No abstract available.
Brain Stem ; Hemorrhage

Transient myeloproliferative disorder (TMD) is similar to congenital leukemia, with leukocytosis, increased peripheral blast cells, and hepatomegaly in the neonatal period. Although TMD occurs only in patients with Down syndrome and trisomy 21 mosaicism, there have been reports of congenital leukemia with trisomy 21 limited to hematopoietic cells showing spontaneous resolution. We identified trisomy 21 in the leukemic cells in a patient with congenital leukemia. As there was no other gene abnormality, we stopped chemotherapy, and the disease resolved spontaneously. We reviewed the cases of clonal trisomy 21 TMD and found that their clinical features were similar to those of TDM associated with Down syndrome. In conclusion, in a phenotypically normal patient with suspected congenital leukemia, it is necessary to confirm the presence of 21 trisomy. If the neonate has only trisomy 21 without other gene abnormalities, intensive chemotherapy may not be required.
Chromosomes, Human, Pair 21 ; Down Syndrome* ; Drug Therapy ; GATA1 Transcription Factor ; Hepatomegaly ; Humans ; Infant ; Infant, Newborn* ; Leukemia ; Leukocytosis ; Mosaicism ; Myeloproliferative Disorders* ; Trisomy*

BACKGROUND/OBJECTIVES: The consumption of dietary supplements has shown an increase among young people in their 20s. We aimed to compare the use of dietary supplements and related factors between Chinese international and Korean college students living in South Korea. SUBJECTS/METHODS: We conducted online surveys of 400 Chinese international students and 452 Korean college students from January to February 2021. We analyzed the factors related to the use of dietary supplements by these students using multi-group structural equation modeling and logistic regression analysis. RESULTS: Approximately 65% of the Chinese international students and 93% of the Korean college students consumed dietary supplements at least once in the year preceding the survey. The common types of dietary supplements consumed by both groups of students were vitamin and mineral supplements, Lactobacillus products, and red ginseng products.Structural equation modeling showed that perception of the consumption of dietary supplements by family and friends positively influenced attitude toward dietary supplements.This effect was higher for Korean college students than for Chinese international students (P < 0.01). Attitude toward dietary supplements positively influenced their use, and this effect was higher for Chinese international students than for Korean college students (P < 0.001). Logistic regression analysis showed that the use of dietary supplements by Chinese international students was significantly associated with age, self-reported health status, interest in health, perception of and attitude toward dietary supplements, and length of residence in South Korea. Among Korean college students, it was associated with exercise frequency and attitude toward dietary supplements. CONCLUSION This study showed significant differences in the use of dietary supplements and related factors between Chinese international and Korean college students. Therefore, nutrition education programs on dietary supplements need to have differentiated content for each group. Such differences also suggest that the industry should consider the relevant characteristics of college students while developing and marketing dietary supplements.

Familial male-limited precocious puberty (FMPP) is a rare form of gonadotropin-independent precocious puberty that is caused by an activating mutation of the LHCGR gene. Herein, we report a case of FMPP with a mutation of the LHCGR gene in a Korean boy with familial history of precocious puberty through 3 generations. A 16-month-old boy presented with signs of precocious puberty, including pubic hair, acne, and increased growth velocity. The patient's grandfather and father had a history of precocious puberty and profound short stature. On physical examination, the patient had prepubertal testes with pubic hair development appropriate for Tanner stage II. The stretched penile length was 7 cm (>2 standard deviation score), and observed bone age was that of a 4-year-old boy. Laboratory findings showed high serum testosterone (5.74 ng/mL [appropriate for Tanner IV–V]; normal range, <0.05 ng/mL) with suppressed luteinizing hormone (<0.07 mIU/mL) and normal serum level of follicular stimulating hormone (0.56 mIU/mL; normal range, 0.38–1.11 mIU/mL). Genetic testing revealed a pathogenic variant of LHCGR (c.1730 C>T (p.Thr577Ileu)), confirming FMPP. Bicalutamide and anastrozole were administered, and pubertal progression was sufficiently suppressed without any specific side effects. To our knowledge, this is the first case of genetically confirmed FMPP in Korea.

Transient global amnesia(TGA) is a transient neurological syndrome, which occurs mostly once in life. Although the pathophysiology of TGA is not yet clear, there are well-known precipitating events such as emotional stress, physical exertion, sexual intercourse, painful experiences, and immersion in cold water. We report a 67-year-old man who developed recurrent amnestic episodes fulfilling the criteria for TGA. He had vascular risk factors and precipitating events. We suggest that the number of trigger events and vascular risk factors is associated with TGA recurrence.
Aged ; Amnesia, Transient Global ; Coitus ; Cold Temperature ; Humans ; Immersion ; Memory ; Physical Exertion ; Recurrence ; Risk Factors ; Stress, Psychological ; Water

Hepatocellular carcinoma is the third leading cause of cancer related mortality worldwide. Only 30% of patients are eligible for curative surgical resection at diagnosis. For patients with advanced hepatocellular carcinoma with accompanying portal vein tumor thrombosis, Sorafenib is recommended as first-line treatment. However, survival gain from sorafenib is unsatisfactory, and there is no standard therapy for patients who are intolerable or refractory to sorafenib. Here we report a case of a 52-year-old man who initially achieved partial response after sorafenib treatment, but eventually showed disease progression and was treated subsequently with transarterial chemoembolization (TACE). Multinodular recurrence occurred, but he was treated with repeated TACE, and has survived for 4 years so far.
Carcinoma, Hepatocellular* ; Diagnosis ; Disease Progression ; Humans ; Middle Aged ; Mortality ; Portal Vein ; Recurrence ; Thrombosis

