No abstract available.
Adrenocorticotropic Hormone* ; Humans ; Infant ; Infant, Newborn ; Spasms, Infantile*

Uterine tumors resembling ovarian sex-cord tumors (UTROSCT) are very rare tumors that occur mainly in the uterine fundus of women in reproductive age. These tumors can be classified into group 1 and group 2 by histological results. In group 1, epithelial-like differentiation is partially observed in the tumors. In group 2, sex-cord elements are predominant in uterine mural mass. We experienced UTROSCT group 1 in a 29-year-old woman who complained of severe abdominal pain that started one week after delivery and UTROSCT group 2 case in a 49-year-old woman who complained of dysfunctional uterine bleeding. We report two different types of UTROSCT cases that we experienced.
Abdominal Pain ; Adult ; Female ; Humans ; Metrorrhagia ; Middle Aged ; Sex Cord-Gonadal Stromal Tumors ; Uterine Diseases ; Uterine Neoplasms

Purpose: We explored the relationship between dry eye syndrome (DES) and parity in women over 20 years of age. Methods: We retrieved data from the Fifth Korean National Health and Nutrition Examination Survey. Of women over 20 years of age, 7,573 diagnosed with DES by ophthalmologists and 7,347 who self-diagnosed DES were included. We used logistic regression to explore the relationship between DES prevalence and parity, and the chi-squared test to compare differences in DES prevalence by someo children. Results: On univariate logistic regression, the DES incidence was significantly affected by residential status, educational level, hours of sleep, and hyperlipidemia, osteoarthritis, thyroid disorder, and menopause status. We subjected these parameters (and age) to multivariate logistic regression. We found no significant relationship between the doctor-diagnosed DES rate and the number of children. Subjectively, the number of children significantly reduced the prevalence of self-diagnosed DES but not that diagnosed by ophthalmologists. The self-diagnosed DES prevalence was significantly lower in women with than without children. Conclusions The KNHANES-V data showed that the prevalence of self-diagnosed DES decreased with the number of children in women aged over 20 years. The prevalence of self-diagnosed DES in women with children was significantly less than that in women without children. However, we found no significant correlation between the number of children and DES status, because DES does not simply reflect poor tear secretion, being rather multifactorial.

The transurethral resection of the prostate (TURP) syndrome is caused by intravascular absorption of an electrolyte-free irrigating fluid during TURP for benign prostatic hypertrophy or prostatic carcinoma. The clinical symptoms and signs include hypertension, bradycardia, respiratory distress, hypotension, nausea, vomiting, confusion, blindness, seizure, coma, hyponatremina, and hypoosmolality. In this case, we incidentally detected very severe dilutional hyponatremia (99 mmol/L) without any symptoms during TURP and immediately took measures to treat TURP syndrome. On the third postoperative day, the hyponatremia had resolved within the normal range.
Absorption ; Blindness ; Bradycardia ; Coma ; Hypertension ; Hyponatremia* ; Hypotension ; Nausea ; Prostate* ; Prostatic Hyperplasia ; Reference Values ; Seizures ; Transurethral Resection of Prostate ; Vomiting

Intraoperative pulmonary embolism can result in severe hemodynamic instability, including cardiac arrest. Therefore, immediate diagnosis and proper treatment are required. We report a case of the acute cardiac and pulmonary embolisms during radical nephrectomy and inferior vena cava (IVC) thrombectomy in a patient with renal cell carcinoma with thrombus in the IVC. We diagnosed the cardiac embolism intraoperatively using the transesophageal echocardiogram, and performed emergent cardiac and pulmonary embolectomies immediately. After the surgery, the patient was discharged without any complication.
Carcinoma, Renal Cell ; Diagnosis ; Embolectomy ; Embolism ; Heart Arrest ; Hemodynamics ; Humans ; Nephrectomy* ; Pulmonary Embolism* ; Thrombectomy* ; Thrombosis ; Vena Cava, Inferior*

Obturator nerve block is occasionally performed during transurethral resection of lateral bladder wall tumors to prevent the violent contraction of the adductor muscle of the thigh. Rare complications including intravascular injection of the local anesthetics and hematoma formation may occur during the obturator nerve block. We report a case of the unintentional breakage of the spinal needle during the obturator nerve block with successful removal of the broken spinal needle by an orthopedic surgeon.
Anesthetics, Local ; Hematoma ; Needles* ; Obturator Nerve* ; Orthopedics ; Thigh ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Lesch-Nyhan syndrome (LNS) is a rare, X-linked recessive inherited disorder caused by a deficiency of the enzyme hypoxanthine-guanine-phophoribosyltransferase, leading to excessive purine production and elevation of uric acid. Clinical manifestations include mental retardation, spasticity, choreathetosis, compulsive self-mutilation, renal calculi followed by obstructive nephropathy, and arthritis. Patient with LNS may have increased risk of aspiration pneumonia, acute renal failure and unexpected sudden death. We accomplished successful general anesthesia in a case of LNS requiring percutaneous nephrolithotomy due to renal calculi.
Acute Kidney Injury ; Anesthesia, General ; Arthritis ; Death, Sudden ; Humans ; Intellectual Disability ; Kidney Calculi* ; Lesch-Nyhan Syndrome* ; Muscle Spasticity ; Nephrostomy, Percutaneous* ; Pneumonia, Aspiration ; Uric Acid

