Small Bowel Hernia due to a Blunt Pelvic Injury

A 91-year-old female presented to Chonnam National University Hospital Regional Trauma Center with a lateral compression type III fracture of the pelvis. She was managed non-operatively for a week in the intensive care unit under close observation and had an emergency operation due to delayed onset of an acute obstructed direct inguinal hernia. Traumatic abdominal wall hernias are rare. However, trauma surgeons should always be aware of the possibility of such injuries because of their critical consequences.

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Staging accuracy of endoscopic ultrasonography in esophageal cancer, Jae Hoon Cheong, Pusan National University Hospital

Endoscopy ◽

10.1055/s-0031-1292097 ◽

2011 ◽

Vol 43 (S 03) ◽

Author(s):

Ryu Dong Yup

Keyword(s):

Esophageal Cancer ◽

Endoscopic Ultrasonography ◽

University Hospital ◽

Staging Accuracy ◽

National University

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Intestinal parasite survey of Kyungpook National University Hospital patients

The Korean Journal of Parasitology ◽

10.3347/kjp.1971.9.2.47 ◽

1971 ◽

Vol 9 (2) ◽

pp. 47 ◽

Cited By ~ 11

Author(s):

Dong Wik Choi ◽

Sung Deok Park ◽

Jae Woun Kim ◽

Doo Hong Ahn ◽

Young Myung Kim

Keyword(s):

Intestinal Parasite ◽

University Hospital ◽

Hospital Patients ◽

National University

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Mobilization versus displacement on lateral stress radiographs for determining operative fixation of minimally displaced lateral compression type I (LC1) pelvic ring injuries

International Orthopaedics ◽

10.1007/s00264-020-04912-3 ◽

2021 ◽

Author(s):

Joshua A. Parry ◽

Motasem Salameh ◽

August Funk ◽

Austin Heare ◽

Stephen C. Stacey ◽

...

Keyword(s):

Pelvic Ring ◽

Type I ◽

Lateral Stress ◽

Lateral Compression ◽

Stress Radiographs ◽

Pelvic Ring Injuries ◽

Operative Fixation ◽

Compression Type

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The traditional experience strategy (TES) and combined ultrasonography examination (CUE) for the treatment of lateral compression type 1 pelvic fractures: a historical control study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03993-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Hai Huang ◽

Bin-Fei Zhang ◽

Ping Liu ◽

Hong-Li Deng ◽

Peng-Fei Wang ◽

...

Keyword(s):

Pelvic Fractures ◽

Definitive Treatment ◽

Lateral Compression ◽

Level Of Evidence ◽

Conservative Group ◽

Medical Records System ◽

The Stability ◽

And Function ◽

Compression Type

Abstract Background It is difficult to judge the stability of lateral compression type-1 (LC-1) pelvic fracture, as it is often based on static images of the pelvis. Compared with the traditional experience strategy, ultrasonography examination may be able to distinguish operative and conservative patients before definitive treatment. However, in previous studies, we have not compared the outcomes between traditional experience strategy (TES group) and combined ultrasonography examination (CUE group). Thus, the aim of the study is comparing the differences between TES and CUE strategy, to identify the value of ultrasonography examination. Methods Medical records system for patients with LC-1 pelvic fractures who were treated with TES and CUE strategy were included. Patients’ baseline characteristics, treatment strategy, and function were recorded at follow-up. Functional outcomes were evaluated using the Majeed grading system. Results In total, 77 patients with LC-1 pelvic fractures were included in the study. There were 42 and 35 patients in TES and CUE group, respectively. Compared to TES group (69 %), there were less proportion patients chosen the operative treatment in CUE group (43 %, P = 0.021). The volume of intraoperative blood loss in CUE operative group was more than TES operative group (P = 0.037). There were more patients with complete sacral fracture in CUE operative group than TES operative group (P = 0.002). The Majeed scores in CUE conservative group was higher than TES conservative group (P = 0.008). The overall Majeed scores in CUE group was higher than that in TES group (P = 0.039). Conclusions The ultrasonography examination could relatively accurately identify the unstable LC-1 pelvis than the traditional experience strategy, the operative rate could be reduced and the overall function of LC-1 patients could be improved under the ultrasonography examination. Level of evidence Level III.

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Circulating regulatory T cells predict efficacy and atypical responses in lung cancer patients treated with PD-1/PD-L1 inhibitors

Cancer Immunology Immunotherapy ◽

10.1007/s00262-021-03018-y ◽

2021 ◽

Author(s):

