Purpose: The objective of this study was to assess the frequency and management protocols for malignant tumors among cases referred for aeromedical consultation. Methods: The research analyzed data collected from aeromedical consultations conducted between January 2014 and December 2022. Parameters examined included demographic information such as sex, age, flight crew classification, and diagnosis. Results: Out of the cases reviewed, 31 patients were diagnosed with malignant tumors, with an average age at diagnosis of 38.5 years, and a male predominance of 26 cases.The most commonly diagnosed malignancies were thyroid cancer, lung cancer, kidney cancer, stomach cancer, and colon cancer. During the initial aeromedical consultation, 22 cases were temporarily grounded while 8 received waivers. Conclusion Given the potential rise in malignant tumor incidence among flight crews due to advancements in medical technology facilitating early detection, it is imperative to emphasize regular check-ups and carefully evaluate aeromedical suitability for flying.

BACKGROUND: There are limited data available regarding the results of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA). We performed a systematic review of the literature to investigate the radiological and clinical outcomes after RSA in patients with RA. METHODS: A literature search for publications between 1987 and 2014 was conducted by 2 independent reviewers using PubMed, Scopus, Embase, and Cochrane Central Register of Controlled Trials. Articles were retrieved by an electronic search using keywords and their combinations. Studies that met inclusion criteria were assessed for pertinent data. RESULTS: Seven studies including 123 shoulders met the inclusion criteria. The mean age of the patients was 67.9 years and the mean follow-up period was 46.6 months. The mean Constant score and American Shoulder and Elbow Surgeons (ASES) score increased from 18.6 and 27.5 preoperatively to 58.6 and 73.7, respectively, at the final follow-up evaluation. The mean active forward flexion, abduction, and external rotation increased from 57.2°, 50.4°, and 11.4° to 127.1°, 116.7°, and 26.4°, respectively. The incidence of scapular notching was 33.7%. Twenty-seven (22.0%) of 123 shoulders had one or more complications, 12 of which (44.4%) had intraoperative or postoperative fractures. Nine shoulders (7.3%) had one or more revision surgeries. CONCLUSIONS: RSA in RA showed similar short- to mid-term results without higher complication rates as compared to RSA in cuff tear arthropathy. Although RSA can be considered a reliable treatment option in patients with RA, further large-scale studies are required to determine the long-term survival of the implant.
Arthritis, Rheumatoid* ; Arthroplasty* ; Elbow ; Follow-Up Studies ; Humans ; Incidence ; Shoulder* ; Surgeons ; Tears

BACKGROUND: Hyperhomocysteinemia has been known to be associated with cerebrovascular disease. It is toxic to vascular endothelial cell and promotes arteriosclerotic detachment. There was no study of the homocysteine level in ischemic stroke patients in Korea except case report. Therefore we measured total plasma homocysteine level in ischemic stroke patients and evaluated association with other stroke risk factors. METHODS: We measured total plasma homocysteine level in 44 patients with ischemic stroke and 16 age-matched normal controls, and analyzed its relationship to other stroke risk factors. Total plasma homocysteine level was determined by using a radioenzymatic method. RESULTS: Total plasma homocysteine level was 12.12 5.11 micromol/L in patients and 9.40 1.93 micromol/L in controls. It was 13.03 5.78 micromol/L in lacunar infarction and 9.96 1.57 micromol/L in territory infarction. The total plasma homocysteine level of the patients with hypertension, DM, hyperlipidemia, heart disease, smoking, alcohol, previous stroke, carotid bruit was not different statistically from those without them. CONCLUSIONS: Total plasma homocysteine level was significantly higher in the ischemic stroke patients than that of controls. Lacunar infarction showed significantly higher level of total plasma homocysteine compared to territory infarction.
Cerebral Infarction* ; Endothelial Cells ; Heart Diseases ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Hyperlipidemias ; Hypertension ; Infarction ; Korea ; Pilot Projects* ; Plasma* ; Risk Factors ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar

