The idiopathic retroperitoneal fibrosis means that proliferation of fibrous tissue in the retroperitoneal cavity influences the aorta, inferior vena cava, psoas muscle and ureter, and its etiology is not found. Especially, when both ureters are compressed, hydronephrosis resulted in uremia are developed progressively, and it may be treated by urinary diversion. We report a case of idiopathic retroperitoneal fibrosis that treated by bilateral pyelo-ileo-neocystostomy and postoperative metabolic derangement that managed successfully with brief review of literature.
Aorta ; Hydronephrosis ; Psoas Muscles ; Retroperitoneal Fibrosis* ; Uremia ; Ureter ; Urinary Diversion ; Vena Cava, Inferior

PURPOSE: Comparing the results of traffic accident deaths between ours and a previous study, we assessed the improvement in the emergency medical service system and the traumatic care system. METHODS: Three hundred twenty-one traumatic accident deaths occurring in Chunan and the nearby region between 1999 and 2000 were reviewed; data were obtained from paramedic trip reports, medical records, and radiological findings. RESULTS: One hundred fifty-eight (49%) deaths occurred in the prehospital setting. The remaining 163 (51%) patients were transported to the hospital. Of these, 89 (55%) died in the first 48 hours (acute), 26 (16%) within three to seven days (early) and 48 (29%) after seven days (late). Central nervous system injuries were the most frequent cause of death (57%), followed by exsanguination (25%) and organ failure (8%). Two distinct peaks of time were found on analysis: 50% of the patients died within the first 60 minutes, and 9% of the patients died at three to seven days after injury. The overall preventable death rate was 24%. CONCLUSION: Access to the prehospital emergency medical system was improved, and there was greater proportion of late deaths due to brain injury. We found the distribution to be a bimodal distribution.
Accidents, Traffic ; Allied Health Personnel ; Brain Injuries ; Cause of Death ; Central Nervous System ; Chungcheongnam-do ; Emergencies ; Emergency Medical Services ; Epidemiology* ; Exsanguination ; Humans ; Medical Records ; Mortality

Humans ; Pregnancy Rate ; Sterilization, Tubal*

BACKGROUND: The aims of our study were to evaluate the success rate of irrigation and debridement with component retention (IDCR) for acutely infected total knee arthroplasty (TKA) (< 4 weeks of symptom duration) and to analyze the factors affecting prognosis of IDCR. METHODS: We retrospectively reviewed 28 knees treated by IDCR for acutely infected TKA from 2003 to 2012. We evaluated the success rate of IDCR. All variables were compared between the success and failure groups. Multivariable logistic regression analysis was also used to examine the relative contribution of these parameters to the success of IDCR. RESULTS: Seventeen knees (60.7%) were successfully treated. Between the success and failure groups, there were significant differences in the time from primary TKA to IDCR (p = 0.021), the preoperative erythrocyte sedimentation rate (ESR; p = 0.021), microorganism (p = 0.006), and polyethylene liner exchange (p = 0.017). Multivariable logistic regression analysis of parameters affecting the success of IDCR demonstrated that preoperative ESR (odds ratio [OR], 1.02; p = 0.041), microorganism (OR, 12.4; p = 0.006), and polyethylene liner exchange (OR, 0.07; p = 0.021) were significant parameters. CONCLUSIONS: The results show that 60.7% of the cases were successfully treated by IDCR for acutely infected TKA. The preoperative ESR, microorganism, and polyethylene liner exchange were factors that affected the success of IDCR in acutely infected TKA.
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Arthroplasty, Replacement, Knee/*adverse effects ; Arthroscopy ; Debridement ; Female ; Humans ; Joint Diseases/microbiology/surgery/therapy ; Knee Joint/microbiology/*surgery ; Knee Prosthesis/microbiology ; Male ; Middle Aged ; Prosthesis-Related Infections/etiology/microbiology/*therapy ; Retrospective Studies ; Therapeutic Irrigation ; Treatment Outcome

