Chemical neurolysis can be an extremely effective intervention for reducing spasticity. Phenol nerve block as a method of chemical neurolysis has been used over 40 years, nevertheless, many clinicians remain reluctant to perform this procedure. This is largely due to the fear of its side effects and complications such as excessive muscle weakness or increased spasticity of antagonistic muscles. The purpose of this study was to titrate the nerve block effects of phenol with different concentrations and different volumes of the phenol solution. Left tibial nerves of forty eight adult rabbits were injected with phenol solution of different concentrations(5%, 4%, 3%) and volumes(0.3 ml, 0.2 ml, 0.1 ml) into the epineural sheath. Nerve conduction study of the gastrocnemius muscle was performed before and after the nerve blocks(1day, 1week, 2weeks, 4weeks, 8weeks). The proportion of compound muscle action potential(CMAP) amplitudes and areas before and after the nerve blocks was used for the evaluation of nerve block effect. There was a statistically significant difference in the proportion among three volumes of phenol solution(p<0.05). However there was no statistical difference in the proportion among three concentrations of phenol solution(p>0.05) although the higher concentration of phenol solution showed the tendency for smaller proportion. The area of histological degeneration appeared at 2 weeks following nerve block alongside the perineurium. The depth of degeneration area of nerve fascicle varied according to the distance from injection point. These data suggest that the nerve block effect of phenol can be titrated more easily with the volume of phenol solution rather than the concentration until 8 weeks after the nerve block. The variation of the extent of degeneration with different volumes of phenol solution seems to be the mechanism for the titration.
Adult ; Humans ; Muscle Spasticity ; Muscle Weakness ; Muscle, Skeletal ; Muscles ; Nerve Block* ; Neural Conduction ; Peripheral Nerves* ; Phenol* ; Rabbits ; Tibial Nerve

BACKGROUND: Dermatophytoses tend to have a poorer outcome in diabetic patients than in non-diabetic patients. Therefore, diabetic patients need to pay a closer attention to the prevention and treatment of dermatophytoses. The aim of this study was to determine the level of understanding of the dermatophytoses in diabetic patients and to clarify the factors associated with the level of understanding. METHODS: A questionnaire survey was carried out from June to July, 2005, targeting 200 patients who had visited two hospitals in Seoul for the management of diabetes. There were 163 respondents (response rate 50.9%). The degree of understanding was calculated by giving 1 point to each question, with a maximum of 12 points. RESULTS: The average degree of understanding of dermatophytoses was 6.68 points (SD 1.79). Younger age (P= 0.0002), high education level (P=0.0035), and high income (P=0.0013) were the factors related to a better understanding of dermatophytoses. The patients who had obtained the information on dermatophytoses from the websites, broadcasts, newspapers, or magazines showed higher recognition points than others (P=0.0377). The body mass index, the duration of diabetes, the complications associated with diabetes did not affect the understanding of dermatophytoses. CONCLUSION: There are many diabetes patients who do not know enough about dermatophytoses. Diabetes itself is not related to the level of understanding of dermatophytoses. However, diabetic patients who are older, have a lower level of education, and a low income will need to be informed about prevention and treatment of dermatophytoses.
Body Mass Index ; Surveys and Questionnaires ; Diabetes Mellitus ; Education ; Humans ; Periodicals ; Periodicals as Topic ; Primary Prevention ; Seoul ; Tinea*