PURPOSE: To evaluate patient characteristics such as deformity type, associated disease, and family history, and results of treatment of pre-axial polydactyly with hallux varus deformity. MATERIALS AND METHODS: We carried out a retrospective study of 5 patients who presented with preaxial polydactyly with hallux varus deformity, and were treated between 2003 and 2010 at the authors' hospital. Surgeries including extra digit excision, local flap, osteotomy, and interphalangeal joint fusion were performed taking into consideration the deformity types and patient's age. Family history, associated disease, and types of duplication were assessed, and the outcomes of surgery were evaluated with radiographs and appearances of foot. The mean follow-up period was 34 months. RESULTS: All 5 patients had one or more associated anomalies such as congenital anterolateral tibial bowing and polydactyly in three, translocation of chromosome 2 : 13 associated with cryptorchidism in one, pes planovalgus in one, residual poliomyelitis in one, syndactyly of the foot in two, and leg length discrepancy in one patient. There was no family history of hallux polydactyly in any of the cases. All five patients had duplication of the distal phalanx and one of them had a blocked proximal phalanx. The extra digit was completely removed and the varus deformity was corrected in all cases. CONCLUSION: There was a high incidence of associated diseases in patients with hallux polydactyly and varus deformity. Deformity correction could be obtained by surgeries chosen according to the individual deformity type and patient age.
Chromosomes, Human, Pair 2 ; Congenital Abnormalities ; Cryptorchidism ; Follow-Up Studies ; Foot ; Hallux ; Hallux Varus ; Humans ; Incidence ; Joints ; Leg ; Male ; Osteotomy ; Poliomyelitis ; Polydactyly ; Retrospective Studies ; Syndactyly

Anaphylaxis is one of major causes of morbidity and mortality during anesthesia. Muscle relaxants are the most common cause of anaphylaxis during anesthesia. A 54-year-old woman was scheduled for thyroidectomy. She had no history of allergy and had never previously undergone general anesthesia, Lidocaine, propofol and vecuronium were injected sequentially to induce general anesthesia. Two minutes after the vecuronium injection, severe hypotension, tachycardia and bronchospasm developed, and delayed skin rashes appeared. The patient recovered without any significant complications after immediate proper intensive care. The operation was delayed and a skin test was performed on the 7th day after discharge. She revealed a positive skin test for vecuronium. The anesthesia was re-induced without muscle relaxant and maintained with propofol and remifentanil infusion. Surgery was completed uneventfully, and the patient recovered without any adverse reaction.
Anaphylaxis ; Anesthesia ; Anesthesia, General ; Bronchial Spasm ; Exanthema ; Female ; Humans ; Hypersensitivity ; Hypotension ; Critical Care ; Lidocaine ; Middle Aged ; Muscles ; Piperidines ; Propofol ; Skin Tests ; Tachycardia ; Thyroidectomy ; Vecuronium Bromide

Anaphylaxis is one of major causes of morbidity and mortality during anesthesia. Muscle relaxants are the most common cause of anaphylaxis during anesthesia. A 54-year-old woman was scheduled for thyroidectomy. She had no history of allergy and had never previously undergone general anesthesia, Lidocaine, propofol and vecuronium were injected sequentially to induce general anesthesia. Two minutes after the vecuronium injection, severe hypotension, tachycardia and bronchospasm developed, and delayed skin rashes appeared. The patient recovered without any significant complications after immediate proper intensive care. The operation was delayed and a skin test was performed on the 7th day after discharge. She revealed a positive skin test for vecuronium. The anesthesia was re-induced without muscle relaxant and maintained with propofol and remifentanil infusion. Surgery was completed uneventfully, and the patient recovered without any adverse reaction.
Anaphylaxis ; Anesthesia ; Anesthesia, General ; Bronchial Spasm ; Exanthema ; Female ; Humans ; Hypersensitivity ; Hypotension ; Critical Care ; Lidocaine ; Middle Aged ; Muscles ; Piperidines ; Propofol ; Skin Tests ; Tachycardia ; Thyroidectomy ; Vecuronium Bromide

