We present a case of iatrogenic lumbar foraminal stenosis caused by bone-cement leakage during vertebroplasty, successfully managed using transforaminal endoscopic lumbar foraminotomy (TELF). Vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures (VCFs); however, complications such as bone-cement leakage can lead to vascular or neurological issues, including lumbar radiculopathy. TELF is a minimally invasive surgical option for addressing various forms of lumbar foraminal stenosis. An 82-year-old female patient presented to Gachon University Gil Medical Center with severe right inguinal pain radiating to the anterior thigh and knee. Six months prior, she had undergone vertebroplasty at the L3 level for an osteoporotic VCF at another hospital. Following the procedure, she developed radicular leg pain with a diminished knee jerk reflex, which progressively worsened despite extensive conservative treatment. Magnetic resonance imaging and computed tomography revealed right-sided L3–4 foraminal stenosis caused by bone-cement leakage from the prior vertebroplasty. TELF was performed under local anesthesia to decompress the affected area. Bone-cement fragments, along with hypertrophic bone and ligaments, were successfully removed, achieving sufficient decompression of the exiting nerve root. The patient experienced immediate postoperative pain relief. This case represents the first documented instance of endoscopic decompression for iatrogenic foraminal stenosis following vertebroplasty. TELF, performed safely under local anesthesia, demonstrates its effectiveness as a minimally invasive solution for this rare complication.

We present a case of iatrogenic lumbar foraminal stenosis caused by bone-cement leakage during vertebroplasty, successfully managed using transforaminal endoscopic lumbar foraminotomy (TELF). Vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures (VCFs); however, complications such as bone-cement leakage can lead to vascular or neurological issues, including lumbar radiculopathy. TELF is a minimally invasive surgical option for addressing various forms of lumbar foraminal stenosis. An 82-year-old female patient presented to Gachon University Gil Medical Center with severe right inguinal pain radiating to the anterior thigh and knee. Six months prior, she had undergone vertebroplasty at the L3 level for an osteoporotic VCF at another hospital. Following the procedure, she developed radicular leg pain with a diminished knee jerk reflex, which progressively worsened despite extensive conservative treatment. Magnetic resonance imaging and computed tomography revealed right-sided L3–4 foraminal stenosis caused by bone-cement leakage from the prior vertebroplasty. TELF was performed under local anesthesia to decompress the affected area. Bone-cement fragments, along with hypertrophic bone and ligaments, were successfully removed, achieving sufficient decompression of the exiting nerve root. The patient experienced immediate postoperative pain relief. This case represents the first documented instance of endoscopic decompression for iatrogenic foraminal stenosis following vertebroplasty. TELF, performed safely under local anesthesia, demonstrates its effectiveness as a minimally invasive solution for this rare complication.

We present a case of iatrogenic lumbar foraminal stenosis caused by bone-cement leakage during vertebroplasty, successfully managed using transforaminal endoscopic lumbar foraminotomy (TELF). Vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures (VCFs); however, complications such as bone-cement leakage can lead to vascular or neurological issues, including lumbar radiculopathy. TELF is a minimally invasive surgical option for addressing various forms of lumbar foraminal stenosis. An 82-year-old female patient presented to Gachon University Gil Medical Center with severe right inguinal pain radiating to the anterior thigh and knee. Six months prior, she had undergone vertebroplasty at the L3 level for an osteoporotic VCF at another hospital. Following the procedure, she developed radicular leg pain with a diminished knee jerk reflex, which progressively worsened despite extensive conservative treatment. Magnetic resonance imaging and computed tomography revealed right-sided L3–4 foraminal stenosis caused by bone-cement leakage from the prior vertebroplasty. TELF was performed under local anesthesia to decompress the affected area. Bone-cement fragments, along with hypertrophic bone and ligaments, were successfully removed, achieving sufficient decompression of the exiting nerve root. The patient experienced immediate postoperative pain relief. This case represents the first documented instance of endoscopic decompression for iatrogenic foraminal stenosis following vertebroplasty. TELF, performed safely under local anesthesia, demonstrates its effectiveness as a minimally invasive solution for this rare complication.

