Background: Monitoring the oxygenation status is crucial during general anesthesia to ensure patient safety. Although noninvasive pulse oximetry is commonly used to monitor percutaneous oxygen saturation (SpO2), it may not accurately reflect changes in oxygen partial pressure when the latter is excessively high or low. The oxygen reserve index (ORi) provides real-time information about the oxygen reserve status.Case: We present a case of successful management of subglottic stenosis using balloon bronchoscopy in an infant with a left ventricular assist device implantation under ORi monitoring to predict hypoxemia during the surgical procedure. Conclusions Utilizing ORi monitoring during anesthesia for procedures involving apnea in critically ill infants can help predict impending desaturation before a drop in SpO2 occurs, allowing anesthesiologists to effectively anticipate and manage the apnea period. Continuous ORi monitoring offers valuable insights during surgical procedures, especially in infants with compromised respiratory and cardiovascular functions.

Objectives: The aim of this study is to determine whether there is a difference between right and left femur bone mineral density (BMD) in postmenopausal women. Methods: We performed a retrospective chart review of postmenopausal women who underwent bone mineral density (BMD) measurement from 2010 to 2019 at a single center using dual-energy X-ray absorptiometry (DXA). Data, including BMD and T-scores of bilateral hip and lumbar spine, was gathered for all postmenopausal women above the age of 50 years. The continuous variables were expressed as means with standard deviation for normal distribution and analyzed with a two-sample t-test. Multiple regression analysis was used to test the effect of underlying medical conditions on T-score of bilateral hips. For all analyses, a p-value of ＜0.05 was considered significant. Results: 346 patients were included in the study with a mean age at imaging of 62 + 9.7 years and body mass index (BMI) of 23.4 + 6.1 kg/m2 . There were no significant differences between right and left femoral BMDs in all patients. There were significant differences in BMD of both total femurs in women in their 60s and women with normal BMD. There was no difference in both femur BMDs between those taking hormone therapy and those not taking hormone therapy. In patients undergoing osteoporosis treatment, there was a difference in the BMD of both femur neck. Calcium and vitamin D intake were not associated with differences between both femur BMD. We found a significant correlation between the BMD measures at lumbar spine and both femur (p ＜ 0.01). Conclusion There were no significant differences between right and left femoral BMDs in postmenopausal women. Therefore, BMD may be measured at either hip. The correlation of bone density between lumbar spine and femur neck is shown to be statistically meaningful. Based on the knowledge of the correlation coefficients between lumbar spine and femur neck, it seems possible to predict the BMD result of one location through the measurement of another.

The Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency developed a primary imaging test for suspected traumatic thoracolumbar spine injury. This guideline was developed using an adaptation process involving collaboration between the development committee and the working group. The development committee, consisting of research methodology experts, established the overall plan and provided support on research methodology. The working group, composed of radiologists with expertise in musculoskeletal imaging, wrote the recommendation. The guidelines recommend that thoracolumbar spine computed tomography without intravenous contrast enhancement be the first-line imaging modality for diagnosing traumatic thoracolumbar spine injury in adults.
Adult ; Cooperative Behavior ; Evidence-Based Practice ; Humans ; Magnetic Resonance Imaging ; Radiography ; Research Design ; Spine

The adequate dietary intake is important to maintain the nutritional status of the patients after pancreatic cancer surgery. This prospective study was designed to investigate the dietary intake and the nutritional status of the patients who had pancreatic cancer surgery. Thirty-one patients (15 men, 16 women) were enrolled and measured body weight, body mass index (BMI), nutritional risk index (NRI), and Malnutrition Universal Screening Tool (MUST). Actual oral intake with nutritional impact symptoms recorded on the clinical research foam at every meal and medical information were collected from electronic medical charts. The rates of malnutrition at admission were 45.1% (14/31) and 28.9% (9/31) by NRI and MUST method, respectively, but those were increased to 87% (27/31) and 86.6% (26/31) after operation on discharge. The median values of daily intake of energy, carbohydrates, fat, and protein were 588.1 kcal, 96.0 g, 11.8 g, and 27.0 g, respectively. Most patients (n = 20, 64.5%) experienced two or more symptoms such as anorexia, abdominal bloating and early satiety. There were negative correlations between C-reactive protein (CRP) levels and the intake of total energy, protein, fat, and zinc. The rates of malnutrition were increased sharply after surgery and the dietary intake also influenced the inflammatory indicators. The results suggested that need of considering special therapeutic diets for the patients who received pancreatic surgery.
Anorexia ; Body Mass Index ; Body Weight ; C-Reactive Protein ; Carbohydrates ; Diet ; Humans ; Male ; Malnutrition ; Mass Screening ; Meals ; Methods ; Nutritional Status* ; Pancreatic Neoplasms* ; Prospective Studies ; Zinc

