Osteoporotic vertebral compression fractures have become common in aging societies and can lead to a decreased quality of life with severe back pain and neurological deficits.Traditional direct decompression and stabilization surgeries can produce sufficient decompression and provide good results. However, after surgical treatment, some elderly patients with numerous chronic diseases often experience severe postoperative complications owing to the long surgery duration and massive bleeding. Therefore, to prevent perioperative morbidity, other surgical methods that simplify the surgical process and reduce the operation time are required. Herein, we describe a case of indirect decompression using ligamentotaxis and sequential anabolic agents. To examine their effectiveness during surgery, we monitored intraoperative motor-evoked potentials. The patient’s neurological symptoms improved postoperatively. After the operation, the anabolic agent “romosozumab” was injected monthly to treat osteoporosis, prevent additional fractures, and accelerate posterolateral fusion. On serial follow-up, the anterior body height of the fractured vertebra improved significantly, demonstrating the importance of osteoporosis treatment using anabolic agents.Indirect decompression surgery may have early effects, whereas sequential anabolic agent use may consolidate the long-term effects of surgical treatment.

BACKGROUND: Usually, high-flow nasal cannula (HFNC) therapy is indicated for de novo acute hypoxemic respiratory failure (AHRF). Although only a few researches have examined the effectiveness of HFNC therapy for respiratory failure with hypercapnia, this therapy is often performed under such conditions for various reasons. We investigated the effectiveness of HFNC therapy for AHRF patients with hypercapnia compared to those without hypercapnia.METHODS: All consecutive patients receiving HFNC therapy between January 2012 and June 2018 at a university hospital were enrolled and classified into nonhypercapnic and hypercapnic groups. We compared the outcomes of both groups and adjusted the outcomes with propensity score matching.RESULTS: A total of 862 patients were enrolled, of which 202 were included in the hypercapnic group. HFNC weaning success rates were higher, and intensive care unit (ICU) and hospital mortality was lower in the hypercapnic group than in the nonhypercapnic group (all P < 0.05). However, no statistical differences in HFNC weaning success (adjusted P = 0.623, matched P = 0.593), ICU mortality (adjusted P = 0.463, matched P = 0.195), and hospital mortality (adjusted P = 0.602, matched P = 0.579) were noted from the propensity-adjusted and propensity-matched analyses. Additionally, in the propensity score-matched subgroup analysis (according to chronic lung diseases and causes of HFNC application), there was also no significant difference in outcomes between the two groups.CONCLUSION: In AHRF with underlying conditions, HFNC therapy might be helpful for patients with hypercapnia. Large prospective and randomized controlled trials are required for firm conclusions.

BACKGROUND: Usually, high-flow nasal cannula (HFNC) therapy is indicated for de novo acute hypoxemic respiratory failure (AHRF). Although only a few researches have examined the effectiveness of HFNC therapy for respiratory failure with hypercapnia, this therapy is often performed under such conditions for various reasons. We investigated the effectiveness of HFNC therapy for AHRF patients with hypercapnia compared to those without hypercapnia. METHODS: All consecutive patients receiving HFNC therapy between January 2012 and June 2018 at a university hospital were enrolled and classified into nonhypercapnic and hypercapnic groups. We compared the outcomes of both groups and adjusted the outcomes with propensity score matching. RESULTS: A total of 862 patients were enrolled, of which 202 were included in the hypercapnic group. HFNC weaning success rates were higher, and intensive care unit (ICU) and hospital mortality was lower in the hypercapnic group than in the nonhypercapnic group (all P < 0.05). However, no statistical differences in HFNC weaning success (adjusted P = 0.623, matched P = 0.593), ICU mortality (adjusted P = 0.463, matched P = 0.195), and hospital mortality (adjusted P = 0.602, matched P = 0.579) were noted from the propensity-adjusted and propensity-matched analyses. Additionally, in the propensity score-matched subgroup analysis (according to chronic lung diseases and causes of HFNC application), there was also no significant difference in outcomes between the two groups. CONCLUSION In AHRF with underlying conditions, HFNC therapy might be helpful for patients with hypercapnia. Large prospective and randomized controlled trials are required for firm conclusions.

