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Background Polo-like kinase 4 (PLK4) is a serine/threonine protein kinase located in the centriole of the chromosome during the cell cycle. PLK4 overexpression has been described in a variety of many common human epithelial tumors. Conversely, PLK4 acts as a haploinsufficient tumor suppressor in some situations, highlighting the importance of strict regulation of PLK4 expression, activity, and function. Meanwhile, the importance of chemoradiation resistance in rectal cancer is being emphasized more than ever. We aimed to analyze PLK4 expression and the tumor regression grade (TRG) in patients with rectal cancer, treated with chemoradiotherapy (CRT). Methods A retrospective study was conducted on 102 patients with rectal cancer who received preoperative CRT. Immunohistochemistry for PLK4 in paraffin-embedded tissue was performed from the biopsy and surgical specimens. Results We found significant association between high expression of PLK4 and poor response to neoadjuvant CRT (according to both Mandard and The Korean Society of Pathologists TRG systems) in the pre-CRT specimens. Other clinicopathologic parameters did not reveal any correlation with PLK4 expression. Conclusions This study revealed an association between high expression of PLK4 in the pre-CRT specimens and TRG. Our results indicated that PLK4 could potentially be a new predictor for CRT effect in patients with rectal cancer.

A 59-year-old man presented for possible durable ventricular assist device (VAD) implan-tation. He had previously been diagnosed with congenitally corrected transposition of the great arteries, a ventricular septal defect, an atrial septal defect, pulmonary valve stenosis, and aortic valve regurgitation. In the previous 22 years, he had undergone palliative cardi-ac surgery 3 times. VAD implantation as a bridge to transplantation was planned. Owing to severe adhesions, mesocardia, a left ascending aorta, and moderate aortic regurgitation, we performed VAD implantation and aortic valve closure via a dual left thoracotomy and partial sternotomy.

Background: There is no established surgical procedure for the treatment of epiphrenic esophageal diverticulum. The aim of this study was to compare the clinical outcomes of esophageal diverticulectomy using abdominal and thoracic approaches. Methods: We retrospectively reviewed 30 patients who underwent esophageal diverticulectomy through the thoracic or abdominal approach for an epiphrenic diverticulum at a single center between 1996 and 2018. We compared clinical outcomes, including the postoperative length of stay, time from the operation to oral feeding, leakage rate, and reoperation rate between the 2 groups. Results: The median age was 56 years. Of the 30 patients, 18 (60%) underwent diverticulectomy via the thoracic approach and 12 (40%) underwent the abdominal approach. The median hospital stay was 10 days (range, 5–211 days) in the thoracic approach group and 9.5 days (range, 5–18 days) in the abdominal approach group. The median time from the operation until oral feeding was 6.5 days (range, 3–299 days) when the thoracic approach was used and 5 days (range, 1–11 days) when the abdominal approach was used. In the thoracic approach group, the leakage rate was 16.67% and the reoperation rate was 27.78%. However, there were no cases of leakage or reoperation in the abdominal approach group. Conclusion: The abdominal approach for esophageal diverticulectomy is a feasible and appropriate alternative to the thoracic approach.

Purpose: This study aimed to improve emergency care for future neonatal patients. Methods: We conducted a clinical analysis of neonatal patients who visited the emergency department of Soonchunhyang University Bucheon Hospital from January 2004 to December 2012. We reviewed the medical records of 972 neonates less than 28 days of age. Results: The male:female ratio was 1.2:1. In terms of patient inflow, the peak month was September (10.3%), the peak day of the week was Saturday (205%), and the peak time of the day was 18:00-23:59 (39.0%). The most common symptom was fever (17.7%), and final outcomes were as follows: approved discharge (50.1%), admittance to the hospital (37.6%), transfer to another hospital (3.2%), discharge against medical advice (3.0%) and death (0.1%). There was no difference in the number of visits for irritability based on sex, age of the child, maternal age, parity, gestation, birth weight, type of birth, or season. However, the proportion of discharges was significantly higher in the group comprising the irritable infants (77.4%) than in the group comprising non-irritable infants (50.4%) (P<0.001). Conclusion: A newborn's transition from intrauterine to extrauterine life involve numerous physiologic and biochemical changes. Some visits are due to non-serious diseases, and reflect insufficient knowledge and information of the parents; this highlights the pressing need for parents' education. [ABSTRACT FROM AUTHOR]

