Background: This study aimed to 1) assess the effect of total hip arthroplasty (THA) on coronal limb alignment, namely, the hip–knee–ankle angle (HKA), 2) identify factors that determine changes in the HKA, and 3) determine whether alignment changes influence the knee joint space width. Methods: We retrospectively evaluated 266 limbs of patients who underwent THA. Three types of prostheses with neck shaft angles (NSAs) of 132°, 135°, and 138° were used. Several radiographic parameters were measured in the preoperative and final radiographs (at least 5 years after THA). A paired t-test was used to confirm the effect of THA on HKA change.Multiple regression analysis was performed to identify radiographic parameters related to HKA changes following THA and changes in knee joint space width. Subgroup analyses were performed to reveal the effect of NSA change on the HKA change, and the proportion of total knee arthroplasty usage and changes in radiographic parameters between maintained joint space and narrowed joint space groups were compared. Results: The preoperative mean HKA was 1.4° varus and increased to 2.7° varus after THA.This change was related to changes in the NSA, lateral distal femoral angle, and femoral bowing angle. In particular, in the group with a decrease in NSA of > 5°, the preoperative mean HKA was largely changed from 1.4° varus to 4.6° varus after THA. The prostheses with NSA of 132° and 135° also led to greater varus HKA changes than those with an NSA of 138°. Narrowing of the medial knee joint space was related to changes in the varus direction of the HKA, decrease in NSA, increase in femoral offset. Conclusion A large reduction in NSA can lead to considerable varus limb alignment after THA, which can have adverse effects on the medial compartment of the ipsilateral knee.

Adverse transfusion reactions (ATRs) are unexpected reactions to transfusion. This study examined the frequency, types of ATRs, and related blood products retrospectively in pediatric patients with less information than in adult patients. Four hundred and forty transfusions were performed for two months at a children’s hospital: 247 units of red blood cell (RBC) products, 142 units of platelet products, and 41 units of fresh frozen plasma (FFP) were used.Five adverse reactions occurred in five patients, three cases were allergic reactions, and two were febrile nonhemolytic reactions. The frequency was 1.13%, and apheresis platelets and leukocyte-reduced RBC were transfused. Two patients’ ATRs were found in the previous transfusions, and ATRs were repeated in subsequent transfusions in one patient. One of the ATRs was not reported to the blood bank and was then discovered during the study. Because pediatric patients may have limitations in recognizing or expressing their symptoms compared to adults, medical staff rely solely on vital signs and laboratory results rather than symptoms, causing difficulty in noticing ATRs. Information on ATRs and education on appropriate blood products will improve awareness of ATRs and blood management among medical staff at transfusion sites and blood banks.

Background: The symptoms of adrenal insufficiency (AI) overlap with the common effects of advanced cancer and chemotherapy. Considering that AI may negatively affect the overall prognosis of cancer patients if not diagnosed in a timely manner, we analyzed the incidence, risk factors, and predictive methods of AI in cancer patients. Methods: We retrospectively analyzed the medical records of 184 adult patients with malignancy who underwent a rapid adrenocorticotrophic hormone stimulation test in the medical hospitalist units of a tertiary hospital. Their baseline characteristics and clinical features were evaluated, and the risk factors for AI were identified using logistic regression analysis. Results: Of the study patients, 65 (35%) were diagnosed with AI, in whom general weakness (63%) was the most common symptom. Multivariate logistic regression showed that eosinophilia (adjusted odds ratio [aOR], 4.28; 95% confidence interval [CI], 1.10–16.63; P = 0.036), history of steroid use (aOR, 2.37; 95% CI, 1.10–5.15; P = 0.028), and history of megestrol acetate use (aOR, 2.71; 95% CI, 1.38–5.33; P = 0.004) were associated with AI. Baseline cortisol levels of 6.2 μg/dL and 12.85 μg/dL showed a specificity of 95.0% and 95.4% for AI diagnosis, respectively. Conclusion AI was found in about one-third of patients with cancer who showed general symptoms that may be easily masked by cancer or chemotherapy, suggesting that clinical suspicion of AI is important while treating cancer patients. History of corticosteroids or megestrol acetate were risk factors for AI and eosinophilia was a pre-test predictor of AI.Baseline cortisol level appears to be a useful adjunct marker for AI.

