Epiduroscopy is very useful in the treatment of not only low back pain caused by failed back surgery syndrome, epidural scar or herniated disc but also by chronic refractory low back pain which does not respond to interventional conservative treatment including fluoroscopically-directed epidural steroid injections and percutaneous adhesiolysis. Because cauterization using a laser fiber has become recently available, a wider opening is required to enter into the sacral canal in the case of epiduroscopic laser neural decompression (ELND). However, in a few patients, it is difficult to insert a device into the epidural space due to stenosis around the opening, and there is no alternative method. Herein, we report a case where a hiatus rasp specially designed for such patients was used to perform the operation.
Cicatrix ; Constriction, Pathologic ; Decompression ; Epidural Space ; Failed Back Surgery Syndrome ; Humans ; Intervertebral Disc Displacement ; Low Back Pain

20-40% of cases of acute transverse myelitis are attributed to viral infections, although the specific viral etiology is only rarely identified. We have studied one patient with transverse myelitis in association with acute hepatitis B virus infection. Hepatitis virus should be considered as rare cause of transverse myelitis.
Hepatitis B virus* ; Hepatitis B* ; Hepatitis Viruses ; Hepatitis* ; Humans ; Myelitis, Transverse*

BACKGROUND: Neuroplasty using a Racz catheter or epiduroscope and percutaneous endoscopic laser discectomy are performed as treatment for chronic refractory low back and/or lower extremity pain, but they are limited in that they cannot completely remove the causing pathology. Lately, epiduroscopic laser neural decompression (ELND) has been receiving attention as an alternative treatment, but there are insufficient reports of results. Hence we aimed to investigate and report the data in our hospital. METHODS: Seventy-seven patients were selected who had received ELND via the anterior and posterior epidural approach through the pain clinic in our hospital from March 2011 to July 2012. Their medical records including age, diagnosis, epiduroscopic findings and degree of symptom relief were investigated. The degree of symptom relief following the procedure was categorized into 5 stages of very good (5), good (4), no change (3), bad (2), and very bad (1) at 2 weeks and 1 month after the procedure. RESULTS: The subjects were 30 males and 47 females. Mean age was 54.6 for males and 59.6 for females, so the overall mean age was 58.1 years old, with the youngest being 23 and the oldest 88 years old. In epiduroscopic images of all patients, more than one situation of herniated disc, fibrous tissue and adhesion, or inflammation was observed. Sixty-seven patients (87.0%) showed symptom relief 2 weeks after the procedure and 63 patients (81.8%) showed relief after 1 month. CONCLUSIONS: ELND is considered to be an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, and failed back surgery syndrome which cannot be alleviated with existing non-invasive conservative treatment.
Catheters ; Decompression ; Diskectomy ; Failed Back Surgery Syndrome ; Female ; Humans ; Inflammation ; Intervertebral Disc Displacement ; Lower Extremity ; Male ; Medical Records ; Pain Clinics ; Spinal Stenosis

OBJECTIVE: Increasingly it is being recognized that genetic factors play a significant role in causing malformation. There are many available prenatal diagnostic methods including cytogenetic karyotyping using amniocentesis and cordocentesis, fluorescence in situ hybridization(FISH), and primed in situ labelling(PRINS). Our purpose was to attempt to discuss the clinical use of cytogenetic karyotyping, FISH, and PRINS. METHODS: We conducted 222 cases of cytogenetic karyotyping using amniocentesis and cordocentesis, l0 cases of FISH, and 10 cases of PRINS from January 1996 to July 1998 at Ewha Womans University Mokdong Hospital. Age distribution, chromosomal abnormalities by age group, indication, karyotype, and baby outcomes were performed. RESULTS: Overall incidence of chromosomal abnormalities was 7.7%(17cases) and chromosomal abnormalities were most frequently noted in 30-34 year old women and 35-39 year old women(2.3%, respectively). Among 222 cases, 25-29 year old women were highest(30.2%). Chromosomal abnormalities among cytogenetic karyotyping cases were Down syndrome, Edward syndrome, Patau syndrome, Deletion(8), Inversion(9), etc. The 5 cases of healthy baby among chromosomal abnormalities were delevered. Among 213 cases of karyotyping using amniocentesis, abnormal karyotyping cases were 15 cases. Among 15 cases, 8 cases were terminated and 5 cases of healthy baby were delivered. Among 9 cases of karyotyping using cordocentesis, 2 cases of chromosomal abnormalities(Edward, Down syndrome) were found and 3 cases healthy baby were delivered. Among 10 cases of FISH results, 6 case of FISH results were the same with G-banding and were different from G-banding. Among 10 cases of PRINS results, we got the PRINS results from 7 cases. CONCLUSION: It is concluded that cytogenetic karyotyping, FISH, and PRINS are very useful to detect chromosomal abnormalities.
Age Distribution ; Amniocentesis ; Chromosome Aberrations ; Cordocentesis ; Cytogenetics* ; Down Syndrome ; Female ; Fluorescence* ; Humans ; In Situ Hybridization* ; Incidence ; Karyotype ; Karyotyping* ; Prenatal Diagnosis* ; Primed In Situ Labeling