Bovine coccidiosis is one of the most important parasitic diseases affecting calf productivity. Here, we investigated the prevalence of Eimeria spp. in pre-weaned native Korean calves and determined the correlation between diarrhea and Eimeria spp. Fecal samples were collected from individual calves (288 normal and 191 diarrheic) in 6 different farms. Of the 479 samples, Eimeria oocysts were detected in 124 calves (25.9%). Five Eimeria spp. were identified; E. zuernii (18.8%) was the most prevalent, followed by E. auburnensis (12.5%), E. bovis (7.5%), E. subspherica (5.8%), and E. bukidnonensis (1.0%). A significant correlation was observed between diarrhea and mixed infection with more than 2 Eimeria spp. (odds ratio [OR]=2.21; 95% confidence interval [CI]: 1.09–4.49; P=0.03) compared to single infection (OR=1.29; 95% CI: 0.77–2.15; P=0.33). Of the 5 Eimeria spp. identified, E. subspherica (95% CI: 1.24–5.61; P=0.01) and E. bukidnonensis (95% CI: 825.08–1,134.25; P=0.00) strongly increased the risk of diarrhea by 2.64-fold and 967.39–fold, respectively, compared to other species. Moreover, mixed infection with E. auburnensis and E. bukidnonensis was significantly associated with diarrhea (OR=2,388.48; 95% CI: 1,009.71–5,650.00; P < 0.00) in pre-weaned native Korean calves. This is the first report to demonstrate the importance of E. bukidnonensis associated with diarrhea in pre-weaned native Korean calves. Further epidemiological studies should investigate the prevalence of E. bukidnonensis and the association between E. bukidnonensis and diarrhea.
Agriculture ; Coccidiosis ; Coinfection ; Diarrhea ; Efficiency ; Eimeria ; Epidemiologic Studies ; Oocysts ; Parasitic Diseases ; Prevalence

Primary small cell carcinoma of the paranasal sinuses is extremely rare. It is aggressively locally invasive, with high recurrence and metastatic rates. A combination of systemic chemotherapy and locoregional treatment, such as radiotherapy, is currently recommended based on the treatment of small cell carcinoma of lung. We report a case of small cell carcinoma originating from the maxillary sinus with distant metastasis at the time of diagnosis. The patient had a good initial therapeutic response to etoposide-cisplatin chemotherapy, but the cancer progressed after the sixth cycle of chemotherapy and the prognosis was poor.
Carcinoma, Small Cell* ; Diagnosis ; Drug Therapy ; Humans ; Lung ; Maxillary Sinus* ; Neoplasm Metastasis* ; Paranasal Sinuses ; Prognosis ; Radiotherapy ; Recurrence

Primary mesenteric carcinoid tumor is very rare, although secondary mesenteric involvement is common, reported as 40% to 80%. And distant metastasis rate reported as 80% to 90%, when the size is larger than 2 cm. We present a case of very rare primary mesenteric carcinoid tumor showing benign character though large size. The patient visited St. Vincent's Hospital, The Catholic University of Korea with increasing palpable abdominal mass. At laparotomy, a well encapsulated mass arising from the mesentery near the ligament of Treitz was found without any adjacent organ invasion or distant metastasis. The mass was measured as 8.2 x 7.3 cm and histopathologically benign character. At 11 months of follow up, the patient was recurrence free.
Carcinoid Tumor ; Follow-Up Studies ; Humans ; Korea ; Laparotomy ; Ligaments ; Mesentery ; Neoplasm Metastasis ; Recurrence

Inflammatory myofibroblastic (IMF) tumor is a rare solid tumor that often affects children. IMF tumors occur primarily in the lung, but the tumor may affect any organ system with protean manifestations. A 22-year-old woman was evaluated for palpable low abdominal mass that had been increasing in size since two months prior. Abdominal computed tomography showed a lobulated, heterogeneous contrast enhancing soft tissue mass, 6.5 x 5.7 cm in size in the ileal mesentery. At surgery, the mass originated from the greater omentum laying in the pelvic cavity and was completely excised without tumor spillage. Histologically, the mass was a spindle cell lesion with severe atypism and some mitosis. Immunohistochemistry for anaplastic lymphoma kinase-1 revealed that the lesion was an IMF tumor. Because of its local invasiveness and its tendency to recur, this tumor can be confused with a soft tissue sarcoma. Increasing physician awareness of this entity should facilitate recognition of its clinical characteristics and laboratory findings.
Child ; Female ; Humans ; Immunohistochemistry ; Lung ; Lymphoma ; Mesentery ; Mitosis ; Myofibroblasts ; Omentum ; Sarcoma ; Young Adult

