Allogenic peripheral blood stem cell transplantation (Allo-PBSCT) is being used to treat hematological malignancies with increasing frequency. Graft-versus-host disease (GvHD) is a complex complication of PBSCT. A 43-year-old woman came to the gynecology clinic for amenorrhea. She had been diagnosed with acute myeloid leukemia 2 years earlier and treated with induction and consolidation chemotherapy. After developing complete remission, she underwent Allo-PBSCT. When she started chemotherapy, her menstrual cycle completely disappeared. Fourteen months after menopausal hormone replacement therapy, it was discovered that her upper vaginal canal was completely obstructed. The lower vagina had an atrophic appearance. We report a rare case of partial vaginal obstruction as a complication of chronic GvHD and review the literature. We expect that this case report provides an opportunity to remind clinician of the gynecologic complications of GvHD.
Amenorrhea ; Consolidation Chemotherapy ; Female ; Graft vs Host Disease ; Gynecology ; Hematocolpos ; Hematologic Neoplasms ; Hormone Replacement Therapy ; Humans ; Leukemia, Myeloid, Acute ; Menstrual Cycle ; Peripheral Blood Stem Cell Transplantation ; Porphyrins ; Vagina

OBJECTIVES: It has been known that there is a difference in anogenital distance (AGD) in the animals and newborn depending on the exposure of androgenic hormones. The anatomical changes occur in the female genitalia in women after menopause. This was pilot study to find out whether the menopause affects AGD. METHODS: We evaluated a total of 50 women targeted for premenopausal and postmenopausal group in each 25 people. AGD was defined as a length between the posterior commissure of labia and anal center. AGD was measured in lithotomy position using sterile paper ruler. In order to control bias of the height and weight, which could influence the AGD, anogenital index (AGI) is defined as the weight divided by the AGD value. We used a Mann-Whitney U test to analyze the relationship between AGD and menopause for statistical analysis. RESULTS: AGD was significantly longer in premenopausal women compared to postmenopausal women (34.8 +/- 6.4 vs. 30.3 +/- 6.6, P = 0.019). AGI was significantly higher in premenopausal women than postmenopausal women (1.7 +/- 0.4 vs. 1.3 +/- 0.3, P < or = 0.000). CONCLUSION: The changes of AGD and AGI in postmenopausal women demonstrated to have potential to be used as on scale predicting the physical changes that may occur after menopause. This study could be used as the cornerstone of a large-scale studies in the future.
Animals ; Bias (Epidemiology) ; Female ; Genitalia, Female ; Humans ; Infant, Newborn ; Menopause* ; Perineum ; Pilot Projects*

Here we describe a case of rapidly expanding ascending aortic aneurysm in a patient with relapsing polychondritis. To prevent aneurysm rupture, the patient underwent emergent surgical repair. Silent inflammation can progress in the aorta wall, even in asymptomatic patients with mild disease activity under immunosuppressive treatment, leading to the rapid growth of aortic aneurysms. Close monitoring with routine imaging is needed once a patient with relapsing polychondritis is diagnosed with an aortic aneurysm.
Aneurysm ; Aorta ; Aortic Aneurysm* ; Aortitis ; Humans ; Inflammation ; Polychondritis, Relapsing* ; Rupture

Purpose: Long-term tracheal stent placement can increase the risk of stent-related complications; hence, removal of the stent after stabilization is attempted. However, little evidence has been established regarding the risk factors for tracheal restenosis. We aimed to identify the risk factors for tracheal restenosis in patients with post-intubation tracheal stenosis (PITS) and post-tracheostomy tracheal stenosis (PTTS). Materials and Methods: We retrospectively analyzed patients with PITS and PTTS between January 2004 and December 2019. Patients were classified into a success or failure group according to treatment outcomes. Patients with successful stent removal were defined as patients who did not require additional intervention after stent removal during the follow-up period. Multiple logistic regression analysis was performed to identify the factors associated with tracheal restenosis. Results: Among 269 stented patients, 130 patients who had removed the stent were enrolled in this study. During the follow-up period, 73 (56.2%) patients had a stable clinical course; however, 57 (43.8%) patients had restenosis. The proportion of trauma-induced intubation was higher in the success group than in the failure group (p=0.026), and the median stent length was shorter in the success group (45 mm) than in the failure group (50 mm, p=0.001). On multivariate analysis, trauma-induced intubation [adjusted odds ratio (aOR), 0.329; 95% confidence interval (CI), 0.117–0.927; p=0.036], and stent length <50 mm (aOR, 0.274; 95% CI, 0.130–0.578; p=0.001) were associated with a decreased risk of restenosis. Conclusion Trauma-induced intubation and stent length were associated with successful stent removal.

