scholarly journals Inflammatory Cloacogenic Polyps In Children: Diagnostic Yield of Rectal Retroflexion During Colonoscopy

2021 ◽  
Author(s):  
You Ie Kim ◽  
Jung Yeon Joo ◽  
Hye Ran Yang
Keyword(s):  
Diagnostic Yield ◽  
Medical Center ◽  
Pediatric Population ◽  
Occult Blood ◽  
Transitional Zone ◽  
Colorectal Polyps ◽  
Laboratory Test Results ◽  
Significant Difference ◽  
National University ◽  
Seoul National University

Abstract Background and Aims: Inflammatory cloacogenic polyps (ICPs) are inflammatory lesions occurring around the anal transitional zone. These are rare in the pediatric population, and most reported cases are found in adults. Therefore, this study aimed to evaluate the usefulness of rectal retroflexion (RR) during colonoscopy in detecting ICPs in children.Methods: A total of 1,837 colonoscopies were performed in 1,278 children between September 2003 and August 2020 at the Seoul National University Bundang Hospital. The laboratory test results and colonoscopic and histopathological findings were retrospectively reviewed. ICP was detected using the RR and was diagnosed based on the histologic findings of the polyp. Results: A total of 69 patients were diagnosed with juvenile polyps (n = 62) or ICP (n = 7), with the latter being detected through RR. All children with ICP were diagnosed from 2013 onwards when RR during colonoscopy came to be routinely performed in our medical center. The patients with ICP were older at diagnosis and more associated with a family history of colorectal polyps than JP. Stool occult blood and the polyps’ endoscopic characteristics, such as number, location, volume, and shape, significantly varied between the two groups. Additionally, there was a statistically significant difference in the polypectomy method. During the long-term follow-up, there was no recurrence of ICP. Conclusions: Due to their location at the anorectal junction, ICPs may be overlooked during colonoscopy, leading to misdiagnosis. Therefore, a retroflexion view during colonoscopy may help detect ICPs in pediatric patients, especially those presenting with hematochezia.

Reactions of Alkenes: The RajanBabu Synthesis of Pseudopterosin G-J Aglycone Dimethyl Ether

2015 ◽  
Author(s):  
Douglass F. Taber
Keyword(s):  
Medical Center ◽  
Selective Reduction ◽  
Oxidative Cleavage ◽  
University Of Texas ◽  
Furman University ◽  
National University ◽  
Institute Of Technology ◽  
Seoul National University ◽  
The University ◽  
Medical University

Xiangge Zhou of Sichuan University showed (Tetrahedron Lett. 2011, 52, 318) that even the monosubstituted alkene 1 was smoothly converted to the methyl ether 2 by catalytic FeCl3. Brian C. Goess of Furman University protected (J. Org. Chem. 2011, 76, 4132) the more reactive alkene of 3 as the 9-BBN adduct, allowing selective reduction of the less reactive alkene to give, after reoxidation, the monoreduced 4. Nobukazu Taniguchi of the Fukushima Medical University added (Synlett 2011, 1308) Na p-toluenesulfinate oxidatively to 1 to give the sulfone 5. Krishnacharya G. Akamanchi of the Indian Institute of Chemical Technology, Mumbai oxidized (Synlett 2011, 81) 1 directly to the bromo ketone 6. Osmium is used catalytically both to effect dihydroxylation, to prepare 8, and to mediate oxidative cleavage, as in the conversion of 7 to the dialdehyde 9. Ken-ichi Fujita of AIST Tsukuba devised (Tetrahedron Lett. 2011, 52, 3137) magnetically retrievable osmium nanoparticles that can be reused repeatedly for the dihydroxylation. B. Moon Kim of Seoul National University established (Tetrahedron Lett. 2011, 52, 1363) an extraction scheme that allowed the catalytic Os to be reused repeatedly for the oxidative cleavage. Maurizio Taddei of the Università di Siena showed (Synlett 2011, 199) that aqueous formaldehyde could be used in place of Co/H2 (syngas) for the formylation of 1 to 10. Hirohisa Ohmiya and Masaya Sawamura of Hokkaido University prepared (Org. Lett. 2011, 13, 1086) carboxylic acids (not illustrated) from alkenes using CO2. Joseph M. Ready of the University of Texas Southwestern Medical Center selectively arylated (Angew. Chem. Int. Ed. 2011, 50, 2111) the homoallylic alcohol 11 to give 12. Many reactions of alkenes are initiated by hydroboration, then conversion of the resulting alkyl borane. Hiroyuki Kusama of the Tokyo Institute of Technology photolyzed (J. Am. Chem. Soc. 2011, 133, 3716) 14 with 13 to give the ketone 15. William G. Ogilvie of the University of Ottawa added (Synlett 2011, 1113) the 9-BBN adduct from 1 to 16 to give 17. Professors Ohmiya and Sawamura effected (Org. Lett. 2011, 13, 482) a similar conjugate addition, not illustrated, of 9-BBN adducts to α,β-unsaturated acyl imidazoles.

