Aneurysm of the carotid artery is an uncommon clinical disease which can occur as the result of atherosclerotic degeneration, fibromuscular dysplasia, or traumatic injury. Because of the risk of aneurysm rupture as well as the neurological sequelae caused by cerebral atheroembolism, surgical intervention is usually required. Internal jugular vein cannulation is the preferred approach for temporary hemodialysis catheter placement. However, the patient with renal failure on hemodialysis who has comorbid condition, the risk of pseudoaneurysm of carotid artery is increased. Here we report a patient on hemodialysis who developed common carotid artery pseudoaneurysm following an attempted internal jugular vein catheterization. A review of relevant literature is also presented.
Aneurysm ; Aneurysm, False* ; Carotid Arteries ; Carotid Artery, Common* ; Catheterization ; Catheterization, Central Venous* ; Catheters ; Central Venous Catheters* ; Embolism, Cholesterol ; Fibromuscular Dysplasia ; Humans ; Jugular Veins ; Renal Dialysis* ; Renal Insufficiency ; Rupture

BACKGROUND: The low cardiopulmonary resuscitation (CPR) survival rate in Korea might be associated with inadequate education, an insufficient number of trained medical personnel, the inappropriate management of instruments and drugs in CPR carts. The purpose of this study was to determine the current status of these factors in major Korean university hospitals. METHODS: We surveyed the following items among anesthesiologists at 13 university hospitals via E-mail. The items in the questionnaire were; 1) the time allocated to CPR instruction for medical students and anesthesiology residents in a year, 2) the organization, call system, and the role of each member of the CPR team, 3) the establishment of standard in-hospital CPR protocol, 4) the CPR cart items list and their exchange intervals, and 5) post-CPR reporting. RESULTS: The durations of education for anesthesiology residents and medical students were <3 and 7 hours per year. The CPR team designated on documents differed from actual practice. Only one hospital had a standard CPR protocol. Most hospitals had a list of CPR cart, contents, items but the exchange intervals were irregular. Post-CPR reports were written only in intensive care units and emergency rooms. The involvement of nurses in CPR was minimal. CONCLUSIONS: In conclusion, recommend that the following be established; more profound CPR education program for anesthesiology residents and medical students, appropriate clarification of duties for each CPR team members, a standard in-hospital CPR protocol, and the systematic maintenance of drugs, instruments, and CPR records.
Anesthesiology ; Cardiopulmonary Resuscitation* ; Education* ; Electronic Mail ; Emergency Service, Hospital ; Hospitals, University* ; Humans ; Intensive Care Units ; Korea ; Surveys and Questionnaires ; Students, Medical ; Survival Rate

We experienced a case of partial DiGeorge syndrome in a 35+5 week premature female infant presented with micrognathia, fish-shaped mouth, beaked nose, nasal regurgitation, obstructive sleep apnea, velopharyngeal insufficiency and late onset hypocalcemic seizures. The chromosome 22q11 microdeletion was found by the FISH method. The lab findings showed serum calcium level of 4.4 mg/dL, ionized calcium level of 0.49 mg/dL, phosphorous level of 7.5 mg/dL, magnesium level of 1.3 mg/dL and PTH-RIA level of <1 pq/mL. Initial treatment was done with 10% calcium gluconate infusion and magnesium sulfate followed by oral calcium gluconate and low phosphorous- formula milk feeding. The serum calcium level was normalized in 6 days. Nasal regurgitation, desaturation with obstructive sleep apnea continued. T-cell functions and numbers(CD 3, CD 4, CD 8)were decreased but Ig G/A/M levels were normal. No visible signs of thymus shadow were seen in either chest X-ray and chest MRI. Electrocardiography and echocardiography showed normal heart. Kidney ultrasonographby showed right side mild hydronephrosis. Neurosonography was normal but EEG showed electrical partial seizure. Hearing assessment by BERA showed mild to moderate hearing impairment. Velopharyngoplasty is scheduled for further treatment. A brief review of literature was made.
Animals ; Beak ; Calcium ; Calcium Gluconate ; DiGeorge Syndrome* ; Echocardiography ; Electrocardiography ; Electroencephalography ; Female ; Hearing ; Hearing Loss ; Heart ; Humans ; Hydronephrosis ; Infant ; Kidney ; Magnesium ; Magnesium Sulfate ; Magnetic Resonance Imaging ; Milk ; Mouth ; Nose ; Seizures ; Sleep Apnea, Obstructive ; T-Lymphocytes ; Thorax ; Thymus Gland ; Velopharyngeal Insufficiency