OBJECTIVES: This study was to evaluate the impacts of simultaneous exposure to noise and mixed solvents on workers'hearing threshold level (HTL) over five-year period. METHODS: The study was conducted by interview and annual audiometric test on workers in ship building industry from 1994 to 1998. The cases(workers who exposed to noise and mixed solvent simultaneously) were 43 male workers and controls (workers who exposed to nolle) were selected by matching method with regard to age, sex, carrier, and noise exposure level. To assess the impacts of solvent exposure on hearing threshold level, with considering other factors, general liner model was used. RESULTS: 1. The audiogram of all subjects showed typical sensorineural hearing loss pattern. The mean HTLe were increased at high frequency (4000HB and 8000Hz) for study period. 2. The HTLs of cases were more increased than those of controls at high frequencies (4000Hz and 8000Hz), but there was not statlstical significance. 3. The impact of age on the HTL was statistically significant at 250Hz and 500Hz (p(0.05), and the impact of noise on the HTL was statistically significant at 250Hz, 2000Hz and 4000Hz (p(0.05), but the impact solvent exposure on the HTL was not significant. 4. The changes in HTLs of cases were higher than those of controls at high frequency, there were not statistical significance at 4000Hz, but only at 8000Hz (p=0.087). 5. Statistical analysis of the general linear model implicated that the changes in HTL was impacted by noise exposure bevel significantly (p=0.031) and Impacted by solvent exposure weakly (p=0.087) at 8000Hz. CONCLUSIONS: The results of this study suggest that workers who simultaneously exposed to noise and mixed solvent were at risk for more affected HTL than those exposed to noise exposure only, but we could not find definitive evidence. Further detailed studies must be made in large number of workers.
Construction Industry ; Hearing Loss* ; Hearing Loss, Sensorineural ; Hearing* ; Humans ; Linear Models ; Male ; Noise ; Ships ; Solvents

Background: To report the long-term clinical and radiologic results of impaction bone grafting and standard cemented polished stem for femoral revision arthroplasty in patients with extensive bone deficiency. Methods: We retrospectively reviewed 47 hips that underwent femoral revision hip arthroplasty using an impaction-morselized allograft with a standard cemented polished stem. The average age at the time of revision hip arthroplasty was 55 years (range, 39–75 years). The modified Harris hip score (HHS) was used for clinical evaluation. The radiologic evaluation focused on stem subsidence, stem position, progressive radiolucent lines, bone remodeling, and the incorporation of allografts. Results: The modified HHS improved from an average of 55.04 (range, 25–79.5) preoperatively to 90.1 (range, 81–93.2) at the last follow-up. The mean follow-up duration was 13.5 years (10.9–17.8 years). The radiographic analysis revealed stable stems.Femoral stems showed an average subsidence of 3.2 mm (range, 2–8 mm) in the cement mantle. However, there was no mechanical failure or subsidence of the cement mantle in the femurs. The stem position was neutral or varus less than 5°. No progressive radiolucent line or osteolysis was observed. Evidence of cortical and trabecular remodeling was observed in all cases. There were four cases of intraoperative cracks and four cases of distal femur splitting. Conclusions Initial stem stability using impaction bone grafting and a standard cemented polished stem in femoral revision arthroplasty resulted in good outcome. Delicate impaction grafting techniques and intraoperative crack and splitting fixation are the points that need attention for successful long-term results.

