The usefulness of microscopic examination of pure bile directly collected from the biliary tract during endoscopic retrograde cholangiography and without hormonal stimulation was evaluated in 86 patients. Cholesterol monohydrate crystal and/or calcium bilirubinate granule were observed in the bile of 64% of GB stones, 88% of CBD stones and l00% of IHD stones. But only 4% of non stone control group were positive crystals examinations. According to this results, microscopic examinations:of bile samples collected during endoscopic retrograde cholangiography exhibited a sensitivity and a specificity for cholelithiasis recognition of 82.3% and 95.8%, respectively, with a positive and negative predictive value of 98.1% and 67.6%, respectively. We conclude that microscopic bile examinations of bile samples collected during ERC is useful to investigate in patients with suspected cholelithiasis.
Bile* ; Biliary Tract ; Bilirubin ; Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholelithiasis ; Cholesterol ; Gallstones ; Humans ; Sensitivity and Specificity

No abstract available.
Child* ; Glomerulonephritis* ; Humans

No abstract available.
Cholelithiasis* ; Diverticulum*

The results of 17 fractures of tibial shaft treated with Rush nails under the image intensifier and early weight bearing are reported. Thirteen of these fractures were closed. All fractures were united between 12 and 21 weeks clinically, 17 and 26 weeks radiologically after operation. All cases were healed without significant complications, such as fracture disease. The advantages of this method were as follows; 1) normal knee motion and early weight bearingare possible during healing. 2) There is a relatively rapid restoration of bone continuity. This method of treatment for tibial shaft fractures were indicated as follows; 1. Mid-shaft fracture. 2. Segmental fracture of shaft. 3. Expectation of compression force at fracture surface by weight bearing. 4. Open fracture of shaft.
Fractures, Open ; Knee ; Methods ; Tibia ; Weight-Bearing

Fatal airway obstruction due to the presence of blood clot occurs in a variety of clinical settings. Initial efforts to remove an airway clot, if warranted, involve suctioning, lavage, and forceps extraction through a flexible bronchoscope. If unsuccessful, further management options include rigid bronchoscopy, balloon-tip embolectomy catheter dislodgement, and the application of topical thrombolytic agents. We report a case of complete airway obstruction that developed after the aspiration of a blood clot during emergency operative vessel ligation in a 86-year-old female patient with gastric ulcer bleeding. Initial conventional suctioning was unsuccessful, in this case, due to a large firmly adherent clot. Therefore we peformed the alternative suctioning technique using suction attached directly to the existing tracheal tube in situ, with the cuff deflated. However, repeated direct tracheal suctioning alone failed to prevent cardiac arrest. Thereafter, simultaneously with several CPR chest compressions, large cylindrical clots were sucked up by direct tracheal suctioning. Presumably simultaneous chest compression has the potential advantage of creating higher airway pressures that provide effective kinetic energy to obstructing object.
Aged, 80 and over ; Airway Obstruction ; Bronchoscopes ; Bronchoscopy ; Cardiopulmonary Resuscitation ; Catheters ; Embolectomy ; Emergencies ; Female ; Fibrinolytic Agents ; Heart Arrest* ; Hemorrhage* ; Humans ; Ligation ; Resuscitation ; Stomach Ulcer ; Suction ; Surgical Instruments ; Therapeutic Irrigation ; Thorax ; Trachea

BACKGROUND: Previous studies have shown that thyroglobulin (Tg) measurement in fine-needle aspirates (FNA) of lymph nodes can assist in evaluating cervical lymph node metastasis. In this study, we evaluated the diagnostic performances of FNA-Tg, serum-Tg, and FNA-Tg/serum-Tg in detecting lymph node metastasis. METHODS: We retrospectively analyzed the diagnostic performances of FNA-Tg and serum-Tg in 641 cases (518 patients) with papillary thyroid cancer that underwent ultrasonography-guided fine-needle aspiration of cervical lymph nodes between March 2009 and February 2010. RESULTS: The number of lymph nodes and median FNA-Tg level of the positive lymph node cytology group were 99 and 1,300 ng/mL (range, 0.2-5,000), respectively, whereas corresponding values in the negative cytology group were 359 and 4.7 ng/mL (range, 0.1-1,173). The AUCs of FNA-Tg, serum-Tg, and FNA-Tg/serum-Tg ratio were 0.93 (95% CI, 0.90-0.97), 0.64 (95% CI, 0.57-0.70), and 0.83 (95% CI, 0.78-0.88), respectively. The sensitivity and specificity of FNA-Tg were 90.9% and 98.3%, respectively, and the percentage agreement with the cytology results was 96.7%. CONCLUSIONS: The agreement of FNA-Tg with the cytology results was good at the cutoff value of 35.9 ng/mL. The measurement of FNA-Tg in cases with uninterpretable cytology results can be useful in evaluating lymph node metastasis of papillary thyroid cancer.
Area Under Curve ; Biopsy, Fine-Needle ; Lymph Nodes ; Neoplasm Metastasis ; Retrospective Studies ; Sensitivity and Specificity ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms

