No abstract available.
Foreign Bodies* ; Granuloma, Foreign-Body* ; Lipectomy*

We report a case of rare cervical isthmic spondylolisthesis of C6-7 combined occult spinal bifida at C6, and review the radiologic finding, different diagnosis and treatment. A 23-year old female presented nuchal, back pain after traffic accident. Radiologic finding showed the 6th cervical isthmic defect, spondylolisthesis and dysplasia. The patient was conservatively treated about 8 weeks, and 10 months after injury, she was symptom free with full range of motion of cervical spine and she was followed up. Cervical spondylolysis is a very rare condition. This clinical importance is vulnerable to trauma. For whatever reasons, symptomatic patients need to be treated by conservative or surgical option.
Accidents, Traffic ; Back Pain ; Cervical Vertebrae ; Female ; Humans ; Range of Motion, Articular ; Spine ; Spondylolisthesis ; Spondylolysis

PURPOSE: To evaluate the efficacy of two-phase dynamic helical CT, including the gastric mucosal phase, for the detection of atypical non-hyperattenuating early gastric carcinoma (EGC). MATERIALS AND METHODS: In 32 patients, we evaluated the two-phase helical CT findings of endoscopically suspected EGC for changes of the inner hyperattenuating mucosal layer, the hypoattenuating outer layer and the serosal surface. Two gastrointestinal radiologists working together reached their conclusions before pathologic diagnosis had been made. The first, so-called gastric mucosal, phase was obtained 38 -45 sec after the start of IV injection of 150 ml/sec contrast material at a rate of 4 ml/sec to obtain maximum enhancement of the mucosal layer. RESULTS: Among 32 patients, EGC was confirmed in 30 and AGC (T2) in two. Using two-phase helical CT, the detection rate for typical hyperattenuating EGC was 27 % (8/30). Lesions showing focal interruption of the mucosal layer without abnormal enhancement of the outer layer (EGC atypical enhancement pattern type 1) were detected in five patients during the mucosal phase, and were pathologically confirmed as 3 EGC IIc+III, 1IIc+IIa, and I IIb+IIc. Lesions showing a locally protuding lesion of the inner and preserved outer layers, with a smooth serosal surface (EGC atypical enhancement pattern type 2) and which could be distinguished from normal folds, were detected in six patients during the mucosal phase, and were pathologically confirmed as 2 EGC IIb+IIc, 1 IIc+IIa, and 3 IIc+IIb. Lesions were less distinct during the equilibrium phase, and there was no change in the enhancement pattern. The overall detection rate for EGC in which an atypical enhancement pattern was added to the typical one showed improvement (19/30, 63 % ). CONCLUSION: Helical CT using a two-phasic scan technique including the mucosal phase was efficient for various combinations of EGC II and/or III, including IIc. The findings were atypical and non-hyperattenvating, but reliable, and improved the overall detection rate.
Diagnosis ; Humans ; Stomach Neoplasms* ; Tomography, Spiral Computed*

Medial meniscal root tears have been repaired using various methods. Arthroscopic all-inside repair using a suture anchor is one of the popular methods. However, insertion of the suture anchor into the proper position at the posterior root of the medial meniscus is technically difficult. Some methods have been reported to facilitate suture anchor insertion through a high posteromedial portal, a posterior trans-septal portal, or a medial quadriceptal portal. Nevertheless, many surgeons still have difficulty during anchor insertion. We introduce a technical tip for easy suture anchor insertion using a 25° curved guide and a soft suture anchor through a routine posteromedial portal.
Menisci, Tibial ; Surgeons ; Suture Anchors* ; Sutures* ; Tears