BACKGROUND: Dermatophytoses tend to have a poorer outcome in diabetic patients than in non-diabetic patients. Therefore, diabetic patients need to pay a closer attention to the prevention and treatment of dermatophytoses. The aim of this study was to determine the level of understanding of the dermatophytoses in diabetic patients and to clarify the factors associated with the level of understanding. METHODS: A questionnaire survey was carried out from June to July, 2005, targeting 200 patients who had visited two hospitals in Seoul for the management of diabetes. There were 163 respondents (response rate 50.9%). The degree of understanding was calculated by giving 1 point to each question, with a maximum of 12 points. RESULTS: The average degree of understanding of dermatophytoses was 6.68 points (SD 1.79). Younger age (P= 0.0002), high education level (P=0.0035), and high income (P=0.0013) were the factors related to a better understanding of dermatophytoses. The patients who had obtained the information on dermatophytoses from the websites, broadcasts, newspapers, or magazines showed higher recognition points than others (P=0.0377). The body mass index, the duration of diabetes, the complications associated with diabetes did not affect the understanding of dermatophytoses. CONCLUSION: There are many diabetes patients who do not know enough about dermatophytoses. Diabetes itself is not related to the level of understanding of dermatophytoses. However, diabetic patients who are older, have a lower level of education, and a low income will need to be informed about prevention and treatment of dermatophytoses.
Body Mass Index ; Surveys and Questionnaires ; Diabetes Mellitus ; Education ; Humans ; Periodicals ; Periodicals as Topic ; Primary Prevention ; Seoul ; Tinea*

Background and Objectives: Fibrin sealant (FS) is widely used to reduce postoperative bleeding. This analysis aimed to assess the efficacy of FS to reduce complications after rhinoplasty.Materials and Method We searched PubMed, Scopus, Embase, the Cochrane Library, and the Web of Science database for articles on FS and rhinoplasty from the inception of publication to December 29, 2021. Post-rhinoplasty complications, such as edema and ecchymosis, were recorded. The final meta-analysis was performed using three studies. Results: Two subgroups were created based on the FS usage after rhinoplasty. The FS effect on edema reduction was favorable on the postoperative day-1 (standardized mean difference [SMD]=-1.07 [-1.70; -0.45]). In addition, the FS effect on ecchymosis reduction was favorable on the postoperative day-1 postoperative (SMD=-1.33 [-2.15; -0.50]). Conclusion Our study shows that FS reduces the early complications of rhinoplasty.

OBJECTIVE: The purpose of this study was to titrate the nerve block effect of phenol with different concentrations of phenol solution by electrophysiological and mechanical measurements. METHOD: Right tibial nerves of twenty three adult rabbits were blocked by phenol solution with different concentrations (3%, 5%). Nerve conduction study for compound muscle action potential (CMAP), tension by electrical stimulation, and stiffness (slope) of stretch reflex of the triceps surae were performed after nerve block (4 weeks, 8 weeks, 16 weeks). The ratios of each values of right limb to those of left limb were used to evaluate the nerve block effect. RESULTS: The ratios of CMAP amplitude, tension, and slope of 3% group were 0.36, 0.55, and 0.56 at 4 weeks and those of 5% group were 0.21, 0.25, and 0.58. There were statistically significant differences of the CMAP amplitude and tension ratios, however there was no statistically significant difference of the slope ratio between two groups at 4 weeks. The ratios of CMAP amplitude, tension, and slope of 5% phenol group were increased with time. CONCLUSION: Nerve block effects by 5% phenol solution were greater than 3%. These data suggest that nerve block effect can be titrated with concentration of phenol solution.
Action Potentials ; Adult ; Electric Stimulation ; Extremities ; Humans ; Nerve Block* ; Neural Conduction ; Peripheral Nerves* ; Phenol* ; Rabbits ; Reflex, Stretch ; Tibial Nerve

No abstract available.
Astrocytoma ; Brain* ; Drug Therapy ; Glioblastoma ; Glioma* ; Humans ; Nimustine* ; Radiotherapy*

Schwannoma is benign tumor that can occur in any part of the nerve that contains a Schwann cell. It is rare in the head and neck region and is characterized by common postoperative neurologic symptoms. We experienced a cervical schwannoma in a 22-year-old young man. Except for a foreign body sensation in the neck and a mass in the anterior region, there were no other complaints. A retropharyngeal schwannoma was most suspected considering neck computed tomography, magnetic resonance imaging, laryngoscopy and fine needle aspiration. Surgical treatment was performed, and the origin of the schwannoma was diagnosed as the tonsillar branch of the glossopharyngeal nerve. Histopathological examination confirmed the presence of a schwannoma with typical characteristics. After surgery, the patient recovered without any side effects. We report this case with a review of the literature.

