No abstract available.
Bowen's Disease ; Fingers

Symptomatic epidural varix presenting with radiculopathy is extremely rare. The most common misdiagnosis is reported as a sequestrated prolapsed nucleus pulposus in the preoperative evaluation. The method of evaluating enhanced MRI studies improved the efficacy of discovery and treatment of this condition. We experienced 6 cases of epidural varices that were diagnosed with T1 fat suppressed post-gadolinium enhanced MRI studies and we present the operative findings.
Diagnostic Errors ; Magnetic Resonance Imaging* ; Radiculopathy ; Varicose Veins*

PURPOSE: Recent studies have shown the important roles of cyclooxygenase-2 (COX-2) in a variety of cancers derived from epithelial cells, such as human colorectal adenocarcinoma and other tumors, including those of the breast, cervix, and stomach. In this study, we purposed to evaluate the clinical significance of COX-2 expression in prostate cancer. MATERIALS AND METHODS: Tumor specimens from 25 patients, who underwent a transurethral resection (TUR) or radical prostatectomy, were obtained between March 1995 and August 2004 from the Department of Urology, Chungbuk National University Hospital. Benign prostatic hyperplasia (BPH) tissues were also acquired from 27 age-matched control patients. Immunohistochemical staining for COX-2 was performed on paraffin embedded specimens, using the anti-human COX-2 monoclonal antibody. The immunoreactivity of COX-2 was scored from 0 to 3 , according to the intensity of the staining. RESULTS: COX-2 expression was detected in 24 of the 25 tumor samples (96%), but in none of the 27 BPH tissues (p<0.001). There was no significant correlation between the COX-2 expression and Gleason score. CONCLUSIONS: This study shows that COX-2 is expressed in human prostate cancer, as in other cancers, which supports the possibility that COX-2 might play an important role in the development of human prostate cancer. Further studies will be required to clarify the role of COX-2 in the development and progression of prostate cancer.
Adenocarcinoma ; Breast ; Cervix Uteri ; Chungcheongbuk-do ; Cyclooxygenase 2* ; Epithelial Cells ; Female ; Humans* ; Immunohistochemistry ; Neoplasm Grading ; Paraffin ; Prostate* ; Prostatectomy ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; Stomach ; Urology

Tardive dystonia is characterized by sustained, generally slow involuntary twisting movements. It is estimated to occur at a frequency of 1% to 4% among patients who are taking an antipsychotic agent. Unlike the first generation antipsychotics, the second generation antipsychotics are less likely to cause neuroleptic-induced movement disorder. For aripiprazole, only a few cases have been reported for tardive dystonia. We present a young male, who developed a severe tardive dystonia after taking aripiprazole for 5 years. The patient was admitted to for the treatment of both hisdystonic and psychotic symptoms. Olanzapine was administered instead of aripiprazole and while his psychotic symptoms improved, the dystonic symptoms were continued. Therefore, olanzapine was switched to clozapine while augmenting with benzodiazepine, anti-cholinergic, and ginko biloba to control his tardive dystonia. After 2 weeks of treatment, the dystonic movement decreased remarkably.
Antipsychotic Agents ; Aripiprazole* ; Benzodiazepines ; Clozapine ; Ginkgo biloba ; Humans ; Male ; Movement Disorders* ; Psychotic Disorders

Cardiovascular disease (CVD) is the leading cause of death worldwide and small dense low-density lipoprotein (sdLDL) has been suggested to be a potential risk factor for cardiovascular disease (CVD). We reviewed published studies on formation and measurement of sdLDL, as well as relationship between LDL subfractions and CVD. sdLDL particle formation is highly dependent on triglycerides (TG) levels, and the physicochemical properties of sdLDL particles provide a potential for increased atherogenicity. Various conditions (e.g. hypertriglyceridemia, diabetes mellitus, metabolic syndrome, chronic renal failure and HIV infections) with increased cardiometabolic risk are associated with increased sdLDLs. Most studies suggest that sdLDL particles are associated with increased prevalence of clinical and subclinical CVDs, as well as non-coronary forms of atherosclerosis. Moreover, LDL size seems to be an important determinant of the progression of CVD. Therapeutic modulation (mostly fibrates, but also some statins, as well as niacin and thiazolidinediones) of small LDL size, number and distribution may decrease CVD risk. However, no definitive causal relationship is yet established, probably due to the close association between sdLDL and triglycerides and other risk factors.
Atherosclerosis ; Cardiovascular Diseases ; Cause of Death ; Diabetes Mellitus ; Fibric Acids ; HIV ; Hypertriglyceridemia ; Kidney Failure, Chronic ; Lipoproteins ; Niacin ; Prevalence ; Risk Factors ; Triglycerides

OBJECTIVE: To investigate the effects of glenohumeral internal rotation deficit (GIRD) on the isokinetic strength, body pain, and the quality of life in male high school baseball players of Korea. METHODS: Fifty-six male high school baseball players were divided into either group A (GIRD> or =20degrees, n=12) or group B (GIRD<20degrees, n=44). The range of motion in the shoulder and the isokinetic strength were measured. Questionnaires were administered regarding the body pain location by using the visual analogue scale, and the quality of life was measured by using the SF-36 Form. RESULTS: All subjects had increased external rotation range of motion and decreased internal rotation in the throwing shoulder. The incidence of GIRD (> or =20degrees) was 21.43% in the present study. In the isokinetic strength test, a significantly weaker muscular state at an angular velocity of 180degrees/s was observed in group A, compared to group B. For the comparison of the pain, the frequency of shoulder pain was higher (33.93%) than other body pain, among the study subjects. CONCLUSION: GIRD is one of the main risk factors of glenohumeral joint damage, and it is correlated with reduced isokinetic strength and quality of life. High school baseball players will need appropriate shoulder rehabilitation programs for the improvement in their quality of life and performance.
Baseball* ; Humans ; Incidence ; Korea ; Male ; Quality of Life* ; Range of Motion, Articular ; Rehabilitation ; Risk Factors ; Shoulder ; Shoulder Joint ; Shoulder Pain ; Surveys and Questionnaires