Mycobacterium avium complex (MAC) is the most common pathogen in nontuberculous mycobacterial lung diseases, but vertebral osteomyelitis caused by MAC is rare. We experienced a case of vertebral osteomyelitis with epidural abscess in a rheumatoid arthritis patient who received immunosuppressive agents. Initial assessment was tuberculous vertebral osteomyelitis, and then treated with antituberculous drugs. Fifty-six days later, Mycobacterium intracellulare was identified from abscess culture and drugs were altered to clarithromycin, rifabutin, and ethambutol. After 3 months of M. intracellulare treatment, the radiological findings showed increases of epidural abscess. According to the suseptibility, the patient received intravenous amikacin for four weeks, and then, oral ciprofloxacin in addition to clarithromycin, rifabutin, and ethambutol. The patient is being treated with the medication for 13 months and currently showing slow improvements. [ABSTRACT FROM AUTHOR]

Hypercalcemia is a common electrolyte imbalance in patients with malignancy. Approximately 80% of hypercalcemia is associated with humoral hypercalcemia of malignancy (HHM), but occurs rarely in colorectal carcinomas. A 72-year-old man was admitted with abdominal pain and bowel habit change. Colonoscopy showed a malignant tumor in the transverse colon. Laboratory data showed an elevated serum calcium level (11.6 mg/dL) and elevated parathyroid hormone-related peptide level (12.2 pmol/L). Histology showed poorly differentiated adenocarcinoma. We infused intravenous normal saline, furosemide and pamidronate. The serum calcium level was subsequently normalized. However, the patient died from cancer progression 10 days later. With a review of the relevant literature, we report a case of adenocarcinoma of the transverse colon with HHM. [ABSTRACT FROM AUTHOR]

This research was conducted to improve the vegetation survey method using hyperspectral imaging and LiDAR techniques. Using Ocean FX, spectral data of seven representative species of Mount Hambaek were acquired, and hyperspectral image data of Mount Hambaek were acquired using AisaFENIX 1K and microCASI-1920 sensors. For spectral data and hyperspectral image data, tree species data were extracted using the Spectral Angle Mapper (SAM) technique, and data such as tree species location, height, and diameter at breast height were extracted through LiDAR data. the results of an investigation A total of 39,351 trees were surveyed in the Mount Hambuk area, with 25,930 trees (65.9%) in Quercus mongolica, followed by Larix kaempferi with 6,805 trees (17.3%), Alnus sibirica with 3,625 trees (9.2%), Pinus dendiflora 1,764 trees (4.5%), Pinus koraiensis 605 trees (1.5%), Pinus rigida 405 trees (1.0%), and Betulaermanii 217 trees (0.5%), As a result of selecting 28 representative colonies to be surveyed and conducting on-site verification, 27 out of 28 colonies were found to be 96.43% accurate.

The average temperature of the Korean Peninsula over the past 30 years has risen 1.4°C compared to the early 20th century (1912-1941), exceeding the global temperature increase trend. Vegetation responds very sensitively to climate change. Changes in phenological response, such as fall fliage, fruiting time of vascular plants, and appearance of insects, have occurred. Areas around Wando Arboretum, the target area of this study, belongs to the subtropical climate zone. In this study, we aimed to provide basic data for systematic management of biological resources through out the survey of vegetation distribution in the area around Wando Arboretum where warm-temperate plants distribute, using hyperspectral imaging-LiDAR. As a result of converting the classification images of individual information using hyperspectral images and Lidar into objects by vegetation correlation, a total of 27 classifications were confirmed with 18 families, 24 species, and three varieties. In addition, a total of 29,884 individuals were identified.

