BACKGROUND Closed rupture of the little and ring finger flexor tendons caused by the hamate is mostly associated with a fracture or nonunion of the hamate hook.Only one case of a closed rupture of the finger flexor te...BACKGROUND Closed rupture of the little and ring finger flexor tendons caused by the hamate is mostly associated with a fracture or nonunion of the hamate hook.Only one case of a closed rupture of the finger flexor tendon caused by osteochondroma in the hamate has been reported.Here,we present a case study to highlight the possibility of hamate osteochondroma as a rare cause of finger closed flexor tendon rupture based on our clinical experience and literature review.CASE SUMMARY A 48-year-old man who had been a rice-field farmer for 7–8 h a day for the past 30 years visited our clinic due to the loss of right little finger and ring finger flexion involving both the proximal and distal interphalangeal joints.The patient was diagnosed with a complete rupture of the ring and little finger flexors because of the hamate and was pathologically diagnosed with an osteochondroma.Exploratory surgery was performed,and a complete rupture of the ring and little finger flexors due to an osteophyte-like lesion of the hamate was observed,which was pathologically diagnosed as an osteochondroma.CONCLUSION One should consider that osteochondroma in the hamate may be the cause of closed tendon ruptures.展开更多
BACKGROUND The optimal treatment for heart failure(HF)is a combination of appropriate medications.Controlling the disease using only medical therapy is difficult in patients with HF,severe hypercapnia,and desaturation...BACKGROUND The optimal treatment for heart failure(HF)is a combination of appropriate medications.Controlling the disease using only medical therapy is difficult in patients with HF,severe hypercapnia,and desaturation.These patients should first receive ventilator support followed by pulmonary rehabilitation(PR).CASE SUMMARY We report two cases in which arterial blood gas(ABG)improved and PR was possible with appropriate ventilator support.Two patients with extreme obesity complaining of worsening dyspnea–a 47-year-old woman and a 36-year-old man both diagnosed with HF–were hospitalized because of severe hypercapnia and hypoxia.Despite proper medical treatment,hypercapnia and desaturation resolved in neither case,and both patients were transferred to the rehabilitation department for PR.At the time of the first consultation,the patients were bedridden because of dyspnea.Oxygen demand was successfully reduced once noninvasive ventilation was initiated.As the patients’dyspnea gradually improved to the point where they could be weaned off the ventilator during the daytime,they started engaging in functional training and aerobic exercise.After 4 mo of followup,both patients were able to perform activities of daily living and maintain their lower body weight and normalized ABG levels.CONCLUSION Symptoms of patients with obesity and HF may improve once ABG levels are normalized through ventilator support and implementation of PR.展开更多
BACKGROUND Endoscopic submucosal dissection(ESD)is the treatment of choice for early gastric cancer and premalignant gastric dysplasia.In some cases,ESD induced ulcer heals as a polypoid nodular scar(PNS).These scars ...BACKGROUND Endoscopic submucosal dissection(ESD)is the treatment of choice for early gastric cancer and premalignant gastric dysplasia.In some cases,ESD induced ulcer heals as a polypoid nodular scar(PNS).These scars may make the physicians raise several clinical implications such as post-ESD neoplastic recurrence.CASE SUMMARY We described a case of gastric ESD induced PNS which is regressed after Helicobacter pylori(H.pylori)eradication.A 58-year-old male patient was referred to the outpatient clinic for evaluation and treatment of gastric low-grade dysplasia(LGD).ESD was performed.A PNS was developed at the ESD site.An endoscopic biopsy was done and there was no histological evidence of remnant tumor or recurrence but a hyperplastic mucosal change.The PNS showed increase in size in follow-up endoscopy,and the biopsy specimen demonstrated H.pylori infestation.H.pylori eradication was done and the PNS was regressed.CONCLUSION H.pylori eradication is considerable for the regression of PNS if H.pylori infesta tion is confirmed.展开更多
