No abstract available.
Kyphosis*

Tsutstugamushi disease is a major febrile disease that generally occurs in the fall in Korea with hemorrhagic fever with renal syndrome and leptospirosis. This disease is often accompanied by interstitial pneumonia, acute renal failure and liver failure. The causative agent, namely Orientia tsutsugamushi, is transmitted to humans through the bite of a laval trombiculid mite, which is commonly known as a chigger. A 78 year old man was admitted in October 2004 with intractable fever and a drowsy mentality. Two weeks earlier, he visited a private clinic complaining of a simple skin rash. He was treated with antihistamine and steroid, but his symptoms were aggravated and he was referred to our hospital. His physical examination and laboratory findings showed a septic shock status. The maculopapular rash had spread over his face, chest, abdomen and extremities. Eschar was observed in lower back area but it was too difficult to distinguish it from other skin rashes. His chest X-ray appeared as diffuse nodular patchy consolidations in the bilateral lung parenchyme. He was treated with a mechanical ventilator and doxycycline under th suspicion of Tsutstugamushi disease. However, he suffered multiorgan failure accompanied by acute respiratory distress syndrome, acute renal failure and acute hepatitis. He was treated in the intensive care unit for approximately 12 weeks and his general condition was recovered.
Abdomen ; Acute Kidney Injury ; Aged ; Doxycycline ; Exanthema ; Extremities ; Fever ; Hemorrhagic Fever with Renal Syndrome ; Hepatitis ; Humans ; Intensive Care Units ; Korea ; Leptospirosis ; Liver Failure ; Lung ; Lung Diseases, Interstitial ; Orientia tsutsugamushi ; Physical Examination ; Respiratory Distress Syndrome, Adult ; Scrub Typhus ; Shock, Septic ; Thorax ; Trombiculidae ; Ventilators, Mechanical

Extrarenal manifestations of hemolytic uremic syndrome (HUS) have increasingly been recognized and may be major determinants of mortality and morbidity. Although microthrombi are often found in the pulmonary and coronary circulation, apparent lung and cardiac involvement are clinically infrequent. We describe here a 10-month-old boy with HUS who developed pulmonary hemorrhage, acute respiratory distress syndrome and dilated cardiomyopathy. Complete renal as well as clinical recovery from these very uncommon complications was achieved by optimum supportive care.
Cardiomyopathies ; Cardiomyopathy, Dilated ; Coronary Circulation ; Hemolytic-Uremic Syndrome* ; Hemorrhage ; Humans ; Infant ; Lung ; Male ; Mortality ; Respiratory Distress Syndrome, Adult

The bronchopulmonary sequestration is a rare congenital malformation of the lung, concerning about the abnormal feeding systemic artery, needed for invasive angiography for definite diagnosis. This case report is described that patient diagnosed by multi-detectional computed tomography (MDCT) without angiography and combined with aspergillosis within an intralobar seqestration. He was 43-year old male patient with left submandibular mass. On chest PA, abnormal cystic lesion was shown in left lower lung field. There were multiple cysts with internal air-fluid level in left lower lobe on computed tomography. By useing MDCT, we could reconstruct internal structures and feeding artery, arising from thoracic aorta. We could confirm the intralobar bronchopulmonary sequestration. Lobectomy of the left lower lobe was done. On histologic finding, there was intralobar type pulmonary seqestration with chronic inflammation with hyphae of aspergillus species focally.
Adult ; Angiography ; Aorta, Thoracic ; Arteries ; Aspergillosis* ; Aspergillus ; Bronchopulmonary Sequestration* ; Diagnosis ; Humans ; Hyphae ; Inflammation ; Lung ; Male ; Thorax

