Ultrasonographic and radiographic findings in 72 cases of pelvic masses which have been provedhistopathologically were analyzed. The results were as follows; 1. Among 72 cases, 28 cases were uterine massesand 44 cases were adnexal masses. 2. Pathologic accuracies of ultrasonographic diagnosis were 64.3% in uterinemasses, 70.5% in adnexal masses, and 68.1% in all pelvic masses. 3. Plain or IVP findings were not specific indiagnosis and showed secondary mass effects or functional disturbances. 4. Because of its high accuracy ofpathologic diagnosis and safety, ultrasonography can be regared as the most valuable and preferential study. Butin cases of cystic myomas, endometrioses, cystic missed abortions and huge masses, the accurate diagnoses weredifficult.
Abortion, Missed ; Diagnosis ; Endometriosis ; Female ; Myoma ; Pregnancy ; Ultrasonography

A fracture of the distal tibial articular surface is fortunately an uncommon injury, since it can be exeptionally difficult to manage. The term plafond is gar'nering general acceptance since there is no anatomic name for the specific location of this fracture. The term was introduced more than 50 years ago in American orthopaedic literature to describe these injuries. The literal meaning of plafond is the underside of a floor, i.e., a ceiling, so the term refers to that portion of the distal articular surface of the tibia which articulates with the superior articular surface of the talus. It excludes the medial malleolar joint surface. Fracture of the plafond have also been called compression, pylon, Malgaigne and explosion fractures. A plafond fracture is defined as one caused primarily from direct axial compression resulting in elevation andgor displacement of all or part of the distal articular surface of the tibia, excluding isolated or combined fractures of the medial and posterior malleoli that are recognizably caused by rotational forces. We reviewed 16 cases(14 patients) of tibial plafond fractures treated at the Department of Orthopaedic Surgery of Soan Chun Hyang University Hospital during 8.5 years period from June 1974 to December 1982. The longest duration of follow-up was 5 years and 6 months, the shortest, 6 months, and the average, 1 year and 6 months. They were classified according to Moore et al., and assessed according to the criteria of Joy et al. The following results were obtained: l. Of the 14 patients, male were 12, female were 2. 2. The average age of the patients was 38 years old. 3. The most common causative injury was fall-down. 4. The most common type in radiological study was dorsiflexion type. 5. In method of treatment, operative treatment was done in 9 cases and non-operative in 6 cases. 6, The average duration of the cast immobilization in non-operative treatment was 12 weeks and operative, 10 weeks. 7. Better results were obtained by operative treatment than non-operative treatment. 8, The complications were encounted in 1 case of non-operative, 2 cases of operative treatment. 9. We agree that the accurate anatomical reduction with rigid internal fixation assures better results in the tibial plafond fracture.
Clinical Study ; Explosions ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Joints ; Male ; Methods ; Talus ; Tibia

BACKGROUND: When it is difficult to insure adequate blood vessels, an expanded polytetrafluoroethylene (e-PTFE) graft has been accepted as an alternative although its long-term patency is not equal to that of an autogenous arteriovenous fistula (AVF) for the purpose of performing hemodialysis. There being no hemodynamic guidelines for creating an autogenous or e-PTFE AVF, we prospectively investigated the difference in blood flows between autogenous and e-PTFE AVFs after internal AVF creation in order to identify an ideal AVF. METHODS: We performed color doppler ultrasonography on 15 patients who experienced AVF creation between December 1997 and December 1998 at the Wallace Memorial Baptist Hospital in Pusan and compared the volume flow per minute, the peak systolic velocity, and the cross-sectional area between an autogenous and an e-PTFE AVF. RESULTS: Eight (8) patients experienced an autogenous vein AVF creation, and seven (7) patients experienced an AVF creation using 4x6 mm graded e-PTFE (Impra(R)). 1. Average volume flow: 1611.87 +/-687.52 mL/min for autogenous AVFs and 1725.28+/-269.06 mL/min for e-PTFE AVFs (p=0.67). 2. Average peak systolic velocity: 128.98+/-52.83 cm/sec for autogenous AVFs and 81.71+/-8.93 cm/sec in e-PTFE AVFs (p=0.04). 3. Average cross-sectional area: 0.23+/-0.10 cm2 for autogenous AVFs and 0.34+/-0.02 cm2 for e-PTFE AVFs (p=0.02). 4. There were no postoperative complications, such as venous hypertension or distal ischemia, except for one puncture-site infection. CONCLUSIONS: There was no significant difference in volume flows between autogenous AVFs and 4x6 mm graded e-PTFE graft AVFs after internal AVF creation. In the e-PTFE graft AVFs, the cross-sectionalarea was greater and the peak systolic velocity was smaller compared with those of autogenous AVFs. These results suggest that, in e-PTFE AVF creation in order to maintain on adequate minute volume flow, it is important to minimized the cross-sectional area of the outflow vessel where the lower compliance of the e-PTFE graft increases outflow resistance. Also, we conclude that choosing the appropriate blood vessels and using a meticulous surgical technique are mandatory in establishing optimal hemodynamics for arteriovenous fistulae.
Arteriovenous Fistula* ; Blood Vessels ; Busan ; Compliance ; Hemodynamics ; Humans ; Hypertension ; Ischemia ; Kidney Failure, Chronic* ; Polytetrafluoroethylene* ; Postoperative Complications ; Prospective Studies ; Protestantism ; Renal Dialysis* ; Transplants* ; Ultrasonography, Doppler, Color ; Veins