Background: In some patients, coronavirus disease 2019 (COVID-19) is accompanied by loss of smell and taste, and this has been reportedly associated with exposure to air pollutants. This study investigated the relationship between the occurrence of chemosensory dysfunction in COVID-19 patients and air pollutant concentrations in Korea. Methods: Information on the clinical symptom of chemosensory dysfunction, the date of diagnosis, residential area, age, and sex of 60,194 confirmed COVID-19 cases reported to the Korea Disease Control and Prevention Agency from January 20 to December 31, 2020 was collected. In addition, the daily average concentration of air pollutants for a week in the patients’ residential area was collected from the Ministry of Environment based on the date of diagnosis of COVID-19. A binomial logistic regression model, using age and gender, standardized smoking rate, number of outpatient visits, 24-hour mean temperature and relative humidity at the regional level as covariates, was used to determine the effect of air pollution on chemosensory dysfunction. Results: Symptoms of chemosensory dysfunction were most frequent among patients in their 20s and 30s, and occurred more frequently in large cities. The logistic analysis showed that the concentration of particulate matter 10 (PM 10 ) and 2.5 (PM 2.5 ) up to 2 days before the diagnosis of COVID-19 and the concentration of sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), carbon monoxide (CO), and ozone (O 3) at least 7 days before the diagnosis of COVID-19 affected the development of chemosensory dysfunction. In the logistic regression model adjusted for age, sex, standardized smoking rate, number of outpatient visits, and daily average temperature and relative humidity, it was found that an increase in the interquartile range of PM 10 , PM 2.5 , SO 2 , NO 2 , and CO on the day of diagnosis increased the incidence of chemosensory dysfunction 1.10, 1.10, 1.17, 1.31, and 1.19-fold, respectively. In contrast, the O 3 concentration had a negative association with chemosensory dysfunction. Conclusion High concentrations of air pollutants such as PM 10 , PM 2.5 , SO 2 , NO 2 , and CO on the day of diagnosis increased the risk of developing chemosensory dysfunction from COVID-19 infection. This result underscores the need to actively prevent exposure to air pollution and prevent COVID-19 infection. In addition, policies that regulate activities and products that create high amounts of harmful environmental wastes may help in promoting better health for all during COVID-19 pandemic.

We present a case of an unusual infectious complication of a ruptured mediastinal abscess after endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), which led to malignant pleural effusion in a patient with stage IIIA non-small-cell lung cancer. EBUS-TBNA was performed in a 48-year-old previously healthy male, and a mediastinal abscess developed at 4 days post-procedure. Video-assisted thoracoscopic surgery was performed for debridement and drainage, and the intraoperative findings revealed a large volume pleural effusion that was not detected on the initial radiographic evaluation. Malignant cells were unexpectedly detected in the aspirated pleural fluid, which was possibly due to increased pleural permeability and transport of malignant cells originating in a ruptured subcarinal lymph node from the mediastinum to the pleural space. Hence, the patient was confirmed to have squamous cell lung carcinoma with malignant pleural effusion and his TNM staging was changed from stage IIIA to IV.
Abscess* ; Debridement ; Drainage ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Humans ; Lung ; Lung Neoplasms ; Lymph Nodes* ; Male ; Mediastinum ; Middle Aged ; Needles* ; Neoplasm Staging ; Permeability ; Pleural Effusion ; Pleural Effusion, Malignant* ; Thoracic Surgery, Video-Assisted

BACKGROUND AND PURPOSE: The purpose of this study was to characterize abnormal cortical activity during sleep in restless legs syndrome (RLS) patients and to determine the effects of treatment with a dopamine agonist. Based on whole-brain electroencephalograms, we attempted to verify alterations in the functional network as well as the spectral power of neural activities during sleep in RLS patients and to determine whether the changes are reversed by treatment with pramipexole. METHODS: Twelve drug-naïve RLS patients participated in the study. Overnight polysomnography was performed before and after treatment: the first recording was made immediately prior to administering the first dose of pramipexole, and the second recording was made 12–16 weeks after commencing pramipexole administration. Sixteen age-matched healthy participants served as a control group. The spectral power and interregional phase synchrony were analyzed in 30-s epochs. The functional characteristics of the cortical network were quantified using graph-theory measures. RESULTS: The delta-band power was significantly increased and the small-world network characteristics in the delta band were disrupted in RLS patients compared to the healthy controls. These abnormalities were successfully treated by dopaminergic medication. The delta-band power was significantly correlated with the RLS severity score in the RLS patients prior to treatment. CONCLUSIONS: Our findings suggest that the spectral and functional network characteristics of neural activities during sleep become abnormal in RLS patients, and these abnormalities can be successfully treated by a dopamine agonist.
Delta Rhythm* ; Dopamine Agonists* ; Dopamine* ; Electroencephalography ; Healthy Volunteers ; Humans ; Polysomnography ; Restless Legs Syndrome*

