Malignancy may cause variable musculoskeletal symptoms which resemble connective tissue disorder. This symptoms as a fine sign of hidden neoplasm can precede the diagnosis of underlying malignancy. But only one case of stomach cancer associated with cancer arthritis was reported in the world. This fact is very interesting in Asia which has high prevalence of stomach cancer. We experienced one case of gastric adenocarcinoma with oligoarthritis involving both knee and right elbow. A 48-year-old man was diagnosed stomach cancer by gastric endoscope and biopsy. After then, he complained pain, tenderness, heating sensation, swelling of both knee and right elbow with high fever. Both knee MRI showed abundant synovial effusion and soft tissue edema. Full dose of nonsteroidal anti-inflammatory drug was not effective to control fever and arthritis. But fever and arthritis were gone after resection of tumor.
Adenocarcinoma* ; Arthritis ; Asia ; Biopsy ; Connective Tissue ; Diagnosis ; Edema ; Elbow ; Endoscopes ; Fever ; Heating ; Hot Temperature ; Humans ; Knee ; Magnetic Resonance Imaging ; Middle Aged ; Prevalence ; Sensation ; Stomach Neoplasms

No abstract available.
Animals ; Rats*

No abstract available.
Animals ; Coal* ; Dust* ; Lung* ; Rats* ; Silicon Dioxide*

Purpose: Gastric subepithelial tumor (GST) is a disease entity that includes all gastric subepithelial lesions. The oncologically safe surgical technique is complete resection with adequate resection margins. Most of the studies about laparoscopic gastric wedge rsection (LGWR) in GST focus on oncologic curability or surgical effectiveness. However, studies on the factors associated with the operation time are rare. Therefore, this study was conducted to analyze and compare the factors associated with the operation time of LGWR. Methods: From 2010 to 2019, 145 consecutive patients undergoing LGWR were reviewed retrospectively. Clinical characteristics of GST and operation time were analyzed and compared. Results: A total of 145 patients was enrolled and reviewed. There were 59 males (40.7%) and 86 females (59.3%) with a mean age of 53.6 years and mean body mass index (BMI) of 23.9 kg/m 2 . Mean tumor size was 2.9 cm and mean operation time was 66.0 minutes. In statistically, the mean operation time showed significant association with tumor size, BMI, longitudinal tumor location and tumor location between lesser and greater curvature. In multivariate analysis, tumor size, BMI and longitudinal classification of tumor location are statistically significant. Conclusion A shorter operation time is expected when there is a small tumor, low BMI and mid portion of the stomach GST. Preoperative evaluation for tumor size and body weight is important. In patients with large GST, obesity and both end stomach GST, we think that pre-operative preparation for long operation time should be considered.

BACKGROUND AND OBJECTIVES: Intraoperative echocardiography (IOE), mostly done by transesophageal methods, provides an important means of accessing cardiac structure and function during cardiac and noncardiac surgery. The purpose of this study was to determine the role of IOE by identifying the frequency of the use of IOE during cardiac surgery, the rate of second pump operations determined by IOE findings, and the results of the operations. SUBJECTS AND METHODS: Sixty-five patients (93 lesions) underwent cardiac surgery with the concomitant IOE done by a cardiologist in a single institution between March 1997 and October 1998. The data was collected retrospectively by reviewing the hospital records and IOE videotapes. IOE was applied to 18.9% of total cardiac operations, primarily being used in MV surgery (48.4%). A pre-pump IOE was done in 2 cases and the post-pump procedure was done in the remainder. A second pump operation was performed in 4 cases (6.25%) and all of these were found to be successful after immediate re-operation. CONCLUSION: IOE was primarily used in valve operations, particularly in procedures involving the mitral valve. IOE appears to be useful in determining the immediate results following cardiac surgery and may contribute to determining the prognosis of the patient.
Echocardiography ; Echocardiography, Transesophageal* ; Hospital Records ; Humans ; Mitral Valve ; Monitoring, Intraoperative ; Prognosis ; Retrospective Studies ; Thoracic Surgery ; Videotape Recording

