The fate of testicular salvage in spermatic cord torsion depends on the duration of ischemia and the degree of torsion. Even though spermatic cord torsion (SCT) can occur at any age, it is rarely reported in older patients. If the physician does not pay close attention to this unusual situation, the lack of suspicion for SCT may result in a missed or delayed diagnosis. We report a very uncommon case of missed SCT occurring in a 63-year-old man.
Delayed Diagnosis ; Humans ; Ischemia ; Middle Aged ; Spermatic Cord ; Spermatic Cord Torsion ; Testis

Both death certificates and postmortem examination certificates are used as proof of death. These certificates sometimes contain erroneous information but how frequently they do so is unknown. In particular, only a few studies have measured the accuracy of the cause and manner of death on Korea death documents. In this study, we compared the cause and manner of death on both kinds of certificates with those on autopsy reports to determine the frequency of errors, and to identify way to improve the accuracy of these certificates. In 2012, 528 autopsies were requested of out institute, and certificates were submitted in 241 of the cases. The manner of death was classified as natural, unnatural, or unknown. The cause of death in the autopsy report matched that on the death certificate in 37 of 63 cases (58.7%), and the manner of death matched in 40 of 63 cases (63.5%). The cause of death in the autopsy report matched that on the postmortem examination certificate in 62 of 178 cases (34.8%), and the manner of death matched in 74 of 178 cases (41.6%). Death certificates and postmortem examination certificates are important documents. We identified many incorrect reports of causes and manners of death on both kinds of documents, especially the postmortem death certificates. These inaccuracies are presumably due to a lack of forensic information and education, as well as lack of interest on the part of medical doctors.
Autopsy* ; Cause of Death ; Death Certificates* ; Education ; Korea

OBJECTIVE: The objectives of this study were to evaluate the reliability of the Korean version of Spinal Cord Independence Measure (SCIM) and to compare the sensitivity of the SCIM to functional changes of spinal cord injury (SCI) patients with that of the Functional Independence Measure (FIM). METHOD: Seventeen subjects with SCI were studied. The SCIM was translated and modified to convert as SCIM Korean-version. All patients were evaluated with the SCIM and the FIM by two raters every other week. To determine inter-rater reliability, the relationship between the SCIM scores obtained by two raters was evaluated by Kappa coefficient and linear regression. To determine relative sensitivity of the test to functional changes, changes in the scores on the SCIM and FIM were compared by McNemar test. RESULTS: The Kappa coefficient of the various individual tasks in SCIM ranged between 0.63 and 1.00. High correlations were also found between the total SCIM scores for the paired raters (r=0.99, p<0.01). The SCIM detected all the functional changes detected by FIM total scoring, but in 3 (14%) of 22 sequential test batteries, the FIM missed changes detected by SCIM total scoring. CONCLUSION: These results demonstrated that the SCIM is reliable and more sensitive than the FIM in reflecting the functional changes of SCI patients.
Humans ; Linear Models ; Spinal Cord Injuries* ; Spinal Cord*

OBJECTIVE: To evaluate the effect of different kind of abdominal corsets on pulmonary function and energy consumption in the patients with cervical spinal cord injury. METHOD: Five subjects with quadriplegia due to cervical spinal cord injury were enrolled. A quantitative evaluation of vital capacity, tidal volume, and oxygen consumption was done using K4b2 (COSMED, Italy) under following six conditions; 1) supine position without abdominal corset, 2) sitting position without abdominal corset, 3) supine position with non-elastic abdominal corset, 4) sitting position with non-elastic abdominal corset, 5) supine position with elastic abdominal corset, 6) sitting position with elastic abdominal corset. Wilcoxon signed-rank test was applied for statistical assessment of group difference. RESULTS: Vital capacity and tidal volume in the condition with elastic abdominal corset were significantly increased than those of the condition without corset (p<0.05) or of the condition with non-elastic corset (p<0.01) in both sitting and supine position. Vital capacity and tidal volume in the condition with non-elastic abdominal corset were significantly decreased than those of the condition without corset (p<0.05) in both sitting and supine position. Oxygen consumption was least in the condition with elastic abdominal corset (p<0.05). CONCLUSION: These results demonstrated that the elastic abdominal corset is beneficial in improving the efficiency of breathing for the patients with cervical spinal cord injury. However, non-elastic abdominal corset is harmful to these patients.
Evaluation Studies as Topic ; Humans ; Oxygen Consumption* ; Oxygen* ; Quadriplegia ; Respiration ; Spinal Cord Injuries ; Supine Position ; Tidal Volume ; Vital Capacity

