No abstract available.
Bites, Human* ; Ear* ; Humans ; Humans* ; Hyperbaric Oxygenation* ; Transplants*

BACKGROUND: The superior orbital fissure is a small area that connects the middle cranial fossa and the orbit. Many studies have measured the size of the superior orbital fissure. However, there is no standard value for the size of the superior orbital fissure. Therefore, we conducted this study to provide the average size of the superior orbital fissure in Korean adults. METHODS: We measured the widths of the superior orbital fissures of 142 patients using computed tomography scans. Because the width of the superior orbital fissure varies at different locations, we measured the superior orbital fissure width at the level of the optic canal. RESULTS: In the males, the width of the superior orbital fissure on both sides was 3.79±0.93 mm, and these values were 3.79±0.96 mm for the left side and 3.783±0.92 mm for the right side. In the females, the widths of the superior orbital fissures were 3.62±1.35 mm on the left side, 3.69±1.18 mm on the right side, and 3.65±1.26 mm across both sides. CONCLUSION: There were no significant differences between the males and females or between the left and right sides. The present study suggests that we may accept the hypothesis that a congenitally narrow superior orbital fissure may be a risk factor for the superior orbital fissure syndrome. Surgeons should take precaution with patients who have narrow superior orbital fissures during the perioperative period.
Adult* ; Cranial Fossa, Middle ; Cranial Nerves ; Female ; Humans ; Male ; Orbit* ; Perioperative Period ; Risk Factors ; Surgeons ; Tomography, X-Ray Computed

Gastrointestinal (GI) tract metastasis of primary breast cancer is very rare. We present a patient with small bowel obstruction from distant metastasis of primary breast cancer. Each characteristic features of concern of GI tract distant metastasis from many pervious studies has been reported differently. We should remember that GI tract metastasis may coexist when patients with breast cancer have intermittent or recurrent abdominal pain with or without obstructive symptoms.
Abdominal Pain ; Breast Neoplasms ; Breast ; Gastrointestinal Tract ; Humans ; Intestinal Obstruction ; Neoplasm Metastasis ; Neoplasm Recurrence, Local

Leg length discrepancies are a common cause of patient dissatisfaction after total hip arthroplasty (THA). The equalization of limb lengths and restoration of the anatomic geometry of the hip to restore normal gait and function are the primary goals during THA. Patients recognize a leg length discrepancy when one leg is shorter than the other by 6 mm or longer than the other by 10 mm after THA. Outside of this range, several problems would occur. Therefore, we should try to maintain leg length during THA via preoperative and intra-operative planning.
Arthroplasty ; Extremities ; Gait ; Hip ; Humans ; Leg ; Tacrine

PURPOSE: Breast cancer is one of the most common malignancies worldwide and the second most common cancer among Korean women. The prognosis of breast cancer is poor in patients with other primary cancers. However, there have been few clinical studies regarding this issue. Therefore, we analyzed the characteristics and prognosis of patients with breast cancer with multiple primary cancers (MPCs). METHODS: Data from the Korean Breast Cancer Society Registry were analyzed. Data from enrolled patients who underwent surgery for breast cancer were analyzed for differences in prognosis dependent on the presence of MPCs, and which MPC characteristics affected their prognosis. RESULTS: Among the 41,841 patients analyzed, 913 patients were found to have MPCs, accounting for 950 total MPCs. There was a significant difference in survival rates between the breast cancer only group and the MPC group. The 5-year survival rates were 93.6% and 86.7% and the 10-year survival rates were 87.5% and 70.4%, respectively. Among the 913 patients with MPCs, patients with two or more MPCs had significantly worse prognoses than patients with a single MPC. With respect to the time interval between breast cancer and MPC occurrence, patients with a 5-year or greater interval had significantly better prognoses than patients with less than 1 year between occurrences. Among MPCs, thyroid cancer was the most common primary cancer. However, this type was not related to the prognosis of breast cancer. Gynecologic cancer, colorectal cancer, upper gastrointestinal cancer, and lung cancer were related to breast cancer prognosis. CONCLUSION: MPCs were a poor prognostic factor for patients with breast cancer. Two or more MPCs and a shorter time interval between occurrences were worse prognostic factors. Although MPCs were a poor prognostic factor, thyroid cancer did not affect the prognosis of patients with breast cancer.
Breast Neoplasms* ; Breast* ; Colorectal Neoplasms ; Female ; Gastrointestinal Neoplasms ; Humans ; Lung Neoplasms ; Neoplasms, Multiple Primary ; Prognosis* ; Survival Rate ; Thyroid Neoplasms

