OBJECTIVE: To compare surgical outcomes of patients with myoma after robot-assisted laparoscopic myomectomy and laparoscopic myomectomy. METHODS: Retrospective chart review of 15 robot-assisted laparoscopic myomectomy (RLM) patients and 30 laparoscopic myomectomy (LM) patients at Jeju National University Hospital in Jeju between July 2009 and July 2012. Clinical features and surgical outcomes were compared. RESULTS: Surgical time was longer among RLM patinets (185.7 min vs 114.4 min). Patients undergoing robot-assisted myomectomy had a bigger size of the largest myoma, and bigger average size of the myomas. When adjusted for myoma size and number, no significant differences were noted between robotic (RLM: 24.5 min/cm) vs laparoscopic (LM: 21.5 min/cm) groups for mean operating time/total diameter. Blood loss (1.7 g/dl vs 1.95 g/dl), transfusion (0% vs 6.6%) were both no significant differences between the robotic and laparoscopic groups. CONCLUSION: When adjusted for myoma size and number, short-term outcomes were similar after robotic and laparoscopic myomectomy. Robot-assisted myomectomy is considered reliable procedure.
Humans ; Laparoscopy ; Myoma ; Operative Time ; Retrospective Studies

No abstract available.
Lung* ; Thorax*

Dysphagia is a major disability in patients with Parkinson’s disease. Unlike typical motor symptoms, dysphagia is relatively unresponsive to dopaminergic drugs. However, occasionally, swallowing difficulties are much improved by dopaminergic agonists and significantly affected by on/off periods. In such cases, it is difficult to assess the severity of dysphagia accurately if swallowing function evaluation is performed without considering the wearing-off phenomenon in patients with PD. Here, we report a case of dysphagia in a female patient with Parkinson’s disease that was severely affected by the wearing-off phenomenon in response to prolonged use of levodopa. The patient presented with severe oral phase delay with choking symptoms during fluid intake. A videofluoroscopic swallow study performed during an ‘off-period’ showed massive aspiration with severely impaired swallowing function.However, when swallowing evaluation was performed during the ‘on-period’, almost no abnormal function was observed. After adopting an on/off period-tailored diet prescription, sufficient nutrition was possible without aspiration. Consideration of the wearing-off phenomenon is essential when evaluating swallowing function in patients with Parkinson’s disease. Patient-specific swallowing evaluations and diet prescriptions are needed to establish optimal therapeutic strategies.

Purpose: Few studies that have evaluated the relationships between physical activity (PA) patterns of weekend warriors (i.e., individuals who perform all their weekly exercises in one or two sessions) and health outcomes have reported inconsistent findings. The present study sought to examine the association between weekend warrior PA patterns and cardiometabolic risk factors in Korean adults. Methods: This cross-sectional study included 29,543 men and women who participated in the Korean National Health and Nutrition Examination Survey between 2014 and 2019. The weekend warrior PA was defined as at least 150 minutes/week of moderate-intensity or at least 75 minutes/week of vigorous-intensity PA concentrated in one or two sessions/week. Results: Compared with the inactive PA patterns, the multivariable-adjusted odds ratio (95% confidence interval) between the weekend warrior PA patterns and cardiometabolic risk factors were 0.89 (0.69–1.15) for hypertension, 0.81 (0.55–1.17) for diabetes, 0.92 (0.69–1.22) for dyslipidemia, 1.10 (0.91–1.34) for obesity, and 1.0 (0.83–1.27) for metabolic syndrome. Regularly active PA patterns, however, had lower odds of diabetes and metabolic syndrome. Conclusion Our results suggested that no evidence of significant associations between the weekend warrior PA patterns and cardiometabolic risk factors in a representative Korean population. Large-scale prospective cohort studies are warranted to confirm or refute these findings.