Autism spectrum disorder (ASD) is characterized by persistent deficits within two core symptom domains: social communication and restricted, repetitive behaviors. Although numerous studies have reported psychopharmacological treatment outcomes for the core symptom domains of ASD, there are not enough studies on fundamental treatments based on the etiological pathology of ASD. Studies on candidate medications related to the pathogenesis of ASD, such as naltrexone and secretin, were conducted, but the results were inconclusive. Oxytocin has been identified as having an important role in maternal behavior and attachment, and it has been recognized as a key factor in the social developmental deficit seen in ASD. Genetic studies have also identified associations between ASD and the oxytocin pathway. As ASD has its onset in infancy, parents are willing to try even experimental or unapproved treatments in an effort to avoid missing the critical period for diagnosis and treatment, which can place their child in an irreversible state. While therapeutic application of oxytocin for ASD is in its early stages, we have concluded that oxytocin would be a promising therapeutic substance via a thorough literature review focusing on the following: the relationship between oxytocin and sociality; single nucleotide polymorphisms as a biological marker of ASD; and validity verification of oxytocin treatment in humans. We also reviewed materials related to the mechanism of oxytocin action that may support its potential application in treating ASD.
Autistic Disorder* ; Child ; Autism Spectrum Disorder* ; Critical Period (Psychology) ; Diagnosis ; Humans ; Maternal Behavior ; Naltrexone ; Oxytocin* ; Parents ; Pathology ; Polymorphism, Single Nucleotide ; Secretin ; Social Change ; Biomarkers

We performed microscopic sperm aspiration and IVF in 2 cases of distal vas obstruction. 4 cases or epididymal obstruction, 3 cases of congenital vas aplasia. The results were as follows ; 1. The fertilization was successful in 2 cases of distal vas obstruction(100%). 1 case of epididymal obstruction(25%). 1 case of congenital vas. aplasia(33.3%). 2. In 4 cases with Sertoli cell failure. the count and quality of aspirated sperm was lower than in 5 cases with normal hormonal study. The fertilization was successful in 1 case with Sertoli cell failure(25%) and 3 cases with normal hormonal study(60%). In conclusion. microscopic sperm aspiration and IVF proved helpful in treatment of patients with distal vas obstructin, congenital vas aplasia. but the vasoepididymostomy proved more helpful in treatment of patients with epididymal obstruction then microscopic sperm aspiration and IVF until now. When microscopic sperm aspiration and IVF is performed, it seems that in Sertoli cell failure group. there will be lesser fertilization success cases than in normal hormonal study group.
Azoospermia* ; Fertilization ; Fertilization in Vitro* ; Humans ; Sperm Retrieval* ; Spermatozoa*

Objective: The aim of this nationwide age- and sex- matched longitudinal follow up study is to determine the risk of Parkinson’s disease (PD) associated with ischemic stroke in Korea. Methods: Patient data were collected from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). PD was identified using the International Classification of Diseases (ICD) 10-CM code G 20. In total, 6,475 patients were enrolled in the PD group from the NHISS. After subtracting 1,039 patients who underwent hospitalization less than once or those who visited an outpatient clinic less than two times, 5,259 patients who were diagnosed after January 1, 2004 ultimately participated in this study. After case-control match was done through 1:5 age- and sex- stratified matching, 26,295 individuals were chosen as control. Kaplan-Meier method and Cox proportional hazard regression analysis were performed to evaluate the risk of ischemic stroke in PD. Results: The hazard ratio of ischemic stroke in the PD group was 3.848 (95% confidence interval (confidence interval [CI]): 3.14-4.70) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in PD group was 3.885 (95% CI: 3.17-4.75) after adjusting for comorbidities. According to subgroup analysis, in male and female and non-diabetes and diabetes and non-hypertension and hypertension and dyslipidemia and non-dyslipidemia subgroups, ischemic stroke incidence rates were significantly higher in the PD group than those in the control group. Conclusions This nationwide longitudinal study suggests an increased risk of ischemic stroke in PD patients.