PURPOSE: The gastric cancer is most frequent malignant disease in Korea. With increase of GNP and social welfare, lot of people pay attention to that. But many of gastric cancer patients who were diagnosed, are advanced -stage III or more- case and produces poor result of treatment. Nowadays many surgeons report that the resection of cancer mass and radical lymph node dissection, which called systematic lymph node dissection, can increase the longterm survival rate and curability of patients. For this purpose Maruyama and his colleagues made a program to predict the 5 year survival rate, cause of death, and the status of lymph node metastases. We put the basic datas of pateints in AGC into Maruyama's program and compare its result to final histologic reports. We would check sesitivity, specificity, positive predictive value, negative predictive values between Maruyamas program and hitologic reports. MATERIALS AND METHODS: From Sep. 1995 to Sep. 1996, We operated 55 patients with gastric cancer with this program in GNUH. We checked the histopathologic reports and put the data into the prediction program. The datas were sex, age, maximal size of tumor, differentiation, gross type and location. We compared status of lymph node metastases, TNM stages between the reports of histopathology and that of predictive program. RESULTS: In early stages the sensitivity and specificity of the program showed poor result but in advanced stages did not. The distribution of lymph node metastasis showed a same pattern. The patterns of perigastric lymph node metastasis were somewhat different according to the location of tumor. But its significance was not confirmed. We analysed the metastaic rate between lymph node groups and compared with the results between two reports. The sensitivity, and negative predictive value were 100% in each groups, and positive predictive value was also high. CONCLUSION: The systematic lymph node dissection is an effective and safe procedure in the surgical treatment of gastric cancer. We suggest that the techniques should be standardized and popularized in Korea. This procedure will improve the survival rate of gastric cancer patients and decrease the local recurrence of gastric cancer.
Cause of Death ; Humans ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Recurrence ; Sensitivity and Specificity ; Social Welfare ; Stomach Neoplasms* ; Survival Rate

BACKGROUND: Defects of the cheek present a reconstructive challenge because of the visibility of the site, as well as the limited local tissue supply. In addition, the cheek abuts several structures with expressive function, such as the eye, mouth, and surrounding facial musculature. This report describes a system of classifying cheek defects according to tumor size and location and present corresponding reconstruction techniques used to accomplish three-dimensional restoration of all missing components and adequate texture matching. METHODS: From 2008 to 2013, 27 patients with cheek defects resulting from skin cancer excision were treated. According to the size of the defect, location on the cheek, and relationships to adjacent structures and existing skin tension lines, different surgical methods were applied. RESULTS: The procedures used for cheek reconstruction included direct closure, Limberg flap, V-Y advancement flap, slide-swing flap, cheek rotation flap, and full-thickness skin graft. All flaps healed well without major complications, and no cancer recurrence was detected during follow-up. CONCLUSIONS: The anatomic classification of skin cancers and surgical protocols described in this report is simple and appropriate for reconstruction involving the cheek. Wide excision of skin cancer and appropriate, relatively easy-to-perform flaps based on this classification system can successfully produce safe and aesthetically-pleasing surgical outcomes.
Cheek* ; Classification ; Esthetics ; Follow-Up Studies ; Humans ; Mouth ; Reconstructive Surgical Procedures ; Recurrence ; Skin Neoplasms* ; Skin* ; Surgical Flaps ; Transplants

A 57-year old man who was admitted to an emergency room of a tertiary hospital with hemoptysis developed malarial fever 19 days later and then died from severe falciparum malaria 2 days later. He had not traveled outside of Korea for over 30 years. Through intensive interviews and epidemiological surveys, we found that a foreign patient with a recent history of travel to Africa was transferred to the same hospital with severe falciparum malaria. We confirmed through molecular genotyping of the MSP-1 gene that Plasmodium falciparum genotypes of the 2 patients were identical. It is suggested that a breach of standard infection control precautions resulted in this P. falciparum transmission between 2 patients in a hospital environment. This is the first report of a nosocomial transmission of falciparum malaria in Korea.
Africa ; Amino Acid Sequence ; Animals ; Cross Infection/parasitology/*transmission ; Fatal Outcome ; Humans ; Korea ; Malaria, Falciparum/parasitology/*transmission ; Male ; Merozoite Surface Protein 1/chemistry/genetics ; Middle Aged ; Molecular Sequence Data ; Plasmodium falciparum/chemistry/genetics/*isolation & purification ; Protozoan Proteins/chemistry/genetics ; Sequence Alignment ; Travel