Sunah Suk;Yeon Joo Seo;Dae Young Cheung;Han Hee Lee;Jin Il Kim;Soo-Heon Park
Clinical Endoscopy
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v.56
no.4
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pp.470-478
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2023
Background/Aims: Metachronous recurrence incidences and risk factors following endoscopic submucosal dissection (ESD) for gastric adenocarcinoma and dysplasias were investigated. Methods: Retrospective review of electronic medical records of patients who underwent gastric ESD at The Catholic University of Korea, Yeouido St. Mary's Hospital. Results: A total of 190 subjects were enrolled for analysis during the study period. The mean age was 64.4 years and the male sex occupied 73.7%. The mean observation period following ESD was 3.45 years. The annual incidence rate of metachronous gastric neoplasms (MGN) was about 3.96%. The annual incidence rate was 5.36% for the low-grade dysplasia group, 6.47% for the high-grade dysplasia group, and 2.74% for the EGC group. MGN was more frequent in the dysplasia group than in the EGC group (p<0.05). For those with MGN development, the mean time interval from ESD to MGN was 4.1 (±1.8) years. By using the Kaplan-Meier model, the estimated mean MGN free survival time was 9.97 years (95% confidence interval, 8.53-11.40) The histological types of MGN were not related to the primary histology types. Conclusions: MGN following ESD developed in 3.96% annually and MGN was more frequent in the dysplasia group. The histological types of MGN did not correlate with those of primary neoplasm.
Purpose: Nondisplaced femoral neck fractures have traditionally been treated with in situ fixation. However, poor surgical and clinical outcomes have been reported for fractures with valgus deformity >15°, and the reduction of valgus impaction has recently been emphasized. In addition, early degenerative osteoarthritis can be caused by cam-type femoroacetabular impingement after healing of femoral neck fractures. This study was designed with the objective of confirming the difference in progression of radiographic osteoarthritis according to the severity of the valgus deformity. Materials and Methods: Patients who underwent internal fixation using multiple cannulateld screws for management of nondisplaced femoral neck fractures were divided into two groups: high valgus group (postoperative valgus angle ≥15°) and low valgus group (postoperative valgus angle <15°). Evaluation of demographic data and changes in the joint space width from the immediate postoperative period to the latest follow-up was performed. Results: A significant decrease in joint space width in both hip joints was observed in the high valgus group when compared with the low valgus group, including cases with an initial valgus angle less than 15° and those corrected to less than 15° of valgus by reduction. No complications requiring surgical treatment were observed in either group; however, two cases of avascular necrosis, one in each group, which developed in the low valgus group after reduction of the fracture, were followed for observation. Conclusion: Performing in situ fixation in cases involving a valgus deformity ≥15° in non-displaced femoral neck fractures may cause accelerated narrowing of the hip joint space.
Woo-nyoung Jung;Mee-ryoung Song;Yeon-joo Yoo;Min-seong Lee;Young-min Ahn;Se-young Ahn;Byung-cheol Lee
The Journal of Internal Korean Medicine
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v.45
no.2
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pp.303-313
/
2024
Introduction: We describe the effects of Sosiho-tang decoction and insulin combination therapy, as well as the effect of integrated traditional Korean medicine therapy, using continuous glucose monitoring (CGM) in a diabetic patient complaining of a range of diabetic symptoms. Case report: A 24-year-old female presented with symptoms of diabetes, including weight loss, thirst, and polyuria, and was diagnosed with type 2 diabetes through blood tests, endocrine tests, and autoantibody tests. During hospitalization, the patient received insulin therapy and Sosiho-tang decoction concurrently, achieving normal blood glucose levels. After discharge, adhering to the Sosiho-tang decoction and CGM enabled the insulin dosage to be gradually reduced while maintaining normal blood glucose levels. Conclusion: Combination therapy with insulin and Sosiho-tang rapidly reduced hyperglycemia in the short term. CGM post-discharge allowed for observation of the patient's blood glucose levels. Ultimately, Sosiho-tang medication lowered blood glucose levels, reduced insulin requirements, and facilitated a reduction in the insulin dosage.