To examine the effect of retinal branch vein occlusion (BRVO) on protein tyrosine phosphorylation, production of angiogenic growth factors, and activation of signal proteins in the tyrosine kinase pathways in the retina, BRVO was induced in cat retina by coagulation of retinal veins with diathermy. At 2 days, 1, 3, and 6 weeks after induction of BRVO, the retina was divided into 3 parts; a part within the distribution of the occluded vein [BRVO(IN)] or a part outside the distribution of the occluded vein [BRVO(OUT)], an prepared for western blot analysis. Overall, tyrosine-phosphorylated proteins were increased after BRVO, especially in BRVO(IN) at 2 days and 1 week. The vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were also increased in BRVO(IN) at 1 week and 2 days, respectively. The phospholipase Cgamma(PLCgamma) and mitogen-activated protein kinase (MAPK) were activated at these points. In this study, we concluded that the BRVO increased overall protein tyrosine phosphorylation in the cat retina in association with the increase of angiogenic growth factors (VEGF, bFGF) and activation of 2 signal proteins (PLCgamma and MAPK)in the tyrosine kinase pathways. These results suggest that the protein tyrosine phosphorylation may in part play an important role in mitogenesis of vascular endothelial cells and other retinal responses after BRVO.
Animals ; Blotting, Western ; Cats* ; Diathermy ; Endothelial Cells ; Fibroblast Growth Factor 2 ; Intercellular Signaling Peptides and Proteins ; Phospholipases ; Phosphorylation ; Protein Kinases ; Protein-Tyrosine Kinases* ; Retina ; Retinal Vein ; Retinaldehyde ; Tyrosine ; Vascular Endothelial Growth Factor A ; Veins

BACKGROUND: Since open Wiltse approach allows limited visualization for foraminal stenosis leading to an incomplete decompression, we report the short-term clinical and radiological results of unilateral biportal endoscopic foraminal decompression using 0° or 30° endoscopy with better visualization. METHODS: We examined 31 patients that underwent surgery for neurological symptoms due to lumbar foraminal stenosis which was refractory to 6 weeks of conservative treatment. All 31 patients underwent unilateral biportal endoscopic far-lateral decompression (UBEFLD). One portal was used for viewing purpose, and the other was for surgical instruments. Unilateral foraminotomy was performed under guidance of 0° or 30° endoscopy. Clinical outcomes were analyzed using the modified Macnab criteria, Oswestry disability index, and visual analogue scale. Plain radiographs obtained preoperatively and 1 year postoperatively were compared to analyze the intervertebral angle (IVA), dynamic IVA, percentage of slip, dynamic percentage of slip (gap between the percentage of slip on flexion and extension views), slip angle, disc height index (DHI), and foraminal height index (FHI). RESULTS: The IVA significantly increased from 6.24°± 4.27° to 6.96°± 3.58° at 1 year postoperatively (p = 0.306). The dynamic IVA slightly decreased from 6.27°± 3.12° to 6.04°± 2.41°, but the difference was not statistically significant (p = 0.375). The percentage of slip was 3.41% ± 5.24% preoperatively and 6.01% ± 1.43% at 1-year follow-up (p = 0.227), showing no significant difference. The preoperative dynamic percentage of slip was 2.90% ± 3.37%; at 1 year postoperatively, it was 3.13% ± 4.11% (p = 0.720), showing no significant difference. The DHI changed from 34.78% ± 9.54% preoperatively to 35.05% ± 8.83% postoperatively, which was not statistically significant (p = 0.837). In addition, the FHI slightly decreased from 55.15% ± 9.45% preoperatively to 54.56% ± 9.86% postoperatively, but the results were not statistically significant (p = 0.705). CONCLUSIONS: UBEFLD using endoscopy showed a satisfactory clinical outcome after 1-year follow-up and did not induce postoperative segmental spinal instability. It could be a feasible alternative to conventional open decompression or fusion surgery for lumbar foraminal stenosis.
Constriction, Pathologic* ; Decompression* ; Endoscopy ; Follow-Up Studies ; Foraminotomy ; Humans ; Minimally Invasive Surgical Procedures ; Spinal Stenosis ; Spine* ; Surgical Instruments

Objectives: This study is intended to develop a curriculum for kindergarten food and nutrition education aimed at preschool children, reflecting government policy and meeting the demands of preschool settings. Methods: Existing educational materials were analyzed, and key elements of the 2019 Revised Nuri Curriculum (“Nuri Curriculum”) and Guidelines for Nutrition and Food Education in Kindergartens, Elementary, Middle, and High Schools (“Guidelines”) were examined as foundational information for developing the curriculum for food and nutrition education. Results: Basing ourselves on the five domains of the Nuri Curriculum, “Physical Activity and Health,” “Communication,” “Social Relationships,” “Art Experience,” and “Natural Science Inquiry,” we integrated three areas from the Guidelines, namely “Dietary Habits and Health,” “Dietary Habits and Safety,” and “Dietary Habits and Culture,” to structure the curriculum for kindergarten food and nutrition education. Three specific domains, “Nutrition and Health,” “Food and Culture,” and “Safe Dietary Practices,” were tailored for preschool children, each comprising core concepts, content elements, and educational materials. In the “Nutrition and Health” domain, core concepts such as “nutrition” were addressed through content elements such as “balanced eating” and “vegetables and fruit,” while “health” included elements such as “eating regularly” and “nutrients for disease prevention,” each with two educational content components. The “Food and Culture” domain focused on “food” with content on “local foods (vegetable-garden experience)” and “food culture” with content on “our dining table (rice and side dishes),” “our agricultural products,” “global cuisine (multiculture),” and “considerate dietary practices,” each with four educational content components. The “Safe Dietary Practices” domain included core concepts such as “hygiene” with content on “hand-washing habits” and “food poisoning management,” and “safety” with content on “food labeling.” Conclusions The systematized curriculum for kindergarten food and nutrition education aligns with the Nuri Curriculum and is interconnected with the Guidelines. This curriculum can be used as foundational material for developing educational resources tailored to the characteristics of preschoolers, contributing to effective implementation in early childhood education.