scholarly journals Rationale for Small Glenoid Baseplate: Position of Central Cage within Glenoid Vault (Exactech® Equinoxe® Reverse System)

2019 ◽  
Vol 22 (1) ◽  
pp. 24-28
Author(s):  
Joo Han Oh ◽  
Sanghyeon Lee ◽  
Sung-Min Rhee ◽  
Hyeon Jang Jeong ◽  
Jae Chul Yoo
Keyword(s):  
Medical Center ◽  
Total Shoulder Arthroplasty ◽  
Fixation Group ◽  
National University ◽  
Glenoid Baseplate ◽  
Seoul National University ◽  
Reverse Total Shoulder ◽  
Group Center ◽  
Determining Factor ◽  
Center Distance

Background: Glenoid baseplate location is important to good clinical outcomes of reverse total shoulder arthroplasty (RTSA). The glenoid vault is the determining factor for glenoid baseplate location, but, to date, there are no reports on the effect of central cage location within the glenoid vault on RTSA outcomes when using the Exactech<sup>®</sup> Equinoxe<sup>®</sup> Reverse System. The purpose of this study was to determine the appropriate cage location in relation to the glenoid vault and monitor for vault and/or cortex penetration by the cage.Methods: Data were retrospectively collected from the Samsung Medical Center (SMC) and Seoul National University Bundang Hospital (SNUBH). Patients who underwent RTSA between November 2016 and February 2018 were enrolled. Glenoid vault depth, central cage location within the vault were examined. Inferior glenoid rim?center distance, inferior glenoid rim?cage distance, and center?cage center distances were collected.Results: Twenty-two patients were enrolled. Three SNUBH patients had inappropriate central cage fixation (33.3%) versus 4 SMC patients (30.8%). All cage exposures were superior and posterior to the glenoid vault. Mean center?cage distance was 5.0 mm in the SNUBH group and 5.21 mm in the SMC group. Center?prosthesis distance was significantly longer in the inappropriate fixation group than in the appropriate fixation group (<i>p</i><0.024).Conclusions: To ensure appropriate glenoid baseplate fixation within the glenoid vault, especially in a small glenoid, the surgeon should place the cage lower than usually targeted, and it should overhang the inferior glenoid rim.

scholarly journals The Impact of Writing on Academic Performance for Medical Students

2020 ◽  
Author(s):  
Songeui Kim ◽  
Ji Won Yang ◽  
Jaeseo Lim ◽  
Seunghee Lee ◽  
Jungjoon Ihm ◽  
...  
Keyword(s):  
Medical Education ◽  
Academic Performance ◽  
Medical Students ◽  
Transfer Of Knowledge ◽  
Educational Benefits ◽  
Significant Difference ◽  
National University ◽  
Seoul National University ◽  
The Impact ◽  
The Given

