Anterior knee pain (AKP) syndrome is one of the most common conditions that prompt active young individuals to seek evaluation at sports injury clinics. Compared to the general population, patients with AKP appear to be at a higher risk of developing patellofemoral osteoarthritis. AKP can be detrimental to the affected patient’s quality of life and, in the larger context, it could markedly burden the economy with high healthcare costs. This opinion aims to present a comprehensive evaluation of AKP to improve its management in clinical practice.Current Concepts: AKP has a multifactorial etiology. It can be attributed not only to structures within and around the knee but also to external factors, such as limb malalignment, weakness of specific hip muscle groups, and core and ligamentous laxity. Hence, AKP warrants a detailed evaluation of patient’s medical history and a thorough clinical examination complemented by relevant radiological investigations to identify its origin in the knee and the underlying cause. Conservative management yields favorable outcomes in the majority of patients with AKP, whereas surgical management becomes necessary only when well-characterized structural abnormalities of the knee or limb correlate with the clinical presentation of AKP or when conservative measures fail to provide substantial and sustained symptoms relief.Discussion and Conclusion: The treatment strategy for AKP should be individualized based on the patient’s profile and the specific cause identified. Therefore, the management of AKP requires a focused evaluation of the patient’s medical history, clinical examination, and radiological investigations to identify the condition’s origin and underlying cause.

PURPOSE: To report the surgical results of unilateral pediatric cataracts from uncertain causes in relatively older children and to identify factors related to better visual outcomes. METHODS: We retrospectively evaluated the medical records of 39 patients who underwent surgery between the ages of 3 and 10 years for unilateral pediatric cataracts of no known cause. All patients underwent primary intraocular lens implantation and postoperative amblyopia treatment. A postoperative final visual acuity better than 20 / 30 was considered to be a good visual outcome. RESULTS: The mean age of patients was 6.0 ± 1.8 years at the time of surgery. The mean preoperative visual acuity was 1.07 ± 0.71 logarithm of the minimum angle of resolution (range, 0.15 to 3.00), while the mean final postoperative visual acuity was 0.47 ± 0.54 logarithm of the minimum angle of resolution (range, 0.00 to 2.00). Of 39 patients, 18 (46.2%) achieved a good visual outcome. Only the preoperative visual acuity maintained a significant association with a good visual outcome according to our multivariate analysis (p = 0.040). A preoperative visual acuity of 20 / 100 or better was found to increase the chance of achieving a good visual outcome by 13.79-fold (95% confidence interval, 1.13 to 167.58). CONCLUSIONS: The visual outcome of unilateral pediatric cataract surgery for cataracts with no specific cause identified in patients after three years of age could be satisfactory, especially with a preoperative visual acuity of 20 / 100 or better.
Amblyopia ; Cataract* ; Child ; Humans ; Lens Implantation, Intraocular ; Medical Records ; Multivariate Analysis ; Phacoemulsification ; Prognosis ; Retrospective Studies ; Visual Acuity

No abstract available.
Humans ; Pregnancy ; Scrub Typhus

No abstract available.
Humans ; Pregnancy ; Scrub Typhus

PURPOSE: Thyroid cancer is the most common malignancy affecting the endocrine glands. The incidence of his malady has conspicuously increased during the recent years. Thyroid diseases affect women approximately 3 times more often than men, and this incidence decreases after menopause. This gender difference has suggested that the female sex steroids stimulate the growth of the thyroid, the same as for the breast. In the present study, we investigated the expressions of estrogen receptor (ER) and progesterone receptor (PR) in thyroid lesions. METHODS: The tissues from 193 human thyroid glands (136 thyroid cancers and 57 adenomatous hyperplasias) were used for the present immunohistochemical assessment of the ER and PR expressions. RESULTS: The incidences of the estrogen and progesterone receptor positive cases were 19.7 and 41.5%, respectively. The incidence of the progesterone receptor positive cases was higher for females (46.5%) than for males (19.4%) however, the expression of estrogen receptor was not different significantly between the females and males. Higher expressions of estrogen and progesterone receptors were detected in the thyroid cancers than in the adenomatous hyperplasias. The PR expression seemed to correlate with the tumor size: a higher PR expression was found in the T3 cancers than in the T2 cancers. CONCLUSION: Our findings provide new insight that the ER and PR expressions may be related to the pathogenesis and progression of thyroid cancer.
Breast ; Endocrine Glands ; Estrogens* ; Female ; Humans ; Hyperplasia ; Incidence ; Male ; Menopause ; Progesterone* ; Receptors, Progesterone* ; Steroids ; Thyroid Diseases ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule*

