Studies of brain magnetic resonance imaging (MRI) of neonatal white matter damage are few, and descriptions of this type of brain damage are limited. During the past three years, we have encountered three full-term infants with selective white matter damage over the course of their viral illness. All three neonates presented with seizures a few days after showing symptoms of a viral illness. The results of bacterial cultures of the blood, CSF, and stool were negative. Newborn screening tests for organic aciduria, amino acid metabolism disorders, and fatty acid oxidation defects were also negative. In two infants, an electroencephalogram (EEG) showed slow basic activity, which is a typical finding in patients with encephalitis/encephalopathy. The Diffusion-weighted MRI (DWI) showed abnormally high signal intensity localized to the white matter of the corpus callosum, thalamus, internal capsule, or hippocampus. The findings of DWI suggested that the neonates' lesions had occurred recently. All patients recovered completely.
Brain ; Corpus Callosum ; Electroencephalography ; Hippocampus ; Humans ; Infant ; Infant, Newborn* ; Internal Capsule ; Magnetic Resonance Imaging ; Mass Screening ; Metabolism ; Seizures ; Thalamus

Among 7,500 patients whom we have performed gastrofiberoscopy from July 1979 to June 1,982, 226 cases of stomach cancer were diagnosed. The frequency was 3. 0%. The ratio of male to female was 2: 1, the peak incidence, 69 cases(30.5%) was in 5th decade. 1) The frequency of stomach cancer among the age were 0. 5% in 1st decade, 0.4% in 2nd decade, 1.2% in 3rd decade, 2.5% in 4th decade, 5.9% in 5th decade, 12.6% in 6th decade 16.8% in 7th decade. (continue...)
Female ; Humans ; Incidence ; Male ; Stomach Neoplasms* ; Stomach*

Background: The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease. Methods: In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed. Results: There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001). Conclusion In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

Background: Aortic valve replacement (AVR) has recently been performed at many centers using a minimally invasive approach to reduce postoperative mortality, morbidity, and pain. Most previous reports on minimally invasive AVR (MiAVR) have mainly focused on aortic stenosis, and those exclusively dealing with aortic regurgitation (AR) are few. The purpose of this study was to investigate early surgical results and review our experience with patients with chronic severe AR who underwent AVR via right anterior mini-thoracotomy (RAT). Methods: Data were retrospectively collected in this single-center study. Eight patients who underwent RAT AVR between January 2020 and January 2024 were enrolled. Short-term outcomes, including the length of hospital stay, in-hospital mortality, postoperative complications, and echocardiographic data, were analyzed. Results: No in-hospital mortalities were observed. Postoperative atrial fibrillation occurred temporarily in three patients (37.5%). However, none required permanent pacemaker implantation or renal replacement therapy. The median values of ventilator time, length of intensive care unit stay, and hospital stay were 17 hours, 34.5 hours, and 9 days, respectively. Preoperative and postoperative measurements of left ventricular ejection fraction were similar. However, the left ventricular end systolic and diastolic diameters significantly decreased postoperatively from 42 mm to 35.5 mm (p=0.018) and 63 mm to 51 mm (p=0.012), respectively. Conclusion MiAVR via RAT is a safe and reproducible procedure with acceptable morbidity and complication rates in patients with chronic severe AR. Despite some limitations such as a narrow surgical field and demanding learning curve, MiAVR is a competent method for AR.

We report very rare case of concurrent bronchial atresia and bronchogenic cyst. Morphologic apical segment of right upper lobe directly stemmed from right main bronchus. Bronchogenic cyst was communicating with atretic segmental bronchus and both were filled with mucus. The etiology is not well known, however it is likely that a single insult arround the 5th~6th week causes both malformations.
Bronchi ; Bronchogenic Cyst* ; Mucus

BACKGROUND: The goal of acute myelogenous leukemia(AML) therapy is to obtain the complete remission(CR) and to improve disease-free survival. Advances in chemotherapy and supportive care provided significant improvement in CR rate up to 60~85% patients with AML. METHODS: Forty two patients with previously untreated AML at Yeung Nam University Hospital from April 1985 through November 1996 were treated with AD(7-3) regimen for induction chemotherapy and followed by two courses of consolidation with AD(5-2) regimen. And the authors analyzed clinical factors related to the CR and overall survival. RESULTS: Twenty-four of the 42 patients achieved CR, and median duration of remission in 24 patients achieved CR was 56 weeks(4~ 305 +weeks). Median duration of survival in all 42 cases was 46 weeks(2~340 + weeks), and in 24 cases achieved CR was 73 weeks(12~340 +weeks). Causes of induction failure included infection in 9 cases, bleeding in 3 cases and drug resistance in 6 cases. Among the potential prognostic variables including age, initial WBC count, performance status, and presence of Auer rods and infection at the time of diagnosis, none was statistically significantly related to the prognosis. CONCLUSION: Further clinical trials for effective remission induction and postremission chemotherapy are necessary to overcome drug resistance and to increase the CR rate and duration.
Adult* ; Diagnosis ; Disease-Free Survival ; Drug Resistance ; Drug Therapy* ; Hemorrhage ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute* ; Prognosis ; Remission Induction* ; Survival Rate