OBJECTIVES: The 2nd to 4th digit length(2D:4D) ratio reflects the amount of exposure and sensitivity to the prenatal sex hormone and it is considered to be the most convenient and useful way to understand the influence of sex hormone in the determination of human behavioral traits. This study was carried out to find the correlation between the 2D:4D ratio and characteristics of temperament and character in Korean university students. We assumed that 2D:4D ratio would show a strong correlation with temperament which is defined to be an inclination of an automatical emotional response to a stimulus. METHODS: Participants were 104 university students who completed 2 self-report measures:Temperament and Character Inventory(TCI), Temperament Test. We examined the 2D:4D ratio of each subject by measuring the lengths of the 2nd and 4th fingers using a photocopy measurement. We performed statistical analyses using correlation test and t-test to examine the relationship between 2D:4D ratio and psychological characteristics. RESULTS: We found out the typical sex difference in 2D:4D ratio. Women had significantly higher 2D:4D ratio than men. TCI-Character factor(TCI-C) didn't show any significant correlation with the 2D:4D ratio. TCI-Tempterament factor(TCI-T) and the item of Temperament Test showed a significant correlation with the 2D:4D ratio. In correlation analysis of the total group including all women and men, the 2D:4D ratio showed a significant positive correlation in a subscale(shyness with stranger) of harm avoidance scales in TCI-T. In correlation analysis of women's group, the 2D:4D ratio showed a significant positive correlation in two subscales( fear of uncertainty) and[shyness to stranger] of harm avoidance scales in TCI-T. In correlation analysis of men's group, the 2D:4D ratio showed a significant negative correlation with a sanguine temperament item of the Temperament Test. CONCLUSION: The results suggest that the amount of exposure to sex hormone in the prenatal period seems to have an impact on the determination of temperament and characteristics.
Female ; Fingers ; Humans ; Male ; Sex Characteristics ; Temperament ; Testosterone ; Weights and Measures

Background: Glucocorticoids are one of the current standard agents for moderate to severe coronavirus disease 2019 (COVID-19) treatment based on the RECOVERY trial. Data on the real clinical application of steroids for COVID-19 are scarce and will help guide the optimal use of steroids. We described the current prescription pattern of steroids for COVID-19 and investigated the factors related to specific practices. Methods: All adults aged ≥ 19 years who were diagnosed with COVID-19 by real-time reverse transcription-polymerase chain reaction and admitted to one of 3 study hospitals from 8 December 2020 to 30 June 2021 were enrolled. Demographic and clinical data, including medications and oxygen therapy, were retrospectively collected from electronic medical records. The severity of comorbidities and COVID-19 were measured. The subjects were divided into steroid and nonsteroid groups, and the steroid group was then subdivided into standard and higher/longer groups. Results: Among a total of 805 patients, 217 (27.0%) were treated with steroids. The steroid group showed a higher rate of oxygen therapy (81.1% vs. 2.7%), more concomitant use of remdesivir (77.4% vs. 1.4%) or antibiotics (79.3% vs. 4.3%), and a higher proportion of high risk according to National Early Warning Score-2 score (30.0% vs. 0.9%) or severe risk according to National Institute of Allergy and Infectious Disease Ordinal Scale score (81.1% vs. 2.7%) than the nonsteroid group. The mortality of the steroid group was 4.6%. In the steroid group, 82.5% received a standard or lower dose of steroids within ten days, and 17.5% (38/217) received a higher or longer dose of steroids. Multivariate analysis showed that initial lymphopenia (adjusted odds ratio [aOR], 0.94; 95% confidence interval [CI], 0.89–0.99) and high level of lactate dehydrogenase (LDH) (aOR, 1.00; 95% CI, 1.00–1.01) were independent risk factors for higher doses or longer steroid use. Conclusion The dose and duration of steroids were in line with current guidelines in 82.5% of COVID-19 patients, but the outliers may need tailored therapy according to surrogate markers, such as initial lymphopenia or high level of LDH.