BACKGROUND: This study introduces a surgical technique with good clinical outcome useful in the treatment of osteoporotic displaced 3- or 4-part proximal humeral fractures. METHODS: From May 2014 to February 2016, 16 patients with displaced 3- or 4-part proximal humeral fractures were treated by application of a locking plate with an endosteal strut allograft via a deltoid splitting approach with a minimum follow-up of 12 months. The allograft was inserted through a fractured gap of the greater tuberosity to support the humeral head and then fixed by a locking plate with meticulous soft tissue dissection to protect the axillary nerve. Surgical outcomes were evaluated by the American Shoulder and Elbow Surgeons (ASES) and visual analogue scale (VAS) scores, radiological imaging, and clinical examination. Fixation failure on radiographs was defined as a >5° loss of neck shaft angle (NSA) compared to that on an immediate postoperative radiograph. Avascular necrosis (AVN) of the humeral head was also evaluated. RESULTS: In all cases, complete union was achieved. The ASES and VAS scores were improved to 85.4 ± 2.1 and 3.2 ± 1.3, respectively. Twelve patients (75.0%) had greater than a 5° change in NSA; the average NSA change was 3.8°. Five patients (31.3%) had unsatisfactory ranges of motion exhibiting a < 100° active forward flexion. No axillary nerve injuries or AVN were observed at the last follow-up. One patient was converted to reverse total arthroplasty due to severe pain and functional deficit. CONCLUSIONS: Minimally invasive fixation via a locking compression plate and an endosteal fibula strut allograft in Neer classification 3-or 4-part fractures with severe osteoporosis in elderly patients can achieve good clinical results.
Aged ; Allografts ; Arthroplasty ; Classification ; Elbow ; Fibula ; Follow-Up Studies ; Humans ; Humeral Head ; Minimally Invasive Surgical Procedures ; Neck ; Necrosis ; Osteoporosis ; Range of Motion, Articular ; Shoulder ; Shoulder Fractures ; Surgeons

PURPOSE: The purpose of this study was to evaluate the demographics, clinical features, and outcomes of arthroscopic partial meniscectomy (APM) for isolated medial meniscus horizontal cleavage tears (MMHCTs) in patients under 45 years of age. MATERIALS AND METHODS: We retrospectively reviewed 98 patients (100 knees) under 45 years who underwent APM for MMHCTs. Clinical outcomes were assessed using International Knee Document Committee (IKDC) subjective core, Tegner activity scale, visual analog scale (VAS) pain score, and a question on the symptom relief. RESULTS: 79% were male and 70% had no trauma. The mean symptom duration was 10 months. At arthroscopy, a flap tear was identified in 75%. At a mean of 19-month follow-up, the IKDC subjective score, Tegner activity scale, and VAS pain score were significantly improved compared to the preoperative values (p=0.025, p=0.043, and p=0.032, respectively). While 85% were free of symptoms, 15% had persistent pain. No significant differences in outcomes were observed based on the tear type and the presence of flap tears. No progression or development of radiographic degenerative changes was observed in all knees. CONCLUSIONS: Demographics of MMHCTs under age 45 showed a male dominance and higher frequency of non-traumatic tears. APM was beneficial to symptomatic HCTs in this cohort during the short-term follow-up. Type of HCTs and combined flap tears did not affect clinical outcomes.
Arthroscopy ; Cohort Studies ; Demography ; Follow-Up Studies ; Humans ; Knee ; Lysholm Knee Score ; Male ; Menisci, Tibial ; Retrospective Studies ; Tears ; Visual Analog Scale

Objective: The aim of this nationwide age- and sex- matched longitudinal follow up study is to determine the risk of Parkinson’s disease (PD) associated with ischemic stroke in Korea. Methods: Patient data were collected from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS). PD was identified using the International Classification of Diseases (ICD) 10-CM code G 20. In total, 6,475 patients were enrolled in the PD group from the NHISS. After subtracting 1,039 patients who underwent hospitalization less than once or those who visited an outpatient clinic less than two times, 5,259 patients who were diagnosed after January 1, 2004 ultimately participated in this study. After case-control match was done through 1:5 age- and sex- stratified matching, 26,295 individuals were chosen as control. Kaplan-Meier method and Cox proportional hazard regression analysis were performed to evaluate the risk of ischemic stroke in PD. Results: The hazard ratio of ischemic stroke in the PD group was 3.848 (95% confidence interval (confidence interval [CI]): 3.14-4.70) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in PD group was 3.885 (95% CI: 3.17-4.75) after adjusting for comorbidities. According to subgroup analysis, in male and female and non-diabetes and diabetes and non-hypertension and hypertension and dyslipidemia and non-dyslipidemia subgroups, ischemic stroke incidence rates were significantly higher in the PD group than those in the control group. Conclusions This nationwide longitudinal study suggests an increased risk of ischemic stroke in PD patients.