The immature fruits of Poncirus trifoliate are used as a medicine for the treatment of gastrointestinal disorders,inflammation,and allergies in East Asia.However,their effect on colon cancer cells remains unclear.We i...The immature fruits of Poncirus trifoliate are used as a medicine for the treatment of gastrointestinal disorders,inflammation,and allergies in East Asia.However,their effect on colon cancer cells remains unclear.We investigated the effect of the immature fruit of P.trifoliate extract on colorectal adenocarcinoma.The extract of the immature fruit of P.trifoliata inhibited the proliferation of CT-26 cells compared with untreated cells and it induced autophagy and apoptosis through the protein kinase B/mammalian target of rapamycin and 5'-AMP-activated protein kinase pathways.The number of autophagic vacuoles and autophage markers increased in response to the extract.At later time-points,apoptosis increased dose/time-dependently.In CT-26 cells pre-treated a pan-caspase inhibitor prior to P.trifoliata immature fruit extract treatment,we did not find any change in pro-caspase 3 and pro-PARP levels.Additionally,in cells pre-treated autphage inhibitor,SQSTM1/p62 and LC3AB,pro-caspase 3 and pro-PARP levels did not change.Our results indicate the molecular mechanisms that the extract of the immature fruit of P.trifoliata induces apoptosis in colorectal carcinoma cells by inducing mitochondrial autophagy.In this study,we provided a draft for further investigate the use of MEPT for colorectal cancer inhibition.展开更多
BACKGROUNDAutonomic dysreflexia (AD) can be a life-threatening condition in patients withspinal cord injury. It is important to prevent bladder overdistension in thesepatients as it may trigger AD. Sensation-dependent...BACKGROUNDAutonomic dysreflexia (AD) can be a life-threatening condition in patients withspinal cord injury. It is important to prevent bladder overdistension in thesepatients as it may trigger AD. Sensation-dependent bladder emptying (SDBE), asa method of bladder management, improves the quality of life and allowsphysiologic voiding. In this study, we report disruption of the SDBE habit afterbladder overdistension leading to AD with chest pain.CASE SUMMARYA 47-year-old male with a diagnosis of C4 American Spinal Cord InjuryAssociation impairment scale A had been emptying his bladder using the cleanintermittent catheterization method with an itchy sensation in the nose as asensory indication for a full bladder for 23 years, and the usual urine volume wasabout 300-400 mL. At the time of this study, the patient had delayed catheterizationfor approximately five hours. He developed severe abdominal pain andheadache and had to visit the emergency room for bladder overdistension (800mL) and a high systolic blood pressure (205 mmHg). After control of AD, ahypersensitive bladder was observed despite using anticholinergic agents. Thesensation indicating bladder fullness changed from nose itching to pain in theabdomen and precordial area. Moreover, the volume of the painful bladder fillingsensation became highly variable and was noted when the bladder urine volumeexceeded only 100 mL. The patient refused intermittent clean catheterization Finally, a cystostomy was performed, which relieved the symptoms.CONCLUSIONPatients using physiologic feedback, such as SDBE, for bladder management arerecommended to avoid bladder overdistension.展开更多
BACKGROUND Axillary thoracotomy and muscle flap are muscle-and nerve-sparing methods among the surgical approaches to bronchopleural fistula(BPF).However,in patients who are vulnerable to a nerve compression injury,ne...BACKGROUND Axillary thoracotomy and muscle flap are muscle-and nerve-sparing methods among the surgical approaches to bronchopleural fistula(BPF).However,in patients who are vulnerable to a nerve compression injury,nerve injury may occur.In this report,we present a unique case in which the brachial plexus(division level),suprascapular,and long thoracic nerve injury occurred after BPF closure surgery in a patient with ankylosing spondylitis and concomitant multiple joint contractures.CASE SUMMARY A 52-year-old man with a history of ankylosing spondylitis with shoulder joint contractures presented with right arm weakness and sensory impairment immediately after axillary thoracotomy and latissimus dorsi muscle flap surgery for BPF closure.During the surgery,the patient was positioned in a lateral decubitus position with the right arm hyper-abducted for approximately 6 h.Magnetic resonance imaging and ultrasound revealed subclavius muscle injury or myositis with brachial plexus(BP)compression and related neuropathy.An electrodiagnostic study confirmed the presence of BP injury involving the wholedivision level,long thoracic,and suprascapular nerve injuries.He was treated with medication,physical therapy,and ultrasound-guided injections.Ultrasoundguided steroid injection at the BP,hydrodissection with 5%dextrose water at the BP and suprascapular nerve,and intra-articular steroid and hyaluronidase injection at the glenohumeral joint were performed.On postoperative day 194,the pain and arm weakness were resolved,and a follow-up electrodiagnostic study showed marked improvement.CONCLUSION Clinicians should consider the possibilities of multiple nerve injuries in patients with joint contracture,and treat each specific therapeutic target.展开更多
