Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

Background and Objectives: Tracheostomy is a relatively safe procedure, and the recent emergence of COVID-19 has raised the need to perform tracheostomy immediately in the bed of an intensive care unit (ICU) rather than an operating room. The purpose of this study was to determine the occurrence of complications related to surgical tracheotomy performed in the ICU by an ENT specialist.Materials and Method From March 2019 to January 2022, a total of 101 patients underwent tracheostomy in the ICU. Demographics and complications were classified according to postoperative period. Results: Within 24 hours after the procedure, bleeding events were confirmed in 2 patients (2.0%) with mild bleeding. One case (1.0%) of ventricular fibrillation occurred shortly after the procedure. There were no complications from 24 hours to 1 week after procedure. After one week, 4 patients (4.5%) had a local infection, and 3 patients (3.4%) had a tube obstruction. During all follow-up periods, there were no serious side effects such as death, major vascular injury, pneumothroax. No complications were observed throughout the entire period in 6 COVID-19 patients. Conclusion The number of complications of surgical tracheotomy in the ICU performed by a specialist was lower than in previous studies, and there were no complications that delayed treatment or endangered life. The ENT training hospitals should provide sufficient training opportunities for residents to perform surgical tracheostomy and strive to minimize complications associated with the procedure and pre- and post-operative management under the detailed guidance and supervision of specialists.

Upper gastrointestinal bleeding is one of the most common complications in patients with chronic renal failure. Common causes are peptic ulcer, gastritis, duodenitis, esophagitis, Mallory-Weiss tear, and angiodysplasia. However, gastric polyp is a rare cause of upper gastrointestinal bleeding. We diagnosed a bleeding hyperplastic polyp in chronic renal failure patient with melena. He had a bleeding polyp with a Y-shaped stalk. This polyp was treated effectively by endoscopic snare polypectomy.
Angiodysplasia ; Duodenitis ; Esophagitis ; Gastritis ; Hemorrhage* ; Humans ; Kidney Failure, Chronic* ; Mallory-Weiss Syndrome ; Melena ; Peptic Ulcer ; Polyps* ; SNARE Proteins

Upper gastrointestinal bleeding is one of the most common complications in patients with chronic renal failure. Common causes are peptic ulcer, gastritis, duodenitis, esophagitis, Mallory-Weiss tear, and angiodysplasia. However, gastric polyp is a rare cause of upper gastrointestinal bleeding. We diagnosed a bleeding hyperplastic polyp in chronic renal failure patient with melena. He had a bleeding polyp with a Y-shaped stalk. This polyp was treated effectively by endoscopic snare polypectomy.
Angiodysplasia ; Duodenitis ; Esophagitis ; Gastritis ; Hemorrhage* ; Humans ; Kidney Failure, Chronic* ; Mallory-Weiss Syndrome ; Melena ; Peptic Ulcer ; Polyps* ; SNARE Proteins

Primary adenocarcinoma of the duodenum is a rare disease, representing 0.35% of all gastrointestinal neoplasm and 0.042% of all malignant neoplasm. Since Ham-burger described the first duodenal caricinoma in 1746, the incidence has shown an increasing tendency. Compared with upper gastrointestinal contrast studies, the gastroduodenoscopy has gained an increasing popularity as an invesitigative tool in recent years. But the diagnosis is usually made at a very late stage because the symptoms are often non-specific, which contributes to delayed diagonsiss and poorer prognosis. We have experienced two cases of the primary carcinoma of the duodenal bulb and one case of carcinoma of the second portion, which were diagnosed by biopsy with gastrofiberoscopic endoscopy and operative finding. So we report three csses with a brief review of literature.
Adenocarcinoma* ; Biopsy ; Diagnosis ; Duodenum* ; Endoscopy ; Gastrointestinal Neoplasms ; Incidence ; Prognosis ; Rare Diseases

