BACKGROUND: Selective lumbar nerve root block (SNRB) is generally accepted as an effective treatment method for back pain with sciatica. However, it requires devices producing radioactive materials such as C-arm fluoroscopy. This study evaluated the usefulness of the longitudinal view of transverse process and needles for medial branch block as landmarks under ultrasonography. METHODS: We performed selective nerve root block for 96 nerve roots in 61 patients under the guidance of ultrasound. A curved probe was used to identify the facet joints and transverse processes. Identifying the lumbar nerve roots under the skin surface and ultrasound landmarks, the cephalad and caudal medial branch blocks were undertaken under the transverse view of sonogram first. A needle for nerve root block was inserted between the two transverse processes under longitudinal view, while estimating the depth with the needle for medial branch block. We then injected 1.0 mL of contrast medium and checked the distribution of the nerve root with C-arm fluoroscopy to evaluate the accuracy. The visual analog scale (VAS) was used to access the clinical results. RESULTS: Seven SNRBs were performed for the L2 nerve root, 15 for L3, 49 for L4, and 25 for L5, respectively. Eighty-six SNRBs (89.5%) showed successful positioning of the needles. We failed in the following cases: 1 case for the L2 nerve root; 2 for L3; 3 for L4; and 4 for L5. The failed needles were positioned at wrong leveled segments in 4 cases and inappropriate place in 6 cases. VAS was improved from 7.6 +/- 0.6 to 3.5 +/- 1.3 after the procedure. CONCLUSIONS: For SNRB in lumbar spine, the transverse processes under longitudinal view as the ultrasound landmark and the needles of medial branch block to the facet joint can be a promising guidance.
Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Female ; Humans ; Low Back Pain/etiology/*therapy ; Lumbar Vertebrae/anatomy & histology/*ultrasonography ; Male ; Middle Aged ; Nerve Block/*methods ; Sciatica/etiology/*therapy ; Spinal Stenosis/complications/*diagnosis ; Zygapophyseal Joint/anatomy & histology/ultrasonography

Purpose: The calculation of the intraperitoneal organ surface area is important for understanding their anatomical structure and for conducting basic and clinical studies on diseases related to the peritoneum. To measure the intraperitoneal surface area in a living body by applying artificial intelligence (AI) techniques to the abdominal cavity using computed tomography and to prepare clinical indicators for application to the abdominal cavity. Methods: Computed tomography images of ten adult males and females with a healthy body mass index and ten adults diagnosed with colon cancer were analyzed to determine the peritoneal and intraperitoneal surface areas of the organs. The peritoneal surface was segmented and three-dimensionally modeled using AI medical imaging software. In addition to manual work, three-dimensional editing, filtering, and connectivity checks were performed to improve work efficiency and accuracy. The colon and small intestine surface areas were calculated using the mean length and diameter. The abdominal cavity surface area was defined as the sum of the intraperitoneal area and the surface areas of each organ. Results: The mean peritoneal surface area of all participants was measured as 10,039 ± 241 cm2 (males 10,224 ± 171 cm2 and females 9,854 ± 134 cm2). Males had a 3.7% larger peritoneal surface area than females, with a statistically significant difference (P < 0.001). Conclusion The abdominal cavity surface area can be measured using AI techniques and is expected to be used as basic data for clinical applications.

BACKGROUND AND OBJECTIVES: In this study, we evaluated differences in the prevalence of allergic rhinitis, asthma, atopic dermatitis and specific immunoglobuline E (IgE) value for some respiratory antigens in Korean adults. SUBJECTS AND METHOD: The study was conducted using data from the 5th National Health and Nutrition Survey (2010-2012). All subjects who were aged 19 years or older completed questionnaires on asthma, atopic dermatitis and allergic rhinitis. The subjects were first divided into male and female, and then into age groups of 19-29, 30-39, 40-49, 50-59, 60-69, ≥70 each. The lifetime and current prevalence rates for allergic rhinitis, asthma, and atopic dermatitis were calculated for each age group. The total and specific IgE level for Dermatophagoides farinae (DF), cockroach, and dog dander were also calculated. RESULTS: Final participants of 17542 were analyzed for the prevalence rate among the total of 25534 participants. The mean IgE level was calculated from 2028 subjects from the final participants. In asthma, the lifetime prevalence and current prevalence increased with age, but decreased with atopic dermatitis and allergic rhinitis. Total IgE level increased with age, but IgE level of DF reached its peak at 20-29 years, and then decreased rapidly thereafter. There was no clear trend for cockroach and dog dander. CONCLUSION: The prevalence of allergic diseases in adults varies widely by age group. Asthma has a low prevalence after age 20 and gradually increases after age 50. Atopic dermatitis and allergic rhinitis are the most prevalent in their 20s and gradually decrease thereafter.
Adult* ; Animals ; Asthma ; Cockroaches ; Dander ; Dermatitis, Atopic ; Dermatophagoides farinae ; Dogs ; Female ; Humans ; Immunoglobulin E ; Immunoglobulins ; Korea* ; Male ; Methods ; Nutrition Surveys* ; Prevalence* ; Rhinitis, Allergic

BACKGROUND AND OBJECTIVES: The purpose of this study was 1) to assess differences in categories of olfactory dysfunction according to the pathological classification of chronic rhinosinusitis with nasal polyp (CRSwNP) patients; 2) to identify the degree of olfaction recovery after endoscopic sinus surgery (ESS); and 3) to identify the factors that predict the changes in olfactory status. SUBJECTS AND METHOD: The sample of the study consisted of patients with CRSwNP who underwent ESS with biopsy from January 2012 to September 2014. Seventy five patients were classified into eosinophilic CRS (ECRS) and non-ECRS groups. During an approximately five-month follow-up, the Korean Version of Sniffin' Sticks test II (KVSS II) was conducted on each patient to examine the difference between the preoperative and postoperative states of olfactory function. RESULTS: The ECRS group showed a statistical significant increase in the postoperative KVSS II scores when compared to the preoperative scores, while the non-ECRS group did not show any statistically significant change. For the anosmia category by KVSS II, the ECRS group showed significantly improved olfactory function test scores for the threshold, discrimination, and identification tests. CONCLUSION: ECRS and preoperative olfactory function status (anosmia) could be predictable factors of postoperative olfactory function.
Biopsy ; Classification ; Discrimination (Psychology) ; Eosinophils* ; Follow-Up Studies ; Humans ; Methods ; Nasal Polyps ; Olfaction Disorders ; Polyps* ; Smell

Primary malignant lymphoma of the urinary bladder is a rare disease, and it accounts for only 0.2% of all the cases of extranodal lymphoma. The prognosis of primary bladder lymphoma has been favorable, with many patients being alive and well several years after treatment. We report here on a case of primary diffuse large B cell lymphoma of the urinary bladder in a 75-year-old man patient who presented with a one-month history of persistent dysuria. The abdominal CT revealed a mass at the posterior wall of the urinary bladder. The tissue obtained by transurethral cystoscopy showed an atypical lymphoid proliferation, which was consistent with diffuse large B cell lymphoma. The patient received systemic chemotherapy of rituximab and CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) and he achieved a significant partial remission.
Aged ; Antibodies, Monoclonal, Murine-Derived ; Cystoscopy ; Doxorubicin ; Dysuria ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Prognosis ; Rare Diseases ; Urinary Bladder ; Vincristine ; Rituximab