BACKGROUND: Understanding the biologic behavior of a tumor is a prerequisite for tumor registration code assignment. The aim of this report was to propose appropriate behavior codes of the International Classification of Disease Oncology 3 (ICD-O3) to rare, yet pathologically interesting hematopoietic and soft tissue tumors. METHODS: The Study Group for Hematopathology, the Bone and Soft Tissue Pathology Study Group, and the Cancer Registration Committee prepared the questionnaire containing provisional behavior codes of selected diseases. RESULTS: In situ lesions of mantle cell and follicular lymphomas, dendritic cell tumors, and neoplasms with perivascular epithelioid cell differentiation (PEComa), not otherwise specified were classified as malignant (-/3). The fibromatosis group, with the exception of lipofibromatosis, was proposed as benign (-/0). Lipofibromatosis and several diseases that belong to the PEComa group were proposed as uncertain malignant potential (-/1). For the hematologic and soft tissue tumors, 274 and 288 members of the Korean Society of Pathologists, respectively, provided opinions through questionnaire, and most responders showed agreement with the provisional behavior code proposed. CONCLUSIONS: The determination of behavior codes for the rare diseases described in this study, especially those of the PEComa group or malignant lymphoma, could be viewed as impractical and premature, but this study provides the basis for future research on this topic.
Dendritic Cells ; Epithelioid Cells ; Fibroma ; Hematologic Neoplasms ; Lymphoma ; Lymphoma, Follicular ; Perivascular Epithelioid Cell Neoplasms ; Surveys and Questionnaires ; Rare Diseases ; Soft Tissue Neoplasms

BACKGROUND: Dendritic cells (DCs) play an important role in immune reactions. This study was designed to identify the distribution patterns of DCs and regulatory T-cells (Tregs) in cutaneous lymphomas. METHODS: Immunohistochemistry was used to determine langerin expression on Langerhans cells, CD11b on inflammatory DCs, CD209 and CD11c on dermal DCs, CD303 on plasmacytic DCs, and Foxp3 on Tregs in 81 cases of cutaneous lymphomas. RESULTS: Various DCs and Tregs were identified in most cutaneous lymphomas. Plasmacytic DCs, inflammatory DCs and Tregs were identified mainly in tumor areas, whereas dermal DCs were distributed both in the tumor and stromal areas. Among DCs, dermal DCs were most prominently identified in the cutaneous lymphomas not only in the tumor area but also in the stroma. The intense stromal infiltration of dermal DCs was consistent finding in T-cell lymphomas. Diffuse large B-cell lymphoma (DLBCL), not otherwise specified also showed intense stromal infiltration of dermal DCs, but stromal infiltration in DLBCL, leg type was relatively scant. CONCLUSIONS: The results suggest that all types of DCs and Tregs are involved in cutaneous lymphoma tumor immunity. Among them dermal DCs may play a dominant role.
Dendritic Cells ; Immunohistochemistry ; Langerhans Cells ; Leg ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; T-Lymphocytes, Regulatory

Adult intussusception is rare involving of only 1% of the causes of bowel obstruction. We report a case of a 39-year-old female with intussusceptions due to inverted Meckel's diverticulum. She visited our hospital for diffuse abdominal pain during 1 week and aggravated abdominal pain for 2 days. Vital signs were stable, and there was periumbilical tenderness. She had no history of abdominal operation. CT scan showed a 3.7x2.1 cm of fatty mass with focal intussusception in the distal ileum. When the emergency operation was performed, the patient was found to be suffering from ileocolic intussusception. A manual reduction of intussusception showed inverted Meckel's deverticulum at 65 cm proximal to the ileocecal valve, and the segmental resection of small bowel including a Meckel's diverticulum was performed. Pathologic examination revealed a Meckel's diverticulum containing a 0.6x0.6 cm sized aberrant pancreas.
Abdominal Pain ; Adult ; Emergencies ; Female ; Humans ; Ileocecal Valve ; Ileum ; Intussusception ; Meckel Diverticulum ; Pancreas ; Stress, Psychological ; Vital Signs