No abstract available.
Anemia, Aplastic*

BACKGROUND: Geriatric patients undergoing artificial joint replacement have increased not only in numbers but in age over the past years. These patients usually have accompanying comorbidities which may be increased by age itself and these comorbidities increases clinical challenge while undergoing anesthesia. METHODS: Raw data from 1992 to 2006 undergoing artificial joint replacement were collected and investigated retrospectively. Five-year periods of interest (POI) were created for analysis. POI I is five-year periods of interest from 1992 to 1996, POI II from 1997 to 2001 and POI III from 2002 to 2006. Changes in demographic variables and prevalence of a variety of comorbidities were statistically evaluated. RESULTS: We identified 4,196 patients in whom artificial joint replacement was performed between 1992 and 2006. Of those, 805, 1,212 and 2,179 were performed in POI I, POI II and POI III, respectively. The average age and the prevalence of hypertension and diabetes mellitus increased significantly. CONCLUSIONS: The prevalence of comorbid diseases among the patients undergoing artificial joint replacement has increased significantly for hypertension and diabetes mellitus. Also increase in average age of patients undergoing surgery as well as accompanying comorbidities pose an increased clinical challenge. A thorough preanesthetic evaluation and optimal anesthetic technique is necessary to decrease the morbidity and mortality in geriatric patients undergoing artificial joint replacement on the lower extremities.
Anesthesia ; Arthroplasty ; Comorbidity ; Diabetes Mellitus ; Humans ; Hypertension ; Joints ; Lower Extremity ; Prevalence ; Retrospective Studies

No abstract available.
Humans* ; Ligamentum Flavum*

In this study, we report the case of a 59-year-old male patient with organophosphate pesticide poisoning. He visited the local emergency medical center after ingesting 250 ml of organophosphate pesticide. The patient’s symptoms improved after the initial intravenous infusion of pralidoxime 5 g and atropine 0.5 mg. However, 18 hours after admission, there was a worsening of the symptoms. A high dose of atropine was administered to improve muscarinic symptoms. A total dose of 5091.4 mg of atropine was used for 30 days, and fever and paralytic ileus appeared as side effects of atropine. Anticholinergic symptoms disappeared only after reducing the atropine dose, and the patient was discharged on the 35th day without any neurologic complications.

No abstract available.
Cardiac Tamponade* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Purpose: This study aimed to evaluate the relationship between prostate volume and lower urinary symptom (LUTS) in subjects undergoing health checkup and to know the usefulness of TRUS in health screening.
Materials and Methods: The study was conducted in 883 men aged ≥20 years who underwent TRUS for health screening. All participants had filled in the international prostate symptom score (IPSS) and were tested for prostate-specific antigen; prostate volume, central gland volume, and transitional zone index were measured using TRUS. We analyzed the differences in the IPSS by prostate volume and differences in prostate volume by severity of LUTS and correlation between prostate volume and each component of IPSS.
Results: There were differences in the total IPSS, storage score, and voiding score between the subjects with prostate volumes of ≥30 mL or not (p=0.027, p=0.037, and p=0.029, respectively). However, the differences were found only for urgency and weak stream. The volume of the severe symptom group was bigger than those of the mild and moderate symptom groups (p=0.002 and p=0.014). The correlation between prostate volume and IPSS was significant only for the between the central volume and nocturia (r=0.112, p＜0.01).
Conclusions The relationship between prostate volume and urinary symptoms showed significant but low correlation and found only in some components. For the accurate diagnosis, it would be more useful to accompany various voiding-related surveys in addition to TRUS during health screening. (Korean J Urol Oncol 2020;18:53-60)

Background and Objectives: This study aimed to evaluate the clinical features and the clinical factors associated with prognosis of sudden sensorineural hearing loss (SSNHL) in diabetic patients. Subjects and Methods: Forty-nine diabetic with unilateral SSNHL were retrospectively included. All patients received systemic high dose steroid therapy within one month after onset and had more than one month of follow-up audiogram. The basic characteristics of the patients, initial and follow-up audiograms, laboratory data, and methods of steroid treatment were collected. Results: Compared to reference values in healthy subjects, 79%, 55%, and 45% of the patients had higher values of mean neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), respectively. Older patients had significantly less degree of hearing loss, but they also had significantly worse hearing thresholds in the unaffected ear. After steroid treatment, less than half patients (47%) showed hearing recovery. Simultaneous intratympanic dexamethasone (ITD) injections with systemic steroid did not confer an additional hearing gain or an earlier recovery rate in diabetic patients with SSNHL. In the multivariate analysis, initial hearing thresholds of affected ear and timing of steroid treatment were significantly associated with hearing prognosis in diabetic patients with SSNHL. Conclusions Diabetic patients with SSNHL tended to have increased NLR, LMR, and PLR, which are reported to be associated with microvascular angiopathy. Simultaneous ITD injections to improve hearing recovery in diabetic patients with SSNHL seems unnecessary.

Background: The aim of this study was to develop a scoring system to stratify the risk of papillary thyroid cancer (PTC) and to select the proper management. Methods: We performed a systematic search of MEDLINE and Embase. Data regarding patients’ prognoses were obtained from the included studies. Odds ratios (ORs) with statistical significance were extracted from the publications. To generate a risk scoring system (RSS), ORs were summed (RSS1), and summed after natural-logarithmic transformation (RSS2). RSS1 and RSS2 were compared to the eighth edition of the American Joint Committee on Cancer (AJCC) staging system and the 2015 American Thyroid Association (ATA) guidelines for thyroid nodules and differentiated thyroid carcinoma. Results: Five meta-analyses were eligible for inclusion in the study. Eight variables (sex, tumour size, extrathyroidal extension, BRAF mutation, TERT mutation, histologic subtype, lymph node metastasis, and distant metastasis) were included. RSS1 was the best of the analysed models. Conclusion We developed and validated a new RSS derived from previous meta-analyses for patients with PTC. This RSS seems to be superior to previously published systems.

We report here a human case probably mixed-infected with Clonorchis sinensis and Fasciola sp. who was diagnosed by computed tomography (CT) scan, serological findings, and/or fecal examination. The patient was a 43-year-old Korean female and was admitted to Kyung Hee University Hospital with the complaints of fever and abdominal pain. On admission, marked eosinophilia was noted in her peripheral blood. CT scan showed specific lesions for clonorchiasis and fascioliasis in the liver, along with lesions suggestive of amebic abscess. Micro-ELISA revealed positive results for the 2 helminthic infections. Eggs of C. sinensis and trophozoites of Entamoeba histolytica were observed in the stool. Treatment with praziquantel followed by metronidazole and tinidazole reduced abnormalities in the liver and eosinophilia. This is the first case report of a possible co-infection with 2 kinds of liver flukes in the Republic of Korea.