Background: Effective treatment of Graves’ disease during pregnancy is important because uncontrolled hyperthyroidism is associated with increased fetal and maternal morbidity and mortality. While there have been case reports of patients with Graves’ disease who failed to achieve euthyroid state during pregnancy, anesthesiologists rarely encounter patients with uncontrolled hyperthyroidism undergoing urgent Cesarean section.Case: A 31-year-old pregnant patient had uncontrolled hyperthyroidism due to Graves’ disease despite medical treatment. Her signs and symptoms suggested fetal distress and aggravation of the disease, leading to hospitalization. After a failed induction for vaginal delivery, an urgent Cesarean section was performed under spinal anesthesia via an interlaminar approach using 9 mg of 0.5% heavy bupivacaine and 20 μg of fentanyl. It resulted in successful delivery, with no perioperative complications for the mother and neonate. Conclusions This case demonstrates that spinal anesthesia may provide clinical stability to patients with uncontrolled hyperthyroidism undergoing urgent Cesarean section.

Polycystic liver disease (PLD) is a hereditary disease characterized by the presence of 20 or more liver cysts. It is classified into three types: isolated autosomal dominant PLD, PLD with autosomal dominant polycystic kidney disease, and PLD with autosomal recessive polycystic kidney disease. Genetic alterations, ciliary dysfunction of the biliary epithelial cells, and aberrant cell signaling pathways are the main factors contributing to the pathophysiology of PLD; however, other complicated mechanisms are also involved. The Gigot and Schnelldorfer classifications are widely used in clinical practice. Most patients with PLD are asymptomatic; however, a few patients with advanced-stage disease may develop symptoms and complications that impair their quality of life and require treatment. The known treatment options for PLD are somatostatin analogues, aspiration with sclerotherapy, fenestration, hepatic resection, and liver transplantation. Although liver transplantation remains the only curative treatment for PLD, medical therapies are gradually being developed with the increasing knowledge of the disease’s pathophysiology. This review focuses on the clinical manifestations and diagnosis of PLD, as well as treatment strategies, to support clinicians regarding the clinical management of the disease.

Stress and trauma research has traditionally focused on negative sequelae of adversity. Recently, research has begun to focus on positive outcomes, specifically post-traumatic growth (PTG) - "positive change experienced as a result of the struggle with trauma" - which emphasizes the transformative potential of one's experiences with highly stressful events and circumstances. This article describes the concept of PTG at three different perspectives. In addition we reviewed the neurobiological factors and mechanism of PTG. It has shown that PTG is mediated by adaptive changes in several neural circuits involving numerous neurotransmitter and molecular pathways. Much more study is required to achieve a deeper understanding the biological and psychological underpinnings of PTG, as well as the interactions between these factors. After all, the clinical phenomenology of PTG is very important for mental growth after trauma. The findings of this article provide further directions for research and clinical implication of PTG.
Fertilization* ; Life Change Events ; Neurobiology* ; Neurotransmitter Agents

This correction is being published to correct the 1st author's English name in above article.

Pulmonary blastoma is a rare type of primary lung cancer that accounts for only 0.25%-0.5% of all lung malignancies. Pulmonary blastoma consists of three subgroups: classic biphasic pulmonary blastoma (CBPB), pleuropulmonary blastoma, and well-differentiated fetal adenocarcinoma. Due to the rarity of the tumor, metastatic brain tumor from CBPB is extremely rare, and only 13 cases, including our case, have been reported. A 60-year-old woman who underwent left upper lobectomy of the lung because of pathologically diagnosed as CBPB 5 months ago, suddenly lost consciousness and presented with stupor mental status. The emergent CT scan showed a large, 51 mL, intracerebral hemorrhage on left parieto-occipital lobe with midline shifting. The patient underwent emergent craniotomy, and a hypervascular tumor was identified during the operation. Histopathologic examination reported metastatic pulmonary blastoma, CBPB. The patient has been in a vegetative state, but there has been no evidence of recurrence over a 6-month follow-up period. We report a rare case of brain metastasis from CBPB presenting with altered mentality due to massive tumor bleeding. This is the only reported case of brain metastasis from CBPB presenting with acute intracerebral hemorrhage.

Background: Extraventricular neurocytoma (EVN) is an extremely rare neuronal neoplasm that arises outside the ventricle. The clinical implication of the heterogenous prognosis of this rare tumor has not yet been clarified. Herein, we analyzed our institutional series of EVN. Methods: A total of eight consecutive cases were enrolled and investigated. The prognosis of EVN was analyzed and compared to that of central neurocytoma (CN). Results: There were two male and six female patients, and the median age was 36.5 years. The median tumor size was 38 mm, and the most common location of the tumor was the frontal lobe (3, 37.5%), followed by the parietal and temporal lobes. In brain imaging, four (50%) tumors showed peritumoral edema and three (37.5%) tumors showed calcification. All patients underwent gross total resection, and two (25%) underwent adjuvant radiotherapy. The 5-year overall survival (OS) was 55.6%, and the 2-year progression-free survival (PFS) was 42.9%. The OS and PFS of EVN were poor compared to those of CN. Although EVN is a single disease entity, individual patients showed varying prognosis. One patient showed no recurrence during the 7-year follow-up period; however, another patient had a recurrence 4 months after surgery and died 2 years later. Conclusion EVN may be a heterogenous disease entity. Additional cases with long-term followup are needed to develop optimal management protocols.

