Antral web (prepyloric mucosal diaphragm) is a rare gastric anomaly that disturbs the gastric outlet and has sometimes been a diagnostic problem to the radiologist and the endoscopist. It is composed of mucosa that enclose a membrane of submucosa and located at the antrum on variable distances from the pylorus. Web is congenital in origin but may be secondary to chronic peptic ulcer disease. Obstructive symptoms may not occur when diaphragmatic aperture is larger than 1 centimeter in diameter. The diagnosis of web relies on the history, barium study and gastroscopic findings but it may be noticed after laparotomy. We experienced an antral web which demonstrated characteristic endoscopic and radiologic findings in an eight-year-old girl. These typical distinguishable findings in endoscopic and barium study in this case can remind of the antral web in patients with gastric outlet obstruction symptoms. Antral web or pyloric web, although rare, should be considered in the differential diagnosis of upper gastrointestinal obstructive symptoms in patients of any age.
Barium* ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Female* ; Gastric Outlet Obstruction ; Humans ; Laparotomy ; Membranes ; Mucous Membrane ; Peptic Ulcer ; Pylorus

We evaluated the results of twelve total elbow arthroplasties that had been performed from Feb. 1986 to Mar. 1993 in ten patients. The duration of follow-up averaged three years two months(range, one year to seven years one month). There were six females and four males. Two females had bilateral procedures. The average age at the time of the operation was 35.3 years(range, 22 to 53). Five patients had severe rheumatoid arthritis, four patients had fracture sequelae around elbows and one patient had sequele of tuberculous arthritis. Total elbow arthroplasty had been performed for improving the range of motion and relief of pain. Total elbow arthroplasties had been performed in six cases of total ankylotic elbows and in six cases who complained severe painful limitation of motion of the elbow joints. Preoperatively, ankylotic group were fixed by 30 degrees of flexion on an average. In painful elbow group, the average total range of motion was 68 degrees. The prosthesis which were used in total elbow arthroplasties were semiconstrained type in nine cases and noncostrained in three cases. Most of the patients had relief of pain. Postoperative complications were permanent ulnar nerve palsy in one case, superficial infection in one case and dislocation in one case. Total gain of range of motion(ROM) was 17 degrees in painful elbow group and 102 degrees in ankylotic elbows. Total elbow arthroplasty was effective method for improvement of range of motion in ankylotic elbows and relief of pain in elbows which had painful limitation of motion.
Ankylosis ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Dislocations ; Elbow Joint ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Postoperative Complications ; Prostheses and Implants ; Range of Motion, Articular ; Ulnar Neuropathies

In this article, the sixth author's affiliation was misprinted unintentionally.

To examine the effect of obesity on volume perception according to size and color of rice bowl, we divided female college students into a normal weight group (<30% fat mass, n=100) and obese group (> or =30% fat mass, n=83) and then measured perceived volume of rice bowls of various sizes (general size; 350 ml vs. small size; 188 ml) and color (yellow, white, blue, and black) containing the same amount of cooked white rice (210 g). Normal weight group perceived that the general rice bowl contained significantly more cooked white rice compared to the small rice bowl. In contrast, the obese group perceived that the general rice bowl contained significantly less cooked white rice than the small rice bowl. The estimated variance in perceived volume of both bowls was significantly bigger in the obese group compared to the normal group. There were no differences in perceived volume among any of the subjects (both normal and obese groups) according to rice bowl color. However, the estimated variance in perceived volume in the obese group was significantly larger than that in the normal group for all of the rice bowls. In conclusion, rice bowl size and color might affect volume perception, and volume perception in obese people may be different from that of normal weight people.
Female ; Humans ; Obesity

Objective: Immune reactions following traumatic brain injury (TBI) cause many complications, including intravascular dissemination. Antithrombin III (AT-III) plays an important role in suppressing abnormal clot formation and ensuring hemostasis. Therefore, we investigated the efficacy of serum AT-III in patients with severe TBI. Methods: This retrospective study included 224 patients with severe TBI who visited a single regional trauma center between 2018 and 2020. AT-III levels were measured immediately after the TBI diagnosis. AT-III deficiency was defined as an AT-III serum level <70%. Patient characteristics, injury severity, and procedures were also investigated. Patient outcomes included Glasgow Outcome Scale scores at discharge and mortality. Results: AT-III levels were significantly lower in the AT-III deficient group (n=89; 48.27% ± 1.91%) than in the AT-III sufficient group (n = 135, 78.90% ± 1.52%) (p < 0.001). Mortality occurred in 72 of the 224 patients (33.04%), indicating that there were significantly more patients in the AT-III-deficient group (45/89, 50.6%) than in the AT-III-sufficient group (27/135, 20%). Significant risk factors for mortality included the Glasgow Coma Scale score (P = 0.003), pupil dilatation (P = 0.031), disseminated intravascular coagulopathy (P = 0.012), serum AT-III level (P = 0.033), and procedures including barbiturate coma therapy (P = 0.010). Serum AT-III levels were significantly correlated with Glasgow Outcome Scale scores at discharge (correlation coefficient = 0.455, p < 0.001). Conclusion Patients with AT-III deficiency after severe TBI may require more intensive care during treatment, because AT-III levels reflect injury severity and correlate with mortality.