Bronchoalveolar lavage (BAL) is performed via bronchoscopy, typically under conscious sedation. It plays a crucial role in the differential diagnosis of lung disease, because it provides valuable information about the lung parenchyma, including cellular composition, the presence of microorganisms, and cytological features. Furthermore, BAL has therapeutic applications and is widely used in medical research. However, careful patient selection is required, because the diagnostic yield may vary and the procedure has inherent risks.

Bronchoalveolar lavage (BAL) is performed via bronchoscopy, typically under conscious sedation. It plays a crucial role in the differential diagnosis of lung disease, because it provides valuable information about the lung parenchyma, including cellular composition, the presence of microorganisms, and cytological features. Furthermore, BAL has therapeutic applications and is widely used in medical research. However, careful patient selection is required, because the diagnostic yield may vary and the procedure has inherent risks.

Bronchoalveolar lavage (BAL) is performed via bronchoscopy, typically under conscious sedation. It plays a crucial role in the differential diagnosis of lung disease, because it provides valuable information about the lung parenchyma, including cellular composition, the presence of microorganisms, and cytological features. Furthermore, BAL has therapeutic applications and is widely used in medical research. However, careful patient selection is required, because the diagnostic yield may vary and the procedure has inherent risks.

Bronchoalveolar lavage (BAL) is performed via bronchoscopy, typically under conscious sedation. It plays a crucial role in the differential diagnosis of lung disease, because it provides valuable information about the lung parenchyma, including cellular composition, the presence of microorganisms, and cytological features. Furthermore, BAL has therapeutic applications and is widely used in medical research. However, careful patient selection is required, because the diagnostic yield may vary and the procedure has inherent risks.

165Dy Hydroxide Macroaggregates(165Dy HMA) has a short half life(2.3 hours) and a size range of 3-5µm that give the advantage of reduced leakage and a shorter hospital stay. This report will show the results of a prospective open study on the efficacy and safety of 165Dy HMA in 178 knees of 141 patients with chronic synovitis refractory to conventional antirheumatic therapy. The final global assessment was classified as good, fair or poor. Extra-articular leakage of 165Dy HMA was determined by the scintigraphic evaluation of liver, groin and knee joints. The optimum radiation dose was 250 mCi. The mean follow up periods were 32.4(14-112) weeks. Thirty seven percent of the knees showed good results, 48% fair results and 15% poor results. In the knees with stage I radiographic changes, 82% showed improvement including 32% of the patients with good results. In the knees with stage II radiographic changes, 90% showed improvement including 42% of the patients with good results. The mean period of improvement for the 158 knees that responded to treatment was 41.4(24-106) weeks. Leakage of radioactivity from the injected joint was minimal. Adverse reactions were rare(radiation burn : 4 cases, transient postinjection swelling : 14 cases). In conclusion, 165Dy HMA radiation synovectomy is a safe and useful therapy for chromic synovitis of the rheumatoid knees.
Arthritis, Rheumatoid ; Burns ; Follow-Up Studies ; Groin ; Humans ; Injections, Intra-Articular ; Joints ; Knee Joint ; Knee ; Length of Stay ; Liver ; Prospective Studies ; Radioactivity ; Synovitis

Mediastinal tuberculous lymphadenitis rarely mimics esophageal submucosal tumor, particularly in the case of multidrug-resistant tuberculosis (MDR-TB). Herein, we report the case of a 61-year-old woman who visited a local hospital complaining of odynophagia. An initial esophagogastroduodenoscopy revealed an esophageal submucosal tumor, and subsequent chest computed tomography showed subcarinal lymphadenopathy with an esophagomediastinal fistula. The patient was then referred to Samsung Medical Center, and a second esophagogastroduodenoscopy showed deep central ulceration, as well as a suspicious fistula in the esophageal submucosal tumor-like lesion. A biopsy examination of the ulcerative lesion confirmed focal inflammation only. Next, an endobronchial, ultrasound-guided lymph node biopsy was performed, and TB was confirmed. The patient initially began a course of isoniazid, rifampicin, ethambutol, and pyrazinamide. However, after a drug sensitivity test, she was diagnosed with MDR-TB, and second-line anti-TB medications were prescribed. She recovered well subsequently.
Biopsy ; Endoscopy, Digestive System ; Esophageal Fistula ; Ethambutol ; Female ; Fistula* ; Humans ; Inflammation ; Isoniazid ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Middle Aged ; Pyrazinamide ; Rifampin ; Thorax ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Multidrug-Resistant ; Ulcer