No abstract available.

No abstract available.
Carcinoma, Hepatocellular* ; Spleen*

A 29-year-old woman presented with secondary amenorrhea, primary infertility, and virilization, which had developed over the past 2 years was suspected to have a virilizing tumor at her left ovary. Her serum testosterone level was markedly elevated (380 ng/dL). Left salpingooophorectomy was performed, and histopathological examination revealed a thecoma of the left ovary. The postoperative serum testosterone level returned to 65 ng/dL. The patient did not have regression of virilism soon. However, the patient had a normal menstruation 29 days after surgery and gave birth to a baby 13 months after surgery.
Adult ; Female ; Humans ; Menstruation ; Ovarian Neoplasms/blood/*complications/*surgery ; Ovariectomy ; Pregnancy ; Pregnancy Outcome ; Testosterone/blood ; Thecoma/blood/*complications/*surgery ; Virilism/blood/*etiology/surgery

The age-standardized incidence and mortality rates of gastric cancer have been decreasing worldwide. However, due to the rapid increase in the aging population, the absolute number of cases is actually increasing, and some countries, including Korea, show a divergent trend in the incidence of gastric cancer in younger generations. Gastric cancer is the second most common cancer in Korea. In the present review, several epidemiologic factors associated with the risk of gastric cancer are evaluated, including family history of gastric cancer, Helicobacter pylori infection, cigarette smoking, and adverse dietary factors. The practice of and participation in gastric cancer screening are reviewed. Prevention strategies based on evidence from Korean epidemiologic studies and early detection by regular screening are important for the reduction of the burden from gastric cancer.
Aging ; Diagnosis ; Epidemiologic Factors ; Epidemiologic Studies ; Epidemiology* ; Family Characteristics ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Mass Screening* ; Mortality ; Risk Factors ; Smoking ; Stomach Neoplasms*

The age-standardized incidence and mortality rates of gastric cancer have been decreasing worldwide. However, due to the rapid increase in the aging population, the absolute number of cases is actually increasing, and some countries, including Korea, show a divergent trend in the incidence of gastric cancer in younger generations. Gastric cancer is the second most common cancer in Korea. In the present review, several epidemiologic factors associated with the risk of gastric cancer are evaluated, including family history of gastric cancer, Helicobacter pylori infection, cigarette smoking, and adverse dietary factors. The practice of and participation in gastric cancer screening are reviewed. Prevention strategies based on evidence from Korean epidemiologic studies and early detection by regular screening are important for the reduction of the burden from gastric cancer.
Aging ; Diagnosis ; Epidemiologic Factors ; Epidemiologic Studies ; Epidemiology* ; Family Characteristics ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Mass Screening* ; Mortality ; Risk Factors ; Smoking ; Stomach Neoplasms*

Click sound can evoke myogenic potentials in active sternocleidomastoid(SCM) muscle. These are due to activity of vestibular afferent rather than cochlear, which produce very short latency inhibition of ipsilateral motor unit activity. We investigated the click-evoked vestibulocollic reflexes in neck muscles to find out the significance and relationship of latency and amplitude of myogenic potentials between two different methods of muscles activation. EMGs were recorded from surface electrode evoked by sound stimuli(95dB SPL, 5/sec repetitive rate, 512 times) over SCM muscles on each side. Myogenic potentials have two biphasic responses which were termed P1, N1, P2, N2 based on the polarity of their components. The subjects were 24 normal volunteers. EMG recordings were obtained from 12 subjects(Group 1) who keeped head 10 cm above ground in supine position to activate their neck flexors to the degree required through the averaging runs(bilateral SCM muscles activation method). EMGs from another 12 subjects(Group 2) were recorded by rotating head to the opposite side to activate SCM muscle throughout the procedure(unilateral SCM muscle activation method). The latencies and amplitudes of myogenic potentials in the SCM muscle after stimulation were analysed and compared between the two methods. The latencies(msec) of P1 and N1 were 11.2+/-2.4, 21.7+/-1.1 respectively in Group 1 and 13.3+/-2.4, 23.0+/-1.1 respectively in Group 2. The amplitude(uV) of P1-N1 were 38.78.1 in Group 1 and 33.28.1 in Group 2. There were no significant differences in latencies and amplitudes of P1 and N1 between the groups(p<0.05). Unilateral muscle activation is easier and comfortable than the bilateral muscle activation and there were no significant difference in latency and amplitude of P1. The myogenic potential of unilateral vestibular function loss disappeared in a patient who was labyrinthectomized but there was normal response of potential in a patient who is profound sensory neural hearing loss. Click evoked myogenic potentials is a simple method of examining vestibulocollic reflex. Click evoked myogenic potential is related to vestibular status.
Electrodes ; Head ; Healthy Volunteers ; Hearing Loss ; Humans ; Muscles ; Neck ; Neck Muscles ; Reflex* ; Supine Position

Budd-Chiari syndrome (BCS) is a rare disease caused by the obstruction of the hepatic venous outflow or the inferior vena cava above the hepatic vein. It has been attributed to various etiologic factors. Including intrinsic vascular thrombosis, hepatic tumor invasion/compression, or associated with an idiopathic obstructing membrane. However, in most cases no definitive etiologic factors have been identified. Recently, we experienced a case of 21-year-old man who had Budd-Chiari syndrome associated with diaphragmatic hernia. Venous flow returned to normal on reintroduction of the liver into the abdominal cavity and closure of the defect in the diaphragm. To our knowledge, this is the rare report in our country. Here, we report this case with review of literatures.
Abdominal Cavity ; Budd-Chiari Syndrome* ; Diaphragm ; Hepatic Veins ; Hernia ; Hernia, Diaphragmatic* ; Humans ; Liver ; Membranes ; Rare Diseases ; Thrombosis ; Vena Cava, Inferior ; Young Adult

