PURPOSE: The lessor saphenous vein is an anatomical index in various surgical methods involving an approach to the popliteal fossa. However, occasionally, there have been some cases where the surgical process was difficult because the lessor saphenous vein was not found in the popliteal fossa during the operation process. The aim of this study is to determine the frequency of the anatomical variation of lessor saphenous vein not found in the popliteal fossa with a review of the literature. MATERIALS AND METHODS: This study was conducted on 83 cases of selective neurectomy for hypertrophic calf performed in our clinic from March 1997 to June 2013. There were 42 patients, with a mean age of 32.8 years old. We confirmed the existence of the lessor saphenous vein in the popliteal fossa during the operation process. RESULTS: Among 83 cases during this study period, the lesser saphenous vein was not found in four cases. In one patient, no lesser saphenous vein was found on either side of the popliteal fossa, and in two patients, no lesser saphenous vein was found on the left side of the popliteal fossa. As a result, the frequency of variation was found to be 4.8%. CONCLUSION: Due to the anatomical variation of the lessor saphenous vein, it may not be found in the midline of the popliteal fossa. Based on the literature review, several possibilities for failure to observe the lesser saphenous vein could be suggested. If surgeons are well aware of these possibilities, the steadier operation could be performed.
Anatomic Variation ; Humans ; Methods ; Popliteal Vein ; Saphenous Vein*

Mature cystic teratoma of the ovary is the most common ovarian germ cell tumor and benign, but malignant transformation occurs in less than 2% of benign mature teratoma. Of the malignancies arising in teratomas, squamous cell carcinoma is the most common, however, carcinoid tumors or adenocarcinomas arising in mature cystic teratoma are uncommon, especially simultaneously. We present an unusual case of premenopausal woman having carcinoid tumor and mucinous adenocarcinoma simultaneously arising in ovarian muture cystic teratoma.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Carcinoid Tumor* ; Carcinoma, Squamous Cell ; Female ; Humans ; Mucins* ; Neoplasms, Germ Cell and Embryonal ; Ovary ; Teratoma*

Early esophageal cancer is defined as a tumor invading the mucosa with or without lymph node or distant organ metastasis. In the current guidelines for early esophageal cancer, absolute indication for endoscopic resection include lesions limited to the epithelium or lamina propria mucosa not exceeding two-thirds of the circumference, and relative indications include lesions limited to the muscularis mucosa or the upper third of the submucosal layer and not accompanied by clinical evidence of lymph node metastasis. After endoscopic submucosal dissection for early esophageal cancer, locally recurrent cancer can occur, especially in the case of incomplete resection. Here, we report a rare case of a submucosal tumor-like recurrence after endoscopic resection of early esophageal cancer.
Endosonography ; Epithelium ; Esophageal Neoplasms ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Recurrence

OBJECTIVE: The heartbeat classification of the electrocardiogram is important in cardiac disease diagnosis. For detecting QRS complex, conventional detection algorithmhave been designed to detect P, QRS, Twave, first. However, the detection of the P and T wave is difficult because their amplitudes are relatively low, and occasionally they are included in noise. Furthermore the conventionalmulticlass classificationmethodmay have skewed results to themajority class, because of unbalanced data distribution. METHODS: The Hermite model of the higher order statistics is good characterization methods for recognizing morphological QRS complex. We applied three morphological feature extraction methods for detecting QRS complex: higher-order statistics, Hermite basis functions andHermitemodel of the higher order statistics.Hierarchical scheme tackle the unbalanced data distribution problem. We also employed a hierarchical classification method using support vector machines. RESULTS:We compared classification methods with feature extraction methods. As a result, our mean values of sensitivity for hierarchical classification method (75.47%, 76.16% and 81.21%) give better performance than the conventionalmulticlass classificationmethod (46.16%). In addition, theHermitemodel of the higher order statistics gave the best results compared to the higher order statistics and the Hermite basis functions in the hierarchical classification method. CONCLUSION: This research suggests that the Hermite model of the higher order statistics is feasible for heartbeat feature extraction. The hierarchical classification is also feasible for heartbeat classification tasks that have the unbalanced data distribution.
Classification* ; Diagnosis ; Electrocardiography* ; Heart Diseases ; Noise ; Support Vector Machine