Objective: To investigate the feasibility of using a deep learning-based analysis of auscultation data to predict significant stenosis of arteriovenous fistulas (AVF) in patients undergoing hemodialysis requiring percutaneous transluminal angioplasty (PTA). Materials and Methods: Forty patients (24 male and 16 female; median age, 62.5 years) with dysfunctional native AVF were prospectively recruited. Digital sounds from the AVF shunt were recorded using a wireless electronic stethoscope before (pre-PTA) and after PTA (post-PTA), and the audio files were subsequently converted to mel spectrograms, which were used to construct various deep convolutional neural network (DCNN) models (DenseNet201, EfficientNetB5, and ResNet50). The performance of these models for diagnosing ≥ 50% AVF stenosis was assessed and compared. The ground truth for the presence of ≥ 50% AVF stenosis was obtained using digital subtraction angiography. Gradient-weighted class activation mapping (Grad-CAM) was used to produce visual explanations for DCNN model decisions. Results: Eighty audio files were obtained from the 40 recruited patients and pooled for the study. Mel spectrograms of “pre-PTA” shunt sounds showed patterns corresponding to abnormal high-pitched bruits with systolic accentuation observed in patients with stenotic AVF. The ResNet50 and EfficientNetB5 models yielded an area under the receiver operating characteristic curve of 0.99 and 0.98, respectively, at optimized epochs for predicting ≥ 50% AVF stenosis. However, GradCAM heatmaps revealed that only ResNet50 highlighted areas relevant to AVF stenosis in the mel spectrogram. Conclusion Mel spectrogram-based DCNN models, particularly ResNet50, successfully predicted the presence of significant AVF stenosis requiring PTA in this feasibility study and may potentially be used in AVF surveillance.

PURPOSE: Patients with aplastic anemia (AA) are now living longer and therefore are at increased risk for the development of osteonecrosis of the hip. However, studies on the results of total hip arthroplasty (THA) are lacking. The purpose of this study is to present the result of THA in patients with AA. MATERIALS AND METHODS: We retrospectively reviewed the data for a group of 29 patients (45 hips) with AA who presented to our institution for THA between May 2008 and May 2012. All hips were replaced because of osteonecrosis of the femoral head. A specific prospective protocol was followed for the perioperative transfusion of platelets and blood. The clinical and radiographic evaluations were done, and the minimum follow-up period was 3 years (mean, 49.2 months; range, 36 to 84 months). RESULTS: Three hips had excessive perioperative bleeding and hematoma formation, and then hematoma evacuations were done; one hip was finally revised because of infection of acetabular component. One patient with poorly controlled AA died due to delayed infection on the hip joint. All hips showed stable fixation, and the mean Harris hip score was improved from 54.2 points (range, 42 to 69 points) preoperatively to 90.8 points (range, 73 to 97 points) at the time of the latest follow-up. CONCLUSION: In the present study, the durability of implant fixation was maintained and the clinical results demonstrated a sustained increase in function of the hip. Postoperatively, paying attention to bleeding and infection should be needed.
Acetabulum ; Anemia, Aplastic* ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies ; Head ; Hematoma ; Hemorrhage ; Hip ; Hip Joint ; Humans ; Osteonecrosis ; Prospective Studies ; Retrospective Studies

