We assessed the accuracy of clinical evaluation, arthrography, and arthroscopy in the diagnosis of meniscal lesions in twenty-nine knees in which arthrotomy and menisectomy were performed after evaluation by these three methods, At surgery, thirty menisci of twenty-nine knees were removed, of which twenty-eight were abnormal and two were normal. In these thirty menisci, a correct diagnosis was made clinically eighteen times, arthrographically twenty times, and arthroscopically twenty-seven times. Posterior horn tears of medial meniscus and discoid lateral meniscus were well visualized but lateral meniscal tears were poorly visualized on arthrogram. The errors of arthroscopy occurred in two tears confined to outer one half of medial menscal posterior horn, and in a normal meniscus as false positive. Based on this study, it was concluded that both the arthrography and arthroscopy are valuable techniques for the diagnosis of meniscal lesions, and that we can expect correct diagnosis of all the meniscal lesions by the use of complementary roles of the two and by the experiences.
Animals ; Arthrography ; Arthroscopy ; Diagnosis ; Horns ; Knee ; Menisci, Tibial ; Tears

Background: Rapid electrocardiography diagnosis within 10 minutes of presentation is critical for acute myocardial infarction (AMI) patients in the emergency department (ED).However, the coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the emergency care system. Screening for COVID-19 symptoms and implementing isolation policies in EDs may delay the door-to-electrocardiography (DTE) time. Methods: We conducted a cross-sectional study of 1,458 AMI patients who presented to a single ED in South Korea from January 2019 to December 2021. We used multivariate logistic regression analysis to assess the impact of COVID-19 pandemic and ED isolation policies on DTE time and clinical outcomes. Results: We found that the mean DTE time increased significantly from 5.5 to 11.9 minutes (P < 0.01) in ST segment elevation myocardial infarction (STEMI) patients and 22.3 to 26.7 minutes (P < 0.01) in non-ST segment elevation myocardial infarction (NSTEMI) patients.Isolated patients had a longer mean DTE time compared to non-isolated patients in both STEMI (9.2 vs. 24.4 minutes) and NSTEMI (22.4 vs. 61.7 minutes) groups (P < 0.01). The adjusted odds ratio (aOR) for the effect of COVID-19 duration on DTE ≥ 10 minutes was 1.93 (95% confidence interval [CI], 1.51–2.47), and the aOR for isolation status was 5.62 (95% CI, 3.54–8.93) in all patients. We did not find a significant association between in-hospital mortality and the duration of COVID-19 (aOR, 0.9; 95% CI, 0.52–1.56) or isolation status (aOR, 1.62; 95% CI, 0.71–3.68). Conclusion Our study showed that ED screening or isolation policies in response to the COVID-19 pandemic could lead to delays in DTE time. Timely evaluation and treatment of emergency patients during pandemics are essential to prevent potential delays that may impact their clinical outcomes.

PURPOSE: We analysed the clinical data to compare the usefulness of ultrasound guided vacuum-assisted Mammotome biopsy between 8G and 11G probes. METHODS: 108 cases in this study underwent an ultrasound- guided minimally invasive excisional breast biopsy through small incision. Removal of the breast lesions was accomplished Mammotome biopsy with 8G or 11G probes. RESULTS: The 108 lesions was excised. Mean size of the lesions were 10.7 mm in 8G and 9 mm in 11G. 105 lesions (95%) had benign pathology, three lesions (2.8%) were malignant, and two lesions (1.9%) had atypical ductal hyperplasia. As procedural complications, hematoma was 23/58 (39.7%) in 8G and 10/50 (20%) in 11G, and ecchymosis was 33/58 (55%) in 8G and 11/50 (22%) in 11G. But there was no major complications which need hospitalization and surgical intervention. CONCLUSION: Breast biopsy using Mammotome with 8G probe is as safe as 11G and effective technique.
Biopsy* ; Breast ; Ecchymosis ; Hematoma ; Hospitalization ; Hyperplasia ; Pathology ; Ultrasonography

Gastric tuberculosis is rare even in the endemic areas of tuberculosis, and can mimic neoplasm by causing elevation of the mucosa with or without ulceration. Here, we report a case in which a 54-year-old female patient admitted for resection of early gastric cancer was found to have coexisting histopathologically and bacteriologically confirmed gastric cancer and tuberculosis.
Female ; Humans ; Hydrazines ; Mucous Membrane ; Stomach Neoplasms ; Tuberculosis ; Tuberculosis, Gastrointestinal ; Ulcer