BACKGROUND: Remifentanil is useful during general anesthesia because of its rapid onset and short acting time. However, some studies report that due to opioid-induced hyperalgesia (OIH) and tolerance, remifentanil also increases early postoperative pain. The occurrence of OIH and opioid-induced tolerance is mainly thought to be due to central sensitization by the activation of NMDA receptors. Therefore, we investigated the effects of continuous infusion of ketamine, an NMDA receptor antagonist, on postoperative pain and the quantity of opioids used. METHODS: 40 patients scheduled to undergo laparoscopic gynecologic surgery were randomly allocated into two groups. Anesthesia was equally maintained with sevoflurane and 4 ng/ml of remifentanil in all patients. Ketamine (0.3 mg/kg) was injected and followed with a continuous dosage of 3 microl/kg/min in the ketamine group (n = 20) while the control group was injected and infused with an equal amount of normal saline. We compared postoperative VAS up to 7 hours and morphine demand through PCA. RESULTS: Postoperative VAS and morphine demand was significantly lower in the ketamine group 2 and 3 hours after surgery, respectively. CONCLUSIONS: When general anesthesia is maintained with sevoflurane and remifentanil in patients undergoing laparoscopic gynecologic surgery, continuous infusion of low dose ketamine decreased early postoperative pain and the quantity of opioids used.
Analgesics, Opioid ; Anesthesia ; Anesthesia, General ; Central Nervous System Sensitization ; Female ; Gynecologic Surgical Procedures ; Humans ; Hyperalgesia ; Ketamine ; Methyl Ethers ; Morphine ; N-Methylaspartate ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Piperidines ; Receptors, N-Methyl-D-Aspartate

PURPOSE: To investigate the difference in blood loss between two injection methods, intravenous (IV) and intra-articular (IA) methods via drain tube. MATERIALS AND METHODS: A total of 183 patients who underwent total knee arthroplasty between October 2013 and March 2016 were included. The method of tranexamic acid (TXA) administration was intravenously injected before August 2015, and it was applied thereafter to the joint through a drainage tube post intra-articular suture. Our subjects were divided into the following groups: The intravenous unilateral (IVU), intravenous bilateral (IVB), intra-articular unilateral (IAU), and intra-articular bilateral (IAB) groups. Hemoglobin and hematocrit, drainage amount, transfusion frequency, mean transfusion volume, and blood loss, as well as complications were compared between the groups. RESULTS: Drainage amount was 558.08±296.29 ml in IVU, and 498.39±199.70 ml in IAU; there was less drainage in IAU than in IVU, but without significance (p=0.262). Moreover, the drainage amount was 1,110.39±396.23 ml in IVB and 827.14±282.47 ml in IAB, which was significantly lower in IAB (p=0.000). Transfusion frequency was 5 patients (10.0%) in IVU and 2 patients (4.5%) in IAU, but without significant difference (p=0.442). Moreover, the frequency was 16 patients (29.6%) in IVB and 1 patient (2.9%) in IAB, which was significantly lower in the IAB group (p=0.002). Mean transfusion volume was 44.80±144.71 ml in IVU and 21.80±106.86 ml in IAU, but without significant difference (p=0.389); the volume was 177.80±321.00 ml in IVB and 18.30±108.18 ml in IAB, with statistical significance (p=0.001). Blood loss was 1,318.70±724.20 ml in IVU and 963.28±454.03 ml in IAU, which was significantly lower in the IAU (p=0.006); blood loss was 1,837.40±699.70 ml in IVB, and 1,337.60±382.20 ml in IAB and it was significantly lower in IAB (p=0.000). Complications included deep vein thrombosis in one case in IVU. CONCLUSION: In TKA, IA injection of TXA significantly reduced blood loss compared with IV injection, especially in bilateral TKA.
Arthroplasty, Replacement, Knee* ; Blood Transfusion ; Drainage ; Hematocrit ; Humans ; Joints ; Methods ; Sutures ; Tranexamic Acid* ; Venous Thrombosis

PURPOSE: To compare the radiographic and clinical results of medial open wedge high tibial osteotomy (OWHTO) using autogenous bone graft and allogenous cancellous bone graft for medial compartment osteoarthritis of the knee with two-year follow-up. MATERIALS AND METHODS: Fifty-one patients (52 knees) who underwent medial OWHTO from October 2007 to April. 2010 were included in the study. The patients were divided into group I (n=29) that received an autogenous tricortical bone graft and group II (n=23) that received an allogenous cancellous bone chip graft. The radiographic parameters (preoperative anatomical and mechanical femorotibial angles, modified tibial bone varus angle, and posterior tibial slope), clinical parameters, bone union period, and complications were evaluated from medical records. RESULTS: The radiographic and clinical outcomes did not show significant difference between two groups. The average bone union period was 11.7 weeks in group I and 12.1 weeks in group II. The visual analog scale score on the first postoperative day was significantly higher in group I than group II. CONCLUSIONS: Medial OWHTO using allogenous cancellous bone graft for medial compartment osteoarthritis of the knee can be considered as an alternative treatment method that provides equivalent radiographic and clinical results of OWHTO using autogenous bone graft and causes less immediate postoperative pain.
Follow-Up Studies ; Humans ; Knee ; Osteoarthritis ; Osteotomy ; Pain, Postoperative ; Transplants