“Poland’s syndrome” is a rare congenital disease whereby defects can accompany the chest, nipple, chest wall, and extremities on one side of the body. We diagnosed a 19-year-old male patient who presented to another hospital for a routine physical exam before enlisting in the military and was suspected of having a left brachial plexus injury. His chief complaint was the flatness of the left anterior chest wall without any significant functional inconvenience. Aplasia of the pectoralis minor and costosternal portion of the pectoralis major was observed through physical examination and computed tomography (CT). The patient was diagnosed with left-sided Poland’s syndrome without any limb abnormalities. Poland Syndrome should be highly considered in patients presenting with bilateral chest wall imbalance in the absence of with a recent traumatic history.

Purpose: This study evaluated the usefulness of a silicone ring tourniquet by analyzing the changes in the perioperative hemoglobin (Hb) levels or amount of perioperative bleeding compared to those of a pneumatic tourniquet or no usage during minimally invasive plate fixation for distal femoral fractures. Materials and Methods: From January 2017 to December 2019, 30 patients who underwent minimally invasive plate fixation using a locking compression plate for distal femoral fractures were evaluated and classified as a silicone ring tourniquet (Group 1), a pneumatic tourniquet (Group 2), and no usage (Group 3). The variables for analysis were age, sex, preoperative Hb (preHb), postoperative 72-hour Hb (postHb), differences between preHb and postHb (preHb-postHb), amount of intraoperative and overall transfusion, estimated unit of transfusion corrected by preHb-postHb and total transfusion (Hb-lost), amount of intraoperative and postoperative and total bleeding. One-way ANOVA was used to identify the differences between the groups. Results: The age, sex, operation time, preHb, preHb-postHb, amount of intraoperative and overall transfusion and Hb-lost were similar in the two groups. The amount of intraoperative bleeding was significantly lower in Group 1 than Group 3 (p=0.004), but there was no difference in the amount of postoperative and total bleeding between the two groups. Conclusion The use of a silicone ring tourniquet in the minimally invasive plate fixation for distal femoral fractures decreased the amount of intraoperative bleeding compared to no use of a tourniquet.

Adenomyoma of the gastrointestinal tract has been considered to be a form of pancreatic heterotopia. Heterotopic pancreatic tissue in the gastrointestinal tract is a relatively not uncommon abnormality, but adenomyoma is a rarely reported tumor and its ineidence is difficult to determine. Adenomyoma is similar to aberrant pancreas in both appearance and location, and cannot be differentiated endoscopically or radiographically. Histologically, adenomyoma is primarily composed of smooth muscle and undifferentiated duct like structures. It is usually of no clinical importance and incidentally detected, but according to its location and size of the mass, it may become a serious clinical problem. Its real importance lies in the recognition of its existence, to facilitate a timely diagnosis, We present a case of adenomyoma of the duodenum with a brief literature review.
Adenomyoma* ; Diagnosis ; Duodenum* ; Esophagus* ; Gastrointestinal Tract ; Intestines* ; Muscle, Smooth ; Pancreas ; Stomach*

BACKGROUND AND OBJECTIVES: Stem cell-based therapy is a potential new approach in the treatment of stroke. However, the efficacy and safety of these treatments are not yet fully understood. Therefore, we performed a meta-analysis of available single-arm studies using stem cell-based therapy in patients with stroke. METHODS: We searched MEDLINE, EMBASE, and the Cochrane database for studies of stem cell therapy in patients with stroke from its inception through July 2014. The articles included in the search were restricted to the English language, studies with at least 5 patients, and those using cell-based therapies for treating stroke. RESULTS: Fourteen studies included in the meta-analysis. The pooled mean difference in National Institutes of Health Stroke Scale (NIHSS) scores from baseline to follow-up points was 5.7 points (95%CI: -8.2 to -3.2, I2=91.5%) decreased. Also the pooled mean difference in modified Bathel index (BI) score was increased by 31.5 points (95%CI: 35.6~14.9, I2=52.7%) and the pooled incidence rate to achieve on modified Rankin score (mRS)< or =2 was 40% (95% CI: 30%~51%, I2=35.4%) at follow-up points. The pooled incidence rates of death, seizure, and infection were 13% (95%CI, 8~23%), 15% (95%CI, 8~25%), and 15% (95%CI, 8~23%), respectively. CONCLUSIONS: The published data suggest that stem cell-based therapy for patients with stroke can be judged as effective based on single arm clinical studies. However, clinical benefits of stem cell therapy for patients with stroke need further investigation and reevaluation to test the clinical efficacy.
Arm* ; Follow-Up Studies ; Humans ; Incidence ; National Institutes of Health (U.S.) ; Seizures ; Stem Cells* ; Stroke*

