No abstract available.
Ultrasonography*

Mycoplasma pneumoniae is the only known human pathogen among the Mycoplasma species isolated from the human respiratory tract. This pathogen causes respiratory infections most commonly in school-aged children and young adults. It may causes a variety of pulmonary manifestations and a few complication. empyema(pyothorax) as a complication of mycoplasma infection in children has been rarely reported. We report these two cases of empyema(pyothorax) preceded by Mycoplasma pneumoniae pneumonia in 5-year-old boy and 6-year-old girl. They were successfully managed by administration of antibiotics as well as surgical drainage.
Anti-Bacterial Agents ; Child* ; Child, Preschool ; Drainage ; Empyema ; Empyema, Pleural ; Female ; Humans ; Male ; Mycoplasma Infections ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory System ; Respiratory Tract Infections ; Young Adult

Stomach cancer has a high annual mortality rate worldwide necessitating early detection and accurate treatment. Even experienced specialists can make erroneous judgments based on several factors. Artificial intelligence (AI) technologies are being developed rapidly to assist in this field. Here, we aimed to determine how AI technology is used in gastric cancer diagnosis and analyze how it helps patients and surgeons. Early detection and correct treatment of early gastric cancer (EGC) can greatly increase survival rates. To determine this, it is important to accurately determine the diagnosis and depth of the lesion and the presence or absence of metastasis to the lymph nodes, and suggest an appropriate treatment method. The deep learning algorithm, which has learned gastric lesion endoscopyimages, morphological characteristics, and patient clinical information, detects gastric lesions with high accuracy, sensitivity, and specificity, and predicts morphological characteristics. Through this, AI assists the judgment of specialists to help select the correct treatment method among endoscopic procedures and radical resections and helps to predict the resection margins of lesions.Additionally, AI technology has increased the diagnostic rate of both relatively inexperienced and skilled endoscopic diagnosticians. However, there were limitations in the data used for learning, such as the amount of quantitatively insufficient data, retrospective study design, single-center design, and cases of non-various lesions. Nevertheless, this assisted endoscopic diagnosis technology that incorporates deep learning technology is sufficiently practical and future-oriented and can play an important role in suggesting accurate treatment plans to surgeons for resection of lesions in the treatment of EGC.

The role of Helicobacter pylori (H. pylori) eradication in patients undergoing gastrectomy for gastric cancer is unclear. Although European and Asian guidelines strongly recommend H. pylori eradication in patients who undergo endoscopic resection for early gastric cancer, these guidelines do not specify the tests useful for diagnosing H. pylori infection, the optimal timing and appropriate eradication regimens, and follow-up strategies in patients undergoing gastrectomy for gastric cancer. This review aims to update the guidelines for the diagnosis and management of H. pylori infection in patients undergoing gastrectomy for gastric cancer. We have focused on the following issues: 1) diagnostic tests for H. pylori infection in the remnant stomach, 2) optimal timing and regimen for H. pylori eradication, and 3) role of H. pylori eradication in reducing the risk of metachronous gastric cancer in the remnant stomach.

The authors developed a computerized documentation system to record and store all the data pertaining to an endoscopic examination of the upper digestive tract. The system was programmed using the database management system Clipper Version 5.01. It is easy and convenient to use due to advanced deaign of input screen using menu bars and pull down menu and windows. The system was designed to permit the easy storage and retrieval of data by personnel who lack computer skills and who may only have limited typing ability. Today this system has been in daily use for 1 year at the endoscopic units of 8 different branch hospitals of Catholic university,medical college. Overall the experience in these centers has been positive, with excelient or good participation. Characteristics of this system are a menu-driven system, data input by predefined list, instantaneous report generation, on line access to previous examination, late entry of yathologic regerts. and record retrieval, listing according to different criteria. For the description of endoscopic findings and diagnosis, structured input is maintained. All of the findings are chosen from predefined list using pop-up screen and also free text typing is allowed. Therefore time effort was not increased compared to conventional documentation. Structured input and the resulting categorical data affer several advantages.
Database Management Systems ; Diagnosis ; Endoscopy ; Endoscopy, Gastrointestinal* ; Gastrointestinal Tract ; Hospitals, Satellite ; Information Systems