PURPOSE: The purpose of this research was to describe our group counseling methods for medical students with drop-out experiences. METHODS: Group counseling was offered to 11 medical students with drop-out experiences in their previous second semester. All subjects provided written informed consent before participating and completed a 2-day group counseling program using the Gestalt approach. The self-assertiveness training group counseling program consisted of 6 sessions, each of which lasted 90 minutes. Experience reports by participants after the program and data from semi-structured qualitative interviews were qualitatively analyzed. RESULTS: Program participants reported that they were moderately satisfied with the program regarding its usefulness and helpfulness on self-awareness, understanding, and reminding them of attempts to change behavior. Most students showed heightened levels of sincerity perceptions and positive attitudes in every session. The results demonstrated significant changes in experience in self-esteem, self-recognition, and interpersonal relationships. CONCLUSION: A group counseling program using the Gestalt approach could help medical students with drop-out experiences to adjust with 1 year their juniors, enhance their self-esteem, contribute to their psychological well-being, and prevent student re-failure through effective stress management and improved interpersonal relationships.
Counseling ; Humans ; Informed Consent ; Students, Medical

PURPOSE: Reconstruction of a full thickness defect of the nose is a difficult task for plastic surgeons because the anatomical characteristic, shape, and function of the nose all need to be taken into consideration. Most often, a local flap or a composite graft is used, but for a large defect, reconstruction using free flaps is the most ideal method. In free flap reconstruction, the chondrocutaneous preauricular area can be a suitable donor site. We performed a chondrocutaneous preauricular free flap with an interpositional vascular graft for reconstruction of a nasal ala. METHODS: A 46 year-old male presented to the hospital with a right alar deformity induced by a dog bite. During the surgery, the existing scar tissue was removed and thereby a newly formed full thickness defect was reconstructed using the chondrocutaneous preauricular free flap with an interpositional vascular graft harvested from the descending branch of the lateral femoral circumflex vessel between the facial and superficial temporal vessels of the free flap. RESULTS: The flap survived without flap loss and showed symmetry in its overall shape, contour, texture, and color. The patient was satisfied with the results and the surgery yielded no additional scars at the nasolabial fold area. CONCLUSION: The chondrocutaneous preauricular free flap is a valuable method in reconstruction of full thickness defects of the nose, and using the descending branch of the lateral femoral circumflex vessel as the interpositional vascular graft at the anastomotic site produces reliable results.
Animals ; Bites and Stings ; Cicatrix ; Congenital Abnormalities ; Dogs ; Free Tissue Flaps ; Glycosaminoglycans ; Humans ; Male ; Nasolabial Fold ; Nose ; Nose Deformities, Acquired ; Succinates ; Tissue Donors ; Transplants ; Vascular Grafting

No abstract available.
Central Nervous System ; Epilepsy ; Sarcoidosis

No abstract available.
Cheilitis ; Lip ; Sialadenitis

PURPOSE: We evaluated the prevalence and characteristics of breakthrough cancer pain (BTcP) in Korean patients admitted with cancer pain. MATERIALS AND METHODS: In-hospital patients with cancer pain completed a questionnaire concerning severity of background cancer pain (BCP), prevalence and treatment for BTcP, sleep disorders, and satisfaction with cancer pain treatment. Medical records showing medications for BCP and BTcP were also evaluated. RESULTS: Total 609 patients with controlled BCP enrolled. Mean age of the patients was 59.5 years old, and 59% were male. Of all patients, 177 (29%) complained of BTcP. No clinical characteristic predicted BTcP. Of the 177 patients with BTcP, 56% did not receive treatment for BTcP. Patients with BTcP showed significant association with a sleep disorder and dissatisfaction with pain control, compared to those without BTcP (p < 0.0001 and p=0.0498, respectively). Oxycodone-immediate release was the most commonly used short-acting analgesic, followed by intravenous morphine. CONCLUSION: The prevalence of BTcP was 29% in patients admitted with controlled BCP. Although the patients had well-controlled BCP, BTcP showed association with a lower quality of life in patients with cancer. More medical attention is needed for detection and management of BTcP.
Humans ; Inpatients* ; Male ; Medical Records ; Morphine ; Prevalence ; Quality of Life ; Sleep Disorders