Multiple satellite pyogenic granuloma developed on the left upper back of a 14-year-old boy after excision of a hemangioma-like lesion. He has had nevus flammeus on the left upper arm since birth with fine linear telangietasiae around the main lesions. Histopathology showed the capillary proliferation in the dermis, and transmission electron microscopy revealed multiple Weibel-Palade bodies, considered an early endothelial cell marker, in the cytoplasm of the endothelial cells. We believe this patient may have the propensity to develop different angiomatous lesions.
Adolescent ; Arm ; Capillaries ; Cytoplasm ; Dermis ; Endothelial Cells ; Granuloma, Pyogenic* ; Humans ; Male ; Microscopy, Electron, Transmission ; Parturition ; Port-Wine Stain ; Weibel-Palade Bodies

Heterotopic pregnancy is named when an extrauterine (ectopic) pregnancy coexists with an intrauterine pregnancy simultaneously by many causes such as PID (pelvic inflammatory disease), endometriosis, IUD (intrauterine device), previous pelvic surgery and others. This is very rare in general population, with a range of occurrence estimated between 1:7963 and 1:30000. But recently the incidence has increased as the uses of ARTs (assisted reproductive technologies) including ovulation induction, IVF-ET (in-vitro fertilization and embryo transfer) and GIFT (gamete intrafallopian transfer) increase. Because this has high maternal morbidity, mortality and fetal loss, early diagnosis and proper management is very important. We report a case of heterotopic pregnancy following IVF-ET with a brief review.
Early Diagnosis ; Embryonic Structures ; Endometriosis ; Female ; Fertilization ; Incidence ; Mortality ; Ovulation Induction ; Pregnancy ; Pregnancy, Heterotopic*

Backgound: The placement of stents in coronary arteries has been shown to reduce acute closure and restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the subacute stent thrombosis and hemorrhagic complications associated with the anticoagulant regimen. It's known that the complete stent deployment with high pressure inflation and new antiplatelet agents are effective in reduction of subacute thrombosis and hemorrhage. So we evaluated initial results (success and complication rate) after high pressure-stent deployment with new anticoagulation protocol. METHODS: One hundred and ninety one patients with 201 lesions were treated with 231 stents of various types. The high pressure balloon inflation and antiplatelets agents were used in all cases. Final high pressure balloon inflation guided by IVUS were performed in 23 consecutive cases with incomplete stent deployment according to angiographic findings. RESULTS: 1) The indications of stenting (n=210) were De novo in 124 (59%), bailout procedure in 57 (27%), suboptimal result after PTCA in 19 (8%), and restenosis after PTCA in 14 (6%). The location of lesions were LAD in 101, RCA in 67, circumflex in 28, ramus intermedius in 3, and LMT artery in 2 lesions. Angiographic morphologic characteristics were type A in 2, type B in 158 (B1: 57, B2: 101), and type C in 22 lesions. 2) The angiographic and clinical success rate was 96% (192/201) and 92% (186/201) respectively. 3) In angiographic analysis, the baseline average reference vessel dirmeter was 3.33+/-0.35 mm. Baseline minimum lumen diameter (MLD) was 0.58+/-0.29 mm, with baseline percent diameter stenosis of 82.86+/-8.64%. The final stent diameter was 3.37+/-0.29 mm, with mean final percent stenosis of 0.63+/-8.25. The mean MLD after stenting was significantly increased (p<0.001). The mean MLD within stent increased 14%, from 2.91+/-0.39 mm at the nominal balloon inflation (inflation pressure=7 atm) to 3.37+/-0.29 mm at high pressure balloon inflation (inflation pressure <0A65B>12atm) (p<0.001). The length of lesions in GR I (cook), GR II, and Micro II stents were significantly longer than ones in PS, Cordis, Wiktor, Nir (p<0.001). 4) In intravascular ultrasound analysis, the mean lumen CSA at the tightest point within stent increased 11%, from 8.4+/-2.4 mm2 at the intial intravascular ultrasound to 9.4+/-2.1 mm2 at the final intravascular ultrasound (p<0.001). 5) The procedural and postprocedural complications were 2 acute closures associated with AMI and emergent CABG, 1 subacute closure which was revascularized by bail out stenting, 5 major hemorrhage requiring transfusion associated with 1 CVA and 2 metabolic acidosis induced by acute renal failure, and 5 death. CONCLUSION: The high pressure stent deployment procedure and new anticoagulation protocol associating tidopidine and aspirin without coumadin or prolonged heparin infusion allow us to obtain an acceptably low subacute thrombosis or bleeding complication rate. These results are encouraging and allow a wide use of coronary stenting.
Acidosis ; Acute Kidney Injury ; Angioplasty, Balloon ; Arteries ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Platelet Aggregation Inhibitors* ; Stents* ; Thrombosis ; Ultrasonography ; Warfarin