Background/Aims: Tenofovir alafenamide (TAF) has shown less favorable effect on lipids compared to tenofovir disoproxil fumarate (TDF) in clinical trials. However, data regarding these outcomes in patients with chronic hepatitis B (CHB) are scarce. Therefore, this study aimed to evaluate the effect of TAF on the lipid in patients with CHB. Methods: A total of 237 TAF-treated CHB patients compared with TDF, inactive CHB, and non-hepatitis B virus (HBV)-infected control groups using propensity score matching (PSM). Results: Following PSM, each analysis was conducted on cohorts via the matching of 70:140 (TAF:TDF), 89:89 (TAF:inactive CHB), 140:560 (TAF:non-HBV infected control), and 368:1,472 (TDF:non-HBV-infected control). A significant decrease in the total cholesterol (TC) level was noted at 48 weeks in the TDF group compared to the TAF group (176.3±32.9 vs. 156.7±27.7, P<0.001) and the non-HBV-infected control group (175.0±29.5 vs. 156.2±28.3, P<0.001). However, no significant change in TC was observed in the TAF group and inactive CHB or non-HBV-infected control groups at 48 weeks. For the subgroup analyses of TAF vs. non-HBV-infected control subjects and inactive CHB patients whose detailed lipid profile information were available, no between-group differences in TC, low-density lipoprotein (LDL)-cholesterol, highdensity lipoprotein (HDL)-cholesterol, TC/HDL ratio, and LDL/HDL ratio were observed at 48 weeks. Conclusions TDF seems to have a lipid-lowering effect compared to the non-HBV-infected control and TAF-treated groups. However, in real practice, TAF might not worsen the lipid profiles of subjects compared to non-HBV-infected controls and patients with inactive CHB.

Background/Aims: Coronavirus 2019 (COVID-19) accelerated the importance of online learning in the field of medical education.This study compared the impact of online lectures on abdominal ultrasonography (USG) with that of offline lectures and assessed the efficacy of abdominal USG lectures for internal medicine (IM) residents and gastroenterology (GI) fellows. Methods: A 30-minute lecture on upper abdominal USG was delivered online or offline, and a test with 39 short-answer questions was conducted before and after the lecture. Results: The study population included 25 physicians (13 IM residents and 12 GI fellows) in the online group and 23 (20 IM residents, three GI fellows) in the offline group. The rates of USG education experience for online and offline groups were 64.0% and 69.6%, respectively (p=0.919). A significant increase in the test scores was observed after a one-time USG lecture in IM residents in both the online and offline, as well as GI fellows in the online (p<0.0001, <0.0001, and p=0.004, respectively). In addition, the delta scores were similar in the online and offline after a one-time lecture (8.8±4.3 vs. 7.8±3.7, respectively; p=0.406). A comparison of the delta-scores of the IM resident and GI fellow showed no significant difference within either the online or offline (9.0±4.5 vs. 8.4±3.6, p=0.927; 7.3±3.8 vs. 7.3±3.0, p=0.985). Conclusions The effectiveness of online USG lectures was comparable to that of offline lectures. In addition, a 30-minute, one-time abdominal USG lecture provided value to IM residents and GI fellows.

Background/Aims: Coronavirus 2019 (COVID-19) accelerated the importance of online learning in the field of medical education.This study compared the impact of online lectures on abdominal ultrasonography (USG) with that of offline lectures and assessed the efficacy of abdominal USG lectures for internal medicine (IM) residents and gastroenterology (GI) fellows. Methods: A 30-minute lecture on upper abdominal USG was delivered online or offline, and a test with 39 short-answer questions was conducted before and after the lecture. Results: The study population included 25 physicians (13 IM residents and 12 GI fellows) in the online group and 23 (20 IM residents, three GI fellows) in the offline group. The rates of USG education experience for online and offline groups were 64.0% and 69.6%, respectively (p=0.919). A significant increase in the test scores was observed after a one-time USG lecture in IM residents in both the online and offline, as well as GI fellows in the online (p<0.0001, <0.0001, and p=0.004, respectively). In addition, the delta scores were similar in the online and offline after a one-time lecture (8.8±4.3 vs. 7.8±3.7, respectively; p=0.406). A comparison of the delta-scores of the IM resident and GI fellow showed no significant difference within either the online or offline (9.0±4.5 vs. 8.4±3.6, p=0.927; 7.3±3.8 vs. 7.3±3.0, p=0.985). Conclusions The effectiveness of online USG lectures was comparable to that of offline lectures. In addition, a 30-minute, one-time abdominal USG lecture provided value to IM residents and GI fellows.

Background/Aims: Coronavirus 2019 (COVID-19) accelerated the importance of online learning in the field of medical education.This study compared the impact of online lectures on abdominal ultrasonography (USG) with that of offline lectures and assessed the efficacy of abdominal USG lectures for internal medicine (IM) residents and gastroenterology (GI) fellows. Methods: A 30-minute lecture on upper abdominal USG was delivered online or offline, and a test with 39 short-answer questions was conducted before and after the lecture. Results: The study population included 25 physicians (13 IM residents and 12 GI fellows) in the online group and 23 (20 IM residents, three GI fellows) in the offline group. The rates of USG education experience for online and offline groups were 64.0% and 69.6%, respectively (p=0.919). A significant increase in the test scores was observed after a one-time USG lecture in IM residents in both the online and offline, as well as GI fellows in the online (p<0.0001, <0.0001, and p=0.004, respectively). In addition, the delta scores were similar in the online and offline after a one-time lecture (8.8±4.3 vs. 7.8±3.7, respectively; p=0.406). A comparison of the delta-scores of the IM resident and GI fellow showed no significant difference within either the online or offline (9.0±4.5 vs. 8.4±3.6, p=0.927; 7.3±3.8 vs. 7.3±3.0, p=0.985). Conclusions The effectiveness of online USG lectures was comparable to that of offline lectures. In addition, a 30-minute, one-time abdominal USG lecture provided value to IM residents and GI fellows.