Da Hyun Kang ◽

Chaeuk Chung ◽

Pureum Sun ◽

Da Hye Lee ◽

Song-I Lee ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Advanced Nsclc ◽

Checkpoint Inhibitors ◽

Standard Of Care ◽

Treg Cells ◽

University Hospital ◽

X Rays ◽

Lung Cancer Patients ◽

National University

Abstract Background Immune checkpoint inhibitors (ICIs) have become the standard of care for a variety of cancers, including non-small cell lung cancer (NSCLC). In this study, we investigated the frequency of pseudoprogression and hyperprogression in lung cancer patients treated with ICIs in the real world and aimed to discover a novel candidate marker to distinguish pseudoprogression from hyperprogression soon after ICI treatment. Methods This study included 74 patients with advanced NSCLC who were treated with PD-1/PD-L1 inhibitors at Chungnam National University Hospital (CNUH) between January 2018 and August 2020. Chest X-rays were examined on day 7 after the first ICI dose to identify changes in the primary mass, and the response was assessed by computed tomography (CT). We evaluated circulating regulatory T (Treg) cells using flow cytometry and correlated the findings with clinical outcomes. Results The incidence of pseudoprogression was 13.5%, and that of hyperprogression was 8.1%. On day 7 after initiation of treatment, the frequency of CD4+CD25+CD127loFoxP3+ Treg cells was significantly decreased compared with baseline (P = 0.038) in patients who experienced pseudoprogression and significantly increased compared with baseline (P = 0.024) in patients who experienced hyperprogression. In the responder group, the frequencies of CD4+CD25+CD127loFoxP3+ Treg cells and PD-1+CD4+CD25+CD127loFoxP3+ Treg cells were significantly decreased 7 days after commencement of treatment compared with baseline (P = 0.034 and P < 0.001, respectively). Conclusion Circulating Treg cells represent a promising potential dynamic biomarker to predict efficacy and differentiate atypical responses, including pseudoprogression and hyperprogression, after immunotherapy in patients with NSCLC.

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A rare encounter of obstructed direct inguinal hernia

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v22i2.28745 ◽

2019 ◽

Vol 22 (2) ◽

pp. 41-43

Author(s):

Amit Kumar Singh ◽

Nripesh Rajbhandari ◽

Balaram Malla ◽

Gakul Bhatta

Keyword(s):

Emergency Department ◽

Inguinal Hernia ◽

Intestinal Obstruction ◽

Intestinal Resection ◽

Posterior Wall ◽

Acute Intestinal Obstruction ◽

University Hospital ◽

Direct Inguinal Hernia ◽

Direct Hernia ◽

The Right

The direct inguinal hernia has a wider neck and thus usually doesn’t present as strangulation or incarceration in comparison to the indirect component. When direct inguinal hernias are untreated for a longer duration, they may get strangulated and incarcerated. Hence such long-standing direct hernias with features of intestinal obstruction and /or peritonism should be promptly seen and diagnosed to prevent massive and unwanted intestinal resection. We are reporting a case of 83-year-old male presented to Surgical Emergency Department of Dhulikhel Hospital, Kathmandu University hospital with complaints of swelling in the right inguinoscrotal region for 12 years and progressed to become irreducible and painful for 12 hours. Clinically he had an acute intestinal obstruction. Intra-operatively we found a direct hernia containing congested small bowel loops and toxic fluids. The toxic fluid was suctioned and after confirming viability, modified Bassini’s repair was done with reinforcement of the posterior wall. Even direct inguinal hernia of longer duration can cause acute or sub-acute intestinal obstruction with or without features of peritonism. This complication is more common in elderly patients.

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Association of Carotid Artery Endothelial Signal Intensity Gradient with Unilateral Large Artery Ischemic Stroke

Cerebrovascular Diseases ◽

10.1159/000514141 ◽

2021 ◽

Vol 50 (3) ◽

pp. 270-278

Author(s):

Chan-Hyuk Lee ◽

Sang Hyuk Lee ◽

Young I. Cho ◽

Seul-Ki Jeong

Keyword(s):

Ischemic Stroke ◽

Carotid Artery ◽

Signal Intensity ◽

Internal Carotid ◽

University Hospital ◽

Large Artery ◽

Intensity Gradient ◽

National University ◽

Endothelial Shear Stress ◽

Stroke Center

Background: Common carotid artery (CCA) and internal carotid artery (ICA) are aligned linearly, but their hemodynamic role in ischemic stroke has not been studied in depth. Objectives: We aimed to investigate whether CCA and ICA endothelial shear stress (ESS) could be associated with the ischemic stroke of large artery atherosclerosis (LAA). Methods: We enrolled consecutive patients with unilateral ischemic stroke of LAA and healthy controls aged >60 years in the stroke center of Jeonbuk National University Hospital. All patients and controls were examined with carotid artery time-of-flight magnetic resonance angiography, and their endothelial signal intensity gradients (SIGs) were determined, as a measure of ESS. The effect of right or left unilateral stroke on the association between carotid artery endothelial SIG and ischemic stroke of LAA was assessed. Results: In total, the results from 132 patients with ischemic stroke of LAA and 121 controls were analyzed. ICA endothelial SIG showed significant and independent associations with the same-sided unilateral ischemic stroke of LAA, even after adjusting for the potential confounders including carotid stenosis, whereas CCA endothelial SIG showed a significant association with the presence of the ischemic stroke of LAA. Conclusion: Although CCA and ICA are located with continuity, the hemodynamics and their roles in large artery ischemic stroke should be considered separately. Further studies are needed to delineate the pathophysiologic roles of ESS in CCA and ICA for large artery ischemic stroke.

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