Korea consists of 63% forested land, more than twice the global average (31%). Despite ongoing reforestation efforts since the initiation of erosion contron and greening project in 1973, many of the species planted during that plan were nonnative, such as Pinus rigida and Robinia pseudoacacia. The study area, Sejong City, is undergoing various development activities. Given the anticipated influx of nonnative species and the reduction of plant biodiversity, accurate survey and analysis are essential for the conservation of Sejong City. In recent years, remote sensing techniques have been utilized as an alternative to traditional vegetation surveys. Remote sensing employs hyperspectral imagery, and LiDAR, allowing for faster and more accurate data collection and analysis without direct on-site access. This study utilized remote sensing technologies, including hyperspectral imagery and LiDAR, to collect forest resource information in Mt. Geumbyeong, Sejong City. The area around Mt. Geumbyeong, is characterized by Quercus acutissima, Robinia pseudoacacia, and Pinus rigida. In total, there are 19 species, with 43,657 individual trees, an average height of 16.91 m, an average breast height diameter of 38.85 cm, and an average age of 68.99 years. The aim is to provide fundamental data for forest management, urban forestry, and restoration efforts amid various disturbances, such as development activities, in the area. Subsequent and ongoing data collection through additional surveys and environmental assessments in the vicinity would enable the analysis of species-specific growth rates, the impact of disturbance factors, forest management, and health assessments over multiple years.

Purpose In most neonatal intensive care units, echocardiography is performed at the bedside. The lack of closure of interatrial communications (IACs) in the oval fossa can affect mortality and morbidity. This study aimed to establish the rate of spontaneous closure of IACs diagnosed in the neonatal period and predict the need for subsequent evaluation according to various factors, including defect size and shape. Methods The study group comprised 1,242 newborns admitted between March 2017 and December 2020. We judged the closure of the IACs and evaluated the risk factors of each. Patients were classified into the absence or presence of IACs. The morphology of the IACs was classified into atrial septal defects, patent foramen ovale, and multiple holes. Results A total of 317 patients (131 female, 186 male) were enrolled in the study, and the average defect size was 3.0±1.0 mm. An overall spontaneous closure rate of 89.9% was observed during an average follow-up interval of 5.1±1.1 months. When multiple Cox regression analyses were performed to analyze the risk factors for spontaneous closure, initial defect size was a significant factor. The optimal cut-off value for predicting spontaneous closure of the IAC was 3.05 mm, and the area under the receiver operating characteristic curve was 0.625 (95% confidence interval, 0.520 to 0.729). Preterm infants had a larger defect size corrected for birth weight and a higher closure rate than term infants. Conclusion Other than large defect size, no factors delayed spontaneous closure. When defects in the oval fossa measure ≤3 mm, most patients experience spontaneous closure by 7 months of age.

Endovascular repair of popliteal artery aneurysms (PAA) using a stent graft is suitable for patients with favorable anatomy. In the domestic situation where Gore Medical withdrew, we report two cases of unusual complications of pseudoaneurysm after endovascular repair of PAA. A 44-year-old male with a history of bypass surgery for a PAA presented with recurrent vein graft pseudoaneurysm. Endovascular treatment using a domestic stent graft was performed. However, pseudoaneurysm developed due to the graft fabric tear 1 month later, requiring surgical removal. In another case, an 84-year-old female presented with acute limb ischemia related to PAA. Endovascular aneurysm repair with the same domestic stent graft was performed. However, stent graft failure occurred 2 years later and the patient underwent open surgical repair. There was a graft fabric disintegration. When proper endovascular device is not available, open surgical treatment is the best option for treating PAA.