PURPOSE: The aims of our study were to correlate the degree of metabolic activity in normal glandular tissue measured on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) with qualitative background parenchymal enhancement (BPE) grades on magnetic resonance imaging (MRI), and to investigate the change in standardized uptake value (SUV) according to the patients' menstrual cycles. METHODS: From January 2013 to December 2015, 298 consecutive premenopausal patients with breast cancer who underwent both breast MRI and 18F-FDG PET/CT were identified. BPE was evaluated in the contralateral breast of cancer patients and categorized as minimal, mild, moderate, or marked based on Breast Imaging Reporting and Data System criteria. We analyzed the correlation between BPE and maximum SUV (SUVmax) and mean SUV (SUVmean) values. We also analyzed the metabolic activity of normal glandular tissue according to the patients' menstrual cycles. RESULTS: The mean SUVmax and SUVmean values differed significantly according to BPE grade (p < 0001), with the lowest values occurring in the minimal group and the highest values occurring in the marked group. Spearman's correlation coefficients revealed moderate correlations between BPE grade and SUVmax (r=0.472, p < 0.001) and BPE and SUVmean (r=0.498, p < 0.001). The mean SUVmax and SUVmean values differed significantly according to the patients' menstrual cycles, with the highest values in the 3rd week and the lowest value in the 2nd week. Of 29 patients with low metabolic parenchyma (high BPE but low SUVmean values), 17 (58.6%) were in the 4th week of their menstrual cycle. CONCLUSION: The metabolic activity of normal breast parenchyma, which is highest in the 3rd week and lowest in the 2nd week of the menstrual cycle, correlates moderately with BPE on MRI. Metabolic activity tends to be lower than blood flow and vessel permeability in the 4th week of the menstrual cycle.
Breast ; Breast Neoplasms ; Electrons* ; Female ; Fluorodeoxyglucose F18 ; Humans ; Information Systems ; Magnetic Resonance Imaging ; Menstrual Cycle* ; Metabolism ; Permeability ; Positron-Emission Tomography and Computed Tomography

PURPOSE: The current multicenter phase II study was conducted to evaluate the efficacy and safety of the combination of docetaxel and gemcitabine as neoadjuvant chemotherapy (NAC) for locally advanced breast cancer. METHODS: A total of 98 patients with stage II–III breast cancer were enrolled. The primary endpoint was pathological complete response (pCR) rate of invasive cancer after the completion of the fourth cycle of NAC. The secondary endpoints included response rate (RR), rate of breast-conserving surgery, toxicity, and disease-free survival (DFS). This study is registered with ClinicalTrials.gov (NCT01352494). RESULTS: pCR in the breast and the axillary lymph node was observed in seven of the 98 enrolled patients (7.1%). The overall clinical RR, including partial responses, was 65.3%. Breast-conserving surgery was performed in 75 of the 98 assessable patients (76.5%). Neutropenia was frequent and was observed in 92 of the 98 patients (93.9%), including grade 3 and 4 in 24 patients (24.5%) and 63 patients (64.3%), respectively. Dose reductions were required for 30 of the 92 patients (32.6%). After a median follow-up of 24 months, the overall DFS of the group was 86.7%. CONCLUSION: The combination of docetaxel and gemcitabine did not improve pCR. However, this regimen has shown potential as a NAC by producing a reasonable rate of breast-conserving surgery and favorable responses in patients with locally advanced breast cancer. The therapeutic efficacy of this regimen will be determined in additional trials to overcome the limitations of the current study.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Mastectomy, Segmental ; Neoadjuvant Therapy ; Neutropenia ; Polymerase Chain Reaction

PURPOSE: The purpose of this study was to evaluate the prognostic value of skeletal muscle depletion measured on computed tomography (CT) in patients with non-metastatic invasive breast cancer. METHODS: This retrospective study included 577 consecutive women (mean age ± standard deviation: 48.9 ± 10.2 years with breast cancer who underwent a preoperative positron-emission tomography (PET)/CT scan and curative surgery between January 2012 and August 2014. The total abdominal muscle area (TAMA), subcutaneous fat area (SFA), and visceral fat area (VFA) were measured on CT images at the L3 vertebral level. Univariate and multivariate Cox proportional-hazard regression analyses were performed to evaluate whether there was an association between sarcopenia and overall survival (OS) outcome. RESULTS: Of the 577 women, 49 (8.5%) died after a mean of 46 months. The best TAMA threshold for predicting OS was 83.7 cm². The multivariate Cox proportional-hazard analysis revealed that sarcopenia (TAMA ≤ 83.70 cm²) was a strong prognostic biomarker (hazard ratio [HR], 1.951; 95% confidence interval [CI], 1.061–3.586), along with large tumor size, axillary lymph node metastasis, high nuclear grade, estrogen receptor status, and adjuvant radiation therapy. In the subgroup analysis of patients aged ≥ 50 years, TAMA (≤ 77.14 cm²) was a significant independent factor (HR, 2.856; 95% CI, 1.218–6.695). CONCLUSION Skeletal muscle depletion measured on CT was associated with worse OS outcome in patients with non-metastatic breast cancer.