BACKGROUND: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation (rSO2). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. METHODS: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. RESULTS: The increments of the rSO2 on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The rSO2 on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. CONCLUSIONS: We observed an increment of the rSO2 on the block side from the baseline; however, the rSO2 on the non-block side decreased.
Blood Pressure ; Blood Volume ; Ear ; Heart Rate ; Horner Syndrome ; Humans ; Lidocaine ; Oxygen ; Spectrum Analysis ; Stellate Ganglion

PURPOSE: To analyze difference in bone mineral density (BMD) between intertrochanteric fracture and control group and to explore the predictive value of BMD for intertrochanteric fracture. MATERIALS AND METHODS: 57 patients who were over 60-year-old with intertrochanteric fracture were examined. For control group, 110 patients who did not have any fracture were selected. Dual energy X-ray absorptiometry was studied at 1, 2, 3, 4 lumbar vertebrae, femoral neck, trochanter and Ward's triangle. BMD was compared at each site between two groups statistically. RESULTS: Fracture group consisted of 16 male, 41 female and was average 70.8 year old. Control group consisted of 21 male, 89 female and was average 68.1 year old. There was no differences in sex and age between two groups (p>0.05). BMD of L1, L2 and mean lumbar area were significantly less in fracture group than control group (p<0.05). There was no difference between two groups in BMD of another sites (p>0.05). CONCLUSION: BMD of L1, L2 and mean lumbar area in fracture group had lower value significantly, but had no differences between two groups at another sites. BMD of L1, L2 and mean lumbar area might be used as the most sensitive predictive indicator for risk of osteoporotic fractures including intertrochanteric fracture in elderly patient.
Absorptiometry, Photon ; Aged* ; Bone Density* ; Female ; Femur ; Femur Neck ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Osteoporotic Fractures

Differential diagnosis of invasive aspergillosis from other pulmonary fungal infections including mucormycosis is important because the treatment is pathogen-dependent. Clinically, invasive aspergillosis is often discriminated from other mold infections on the basis of typical histopathologic features in the biopsy specimen. However, biopsy alone is not always complete because different fungal species can display similar histopathologic features. Surrogate markers or molecular-based assays can be useful when the results of conventional diagnostic modalities are conflicting. Here, we present a case of invasive pulmonary aspergillosis histologically mimicking mucormycosis, which was confirmed by fungal polymerase chain reaction.
Aspergillosis ; Biomarkers ; Biopsy ; Diagnosis, Differential ; Fungi ; Invasive Pulmonary Aspergillosis* ; Lung Diseases, Fungal ; Mucormycosis* ; Polymerase Chain Reaction

A primary malignant melanoma occurring within the male urethra is a very rare disease, which usually shows highly malignant potential. Due to the low incidence, the clinical features of this disease remain unclear, and the mode of treatment controversial. Herein, we report a case of a malignant melanoma of the male urethra in a 77 year old man, who was managed by transurethral resection, and has remained uneventful for a 6 month follow-up period.
Aged ; Follow-Up Studies ; Humans ; Incidence ; Male* ; Melanoma* ; Rare Diseases ; Urethra*

Synovial sarcoma comprises approximately 10% of soft tissue sarcomas. Primary pulmonary synovial sarcoma is a rare tumor. It makes up only 0.5% of all primary lung malignancies. It typically presents in adolescents and young adults. The usual progress of the tumor is unknown. We report the rapid progress of a primary pulmonary sarcoma that developed in a 67-year-old woman. In this case, metastatic sarcoma was excluded by positron emission tomography-computed tomography. Synovial sarcoma was histologically confirmed by a biopsy from the lung tissue. The patient had two masses located at the upper lobe of the lung. The patient refused all medical treatment and left our hospital. Two months later, she was readmitted and diagnosed with multiple metastases in the other lung and pancreas. She expired due to syndrome of inappropriate antidiuretic hormone secretion and superior vena cava syndrome four days after admission.
Adolescent ; Aged ; Biopsy ; Electrons ; Female* ; Humans ; Lung* ; Neoplasm Metastasis ; Pancreas ; Sarcoma ; Sarcoma, Synovial* ; Superior Vena Cava Syndrome ; Young Adult