We present the case of a healthy 28-day-old female full-term neonate who was admitted to the neonatal intensive care unit for severe metabolic acidosis, hypoglycemia, and an initial sinus rhythm. The first diagnostic hypothesis was hypovolemic shock, and fluid resuscitation was started immediately. During fluid therapy, cardiovascular collapse occurred with supraventricular tachycardia. The latter was successfully treated with adenosine and beta-blockers. After 8 days, electrocardiography showed ventricular pre-excitation, and Wolff-Parkinson-White syndrome was diagnosed. A novel variant of the MYL2 gene that is related to hypertrophic cardiomyopathy and conduction defect was found after discharge. Cardiogenic shock should be considered, despite being a rare cause of shock in neonates.

The results of the 4th National Ecological Survey reflect the latest status of the ecological environment in South Korea. In this study, we presented spatial data on the distribution of mammals collected through the 4th National Ecological Survey in the southwestern area of the Korean Peninsula, covering Jeollanam-do, Gwangju Metropolitan City and Jeju island. The data consists of information on mammal individuals recorded at the site and information on characteristics of abiotic environment at the recorded points, including spatial units (administrative districts, digital map index, etc.) which are necessary for statistical analysis. The data have high policy and research values because it can elaborate on the descriptive characteristics of the distribution points and identify the relationship between individual abundance and habitat environment. However, when data is utilized in a regional scale, it should precede to consider the survey system, such as how to select the survey area.

Purpose Meconium obstruction of prematurity (MOP) predisposes premature infants to intestinal perforation and prolonged hospitalization if not diagnosed and treated promptly. A standard contrast enema is less effective to treat infants with distal ileal obstructions because the contrast may not reach the obstructed areas. In an effort to avoid risky surgery, we administered oral contrast media to seven clinically diagnosed patients with MOP whose obstructions were not relieved via conventional sonography-guided contrast enema. We retrospectively evaluated whether oral nonionic water-soluble contrast media relieves MOP. Methods Seven of 67 premature infants with MOP were administered oral contrast media from June 2015 to January 2019. Patients were followed-up radiographically for bowel distention and evacuation of contrast media after oral administration. We recorded radiographic improvements, meconium evacuation, time to first feeding after oral contrast media administration, maternal history, and neonatal clinical factors. Results We evaluated five male and two female infants. The median gestational ages and body weights at birth were 27+5 weeks and 890 g, respectively. Radiography in five infants revealed multiple distended intestinal loops without air-fluid interfaces. Two infants had gasless abdomens, in which only stomach gas was visible. Oral contrast media (median, 2.5 mL) were administered at a median age of 7 days; five infants (5/7, 71.4%) responded to this treatment. The remaining two infants, who had ileal stenosis and hypoganglionosis, were surgically managed. Five infants (5/7, 71.4%) had maternal risk factors, and two (28.6%) were small for gestational age. Conclusion Nonionic oral water-soluble contrast medium can serve as a valuable adjunct treatment in premature infants with meconium obstruction.

Background Hysterectomy is one of the major gynecologic surgeries. Historically, several surgical procedures have been used for hysterectomy. The present study aims to evaluate the surgical trends and clinical outcomes of hysterectomy performed for benign diseases at the Yeungnam University Hospital. Methods We retrospectively reviewed patients who underwent a hysterectomy for benign diseases from 2013 to 2018. Data included the patients’ demographic characteristics, surgical indications, hysterectomy procedures, postoperative pathologies, and perioperative outcomes. Results A total of 809 patients were included. The three major indications for hysterectomy were uterine leiomyoma, pelvic organ prolapse, and adenomyosis. The most common procedure was total laparoscopic hysterectomy (TLH, 45.2%), followed by open hysterectomy (32.6%). During the study period, the rate of open hysterectomy was nearly constant (29.4%–38.1%). The mean operative time was the shortest in the single-port laparoscopic assisted vaginal hysterectomy (LAVH, 89.5 minutes), followed by vaginal hysterectomy (VH, 96.8 minutes) and TLH (105 minutes). The mean decrease in postoperative hemoglobin level was minimum in single-port LAVH (1.8 g/dL) and VH (1.8 g/dL). Conversion to open surgery or multi-port surgery occurred in five cases (0.6%). Surgical complications including wound dehiscence, organ injuries, and conditions requiring reoperation were observed in 52 cases (6.4%). Conclusion Minimally invasive approach was used for most hysterectomies for benign diseases, but the rate of open hysterectomy has mostly remained constant. Single-port LAVH and VH showed the most tolerable outcomes in terms of operative time and postoperative drop in hemoglobin level in selected cases.