Extramammary Paget's disease (EMPD) is an uncommon intraepithelial adenocarcinoma, primarily affecting the apocrine-bearing skin. Bowen disease is an intraepithelial squamous cell carcinoma having the potential to become invasive carcinoma. The histopathological concomitant features between EMPD and Bowen disease have been described. One theory is that primary EMPD arises multicentrically, within the epidermis from the pluripotent stem cells. Herein, we describe a case of EMPD that had bowenoid features, and review the previous cases associated with the origin of EMPD.
Adenocarcinoma ; Bowen's Disease ; Carcinoma, Squamous Cell ; Epidermis ; Genitalia ; Genitalia, Male ; Male ; Paget Disease, Extramammary ; Pluripotent Stem Cells ; Skin

Extramammary Paget's disease (EMPD) is an uncommon intraepithelial adenocarcinoma, primarily affecting the apocrine-bearing skin. Bowen disease is an intraepithelial squamous cell carcinoma having the potential to become invasive carcinoma. The histopathological concomitant features between EMPD and Bowen disease have been described. One theory is that primary EMPD arises multicentrically, within the epidermis from the pluripotent stem cells. Herein, we describe a case of EMPD that had bowenoid features, and review the previous cases associated with the origin of EMPD.
Adenocarcinoma ; Bowen's Disease ; Carcinoma, Squamous Cell ; Epidermis ; Genitalia ; Genitalia, Male ; Male ; Paget Disease, Extramammary ; Pluripotent Stem Cells ; Skin

BACKGROUND: The use of intravenous contrast media (CM) has increased for the diagnosis of several diseases. The newly developed low osmolar nonionic contrast agents cause significantly decreased adverse reactions than the higher osmolar ones. However, adverse reactions may still occur, ranging in severity from minor side effects to severe complications. However, there have been few reports about cutaneous adverse reactions (CARs) to nonionic monomer CM. OBJECTIVE: The purpose of this study was to evaluate clinical features of CAR to intravenous nonionic monomer CM. METHODS: A total 47,338 examinees underwent intravenous iodinated contrast-enhanced computed tomography scan using nonionic monomer CM. Among the adverse reactions to the CM, we divided them into cutaneous or noncutaneous and immediate (<1 hr) or late (> or =1 hr) adverse reactions. RESULTS: Adverse reactions were noted in 62 cases out of the total 47,338 cases; 50 cases (80.7%) were categorized CARs. Among them, there were 24 male and 26 female patients. There was no significant difference between the sexes, and CARs occurred in all age groups. The highest occurrence was in the age range of 50~59 years. CARs included urticaria (78%), angioedema (10%), maculopapular rash (8%), erythema (2%), and pruritus without rash (2%). Immediate reactions were 92% (46 cases), while late reactions were 8% (4 cases). CONCLUSION: CARs to nonionic monomer CM accounted for most of the adverse reactions (80.7%) and urticaria was the most common.
Angioedema ; Contrast Media ; Erythema ; Exanthema ; Female ; Humans ; Korea ; Male ; Pruritus ; Urticaria

Inflammatory linear verrucous epidermal nevi (ILVEN) were first described in the literature, in 1971, by Altman and Mehregan. Most cases were reported as solitary lesions. In contrast, systematized ILVEN, involving wide areas of the integument, has only rarely been reported. A variety of treatment modalities has been reported, ranging from topical medications, such as potent corticosteroids or tretinoin 0.1% to variable procedures, including CO2 and pulsed dye laser, cryotherapy, and surgical excision. However, multifocal skin lesion is more difficult to treat. An 8-year old boy was presented with an extensive thick scaly plaques and patches, affecting the trunk and the four extremities sparing face. It developed when he was 3 years old, and he complained pruritus. On physical examination, linear, or whirl-like scaly plaques were seen, along with Blaschko lines. Pathologic finding was in accordance to ILVEN. We treated him with topical calcipotriol, tacrolimus and systemic acitretin. After 8 months, the lesion and symptoms improved.
Acitretin ; Adrenal Cortex Hormones ; Calcitriol ; Cryotherapy ; Extremities ; Lasers, Dye ; Nevus ; Nevus, Sebaceous of Jadassohn ; Physical Examination ; Pruritus ; Skin ; Tacrolimus ; Tretinoin

Collagenous fibroma is a recently described rare benign tumor that mainly affects those in the fifth through seventh decades. It is a painless solitary mass, which grows slowly for more than 6 months, up to 20 cm. Several cases were reported chromosomal rearrangements with a breakpoint at 11q12. Histopathologically, it shows well-circumscribed mass that consists of scattered stellate cells in hypovascular collagenous matrix without atypia or mitosis. Management method is excision with functional preservation. In Korea, only two cases of collagenous fibroma have been reported so far. A 69-year-old woman was presented to our clinic with two painless well-demarcated hard masses, 4.5x4.5 and 4.5x2.5 cm in size, on both anterior superior iliac spine. Traumatic injury or a previous event was not noticed by the patient. After histopathologic examination, those masses were diagnosed as collagenous fibroma.
Aged ; Collagen ; Female ; Fibroma ; Humans ; Korea ; Mitosis ; Spine