Background: The inflation-deflation (ID) method has long been the standard for intraoperative margin assessment in segmentectomy. However, with advancements in vision technology, the use of near-infrared mapping with indocyanine green (ICG) has become increasingly common. This study was conducted to compare the perioperative outcomes and resection margins achieved using these methods. Methods: This retrospective study included patients who underwent direct segmentectomy for clinical stage I lung cancer between January 2018 and September 2022. We compared perioperative factors, including bronchial and parenchymal resection margins, according to the margin assessment method and the type of segmentectomy performed.Since the ICG approach was adopted in April 2021, we also examined a recent subgroup of patients treated from then onward. Results: A total of 319 segmentectomies were performed. ID and ICG were utilized for 261 (81.8%) and 58 (18.2%) patients, respectively. Following April 2021, 61 patients (51.3%) were treated with ID, while 58 (48.7%) received ICG. We observed no significant difference in resection margins between ID and ICG for bronchial (2.7 cm vs. 2.3 cm, p=0.07) or parenchymal (2.5 cm vs. 2.3 cm, p=0.46) margins. Additionally, the length of hospitalization and the complication rate were comparable between groups. Analysis of the recent subgroup confirmed these findings, showing no significant differences in resection margins (bronchial: 2.6 cm vs. 2.3 cm, p=0.25; parenchymal: 2.4 cm vs. 2.3 cm, p=0.75), length of hospitalization, or complication rate. Conclusion The perioperative outcomes and resection margins achieved using ID and ICG were comparable, suggesting that both methods can safely guide segmentectomy procedures.

Background: We evaluated the household secondary attack rate (SAR) of the omicron and delta severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, according to the vaccination status of the index case and household contacts; further, in vaccinated index cases, we evaluated the effect of the antibody levels on household transmission. Methods: A prospective cross-sectional study of 92 index cases and 197 quarantined household contacts was performed. Tests for SARS-CoV-2 variant type and antibody level were conducted in index cases, and results of polymerase chain reaction tests (during the quarantine period) were collected from contacts. Association of antibody levels in vaccinated index cases and SAR was evaluated by multivariate regression analysis. Results: The SAR was higher in households exposed to omicron variant (42%) than in those exposed to delta variant (27%) (P = 0.040). SAR was 35% and 23% for unvaccinated and vaccinated delta variant exposed contacts, respectively. SAR was 44% and 41% for unvaccinated and vaccinated omicron exposed contacts, respectively. Booster dose immunisation of contacts or vaccination of index cases reduced SAR of vaccinated omicron variant exposed contacts. In a model with adjustment, anti-receptor-binding domain antibody levels in vaccinated index cases were inversely correlated with household transmission of both delta and omicron variants.Neutralising antibody levels had a similar relationship. Conclusion Immunisation of household members may help to mitigate the current pandemic.

A seven-month pregnant four-year-old Thoroughbred mare with colic weighing 600 kg was referred to the Jeju National University Equine Hospital. A physical examination and ultrasound suggested epiploic foramen entrapment. The patient underwent ileum resection and end-to-side jejunocecostomy. After surgery, the horse showed a consistent pain when introduced to feeding. A repeat laparotomy was performed to enlarge the stoma size with side-to-side jejunocecostomy. The repeat laparotomy was successful, and the mare gave birth uneventfully. This report describes a case of small intestinal epiploic foramen entrapment and the clinical outcomes of the 2 consecutive laparotomies a Thoroughbred mare in late gestation.

Purpose: This study investigated the characteristics and treatment outcomes of patients who visited the emergency department due to intoxication and analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on their visits. Methods: A retrospective study was conducted using data from the National Emergency Department Information System (NEDIS) on patients who visited the emergency department due to intoxication between January 2014 and December 2020. In total, 277,791 patients were included in the study, and their demographic and clinical data were analyzed. A model was created from 2014 to 2019 and applied to 2020 (i.e., during the COVID-19 pandemic) to conduct a time series analysis distinguishing between unexpected accidents and suicide/self-harm among patients who visited the emergency department. Results: The most common reason for visiting the emergency department was unintentional accidents (48.5%), followed by self-harm/suicide attempts (43.8%). Unexpected accident patients and self-harm/suicide patients showed statistically significant differences in terms of sex, age group, hospitalization rate, and mortality rate. The time series analysis showed a decrease in patients with unexpected accidents during the COVID-19 pandemic, but no change in patients with suicide/self-harm. Conclusion Depending on the intentionality of the intoxication, significant differences were found in the age group, the substance of intoxication, and the mortality rate. Therefore, future analyses of patients with intoxication should be stratified according to intentionality. In addition, the time series analysis of intentional self-harm/suicide did not show a decrease in 2010 in the number of patients, whereas a decrease was found for unintentional accidents.

PURPOSE: This paper proposes proper and effective neck exercises by comparing the deep and superficial cervical flexor muscle activities and thickness according to the pressure level during cranio-cervical flexion exercises between a normal posture group and forward head posture group. METHODS: A total of 20 subjects (8 males and 12 females) without neck pain and disabilities were selected. The subjects' craniovertebral angles were measured; they were divided into a normal posture and a forward head posture group. During cranio-cervical flexion exercises, the thickness of the deep cervical flexor neck muscle and the activity of the surface neck muscles were measured using ultrasound and EMG. RESULTS: The results showed that the thickening of the deep cervical flexor was increased significantly to 28 and 30 mmHg in the forward head posture group. The sternocleidomastoid muscle activity increased significantly to 24, 26, 28, and 30 mmHg in the forward head posture group. The anterior scalene muscle activity increased significantly to 26, 28, and 30mmHg in the forward head posture group. A significant difference of 26, 28, and 30 mmHg in the sternocleidomastoid and anterior scalene muscles was observed between two groups. CONCLUSION: To prevent a forward head posture and maintain proper cervical curve alignment, the use of the superficial cervical flexor muscles must be minimized. In addition, to perform a cranio-cervical flexion exercises to effectively activate the deep cervical flexor muscles, 28 and 30 mmHg for normal posture adults and 28 mmHg for adults with forward head postures are recommended.
Adult ; Exercise ; Head ; Humans ; Male ; Muscles ; Neck ; Neck Muscles ; Neck Pain ; Posture ; Ultrasonography