Background Approximately 100,000 women are diagnosed with cancer each year in Korea. According to a survey by the Korean central cancer registry in 2016, uterine cervical cancer, uterine corpus cancer, and ovarian cancer were the 5th, 7th, and 8th most prevalent cancers respectively among Korean women. The present study aims to review the clinico-pathologic characteristics of patients who were treated for major gynecological malignancies at Yeungnam University Medical Center. Methods Patients with invasive gynecological cancers from January 2012 to February 2019 were retrospectively identified. We analyzed the clinical features, demographic profiles, pathologic data, treatment modality used, adjuvant treatment used, complications, recurrence, and survival outcomes. Results A total of 287 patients (cervical cancer 115; corporal cancer 86; and ovarian, tubal, or primary peritoneal cancer 90) were included. Most cervical (82.7%) and corporal cancers (89.5%) were diagnosed in the early stages (stage I or II), while more than half (58.9%) the cases of ovarian, tubal or peritoneal cancers were diagnosed in the advanced stages (stage III or IV). Surgical complications were observed in 12.2% of cervical cancers, 16.3% of uterine corpus cancers, and 11.1% of ovarian, tubal, and peritoneal cancers, respectively. The 5-year overall survival rate was 94.1%, 91.0%, and 77.1% for cervical, corporal, and ovarian, tubal, or peritoneal cancers, respectively. Conclusion Surgical treatment was satisfactory in terms of the incidence of complications, and survival outcomes were generally good. Clinicians should be aware of the clinical and histopathological characteristics of patients with gynecological cancers to be able to provide optimal strategies and counseling.

Purpose: To evaluate patients who underwent surgical or endovascular treatment after vascular injury related to posterior lumbar disc surgery. Materials and Methods: We retrospectively reviewed seven cases of vascular injuries (four lacerations, one arteriovenous fistula [AVF], and two pseudoaneurysms) related to lumbar disc surgery by a posterior approach from January 1997 to December 2016 at Chonnam National University Hospital. Information of patient characteristics, diagnosis, treatment strategies, and outcomes were analyzed. Results: Five out of seven cases were inhospital cases. In three laceration cases, each patient instantly became hypotensive and a life-threatening arterial injury was suspected. Therefore, the patient was immediately turned to the supine position and surgical repair was performed. The patients with pseudoaneurysm and AVF were treated by endovascular intervention. Remaining two were referred cases under the impression of vascular injuries. One laceration case of them was in preshock condition, and the left common iliac artery was surgically repaired. The other referred patient showed pseudoaneurysm which was treated with stent graft insertion. There was no surgery or endovascular intervention related death and none of the patients suffered any sequela related to vascular injury. Conclusion: Vascular injury associated with posterior lumbar disc surgery is not common, but can be fatal. Early recognition, diagnosis, and prompt treatment are essential to prevent fatal outcomes. Recently, endovascular intervention is increasingly and preferably used because of its low morbidity and mortality. However surgery is still the best option for the patients with unstable vital sign and endovascular approach can be applied to stable patients.