BACKGROUND A large ganglionic cyst extending from the hip joint to the intrapelvic cavity through the sciatic notch is a rare space-occupying lesion associated with compressive lower-extremity neuropathy.A cyst in the...BACKGROUND A large ganglionic cyst extending from the hip joint to the intrapelvic cavity through the sciatic notch is a rare space-occupying lesion associated with compressive lower-extremity neuropathy.A cyst in the pelvic cavity compressing the intrapelvic-sciatic nerve is easily missed in the diagnostic process because it usually presents as atypical symptoms of an extraperitoneal-intrapelvic tumor.We present a case of a huge ganglionic cyst that was successfully excised laparoscopically and endoscopically by a gynecologist and an orthopedic surgeon.CASE SUMMARY A 52-year-old woman visited our hospital complaining of pain and numbness in her left buttock while sitting.The pain began 3 years ago and worsened,while the numbness in the left lower extremity lasted 1 mo.She was diagnosed and unsuccessfully treated at several tertiary referral centers many years ago.Magnetic resonance imaging revealed a suspected paralabral cyst(5 cm×5 cm×4.6 cm)in the left hip joint,extending to the pelvic cavity through the greater sciatic notch.The CA-125 and CA19-9 tumor marker levels were within normal limits.However,the cyst was compressing the sciatic nerve.Accordingly,endoscopic and laparoscopic neural decompression and mass excision were performed simultaneously.A laparoscopic examination revealed a tennis-ball-sized cyst filled with gelatinous liquid,stretching deep into the hip joint.An excisional biopsy performed in the pelvic cavity and deep gluteal space confirmed the accumulation of ganglionic cysts from the hip joint into the extrapelvic intraperitoneal cavity.CONCLUSION Intra-or extra-sciatic nerve-compressing lesion should be considered in cases of sitting pain radiating down the ipsilateral lower extremity.This large juxta-articular ganglionic cyst was successfully treated simultaneously using laparoscopy and arthroscopy.展开更多
Dear Editor,Recently,there has been a rise in interest in the roles of cytokines and cytokine receptors in malignant human tumors.Cytokine receptors,especially typeⅡinterleukin-4 receptor(IL-4R),have recently been ex...Dear Editor,Recently,there has been a rise in interest in the roles of cytokines and cytokine receptors in malignant human tumors.Cytokine receptors,especially typeⅡinterleukin-4 receptor(IL-4R),have recently been examined as novel therapeutic targets of human cancers[1-3].The typeⅡIL-4R complex is composed of IL-4Rαand interleukin-13 receptorα1(IL-13Rα1),and the expression of IL-4Rαand IL-13Rα1 was higher in cancer tissues compared with normal counterpart tissues[3,4].展开更多
文摘BACKGROUND Closed rupture of the little and ring finger flexor tendons caused by the hamate is mostly associated with a fracture or nonunion of the hamate hook.Only one case of a closed rupture of the finger flexor tendon caused by osteochondroma in the hamate has been reported.Here,we present a case study to highlight the possibility of hamate osteochondroma as a rare cause of finger closed flexor tendon rupture based on our clinical experience and literature review.CASE SUMMARY A 48-year-old man who had been a rice-field farmer for 7–8 h a day for the past 30 years visited our clinic due to the loss of right little finger and ring finger flexion involving both the proximal and distal interphalangeal joints.The patient was diagnosed with a complete rupture of the ring and little finger flexors because of the hamate and was pathologically diagnosed with an osteochondroma.Exploratory surgery was performed,and a complete rupture of the ring and little finger flexors due to an osteophyte-like lesion of the hamate was observed,which was pathologically diagnosed as an osteochondroma.CONCLUSION One should consider that osteochondroma in the hamate may be the cause of closed tendon ruptures.
基金Supported by The“Research Base Construction Fund Support Program”funded by Jeonbuk National University in 2021.