Abstract Background Since the 1970s, writing has been widely used in classroom settings. Writing enhances learning, but there are limited studies that prove its effectiveness, especially in the medical education setting. The purpose of this study, therefore, is to investigate the effect of writing on medical students’ academic performance. Methods An experiment was conducted with 139 medical students from Seoul National University College of Medicine. They were randomly assigned to three study conditions: self-study (SS), expository writing (EW), and argumentative writing (AW). Each group studied the given material by the method they were assigned, and they were tested on their understanding and transfer of knowledge. Results The results showed that the two writing groups displayed better performance than the SS group in transfer type items, while there was no difference in scores between the EW and AW group. However, the three groups showed no significant difference in their scores for rote-memory type items . Also, there was a positive correlation between writing score and transfer type items in the AW group. Conclusions This study provides empirical evidence for writing to be adopted in medical education for greater educational benefits. Our findings indicate that writing can enhance learning and higher-order thinking, which are critical for medical students.

IgH Gene Rearrangements Are Strongly Associated with Hyperdiploidy Variant Multiple Myeloma in Korea: A Contradiction to the Pathogenetic Pathway of IgH Tranlocations in Non Hyperdiploidy Variant.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5084-5084
Author(s):  
Hee Won Moon ◽  
Tae Young Kim ◽  
Seong- Ho Kang ◽  
Hyun-Sook Chi ◽  
Eul Zu Seo ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Medical Center ◽  
Cytogenetic Study ◽  
University Hospital ◽  
Korean Patients ◽  
National University ◽  
Asan Medical ◽  
Seoul National University

Abstract Recent studies proposed the classification of multiple myeloma (MM) by the pathways involved in the early pathogenesis; nonhyperdiploid variants with a high incidence of IgH translocations and hyperdiploid variants associated with no IgH translocation. Most studies applied cytogenetic study or flow cytometry to define the ploidy. In this study, we combined the cytogenetic results and fluorescent in situ hybridization results to define the ploidy and investigated IgH tranlocation and 13q deletion in relation to the ploidy level on Korean patients with MM. A total of 135 cases diagnosed as MM between 1997 and 2003 from Seoul National University Hospital and the Asan Medical center were enrolled in this study. Conventional cytogenetic studies and FISH studies with different probes specific for the regions containing the genes or chromosomes (RB1, D13S319, D13S25, IgH/FGFR3, IgH/BCL2, IGH dual color, break apart rearrangement probe, IgH/CCND1, 1q, p53, p16, MLL, CEP 7, 11, 12) were performed. Of 135 patients with MM, 62 (45.9%) patients had hyperdiploid karyotype by cytogenetics and FISH. IgH translocations were observed in 37.4% of Korean patients with MM and were more frequent (54.7%) in hyperdiploid variants than in nonhyperdiploid variants (17.4%). Incidence of deletion 13q was 34.7% and also more frequent in hyperdiploid variants (54.2%) than in nonhyperdiploid variants (16.1%). In conclusion, IgH translocations and 13q deletions were not associated with nonhyperdiploid MM and appeared more frequently in hyperdiploid variant in Korean patients with MM.

Treatment failure pattern of oropharyngeal cancer, especially for the aspect of retropharyngeal lymph node.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18565-e18565
Author(s):  
Byung-Hee Kang ◽  
Jin Ho Kim ◽  
Hong-Gyun Wu ◽  
In Ah Kim ◽  
Keun-Yong Eom
Keyword(s):  
Parotid Gland ◽  
Oropharyngeal Cancer ◽  
Disease Free Survival ◽  
Free Survival ◽  
Irradiation Group ◽  
Significant Difference ◽  
Patient Reported ◽  
National University ◽  
Seoul National University ◽  
Disease Free