Patients admitted to the intensive care unit (ICU) commonly develop pain and agitation. Such symptoms are associated with adverse clinical outcomes, as they can cause delirium, self-removal of life-sustaining devices, difficulty in use of ventilatory supports, hemodynamic instability, intracranial hypertension, posttraumatic stress disorder, etc. Thus, prompt recognition and treatment of pain and agitation are imperative. Identification of possible causes of pain and agitation and nonpharmacological managements should be attempted initially. However, administration of analgesics and sedatives is necessary in many cases. Preemptive interventions prior to procedures to relieve pain are recommended. Intravenous opioids are considered as the first-line drug to treat pain in critically ill patients, especially in those who require mechanical ventilation. For most patients in the ICU, a light level of sedation is associated with improved clinical outcomes. However, patients with unstable medical conditions including severe acute respiratory distress syndrome, hemodynamic instability, refractory status epilepticus, and intracranial hypertension may require a deep level of sedation. Sedation strategies using non-benzodiazepine sedatives may be preferred over sedation with benzodiazepines in mechanically ventilated patients to shorten the duration of mechanical ventilation, length of ICU stay, and days with delirium. Often, ensuring that critically ill patients are free from pain and agitation may conflict with other clinical management goals. Therefore, provision of comprehensive care based on the patients’ condition cannot be overemphasized in the ICU. The purpose of this review is to address pain and agitation management strategies and introduce pharmacological characteristics of sedatives and analgesics commonly used in the ICU.

Hemorrhagic cystitis is defined by lower urinary tract symptoms that include dysuria, hematuria, and hemorrhage and is caused by viral or bacterial infection or chemotherapeutic agents. Reports of hemorrhagic cystitis caused by non-typhoidal salmonella (NTS) are extremely rare. We report a case of a 41-year-old man with hemorrhagic cystitis from NTS that caused massive bleeding and shock. The patient was hospitalized for uncontrolled diabetes and obstructive uropathy related to severe cystitis. A urine culture was positive for group D NTS. This case demonstrated that hemorrhagic cystitis in a patient with a risk factor such as diabetes can be a manifestation of local extra-intestinal NTS infection.

Objectives : The Purpose of this study was to evidence the effect of Herbal Acupuncture therapy(Sangsik no.1) by comparing body fat and obesity degree of Group B(group of Herbal acupuncture therapy and general obesity treatment) with Group A(group of non-Herbal acupuncture therapy and general obesity treatment) in twenty four patients who have received OPD treatment at Sang Ji oriental medical hospital and chiefly diagnosed obesity from June 2000 to September 2001. Methods : We checked the change of Obesity degree with Inbody 3.0. Results and Conclusions : Two groups were no significance, but remarkably showed a significant decrease in Percent Body Fat. According to the above results, it is considered that Herbal Acupuncture therapy(Sangsik no.1) showed a significant decrease in Percent Body Fat, but Others were no significance.

The color of wheat flour and dough affect significantly on the quality of wheat. The major factor causing darkening of dough color is activity of polyphenol oxidase (PPO). Therefore, we examined the relationship between the PPO activities and the genotypes of the PPO-specific molecular markers in Korean wheat cultivars, and tested the usefulness of the selected markers for the selection of Korean wheat germplasm lines low in PPO activity. Five sequence-tagged site (STS) markers specific to wheat PPO genes. PPO-05, PPO-16, PPO-18, PPO-30 and PPO-43, were examined for their levels of polymorphism in Korean wheat cultivars. The genotypes of the marker PPO-18, which is linked to Ppo-AI locus, were correlated significantly highly with the levels of grain PPO activity. Furthermore. Korean wheat cultivars could be classified into the high or low PPO activity group by the allele type of Ppo-AI which was differentiated by the PPO-18. Grain PPO activity was lower about twice in the cultivars with Ppo-AI h allele than in those with Ppo-AI a allele. The cultivars with Ppo-Alb allele had lower grain weight and wide grain width, also they had less ash, protein, Fe and total polyphenol than those with Ppo-Ala allele. Thus, the lightness of flour and dough sheet was brighter in the cultivars with Ppo-Alb allele. The four wheal cultivars including Suwon252, which had lowest PPO activity and Ppo-Alb allele, were selected from 200 genetic lines as valuable genetic resources for the breeding of wheat variety with bright white-colored flour. [ABSTRACT FROM AUTHOR]