To examine regional abnormalities in the brains of patients with obsessive-compulsive disorder (OCD), we assessed the gray matter (GM) density using voxel-based morphometry (VBM). We compared magnetic resonance images (MRIs) acquired from 71 OCD patients and 71 age- and gender-matched normal controls and examined the relationship between GM density and various clinical variables in OCD patients. We also investigated whether GM density differs among the subtypes of OCD compared to healthy controls. We detected significant reduction of GM in the inferior frontal gyrus, the medial frontal gyrus, the insula, the cingulate gyrus, and the superior temporal gyrus of OCD patients. A significant increase in GM density was observed in the postcentral gyrus, the thalamus, and the putamen. Some of these regions, including the insular and postcentral gyrus, were also associated with the severity of obsessive- compulsive symptoms. These findings indicate that the frontal-subcortical circuitry is dysfunctional in OCD, and suggest that the parietal cortex may play a role in the pathophysiology of this disease.
Adolescent ; Adult ; Brain/*pathology ; Child ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Obsessive-Compulsive Disorder/*pathology ; Parietal Lobe/pathology ; Sex Characteristics

The purpose of this study was to evaluate the sequential signal intensity changes in post-traumatic vertebral compression fractures of varying ages. Sixty-six patients with 115 post-traumatic vertebral compression fractures underwent MR imaging. The ages of fractures at the time of MR images ranged from 1 day to 6 years. Sequential follow-up MR imagings were obtained in 4 patients for 2 years after initial MR examination. The fracture sites in all 52 fractures with traumatic events less than 3 months prior were hypointense on T1-weighted images and hyperintense on T2-weighted images (type I). A type I fracture could be subdivided into 3 patterns depending on its morphologic appearance: diffuse (type Ia); patchy (type Ib); and bandlike (type Ic). In 12 fractures of 3 to 5 months after trauma, six showed focal hypointensity (type II) in all pulse sequences, and six showed isointensity (type IV). Four of 51 fractures with trauma over 5 months showed focal hyperintensity on T1-weighted images and isointensity on T2-weighted images (type III); and the remaining 47 fractures showed isointensity on all sequences (type IV). In conclusion, MR imaging is useful in predicting the age of known traumatic compression fractures, so familiarity with these sequential MR findings would be helpful in distinguishing benign from malignant fractures.
Adult ; Aged ; Female ; Human ; Lumbar Vertebrae/*injuries ; *Magnetic Resonance Imaging ; Male ; Middle Age ; Spinal Fractures/*diagnosis ; Time Factors

The seed-borne mycoflora of sorghum and foxtail millet collected from different growing areas in South Korea were isolated and taxonomically identified using dry inspection, standard blotter and the agar plate method. We investigated the in vitro and in vivo germination rates of disinfected and non-disinfected seeds of sorghum and foxtail millet using sterilized and unsterilized soil. The percent recovery of seed-borne mycoflora from the seed components of sorghum and foxtail millet seeds was determined and an infection experiment using the dominant species was evaluated for seedling emergence and mortality. A higher number of seed-borne fungi was observed in sorghum compared to that of foxtail millet. Eighteen fungal genera with 34 fungal species were identified from the seeds of sorghum and 13 genera with 22 species were identified from the seeds of foxtail millet. Five dominant species such as Alternaria alternata, Aspergillus flavus, Curvularia lunata, Fusarium moniliforme and Phoma sp. were recorded as seed-borne mycoflora in sorghum and 4 dominant species (Alternaria alternata, Aspergillus flavus, Curvularia lunata, Fusarium moniliforme) were observed in foxtail millet. The in vitro and in vivo germination rates were higher using disinfected seeds and sterilized soil. More seed-borne fungi were recovered from the pericarp compared to the endosperm and seed embryo. The percent recovery of seed-borne fungi ranged from 2.22% to 60.0%, and Alternaria alternata, Curvularia lunata and 4 species of Fusarium were isolated from the endosperm and embryo of sorghum and foxtail millet. Inoculation of the dominant seed-borne fungi showed considerable mortality of seedlings. All the transmitted seed-borne fungi might well be a primary source of infection of sorghum and foxtail millet crops.
Agar ; Alternaria ; Aspergillus flavus ; Embryonic Structures ; Endosperm ; Fungi ; Fusarium ; Germination ; Republic of Korea ; Seedlings ; Seeds ; Setaria Plant ; Soil ; Sorghum