Purpose: To evaluate the short-term ophthalmic side effects of bilateral same-day intravitreal bevacizumab injections. Methods: We retrospectively analyzed patients who underwent intravitreal bevacizumab injection in both eyes on the same day from January 2015 to June 2019. The patients were followed up at 1 day, 1 week, and 1 month after the injection. Results: A total of 281 patients (153 males and 128 females) and 562 eyes were included in the study, and 950 bilateral same-day intravitreal bevacizumab injections were performed. The mean age of patients was 58.87 ± 13.44 years. The most common cause of bilateral injection was that of complications due to diabetic retinopathy, which accounted for 66.3%, followed by age-related macular degeneration at 22.2%, retinal vein occlusion at 5.1%, and central serious chorioretinopathy at 2.1%. There were 0 cases of endophthalmitis after 950 injections, 13 cases of subconjunctival hemorrhage, and 17 patients with a temporary elevation of intraocular pressure. There were 11 patients with acute intraocular inflammation after bilateral injection, but none in both eyes. Patients with acute intraocular inflammation were followed up at short-term intervals until they improved. All patients showed complete improvement within 2 weeks after injection. Comparing the patients’ condition before and after injection, visual acuity improved (p < 0.001). Conclusions In terms of the frequency of short-term ophthalmic adverse events, bilateral same-day intravitreal bevacizumab injection is a safe procedure with fewer side effects and is more convenient for both the patient and the doctor.

Purpose: To evaluate the short-term ophthalmic side effects of bilateral same-day intravitreal bevacizumab injections. Methods: We retrospectively analyzed patients who underwent intravitreal bevacizumab injection in both eyes on the same day from January 2015 to June 2019. The patients were followed up at 1 day, 1 week, and 1 month after the injection. Results: A total of 281 patients (153 males and 128 females) and 562 eyes were included in the study, and 950 bilateral same-day intravitreal bevacizumab injections were performed. The mean age of patients was 58.87 ± 13.44 years. The most common cause of bilateral injection was that of complications due to diabetic retinopathy, which accounted for 66.3%, followed by age-related macular degeneration at 22.2%, retinal vein occlusion at 5.1%, and central serious chorioretinopathy at 2.1%. There were 0 cases of endophthalmitis after 950 injections, 13 cases of subconjunctival hemorrhage, and 17 patients with a temporary elevation of intraocular pressure. There were 11 patients with acute intraocular inflammation after bilateral injection, but none in both eyes. Patients with acute intraocular inflammation were followed up at short-term intervals until they improved. All patients showed complete improvement within 2 weeks after injection. Comparing the patients’ condition before and after injection, visual acuity improved (p < 0.001). Conclusions In terms of the frequency of short-term ophthalmic adverse events, bilateral same-day intravitreal bevacizumab injection is a safe procedure with fewer side effects and is more convenient for both the patient and the doctor.

No abstract available.
Aged ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Bacteremia/blood/*diagnosis/microbiology ; C-Reactive Protein/analysis ; Cholecystitis/blood/cerebrospinal fluid/microbiology ; Electrophoresis, Gel, Pulsed-Field ; Enterococcus faecium/drug effects/isolation & purification/metabolism ; Humans ; Male ; Microbial Sensitivity Tests ; Microscopy, Electron, Scanning ; Ochrobactrum/drug effects/isolation & purification/*metabolism ; RNA, Ribosomal, 16S/analysis/genetics/metabolism ; Sequence Analysis, DNA ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

BACKGROUND/AIMS: Gallstone pancreatitis has showed higher mortality and morbidity rate as compared to other causes of pancreatitis, and the proper timing of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) is still controversial. But recent several trials reveals early ERCP/EST is safe procedure and can reduce mortality and complication rate in gallstone pancreatitis. METHODS: To assess the safety and effectiveness of early ERCP/EST, we perfomed ERCP and EST, if necessary, in 40 cases of acute gallstone pancreatitis. RESULTS: 1) Early ERCP group (in 72 hours) were 27 cases, delayed group were 13 cases, and 11 early EST group, 16 delayed EST group. No statistically significant difference was found between two groups in blood chemistry and the severity of pancreatitis according to Ranson's criteria, respectively. No remarkable complication due to ERCP or EST was noted, and the hospital days were shorter in early ERCP/EST group with statistical significance, 2) Duodenoscopic findings show 14 normal papillae, 20 papillary edema, hemorrhagic and lacerated papillae in 6 cases. CONCLUSION: In cases of gallstone pancreatitis, early ERCP and EST is considered as a safe and effective treatment modality.
Chemistry ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis* ; Edema ; Gallstones* ; Mortality ; Pancreatitis* ; Sphincterotomy, Endoscopic