PURPOSE: To evaluate long-term change in intraocular pressure (IOP) in eyes undergoing laser iridotomy (LI) and early phacoemulsification after LI in patients with acute angle-closure glaucoma (AACG). METHODS: The retrospective, comparative chart review included patients with AACG, Group A who underwent only LI and Group B who underwent early phacoemulsification within 1 month after LI. Patients were followed up on day 1; week 1; and months 1, 3, 6, and 12 after LI. IOP changes were studied. RESULTS: This study included a total 99 eyes from 99 patients, 37 in group A and 62 in group B. The mean IOP were not significantly different between the two groups at the initial visit or 1 month later. However, group B showed a consistently lower mean IOP that that of group A at 3, 6, and 12 months (p= 0.003, <0.001, <0.001, respectively). The prevalence of IOP increase to greater than 21 mmHg was 3 (8.11%), 5 (13.51%), and 5 patients (13.51%) in group A and 0, 2 (5.41%), and 1 patients (1.61%) in group B at 3, 6, and 12 months, respectively. Group B showed a significantly lower prevalence of IOP increase (p = 0.050, 0.038, 0.026). CONCLUSIONS: We found that patients treated with early phacoemulsification after LI had better outcomes of well-maintained IOP compared to those undergoing LI alone. For AACG patients with coexisting cataract, early phacoemulsification after LI can be considered as a reasonable treatment to maintain IOP.
Cataract ; Glaucoma, Angle-Closure* ; Humans ; Intraocular Pressure ; Phacoemulsification* ; Prevalence ; Retrospective Studies

Focal brainstem encephalitis due to Herpes simplex virus if a very rare infectious disease, occurs with a frequent of 1-2 million population per year. A 3 years old girl is described with infection due to Herpes simplex virus causing brainstem encephalitis. The diagnosis was established by enzyme immunosorbent assays of the cerebrospinal fluid and serum which demonstrated antibody responsed to Herpes simplex virus. The clinicopathological features, radiological findings, laboratories and brainstem biopsies are discussed in the context of the literature.
Biopsy ; Brain Stem* ; Cerebrospinal Fluid ; Child, Preschool ; Communicable Diseases ; Diagnosis ; Encephalitis* ; Female ; Herpes Simplex* ; Humans ; Simplexvirus*

Objectives: Medical artificial intelligence (AI) has recently attracted considerable attention. However, training medical AI models is challenging due to privacy-protection regulations. Among the proposed solutions, federated learning (FL) stands out. FL involves transmitting only model parameters without sharing the original data, making it particularly suitable for the medical field, where data privacy is paramount. This study reviews the application of FL in the medical domain. Methods: We conducted a literature search using the keywords "federated learning" in combination with "medical," "healthcare," or "clinical" on Google Scholar and PubMed. After reviewing titles and abstracts, 58 papers were selected for analysis. These FL studies were categorized based on the types of data used, the target disease, the use of open datasets, the local model of FL, and the neural network model. We also examined issues related to heterogeneity and security. Results: In the investigated FL studies, the most commonly used data type was image data, and the most studied target diseases were cancer and COVID-19. The majority of studies utilized open datasets. Furthermore, 72% of the FL articles addressed heterogeneity issues, while 50% discussed security concerns. Conclusions FL in the medical domain appears to be in its early stages, with most research using open data and focusing on specific data types and diseases for performance verification purposes. Nonetheless, medical FL research is anticipated to be increasingly applied and to become a vital component of multi-institutional research.

