Successful thoracic endovascular repair for complicated Stanford type B acute aortic dissection in two patients is herein reported. The true lumen flow was immediately restored following stent graft deployment in the descending thoracic aorta with subsequent resolution of the distal malperfusion syndrome. One patient is doing well more than 15 months after surgery and another patient who was treated more recently is also doing well 7 months postoperatively.
Aorta, Thoracic ; Humans ; Stents ; Transplants

We report on the application of a venovenous type extracorporeal membrane oxygenator (ECMO) in high-risk tracheal procedures in six cases consisting of five patients with tracheal stenosis. An ECMO should be helpful for preventing respiratory emergency during a tracheal procedure.
Emergencies ; Extracorporeal Circulation ; Extracorporeal Membrane Oxygenation ; Humans ; Membranes ; Oxygenators, Membrane ; Tracheal Stenosis

The role of amino acids in culture media for IVF-ET was examined in a total of 76 cycles. Patients received clomiphene citrate (CC) followed by hMG or GnRH-a combined with gonadotropins (FSH/hMG) for controlled ovarian hyperstimulation. Severe male (<4 x10(6) motile sperm) or age factor (>39 y) patients were excluded in this study. Pregnancy was classified as clinical if a gestational sac or fetal cardiac activity was seen on ultrasound. No significant differences were found in age, duration of infertility, follicle size, the level of E2 on the day of hCG injection, the mean number of oocytes retrieved, total motile sperm count, fertilization rate and the mean number of embryos transferred between bHTF (without amino acids) and mHTF (with amino acids) groups. However, total ampules of gonadotropins were higher (p<0.01) in mHTF group than bHTF group. Significantly (p<0.05) more clinical pregnancies were recorded in mHTF group (13/30) compared with bHTF group (9/46). The multiple pregnancy rates were 11.1% in bHTF group and 77% in mHTF group. There were one ectopic pregnancy in mHTF group and one heterotopic pregnancy in bHTF group. Abortion rates were 22.2% in bHTF group and 7.7% in mHTF, respectively The ongoing pregnancy or livebirth .ate was significantly (p<0.05) higher in mHTF group (12/30) than bHTF group (7/46). These results suggest that the addition of amino acids in culture media is essential for culture of zygotes in vitro and adjustment of energy substrates in phosphate-free culture media appears to be beneficial for human IVF-ET procedure.
Abortion, Induced ; Age Factors ; Amino Acids* ; Clomiphene ; Culture Media ; Embryonic Structures* ; Female ; Fertilization ; Fertilization in Vitro* ; Gestational Sac ; Gonadotropins ; Humans* ; Infertility ; Male ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Multiple ; Sperm Count ; Ultrasonography ; Zygote

The natural history of primary hyperparathyroidism, due to parathyroid adenoma, is unknown. Furthermore, spontaneous resolution of parathyroid necrosis or hemorrhage is rare and usually asymptomatic. Here, we report a case of parathyroid apoplexy of primary hyperparathyroidism, presenting as auditory hallucinations, accompanied with hypocalcemia. A 39-year-old man who was incidentally diagnosed with primary hyperparathyroidism, and waiting surgery for parathyroidectomy presented to psychiatric service with auditory hallucinations. He developed tetany, while taking psychiatric drugs. On a follow-up investigation, his serum calcium level fell from 11.8 to 5.8 mg/dL. His intact parathyroid hormone level also decreased from 1,017 pg/mL to 71.1 pg/mL. The parathyroid apoplexy was confirmed after a surgical removal of the infarcted adenoma. The auditory hallucinations disappeared, and serum calcium level was returned to within the normal range.
Adenoma ; Adult ; Calcium ; Follow-Up Studies ; Hallucinations ; Hemorrhage ; Humans ; Hyperparathyroidism, Primary ; Hypocalcemia ; Natural History ; Necrosis ; Parathyroid Hormone ; Parathyroid Neoplasms ; Parathyroidectomy ; Reference Values ; Stroke ; Tetany