BACKGROUND/AIMS: Functional dyspepsia (FD) is characterized as chronic recurrent upper gastrointestinal symptoms in the absence of any organic disorder. We hypothesized that duodenal low-grade inflammation activates superficial afferent nerve sprouting, thereby contributing to hypersensitivity in patients with FD. METHODS: A prospective case-control study was conducted in a tertiary referral center. FD was defined using the Rome III criteria. Standardized endoscopic biopsies were performed in the stomach and duodenum. Hematoxylin and eosin staining and immunohistochemical staining for major basic proteins were performed to detect granulated eosinophil-derived granules, and S-100 staining was performed to detect fine nerve fibers. RESULTS: A total of 51 patients with FD (82% female; mean age 35.8 ± 13.4 years) and 35 controls were enrolled. Activated eosinophil counts in the duodenum were significantly higher in patients with FD than in controls (41.4% vs 17.1%, P = 0.005). Microscopic duodenitis was more frequently detected in patients with FD than in controls. Fine nerve fibers were more abundant in patients with FD than in controls (45.1% vs 11.4%, P = 0.029). The abundance of fine nerve fibers highly correlated with the degree of activated eosinophils. CONCLUSION: Duodenal low-grade inflammation, such as mucosal eosinophilic accumulation with degranulation, promoted mucosal enteric nerve fiber density and sprouting in patients with FD.
Biopsy ; Case-Control Studies ; Duodenitis ; Duodenum ; Dyspepsia ; Eosine Yellowish-(YS) ; Eosinophils ; Female ; Hematoxylin ; Humans ; Hypersensitivity ; Inflammation ; Mucous Membrane ; Nerve Fibers ; Peripheral Nervous System ; Prospective Studies ; Stomach ; Tertiary Care Centers

The human heart is a complex organ in which many complicated congenital defects may happen and some of them require surgical intervention. Due to the vast complexity of varied anatomical presentations, establishing an accurate and consistent nomenclature system is utmost important to facilitate effective communication among pediatric cardiologists, cardiothoracic surgeons and radiologists. The Van Praagh segmental approach to the complex congenital heart disease (CHD) was developed in the 1960s and has been used widely as the language for describing complex anatomy of CHD over the decades. It utilizes a systematic and sequential method to describe the cardiac segments and connections which in turn allows accurate, comprehensive and unambiguous description of CHD. It can also be applied to multiple imaging modalities such as echocardiogram, cardiac CT and MRI. The Van Praagh notation demonstrates a group of three letters, with each letter representative for a key embryologic region of cardiac anatomy: the atria, ventricles and great vessels. By using a 3-steps approach, we can evaluate complex CHD precisely and have no difficulties in communicating with other medial colleague. This pictorial essay revisits the logical steps of segmental approach, followed by a pictorial illustration of its application.
Congenital Abnormalities ; Heart ; Heart Defects, Congenital* ; Humans ; Logic ; Magnetic Resonance Imaging

Splenosis is defined as the autotransplantation of splenic tissue after a traumatic splenic injury or a splenectomy. It has often been mistaken as an endometriosis, an intraperitoneal carcinoma, a hemangioma and an accessory spleen. It is clinically significant in that it requires no treatment if it is asymptomatic. Here we report a case of 34 year-old woman who had a pelvic splenosis with cyclic abdominal pain for several years, which was initially misdiagnosed as ovarian dermoid cyst. At the time of exploration, a splenosis was observed in the pelvic cavity. After surgery, a multiple splenosis in the abdominal cavity was found through a Tc-99m heat denatured red blood cell scan. The removal of the splenosis in the pelvic cavity resulted in an improvement in her symptoms.
Abdominal Cavity ; Abdominal Pain* ; Adult ; Autografts ; Dermoid Cyst* ; Endometriosis ; Erythrocytes ; Female ; Hemangioma ; Hot Temperature ; Humans ; Spleen ; Splenectomy ; Splenosis*

We experienced a patient with unilateral visual loss after cervical spine surgery in the prone position. During the initial postoperative period, we were not been able to identify the patient's visual loss because of severe conjunctival edema in both eyes. Three days after surgery, the patient complained of right visual loss and was examined by an ophthalmologist. Ophthalmic artery occlusion was taken to be the presumptive cause, based on fluorescein angiography (FAG) and other evidence. He had several risk factors of ophthalmic artery occlusion, such as; prone position, compression of the eye-balls, anatomic abnormality, cervical spine and a long duration operation, intraoperative bleeding, hypotension and smoking, and a diabetic history. We concluded that attention must always be paid to a patients' eyes throughout the perioperative and postoperative period to prevent such a catastrophic postoperative complication.
Edema ; Fluorescein Angiography ; Hemorrhage ; Humans ; Hypotension ; Ophthalmic Artery ; Postoperative Complications ; Postoperative Period ; Prone Position* ; Risk Factors ; Smoke ; Smoking ; Spine*