The fate of testicular salvage in spermatic cord torsion depends on the duration of ischemia and the degree of torsion. Even though spermatic cord torsion (SCT) can occur at any age, it is rarely reported in older patients. If the physician does not pay close attention to this unusual situation, the lack of suspicion for SCT may result in a missed or delayed diagnosis. We report a very uncommon case of missed SCT occurring in a 63-year-old man.
Delayed Diagnosis ; Humans ; Ischemia ; Middle Aged ; Spermatic Cord ; Spermatic Cord Torsion ; Testis

Cardiac papillary fibroelastomas are the second most common primary cardiac tumor. This tumor is usually benign and it involves the cardiac valve. However, most cardiac papillary fibroelastomas originate from a single site, and the incidence of cardiac papillary fibroelastomas originating from multiple sites is very rare (5%). A 55-year-old woman who presented with momentary dizziness and syncope was evaluated by performing echocardiography. Multiple tumors attached to the aortic valve were noted. The mass was removed freely without leaving any defect on the aortic valve leaflet. After the recovery period, the patient is currently being followed up at the outpatient department.
Aortic Valve ; Dizziness ; Echocardiography ; Female ; Heart Neoplasms ; Heart Valves ; Humans ; Incidence ; Middle Aged ; Outpatients ; Syncope

In the oral cavity, complex microbial community is shaped by various host and environmental factors. Extensive literature describing the oral microbiome in the context of oral health and disease is available. Advances in DNA sequencing technologies and data analysis have drastically improved the analysis of the oral microbiome. For microbiome study, bacterial 16S ribosomal RNA gene amplification and sequencing is often employed owing to the cost-effective and fast nature of the method. In this review, practical considerations for performing a microbiome study, including experimental design, molecular analysis technology, and general data analysis, will be discussed.

BACKGROUND: There is an increasing interest in physical activity as a preventive and/or therapeutic option of non alcoholic fatty liver disease (NAFLD). The aim of this study was to examine the association between physical activity and ultrasound-diagnosed NAFLD. METHODS: From April to June 2007, 198 clients who had consumed alcohol less than 140 gram per week among 598 clients who visited a general hospital for medical check-up were enrolled in this study. Clinical, biochemical variables and physical activity were compared. Physical activity was measured by self-reported questionnaire using IPAQ-short form in Korean version. Multiple logistic regression analysis was used to identify independent association. RESULTS: The prevalence of NAFLD was significantly lower in the physical active group (more than 1500 MET- minutes per week) compared to the inactive group (9.6% vs 19.2%, P<0.05). This association was not attenuated when adjusted for age, BMI, HDL cholesterol, triglycerides, fasting glucose, and HOMA2-IR (Odds Ratio 0.23 [95% CI 0.07~0.77, P<0.05]). CONCLUSION: Compared to the physically inactive group, the risk of NAFLD was lower in the physically active group. Our data suggests that regular and moderate physical exercise can prevent the development of fatty liver disease.
Cholesterol, HDL ; Exercise ; Fasting ; Fatty Liver ; Fatty Liver, Alcoholic ; Glucose ; Hospitals, General ; Logistic Models ; Motor Activity ; Obesity ; Prevalence ; Triglycerides ; Surveys and Questionnaires

Background: Nirmatrelvir/ritonavir was Korea's first oral antiviral agent to treat coronavirus disease 2019 (COVID-19). We analyzed the nirmatrelvir/ritonavir prescription rate and treatment outcomes in treatment-eligible patients with COVID-19 receiving home-based care. Materials and Methods: We retrospectively collected data of patients with COVID-19-eligible for nirmatrelvir/ritonavir treatment from January 14, 2022, to February 15, 2022. We analyzed the prescription rate of nirmatrelvir/ritonavir, the reasons for non-prescription, and patient outcomes. Results: A total of 414 patients were included, of whom 44.2% were male, and the mean age was 64.6 (standard deviation [SD] = 8.5). Approximately 73.2% (n = 303) of patients were not prescribed nirmatrelvir/ritonavir. More than fourth-fifths of the patients refused nirmatrelvir/ ritonavir treatment (n = 262, 86.5%). The mean symptom duration was significantly shorter in the prescription group (5.2 days [SD = 2.3] vs. 4.4 days [SD = 1.9], P = 0.001). A total of 6 (1.4%) patients were hospitalized, and none of the patients who received nirmatrelvir/ ritonavir required admission. Among the patients prescribed nirmatrelvir/ritonavir (n = 111), 17 (15.3%) patients experienced side effects, and 5 (4.5%) patients discontinued nirmatrelvir/ ritonavir due to side effects. Conclusion The nirmatrelvir/ritonavir prescription rate was low, with more than fourth-fifths of non-prescriptions being due to patient refusal. Symptom resolution was faster, and no life-threatening side effects were reported. Accurate information about drug safety must be provided to patients to make informed decisions regarding nirmatrelvir/ritonavir treatment.

Accurate identification of microbes facilitates the prediction, prevention, and treatment of human diseases. To increase the accuracy of microbiome data analysis, a long region of the 16S rRNA is commonly sequenced via paired-end sequencing. In paired-end sequencing, a sufficient length of overlapping region is required for effective joining of the reads, and high-quality sequencing reads are needed at the overlapping region. Trimming sequences at the reads distal to a point where sequencing quality drops below a specific threshold enhance the joining process. In this study, we examined the effect of trimming conditions on the number of reads that remained after quality control and chimera removal in the Illumina paired-end reads of the V3–V4 hypervariable region. We also examined the alpha diversity and taxa assigned by each trimming condition. Optimum quality trimming increased the number of good reads and assigned more number of operational taxonomy units. The pre-analysis trimming step has a great influence on further microbiome analysis, and optimized trimming conditions should be applied for Divisive Amplicon Denoising Algorithm 2 analysis in QIIME2 platform.