OBJECTIVES: In this study, we evaluated the efficacy of nebulized bovine pulmonary surfactant on experimentally induced otitis media with effusion (OME) in guinea pigs. METHODS: Twenty guinea pigs were divided into three groups. Four untreated animals served as normal controls. Experimental OME was established in both ears of the remaining 16 animals by a transbullar injection of 10 microL of Pseudomonas aeruginosa lipopolysaccharide in saline. Thereafter, the guinea pigs received nebulized phosphate buffered saline (n=8) or nebulized bovine pulmonary surfactant (n=8). Nebulization was given daily for 7 days. On day 8, all the animals' passive opening pressure (POP) of the Eustachian tube was measured and histopathological observations of the bulla were made by light microscopy. RESULTS: Nebulized bovine pulmonary surfactant significantly reduced the POP compared to that of saline nebulization. The bovine pulmonary surfactant improved the tubal patency and produced less histopathologcally-evident edematous bullar mucosa. CONCLUSION: Nebulization of bovine pulmonary surfactant plays an important role in treating otitis media with effusion in guinea pigs. Our results suggest that the chosen nebulized bovine pulmonary surfactant can be of good clinical benefit for treating OME in the future.
Animals ; Blister ; Ear ; Eustachian Tube ; Guinea ; Guinea Pigs ; Light ; Microscopy ; Mucous Membrane ; Otitis ; Otitis Media ; Otitis Media with Effusion ; Pseudomonas aeruginosa ; Pulmonary Surfactants

OBJECTIVE: The aim of the study was to review the clinical and radiological findings of those non-functioning adenomas(NFAs) with positive immnoreactivity for anterior pituitary hormones. METHODS: Sixty patients with pituitary adenoma were treated at the author's institution between January 2000 and July 2005. All consecutive patients were underwent transsphenoidal surgery by same operator. In addition to the routine histopathological examination, surgical specimen was examined by immunohistochemical staining against adenohypophyseal cells. And clinical analysis was performed by retrospective review of medical records, neuroimaging examinations and immunohistochemical technique. We classified these pituitary adenomas into functioning adenomas (group F), immunopositive NFAs (group S, so-called silent adenoma) and immuno-negative NFAs (group N), and compared clinical and radiological differences between group F, N, and S. RESULTS: Of the 60 cases, group F was 25, group S was 25, and group N was 10. Among the group S, 5 cases showed reactivity against PRL, 1 against GH, 1 against both PRL and GH, 1 against TSH and GH, 2 against ACTH, 11 against FSH and 4 against both LH and FSH. Radiologically, invasiveness was noted in 8 in group S, compared to 3 in group N and 1 in group F (p=0.02). Intratumoral bleeding was noted in 7 of group S, 2 of group N and 2 of group F (p>0.05). CONCLUSION: Silent adenomas were thought to behave more aggressive than other subgroups of pituitary adenomas. And so we suggest the immunohistochemical study against adenohypophyseal cells may be helpful for evaluating clinical course of pituitary adenoma, expecially for, NFAs.
Adenoma* ; Adrenocorticotropic Hormone ; Hemorrhage ; Humans ; Immunohistochemistry ; Medical Records ; Neuroimaging ; Pituitary Gland* ; Pituitary Hormones, Anterior ; Pituitary Neoplasms ; Retrospective Studies

BACKGROUND: Bronchoconstriction is known to be induced by hypocarbia or hypercarbia. But the above effect has not been studied during general anesthesia. This study was proposed to investigate the effects of hypocarbia and hypercarbia on the respiratory system mechanics in 0.5 MAC enflurane anesthetized cats. METHODS: Six cats, weighing 3.0~3.6 kg were used. Pentobarbital sodium was intraperitonially injected to induce anesthesia and endotracheal intubation was followed. The anesthesia was maintained by 0.5 MAC enflurane, oxygen, and air (FiO2; 0.5). Intermittent mandatory ventilation was applied with Siemens Servo 900C ventilator. The inspiratory flow rate and tidal volume were fixed througout the experiment. Only the respiratory rate was adjusted to achieve normocarbia(PaCO2; 31~38 mmHg), hypercarbia(PaCO2; 38~45 mmHg) and hypocarbia(PaCO2; 24~31 mmHg), which were done not in the order. We used the flow-interruption technique to measure respiratory mechanics. The course of changes in the pressure along with the prefixed flow rate and volume were monitored and recorded with Bicore CP100 pulmonary monitor. The data were transfered to a PC and analyzed by Anadat processing software. Total respiratory system, airway and tissue viscoelastic resistances, and dynamic and static compliances were calculated for normocarbia, hypercarbia and hypocarbia. RESULTS: There are no significant differences of resistances and compliances of respiratory system among hypocarbia, normocarbia and hypercarbia. CONCLUSIONS: The changes in PaCO2 do not influence significantly the resistances and compliances measured by the flow interruption technique used in the study.
Airway Resistance ; Anesthesia ; Anesthesia, General ; Anesthetics ; Animals ; Bronchoconstriction ; Carbon Dioxide* ; Carbon* ; Cats* ; Compliance ; Enflurane* ; Intubation, Intratracheal ; Lung ; Mechanics* ; Oxygen ; Pentobarbital ; Respiratory Mechanics ; Respiratory Rate ; Respiratory System* ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

No abstract available.
Humans ; Pericardial Effusion*