PURPOSE: P53 and cyclin D1 have been evaluated as a prognostic marker in papillary thyroid carcinoma (PTC). However, the relationship between p53/cyclin D1 and PTC prognosis has not yet been confirmed. Therefore, we investigated the relationship between p53/cyclin D1 and PTC prognostic factors. METHODS: 919 patients with PTC were enrolled. Immunohistochemistry slides were reviewed for p53 and cyclin D1 immunoreactivity. Patients were classified into two groups according to the p53 and cyclin D1 grade: negative for < or =5% and positive for >5%. Medical records were reviewed to evaluate the prognostic factors, lymph node metastatic ratio (LNMR), and MACIS score. We analyzed patients based on p53/cyclin D1(-/-), p53/cyclin D1(-/+), p53/cyclin D1(+/-), p53/cyclin D1(+/+) separately for evaluation of independent effect of p53 and cyclin D1. RESULTS: Mean age of the patients was 49.73 years (range 15~87), and tumor size was 1.19 cm (range 0.1~5.0). P53 was positive in 809 (88.0%) and cyclin D1 was positive in 748 (81.4%). Positivity of p53 and cyclin D1 were correlated (r=0.448). There was no statistical significance in MACIS score. Positivity of p53 and cyclin D1 were related with larger tumor size, older age, early T stage, more tumor capsulation, and female. LNMR was higher in p53/cyclin D1(+/-) than p53/cyclin D1(-/-) (P=0.036), p53/cyclin D1(-/+) than p53/cyclin D1(-/-) (P=0.034), and p53/cyclin D1(+/+) than p53/cyclin D1(-/-) (P=0.007). CONCLUSION: There was no consistent relationship between p53/cyclin D1 and worse prognostic factors of PTC. However, LNMR was higher in p53(+) and cyclin D1(+) cases independently, much more in p53/cyclin D1(+/+) than p53/cyclin D1(-/-).
Cyclin D1* ; Cyclins ; Female ; Humans ; Immunohistochemistry ; Lymph Nodes ; Medical Records ; Prognosis ; Thyroid Neoplasms*

On ultrasonography, medullary thyroid carcinoma (MTC) shows hypoechogenicity, an irregular margin, a predominantly solid composition, and microcalcifications, similar to those observed in papillary thyroid carcinoma (PTC). MTC presenting as a cystic lesion is rare, and endoscopic thyroidectomy can be performed for benign thyroid masses and early stage PTC, however it is inappropriate for MTC regardless of cystic change. The authors report a case of cystic MTC found after endoscopic thyroid lobectomy and provide a review of the literature on this topic.
Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Ultrasonography

TNF -related apoptosis inducing ligand (TRAIL) is a member of TNF ligand superfamily. TRAIL transduces death signal through two distinct receptors, TRAILR -1I and TRAILR -2, while the engagement of TRAILR -3 and TRAILR -4 interferes with TRAIL -induced apoptosis. The profile of TRAILR expression has been reported to be a mechanism by which transformed cells undergo apoptosis in response to TRAIL while normal cells do not. Rheumatoid arthritis (RA) is an inflammatory autoimmune disease which is characterized by the hyperplasia of synovial membrane. The dysregulation of apoptosis in synoviocytes has been suggested to contribute to synovial hyperplasia. Synovial fibroblasts obtained from patients with RA have been reported to exhibit several semi - transformed aspects. To investigate whether RA synovial fibroblasts acquire the susceptibility to TRAIL -induced apoptosis, synovial fibroblast lines obtained from 2 RA patients and two osteoarthritis (OA) patients were cultured in the presence of recombinant human TRAIL and followed by MTT assay. TRAIL treatment resulted in a significant decrease in the viability of both lines of RA cells, indicating TRAIL -induced cell death of RA synovial fibroblasts, whereas OA synovial fibroblasts and normal human dermal fibroblasts were either resistant or less sensitive to TRAIL as compared with RA synovial fibroblasts. In RT -PCR analyses, the expression levels of TRAILR 4 in RA synovial fibroblasts were lower than in OA synovial fibroblasts, while other receptors in both cell lines were expressed at comparable levels. Immunohistochemical studies showed that in RA synovial tissues TRAILR -3cells were mainly leukocyte infiltrates, implying that such leukocyte infiltrates play a role in the perpetuation of the disease. Taken together, these results suggest that RA synovial fibroblasts acquire the susceptibility to TRAIL -induced cell death during disease progression and this death signal may be regulated by, at least in part, differential expression of TRAILR -4 molecule.
Apoptosis ; Arthritis, Rheumatoid* ; Autoimmune Diseases ; Cell Death* ; Cell Line ; Disease Progression ; Fibroblasts* ; Humans ; Hyperplasia ; Leukocytes ; Osteoarthritis ; Synovial Membrane

