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

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

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*

The aim of this study was to investigate the correlation between physical activity (PA) level and mental health status in a population-based sample of Korean female patients with breast cancer. Our analysis included 76 patients with breast cancer and 44 healthy controls. The Korean versions of the International Physical Activity Questionnaire (IPAQ), Beck Depressive Inventory (BDI), State-Trait Anxiety Inventory-KY (STAI-KY), and Somatosensory Amplification Scale (SSAS), and Quality of Life (QOL) scale were assessed. The frequency of moderate PA level in breast cancer patients was significantly lower than that of healthy control subjects (t = −2.6; P = 0.011). In turn, the incidence of low PA level in breast cancer patients was significantly higher than that observed in healthy controls (t = 2.85; P = 0.005). A moderate PA level was inversely correlated with BDI score (r = −0.35; P = 0.008) and was positively correlated with QOL score (r = 0.38; P = 0.011). A low level of PA was inversely correlated with SSAS score (r = −0.39; P < 0.001). In healthy controls, a high level of PA was positively correlated with QOL score (r = 0.50; P = 0.043). Moderate PA level was inversely correlated with SSAS score (r = −0.59; P < 0.001). A low level of PA was also positively correlated with BDI score (r = 0.35; P = 0.008). A moderate or low intensity of PA was inversely correlated with depression and somatosensory amplification and was positively correlated with QOL in breast cancer patients. Finally, we suggest that progressively low-to-moderate levels of PA can be well adapted to positively impact several measures of mental health.
Anxiety ; Breast Neoplasms* ; Breast* ; Depression ; Female ; Humans ; Incidence ; Mental Health* ; Motor Activity* ; Quality of Life

PURPOSE: The utility of N classification has been questioned after the 7th edition of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) was published. We evaluated the correlation between ratio-based N (rN) classification with the overall survival of pathological T4 gastric cancer patients who underwent D2 lymphadenectomy. MATERIALS AND METHODS: We reviewed 222 cases of advanced gastric cancer patients who underwent curative gastrectomy between January 2006 and December 2015. The T4 gastric cancer patents were classified into four groups according to the lymph node ratio (the number of metastatic lymph nodes divided by the retrieved lymph nodes): rN0, 0%; rN1, ≤13.3%; rN2, ≤40.0%; and rN3, >40.0%. RESULTS: The rN stage showed a large down stage migration compared with pathological T4N3 (AJCC/UICC). There was a significant difference in overall survival between rN2 and rN3 groups in patients with pT4N3 (P=0.013). In contrast, the difference in metastatic lymph nodes was not significant in these patients (≥16 vs. <15; P=0.177). In addition, the rN staging system showed a more distinct difference in overall survival than the pN staging system for pathological T4 gastric cancer patients. CONCLUSIONS: Our results confirm that rN staging could be a good alternative for pathological T4 gastric cancer patients who undergo D2 lymphadenectomy. However, before applying this system to gastric cancer patients who undergo D2 lymphadenectomy, a larger sample size is required to further evaluate the usefulness of the rN staging system for all stages, including less advanced stages.
Classification ; Gastrectomy ; Humans ; Joints* ; Lymph Node Excision* ; Lymph Nodes ; Neoplasm Staging ; Prognosis* ; Sample Size ; Stomach Neoplasms*