We present a case of iatrogenic lumbar foraminal stenosis caused by bone-cement leakage during vertebroplasty, successfully managed using transforaminal endoscopic lumbar foraminotomy (TELF). Vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures (VCFs); however, complications such as bone-cement leakage can lead to vascular or neurological issues, including lumbar radiculopathy. TELF is a minimally invasive surgical option for addressing various forms of lumbar foraminal stenosis. An 82-year-old female patient presented to Gachon University Gil Medical Center with severe right inguinal pain radiating to the anterior thigh and knee. Six months prior, she had undergone vertebroplasty at the L3 level for an osteoporotic VCF at another hospital. Following the procedure, she developed radicular leg pain with a diminished knee jerk reflex, which progressively worsened despite extensive conservative treatment. Magnetic resonance imaging and computed tomography revealed right-sided L3–4 foraminal stenosis caused by bone-cement leakage from the prior vertebroplasty. TELF was performed under local anesthesia to decompress the affected area. Bone-cement fragments, along with hypertrophic bone and ligaments, were successfully removed, achieving sufficient decompression of the exiting nerve root. The patient experienced immediate postoperative pain relief. This case represents the first documented instance of endoscopic decompression for iatrogenic foraminal stenosis following vertebroplasty. TELF, performed safely under local anesthesia, demonstrates its effectiveness as a minimally invasive solution for this rare complication.

We present a case of iatrogenic lumbar foraminal stenosis caused by bone-cement leakage during vertebroplasty, successfully managed using transforaminal endoscopic lumbar foraminotomy (TELF). Vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures (VCFs); however, complications such as bone-cement leakage can lead to vascular or neurological issues, including lumbar radiculopathy. TELF is a minimally invasive surgical option for addressing various forms of lumbar foraminal stenosis. An 82-year-old female patient presented to Gachon University Gil Medical Center with severe right inguinal pain radiating to the anterior thigh and knee. Six months prior, she had undergone vertebroplasty at the L3 level for an osteoporotic VCF at another hospital. Following the procedure, she developed radicular leg pain with a diminished knee jerk reflex, which progressively worsened despite extensive conservative treatment. Magnetic resonance imaging and computed tomography revealed right-sided L3–4 foraminal stenosis caused by bone-cement leakage from the prior vertebroplasty. TELF was performed under local anesthesia to decompress the affected area. Bone-cement fragments, along with hypertrophic bone and ligaments, were successfully removed, achieving sufficient decompression of the exiting nerve root. The patient experienced immediate postoperative pain relief. This case represents the first documented instance of endoscopic decompression for iatrogenic foraminal stenosis following vertebroplasty. TELF, performed safely under local anesthesia, demonstrates its effectiveness as a minimally invasive solution for this rare complication.

PURPOSE: Intraosseous (IO) is an alternative vascular access method for critically ill patients, especially pediatric arrest patients. This study was aimed to evaluate the effect of the education on pre-hospital IO Access of Level 1 Emergency Medical Technicians (Level-1 EMTs). METHODS: Forty four Level-1 EMTs participated in the IO educational program at Seoul Fire Academy. The IO educational program was consisted of a one-hour lecture followed by a one-hour practical training about the use of the powered device (EZ-IO) to artificial bones. Before and after the program, the knowledge and attitude about IO access were measured with 5 points-scale (1 in lowest and 5 in highest positive response) by the structured questionnaire. After the program, the participants were tested on skill performance (success rate of insertion and procedural time) of IO access. RESULTS: The mean working time and age of participants was 7.6+/-2.4 years and 32.1+/-4.2 years, respectively. Median score (5%~95%) of knowledge about indication of IO access was increased from 2(1-4) to 4(3-5) (p<0.01). Median score (5%~95%) on attitude was improved from 2(1-4) to 4(2-5) (p<0.01). Twelve EMTs (30.7%) showed negative response on IO access in the prehospital area. The success rate of insertion at first time was 84.1% and the mean time to success was 45.5+/-9.4 seconds. CONCLUSION: After 2 hour educational program for Level-1 EMTs, the knowledge and attitude of IO access improved significantly and skill performance was very excellent. We can consider the prehospital IO access of level-1 EMTs in Korea.
Critical Illness ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Fires ; Humans ; Mandrillus ; Surveys and Questionnaires