BACKGROUND: Lumbosacral transforaminal epidural injection (TFEI) is an effective treatment for spinal disease. However, TFEI may have several types of complications, some of which can be attributed to intravascular injection. We reviewed studies to compare the intravascular injection rate among different needle types. METHODS: We searched the literature for articles on the intravascular injection rate among different needle types used in TFEI. The search was performed using PubMed, MEDLINE, the Cochrane Library, EMBASE, and Web of Science. RESULTS: A total of six studies comprising 2359 patients were identified. Compared with the Quincke needle, the Whitacre needle reduced the intravascular injection rate (OR = 0.57, 95% CI = [0.44–0.73], P < 0.001). However, compared with the Quincke needle, the Chiba needle did not reduce the intravascular injection rate (OR = 0.80, 95% CI = [0.44–1.45], P = 0.46). In one study, the intravascular injection rate using a blunt-tip needle was lower than that using a sharp needle. In another study, the Whitacre and the blunt-tip needle have similar intravascular injection rates, while, the catheter-extension needle showed a reduced intravascular injection rate. CONCLUSIONS: This meta-analysis showed that the Whitacre needle reduced the intravascular injection rate as compared with the Quincke needle, but failed to establish that the Chiba needle can decrease the intravascular injection rate in TFEI. Moreover, the blunt-tip needle can reduce the intravascular injection rate compared with the Quincke needle, and the catheter-extension needle can reduce the intravascular injection rate compared with the Whitacre and the blunt-tip needle.
Anesthesia, Epidural ; Humans ; Injections, Epidural ; Needles ; Spinal Diseases

Primary community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) endocarditis has rarely been reported in healthy individuals without risk factors, such as skin and soft tissue infections, and intravenous drug abuse. We describe a case of infective endocarditis by CA-MRSA (ST72-PVL negative-SCCmec IVA) in previously healthy individuals with no underlying medical condition and CA-MRSA colonization in the family.
Adult ; Community-Acquired Infections/microbiology/transmission ; Endocarditis/*microbiology ; Family ; Female ; Humans ; *Methicillin Resistance ; Staphylococcal Infections/*diagnosis/drug therapy/*transmission ; Staphylococcus aureus/*drug effects

Schizophyllum commune is a mold in phylum Basidiomycota and is an uncommon human pathogen. Sinusitis and allergic bronchopulmonary mycosis are the two major diseases caused by S. commune. Although there have been several reports of invasive fungal diseases, most of them were invasive sinusitis. We present a case of invasive fungal pneumonia due to S. commune, developed in a patient with acute myeloid leukemia presenting neutropenic fever. The diagnosis was made by characteristic macroscopic and microscopic findings of fungal isolate and was confirmed via sequencing of internal transcribed spacer region. The patient was improved after 8 weeks of antifungal therapy based on the susceptibility result.We propose that S. commune should be considered as an emerging pathogen of invasive fungal pneumonia when a patient is under immunocompromised state. We also reviewed global literatures focused on the invasive fungal diseases caused by S. commune

BACKGROUND: We evaluated the effects of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) on the production of tumor necrosis factor-alpha (TNF-alpha) and expression of nuclear factor-kappaB (NF-kappaB) in stimulated THP-1 cells, a human monocyte cell line. MATERIALS AND METHODS: We evaluated the cytotoxic effect of 15-Deoxy-Delta(12,14)-prostaglandin J(2) (15d-PGJ(2)), one of natural PPAR-gamma ligands, using commercial cell proliferation assay. Cells were pretreated with 15d-PGJ(2) and then stimulated with lipopolysaccharide (LPS) or lipoteichoic acid (LTA). The amount of TNF-alpha was measured by using commercial ELISA method. NF-kappaB activation was evaluated by Western blot analysis. RESULTS: 15d-PGJ(2) showed dose-dependent cytotoxic effect on the tested cells after 4 hr of treatment. Stimulation of cells by LPS or LTA induced TNF-alpha production. TNF-alpha production was markedly decreased in the cells pretreated with 15d-PGJ(2) compared to cells treated only with LPS or LTA in a dose-dependent manner. Pretreatment of 15d-PGJ(2) reduced LPS or LTA induced NF-kappaB expression in the nuclear extracts of THP-1 cells. CONCLUSION: 15d-PGJ(2) pretreatment decreased TNF-alpha production from the THP-1 cells stimulated by LPS or LTA, and this assumed to be associated with inhibition of NF-kappaB activation.
Blotting, Western ; Cell Line ; Cell Proliferation ; Enzyme-Linked Immunosorbent Assay ; Humans ; Ligands ; Lipopolysaccharides ; Monocytes ; NF-kappa B ; Peroxisomes ; Teichoic Acids ; Tumor Necrosis Factor-alpha