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization.
*Embolization, Therapeutic ; Hematoma/radiography/*therapy/virology ; Hemorrhagic Fever with Renal Syndrome/*complications ; Humans ; Kidney Diseases/radiography/*therapy/virology ; Male ; Middle Aged ; *Renal Artery/radiography

Bilateral vocal cord paralysis may occur as a result of thyroid and cervical surgery, tracheal intubation, trauma, and neurodegenerative and neuromuscular diseases. However, there are only a few reported cases of bilateral cord paralysis associated with short-term endotracheal intubation. We report a case of bilateral vocal cord palsy leading to respiratory obstruction following short-term endotracheal intubation.
Intubation ; Intubation, Intratracheal* ; Neuromuscular Diseases ; Paralysis ; Thyroid Gland ; Vocal Cord Paralysis* ; Vocal Cords*

BACKGROUND AND OBJECTIVES: Associations have been reported between the serum uric acid (SUA) level, metabolic syndrome (MS), and atherosclerosis. We have determined the relationship between the SUA level, MS, and arterial stiffness in Korean. SUBJECTS AND METHODS: Cross-sectional data from 1,276 adults who underwent routine laboratory tests and pulse wave velocity (PWV) measurements during a health check-up were analyzed in a gender-specific manner. None of the participants had atherosclerotic cardiovascular disease, diabetes, renal disease, or systemic disease, or were under treatment which would affect SUA levels, or taking medications for hypertension or dyslipidemia. RESULTS: After adjustment for age, smoking status, total cholesterol (TC), and creatinine, the odds ratios (ORs, 95% confidence interval) of gender-specific quartiles of SUA for MS were 1.0, 1.28 (0.66-2.47), 1.46 (0.76-2.82), and 2.21 (1.15-4.26) in females, and 1.0, 1.33 (0.82-2.17), 1.60 (0.96-2.66), and 2.03 (1.21-3.40) in males. However, after adjustment for waist circumference, there were no significant differences in the ORs among the SUA quartile groups in females and males (both, p=NS). The Pearson's correlation coefficients for the relationship between SUA levels and heart-femoral (hf) PWVs or brachial-ankle (ba) PWVs were not significant in females and males (r=0.054 and r=0.015, respectively, in females; r=-0.036 and r=-0.015, respectively, in males; all, p=NS). CONCLUSION: An elevated SUA level is associated with abdominal obesity among the MS components, but the SUA level is not associated with PWV in females or males.
Adult ; Atherosclerosis ; Cardiovascular Diseases ; Cholesterol ; Creatinine ; Dyslipidemias ; Electrolytes ; Female ; Humans ; Hypertension ; Male ; Obesity, Abdominal ; Odds Ratio ; Pulse Wave Analysis ; Smoke ; Smoking ; Uric Acid ; Vascular Stiffness ; Waist Circumference

Craniodiaphyseal dysplasia is a rare genetic disorder of bone due to modelling errors of long bones and skull bones. Facial and cranial thickening and distortion are particularly striking in this form. The genetic understanding of this disorder is unsatisfactory. We present one case of Craniodiaphyseal dysplasia involving facial bone, skull that causes nasal obstruction. This 3-year old female who was diagnosed of craniodiaphyseal dysplasia presented abnormal facial figuring, which is excessively thickened cortical bone resulting in very large craniofacial bony structure. The patient sufferred from respiratory difficulty due to complete obstruction of choana. We performed surgical recanalization of choanal atresia by transpalatal approach and gained good postoperative result.
Child, Preschool ; Choanal Atresia ; Constriction, Pathologic* ; Facial Bones ; Female ; Humans ; Nasal Obstruction ; Skull ; Strikes, Employee