BACKGROUND: Studies of immune response for cancer have demonstrated that the antitumor immune response plays a role in competing against the growth of cancer cells and is frequently altered in advanced cancer. METHODS: We evaluated the changes of peripheral blood lymphocytes and their subsets during preoperative and postoperative periods according to the time sequence of the postoperative condition in gastrointestinal carcinoma patients. Lymphocyte surface markers were determined in 39 stomach cancer patients and 33 colon cancer patients by using the indirect immunofluorescence technique with monoclonal antibodies. The patient's body weights, hemoglobin, hematocrits, total protein, and albumin were also measured preoperatively at and 1, 3, 6, 12, 18, and 24 months postoperatively. RESULTS: There were significant differences of clinico-laboratory findings between the preoperative and the postoperative periods except for hemoglobin, total protein, and albumin in postoperative course. The total leukocyte count significantly decreased from the postoperative 6th month. The lymphocyte count significantly increased from the postoperative 3rd month. The granulocytes decreased significantly in the postoperative 6th month. The T cells and B cells decreased in the postoperative 3rd month and 1st month, respectively. CD8 increased in the postoperative 3rd month and NK cells also increased in the postoperative 3rd, 6th and 24th months. Other peripheral lymphocytes and their subsets showed no significant differences. The changes in the lymphocyte subsets according to stage were not statistically significant (p<0.005). CONCLUSIONS: The postoperative changes in lymphocytes, granulocytes, and NK cells were significantly different compared with preoperative levels, but these results did not correlate with postoperative survival and recurrence rate because of the short postoperative follow-up periods.
Antibodies, Monoclonal ; B-Lymphocytes ; Body Weight ; Colonic Neoplasms ; Fluorescent Antibody Technique, Indirect ; Follow-Up Studies ; Granulocytes ; Hematocrit ; Humans ; Killer Cells, Natural ; Leukocyte Count ; Lymphocyte Count ; Lymphocyte Subsets ; Lymphocytes* ; Postoperative Period ; Recurrence ; Stomach Neoplasms ; T-Lymphocytes

The prevalence of benign prostatic hyperplasia (BPH) is rising with Korea becoming an aging society. As patients age, their comorbidities and the risks associated with anesthesia increase. Recently, there has been an increasing concern regarding sexual function after surgery. As a result, interest in minimally invasive surgery for BPH that does not require anesthesia or affect sexual function has grown. This review article introduces newly developed minimally invasive surgeries for BPH divided into four categories based on the strategy—mechanical, anatomical, atrophic, and laparoscopic. Here, the mechanisms for each surgical method have been introduced. Furthermore, recent representative studies of these procedures with a focus on randomized controlled trials and meta-analyses have also been reviewed. Side effects related to sexual function have also been mentioned briefly along with the efficacy and indication for robotic BPH surgery, which has recently been attracting attention. However, these newer, minimally invasive procedures require additional comparative randomized controlled trials and long-term results to produce more robust evidence for their use.
Aging ; Anesthesia ; Comorbidity ; Humans ; Korea ; Lower Urinary Tract Symptoms ; Methods ; Minimally Invasive Surgical Procedures ; Prevalence ; Prostatic Hyperplasia ; Sexual Dysfunction, Physiological ; Transurethral Resection of Prostate

This article was withdrawn by the authors' request.

The prevalence of benign prostatic hyperplasia (BPH) is rising with Korea becoming an aging society. As patients age, their comorbidities and the risks associated with anesthesia increase. Recently, there has been an increasing concern regarding sexual function after surgery. As a result, interest in minimally invasive surgery for BPH that does not require anesthesia or affect sexual function has grown. This review article introduces newly developed minimally invasive surgeries for BPH divided into four categories based on the strategy—mechanical, anatomical, atrophic, and laparoscopic. Here, the mechanisms for each surgical method have been introduced. Furthermore, recent representative studies of these procedures with a focus on randomized controlled trials and meta-analyses have also been reviewed. Side effects related to sexual function have also been mentioned briefly along with the efficacy and indication for robotic BPH surgery, which has recently been attracting attention. However, these newer, minimally invasive procedures require additional comparative randomized controlled trials and long-term results to produce more robust evidence for their use.

The prevalence of benign prostatic hyperplasia (BPH) is rising with Korea becoming an aging society. As patients age, their comorbidities and the risks associated with anesthesia increase. Recently, there has been an increasing concern regarding sexual function after surgery. As a result, interest in minimally invasive surgery for BPH that does not require anesthesia or affect sexual function has grown. This review article introduces newly developed minimally invasive surgeries for BPH divided into four categories based on the strategy—mechanical, anatomical, atrophic, and laparoscopic. Here, the mechanisms for each surgical method have been introduced. Furthermore, recent representative studies of these procedures with a focus on randomized controlled trials and meta-analyses have also been reviewed. Side effects related to sexual function have also been mentioned briefly along with the efficacy and indication for robotic BPH surgery, which has recently been attracting attention. However, these newer, minimally invasive procedures require additional comparative randomized controlled trials and long-term results to produce more robust evidence for their use.

This article was withdrawn by the authors' request.

Objective: This study was conducted to investigate the prevalence, status, severity, frequency, and impact on life of drooling in children with cerebral palsy. Methods: A total of 74 children with cerebral palsy, aged 2-6 years (53.68±17.33 months), who exhibited drooling symptoms were assessed using the Drooling Severity and Frequency Scale (DSFS) and the Drooling Impact Scale (DIS) to determine the status, severity, frequency, and impact of drooling in drooling group and control group. The study also examined differences in drooling-related factors based on gender, age, and prematurity status. Results: The overall prevalence of drooling was 60.8%, 35.6% in those with spastic quadriplegia, and 77.8% in children at Gross Motor Function Classification System (GMFCS) level III-V. Significant differences were found in drooling severity based on gender, prematurity, and age. Higher scores were observed for drooling severity and frequency, frequency of wiping the mouth, and the impact of drooling on the child’s life compare to control group.Although a few had undergone drooling-related treatments, many parents expressed a desire to receive treatment. It was reported that treatment for drooling was primarily provided by occupational therapists through referrals to rehabilitation medicine, with dysphagia rehabilitation and oral motor therapy being the main interventions. Conclusion By utilizing standardized assessment tools, the severity of drooling according to the specific conditions of children with disabilities was assessed. It is believed that the necessary steps to be taken include identifying the cause of drooling and setting appropriate treatment goals, followed by the provision for a suitable intervention.