For safe thyroidectomy, preservation of the parathyroid gland is mandatory. However, until recently, there has been no reliable method of identifying the parathyroid glands. Thus, the identification of the parathyroid gland has mainly depended on the surgeon’s personal experience. To overcome this limitation, near infrared autofluorescence (NIRAF) imaging technique has been introduced. Many reports support the claim that NIRAF imaging can help surgeons identify the parathyroid gland. However, there have been no reports on the feasibility of NIRAF imaging in detecting the intrathyroidal parathyroid glands that cannot be seen by the naked eye. Recently, we experienced two cases in which intrathyroidal parathyroid glands were identified and auto-transplanted with the use of NIRAF. We would like to share this experience and hope this paper helps thyroid surgeons identify the parathyroid gland more easily which is always a matter of concern.

For safe thyroidectomy, preservation of the parathyroid gland is mandatory. However, until recently, there has been no reliable method of identifying the parathyroid glands. Thus, the identification of the parathyroid gland has mainly depended on the surgeon’s personal experience. To overcome this limitation, near infrared autofluorescence (NIRAF) imaging technique has been introduced. Many reports support the claim that NIRAF imaging can help surgeons identify the parathyroid gland. However, there have been no reports on the feasibility of NIRAF imaging in detecting the intrathyroidal parathyroid glands that cannot be seen by the naked eye. Recently, we experienced two cases in which intrathyroidal parathyroid glands were identified and auto-transplanted with the use of NIRAF. We would like to share this experience and hope this paper helps thyroid surgeons identify the parathyroid gland more easily which is always a matter of concern.

Background/Objectives: Extracapsular dissection has the advantage of reducing complications by minimizing tissue loss of the parotid without intentionally exposing the facial nerve in patients with benign parotid tumor. However, there has been controversy over the surgical results. Thus, the surgical outcomes of extracapsular dissection for benign parotid tumor was compared to those of superficial parotidectomy.Materials & Methods: A retrospective chart review was conducted with 132 patients who received surgery for benign parotid tumor in our center from January 2014 to December 2018 retrospectively. Results: A total of 132 people were enrolled, with 62 people receiving extracapsular dissection, 38 people receiving partial superficial parotidectomy and 32 people receiving superficial parotidectomy. No significant difference was found between the three groups regarding complications such as facial nerve palsy, Frey's syndrome, or first bite syndrome. Operation time and hospital stay was significantly short in extracapsular dissection group. Conclusion For well-selected cases, extracapsular dissection can be considered as an option for surgery of benign parotid tumor.

Background and Objectives: Surgical resection is the basic treatment for benign laryngeal tumors and transoral laser microsurgery (TLM) has been used effectively. Transoral videolaryngoscopic surgery (TOVS) is another method of surgical resection that has been introduced. However, there have not been any studies related to the usefulness of TOVS in benign laryngeal tumors. The purpose of this study was to compare the efficacy and surgical outcomes of TLM and TOVS.Subjects and Method A retrospective chart review of 85 patients were conducted. This review included two groups (TLM group, n=44 versus TOVS group, n=41) of patients who underwent transoral surgery for benign laryngeal tumors. Clinicopathologic factors of the patients and surgical outcomes such as the operation time, amount of intraoperative bleeding, hospital stay, and complications were compared between two groups. Results: There were no significant differences between two groups regarding the clinicopathologic factors and surgical outcomes. The TOVS group presented relatively larger tumor size (p=0.067) and showed a tendency of shorter operation time (36.8±34.5 min) compared to that of TLM (45.6±27.9 min), but with no statistical significance (p=0.199). Conclusion TOVS may be considered as an alternative surgical method for benign laryngeal tumors.