e18565 Background: In radiotherapy for head and neck cancer, it is very important to define the appropriate treatment volumes that determine the treatment outcome and toxicity. We examined the feasibility of omitting elective retropharyngeal (RP) nodal irradiation in oropharyngeal cancer. Methods: We performed a retrospective review from 2009 to 2016; 197 patients with oropharyngeal squamous cell carcinomas were treated with definitive or postoperative radiation therapy at the Seoul National University Hospital or Seoul National University Bundang Hospital. Of these patients, 151 patients (76%) were treated ipsilateral RP nodal areas up to the upper edge of C1 vertebral body, while the other 46 patients (24%) were not. We reviewed patterns of failures, disease free survival, and patient-reported chronic xerostomia status in each patient group. Results: During follow-up period, 2 patient developed RP nodal recurrences (4-108 months, median =46 months). There was no significant between-group difference in disease free survival, with a rate of 80.7% in the high RP nodal-irradiation group and 87.2% in the RP nodal spared group (P=0.17). Patients in the high RP nodal-irradiation group had higher mean ipsilateral parotid gland dose (median 28.7±7.5 Gy vs. 21.3±7.6 Gy, P<0.001) and higher rates of chronic xerostomia (72.2% vs. 58.7%, P=0.030). Conclusions: Only 2 patients with omission of high RP node irradiation developed high RP node failure, and no significant difference in DFS was shown. Omission of high RP nodal irradiation resulted in reduced ipsilateral parotid gland dose, consequently with less chronic xerostomia.

Arteriovenous malformation–associated aneurysms in the pediatric population

2012 ◽  
Vol 9 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Richard C. E. Anderson ◽  
Michael M. McDowell ◽  
Christopher P. Kellner ◽  
Geoffrey Appelboom ◽  
Samuel S. Bruce ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Medical Records ◽  
Clinical Presentation ◽  
Medical Center ◽  
Pediatric Population ◽  
Univariate Analysis ◽  
Columbia University ◽  
Significant Difference ◽  
Relationship Of ◽  
The Relationship

Object Conventional cerebral angiography and treatment for ruptured arteriovenous malformations (AVMs) in children are often performed in a delayed fashion. In adults, current literature suggests that AVM-associated aneurysms may be more likely to hemorrhage than isolated AVMs, which often leads to earlier angiography and endovascular treatment of associated aneurysms. The nature of AVM-associated aneurysms in the pediatric population is virtually unknown. In this report, the authors investigate the relationship of associated aneurysms in a large group of children with AVMs. Methods Seventy-seven pediatric patients (≤ 21 years old) with AVMs were treated at the Columbia University Medical Center between 1991 and 2010. Medical records and imaging studies were retrospectively reviewed, and associated aneurysms were classified as arterial, intranidal, or venous in location. Clinical presentation and outcome variables were compared between children with and without AVM-associated aneurysms. Results A total of 30 AVM-associated aneurysms were found in 22 children (29% incidence). Eleven were arterial, 9 intranidal, and 10 were venous in location. There was no significant difference in the rate of hemorrhage (p = 0.91) between children with isolated AVMs (35 of 55 [64%]) and children with AVM-associated aneurysms (13 of 22 [59%]). However, of the 11 children with AVM-associated aneurysms in an arterial location, 10 presented with hemorrhage (91%). An association with hemorrhage was significant in univariate analysis (p = 0.045) but not in multivariate analysis (p = 0.37). Conclusions Associated aneurysms are present in nearly a third of children with AVMs, and when arterially located, are more likely to present with hemorrhage. These data suggest that early angiography with endovascular treatment of arterial-based aneurysms in children with AVMs may be indicated.

scholarly journals Retrospective study on three-dimensional characteristics of mesiodens using CBCT in pediatric dentistry