OBJECTIVE: To discover the risk factor of postpartum depression and whether this is different from the induced factor of prepartum depression and to clarify what is the recovery factor from prepartum depression. METHODS: In the first test stage, 310 pregnant women were examined and with their postpartum follow-up survey, materials from 85 people in total were retrieved. In order to predict the postpartum depression and find out the recovery factor from prepartum depression, longitudinal study was carried out. For the statistical analysis hierarchical regression analysis and MANOVA were used. RESULTS: Postpartum depression (Beck Depression Inventory; BDI score of 16 or greater) was prevalent amongst 22.4% of pregnant women and prepartum depression was experienced by 10.5% in pregnant women. There were no significant on psychological variable factor of prepartum and postpartum depression. Only preatum depression redicted 33% for postaprtum depression. In the case of depressed during pregnancy but not depressed after pregnancy, recovery factor is related to increase in self-esteem, husband support and improvement in marital satisfaction. Postpartum depression showed twice higher depression ration than prepartum depression and it was serious in terms of degree of depression. CONCLUSION: Postpartum depression is related with lack of husband support that is recovery factor from prepartum depression. Also, unstable attachment is vulnerable to depression but even people with unstable attachment can be recovered from depression with better marriage relationship. Even people without unstable attachment if husband support is reduced then it is suggested that can be subject to vulnerability in depression.
Depression* ; Depression, Postpartum* ; Female ; Fibrinogen ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Marriage ; Postpartum Period* ; Pregnancy ; Pregnant Women ; Risk Factors ; Spouses

PURPOSE: The use of anticonvulsants can cause side effects such as reduction of bone mineral density, requiring attention in growing children. The aim of our study is to investigate the effects of different anticonvulsants on bone mineral density in epileptic patients treated with monotherapy. METHODS: We retrospectively reviewed medical records of 60 subjects who visited the Pediatric Epilepsy Clinic of Bucheon St. Mary's Hospital from January 2013 to December 2017. Bone mineral density was measured with dual photon absorptiometry every 6 months. RESULTS: The number of patients treated with oxcarbazepine, valproate and levetiracetam was 31, 16 and 13, respectively. Reduction of bone mineral density was seen in 8 out of 31 patients (25.8%, P=0.10) treated with oxcarbazepine, 9 out of 16 patients treated with valproate (56.3%, P=0.04) and 4 out of 13 patients treated with levetiracetam (30.8%, P=0.50). CONCLUSION: There was a significant reduction of bone mineral density in patients treated with valproate compared to the other anticonvulsants in our study. We believe attention to bone mineral density is required in children treated with anticonvulsants.
Absorptiometry, Photon ; Anticonvulsants ; Bone Density* ; Child* ; Epilepsy ; Gyeonggi-do ; Humans ; Medical Records ; Retrospective Studies ; Valproic Acid

Totally implanted central venous access devices for chemotherapy (chemoport) are being used increasingly in lung cancer patients. Vascular catheters are associated with various complications including infection, thrombosis as well as spontaneous fractures and embolization of the catheter, which is known as 'pinch-off syndrome'. 'Pinch-off syndrome' refers to the compression of a subclavian central venous catheter between the clavicle and first rib resulting in an intermittent or permanent obstruction, which can lead to tears, transection, or embolization. We report two cases of fractured and embolized implanted subclavian venous catheters in which the fragments were removed percutaneously. A 62-year-old man presented with back pain with a duration of a few weeks. The chest radiograph revealed complete transsection and embolization of the catheter into the right atrium. In addition, a 47-year-old woman with a chemoport had a grade 3 pinch-off sign in a chest radiograph demonstrating complete transsection and embolization of the catheter into the pulmonary artery. Both cases were managed by retrieving the embolized distal fragment percutaneously and removing the proximal section of the catheter.
Back Pain ; Catheters ; Central Venous Catheters ; Clavicle ; Drug Therapy ; Female ; Fractures, Spontaneous ; Heart Atria ; Humans ; Lung Neoplasms* ; Lung* ; Middle Aged ; Pulmonary Artery ; Radiography, Thoracic ; Ribs ; Thrombosis ; Vascular Access Devices