Gastric tuberculosis is rare even in the endemic areas of tuberculosis, and can mimic neoplasm by causing elevation of the mucosa with or without ulceration. Here, we report a case in which a 54-year-old female patient admitted for resection of early gastric cancer was found to have coexisting histopathologically and bacteriologically confirmed gastric cancer and tuberculosis.
Female ; Humans ; Hydrazines ; Mucous Membrane ; Stomach Neoplasms ; Tuberculosis ; Tuberculosis, Gastrointestinal ; Ulcer

BACKGROUND: The efficacy and safety of extended half-life, full-length, pegylated recombinant factor VIII rurioctocog alfa pegol [BAX 855, ADYNOVATE (USA)/ADYNOVI (Europe); Baxalta US Inc., a Takeda company, Lexington, MA, USA] was investigated in previously treated Korean patients with severe hemophilia A (HA). METHODS: A post hoc data analysis from the international, multicenter, phase 2/3 PROLONG-ATE study of rurioctocog alfa pegol in patients with severe HA (NCT01736475) determined annualized bleeding rates (ABRs) and rates of adverse events (AEs) in Korean patients treated in this study. RESULTS: All 10 enrolled Korean patients receiving rurioctocog alfa pegol (9 prophylaxis, 1 on-demand) completed the study [median (range) age, 28.0 (12–50) yr; weight, 64.8 (45–90) kg; 8 patients had ≥1 target joint at screening]. Median (range) ABR was 1.9 (0.0–14.5) for patients on prophylaxis and 62.2 for the patient receiving on-demand treatment. The hemostatic efficacy of rurioctocog alfa pegol was rated “excellent” or “good” and only single infusions were required per bleeding episode. ABRs improved in most patients compared with prestudy values. No dose adjustments were required for prophylaxis, and the dosing frequency was reduced in 8 patients, compared with their previous prophylaxis regimen. No serious AEs were reported; all 9 nonserious AEs (in 3 patients) were mild in severity and unrelated to the study treatment. CONCLUSION: This post hoc analysis of a small group of Korean patients with severe HA indicated that rurioctocog alfa pegol was effective, and no serious AEs were observed. For most patients, the dosing frequency was also reduced compared with their previous regimen.
Factor VIII ; Half-Life ; Hemophilia A ; Hemorrhage ; Humans ; Joints ; Statistics as Topic

OBJECTIVE: The time to positivity (TTP) of blood culture reflects bacterial load and has been reported to be associated with outcome in bloodstream infections. This study was performed to evaluate the relationship between the TTP of blood culture and the mortality rates associated with sepsis and septic shock according to the site of infection. METHODS: We performed a retrospective cohort study on patients with sepsis and septic shock. The rates of blood culture positivity and mortality as well as the relationship between the TTP and 28-day mortality rate were compared among patients with different sites of infection, such as the lungs, abdomen, urogenital tract, and other sites. RESULTS: A total of 2,668 patients were included, and the overall mortality rate was 21.6%. The rates of blood culture positivity and mortality were different among the different infection sites. There was no relationship between the TTP and mortality rates of total, lung, and urogenital infections. Patients with abdominal infections showed a negative correlation between the TTP and 28-day mortality rate. In patients with abdominal infections, a TTP < 20 hours was independently associated with 28-day mortality compared with patients with negative blood culture (hazard ratio, 1.73; 95% confidence interval, 1.16–2.58). However, there was no difference in mortality rates of patients with a TTP≥20 hours and a negative blood culture. CONCLUSION: The shorter TTP in patients with abdominal infections in sepsis and septic shock was associated with a higher 28-day mortality rate.
Abdomen ; Bacterial Load ; Cohort Studies ; Humans ; Lung ; Mortality* ; Retrospective Studies ; Sepsis* ; Shock, Septic