Allergic rhinitis is the most common chronic disease worldwide. Various upper airway symptoms lower quality of life, and due to the recurrent symptoms, multiple treatments are usually attempted rather than one definitive treatment. There are alternatives to medical (medication-based) and nonmedical treatments. A guideline is needed to understand allergic rhinitis and develop an appropriate treatment plan. We have developed guidelines for medical treatment based on previous reports. The current guidelines herein are associated with the “KAAACI Evidence-Based Guidelines for Allergic Rhinitis in Korea, Part 1: Update in pharmacotherapy” in which we aimed to provide evidence-based recommendations for the medical treatment of allergic rhinitis. Part 2 focuses on nonpharmacological management, including allergen-specific immunotherapy, subcutaneous or sublingual immunotherapy, nasal saline irrigation, environmental management strategies, companion animal management, and nasal turbinate surgery. The evidence to support the treatment efficacy, safety, and selection has been systematically reviewed. However, larger controlled studies are needed to elevate the level of evidence to select rational non-medical therapeutic options for patients with allergic rhinitis.

The prevalence of allergic rhinitis (AR) and the socioeconomic burden associated with the medical cost and quality of life of AR have progressively increased. Therefore, practical guidelines for the appropriate management of AR need to be developed based on scientific evidence considering the real-world environment, values, and preferences of patients and physicians. The Korean Academy of Asthma, Allergy and Clinical Immunology revised clinical guidelines for AR to address key clinical questions of the management of AR. Part 1 of the revised guideline covers the pharmacological management of patients with AR in Korea. Through a meta-analysis and a systematic review, we made 4 recommendations for AR pharmacotherapy, including intranasal corticosteroid (INCS)/intranasal antihistamine combination therapy, oral antihistamine/INCS combination therapy, leukotriene receptor antagonist treatment in AR patients with asthma, and prophylactic treatment for patients with pollen-induced AR. However, all recommendations are conditional because of the low or very low evidence of certainty. Well-designed and strictly executed randomized controlled trials are needed to measure and report appropriate outcomes.

BACKGROUND AND OBJECTIVES: The purpose of this study was to investigate 1) the beneficial effect of bosentan treatment (125 mg twice daily) on exercise capacity and echocardiographic variables and 2) the profiles and frequency of adverse events in Korean patients with World Health Organization (WHO) class III or IV pulmonary artery hypertension (PAH). SUBJECTS AND METHODS: Twelve patients who received bosentan treatment were investigated in an open label manner. One patient was excluded in the final analyses due to a prohibited concomitant medication. A 6-minute walk test and echocardiography were performed at baseline and after 12 weeks of treatment. RESULTS: The administration of bosentan for 12 weeks resulted in a significant improvement in exercise capacity (measured with the 6-minute walking distance), WHO functional capacity, and in echocardiographic variables. Bosentan treatment was associated with a decrease in the maximal tricuspid regurgitation jet velocity {from 4.7 m/sec (95% confidence interval, 3.89-5.45) at baseline to 4.4 m/sec (95% confidence interval, 3.61-5.1) at 12 weeks, p=0.03} and systolic pulmonary arterial pressure {from 105 mmHg (95% confidence interval, 74.4-135.6) at baseline to 93 mmHg (95% confidence interval, 66.3-120.1) at 12 weeks, p=0.04}. Treatment with bosentan at a dose of 125 mg twice a day was not associated with life-threatening side effects, although a higher incidence of elevated liver enzymes compared to previous studies was noted. CONCLUSION: Bosentan at a dose of 125 mg twice daily is considered a clinically optimal, safe dose and can be used as a valuable treatment option in Korean PAH patients with WHO functional capacity III or IV, though close monitoring of liver function is required.
Arterial Pressure ; Echocardiography ; Humans ; Hypertension ; Hypertension, Pulmonary ; Incidence ; Liver ; Pulmonary Artery ; Sulfonamides ; Tricuspid Valve Insufficiency ; Walking ; World Health Organization