No abstract available.
Fetus* ; Humans ; Pregnancy, Twin*

Uterine torsion is defined as the mtation of more than 45 degrees around the long axis of the uterus or a rotation which is severe enough to produce symptoms. Torsion of the human pregnant uterus is a very rare complication. The diagnosis is problematic and is often made during a cesrean section due to inhibited labor. Torsion of the human pregnant uterus can be caused by myoma or other uterine abnormalities, ovarian cysts, adhesions, abnormal fetal presentations, or fetal abnormalities ( though no cause can be found in about 20% of cases ). Uterine torsion produces symptoms of varying severity depending on the degree of rotation, and duration of the pregnancy. High mortality rates for both mother and infant have been reported. We experienced one case of the torsion of term pregnant uterus and report this case with a brief review of the concerned literature.
Axis, Cervical Vertebra ; Diagnosis ; Female ; Fetus* ; Humans ; Infant ; Mortality ; Mothers ; Myoma ; Ovarian Cysts ; Pregnancy ; Uterus*

BACKGROUND: Pityriasis versicolor is often found following pathologic transformation of Malassezia fungi from yeast to mycelial forms by a poorly understood mechanism and is characterized by squamous skin lesions manifesting hyper- or hypo-pigmentation. Itraconazole is a synthetic oral antifungal agent of triazole family, which acts as a selective inhibitor of the cytochrome P-450-dependent synthesis of ergosterol and is reported to demonstrate a potent antifungal efficacy against Malassezia yeasts. OBJECT: The present clinical study was designed to evaluate the therapeutic efficacy of one- week regimen of itraconazole by studying 20 patients with pityriasis versicolor, who were diagnosed both clinically and mycologically. In addition, we wished to identify Malassezia species from skin lesions of pityriasis versicolor and examine the possible correlation of a certain Malassezia(M.) species and pityriasis versicolor. METHODS: Twenty patients (ages, 18 to 49) were included in the study, following the diagnosis of pityriasis versicolor, which was based on clinical examinations and mycological studies (microscopy and culture). Patients received a single 200 mg dose of itraconazole (Sporanox? capsules daily with a full meal for one week. For all patients, clinical examinations and culture and microscopic studies were done before treatment, at the end of treatment, and 4 weeks later. Scales obtained from skin lesions were studied by Parker-KOH smear examination and culture studies to identify Malassezia yeasts. Cultures were done using agar media of Leeming & Notman. RESULTS: By comparing skin lesions before and immediately after treatment, marked improvement was observed in 7 patients (35%) and moderate improvement in 12 patients (60%) among a total of 20 patients, and 1 patient (5%) showed no response. On the other hand, by comparing skin lesions examined before treatment and 4 weeks after completing medication, complete cure was observed in 13 cases (65%), marked improvement in 5 (25%), and moderate improvement in 2 (10%). With culture studies before treatment, M. globosa, M. furfur, and M. restricta were isolated as a major fungal species in 18, 1, and 1 patients, respectively. CONCLUSION: The result suggested that administration of a single dose of 200 mg itraconazole (Sporanox? capsules daily for a week is a very effective treatment for pityriasis versicolor and also indicated that pityriasis versicolor is very closely related with the infection of M. globosa.
Agar ; Capsules ; Cytochromes ; Diagnosis ; Ergosterol ; Fungi ; Hand ; Humans ; Itraconazole* ; Malassezia ; Meals ; Pityriasis* ; Skin ; Tinea Versicolor* ; Weights and Measures ; Yeasts

We report a case of infantile acropustulosis in a 7 month-old female infant who had a family history of scabies in her parents and brother. She had pruritic papulovesicles and pustules, predominantly on the hands and feet. Histopathologically, there was a well-circumscribed unilocular, subcorneal pustule filled with neutrophils, mostly. Under the diagnosis of an infantile acropustulosis associated with scabies, she was treated with a potent topical corticosteroid and oral antihistamines without recurrence.
Diagnosis ; Female ; Foot ; Hand ; Histamine Antagonists ; Humans ; Infant ; Neutrophils ; Parents ; Recurrence ; Scabies* ; Siblings

The depressor anguli oris (DAO) muscle is a thin, superficial muscle located below the corner of the mouth. It is the target for botulinum neurotoxin (BoNT) injection therapy, aimed at treating drooping mouth corners. Hyperactivity of the DAO muscle can lead to a sad, tired, or angry appearance in some patients. However, it is difficult to inject BoNT into the DAO muscle because its medial border overlaps with the depressor labii inferioris and its lateral border is adjacent to the risorius, zygomaticus major, and platysma muscles. Moreover, a lack of knowledge of the anatomy of the DAO muscle and the properties of BoNT can lead to side effects, such as asymmetrical smiles. Anatomical-based injection sites were provided for the DAO muscle, and the proper injection technique was reviewed. We proposed optimal injection sites based on the external anatomical landmarks of the face. The aim of these guidelines is to standardize the procedure and maximize the effects of BoNT injections while minimizing adverse events, all by reducing the dose unit and injection points.

