No abstract available.
Pregnancy* ; Rheology* ; Uterine Artery*

No abstract available.
Pregnancy* ; Rheology* ; Umbilical Arteries*

Recurrent spontaneous hemarthrosis is a relatively rare complication of total knee arthroplasty. This paper reports a case of a patient treated with arterial embolization for recurrent spontaneous hemarthrosis even after undergoing arthroscopic surgery. The patient had several relapses after total knee arthroplasty.

Despite the modern advance in effective chemotherapy, gastrointestinal tuberculosis is considered to be relatively frequent in developing countries. The ileocecal region is the most common site of intestinal tuberculosis and duodenal involvement is rare. The isolated duodenal tuberculosis are reported 9 cases in Korea. The symptoms and signs of gastrointestinal tuberculosis are nonspecific and vague. In the absence of pulmonary tuberculosis, the diagnosis may be difficult. Pain and vomiting are common symptoms of duodenal tuberculosis. Patients may present with upper gastrointestinal bleeding. Therefore, tuberculosis should be considered in the differential diagnosis of gastrointestinal bleeding. We herein report a case of duodenal tuberculosis presenting as hematemesis and necessitating hospitalization. After anti-tuberculosis therapy, we have confirmed the healing of the lesion by the follow-up endoscopy, and review the current literature.
Developing Countries ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Endoscopy ; Follow-Up Studies ; Hematemesis* ; Hemorrhage ; Hospitalization ; Humans ; Korea ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Pulmonary ; Vomiting

BACKGROUND: Arthroscopic shoulder surgery can result in severe postoperative pain. A variety of methods have been used to control pain in postoperative period and the results are variable. The purpose of this study was to compare the relative analgesic efficacies of the postoperative intraarticular infusion of ropivacaine, ropivacaine/fentanyl, and ropivacaine/fentanyl/ketorolac after arthroscopic shoulder surgery. METHODS: Thirty patients undergoing arthroscopic shoulder surgery under general anesthesia were randomly assigned to three groups. At the end of surgery, 0.5% ropivacaine 20 ml was infused into the articular space and a continuous infusion catheter was inserted into intraarticular operated site. After surgery, continuous infusion of 0.5% ropivacaine 100 ml (Group 1, n = 10), 0.5% ropivacaine 100 ml including fentanyl 10 microg/kg (Group 2, n = 10), or 0.5% ropivacaine 100 ml including fentanyl 10 microgram/kg and ketorolac 150 mg (Group 3, n = 10) was started through catheter at rate of 2 ml/hr with bolus dose of 0.5 ml with a lock out time of 15 minutes for 2 days. The level of pain was assessed using a visual analogue scale (VAS) postoperative 2, 6, 12, 24 and 48 hours and the amounts of supplemental analgesics were recorded. RESULTS: The VAS was significantly lower after 2, 6, 12 hours in Group 2 than in Group 1. In Group 3, the VAS was significantly lower all hours than in the other two groups. CONCLUSIONS: The combination of fentanyl and ketorolac with ropivacaine did provide better postoperative analgesia than the other groups after arthroscopic shoulder surgery.
Amides ; Analgesia ; Analgesics ; Anesthesia, General ; Catheters ; Fentanyl ; Humans ; Ketorolac ; Pain, Postoperative ; Postoperative Period ; Shoulder