2021 ◽  
Vol 48 (1) ◽  
pp. 77-94
Author(s):  
GiYoun Ryu ◽  
Ji-Soo Song ◽  
Teo Jeon Shin ◽  
Hong-Keun Hyun ◽  
Jung-Wook Kim ◽  
...  
Keyword(s):  
Treatment Plan ◽  
Three Dimensional ◽  
Pediatric Dentistry ◽  
Horizontal Direction ◽  
Permanent Teeth ◽  
Vertical Position ◽  
Factors Affecting ◽  
Significant Difference ◽  
National University ◽  
Seoul National University

The purpose of this study was to investigate the three-dimensional characteristics of mesiodens using Cone-beam Computed Tomography(CBCT) and analyze the factors affecting complications and anesthetic methods of extraction. This study evaluated 602 mesiodens of 452 patients who underwent extraction of mesiodens at the department of Pediatric Dentistry in Seoul National University Dental Hospital between 2017 and 2019.The ratio of mesiodens patients over total patient per year was gradually increased over the past 20 years. Mesiodens with labio-palatally horizontal direction while root directing labial were the most common among the mesiodens with horizontal direction. Mesiodens were the most common at the cervical side of the adjacent teeth(37.0%) and mesiodens located in the near-palatal side were observed about 3.83 times higher than the far-palatal side. Most of the mesiodens(82.1%) were in contact with adjacent permanent teeth on all three sides of the CBCT and 46.2% of mesiodens had curved roots. The patient’s age, vertical position, presence of complications, and proximity showed a significant difference in the selection of general anesthesia among anesthetic methods. The direction and vertical position of mesiodens had a significant effect on complications.These results provide a better understanding of mesiodens for establishing an accurate diagnosis and treatment plan.

scholarly journals Traumatic brain injury in high versus low falls in young children and adolescents: a retrospective analysis

2018 ◽  
Vol 22 (3) ◽  
pp. 233-237 ◽  
Author(s):  
Angela Bandte ◽  
Klaus Püschel ◽  
Kara Krajewski
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Retrospective Analysis ◽  
Medical Center ◽  
Pediatric Population ◽  
Neurosurgical Procedures ◽  
Current Guideline ◽  
Patients Âgés ◽  
Significant Difference ◽  
Fall Height

OBJECTIVESo-called low falls are gaining interest in traumatology. To date, there are no studies on low versus high falls in the pediatric population. The aim of the current analysis was to characterize the symptoms, diagnostics, and injuries associated with high versus low falls and to examine the effect of fall height on injuries and outcome in the context of current guideline-based recommendations.METHODSAfter obtaining study approval from the local ethics committee, the authors reviewed the data for patients ages 5–17 years who had been consecutively treated at either hospital associated with the University Medical Center Hamburg in the period from January 2009 to August 2014 for diagnoses including traumatic brain injury (TBI). Retrospective analysis of the electronic patient charts was performed to obtain data on demographics; accident mechanism; initial neurological status with respect to consciousness, symptoms, and Glasgow Coma Scale score; radiological studies; diagnoses; length of stay; all intracranial procedures; and Glasgow Outcome Scale (GOS) score.RESULTSSixty-five fall-related TBIs among 380 patients were identified; 26 patients fell from a height of 3 m or more and 28 fell from a height under 3 m (height undocumented in 11 cases). Patients who fell from ≥ 3 m were 22 times more likely than those who fell from < 3 m to undergo spiral CT studies in the emergency room (p = 0.05). In addition, there was a 7.4 times greater chance of undergoing cranial CT (p = 0.02). There were significantly more noncerebral injuries requiring surgery in patients who fell from ≥ 3 m versus those who fell from < 3 m (p = 0.007). There was no difference in the frequency of neurosurgical procedures performed between low and high groups. Follow-up ranged from 0 to 92 months (mean 12.5 months, median 0 months). There was no significant difference in good (GOS score 4–5) and poor (GOS score 1–3) outcomes between high and low falls (p = 0.208).CONCLUSIONSLow falls can be associated with intracranial hemorrhages requiring ICU monitoring and/or surgery. The authors encourage intensive monitoring and CT scans based on clinical presentation, not on fall height.

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