The purpose of this study is to evaluate the sealing effect of several root-end filling materials using spectrophotometric analysis. 180 single root teeth with one canal were instrumented and canal filled. Root resected and root end preparation was made. Teeth were randomly classified to 5 experimental group(MTA, EBA, IRM, TCP, ZOE) and 1 control group according to root-end filling material MTA group used PRO ROOT MTA, EBA group used Super EBA, TCP group used NEW APATITE LINER TYPE II main component of which is alpha-tricalcium phosphate(TCP). According to manufacture's instruction experimental material was mixed and retrfilled. After 2% methylene blue solution penetration absorbance for each test sample was measured with spectrophotometer (JASCO UV-530, Japan). The mean absorbance of control and experimental group was as follows; MTA : 0.092, IRM : 0.226, Super EBA : 0.255, ZOE : 0.374, Control : 0.425, TCP : 0.501 and the result analyzed by Turkey test at P=0.05 level. Conclusions of this study are as follows; 1. The absorbance increase in follwing sequence MTA, IRM, Super EBA, ZOE, Control, TCP. 2. MTA showed the least leakage but was not significant with IRM or Super EBA and was significant with control or TCP(p<0.05). 3. TCP had the most leakage and was not significant with control group.
Methylene Blue ; Tooth ; Turkey ; Pemetrexed

Purpose: Postoperative adhesions after thyroidectomy adversely affect patients’ quality of life. This study assessed the anti-adhesive effect and safety of thermosensitive sol-gel agents for patients undergoing thyroidectomy. Methods: A double-blind parallel-group randomized clinical trial involving patients aged 20–70 years undergoing thyroidectomy for thyroid nodules was conducted. From August 2017 to April 2020, 90 patients were randomly assigned to the experimental (n = 45, thermosensitive sol-gel agent applied to the surgical site) and control (n = 45, no treatment) groups in a 1:1 ratio. All patients were assessed using a questionnaire for swallowing difficulty, wrinkle problems, and inflammation at 2 weeks, 3 months, and 6 months after thyroid surgery. For reoperated patients, the degree of adhesion was evaluated according to the adhesion-evaluation score system (range, 0–4). Results: During the follow-up period of 6.50 ± 1.38 months, the swallowing difficulty, wrinkle problem, and inflammation were improved in both groups. However, there was no statistically significant difference between the control and experimental groups related to swallowing difficulty, wrinkle problems, and inflammation. Two patients in the control group and 1 in the experimental group who underwent reoperation had an adhesion-evaluation score of 3 points. There were no adverse effects or allergic reactions. Conclusion A thermosensitive sol-gel agent can be safely used as an anti-adhesive barrier. However, this study did not reveal its efficacy for postoperative adhesions. A more objective and systematic study is required in the future.

PURPOSE: Papillary thyroid carcinoma (PTC) arising from the pyramidal lobe is rare; therefore, clinicopathologic evaluation is lacking. In addition, the rate of occult malignancy in the pyramidal lobe after thyroid surgery is unclear. This study is to evaluate the clinical characteristics of PTCs that involve the pyramidal lobe. METHODS: The study enrolled 1,107 patients who underwent thyroid surgery for PTC at Seoul National University Hospital from 2006 to 2015. Pyramidal lobe status in pathologic reports was clear in all cases. “Pyramidal lobe-dominant PTC” was defined as single pyramidal lobe cancer or multifocal cancer with larger pyramidal lobe tumor. “Incidental pyramidal lobe PTC” was defined as occult cancer identified after thyroidectomy or as multifocal cancer with smaller pyramidal lobe tumor. RESULTS: Ten patients were included in the pyramidal lobe-dominant PTC group. The mean age was 58 ± 12.5 years, and the mean tumor size was 0.7 ± 0.7 cm. Cervical lymph node metastasis was found in 5 patients (50%). Three patients had microscopic lymphatic invasion, and 7 had advanced American Joint Comitee on Cancer (AJCC) stage disease (5 with stage III and 2 with stage IV). Compared with conventional PTC (n = 1,058), pyramidal lobe-dominant PTC was significantly associated with lymphatic invasion (P = 0.031) and advanced AJCC stage (P = 0.022). The prevalence of incidental pyramidal lobe PTC was 3.56%. CONCLUSION: Pyramidal lobe PTC is relatively small in size; however, the rate of extrathyroidal extension and lymph node metastasis is high. Preoperative evaluation of nodal status is important, and the extent of surgery should be determined in accordance with the preoperative diagnosis.
Diagnosis ; Humans ; Joints ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Metastasis ; Prevalence ; Seoul ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

We want to add funding statement in ACKNOWLEDGEMENTS section of this article.
Financial Management* ; Thyroid Gland* ; Thyroid Neoplasms*

Purpose: The aim of this study was to compare the large multi-institutional data of surgical outcomes of bilateral axillo-breast approach (BABA) robotic (RT) and endoscopic thyroidectomy (ET) and to evaluate the merits of robotic thyroidectomy. Methods: From 2004 to 2015, 1,029 patients underwent BABA ET, and from 2008 to 2015, 2003 patients underwent BABA RT in 3 large volume centers in Korea. Two groups were retrospectively compared in terms of clinicopathologic characteristics, complications, surgical completeness, and long-term outcomes using propensity score matching analysis. Results: Both groups had similar demographic characteristics including age, sex, tumor size, pathologic stage, and hospital stay after matching. Each group had similar rate of transient hypoparathyroidism, however, ET showed significantly higher rate of permanent hypoparathyroidism (ET 5.2% vs. RT 2.3%, P = 0.05), and transient vocal cord palsy (ET 14.4% vs. RT 9.1%, P = 0.006). Total operation time was longer in the ET group irrespective of surgical extents, including lobectomy (P = 0.016), total thyroidectomy (P = 0.031), and total thyroidectomy with central lymph node dissection (P = 0.019). The rate of patients with off-Tg under 1.0 ng/mL after 1st ablation was significantly higher in RT than ET group (ET 64.6% vs. RT 92.7%, P < 0.001). In long-term follow-up of cancer patients, 1.4% experienced recurrence after ET (10 cases), while 0.3% cases experienced recurrence after RT (5 cases) (P < 0.001). Conclusion Both ET and RT can be safe and effective methods to treat thyroid diseases. However, the application of robotic system may help to overcome the limitations of the instruments and surgeon’s skills.