OBJECTIVE: We were trying to identify the expression of Wnt 1 and beta-catenin in normal ovarian epithelium and epithelial ovarian tumor. METHODS: We used archival formalin-fixed and paraffin-embedded tissues from Comprehensive Gynecologic Cancer Center and the Department of Pathology at Bundang CHA Hospital from 2000 to 2005. Immunohistochemical staining for Wnt 1 and beta-catenin was performed on the ovarian epithelial tissues. Statistical analyses were performed with SPSS 10.1 for Windows and significance was defined as P<0.05. RESULTS: Of 114 cases, the cases were composed of 54 carcinomas, 40 borderline tumors, 12 benign tumors and 8 normal control ovarian tissues. Abnormal nucleocytoplasmic expression of beta-catenin was found in 4 endometrioid carcinomas. The nuclear expression of beta-catenin was found especially in the components of the endometrioid carcinoma (28.6%, P<0.05). Wnt 1 was overexpressed in all 9 clear cell carcinomas, but not frequent in the other types of malignant tumors (P<0.05). We found a statistically significant correlation between beta-catenin nuclear localization and endometrioid carcinomas. And we found a significant correlation between Wnt 1 expression and clear cell carcinomas. CONCLUSION: It does not seem that Wnt 1 over expression directly provoke the nuclear localization of beta-catenin. But, deregulation of beta-catenin and Wnt 1 may play a role in the pathogenesis of ovarian epithelial carcinogenesis of endometriod carcinoma and clear cell carcinoma. Evaluating this avenue of regulation of beta-catenin and Wnt protein in ovarian epithelial carcinoma may provide a new direction for early diagnosis and treatment in ovarian epithelial carcinoma and provide opportunities for making a certain biomarkers.
beta Catenin ; Carcinoma, Endometrioid ; Early Diagnosis ; Epithelium ; Neoplasms, Glandular and Epithelial ; Ovarian Neoplasms

Duodenal diverticula are first reported by Chomel in 1710. Duodenal diverticula are relatively common in adults with a prevalence of 23% in ERCP. The most duodenal diverticulum is asymptomatic. Complications such as obstruction, cholangitis, biliary stones, ulceration, perforation and hemorrhage can occur in approximately 10%. However, relatively few cases of bleeding from a duodenal diverticulum have been reported. The cause of bleeding from a duodenal diverticulum is uncertain and various suspected etiologies were suggested, such as ectopic gastric mucosa, stasis-induced ulceration, erosion into major vessels, aortoenteric fistulas, intradiverticular polyp, aspirin-induced erosion. We report a case of a bleeding duodenal diverticulum by a Dieulafoy-like lesion and suggest this lesion as one of possible causes of bleeding in duodenal diverticulum.
Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Diverticulum* ; Fistula ; Gastric Mucosa ; Hemorrhage* ; Humans ; Polyps ; Prevalence ; Ulcer

Acute colonic pseudo-obstruction (Ogilvie syndrome) associated with herpes zoster is extremely rare, and few cases have been reported. An 81-year-old woman diagnosed with herpes zoster was referred for accompanying colonic ileus. The diameter of the cecum was 7 cm and a computed tomographic scan showed no definite obstructive cause. Because the patient showed minimal improvement with conservative treatment, endoscopic colonic decompression was performed successfully. Previous studies revealed that the treatment of Ogilvie syndrome associated with herpes zoster does not differ from that of other conditions, and the role of the varicella-zoster virus in this syndrome is unclear. Here, we present the first case of Ogilvie syndrome associated with herpes zoster in Korea, which was improved by endoscopic colonic decompression.
Aged, 80 and over ; Cecum ; Colon ; Colonic Pseudo-Obstruction ; Decompression ; Female ; Herpes Zoster ; Herpesvirus 3, Human ; Humans ; Ileus ; Korea