-SMI and investigate how sarcopenia diagnosed by UT-SMI correlates with outcomes in LT recipients. @*Methods@#In this retrospective study of 332 LT patients from 2018 to 2020, we investigated the association between sarcopenia diagnosed by UT-SMI and patient outcomes after LT. @*Results@#The cut-off values for UT-SMI were 38.3 cm 2 /m 2 for females (area under the curve [AUC], 0.927; P < 0.001) and 46.7 cm 2 /m 2 for males (AUC, 0.898; P < 0.001). The prevalence of sarcopenia diagnosed by UT-SMI was 33.4% in our cohort. Patient and graft survival rates in the UT-SMI sarcopenia group were significantly poorer than those in the UT-SMI non-sarcopenia group (P < 0.001 and P < 0.001). UT-SMI was an independent prognostic factor for patient survival (hazard ratio [HR], 2.182; 95% confidence interval [CI], 1.183–4.025; P = 0.012) and graft survival (HR, 2.227; 95% CI, 1.054–4704; P = 0.036) in our multivariable Cox analysis. @*Conclusion@#We confirmed that sarcopenia diagnosed by UT-SMI is associated with outcomes in LT recipients. In addition, UT-SMI was identified as an independent prognostic factor for patient survival and graft survival. Therefore, UT-SMI could be a good option for CT-based evaluations of sarcopenia in LT recipients.

17.
Annals of Dermatology ; : 190-204, 2023.
Artigo em Inglês | WPRIM | ID: wpr-976631

RESUMO

Background@#Alopecia areata (AA) is a chronic disease with an unpredictable disease course and severe psychological impact. @*Objective@#To provide evidence- and consensus-based insights regarding the treatment of patients with AA in Korea. @*Methods@#We searched for relevant studies on the topical and device-based treatment of AA in the literature from inception until May 2021. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statements, and an agreement of 75% or greater was considered as consensus. @*Results@#Currently, there remains a scarcity of topical treatments, which is supported by robust evidence from a number of high-quality randomized controlled trials. Current evidence supports the efficacy of topical corticosteroids, corticosteroid intralesional injection, and contact immunotherapy in AA patients. Topical corticosteroids and contact immunotherapy are recommended for pediatric AA. A consensus was achieved in 6 out of 14 (42.8%), and 1 out of 5 (20.0%) statements pertaining to topical and device-based treatments in AA, respectively. The expert consensus was from a single country, and the study may not cover all the treatments used. @*Conclusion@#The present study provides up-to-date, evidence-based treatment guidelines for AA based on the consensus reached among experts after considering regional healthcare circumstances, adding diversity to the previous guidelines.

18.
Annals of Dermatology ; : 205-216, 2023.
Artigo em Inglês | WPRIM | ID: wpr-976630

RESUMO

Background@#Alopecia areata (AA) is a chronic disease with an unpredictable course and can have a severe psychological impact on an individual. @*Objective@#To provide evidence and consensus-based statements regarding the treatment of patients with AA in Korea. @*Methods@#We searched for relevant studies from inception to May 2021 regarding the systemic treatment of AA. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statement, and an agreement of 75% or greater was considered as having reached consensus. @*Results@#Current evidence supports the efficacy of systemic corticosteroids, oral cyclosporine monotherapy or combination with systemic corticosteroids, and oral Janus kinase inhibitors in severe AA patients. Systemic steroids may be considered for pediatric patients with severe AA. A consensus was achieved in three out of nine (33.3%), and one out of three (33.3%) statements pertaining to systemic treatment in adult and pediatric AA, respectively. @*Conclusion@#The present study produced up-to-date, evidence-based treatment guidelines for AA associated with the consensus obtained by experts based on the Korean healthcare system.

19.
Artigo em Inglês | WPRIM | ID: wpr-926475

RESUMO

Background@#Emergent and re-emergent canine tick-borne infections are attracting increasing attention worldwide. The rise in pet ownership and the close relationship between dogs and their owners are the most concerning factors because dogs may act as competent reservoirs for human tick-transmitted infectious agents. @*Objectives@#This study contributes to the epidemiological surveillance of canine ticktransmitted infections with zoonotic risk in the Republic of Korea (ROK) by investigating the seroprevalence of the pathogens, Anaplasma spp., Borrelia burgdorferi, and Ehrlichia canis. @*Methods@#Four hundred and thirty whole blood samples from domestic dogs were collected in seven metropolitan cities and nine provinces in the ROK and tested using SensPERT Ab test kits (VetAll Laboratories®) to detect seroreactive animals. @*Results@#The seroprevalence rates identified were 9.8% (42/430) for Anaplasma spp., 2.8% (12/430) for B. burgdorferi, and 1.4% (6/430) for E. canis. The risk factors evaluated in this study that could be associated with the development of a humoral immune response, such as sex, age, and history of tick exposure, were similar. There was only one exception for dogs seroreactive to Anaplasma spp., where the risk factor “tick exposure” was statistically significant (p = 0.047). @*Conclusions@#This serological survey exhibited the widespread presence of Anaplasma spp., B.burgdorferi, and E. canis throughout the ROK. Hence, dogs may play a key role as the sentinel animals of multiple zoonotic infectious agents in the country.

20.
Artigo em Inglês | WPRIM | ID: wpr-913537

RESUMO

Purpose@#Hepatocellular carcinoma (HCC) is rare in HCV patients without cirrhosis, and little is known about the postoperative results of these patients. The present study compares the outcomes of cirrhotic and non-cirrhotic groups after liver resection (LR) in solitary HCV-related HCC patients and identifies risk factors for prognosis according to the presence or absence of cirrhosis in these patients. @*Methods@#Two hundred and 7 adult hepatectomy patients with treatment-naïve solitary HCV-related HCC were identified prospectively at our institution between July 2005 and May 2019. @*Results@#The non-cirrhotic group had better liver function than the cirrhotic group based on platelet count, liver function tests, liver stiffness measurement, and indocyanine green retention rate at 15 minutes but were older than the cirrhotic group. Consistently, noninvasive markers in the cirrhotic group were significantly higher than in the non-cirrhotic group. The cumulative disease-free survival and overall survival in the non-cirrhotic group were significantly higher than in the cirrhotic group. HCC recurrence was related to major LR and α-FP of >40 ng/mL and death was related to long hospitalization and α-FP of >40 ng/mL in multivariate analysis. Noninvasive markers and the presence of cirrhosis were not related to HCC recurrence or death in multivariate analyses. @*Conclusion@#The cirrhotic group showed poor prognosis due to poor liver function after LR compared to the non-cirrhotic group, but this was not sustained in multivariate analysis. The factors influencing HCC recurrence and death were different in the cirrhotic and non-cirrhotic groups.

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