PURPOSE: The purpose of this study was to evaluate the factors that are associated with the accuracy of magnetic resonance (MR) imaging for predicting myometrial invasion and lymph node metastasis in women with endometrial carcinoma. MATERIALS AND METHODS: We retrospectively reviewed the medical records and preoperative MR imaging reports of 128 women who had pathologically proven endometrial carcinoma. We compared the MR imaging and the histopathology findings. RESULTS: The sensitivity, specificity and accuracy for identifing any myometrial invasion (superficial or deep) were 0.81, 0.61 and 0.74, respectively; these values for deep myometrial invasion were 0.60, 0.94 and 0.86, respectively. The sensitivity, specificity and accuracy of MR imaging for detecting lymph node metastasis were 50.0%, 96.6% and 93.0%, respectively. The patients who were older, had more deliveries and a larger tumor size more frequently had incorrect prediction of deep myometrial invasion (p=0.034, p=0.044, p=0.061, respectively). A higher tumor grade, a histology other than the endometrioid type, myometrial invasion on MR findings and a larger tumor size were associated with a more frequent false-negative prediction of lymph node metastasis (p=0.018, p=0.017, p=0.002, p=0.047, respectively). A larger tumor size was also associated with more frequent false-positive results (p=0.009). CONCLUSIONS: There are several factors that make accurate assessment of myometrial invasion or lymph node metastasis difficult with using MRI; therefore, the patients with these factors should have their MR findings cautiously interpreted.
Endometrial Neoplasms* ; Female ; Humans ; Lymph Nodes* ; Magnetic Resonance Imaging* ; Medical Records ; Neoplasm Metastasis* ; Retrospective Studies ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: This study was done to evaluate the safety of Gore-Tex as a nasal implant. Materials and METHOD: A retrospective multicenter study was carried out on 15 surgeons from 11 general hospitals and 4 private practice clinics regarding the safety of the Gore-Tex as a nasal implant. The study involved 853 patients, of whom 656 received primary surgery and 197 revision surgery. Gore-Tex was mainly used as a dorsal implant in a form of sheet or as a reinforced nasal implant. RESULTS: The overall complication rate associated with Gore-Tex was 2.5% (21 cases). Infection was the most common complication (18 cases ; 2.1%) followed by 2 cases of seroma and 1 case of persistent nasal swelling. In 19 out of 21 complication cases, the graft needed removal to control the infection or seroma (91% removal rate). Nine cases of infection developed in both primary cases (1.37%) and in revision cases (4.57%), which suggests a higher association rate between infection and revision cases (p=0.0062). Infection developed within 1 month in 5 cases while 9 cases developed infection after 6 months of operation. Other complications such as aesthetic problems (malpositioning of the implant or dorsal irregularities) were found in 15 cases (1.8%) and hematoma in 1 case. CONCLUSION: The infection rate of Gore-Tex used in rhinoplasty was about 2% and it rose significantly in the revision cases. If infected, almost all of the implanted Gore-Tex needs removal; therefore, we suggest judicious use of Gore-Tex in rhinoplasty.
Hematoma ; Hospitals, General ; Humans ; Polytetrafluoroethylene* ; Private Practice ; Retrospective Studies ; Rhinoplasty* ; Seroma ; Transplants

Nephronophthisis-related ciliopathy (NPHP-RC) is a common genetic cause of end-stage renal failure during childhood and adolescence and exhibits an autosomal recessive pattern of inheritance. Genetic diagnosis is quite limited owing to genetic heterogeneity in NPHP-RC. We designed a novel approach involving the step-wise screening of Sanger sequencing and targeted exome sequencing for the genetic diagnosis of 55 patients with NPHP-RC. First, five NPHP-RC genes were analyzed by Sanger sequencing in phenotypically classified patients. Known pathogenic mutations were identified in 12 patients (21.8%); homozygous deletions of NPHP1 in 4 juvenile nephronophthisis patients, IQCB1/NPHP5 mutations in 3 Senior–Løken syndrome patients, a CEP290/NPHP6 mutation in 1 Joubert syndrome patient, and TMEM67/MKS3 mutations in 4 Joubert syndrome patients with liver involvement. In the remaining undiagnosed patients, we applied targeted exome sequencing of 34 ciliopathy-related genes to detect known pathogenic mutations in 7 (16.3%) of 43 patients. Another 18 likely damaging heterozygous variants were identified in 13 NPHP-RC genes in 18 patients. In this study, we report a variety of pathogenic and candidate mutations identified in 55 patients with NPHP-RC in Korea using a step-wise application of two genetic tests. These results support the clinical utility of targeted exome sequencing to resolve the issue of allelic and genetic heterogeneity in NPHP-RC.
Adolescent ; Diagnosis* ; Exome* ; Genetic Heterogeneity* ; Humans ; Kidney Failure, Chronic ; Korea ; Liver ; Mass Screening ; Wills

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by fat accumulation in the liver. MASLD encompasses both steatosis and MASH. Since MASH can lead to cirrhosis and liver cancer, steatosis and MASH must be distinguished during patient treatment. Here, we investigate the genomes, epigenomes, and transcriptomes of MASLD patients to identify signature gene set for more accurate tracking of MASLD progression. Methods: Biopsy-tissue and blood samples from patients with 134 MASLD, comprising 60 steatosis and 74 MASH patients were performed omics analysis. SVM learning algorithm were used to calculate most predictive features. Linear regression was applied to find signature gene set that distinguish the stage of MASLD and to validate their application into independent cohort of MASLD. Results: After performing WGS, WES, WGBS, and total RNA-seq on 134 biopsy samples from confirmed MASLD patients, we provided 1,955 MASLD-associated features, out of 3,176 somatic variant callings, 58 DMRs, and 1,393 DEGs that track MASLD progression. Then, we used a SVM learning algorithm to analyze the data and select the most predictive features. Using linear regression, we identified a signature gene set capable of differentiating the various stages of MASLD and verified it in different independent cohorts of MASLD and a liver cancer cohort. Conclusions We identified a signature gene set (i.e., CAPG, HYAL3, WIPI1, TREM2, SPP1, and RNASE6) with strong potential as a panel of diagnostic genes of MASLD-associated disease.