文摘BACKGROUND The optimal treatment for heart failure(HF)is a combination of appropriate medications.Controlling the disease using only medical therapy is difficult in patients with HF,severe hypercapnia,and desaturation.These patients should first receive ventilator support followed by pulmonary rehabilitation(PR).CASE SUMMARY We report two cases in which arterial blood gas(ABG)improved and PR was possible with appropriate ventilator support.Two patients with extreme obesity complaining of worsening dyspnea–a 47-year-old woman and a 36-year-old man both diagnosed with HF–were hospitalized because of severe hypercapnia and hypoxia.Despite proper medical treatment,hypercapnia and desaturation resolved in neither case,and both patients were transferred to the rehabilitation department for PR.At the time of the first consultation,the patients were bedridden because of dyspnea.Oxygen demand was successfully reduced once noninvasive ventilation was initiated.As the patients’dyspnea gradually improved to the point where they could be weaned off the ventilator during the daytime,they started engaging in functional training and aerobic exercise.After 4 mo of followup,both patients were able to perform activities of daily living and maintain their lower body weight and normalized ABG levels.CONCLUSION Symptoms of patients with obesity and HF may improve once ABG levels are normalized through ventilator support and implementation of PR.
文摘BACKGROUND Endoscopic submucosal dissection(ESD)is the treatment of choice for early gastric cancer and premalignant gastric dysplasia.In some cases,ESD induced ulcer heals as a polypoid nodular scar(PNS).These scars may make the physicians raise several clinical implications such as post-ESD neoplastic recurrence.CASE SUMMARY We described a case of gastric ESD induced PNS which is regressed after Helicobacter pylori(H.pylori)eradication.A 58-year-old male patient was referred to the outpatient clinic for evaluation and treatment of gastric low-grade dysplasia(LGD).ESD was performed.A PNS was developed at the ESD site.An endoscopic biopsy was done and there was no histological evidence of remnant tumor or recurrence but a hyperplastic mucosal change.The PNS showed increase in size in follow-up endoscopy,and the biopsy specimen demonstrated H.pylori infestation.H.pylori eradication was done and the PNS was regressed.CONCLUSION H.pylori eradication is considerable for the regression of PNS if H.pylori infesta tion is confirmed.
基金supported by Fund of Biomedical Research Institute,Jeonbuk National University Hospital.
文摘The immature fruits of Poncirus trifoliate are used as a medicine for the treatment of gastrointestinal disorders,inflammation,and allergies in East Asia.However,their effect on colon cancer cells remains unclear.We investigated the effect of the immature fruit of P.trifoliate extract on colorectal adenocarcinoma.The extract of the immature fruit of P.trifoliata inhibited the proliferation of CT-26 cells compared with untreated cells and it induced autophagy and apoptosis through the protein kinase B/mammalian target of rapamycin and 5'-AMP-activated protein kinase pathways.The number of autophagic vacuoles and autophage markers increased in response to the extract.At later time-points,apoptosis increased dose/time-dependently.In CT-26 cells pre-treated a pan-caspase inhibitor prior to P.trifoliata immature fruit extract treatment,we did not find any change in pro-caspase 3 and pro-PARP levels.Additionally,in cells pre-treated autphage inhibitor,SQSTM1/p62 and LC3AB,pro-caspase 3 and pro-PARP levels did not change.Our results indicate the molecular mechanisms that the extract of the immature fruit of P.trifoliata induces apoptosis in colorectal carcinoma cells by inducing mitochondrial autophagy.In this study,we provided a draft for further investigate the use of MEPT for colorectal cancer inhibition.
文摘BACKGROUNDAutonomic dysreflexia (AD) can be a life-threatening condition in patients withspinal cord injury. It is important to prevent bladder overdistension in thesepatients as it may trigger AD. Sensation-dependent bladder emptying (SDBE), asa method of bladder management, improves the quality of life and allowsphysiologic voiding. In this study, we report disruption of the SDBE habit afterbladder overdistension leading to AD with chest pain.CASE SUMMARYA 47-year-old male with a diagnosis of C4 American Spinal Cord InjuryAssociation impairment scale A had been emptying his bladder using the cleanintermittent catheterization method with an itchy sensation in the nose as asensory indication for a full bladder for 23 years, and the usual urine volume wasabout 300-400 mL. At the time of this study, the patient had delayed catheterizationfor approximately five hours. He developed severe abdominal pain andheadache and had to visit the emergency room for bladder overdistension (800mL) and a high systolic blood pressure (205 mmHg). After control of AD, ahypersensitive bladder was observed despite using anticholinergic agents. Thesensation indicating bladder fullness changed from nose itching to pain in theabdomen and precordial area. Moreover, the volume of the painful bladder fillingsensation became highly variable and was noted when the bladder urine volumeexceeded only 100 mL. The patient refused intermittent clean catheterization Finally, a cystostomy was performed, which relieved the symptoms.CONCLUSIONPatients using physiologic feedback, such as SDBE, for bladder management arerecommended to avoid bladder overdistension.