PURPOSE: Neck ultrasonography (NUS) is one of the most commonly used methods for evaluating thyroid nodules and preoperative higher TSH levels are known to be associated with differentiated thyroid cancers. This study was conducted to assess whether serum TSH levels and neck ultrasonography are of value in predicting malignancy in patients with atypia of undetermined significance/follicular lesions of undetermined significance (AUS). METHODS: A total of 62 patients (7 men, 55 women; mean age 48.4±11.9 years) who had indeterminate cytologic results indicating AUS underwent thyroidectomy. Preoperative clinical data including serum TSH and the findings of NUS were analyzed retrospectively between malignant and non-malignant groups. RESULTS: The final pathologic results of malignancy were reported in 53 of 62 (85.5%) patients with AUS. There was no significant difference in the mean value of preoperative serum TSH between malignant and non-malignant groups (1.5±1.3 vs. 1.9±1.2, P=NS). In NUS, the patients diagnosed with malignancy in histology showed a higher proportion of calcification, taller-than-wide shape, hypoechoic texture and irregular margin (58.5% vs. 22.2%, P=0.044; 34% vs. 0%, P=0.038; 98.1% vs. 44.4%, P<0.01; 47.2% vs. 0%, P=0.008). CONCLUSION: Serum TSH was not related to malignancy in thyroid nodules showing AUS. However, ultrasonographic features including calcifications, taller-than-wide shape, hypoechoic pattern and irregular margin could be used to predict malignancy. Ultrasonography should be the first useful methods when making decisions regarding management of thyroid nodules showing indeterminate cytologic results as AUS.
Female ; Humans ; Male ; Neck* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography*

BACKGROUND: According to the increasing rate of cesarean section, the efforts of seeking safer and more satisfactory obstetric anesthesia techniques have been continued. Propofol, 2,6 di-isopropyl phenol, is a relatively new intravenous anesthetic agent and has been used for induction and maintenance for total intravenous anesthesia (TIVA). Authors examined the anesthetic technique using following anesthetics combinations; N2O-propofol, fentanyl-propofol, ketamine-propofol and made comparison of these ones for intraoperative hemodynamic stability, maternal and fetal safety. METHODS: Sixty patients (ASA physical status 1 or 2) scheduled for cesarean section were randomly allocated into three groups, group N (propofol-N2O, n=20), group F (propofol-fentanyl, n=20), group K (propofol-ketamine, n=20). We checked the changes of blood pressure and heart rates during operation, anesthetic induction time, neonatal status (Apgar score, umbilical vein blood gas analysis), presence of intraoperative awareness and recovery time. RESULTS: No significant differences in intraoperative hemodynamic changes, induction time and baby status. Total propofol dosages were greater in group N than group K (p<0.05) and maternal recovery time was prolonged in group K than group N or F (p<0.05). CONCLUSIONS: Anesthetic management using propofol-N2O or propofol-fentanyl or propofol-ketamine for cesarean section would provide satisfactory anesthesia without significant adverse effects to both mother and fetus.
Anesthesia* ; Anesthesia, Intravenous* ; Anesthesia, Obstetrical ; Anesthetics ; Blood Pressure ; Cesarean Section* ; Female ; Fetus ; Heart Rate ; Hemodynamics ; Humans ; Intraoperative Awareness ; Mothers ; Phenol ; Pregnancy ; Propofol ; Umbilical Veins