OBJECTIVE: We retrospectively assessed the efficacy of stereotactic radiosurgery (SRS) for dural arteriovenous fistulas (DAVFs) involving the transverse-sigmoid sinus and analyzed the angiographic and clinical results with our 8-year experience.METHODS: Nine patients with intracranial DAVFs involving the transverse-sigmoid sinus underwent SRS using a Gamma Knife® (Elekta Inc., Atlanta, GA, USA) between 2009 and 2016. Five patients underwent SRS for residual DAVFs after embolization and four patients were treated with SRS alone. The median target volume was 1.9 cm3 (range, 0.8–14.2) and the median radiation dose of the target was 17 Gy (range, 16–20). The median follow-up period was 37 months (range, 7–81).RESULTS: Pulsating tinnitus (33%) was the most common symptom. DAVFs were completely obliterated in four patients (44%) and subtotally obliterated in five (56%). Six patients (67%) showed complete recovery of symptoms or signs, and three (33%) showed incomplete recovery. One patient experienced a recurrent seizure. Adverse radiation effects after SRS occurred in one patient (11%). The total obliteration rates after SRS were 16.7%, 37.5%, and 68.7% at 1, 2, and 3 years, respectively. The median interval from SRS to total obliteration of the fistula was 31 months (range, 12–38). The rates at which the symptoms started to improve were 40% at 1 month and 80% at 2 months after SRS. Symptoms started to improve at a median of 5 weeks after SRS (range, 3–21).CONCLUSION: SRS with or without embolization is a safe and effective treatment to relieve symptoms and obliterate DAVFs on the transverse-sigmoid sinus.
Central Nervous System Vascular Malformations ; Fistula ; Follow-Up Studies ; Humans ; Radiation Effects ; Radiosurgery ; Retrospective Studies ; Seizures ; Tinnitus ; Transverse Sinuses

No abstract available.
Arthritis* ; Immunoblastic Lymphadenopathy*

PURPOSE: The purpose of this research was to evaluate the relationship between the 2007 Korean medical licensing examination (KMLE) and the 2006 Learning Objectives for Medical Students (LOMC) produced by the Association of Korean Medical Colleges' Council of Deans. METHODS: A total of 493 questions from the 2007 KMLE and the 2006 LOMC were used. The percentage and the frequency of each LOMC used in the 2007 KMLE were analyzed. The possibility of answering questions guided by the LOMC was analyzed. When questions could not be answered using the LOMC, we further categorized these questions into areas of medicine and specific causes. RESULTS: A total of 669 (14.03%) learning objectives were used to solve questions from the 2007 KMLE. A learning objective was used a maximum of 5 times in the 2007 KMLE, and the percentages of one time, 2 times, 3 times, 4 times, and 5 times were 84.90%, 12.11%, 2.39%, 0.45%, and 0.15%, respectively. Four hundred six of 493 questions were solvable using the learning objectives, and 87 (17.65%) were not. When several steps were needed to solve a question, 15 questions (17.24%) could not be solved due to a lack of learning objectives for some of those steps. Overall, the 87 unsolvable questions were from internal medicine (37.9%), obstetrics & gynecology (14.9%), medical law (12.6%), pediatrics (10.3%), general surgery (9.2%), psychiatry (6.9%), and preventive medicine (1.1%). Questions difficult to solve specifically due to absent learning objectives were in the areas of treatment and procedure (29.67%), test and diagnosis (13.19%), symptoms (9.89%), pathophysiology (7.69%), complications (6.59%), and disease entity (6.59%). CONCLUSION: Discrepancy was observed between the 2007 KMLE and the 2006 LOMC. To solve this problem, the reorganization of both the KMLE and the LOMC based on a clear consensus of a primary care physician's role is believed to be needed.
Consensus ; Gynecology ; Humans ; Internal Medicine ; Jurisprudence ; Learning ; Licensure ; Obstetrics ; Pediatrics ; Physician's Role ; Preventive Medicine ; Primary Health Care ; Students, Medical