The uterus, one of women's reproductive organs, is also closely related to women's health. Among them, hemorrhagic luteal cysts, one of the causes of pelvic pain that women often experience, were observed through CT and ultrasound, and the quality of images was evaluated through quantitative and qualitative evaluations. This study sought to find out whether the test method is more helpful to patients during CT and ultrasound. This study was conducted on 15 adolescent women and 15 adult women(21.31±3.45 average age). The equipment used for filming used EC3-10X (3~10 MHZ) and Philips Mx8000 iCT 256 among Endocavity Probes among Ecube Platinum. After setting a constant ROI on the cyst and the interface as a quantitative analysis method, SNR and CNR values were measured on a 5-point scale based on image quality, lesion clarity, image distortion, clarity of the interface, and motion artifacts (p<0.05). Independent t-test and Mann Whiteny U were performed, and the statistical program used was noted when SPSS (Version 22.0 for windows software package, Chicago, IL, USA) was statistically less than 0.05. Comparing the SNR and CNR values for this experiment, it can be seen that the SNR value was higher in the case of CT images(p<0.05). As a result of the qualitative evaluation, the quality of the image, the clarity of the lesion, the distortion of the image, the clarity of the interface, and the clarity of the boundary were measured on a 5-point scale based on the movement artifact. Comparing each score, CT images scored higher with a finer difference than ultrasound images(p<0.05). In conclusion, both test methods showed excellent results in finding the patient's lesions. However, in quantitative and qualitative evaluations, CT produced higher results in detecting lesions than ultrasound. However, for cyst tests that require continuous observation, ultrasonography, a non-invasive method that is advantageous for patients, will be clinically useful. Therefore, observing the patient's lesions by appropriately distributing these two test methods will provide optimal diagnostic information. These results will be useful for providing clinical basic data and educational materials to CT and US users in the future.
Kyu-Ho Yi;Hyungkyu Bae;Soo-Bin Kim;Woo-Ram Kim;Won Lee;Ji-Soo Kim;Hee-Jin Kim
Anatomy and Cell Biology
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v.57
no.1
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pp.13-17
/
2024
Masseter are commonly botulinum neurotoxin targeted muscle for facial contouring in aesthetic field. However, paradoxical masseteric bulging is common adverse effect that has not been discussed with ultrasonographic observations. Retrospective study has been conducted from October, 2021 to January, 2023, out of 324 patients have done blinded botulinum neurotoxin injection in the masseter at the middle and lower portion of the masseter with each side of 25 units (letibotulinum neurotoxin type A), 3 patients demonstrated paradoxical masseteric bulging has been reported and the image observed by ultrasonography by physician. Based on the observations made, we can infer that the function of the moving muscle involves twisting of the muscle fibers during contraction, along with the twisting of the deep inferior tendon, which causes the muscle to be divided into anterior and posterior compartments rather than into superficial and deep compartments of masseter. In ultrasonographic observe the skin surface of a patient with paradoxical masseteric bulging, it is observable that either the anterior or posterior part contracts significantly. The functional units of anterior and posterior compartment are observable as muscular contraction of inward movement of the muscle from either the anterior or posterior functional unit.
