Trends of Diabetes and Prediabetes Prevalence among Korean Adolescents From 2007 to 2018

BackgroundTo provide updated prevalence data and to estimate changes in the prevalence of diabetes among Korean adolescents by sex and age between 2007 and 2018.MethodsWe used the data of children and adolescents (8,718 subjects aged 10 to 18 years) from the Korea National Health and Nutrition Examination Survey IV–VII (KNHANES 2007–2018). The recent prevalence of diabetes and pre-diabetes was estimated by using the latest KNHANES VII. The linear trends were estimated by comparing 3-year KNHANES cycles according to sex and by using logistic regression.ResultsThe prevalence of diabetes and pre-diabetes was 0.298% (95% confidence interval [CI], 0.289–0.308) and 7.914% (95% CI, 0.43–0.49). The prevalence of diabetes significantly increased from 0.189 to 0.430 during KNHANE IV and VII. A positive linear trend is significant for diabetes (P trends = 0.006) in only male subjects. The prevalence of pre-diabetes significantly increased from 5.86 to 12.08 in both sexes. During KNHANES IV and VII, the prevalence of obesity increased significantly.ConclusionBetween 2007 and 2018, the prevalence of diabetes among Korean adolescents increased. Further studies are required to determine the causes of these increases.     

Pediatric Emergency Department Utilization and Coronavirus Disease in Daegu,Korea

BackgroundLimited data exist on children''s utilization of the emergency department (ED) in the ongoing coronavirus disease 2019 (COVID-19) pandemic. Thus, we aimed to examine ED utilization among pediatric patients and the impact of COVID-19 in one large city affected by the outbreak.MethodsThis retrospective study included data from six EDs in Daegu, Korea. We compared the demographic and clinical data of patients presenting to the ED during the COVID-19 pandemic (February 1st–June 30th 2020) with those of patients who visited the ED in this period during 2018 and 2019.ResultsFewer patients, particularly children visited the EDs during the study period in 2020 than those in the previous (2018/2019) year period: the number of adult patient decreased by 46.4% and children by 76.9%. Although the number of patients increased from the lowest point of the decrease in March 2020, the number of pediatric patients visiting the ED remained less than half (45.2%) in June 2020 compared with that of previous years. The proportion of patients with severe conditions increased in adults, infants, and school-aged children, and consequently resulted in increased ambulance use and higher hospitalization rates. Fewer infants and young children but more school-aged children visited the ED with febrile illnesses in 2020 than in 2018/2019.ConclusionThe COVID-19 pandemic has led to a substantial decrease in pediatric ED utilization. These findings can help reallocate human and material resources in the EDs during infectious disease outbreaks.     

Transarterial embolisation for gastroduodenal bleeding following endoscopic resection

Objectives:Transcatheter arterial embolisation (TAE) is widely used to treat gastrointestinal bleeding. This paper reports the safety and efficacy of TAE for bleeding following endoscopic resection, including endoscopic mucosal resection and endoscopic submucosal dissection.Methods:Fifteen consecutive patients (13 males, two females; mean age 62.2 years) from two tertiary medical centres who underwent TAE for gastroduodenal bleeding after endoscopic resection from November 2001 to December 2020 were included. Patient demographics, clinical presentations, angiographic findings, and TAE details were retrospectively reviewed.Results:Immediate bleeding during endoscopic resection was noted in four patients. Delayed bleeding 1–30 days after endoscopic resection in nine patients presented with haematochezia (n = 4), haematemesis (n = 6) and melaena (n = 1). Endoscopic haemostasis was attempted in 11 patients (73.3%) but failed due to continued bleeding despite haemostasis (n = 6), failure to secure endoscopic field (n = 3) and unstable vital signs (n = 2). Eleven patients had positive angiographic findings for bleeding, and all bleeding arteries were embolised except one owing to failed superselection of the bleeder. In the other four patients with negative angiographic findings, the left gastric artery with/without the right gastric artery or the accessory left gastric artery was empirically embolised using gelatin sponge particles. Both technical and clinical success rates were 93.3% (14/15). No procedure-related complications occurred during follow-up.Conclusions:TAE is safe and effective in the treatment of immediate and delayed bleeding after endoscopic resection procedures.Advances in knowledge:This is the first and largest 20-year bicentric study published in English on this topic. Empirical TAE for angiographically negative bleeding sites was also effective without significant complications.     

水中总α放射性测量的制源厚度及效率校准研究

目的 研究制源厚度及效率校准对水中总α放射性测量结果的影响。方法 分别采用²⁴¹Am和天然铀标准溶液加入水样制备样品源、²⁴¹Am标准物质粉末直接铺样制备标准源,研究质量厚度与探测效率的关系、质量厚度对样品源净计数率的影响、有效厚度的测定以及有效厚度法和厚源法对同一水样测量结果的影响。结果 在水样中分别加入²⁴¹Am和天然铀标准溶液测得水样的有效厚度均与经验值4 mg/cm²基本一致;水样的α计数率在质量厚度为2A~5A mg/cm²时近似处于线性增长趋势,>10A mg/cm²时计数率基本平稳不再增加（A为样品盘面积,cm²）;分别采用有效厚度法和厚源法测量同一水样的总α放射性,铺样在质量厚度为10A mg/cm²时,两种方法的结果最一致。结论 在分析水样总α放射性时,为减少因样品源质量厚度不同引起的总α计数率偏差、因标准源质量厚度不同所致的探测效率偏差,铺样厚度均选择为10A mg/cm²较为合理。     