Methods: We have retrospectively studied IDTs by four surgeons during 1 or 2 years after starting BESS for lumbar degenerative diseases and analyzed the locations, sizes, and specific endoscopic conditions specific to each. Results: Twenty-five cases (1.6%) of IDTs among 1,551 cases of BESS occurred; 13 cases (52%) of these were within the first 6 months. The locations were dorsal midline in 12 cases, ipsilateral side in 11 cases, and contralateral side in two cases. The tear sizes were <10 mm in 20 cases and ≥10 mm in five cases. IDT commonly occurred due to injury of central dural folding during flavectomy under turbid surgical fields due to small bleeds under water. Twenty cases with IDTs of <10 mm were treated well with the patch technique. Among five cases of ≥10 mm, three underwent open repair within a few days, and two of these which failed to conservative management required a delayed revision operation due to pseudomeningocele. No cases progressed to surgical site infection or infectious spondylitis. Conclusions IDTs of <10 mm can be successfully treated with the patch technique. To prevent IDT during the early learning period, maintaining clear visibility by securing fluent saline outflow and meticulous hemostasis of small bleeding from exposed cancellous bone and epidural vessels is essential with caution not to injure the central dural folding during midline flavectomy.

STUDY DESIGN: A retrograde study, using Computerized Tomography (CT), to evaluate a safer approaching angle and distance for a percutaneous endoscopic discectomy. OBJECTIVES: To measure the safest approaching angle and distance in a percutaneous endoscopic discectomy at each vertebra level in Koreans. LITERATURE REVIEW SUMMARY: Some authors have shown an approaching angle of between 25 to 30 degrees, but reports on Koreans patients are very rare. MATERIALS AND METHODS: 200 cases of abdomino-pelvic CT were investigated. The minimal angle of safe approach was composed of two lines, one horizontal line passing through the mid point in the posterior cortex of upper vertebra, with the other extending passed the mid point of posterior cortex in the upper vertebra to the dorsal margin of the retroperitoneal fat or peritoneum. The maximal distance for a safe approach was measured from the end of spinous process to the point where the extended former second line crosses the skin. The minimal angles and maximal distances for safe approaches in males and females, from the right and left sides, at each level of the intervertebral space and in groups according to the BMI were compared. RESULTS: Females had a larger mean minimal angle for a safe approach (14.7 degrees) than that for males (9.6 degrees). However, no differences were observed between the right (12.0 degrees) and left sides (12.4 degrees). At each vertebral level, L2-3(16.4 degrees), L3-4(11.3 degrees) and L4-5(8.8 degrees), significant differences were observed. However, obesity had no influence on the different angles for a safe approach. The maximal distances for safe approaches were 12.9 and 12,6cm in males and female, 12.8 cm in for both of the right and left sides, and 11.8, 13.0 and 13.6cm in L2-3, L3-4 and L4-5, respectively. No differences were observed in any of the above group, but the more obese group had a longer distance. CONCLUSIONS: Females and the upper level of the intervertebral space had larger minimal angles for a safe approach, but there were no differences in relation to gender, direction and obesity. All the maximal distances for safe approaches were the same in males, females, right and left, and at each level of the intervertebral space, but the more obese group had a longer distance. A safer zone for the approach in a percutaneous endoscopic lumbar discectomy can be taken, considering the gender, vertebra level and obesity.
Diskectomy* ; Female ; Humans ; Intra-Abdominal Fat ; Male ; Obesity ; Peritoneum ; Skin ; Spine