BACKGROUND: Research of clinical contents and proper development of education program is essential in family medicine. Therefore, this study is carried out to obtain data for residency training, and to provide references to family physicians who give primary health care in rural community by analyzing prospectively the clinical contents of new patients in a local family practice clinic. METHODS: The authors visited family practice clinic in a rural area practiced by a family physician board certified in family medicine. There were 3,126 new patients from Jan. 1996 to Dec. 1996 evenly distributed by month and area, 1,000 patients were sampled randomly and the collected data were classified according to the ICPC(International Classification of Primary Care) coding system. RESULTS: Among the selected 1,000 patients, males were 432(43.2%) and females were 568(56.8%). Age distribution was highest In the fifties(50-59 years old) (20.7%). The total number of Reason For Encounter(RFE) was 1,417, the average RFE was 1.41 per patient and the kind of RFEs was 93, among which cough was the most frequent RFE by 233 cases(16.4% ). The 87 kinds of diagnoses were used and URl(Upper Respiratory Infection) accounted for the major portion by 287 cases(21.9%). The diagnostic examination per patient was 0.42. The most frequently used test was x-ray of an extremity by 68 cases(16.1% ). Referrals to other departments were made in 3.3% of visitors of which Internal Medicine was highest(39.4%). CONCLUSIONS: The clinical contents were classified more comprehensively by using ICPC with given code RFE, care process, and diagnosis. More study on ICPC is necessary for classification to help analyze clinical contents in primary care.
Age Distribution ; Classification ; Clinical Coding ; Cough ; Diagnosis ; Education ; Extremities ; Family Practice* ; Female ; Humans ; Internal Medicine ; Internship and Residency ; Male ; Physicians, Family ; Primary Health Care ; Prospective Studies ; Referral and Consultation ; Rural Population

OBJECTIVES: Entrapment of the suprascapular nerve is frequently overlooked in the differential diagnosis of shoulder pain. METHODS: Suprascapular entrapment neuropathy is a well-defined clinical entity and EMG and NCV is used to confirm a diagnosis. But the diagnosis is typically not considered until patients develop severe weakness secondary to atrophy of the spinous musculature that the nerve supplies. RESULTS: A narrow suprascapular notch has rarely been reported as a work-related factor of this entrapment neuropathy. Diagnosis of suprascapular entrapment neuropathy is based on the patients' clinical course, neurologic, radiologic, and electrophysiologic findings. One of the most helpful evaluations was the anteriorposterior projection with the X-ray tube angled 15-30 degree caudally. The suprascapular entrapment neuropathy is relatively uncommon entity of shoulder discomfort (pain, weakness, and atrophy). CONCLUSIONS: If the worker who used his shoulder joint repetitiously having the shoulder pain and muscle weakness, we must rule out the suprascapular entrapment neuropathy. And it is needed to evaluate the motions which cause suprascapular entrapment neuropathy as the ergonomic factor.
Atrophy ; Diagnosis ; Diagnosis, Differential ; Equipment and Supplies ; Humans ; Muscle Weakness ; Shoulder ; Shoulder Joint ; Shoulder Pain

Fat embolism syndrome is a rare disease associated with long bone fractures and plastic surgery. In previous studies of cerebral fat embolism, no reports of cardiac arrest occurred by cerebral fat embolism. Therefore, we aimed to report the first case of cardiac arrest by cerebral fat embolism after scalp lipoma removal.

Background: Accessory infraorbital foramen (AIOF) can change the normal course of emerging branches of the infraorbital nerve and blood vessels exiting the infraorbital foramen (IOF). This study aimed to examine the AIOF, number of foramina, and their position in relation to IOF using cone-beam computed tomography (CBCT). Methods: We performed a retrospective CBCT assessment of hospital records between January 2018 and August 2022. The CBCT of 507 patients were examined to extract information on the prevalence, number, position, linear distance from the IOF, and diameter of AIOF in relation to demographic factors. Descriptive statistics were used to evaluate the prevalence of AIOF. Mean and standard deviation were used to calculate the linear distance and diameter of the AIOF, respectively. The AIOFs, its distribution, and number were compared between sexes and sides using the chi-square test. The independent t-test and Mann–Mann-Whitney test were used to compare the mean difference between the sexes and sides. Statistical significance was set at P < 0.05. Results: In this current study, the prevalence of AIOF was 7.1% (36 of the 507 patients). Additionally, the current study examined the number of foramina using a single foramen on each side and double foramina located bilaterally at a distance from the AIOF to the IOF. The mean AIOF diameter was also studied, and the AIOF position with respect to the IOF on CBCT was superomedial or inferomedial. There were no statistically significant associations between any of the parameters assessed in this study when comparing sex and sides. Conclusions A greater number of patients with AIOF presented with a single foramen and unilateral occurrence, without a statistically significant difference. The AIOF was most commonly located superomedial to the IOF.

Fourteen African swine fever (ASF) outbreaks occurred in the pig farms in the northwestern region of South Korea, near the border with North Korea, from September 16, 2019 to October 9, 2019. Active and passive surveillance on the ASF-infected farms indicated that the infection was limited only to pigsties where the infected pigs were detected on the farm for the first time before further transmission to other pigsties and farms. This early detection could be one of the pivotal factors for the prompt eradication of ASF in domestic pig farms within 1 month in the northwestern region of South Korea.