BACKGROUND: We investigated the usefulness of infrequent-restriction-site polymerase chain reaction (IRS-PCR) compared with pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) on the molecular epidemiologic analysis of methicillin-resistant Staphylococcus aureus (MRSA). MATERIALS AND METHODS: We used fifty clinical isolates of MRSA collected from 10 university hospitals located in Seoul. We performed three procedures on these isolates: PFGE using SmaI, IRS-PCR using XbaI-Hha I or EagI-Hha I, and MLST using seven house-keeping genes. We determined the clusters of molecular types by dendrogram using the unweighted pair group method with arithmetic mean (UPGMA) and Dice coefficients. RESULTS: MLST analysis showed that isolates exhibited ST1, ST5, ST72, ST89, and ST239. In PFGE, the isolates clustered into 5 major groups with 80% similarity, which subsequently became classified into 18 subgroups with 95% similarity. In IRS-PCR using EagI-HhaI restriction enzymes, there was little resolution among the patterns of isolates. However, XbaI-HhaI IRS-PCR showed 5 groups with a 90% similarity. These groups were then classified into 9 subgroups with a 95% similarity. There were no significant differences among the isolates from different hospitals. CONCLUSIONS: The XbaI-HhaI IRS-PCR method could be a useful tool in the molecular epidemiology of MRSA. Its resolution power was good enough to analyze isolates, because the patterns of IRS-PCR were closely correlated with those of MLST and showed diverse groups.
Electrophoresis, Gel, Pulsed-Field ; Genes, Essential ; Hospitals, University ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Molecular Epidemiology ; Multilocus Sequence Typing ; Polymerase Chain Reaction ; Staphylococcus ; Staphylococcus aureus

BACKGROUND: We wanted to evaluate the immunomodulatory effect of three antifungal agents, amphotericin B (AmB), micafungin (MF), itraconazole (ITZ), in the aspect of cytokine production and expression of nuclear factor-kappaB (NF-kappaB) in the Aspergillus fumigatus conidia treated-RAW264.7 cells, a murine alveolar macrophage cell line. MATERIALS AND METHODS: We evaluated cytotoxic effect of antifungal agents using commercial cell proliferation assay. Tumor necrosis factor (TNF)-alpha and interleukin (IL)-10 production according to stimulation (control, A. fumigatus conidia only, conidia + antifungal drug, conidia + antifungal drug + G(M)-CSF) was evaluated and compared each using commercial ELISA method. NF-kappaB activation was evaluated by western blot analysis. RESULTS: AmB, MF, ITZ showed dose-dependent cytotoxic effect on the tested cells. Stimulation of cells by A. fumigatus conidia induced TNF-alpha production. Pretreatment of AmB at concentration not affecting cellular survival did not change the production of TNF-alpha compared to conidia treated cells, but pretreament of MF or ITZ showed reduced amount of TNF-alpha production compared to conidia treated cells. AmB also showed synergistic effect on TNF-alpha production when simultaneously treated with GM-CSF. IL-10 production was markedly increased when the cells were treated with AmB with conidia. MF and ITZ induced less increase of IL-10 production than AmB. AmB also showed synergistic effect on the production of IL-10 when treated with GM-CSF simultaneously. A. fumigatus conidia enhanced expression of NF-kappaB. The degree of NF-kappaB expression was associated with the amount of TNF-alpha and IL-10 produced. CONCLUSION: The antifungal agents we used in this experiment showed that decreased TNF-alpha production and increased IL-10 production from the RAW264.7 cells stimulated by A. fumigatus conidia after pretreatment of antifungal agents. But more studies, such as the association between immunomodulatory effect, antifungal activity and difference of signal pathway of cellular activation according to drugs should be performed.
Amphotericin B ; Antifungal Agents* ; Aspergillus fumigatus* ; Aspergillus* ; Blotting, Western ; Cell Line ; Cell Proliferation ; Cytokines* ; Enzyme-Linked Immunosorbent Assay ; Granulocyte-Macrophage Colony-Stimulating Factor ; Immunomodulation ; Interleukin-10 ; Interleukins ; Itraconazole ; Macrophages* ; Macrophages, Alveolar ; NF-kappa B ; Signal Transduction ; Spores, Fungal* ; Tumor Necrosis Factor-alpha