Background: This study evaluated the effect of remimazolam and propofol on changes in autonomic nerve activity caused by surgical stimulation during orthognathic surgery, using power spectrum analysis of blood pressure variability (BPV) and heart rate variability (HRV), and their respective associations with cardiovascular fluctuations. Methods: A total of 34 patients undergoing Le Fort I osteotomy were randomized to the remimazolam (Group R, 17 cases) or propofol (Group P, 17 cases) groups. Observables included the low-frequency component of BPV (BPV LF; index of vasomotor sympathetic nerve activity), high-frequency component of HRV (HRV HF; index of parasympathetic nerve activity), balance index of the low- and high-frequency components of HRV (HRV LF/HF; index of sympathetic nerve activity), heart rate (HR), and systolic blood pressure (SBP). Four observations were made: (1) baseline, (2) immediately before down-fracture, (3) down-fracture, and (4) 5 min after down-fracture. Data from each observation period were compared using a two-way analysis of variance with a mixed model. A Bonferroni multiple comparison test was performed in the absence of any interaction. One-way analysis of variance followed by Tukey's multiple comparisons test was performed when a significant interaction was observed between time and group, with P < 0.05 indicating statistical significance. Results: Evaluation of autonomic nerve activity in comparison with baseline during down-fracture showed a significant increase in BPV LF (P < 0.001), an increasing trend in HRV LF/HF in Group P, and an increasing trend in HRV HF in Group R. There were no significant differences in HR or SBP between the two groups. Conclusion: During down-fracture of Le Fort I osteotomy, sympathetic nerve activity was predominant with propofol anesthesia, and parasympathetic nerve activity was predominant with remimazolam anesthesia.
Purpose: Management of pediatric subtrochanteric femur fractures (SFFs) is difficult. The aim of this study was to evaluate the outcomes of adolescent SFFs treated with adult proximal humeral locking plates (PHLPs). Materials and Methods: A retrospective analysis of 18 adolescents (11 male, 7 female) with a diagnosis of SFF who underwent internal fixation with a PHLP was conducted. Data regarding injury mechanism, fracture pattern, and time to union were recorded for all patients. In addition, a clinical and functional evaluation of patients was performed using the Harris hip score (HHS), Iowa hip score (IHS), modified Merle d'Aubigne-Postel score (MMAPS), Flynn criteria, and hip range of motion (ROM). Results: The mean age of the patients was 12.72±2.05 years (range, 10-16 years). Radiological observation was performed for evaluation of five different injury mechanisms and different fracture patterns in patients. The mean postoperative HHS was 92.27±5.61, the mean IHS was 90.88±6.46, and the mean MMAPS was 17.22±0.94. According to the Flynn criteria, excellent results were achieved in 14 cases and satisfactory results were obtained in four cases. Measurements of the patients' mean hip ROM values were as follows: 17.77±3.52° in extension, 115.27±6.74° in flexion, 43.05±3.48° in abduction, 27.50±4.28° in adduction, 42.22±4.60° in internal rotation, and 42.22±3.91° in external rotation. Conclusion: Surgery performed on adolescent patients using an adult PHLP showed good, safe results. Therefore, it should be considered as an alternative option.
Seo, Young-Min;Ha, Ki-Tae;Kim, June-Ki;Kim, Jang-Hyun
Journal of Physiology & Pathology in Korean Medicine
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v.21
no.1
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pp.18-27
/
2007
${\ll}$Gup Yu Bang${\gg}$ is the first korean book that specialized in pediatrics. It was written by Jo Jeong-jun in 1869 and contains 87 medical records. Medical records is one of the best way to develop one’s abilities of curing a disease without clinical practice and understanding medical condition of the time. These days we are fully aware of the importance of medical records, but there is no sufficient paper or study on medical records. On this study, we investigate 87 medical record of ${\ll}$Gup Yu Bang${\gg}$ by statistical methods. It was analyzed on the base of items such as age, sex, disease, method of medical treatment, treating prescription, modified medicinal substance, progress of disease. ${\ll}$Gup Yu Bang${\gg}$ contain 87 medical records and among of them, 84 records were Jo Jeong-jun own writings of clinical case. Systemic division of disease showed the highest in digestive disease and most frequent case was symptom of vomiting and diarrhea. The distribution of age was showed the highest in the age group under 5 years and the number of male case was more than female case. It showed that he considered observation of the patient's expression in diagnosis methods and have used 87 kinds of treating prescription and the external treatment, acupuncture, moxa. It showed that he quoted a lot of treating prescription from ${\ll}$Dong eui bo gam${\gg}$, ${\ll}$Yi-Hak-Yip-Mun${\gg}$ and ${\ll}$Xiao Er Yao Zheang Zhi Jue${\gg}$. The further study on medical records in traditional medical literatures, would reveal the developmental progress of Korean pediatrics and inform more actual proof on medical condition of the time.