A sixty-year-old man was admitted due to chest pain. He had a history of pelvic bone fracture fixation with Kirschner wire about 20 years earlier. On examination, we detected a Kirschner wire that had migrated into the right ventricle. Without cardiopulmonary bypass, we removed the migrating Kirschner wire via median sternotomy. The patient recovered without complications and was discharged on the 5th postoperative day.
Cardiopulmonary Bypass ; Chest Pain ; Foreign Bodies ; Fracture Fixation ; Heart ; Heart Ventricles ; Humans ; Pelvic Bones ; Sternotomy

OBJECTIVES: The purpose of this study was to develop a Korean Strength Scale for Youth and to examine its validity and reliability. METHODS: The Korean Strength Scale for Youth is based on a self-reporting, 100 item questionnaire that measures 25 strengths. Each scale item was given a 0–5 rating on a 6-point scale. In order to test the scale's validity and reliability, data were collected from 422 youths (aged 12–18 years). The strength measures included in our analyses were those contained within the Korean Strength Scale for Youth, the Positive Affect and Negative Affect Schedule, the Korean Well-Being Scale for Adolescents, and the Short Five Factor Personality Scale for Children. RESULTS: The results of exploratory factor analysis of the Korean Strength Scale for Youth scale-measures indicated the importance of four factors. The Korean Strength Scale for Youth was shown to have acceptable psychometric properties, including good internal consistency, test-retest reliability, and high convergent correlations. CONCLUSION: The Korean Strength Scale for Youth is a reliable and valid instrument that can be used to assess strengths in adolescents.
Adolescent* ; Appointments and Schedules ; Child ; Humans ; Psychometrics ; Reproducibility of Results

Objectives: The purpose of this study was to identify whether stress experienced by those working in the local civil service was related to their oral health during the COVID-19 pandemic. Methods: A survey was conducted on 431 civil servants from eight districts, currently working in the Daegu City Hall had COVID-19 related work duties during the pandemic. Results: Several factors associated with oral health related quality of life were explored. Demographic details revealed that men had significantly better oral health related life quality as compared to women; further, being younger, being unmarried, and having a lower position had better outcomes for oral health related quality of life. Regarding the relationship between oral health behavior and oral health related quality of life, it was found that the better the subjective oral health, the higher the rate of not visiting the dentist in the past year. The COVID-19 pandemic has been a particularly important time to explore in order to understand how the stress experienced by local government officials is related to their oral health. It has been especially noted that the higher the work stress, the worse the oral health related quality of life amongst individuals. Conclusions Results of this study emphasize that at a time when fatigue among civil servants is increasing due to the prolonged COVID-19 pandemic, oral conditions caused by stress should be identified and greater awareness should be created about oral health care.

Down syndrome is a rare cause of neonatal cholestasis. Neonatal cholestasis in a patient with Down syndrome is usually associated with severe liver diseases, such as neonatal hemochromatosis, myeloproliferative disorder and intrahepatic bile duct paucity. We experienced a case of idiopathic neonatal cholestasis in a patient with Down syndrome, which resolved spontaneously.
Bile Ducts, Intrahepatic ; Cholestasis ; Down Syndrome ; Hemochromatosis ; Humans ; Infant, Newborn ; Liver Diseases ; Myeloproliferative Disorders

Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.
Adult ; Carcinoid Tumor* ; Frameshift Mutation ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Incidental Findings ; Multiple Endocrine Neoplasia Type 1 ; Pancreas ; Recurrence ; Siblings ; Thorax ; Thymectomy

Adrenal myelolipoma (AML) is a rare, usually benign, and nonfunctioning tumor. About 7-15% of adrenal incidentalomas are AMLs, composed of normal hematopoietic elements and mature adipose tissue. AML is usually unilateral and < 4 cm. It is often discovered incidentally on abdominal computed tomography or magnetic resonance imaging. It is related to a chronic increase in adrenocorticotropic hormone, such as that observed in patients with congenital adrenal hyperplasia, Cushing disease, Conn's syndrome, and pheochromocytoma. Here, we report a 28-year-old man diagnosed with non-salt-losing congenital adrenal hyperplasia with huge bilateral AMLs and a literature review.
Adipose Tissue ; Adrenal Hyperplasia, Congenital* ; Adrenocorticotropic Hormone ; Adult ; Humans ; Hyperaldosteronism ; Magnetic Resonance Imaging ; Myelolipoma* ; Pheochromocytoma ; Pituitary ACTH Hypersecretion