Congenital short trachea is a rare congenital anomaly in which the trachea is composed of reduced number of cartilage rings, which result in an abnormally high position of the carina and an abnormal course of the main bronchi. Hazards of congenital short trachea in infants and children include inadvertent bronchial intubation, because it causes bronchiostenosis, pulmonary interstitial emphysema, pneumomediastinum, pneumothorax, and ipsilateral atelectasis. Laryngeal cleft is a rare condition, as well. Symptoms range from mild stridor to massive aspiration and respiratory distress, depending on the severity of the cleft. Until now, a case with combination of these two rare congenital defects has not been reported. Herein, we report a 13 month-old boy who has congenital short trachea with laryngeal cleft.
Bronchi ; Cartilage ; Child ; Congenital Abnormalities ; Emphysema ; Humans ; Infant ; Intubation ; Larynx ; Mediastinal Emphysema ; Pneumothorax ; Pulmonary Atelectasis ; Respiratory Sounds ; Trachea

BACKGROUND: Although case reports have suggested that the erector spinae plane block (ESPB) may help analgesia for patients after breast surgery, no study to date has assessed its effectiveness. This retrospective observational study analyzed the analgesic effects of the ESPB after total mastectomy. METHODS: Forty-eight patients were divided into an ESPB group (n = 20) and a control group (n = 28). Twenty patients in the control group were selected by their propensity score matching the twenty patients in the ESPB group. Patients in the ESPB group were injected with 30 mL 0.375% ropivacaine, followed by catheter insertion for further injections of local anesthetics every 12 hours. Primarily, total fentanyl consumption was compared between the two groups during the first 24 hours postoperatively. Secondary outcomes included pain intensity levels (visual analogue scale) and incidence of postoperative nausea and vomiting (PONV). RESULTS: Median cumulative fentanyl consumption during the first 24 hours was significantly lower in the ESPB (33.0 μg; interquartile range [IQR], 27.0–69.5 μg) than in the control group (92.8 μg; IQR, 40.0–155.0 μg) (P = 0.004). Pain level in the early postoperative stage (<3 hr) and incidence of PONV (0% vs. 55%) were also significantly lower in the ESPB group compared to the control (P = 0.001). CONCLUSIONS: Intermittent ESPB after total mastectomy reduces fentanyl consumption and early postoperative pain. ESPB is a good option for multimodal analgesia after breast surgery.
Acute Pain ; Analgesia ; Anesthesia, Conduction ; Anesthetics, Local ; Breast ; Catheters ; Fentanyl ; Humans ; Incidence ; Mastectomy ; Mastectomy, Simple ; Nerve Block ; Observational Study ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Propensity Score ; Retrospective Studies ; Ultrasonography

Methods: An online survey was conducted on 452 Chinese international students from February 6 to 12, 2020. The respondents were classified into “the Low-frequency group” (< one time/week; n=144), “the Mid-frequency group” (one-two times/week; n=133), and “the High-frequency group” (≥three times/week; n=175) according to their frequency of using university foodservice. The dietary life was compared among the three groups.Binominal logistic regression models were constructed to determine the associations between the frequency of university foodservice use and the changes in dietary life. Results: More than 2/3 (68.1%) of the respondents used the university foodservice at least once per week. Chinese international students who were males and Han Chinese people, lived on campus, had stayed longer in Korea, and had no cooking facilities tended to use the university foodservice more often. The level of satisfaction with the university foodservice was not high (3.52 out of 5-points). Only 20% ate meals three times per day, and only 22% ate breakfast almost every day. The frequencies of overeating and skipping meals increased after studying in Korea. The frequency of university foodservice use, along with the length of residence in Korea, was associated with these negative changes in dietary life. Overeating (OR=2.11) and skipping meals (OR=1.79) were more likely to increase after studying in Korea in the Mid-frequency group than in the High-frequency group. Conclusions The frequency of university foodservice use was associated with the dietary life of Chinese international students in Korea. A high frequency (i.e. ≥three times/week) of using university foodservice may positively affect the dietary life of Chinese international students in Korea.

Fetomaternal hemorrhage (FMH) is due to the entry of fetal blood into the maternal circulation. Although very rare, FMH complicates pregnancies, presents with severe symptoms, and leads to fetal death. Majority of FMH cases are idiopathic and difficult to diagnose. The known used diagnostic tests are Kleihauer-Betke Test (KBT) and flow cytometry, which can detect fetal hemoglobin in the maternal blood. However, such methods have limited use because of low sensitivity, labor-intensive and error-susceptible procedures, poor reproducibility, and tendency to overestimate the FMH volume. Other tests include high performance liquid chromatography (HPLC) and alpha-fetoprotein (AFP) tests, which can be as favorable to confirm FMH as KBT. However, in case of acute FMH, the diagnostic results of KBT, flow cytometry, and HPLC may be false negative. AFP test is a noninvasive, fast, easily assessable, adjuvant, and confirmatory diagnostic test. Published Korean articles show confirmed FMH by KBT or HPLC in singleton late-preterm and term neonates. Herein, we report a case of monochorionic diamniotic twin neonates (birth weight <1,500 g) who presented borderline fetal hemoglobin level because of acute FMH and were diagnosed with FMH by maternal AFP. Our experience of diagnosing FMH rapidly by AFP test will be very helpful to clinicians for the prevention and treatment of FMH during pregnancy.