Dermatomyositis is an autoimmune disease characterized by chronic muscle inflammation that results in specific dermatological signs and decreased muscle strength. It is known to have a strong association with malignancy. Most neuroendocrine tumors arise from the gastrointestinal tract, with less than 1% of cases occurring at the ampulla of Vater. While cases of dermatomyositis associated with neuroendocrine tumors have been reported internationally, to date there have been no cases reported in Korea. This case report presents a 33-year-old male who had undergone pylorus-preserving pancreaticoduodenectomy for a neuroendocrine tumor located at the ampulla of Vater, and had been followed at the hospital after his procedure. Three years post-surgery, the patient developed serious muscle weakness in his upper-right and lower-left extremities, and was subsequently diagnosed with dermatomyositis. This paper presents the first domestic case of dermatomyositis developing in the context of a neuroendocrine tumor at the ampulla of Vater. A literature review on this subject follows in the discussion.
Adult ; Ampulla of Vater* ; Autoimmune Diseases ; Dermatomyositis* ; Extremities ; Gastrointestinal Tract ; Humans ; Inflammation ; Korea ; Male ; Muscle Strength ; Muscle Weakness ; Neuroendocrine Tumors* ; Pancreaticoduodenectomy

Owing to the ability of musculoskeletal ultrasound (US) to depict cross sectional images of synovial joint and related structures, US has become the most reliable tool for evaluation of arthritic activity of rheumatoid arthritis (RA). US can detect early synovitis, assess disease activity, and determine true remission in patients with RA. US also can detect early enthesitis in patients with spondyloarthropathies. In addition, US can provide a reliable tool for measuring skin thickness in patients with systemic sclerosis. With guidance of injection or aspiration, US can result in a better clinical outcome. Thus, educational needs and research networks are increasing. We present a review of rheumatology US, focusing on recent trends and advances.
Arthritis, Rheumatoid ; Humans ; Joints ; Rheumatology* ; Scleroderma, Systemic ; Skin ; Spondylarthropathies ; Synovitis ; Ultrasonography* ; Ultrasonography, Doppler

Rheumatoid arthritis (RA) is frequently associated with various extra-joint complications. Although rare, thromboembolic complications are associated with high morbidity and mortality. We experienced a very rare case of nonbacterial thrombotic endocarditis (NBTE) and subsequent embolic stroke in a patient with RA. A 72-year-old male with a 15-year history of RA suddenly developed neurologic symptoms of vomiting and dizziness. Brain magnetic resonance imaging revealed recently developed multiple cerebellar and cerebral lacunar infarctions. Echocardiography showed a pulsating mitral valve vegetation involving the posterior cusp of the mitral valve leaflet, which was confirmed as NBTE. Immediate anti-coagulation therapy was started. The NBTE lesion disappeared in follow-up echocardiography after 4 weeks of anti-coagulation treatment.
Aged ; Arthritis, Rheumatoid* ; Brain ; Dizziness ; Echocardiography ; Endocarditis ; Endocarditis, Non-Infective* ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Mitral Valve ; Mortality ; Neurologic Manifestations ; Stroke ; Stroke, Lacunar ; Vomiting

Retroperitoneal fibrosis (RPF) is a rare, progressive disease characterized by chronic non specific inflammation of the retroperitoneum. Although the pathogenesis of idiopathic retroperitoneal fibrosis (IRF) remains unclear, IRF has been reported in association with autoimmune disorders. However, few cases of IRF associated with rheumatoid arthritis (RA) have been reported. We experienced a rare case of IRF in a patient with RA and chronic B viral hepatitis. A 39-year-old Korean man with RA and hepatitis B was referred to our hospital due to left hydronephrosis. An abdominal computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a diffuse infiltrating retroperitoneal mass around the abdominal aorta and left ureter. The patient underwent intraureteral stent insertion and was treated with corticosteroid. Three months later, the follow up abdominal CT showed that the retroperitoneal mass had decreased in size. Herein, we report the first case of coexistent IRF, RA, and chronic B viral hepatitis with a literature review.
Adult ; Aorta, Abdominal ; Arthritis, Rheumatoid* ; Follow-Up Studies ; Hepatitis B ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Hydronephrosis ; Inflammation ; Magnetic Resonance Imaging ; Retroperitoneal Fibrosis* ; Stents ; Tomography, X-Ray Computed ; Ureter

Rheumatoid arthritis (RA) can be evaluated with ultrasound using both gray scale and Doppler mode. Gray scale provides cross-sectional images of joints, whereas Doppler shows the vascularity of the proliferated synovium. In RA, ultrasound can detect sub-clinical or early synovitis, assess arthritis more accurately than through clinical examination, and predict recurrence. In particular, a Doppler signal detected inside the joint cavity correlates with disease activity. Imaging remission can reflect the true remission status more accurately than with clinical remission. In this review, we focus on the use of ultrasonographic findings for the diagnosis, assessment, and prediction of RA.
Arthritis ; Arthritis, Rheumatoid* ; Diagnosis ; Joints ; Recurrence ; Synovial Membrane ; Synovitis ; Ultrasonography