The free TRAM flap has been accepted as an excellent method of autogenous tissue breast reconstruction. In addition, oncologic surgeons and plastic surgeons are trying to perform skin preserved mastectomy to get more esthetically better result in breast reconstruction. Breast tissue and mass would be removed through circumareolar incision, and axillary lymph node dissection could be carried through separate incision on axilla. This paper represents our experiences and results of immediate breast reconstruction with transverse rectus abdominis myocutaneous free flap after skin-sparing mastectomy. From 1999 to 2001, the flaps were utilized in 15 patients to reconstruct the new breast by free TRAM flap after skin sparing mastectomy. The mean age of the patients were a 42-years-old. Location of cancer was on the right breast in 12 cases, left breast in 2 cases and bilateral breasts in 1 case. We chose the thoracodorsal artery and its venae commitantes as recipient vessels, and deep inferior epigastric vessels as donor vessels.All flaps survived completely. There has been no flap necrosis, hematoma, and seroma. The results have been functionally and esthetically satisfactory. There are several advantages in this technique comparing with similar breast reconstruction of routine modified radical mastectomy. This technique leaves less scar and allows better preservation of sensation, aesthetically more natural shape, and better symmetry in reconstructed breast with free TRAM flap afterskin sparing-mastectomy.
Arteries ; Axilla ; Breast* ; Cicatrix ; Female ; Free Tissue Flaps* ; Hematoma ; Humans ; Lymph Node Excision ; Mammaplasty* ; Mastectomy* ; Mastectomy, Modified Radical ; Necrosis ; Rectus Abdominis* ; Sensation ; Seroma ; Skin* ; Tissue Donors

The free TRAM flap has been accepted as an excellent method of autogenous tissue breast reconstruction. In addition, oncologic surgeons and plastic surgeons are trying to perform skin preserved mastectomy to get more esthetically better result in breast reconstruction. Breast tissue and mass would be removed through circumareolar incision, and axillary lymph node dissection could be carried through separate incision on axilla. This paper represents our experiences and results of immediate breast reconstruction with transverse rectus abdominis myocutaneous free flap after skin-sparing mastectomy. From 1999 to 2001, the flaps were utilized in 15 patients to reconstruct the new breast by free TRAM flap after skin sparing mastectomy. The mean age of the patients were a 42-years-old. Location of cancer was on the right breast in 12 cases, left breast in 2 cases and bilateral breasts in 1 case. We chose the thoracodorsal artery and its venae commitantes as recipient vessels, and deep inferior epigastric vessels as donor vessels.All flaps survived completely. There has been no flap necrosis, hematoma, and seroma. The results have been functionally and esthetically satisfactory. There are several advantages in this technique comparing with similar breast reconstruction of routine modified radical mastectomy. This technique leaves less scar and allows better preservation of sensation, aesthetically more natural shape, and better symmetry in reconstructed breast with free TRAM flap afterskin sparing-mastectomy.
Arteries ; Axilla ; Breast* ; Cicatrix ; Female ; Free Tissue Flaps* ; Hematoma ; Humans ; Lymph Node Excision ; Mammaplasty* ; Mastectomy* ; Mastectomy, Modified Radical ; Necrosis ; Rectus Abdominis* ; Sensation ; Seroma ; Skin* ; Tissue Donors

The study was conducted to assess school dietitians' preferences for traditional foods, to determine the association with their perception and usage status, and to develop the strategies to increase its utilization of traditional foods in school lunches. The information was obtained by the self-administered questionnaire from the subjects, which were 198 dietitians in schools located in Seoul and Gyeonggi-do. According to the preference for traditional foods, subjects were distributed into three groups (High = 54, Medium = 128, Low = 16). The significances of differences between groups were determined using SPSS 12.0 at p < 0.05. Compared to the dietitians with lower (medium and low) preferences, those with high preferences answered that they had better knowledge (p < 0.001) for traditional foods, and served them more in school lunches (p < 0.01). Also, more dieticians in the high preference group not only felt that they need to train school administrators (p < 0.01) as well as themselves (p < 0.05), but also were currently providing students with the nutrition education on traditional foods (p < 0.05). The results presented the evidence suggesting that having dietitians with higher preference for traditional foods can offer an effective strategy to increase the opportunities for schoolchildren to be exposed to traditional foods. Development of the standard recipes for use in school lunches by the government or the association was answered as the best strategy to increase the use of traditional foods, regardless of the dietitians' preferences.
Administrative Personnel ; Food Preferences ; Humans ; Lunch ; Surveys and Questionnaires

Even for experienced surgeons, it is possible that the complex and variable anatomy and the proximity of important structures make endoscopic sinus surgery a tough job. The main cause of surgical complications is that the image of two dimensional computed tomography scan is not correlated with the endoscopic view during operation. Recently developed computer aided endoscopic sinus surgery(CAESS) may be an important step in reducing the incidence of complications. Authors used the CAESS in 3 cases. The first was the case of huge multiple polyps and needed the revision of surgery. The second was the case of multiple polyps and cleft palate which was operated previously. The last was the case of pituitary cyst. Surgery of the extensive sinus disease or the causes with surgically-congenitally altered anatomical landmarks was safe and easy when CAESS was utilized.
Cleft Palate ; Incidence ; Polyps