PURPOSE: To evaluate the efficacy and safety of silodosin 8 mg once daily in a 12-week treatment of subjects with severe lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: A total of 100 subjects from 10 urology centers in Korea were included in this study. The inclusion criteria were as follows: age > or =50 years, International Prostate Symptom Score (IPSS) > or =20, quality of life (QoL) score > or =3, urine volume > or =120 mL and maximal urinary flow rate (Qmax) <15 mL/s, and postvoid residual volume (PVR) <100 mL. We assessed the improvement of LUTS with change in IPSS, QoL score, Qmax, PVR, and adverse events at baseline and 4 and 12 weeks after treatment with silodosin 8 mg once daily. RESULTS: The IPSS values were 23.27+/-3.34, 15.89+/-6.26, and 13.80+/-6.31 at baseline, 4, and 12 weeks, respectively, with significant improvements (p<0.0001, p=0.0214, respectively). QoL scores were 4.44+/-0.85, 3.38+/-1.20, and 3.04+/-1.20 at baseline, 4, and 12 weeks, respectively, and the differences were statistically significant (p<0.0001). There was a significant difference in Qmax between baseline and 12 weeks (p<0.0001) but not in PVR (p=0.9404) during the clinical trial. The most frequent adverse event in this study was ejaculation failure with 13 cases. However, no subject dropped out because of ejaculation failure, and in 12 of the 13 cases it was fully resolved without further treatment. CONCLUSIONS: Silodosin 8 mg once daily may be effective and safe in Korean patients with severe LUTS associated with BPH.
Ejaculation ; Humans ; Korea ; Lower Urinary Tract Symptoms* ; Male ; Prospective Studies* ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; Residual Volume ; Urology

Therapeutic agents such as antibiotics, hormonal drugs and retinoids are usually applied for the treatment of acne vulgaris. Adult patients with acne vulgaris may suffer from various side effects of the therapeutic agents. Stellate ganglion blocks are known to be effective for general dermatological conditions such as atopic dermatitis and acne vulgaris. We experienced that a stellate ganglion block showed significant therapeutic effects in two patients with severe acne that did not respond to other treatments including medications. A stellate ganglion block should be considered as an effective treatment method for patients with acne vulgaris, especially in cases where little improvement is seen with the use of other treatment methods.
Acne Vulgaris ; Adult ; Anti-Bacterial Agents ; Dermatitis, Atopic ; Humans ; Retinoids ; Stellate Ganglion

To investigate the relationship between the morphologic changes and the expression of keratin and proto-oncogene induced by Beta-propiolactone (BPL), we assessed on the expression of keratins (K8, K10, K13) and proto-oncogenes (c-fos, c-jun, c-myc) in human HaCaT cell line. The cells were treated with 0, 0.1, 1 microgram/ml BPL for 2 or 6 hours. Morphologic studies revealed that BPL changed the cells into fibrocyte-shaped, caused highly lobulated nuclei and reduced desmosomes in their number. Findings of immunofluorescence and Northern blotting indicated that BPL consistently decrease expression of K10 representing a normal differentiation marker of keratinocytes, while increasing expression of K8 and K13 associated with a pathologic differentiation. This reagent also up-regulated expression of c-fos and c-jun, and down-regulated expression of c-myc. Together with staining for each keratin or proto-oncogene and DNA content in flow cytometry, BPL increased K8 expression dramatically at S-G2-M phase. The induction of c-Fos at S-G2-M phase appeared within 2 hours, and c-Jun gradually occurred. However, c-Myc was inhibited regardless of phases of cell cycle. In conclusion, these changes caused by BPL demonstrate a close relationship between the morphologic evidence and the altered expression of each keratin and proto-oncogene.
Blotting, Northern ; Cell Cycle ; Cell Line ; Desmosomes ; DNA ; Flow Cytometry ; Fluorescent Antibody Technique ; Humans ; Keratinocytes ; Propiolactone* ; Proto-Oncogenes*

Many advances, including the development of antibiotics, the advent of diagnostic techniques and the use of nonsurgical drainage have decreased the mortality rate of pyogenic liver abscess. But, early prompt diagnosis and proper treatment is mandatory in gas-forming pyogenic liver abscess because it may run a fulminating course to death. Gas-forming pyogenic liver abscess mostly occurred to old diabetics. Symptoms of duration are shorter and the prognosis is poorer in the gas-forming than in the non-gas-forming liver abscess. We report three cases of gas-forming pyogenic liver abscess which occurred in old diabetic patients. They were successfully managed by parenteral antibiotics and early percutaneous drainage under sonographic guidance. Early and adequate drainage of pus by pigtail catheter may play a crucial role on the treatment of gas-forming liver abscess.
Anti-Bacterial Agents ; Catheters* ; Diabetes Mellitus ; Diagnosis ; Drainage* ; Humans ; Liver Abscess* ; Liver Abscess, Pyogenic ; Liver* ; Mortality ; Prognosis ; Suppuration ; Ultrasonography