Purpose: Single-incision cholecystectomy is a surgical method that offers comparable results to conventional laparoscopic cholecystectomy. However, a high risk of postoperative incisional hernia is an issue in single-incision cholecystectomy. This study evaluated the risk factors and incidences of incisional hernia after single-incision cholecystectomy and the advantage issue of using barbed suture material during wound closures. Methods: A total of 1,111 patients underwent laparoscopic or robotic single-incision cholecystectomy between March 2014 and February 2020 at our institution at CHA Bundang Medical Center. During this period, there were 693 patients who underwent wound closure with monofilament suture material (Monosyn 2-0; B. Braun) and the other 418 patients used barbed suture material (Stratafix 2-0; Ethicon). Results: The two patient groups were comparable in age, body mass index, and diagnosis. The total incidence of incisional hernia after single-incision cholecystectomy was 0.5% (five cases). All patients who developed incisional hernia were in the monofilament suture material group (0.7% vs. 0%, p = 0.021). The inf luence of predictive and possible risk factors on incisional hernia rate was analyzed. Among these factors, only old age was an independent predictive risk factor of incisional hernia. Conclusion Our study showed a low incidence of incisional hernia, all of which occurred in the monofilament suture material group. If technically appropriate, single-incision cholecystectomy does not appear to present a high incidence of hernia. Barbed suture material can be safely applied in wound closure showing comparable incisional hernia incidence to monofilament suture material.

Melatonin and cortisol are clinically important for diagnosing sleep and mood disorders.We developed and validated a liquid chromatography-tandem mass spectrometry (LC-MS/ MS) assay for simultaneous measurement of salivary melatonin and cortisol concentrations according to the Clinical and Laboratory Standards Institute guidelines. Additionally, we compared the LC-MS/MS assay with immunoassays, ELISA (Direct Salivary Melatonin Elisa EK-DSM, Bühlmann Laboratories AG, Schönenbuch, Switzerland) and electrochemiluminescence immunoassay (Cortisol II, Roche, Mannheim, Germany), using 121 saliva samples. The LC-MS/MS assay exhibited good performance in terms of linearity, precision, accuracy, limit of detection, lower limit of quantification, extraction recovery, carry-over, and matrix effect. The LC-MS/MS assay and immunoassays showed strong correlation (Pearson’s r = 0.910 for melatonin, r = 0.955 for cortisol), but demonstrated a significant mean bias of 23.2% (range 54.0–143.7%) for melatonin and 48.9% (range 59.7–184.7%) for cortisol. Our LC-MS/MS assay provided more sensitive and reliable salivary melatonin and cortisol quantification results compared with immunoassays.

Objective: To compare and analyze the differences in the sociodemographic and clinical characteristics of suicide attempters who visited an emergency department (ED) before and during the coronavirus disease (COVID-19) pandemic. Methods: This single center, retrospective study was conducted by reviewing the medical records of patients in the “self-injury/suicide” category of the National Emergency Department Information System who visited an ED between January 2019 and December 2020. We obtained information on baseline characteristics, suicide attempt, and disposition. Data were analyzed using the chi-squared test. Results: A total of 456 patients were included. The number of patients visiting the ED for suicide attempts increased by 18.2% (from 209 to 247 cases) during the COVID-19 pandemic, and the ratio of suicide attempters to the total number of ED visits increased by 48.8% (from 0.43% to 0.64%, P<0.001). There were significant differences in methods of suicide attempt, endotracheal intubation, ED disposition, and the presence of mental illness. Drug overdose (42.1% vs. 53.4%) and gas inhalation (5.7% vs. 8.5%) increased, and hanging decreased (6.0% vs. 2.0%) during the pandemic. Endotracheal intubation (13.9% vs. 5.7%) and intensive care unit admission (29.7% vs. 14.6%) decreased. More patients with the history of mental illness visited during the pandemic (54.0% vs. 70.1%). Conclusion Since the COVID-19 pandemic began, suicide attempts have increased in this single ED although the lethality of those attempts is low.

Purpose: Single-incision cholecystectomy is a surgical method that offers comparable results to conventional laparoscopic cholecystectomy. However, a high risk of postoperative incisional hernia is an issue in single-incision cholecystectomy. This study evaluated the risk factors and incidences of incisional hernia after single-incision cholecystectomy and the advantage issue of using barbed suture material during wound closures. Methods: A total of 1,111 patients underwent laparoscopic or robotic single-incision cholecystectomy between March 2014 and February 2020 at our institution at CHA Bundang Medical Center. During this period, there were 693 patients who underwent wound closure with monofilament suture material (Monosyn 2-0; B. Braun) and the other 418 patients used barbed suture material (Stratafix 2-0; Ethicon). Results: The two patient groups were comparable in age, body mass index, and diagnosis. The total incidence of incisional hernia after single-incision cholecystectomy was 0.5% (five cases). All patients who developed incisional hernia were in the monofilament suture material group (0.7% vs. 0%, p = 0.021). The inf luence of predictive and possible risk factors on incisional hernia rate was analyzed. Among these factors, only old age was an independent predictive risk factor of incisional hernia. Conclusion Our study showed a low incidence of incisional hernia, all of which occurred in the monofilament suture material group. If technically appropriate, single-incision cholecystectomy does not appear to present a high incidence of hernia. Barbed suture material can be safely applied in wound closure showing comparable incisional hernia incidence to monofilament suture material.