Accurate identification of microbes facilitates the prediction, prevention, and treatment of human diseases. To increase the accuracy of microbiome data analysis, a long region of the 16S rRNA is commonly sequenced via paired-end sequencing. In paired-end sequencing, a sufficient length of overlapping region is required for effective joining of the reads, and high-quality sequencing reads are needed at the overlapping region. Trimming sequences at the reads distal to a point where sequencing quality drops below a specific threshold enhance the joining process. In this study, we examined the effect of trimming conditions on the number of reads that remained after quality control and chimera removal in the Illumina paired-end reads of the V3–V4 hypervariable region. We also examined the alpha diversity and taxa assigned by each trimming condition. Optimum quality trimming increased the number of good reads and assigned more number of operational taxonomy units. The pre-analysis trimming step has a great influence on further microbiome analysis, and optimized trimming conditions should be applied for Divisive Amplicon Denoising Algorithm 2 analysis in QIIME2 platform.

Background: In the face of the unexpected coronavirus disease 2019 (COVID-19) pandemic, every country has struggled with insufficient human resources and medical supplies. This study aims to provide the statistical information necessary for discussing how to model stockpiles of medical resources. Methods: This study was conducted at the Hallym University Kangnam Sacred Heart Hospital, in South Korea. The study duration was 2 weeks, centered on March 16, 2022, when the number of daily confirmed patients with COVID-19 in Korea peaked. The number of human resources was obtained by counting the number of healthcare workers using CCTV. Drug prescriptions and medical device usage were obtained from electronic medical records. Results: In total, 117 inpatients and 26,485 outpatients were managed at this hospital during the 2-week study period. Daily visits were highest among nurses in all units, followed by doctors and radiology technicians. The mean daily consumption of personal protective equipment (PPE) per bed was 4.3 sets in the intensive care unit (ICU), 1.8 in the semi-ICU, and 1.4 in the ward. Despite the four-fold difference in the number of patients, there was no statistically significant difference between the two wards in the number of daily visits. Drug prescription rates were higher among inpatients than at-home patients. Conclusions The higher the COVID-19 severity, the higher the consumption of PPE per patient. Among healthcare workers, nurses had the highest number of inpatient treatment visits for COVID-19. To efficiently utilize, PPE, structures containing more isolation beds in a single negative pressure isolation system would be preferred.

Rarely, two different histological types of lymphoma develop in the same person. Sequential lymphoma is defined as two different types of lymphoma occurring in the same person sequentially. A 47-year-old patient with human immunodeficiency virus (HIV) infection who had been diagnosed with mixed cellularity Hodgkin's lymphoma was treated with adriamycin, bleomycin, vinblastine, and dacarbazine combination chemotherapy. After six cycles of chemotherapy, abdominal computed tomography showed multiple liver masses. A percutaneous needle biopsy of the liver and polymerase chain reaction single-strand conformation polymorphism revealed hepatosplenic T-cell lymphoma. The patient died 3 months after the diagnosis of hepatosplenic T-cell lymphoma. To our knowledge, this is the first case of the sequential development of hepatosplenic T-cell lymphoma after Hodgkin's lymphoma in a Korean HIV-infected patient.
Biopsy, Needle ; Bleomycin ; Dacarbazine ; Diagnosis ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; HIV ; Hodgkin Disease ; Humans ; Liver ; Lymphoma* ; Lymphoma, T-Cell ; Middle Aged ; Polymerase Chain Reaction ; Vinblastine

OBJECTIVE: To determine whether the presence of Y-chromosome microdeletion affects the outcome of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) program. METHODS: Fourteen couples with microdeletion in azoospermic factor (AZF)c region who attempted IVF/ICSI or cryopreserved and thawed embryo transfer cycles were enrolled. All of the men showed severe oligoasthenoteratoazoospermia (OATS) or azoospermia. As a control, 12 couples with OATS or azoospermia and having normal Y-chromosome were included. Both groups were divided into two subgroups by sperm source used in ICSI such as those who underwent testicular sperm extraction (TESE) and those used ejaculate sperm. We retrospectively analyzed our database in respect to the IVF outcomes. The outcome measures were mean number of good quality embryos, fertilization rates, implantation rates, beta-hCG positive rates, early pregnancy loss and live birth rates. RESULTS: Mean number of good quality embryos, implantation rates, beta-hCG positive rates, early pregnancy loss rates and live birth rates were not significantly different between Y-chromosome microdeletion and control groups. But, fertilization rates in the Y-chromosome microdeletion group (61.1%) was significantly lower than that of control group (79.8%, p=0.003). Also, the subgroup underwent TESE and having AZFc microdeletion showed significantly lower fertilization rates (52.9%) than the subgroup underwent TESE and having normal Y-chromosome (79.5%, p=0.008). Otherwise, in the subgroups used ejaculate sperm, fertilization rates were showed tendency toward lower in couples having Y-chromosome microdeletion than couples with normal Y-chromosome. (65.5% versus 79.9%, p=0.082). But, there was no significance statistically. CONCLUSIONS: In IVF/ICSI cycles using TESE sperm, presence of Y-chromosome microdeletion may adversely affect to fertilization ability of injected sperm. But, in cases of ejaculate sperm available for ICSI, IVF outcome was not affected by presence of Y-chromosome AZFc microdeletion. However, more larger scaled prospective study was needed to support our results.
Avena ; Azoospermia ; Embryo Transfer ; Embryonic Structures ; Family Characteristics ; Fertilization ; Fertilization in Vitro* ; Humans ; Live Birth ; Male ; Outcome Assessment (Health Care) ; Pregnancy ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; Spermatozoa ; Y Chromosome*