OBJECTIVE: To evaluate the effect of methylphenidate on cognitive function especially on working memory and visuospatial attention in the patients with traumatic brain injury (TBI). METHOD: Eighteen subjects, 16 males and 2 females, with TBI were enrolled. Their mean age was 34.2 years old. A double-blind placebo-controlled study was designed. The baseline cognitive assessment was performed before the administration of drug. Two days after the baseline study, 20 mg of methylphenidate or placebo was administered. The second cognitive assessment was performed 2 hours after the treatment. The follow-up assessment conducted two days after the second test. Cognitive assessments consisted of 'one-back working memory task' and 'endogenous visuospatial attention task', designed using SuperLab Pro 2.0 software. RESULTS: In one-back working memory test, there was significant improvement of response accuracy in methylphenidate group in comparison with placebo group (p<0.01). Significant shortening of reaction time was also seen after the administration of drug in methylphenidate group (p<0.05). In endogenous visuospatial attention test, significant improvement of response accuracy was noticed after the administration of drug in methylphenidate group (p<0.05). CONCLUSION: These results demonstrated that the administration of methylphenidate was beneficial in improving cognitive function following TBI. The effect was prominent in the accuracy of working memory.
Brain Injuries* ; Brain* ; Female ; Follow-Up Studies ; Humans ; Male ; Memory, Short-Term ; Methylphenidate* ; Reaction Time

In the oral cavity, complex microbial community is shaped by various host and environmental factors. Extensive literature describing the oral microbiome in the context of oral health and disease is available. Advances in DNA sequencing technologies and data analysis have drastically improved the analysis of the oral microbiome. For microbiome study, bacterial 16S ribosomal RNA gene amplification and sequencing is often employed owing to the cost-effective and fast nature of the method. In this review, practical considerations for performing a microbiome study, including experimental design, molecular analysis technology, and general data analysis, will be discussed.

Remarkable developments in immuno-oncology have changed the landscape of gastric cancer (GC) treatment. Because immunotherapy intervenes with tumor immune response rather than directly targeting tumor cells, it is important to develop a greater understanding of tumor immunity. This review paper summarizes the tumor immune reaction and immune escape mechanisms while focusing on the role of T cells and their co-inhibitory signals, such as the immune checkpoint molecules programmed death-1 and programmed deathligand 1 (PD-L1). This paper also describes past clinical trials of immunotherapy for patients with GC and details their clinical implications. Strong predictive markers are essential to improve response to immunotherapy. Microsatellite instability, Epstein-Barr virus, PD-L1 expression, and tumor mutational burden are now regarded as potent predictive markers for immunotherapy in patients with GC. Novel immunotherapy and combination therapy targeting new immune checkpoint molecules such as lymphocyte-activation gene 3, T cell immunoglobulin, and mucin domain containing-3, and indoleamine 2,3-dioxygenase have been suggested, and trials are ongoing to evaluate their safety and efficacy. Immunotherapy is an important treatment option for patients with GC and has great potential for improving patient outcome, and further research in immuno-oncology should be carried out.

Background: Benign convulsions with mild gastroenteritis (CwG) are prevalent in young children during the winter. Early in the coronavirus disease 2019 (COVID-19) pandemic, viral gastroenteritis occurrence decreased and seasonal variation was lost, which can change CwG.Purpose: Here we investigated changes in frequency, seasonal variation, and causative viruses of CwG during the COVID-19 pandemic. Methods: We screened 1134 patients (3–36 months) with “other and unspecified convulsions” treated at Chonnam National University Hospital between March 2017 and February 2023; of them, we enrolled 41 (3.6%) with CwG. We compared their medical records from period I (March 2017 to February 2020) to those from period II (March 2020 to February 2023). Publicly available viral gastroenteritis surveillance data from the Korea Disease Control and Prevention Agency (KDCA) were reviewed as reference. Results: Of the 41 patients with CwG, 18 (2.9% of 613) were affected in period I versus 23 (4.4% of 512) in period II (P=0.184). In period I, CwG mainly occurred in winter and spring (55.6% and 22.2%, respectively). In period II, there were fewer CwG cases (39.1%) in winter and more cases in summer and autumn (26.1% and 17.4%, respectively): the cases of norovirus genogroup II (GII)-associated CwG increased significantly in the summer (38.5% vs. 0%, P= 0.046). Norovirus GII was the most common virus (56.1% of isolates). Enteric adenovirus was the second most common (19.5%), with one case in period I and 7 cases in period II (P=0.059). The clinical characteristics of enteric adenovirus-associated CwG were similar to those of norovirus. Seasonal changes in and viral causes of CwG were consistent with those observed in the KDCA stool surveillance data. Conclusion During the COVID-19 pandemic, CwG frequency did not change, seasonal variation was unapparent, and enteric adenovirus-associated CwG frequency increased.