Sacrococcygeal Teratoma : A Tumor at the Center of Embryogenesis

Sacrococcygeal teratoma (SCT) is an extragonadal germ cell tumor (GCT) that develops in the fetal and neonatal periods. SCT is a type I GCT in which only teratoma and yolk sac tumors arise from extragonadal sites. SCT is the most common type I GCT and is believed to originate through epigenetic reprogramming of early primordial germ cells migrating from the yolk sac to the gonadal ridges. Fetal SCT diagnosed in utero presents many obstetrical problems. For high-risk fetuses, fetal interventions (devascularization and debulking) are under development. Most patients with SCT are operated on after birth. Complete surgical resection is the key for tumor control, and the anatomical location of the tumor determines the surgical approaches. Incomplete resection and malignant histology are risk factors for recurrence. Approximately 10–15% of patients have a tumor recurrence, which is frequently of malignant histology. Long-term surveillance with monitoring of serum alpha fetoprotein and magnetic resonance imaging is required. Survivors of SCT may suffer anorectal, urological, and sexual sequelae later in their life, and comprehensive evaluation and care are required.     

Brainstem atrophy in the early stage of Alzheimer’s disease: a voxel-based morphometry study

Brain Imaging and Behavior - Postmortem studies on patients with Alzheimer’s disease (AD) have confirmed that the dorsal raphe nucleus (DRN) in the brainstem is the first brain structure...     

Disorders of Secondary Neurulation : Mainly Focused on Pathoembryogenesis

Recent advancements in basic research on the process of secondary neurulation and increased clinical experience with caudal spinal anomalies with associated abnormalities in the surrounding and distal structures shed light on further understanding of the pathoembryogenesis of the lesions and led to the new classification of these dysraphic entities. We summarized the changing concepts of lesions developed from the disordered secondary neurulation shown during the last decade. In addition, we suggested our new pathoembryogenetic explanations for a few entities based on the literature and the data from our previous animal research. Disordered secondary neurulation at each phase of development may cause corresponding lesions, such as failed junction with the primary neural tube (junctional neural tube defect and segmental spinal dysgenesis), dysgenesis or duplication of the caudal cell mass associated with disturbed activity of caudal mesenchymal tissue (caudal agenesis and caudal duplication syndrome), failed ingression of the primitive streak to the caudal cell mass (myelomeningocele), focal limited dorsal neuro-cutaneous nondisjunction (limited dorsal myeloschisis and congenital dermal sinus), neuro-mesenchymal adhesion (lumbosacral lipomatous malformation), and regression failure spectrum of the medullary cord (thickened filum and filar cyst, low-lying conus, retained medullary cord, terminal myelocele and terminal myelocystocele). It seems that almost every anomalous entity of the primary neural tube may occur in the area of secondary neurulation. Furthermore, the close association with the activity of caudal mesenchymal tissue in secondary neurulation involves a wider range of surrounding structures than in primary neurulation. Although the majority of the data are from animals, not from humans and many theories are still conjectural, these changing concepts of normal and disordered secondary neurulation will provoke further advancements in our management strategies as well as in the pathoembryogenetic understanding of anomalous lesions in this area.     

Perceived Stress,Positive Resources and Their Interactions as Possible Related Factors for Depressive Symptoms

Objective The present study aimed to explore how the patterns of interaction between stress and positive resources differ according to the severity of depression and which resources play the most important role among the various positive resources. Methods The study included 1,806 people who had visited a health screening center for a mental health check-up to evaluate the levels of perceived stress, positive resources, and depressive symptoms. The participants were divided into a depressive group (n=1,642, mean age 50.60, female 68%) and a non-depressive group (n=164, mean age 48.42, female 66.6%). We conducted hierarchical regression analyses and simple slope analyses to examine the interaction between perceived stress and positive resources. Results The interaction between perceived stress and optimism was significantly associated with depression in non-depressive groups. In depressive groups, the interactions between five types of positive resources (optimism, purpose in life, self-control, social support and care) and perceived stress were all significantly related to depression. Conclusion Interventions that promote optimism can be helpful for preventing inevitable stress from leading to depression. A deficiency in positive resources may be a factor in aggravating depression in stressful situations for people reporting moderate to severe depressive symptoms.     

精神科医护人员工作满意度和组织承诺的关系

目的了解精神科医护人员工作满意度和组织承诺现状及关系。方法使用工作满意度量表(MSQ)和组织承诺量表(OCQ)对150名山东省安康医院医护人员进行测查。结果①精神科医护人员工作满意度偏低,组织承诺中等偏上;②不同职业精神科医护人员的内在满意度有显著性差异(t=2.12,P<0.05),不同职称精神科医护人员总体满意度、内在满意度和外在满意度有显著性差异(F=6.03,7.11,P<0.01;F=2.97,P<0.05),不同婚姻状况医护人员工作满意度无显著性差异;③不同职业精神科医护人员规范承诺和总体承诺有显著性差异(t=-2.22,-2.09;P<0.05),不同职称精神科医护人员总体承诺有显著性差异(F=3.03,P<0.05),不同婚姻状况医护人员持续承诺有显著性差异(t=-2.24,P<0.05);④相关分析表明,工作满意度与组织承诺显著相关。结论精神科医护人员的工作满意度处于较低水平;工作满意度和组织承诺受职业类型、职称高低、婚姻状况因素的影响;工作满意度与组织承诺密切相关。