OBJECTIVE: To correlate existing evaluation tools with clinical information on Duchenne muscular dystrophy (DMD) patients following age and to investigate genetic mutation and its relationship with clinical function. METHOD: The medical records of 121 children with DMD who had visited the pediatric rehabilitation clinic from 2006 to 2009 were reviewed. The mean patient age was 9.9+/-3.4 years and all subjects were male. Collected data included Brooke scale, Vignos scale, bilateral shoulder abductor and knee extensor muscles power, passive range of motion (PROM) of ankle dorsi-flexion, angle of scoliosis, peak cough flow (PCF), fractional shortening (FS), genetic abnormalities, and use of steroid. RESULTS: The Brooke and Vignos scales were linearly increased with age (Brooke (y1), Vignos (y2), age (x), y1=0.345x-1.221, RBrooke2=0.435, y2=0.813x-3.079, RVignos2=0.558, p<0.001). In relation to the PROM of ankle dorsi-flexion, there was a linear decrease in both ankles (right and left R2=0.364, 0.372, p<0.001). Muscle power, Cobb angle, PCF, and FS showed diversity in their degrees, irrespective of age. The genetic test for dystrophin identified exon deletions in 58.0% (69/119), duplications in 9.2% (11/119), and no deletions or duplications in 32.8% (39/119). Statistically, the genetic abnormalities and use of steroid were not definitely associated with functional scale. CONCLUSION: The Brooke scale, Vignos scale and PROM of ankle dorsi-flexion were partially available to assess DMD patients. However, this study demonstrates the limitations of preexisting scales and clinical parameters incomprehensively reflecting functional changes of DMD patients.
Animals ; Ankle ; Child ; Cough ; Dystrophin ; Exons ; Gene Deletion ; Humans ; Knee ; Male ; Medical Records ; Muscles ; Muscular Dystrophy, Duchenne ; Range of Motion, Articular ; Scoliosis ; Shoulder ; Weights and Measures

Aorta-right atrial tunnel is a vascular anomaly that originates from the aortic sinus and terminates in either the superior vena cava or the right atrium. The patency of the tunnel can result in volume overload in both ventricles, bacterial endocarditis, aneurysm formation, and spontaneous rupture. Transesophageal echocardiography was performed in a 42-year-old male patient diagnosed with infectious endocarditis, and vegetation of the mitral and aortic valves, right atrial enlargement, and an extracardiac blood vessel connecting the aorta to the right atrium were discovered. Therefore, we were able to diagnose an aorta-right atrial tunnel leading to infectious endocarditis and proceeded with surgical treatment. Together with a review of the literature, we present a case report of a patient with aorta-right atrial tunnel accompanied by infectious endocarditis.
Adult ; Aneurysm ; Aorta ; Aortic Valve ; Blood Vessels ; Echocardiography, Transesophageal ; Endocarditis* ; Endocarditis, Bacterial ; Fistula ; Heart Atria ; Humans ; Male ; Rupture, Spontaneous ; Sinus of Valsalva ; Vena Cava, Superior

Chloroma is a granulocytic sarcoma with it's characteristic greenish color. Recently there is an increased number of cases that are apparently aleukemic when the tumor mass is first presented. Recently we experienced a case of granulocytic sarcoma with characteristic green color (chloroma), which showed no evidence of leukemia in the bone marrow and peripheral blood. This patient presented headache, and was diagnosed brain tumor on computed tomography. A left parietal cranietomy was done to remove a large central dome-like mass, 8 cm, involving the dura with a slightly dusky greenish solid appearance. Compact nests of moderately mature granulocytes and immature cells comprised the tumor. Histochemical and electron microscopic studies confirmed these tumor cells as myeloid cells in varying stages of maturation. Several days after the operation, left cervical lymph nodes became palpated, and the biopsied lymph nodes revealed same neoplastic cells seen in the skull. However, bone marrow aspiration, biopsy and peripheral blood smears did not show any evidence of leukemia.
Adolescent ; Brain Neoplasms/pathology/*surgery ; Female ; Humans ; Leukemia, Myeloid/pathology/*surgery