Background: Benign convulsions with mild gastroenteritis (CwG) are prevalent in young children during the winter. Early in the coronavirus disease 2019 (COVID-19) pandemic, viral gastroenteritis occurrence decreased and seasonal variation was lost, which can change CwG.Purpose: Here we investigated changes in frequency, seasonal variation, and causative viruses of CwG during the COVID-19 pandemic. Methods: We screened 1134 patients (3–36 months) with “other and unspecified convulsions” treated at Chonnam National University Hospital between March 2017 and February 2023; of them, we enrolled 41 (3.6%) with CwG. We compared their medical records from period I (March 2017 to February 2020) to those from period II (March 2020 to February 2023). Publicly available viral gastroenteritis surveillance data from the Korea Disease Control and Prevention Agency (KDCA) were reviewed as reference. Results: Of the 41 patients with CwG, 18 (2.9% of 613) were affected in period I versus 23 (4.4% of 512) in period II (P=0.184). In period I, CwG mainly occurred in winter and spring (55.6% and 22.2%, respectively). In period II, there were fewer CwG cases (39.1%) in winter and more cases in summer and autumn (26.1% and 17.4%, respectively): the cases of norovirus genogroup II (GII)-associated CwG increased significantly in the summer (38.5% vs. 0%, P= 0.046). Norovirus GII was the most common virus (56.1% of isolates). Enteric adenovirus was the second most common (19.5%), with one case in period I and 7 cases in period II (P=0.059). The clinical characteristics of enteric adenovirus-associated CwG were similar to those of norovirus. Seasonal changes in and viral causes of CwG were consistent with those observed in the KDCA stool surveillance data. Conclusion During the COVID-19 pandemic, CwG frequency did not change, seasonal variation was unapparent, and enteric adenovirus-associated CwG frequency increased.

Background: Benign convulsions with mild gastroenteritis (CwG) are prevalent in young children during the winter. Early in the coronavirus disease 2019 (COVID-19) pandemic, viral gastroenteritis occurrence decreased and seasonal variation was lost, which can change CwG.Purpose: Here we investigated changes in frequency, seasonal variation, and causative viruses of CwG during the COVID-19 pandemic. Methods: We screened 1134 patients (3–36 months) with “other and unspecified convulsions” treated at Chonnam National University Hospital between March 2017 and February 2023; of them, we enrolled 41 (3.6%) with CwG. We compared their medical records from period I (March 2017 to February 2020) to those from period II (March 2020 to February 2023). Publicly available viral gastroenteritis surveillance data from the Korea Disease Control and Prevention Agency (KDCA) were reviewed as reference. Results: Of the 41 patients with CwG, 18 (2.9% of 613) were affected in period I versus 23 (4.4% of 512) in period II (P=0.184). In period I, CwG mainly occurred in winter and spring (55.6% and 22.2%, respectively). In period II, there were fewer CwG cases (39.1%) in winter and more cases in summer and autumn (26.1% and 17.4%, respectively): the cases of norovirus genogroup II (GII)-associated CwG increased significantly in the summer (38.5% vs. 0%, P= 0.046). Norovirus GII was the most common virus (56.1% of isolates). Enteric adenovirus was the second most common (19.5%), with one case in period I and 7 cases in period II (P=0.059). The clinical characteristics of enteric adenovirus-associated CwG were similar to those of norovirus. Seasonal changes in and viral causes of CwG were consistent with those observed in the KDCA stool surveillance data. Conclusion During the COVID-19 pandemic, CwG frequency did not change, seasonal variation was unapparent, and enteric adenovirus-associated CwG frequency increased.