PURPOSE: This study prospectively investigated the effects of biofeedback therapy on objective anorectal function and subjective bowel function in patients after sphincter-saving surgery for rectal cancer. METHODS: Sixteen patients who underwent an ileostomy were randomized into two groups, one receiving conservative management with the Kegel maneuver and the other receiving active biofeedback before ileostomy closure. Among them, 12 patients (mean age, 57.5 years; range, 38 to 69 years; 6 patients in each group) completed the study. Conservative management included lifestyle modifications, Kegel exercises, and medication. Patients were evaluated at baseline and at 1, 3, 6, and 12 months after ileostomy closure by using anal manometry, modified Wexner Incontinence Scores (WISs), and fecal incontinence quality of life (FI-QoL) scores. RESULTS: Before the ileostomy closure, the groups did not differ in baseline clinical characteristics or resting manometric parameters. After 12 months of follow-up, the biofeedback group demonstrated a statistically significant improvement in the mean maximum squeezing pressure (from 146.3 to 178.9, P = 0.002). However, no beneficial effect on the WIS was noted for biofeedback compared to conservative management alone. Overall, the FI-QoL scores were increased significantly in both groups after ileostomy closure (P = 0.006), but did not differ significantly between the two groups. CONCLUSION: Although the biofeedback therapy group demonstrated a statistically significant improvement in the maximum squeezing pressure, significant improvements in the WISs and the FI-QoL scores over time were noted in both groups. The study was terminated early because no therapeutic benefit of biofeedback had been demonstrated.
Biofeedback, Psychology* ; Exercise ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Ileostomy* ; Life Style ; Manometry ; Pilot Projects* ; Prospective Studies ; Quality of Life ; Rectal Neoplasms*

PURPOSE: To investigate the relationship of transrectal ultrasound (TRUS) findings with the pathological characteristics of prostate cancer (PCa). MATERIALS AND METHODS: The study was conducted retrospectively by analyzing the data for 970 patients who underwent prostate biopsies. Gleason scores and other clinical variables were compared between PCa patients with and without hypoechoic lesions on TRUS. RESULTS: Of the 970 patients, PCa was diagnosed in 291 (30%). Of these, high-grade PCa (Gleason score of 7 or more) was diagnosed in 190 (65%). The cancer detection rate was higher in patients with hypoechoic lesions (43.9%) than in those without hypoechoic lesions (21.4%, p<0.001). High-grade PCa was detected more often in patients with hypoechoic lesions than in those without hypoechoic lesions (p<0.001). Independent predictors for high-grade PCa by logistic regression analysis included hypoechoic lesions on TRUS and abnormal digital rectal examination findings. CONCLUSIONS: Patients with PCa who had hypoechoic lesions on TRUS had more aggressive pathological disease than did those without lesions. Therefore, hypoechoic lesions on TRUS could be a marker for clinically significant PCa.
Biomarkers ; Biopsy ; Digital Rectal Examination ; Humans ; Logistic Models ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostatic Neoplasms ; Retrospective Studies

No abstract available.
Biopsy* ; Kidney Diseases* ; Kidney*

Squamous cell carcinoma of the nail apparatus is a rare phenomenon. Because of its indolent course and similar presentation to other benign conditions, correct diagnosis in the early stages is practically difficult. We here report two cases of periungual squamous cell carcinoma and squamous cell carcinoma in situ (Bowen's disease). These cases emphasize the importance of extra vigilance and high suspicion when facing intractable atypical lesions on the fingers. Repetitive biopsy with exploratory nail plate extraction should be considered to acquire appropriate specimens, which is critical for early and correct diagnosis.
Biopsy ; Bowen's Disease* ; Carcinoma, Squamous Cell* ; Diagnosis ; Fingers ; Nails

OBJECTIVE: An open cell stent system may offer better apposition of cell struts to vessel wall than a closed cell stent system in acute vasculature. The purpose of this study was to evaluate the feasibility of coiling using the jailing technique with the Neuroform EZ stent system. METHODS: The jailing technique using the open-cell stent system of the Neuroform EZ stent was planned in 22 consecutive patients with 22 cerebral aneurysms. We retrospectively evaluated the technical success of the jailing technique and the occurrence of interference between two microcatheters as well as the factors influencing this interference. RESULTS: The jailing technique was successful in 19/22 patients (86.4%), and interference between two microcatheters occurred in 6/21 (28.6%). The jailing technique failed in 3/22 patients, with problems that included failure of the stent delivery system to advance into the positioned microcatheter in one, interference between the microcatheters during the advancement of the stent delivery system in one, and failure of microcatheter insertion into the aneurysm sac in the remaining patient. Interference between the two microcatheters developed during the advance of the stent delivery system into the positioned microcatheter in all cases. One factor that influences interference between two microcatheters more than expected by chance is the carotid siphon angle (p = 0.019). CONCLUSION: The acuteness of the carotid siphon angle influences the interference between two microcatheters. Therefore, the jailing technique using the Neuroform EZ stent should be performed carefully in cerebral aneurysms with an acute carotid siphon angle because the procedure may possibly fail.
Aneurysm* ; Carotid Artery, Internal* ; Humans ; Intracranial Aneurysm ; Retrospective Studies ; Stents*