PURPOSE: The aim of this study was to investigate how type I diabetes mellitus (T1D) affects the folliculogenesis and oocyte development, fertilization, and embryo development. MATERIALS AND METHODS: A comparative animal study was conducted using two different mouse models of T1D, a genetic AKITA model and a streptozotocin-induced diabetes model. Ovarian function was assessed by gross observation, immunoblot, immunohistochemistry, oocyte counting, and ELISA for serum hormones (insulin, anti-Mullerian hormone, estradiol, testosterone, and progesterone). Maturation and developmental competence of metaphase II oocytes from control and T1D animals was evaluated by immunofluorescent and immunohistochemical detection of biomarkers and in vitro fertilization. RESULTS: Animals from both T1D models showed increased blood glucose levels, while only streptozotocin (STZ)-injected mice showed reduced body weight. Folliculogenesis, oogenesis, and preimplantation embryogenesis were impaired in both T1D mouse models. Interestingly, exogenous streptozotocin injection to induce T1D led to marked decreases in ovary size, expression of luteinizing hormone/chorionic gonadotropin receptor in the ovaries, the number of corpora lutea per ovary, oocyte maturation, and serum progesterone levels. Both T1D models exhibited significantly reduced pre-implantation embryo quality compared with controls. There was no significant difference in embryo quality between STZ-injected and AKITA diabetic mice. CONCLUSION: These results suggest that T1D affects folliculogenesis, oogenesis, and embryo development in mice. However, the physiological mechanisms underlying the observed reproductive effects of diabetes need to be further investigated.
Animals ; Anti-Mullerian Hormone ; Biomarkers ; Blood Glucose ; Body Weight ; Corpus Luteum ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Embryonic Development ; Embryonic Structures ; Enzyme-Linked Immunosorbent Assay ; Estradiol ; Female ; Female ; Fertility ; Fertilization ; Fertilization in Vitro ; Gonadotropins ; Humans ; Immunohistochemistry ; Lutein ; Mental Competency ; Metaphase ; Mice ; Oocytes ; Oogenesis ; Ovary ; Pregnancy ; Progesterone ; Reproduction ; Streptozocin ; Testosterone

BACKGROUND: Protein arginine methyltransferase 1 (PRMT1) is a major enzyme responsible for the formation of methylarginine in mammalian cells. Recent studies have revealed that PRMT1 plays important roles in the development of various tissues. However, its role in pancreas development has not yet been elucidated. METHODS: Pancreatic progenitor cell-specific Prmt1 knock-out (Prmt1 PKO) mice were generated and characterized for their metabolic and histological phenotypes and their levels of Neurog3 gene expression and neurogenin 3 (NGN3) protein expression. Protein degradation assays were performed in mPAC cells. RESULTS: Prmt1 PKO mice showed growth retardation and a severely diabetic phenotype. The pancreatic size and β-cell mass were significantly reduced in Prmt1 PKO mice. Proliferation of progenitor cells during the secondary transition was decreased and endocrine cell differentiation was impaired. These defects in pancreas development could be attributed to the sustained expression of NGN3 in progenitor cells. Protein degradation assays in mPAC cells revealed that PRMT1 was required for the rapid degradation of NGN3. CONCLUSION: PRMT1 critically contributes to pancreas development by destabilizing the NGN3 protein.
Animals ; Diabetes Mellitus ; Endocrine Cells ; Gene Expression ; Islets of Langerhans ; Mice ; Pancreas ; Phenotype ; Protein Stability ; Protein-Arginine N-Methyltransferases ; Proteolysis ; Stem Cells

BACKGROUND AND OBJECTIVES: Sudden sensoryneural hearing loss (SSNHL) is an otological emergency disease of a non-specific cause. If there is no improvement or if the degree of hearing loss is severe, patients are often referred to other medical institution. Many papers have reported regarding the treatment results of SSNHL, however, most of them failed to mention the fact that patients were referred from other clinics after steroid treatment. This paper would like to compare the treatment results between patient groups who had been referred following steroid treatment and those who received steroid treatment for the first time.SUBJECTS AND METHOD: We retrospectively analyzed 127 patients from January 2015 to August 2017. Patients who received steroid treatment for the first time were classified as group 1; those who had received steroid treatment at another hospital and those who were re-treated were classified as group 2. The treatment results of each group were evaluated. RESULTS: According to the results of this study, the recovery rates for group 1 and 2 were 66.7% and 31.4%, respectively. CONCLUSION Most of the previous studies on the treatment results of sudden hearing loss were performed in tertiary medical institutions. It is likely that the treatment results of patients who recovered after treatment in the primary and secondary medical institutions were missed, which means that the results of steroid therapy may be better than those reported previously.