PURPOSE: The aim of this study was to evaluate the applicability of machine learning methods that combine data on age and prostate-specific antigen (PSA) levels for predicting prostate cancer. MATERIALS AND METHODS: We analyzed 943 patients who underwent transrectal ultrasonography (TRUS)-guided prostate biopsy at Chungnam National University Hospital between 2014 and 2018 because of elevated PSA levels and/or abnormal digital rectal examination and/or TRUS findings. We retrospectively reviewed the patients’ medical records, analyzed the prediction rate of prostate cancer, and identified 20 feature importances that could be compared with biopsy results using 5 different algorithms, viz., logistic regression (LR), support vector machine, random forest (RF), extreme gradient boosting, and light gradient boosting machine. RESULTS: Overall, the cancer detection rate was 41.8%. In patients younger than 75 years and with a PSA level less than 20 ng/mL, the best prediction model for prostate cancer detection was RF among the machine learning methods based on LR analysis. The PSA density was the highest scored feature importances in the same patient group. CONCLUSIONS: These results suggest that the prediction rate of prostate cancer using machine learning methods not inferior to that using LR and that these methods may increase the detection rate for prostate cancer and reduce unnecessary prostate biopsy, as they take into consideration feature importances affecting the prediction rate for prostate cancer.
Biopsy ; Chungcheongnam-do ; Digital Rectal Examination ; Forests ; Humans ; Logistic Models ; Machine Learning ; Medical Records ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms ; Retrospective Studies ; Support Vector Machine ; Ultrasonography

Purpose: To evaluate the reliability and validity of the Cataract-related Visual Function Questionnaire (CVFQ). Methods: A prospective cross-sectional study of 141 cataract patients was conducted from March 2022 to June 2022. The questionnaire was created based on a literature review and advice from an expert panel. This study determined its construct validity, criterion validity, internal consistency, and test-retest reliability. Results: The CVFQ consists of 15 items distributed among five categories: overall visual quality, overall visual function, distance vision, near vision, and glare. In the exploratory factor analysis of validity, the first three principal components explained 77.8% of the variance. The p-values in the Spearman correlation test comparing the pre- and postoperative total CVFQ score and best-corrected visual acuity (BCVA) were 0.006 and 0.004, respectively. In the reliability analysis, Cronbach’s alpha was > 0.9 for internal consistency and the p-values of each subcategory were all significant in the analysis of test-retest reliability. Conclusions Our results indicate that the CVFQ is useful for measuring the visual quality and visual function of cataract patients in Korea.

Background: Aging leads to sarcopenia, which is characterized by reduced muscle mass and strength. Many factors, including altered muscle protein turnover, diminished neuromuscular function, hormonal changes, systemic inflammation, and the structure and composition of muscle fibers, play a crucial role in age-related muscle decline. This study explored differences in muscle fiber types contributing to overall muscle function decline in aging, focusing on individuals with hip fractures from falls. Methods: A pilot study at Chungnam National University Hospital collected muscle biopsies from hip fracture patients aged 20 to 80 undergoing surgical treatment. Muscle biopsies from the vastus lateralis and gluteus maximus were obtained during hip arthroplasty or internal fixation. Handgrip strength, calf and thigh circumference, and bone mineral density were evaluated in individuals with hip fractures from falls. We analyzed the relationships between each clinical characteristic and muscle fiber type. Results: In total, 26 participants (mean age 67.9 years, 69.2% male) were included in this study. The prevalence of sarcopenia was 53.8%, and that of femoral and lumbar osteoporosis was 19.2% and 11.5%, respectively. Vastus lateralis analysis revealed an age-related decrease in type IIx fibers, a higher proportion of type IIa fibers in women, and an association between handgrip strength and type IIx fibers in men. The gluteus maximus showed no significant correlations with clinical parameters. Conclusion This study identified complex associations between age, sex, handgrip strength, and muscle fiber composition in hip fracture patients, offering insights crucial for targeted interventions combating age-related muscle decline and improving musculoskeletal health.