Human ovarian follicles reduce rapidly in number throughout fetal and adult life. Throughout the menstrual cycles, primordial follicles grow into mature follicles and then ovulate to form corpus luteum. Apoptosis has been implicated in several events that occur during the process of follicular growth, atresia and the regression of the corpus luteum. By the use of immunohistochemistry, we clarified the involvement of apoptosis in the human ovary during follicular growth, regression and atresia by investigating the expression of Fas, Fas-ligand, Bcl-2 and Bad in primordial follicles, primary follicles and mature follicles. Fas immunostaining was present in primordial oocytes, both oocytes and granulosa cells of primary follicles, preantral follicles and all follicular cells of mature follicles. Fas-ligand and Bad immunostaining patterns were similar to those of Fas except for theca cells. Bcl-2 immunostaining was present in both oocytes and granulosa cells of primary, preantral and mature follicles. In corpus luteum, Fas, Fas-ligand, Bcl-2 and Bad immunostaining were observed and decreased in the regressing corpus luteum. In postmenopausal ovary, Fas, Fas-ligand, Bcl-2 and Bad immunostaining were entirely negative. Bad immunostaining was observed but Bcl-2 was not in atretic follicle. These results suggest that Fas, Fas-ligand, Bcl-2 and Bad may play important roles in human ovary during follicular growth, regression and atresia simultaneously. Further studies should be required to elucidate the underlying mechanism and apoptosis of the disease associated with normal and abnormal ovarian aging.
Adult ; Aging ; Apoptosis ; Corpus Luteum ; Female ; Granulosa Cells ; Humans* ; Immunohistochemistry ; Menstrual Cycle ; Oocytes ; Ovarian Follicle* ; Ovary ; Theca Cells

OBJECTIVE: To examine the relationship between Osteoprotegerin gene polymorphisms, and bone mineral density (BMD). METHODS: Restriction fragment length polymorphisms at the Osteoprotegerin A163G (promoter), G1181C (exon 1) gene site, and BMD at the lumbar spine and proximal femur were analyzed in 229 postmenopausal Korean women (81 normal, 111 osteopenic and 37 osteoporotic patients). BMDs were measured by DEXA. RESULTS: The distribution of A163G and G1181C polymorphisms in all postmenopausal women was as follows: AA 54.6%, AG 37.1%, GG 8.3%; GG 52.4%, GC 38.0%, CC 9.6%, respectively. After adjusting for potential confounding factors such as age, BMI, and menopause duration, A163G polymorphism was significantly associated with BMD at the lumbar spine and G1181C polymorphism BMD at the trochanter in all postmenopausal women. A163G polymorphism was significantly associated with BMD at the lumbar spine in normal and osteoporotic patients, and BMD at the femur neck and wards triangle in normal patients. G1181C polymorphism was significantly associated with BMD at the femur neck in osteopenic and osteoporotic patients, and BMD at the wards triangle and trochanter in osteoporotic patients. CONCLUSION: These findings suggest that osteoprotegerin gene polymorphisms may be an important contributor to the variation of BMD among postmenopausal Korean women.
Bone Density ; Female ; Femur ; Femur Neck ; Humans ; Menopause ; Osteoprotegerin* ; Polymorphism, Restriction Fragment Length ; Spine

PURPOSE: The association of serum albumin concentration on hospital arrival with long-term mortality in survivors from out-of-hospital cardiac arrest (OHCA) was investigated. METHODS: A retrospective analysis was conducted of patients presumed to have cardiac cause of arrest and achieved sustained return of spontaneous circulation (ROSC) from prospective OHCA. The individual medical records were reviewed for data, including initial serum albumin. The primary outcome was survival at 6 months and the secondary outcome was Cerebral Performance Category (CPC) at 6 months. Differences in variables between survivors and non-survivors at 6 months after cardiac arrest were analyzed. Albumin was categorized into tertiles of <2.9 g/dL, 2.9 to 3.7 g/dL, and >3.7 g/dL. Hazard ratios (HRs) were estimated using Cox-proportional hazard models in both univariate and multivariate analysis. All prognostic variables with p value<0.1 in univariate analysis were used in multivariate analysis for adjustment. Receiver operating curve (ROC) analysis was performed to evaluate the discriminative power of albumin. RESULTS: In a total of 547 OHCA patients, 136 patients had a presumed cardiac cause of arrest and sustained ROSC with available initial serum albumin. The survival rate at 6 months was significantly higher in patients in the higher albumin group and neurological outcomes were also more favorable in the higher albumin group (log rank test, p<0.05). In a Cox proportional hazard regression analysis, initial serum lactate and albumin levels were independently associated with 6-month mortality and albumin levels showed moderate discriminative power for 6-month mortality by ROC analysis (AUC=0.738, 95% CI: 0.652-0.825). CONCLUSION: Serum albumin is associated with long-term mortality and neurological outcome in patients with presumed cardiac cause of arrest and sustained ROSC from OHCA.
Heart Arrest ; Humans ; Lactic Acid ; Medical Records ; Mortality* ; Multivariate Analysis ; Out-of-Hospital Cardiac Arrest* ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Retrospective Studies ; ROC Curve ; Serum Albumin* ; Survival Rate ; Survivors