Interferon-γ (IFN-γ) is an important cytokine produced by natural killer (NK) cells and T cells in response to various stimuli. The levels of IFN-γ secreted after stimulation of NK cells using a recombinant cytokine is represented as one of functions of NK cells. Recently, a method for evaluating NK cell activity in whole blood samples was developed. The levels of IFN-γ secreted after NK cell stimulation with PROMOCA™ (ATGen, Korea) and T cell stimulation with phytohemagglutinin (PHA) were compared using two different commercial kits: NK Vue Gold (ATGen, Korea) and QuantiFERON-TB Gold In-Tube (Cellestis, Australia). Participants included 43 healthy individuals. Whole blood samples were incubated with either PROMOCA, a recombinant cytokine that specifically activates NK cells, or with PHA. IFN-γ levels in the supernatants were measured by ELISA. The level of IFN-γ by PROMOCA stimulation (PROMOCA IFN-γ) was more varied than that by stimulation with PHA (PHA IFN-γ) (median 1,544.4 pg/mL [ range 193.7–2,530.9] vs. median 2,470.1 pg/mL [ 2,250.1–2,874.4] P=0.0001). The median of PHA IFN-γ/PROMOCA IFN-γ ratio was 1.9 (1.1–12.4). There was a significant difference in levels of IFN-γ secreted after stimulation with PROMOCA or PHA in the healthy population.
Enzyme-Linked Immunosorbent Assay ; Healthy Volunteers ; Interferon-gamma ; Killer Cells, Natural ; Methods ; T-Lymphocytes

BACKGROUND: Legionella pneumophila has been recognized as an important cause of community-acquired pneumonia(CAP) requiring hospitalization. However, epidemiological data on the occurrence of legionella-related pneumonia is unavailable in Korea. The purpose of this study was to evaluated the etiological imprtance of legionella pneumophila serogroup 1 in patients hospitalized with CAP. METHOD: The CAP patient over 16 year-old were recruited from July 1999 to June 2000 at the Chunchon Sacred Heart Hospital. Fifty four patients (male 29, female 25, average age 63.8±15.3) were included in this study. A diagnosis of a legionella pneumophila infection was based on a urinary antigen test using the Binax Company enzyme immunoassay. The severity of pneumonia was assessed using the Fine's PORT scoring system. RESULT: The average Fine's PORT score was 99.7(±44.9). According to the risk classification proposed by the Infectious Disease Society of America, the number of patients in each class(from class I to class V) were 6(11.1%), 13(24.1%), 9(16.7%), 14(25.8%), and 12(22.2%), respectively. Thirty two patients(59.3%) were initially admitted to the intensive care unit. The mortality rate was 16.7%(9 in 54). In all patients, urinary antigens to Legionella pneumophila serogroup 1 were not detected. CONCLUSION: Legionella pneumophila may play little role in causing adult CAP in Korea. Therefore, the routine use of macrolide in the empirical treatment of the CAP patients based upon the ATS guidelines(1993) in Korea should be reevaluated.
Adult ; Americas ; Classification ; Communicable Diseases ; Diagnosis ; Female ; Gangwon-do ; Heart ; Hospitalization ; Humans ; Immunoenzyme Techniques ; Intensive Care Units ; Korea* ; Legionella pneumophila* ; Legionella* ; Legionnaires' Disease ; Mortality ; Pneumonia*

No abstract available.
Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular*

Purpose: The technique for transanal resection of rectal tumors has evolved from conventional methods to minimally invasive approaches. However, the research comparing long-term results between these approaches is limited. Methods: Between 2016 and 2022, a total of 133 patients who underwent transanal excision were analyzed. Patients were classified into 2 groups according to surgical approach: conventional transanal approach (CTA) and minimally invasive transanal approach (MTA). Medical records were analyzed to compare surgical and oncological outcomes between the 2 groups. Results: There were no significant differences observed in patient’s demographics and tumor characteristics, except the MTA group exhibited a statistically longer distance from the anal verge. Although statistical significance was not reached, the MTA group demonstrated a 100% margin-negative rate in contrast to the CTA group, which had worse outcomes for both margin status and fragmentation. Recurrence was observed only in the CTA group containing pT1 rectal cancer and grade 1 neuroendocrine tumor, with negative margins and no fragmentation. Conclusion The minimally invasive approach did not demonstrate statistical superiority but showed technical feasibility through the absence of margin-positive cases and the use of the clip handle method. Further studies are needed to validate these findings and assess broader applicability.

Purpose: The technique for transanal resection of rectal tumors has evolved from conventional methods to minimally invasive approaches. However, the research comparing long-term results between these approaches is limited. Methods: Between 2016 and 2022, a total of 133 patients who underwent transanal excision were analyzed. Patients were classified into 2 groups according to surgical approach: conventional transanal approach (CTA) and minimally invasive transanal approach (MTA). Medical records were analyzed to compare surgical and oncological outcomes between the 2 groups. Results: There were no significant differences observed in patient’s demographics and tumor characteristics, except the MTA group exhibited a statistically longer distance from the anal verge. Although statistical significance was not reached, the MTA group demonstrated a 100% margin-negative rate in contrast to the CTA group, which had worse outcomes for both margin status and fragmentation. Recurrence was observed only in the CTA group containing pT1 rectal cancer and grade 1 neuroendocrine tumor, with negative margins and no fragmentation. Conclusion The minimally invasive approach did not demonstrate statistical superiority but showed technical feasibility through the absence of margin-positive cases and the use of the clip handle method. Further studies are needed to validate these findings and assess broader applicability.