Toxic effects of 2-bromopropane (2-BP) on the hematopoietic system and testis were investigated in male Srague-Dawley (SD) rats. 80 male SD rats, 5 weeks old, were treated with 2-BP in corn oil at levels of 0, 100, 330 and 1,000 mg/kg/day for 4 weeks orally. 10 animals from each group were maintained for additional 8 weeks following the treatment. In addition, 60 male SD rats were divided into 2 groups and administered 2-BP in corn oil at levels of 0 and 1,000 mg/kg/day orally and sacrificed after 1. 2 and 3 weeks of treatment. Clinical observation. body weight changes, food consumption, organ weight changes. hematology, serum chemistry and histopathology of the testis were performed in the study. No clinical sign and mortality were observed in the study. The body weights were significantly reduced with the treatment but gradually recovered. The relative organ weights of the testis and thymus significantly decreased in both of the groups treated with 1,000 mg/kg/day for 3 and 4 weeks. In the recovery groups, organ weights of the testis and epididymis were significantly reduced in both of the groups treated with 330 and 1,000 mg/kg/day. Platelets and reticulocytes were significantly reduced in both of the group treated with 1.000 mg/kg/day for 3 and 4 weeks. While red blood cells were de-creased but mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were increased in the recovery group. Significant increase of chloride was observed in all of the treatment groups except the recovery groups, and calcium was significantly increased in both of the groups treated with 1,000 mg/kg/ day for 3 and 4 weeks. On the other hand. there were significant decreases in alanine aminotransferase (ALT) and aspatate aminotransferase (AST) in most of groups treated with 1.000 mg/kg/day. In the testis. the spermatogonia in stages I-VI were mostly depleted and the spermatocytes in stages VII-VIII were de-generated or necrotized at week 1 after treatment of 2-BP. The degeneration of germ cells and the a-trophy of seminiferous tubules became more severe in time-dependent and dose-dependent manners. The damaged tubules showed regeneration in part. however. they did not appear to be completely recovered within 8 weeks of the recovery period. On the basis of the results. it is suggested that 2-BP would cause toxicities in hematopoiesis by possibly interfering the production of red blood cells and platelets and in spermatogenesis by the destruction oj spermatogonia in SD male rats.
A study was undertaken on rats in order to clarify the gastric mucosal, morphologic response to oral and subcutaneous administration of acetylsalicylic acid(aspirin). Aspirin was administered orally (oral group) and subcutaneously (subcutaneous group) at does rate of 60 mg per kg of body weight per day to 40 normal rats. On the 1st, 3rd, 7th, and 15th day of administration, in addition to clinical observation, 5 rats each from the both groups were sacrificed and examined macroscopically, histologically and electron-microscopically for the morphological changes of gastric mucosal cells with the following results. Although the clinical, macroscopic and histological changes were not significant, marked ultrastructural changes were observed. Parietal and chief cells were affected most severely by the administration of aspirin ; parietal cells showed increase in the number of SER and intracellular canaliculi, where-as in chief cells fragmentation, luminal dilatation, decrease in the number and structural abnormalities of RER were seen. Relatively mild changes were observed in mucous, mucous neck and basal-granulated cells. Although the degree of changes was milder than those of oral group, the similar changes were also observed in the subcutaneous group. From these results, it would be concluded that aspirin injury of gastric mucosa is effected not only by the direct injury to the mucosa but also indirectly by the blood concentration of aspirin.
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