文摘BACKGROUND Axillary thoracotomy and muscle flap are muscle-and nerve-sparing methods among the surgical approaches to bronchopleural fistula(BPF).However,in patients who are vulnerable to a nerve compression injury,nerve injury may occur.In this report,we present a unique case in which the brachial plexus(division level),suprascapular,and long thoracic nerve injury occurred after BPF closure surgery in a patient with ankylosing spondylitis and concomitant multiple joint contractures.CASE SUMMARY A 52-year-old man with a history of ankylosing spondylitis with shoulder joint contractures presented with right arm weakness and sensory impairment immediately after axillary thoracotomy and latissimus dorsi muscle flap surgery for BPF closure.During the surgery,the patient was positioned in a lateral decubitus position with the right arm hyper-abducted for approximately 6 h.Magnetic resonance imaging and ultrasound revealed subclavius muscle injury or myositis with brachial plexus(BP)compression and related neuropathy.An electrodiagnostic study confirmed the presence of BP injury involving the wholedivision level,long thoracic,and suprascapular nerve injuries.He was treated with medication,physical therapy,and ultrasound-guided injections.Ultrasoundguided steroid injection at the BP,hydrodissection with 5%dextrose water at the BP and suprascapular nerve,and intra-articular steroid and hyaluronidase injection at the glenohumeral joint were performed.On postoperative day 194,the pain and arm weakness were resolved,and a follow-up electrodiagnostic study showed marked improvement.CONCLUSION Clinicians should consider the possibilities of multiple nerve injuries in patients with joint contracture,and treat each specific therapeutic target.
文摘BACKGROUND A large ganglionic cyst extending from the hip joint to the intrapelvic cavity through the sciatic notch is a rare space-occupying lesion associated with compressive lower-extremity neuropathy.A cyst in the pelvic cavity compressing the intrapelvic-sciatic nerve is easily missed in the diagnostic process because it usually presents as atypical symptoms of an extraperitoneal-intrapelvic tumor.We present a case of a huge ganglionic cyst that was successfully excised laparoscopically and endoscopically by a gynecologist and an orthopedic surgeon.CASE SUMMARY A 52-year-old woman visited our hospital complaining of pain and numbness in her left buttock while sitting.The pain began 3 years ago and worsened,while the numbness in the left lower extremity lasted 1 mo.She was diagnosed and unsuccessfully treated at several tertiary referral centers many years ago.Magnetic resonance imaging revealed a suspected paralabral cyst(5 cm×5 cm×4.6 cm)in the left hip joint,extending to the pelvic cavity through the greater sciatic notch.The CA-125 and CA19-9 tumor marker levels were within normal limits.However,the cyst was compressing the sciatic nerve.Accordingly,endoscopic and laparoscopic neural decompression and mass excision were performed simultaneously.A laparoscopic examination revealed a tennis-ball-sized cyst filled with gelatinous liquid,stretching deep into the hip joint.An excisional biopsy performed in the pelvic cavity and deep gluteal space confirmed the accumulation of ganglionic cysts from the hip joint into the extrapelvic intraperitoneal cavity.CONCLUSION Intra-or extra-sciatic nerve-compressing lesion should be considered in cases of sitting pain radiating down the ipsilateral lower extremity.This large juxta-articular ganglionic cyst was successfully treated simultaneously using laparoscopy and arthroscopy.
基金supported by grants from the Medical Research Center Program(2017R1A5A2015061)through the National Research Foundation(NRF)funded by the Korean government,the Ministry of Science,ICT and Future Planning(MSIP).
文摘Dear Editor,Recently,there has been a rise in interest in the roles of cytokines and cytokine receptors in malignant human tumors.Cytokine receptors,especially typeⅡinterleukin-4 receptor(IL-4R),have recently been examined as novel therapeutic targets of human cancers[1-3].The typeⅡIL-4R complex is composed of IL-4Rαand interleukin-13 receptorα1(IL-13Rα1),and the expression of IL-4Rαand IL-13Rα1 was higher in cancer tissues compared with normal counterpart tissues[3,4].