Objective: Various patient placement criteria (PPC) have been developed to address alcohol use disorder (AUD), which has a high relapse rate and imposes substantial socioeconomic costs. Although research has shown PPC to be an effective tool, evidence supporting the Korean-PPC (K-PPC) is insufficient. This paper investigated whether treatment matching with the K-PPC was effective, based on variables related to AUD. Methods: In total, 524 participants were evaluated using the 6 dimensions of the K-PPC and levels of care (LoC) were recommended based on the results. Participants whose treatment matched with the recommended LoC were classified into the matched group, and those whose treatment did not match were classified into the mismatched group. Subsequently, treatment was planned according to the determined LoC, and a total of 3 follow-up evaluations were conducted at 1 month, 3 months, and 6 months. Results: There was no significant difference in the follow-up rate between the K-PPC matched group and the mismatched group. Of the variables measured by the 6 dimensions of the K-PPC, alcohol-related variables, depression, insight, and biomedical outcomes showed the most significant results (especially alcohol-related variables) from the baseline evaluation to the 6-month follow-up. In addition, the average adherence to the treatment program in the 6-month period was found to be higher in the matched group than in the mismatched group. Conclusion The K-PPC could be effective for placing patients and providing treatment by matching patient characteristics. Enhancing treatment program retention can also have a positive effect on clinical outcomes.

OBJECTIVES: The present study takes part of the agricultural district cohort study of a certain county located in Gyeonggido and aims to investigate the difference of the heart rate variability(HRV) according to the social support level. METHODS: We used data from 1727 participants of a health promotion program who are older than 40 years old. A physical examination, as well as a one-to-one interview to obtain sociodemographic characteristics, was performed with each participant. In addition, the participants completed the Medical Outcomes Study-Social Support Survey(MOS-SSS) for their the social support level to be assessed, and their HRV were measured to evaluate their autonomic function. The entire group was divided in two groups according to its MOS-SSS points to facilitate the research. Those who were evaluated as the high 25%(432 persons) were denominated as high social support (HSS) group and those who were evaluated as the low 25%(425 persons) were denominated as poor social support(PSS) group. RESULTS: The two groups showed significant differences on the sociodemographic factor such as mean age and gender composition(p<0.05). Comparing the indices related to the HRV, the HSS group had the following values higher than the PSS group : SDNN(F=4.938, p=0.027), TP(F=8.088, p=0.005), VLF(F=6.220, p=0.013) LF (F=3.873, p=0.049). CONCLUSION: According to the research, the PSS group showed dysfunction on their autonomic nervous system comparing to the HSS group. The social support helps an individual overcome difficulties, helps the adaptation during the changes of circumstances and in stressful situations it serves like a buffer. Based on that, it's possible to define that a low social support level gave an impact on the autonomic function. Also, using the fact that the HRV can evaluate the autonomic function in an objective view, it was possible to visualize that it has a potential to be used as an assistant factor to evaluate the social support.
Autonomic Nervous System ; Cohort Studies ; Health Promotion ; Heart ; Heart Rate ; Physical Examination

Tracheostomy is one of the oldest surgical procedures in medical history. The indications for a tracheostomy include the relief of an upper airway obstruction, long-term mechanical ventilation, and decreased airway resistance to help wean the patient from mechanical ventilator support. Unfortunately, tracheostomy is also associated with a number of problems including, bleeding, infection, pneumothorax, and tracheal stenosis. A pneumothorax is an uncommon complication of a tracheostomy, and can result from direct injury to the pleura or positive pressure ventilation through a dislocation of the tracheostomy tube. We report an uncommon case of a tracheostomy-induced bilateral tension pneumothorax with a review of the literature.
Airway Obstruction ; Airway Resistance ; Dislocations ; Hemorrhage ; Humans ; Pleura ; Pneumothorax* ; Positive-Pressure Respiration ; Respiration, Artificial ; Tracheal Stenosis ; Tracheostomy* ; Ventilators, Mechanical