Hantaan (HTN) and Seoul (SEO) viruses, murid rodent-borne hantaviruses, are known to causes hemorrhagic fever with renal syndrome (HFRS) in Korea. To determine the genomic diversity and molecular phylogeny of HTN and SEO viruses found in Korea, we amplified for part of M and S genomic segments of hantaviruses from sera of HFRS patients and lung tissues of hantavirus seropositive striped-field mice. Both M and S segment of 16 HTN and 2 SEO viruses were amplified by nested reverse transcripton-polymerase chain reaction. Based on 324 nucleotides in the M genomic segment, the HTN and SEO strains showed 93.8~100% and 99.1~99.4% homologies, respectively. Similarly, based on 230 nucleotides in the S genomic segment, HTN and SEO strains showed 90.9~100% and 100% homologies, respectively. Phylogenetic analysis of M and S segments indicated that HTN strains could be divided into at least two main groups in M and S trees and the sequence differences detected among the S and M genomic segments of HTN viruses are consistent with reassortment having taken place between HTN virus strains.
Animals ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea ; Lung ; Mice ; Muridae ; Nucleotides ; Phylogeny ; Seoul virus* ; Seoul*

In many clinical settings, patients undergoing major surgery and patients with critical illness or cancer routinely receive a central venous catheter (CVC). Although several complications including hematoma formation, hemothorax, hydrothorax, chylothorax and cardiac tamponade with vascular injury are associated with the placement of CVCs, their incidence are not frequent. Especially, hydromediastinum and bilateral hydrothorax are very rare. We experienced an unusual complication of hydromediastinum and bilateral hydrothorax by left brachiocephalic vein perforation with misplacement of the catheter tip after right subclavian vein catheterization.
Brachiocephalic Veins ; Cardiac Tamponade ; Catheterization ; Catheters ; Central Venous Catheters ; Chylothorax ; Critical Illness ; Hematoma ; Hemothorax ; Humans ; Hydrothorax ; Incidence ; Subclavian Vein ; Vascular System Injuries

Incidences of major feline viral diseases provide basic information for preventing viral disease in cats. Despite the growing interest in feline viral diseases, sero-surveillances have been lacking. In this study, we analyzed the diagnoses of feline viral diseases and conducted a sero surveillance of feline panleukopenia virus (FPV), feline calicivirus (FCV), feline herpesvirus-1 (FHV-1), and feline infectious peritonitis virus (FIPV) in Korean cats. Of the 204 confirmed cases since 2015, the numbers of diagnoses for FPV, FIPV, FCV, feline influenza virus, and FHV-1 were 156, 32, 12, 3, and 1 case, respectively. In total, 200 sera, collected between 2019 and 2021, were screened for the presence of antibodies against FPV, 2 FCVs, FHV-1, and FIPV using a hemagglutination inhibition test and a virus-neutralizing assay (VNA). The overall seropositive rates in cats tested for FPV, the 2 FCVs, FHV-1, and FIPV were 92.5%. 42.0%, 37.0%, 52.0%, and 14.0%, respectively. A low correlation (r = 0.466) was detected between the VNA titers of 2 FCV strains. The highest incidence and seropositive rate of FPV reveal that FPV is circulating in Korean cats. The low r-value between 2 FCVs suggests that a new feline vaccine containing the 2 kinds of FCVs is required.

PURPOSE: This study measured the availability of the ‘inferior vena cava (IVC) diameter ratio’ in sepsis or septic shock patients using computed tomography (CT) to determine if it can be used as a predictive factor for the 28-day mortality. METHODS: This retrospective analysis included patients between March 2016 and February 2017. One hundred fortyeight sepsis patients and 62 septic shock patients were included. The patients were divided into 2 groups (28-day survivors and non-survivors). The IVC diameter ratio (maximal transverse-to-maximal anteroposterior diameter immediately below the level of the renal vein) was measured by abdominal CT in the axial view. Using SPSS Statistics ver. 20.0, the IVC diameter ratio was analyzed by logistic regression analysis to identify the predictors of the 28-day mortality. Receiver operating characteristics (ROC) curves were used to determine the cut-off value for the maximum sensitivity and specificity for an evaluation of the availability as a predictive factor (28-day mortality). RESULTS: In the sepsis group, 38 out of 148 patients (25.7%) died. In the septic shock group, 29 out of 62 patients (46.8%) died. The IVC diameter ratio was significantly higher in the non-survivors than the survivors in both the sepsis and septic shock groups. In the sepsis patients, the odds ratio was 8.95. The area under the ROC curve (AUC) of the IVC diameter ratio for the 28-day survival was 0.817; the cut-off value was 1.60:1. The sensitivity and specificity was 73.7% and 75.5%, respectively. The positive and negative predictive value was 50.9% and 89.2%, respectively. In the septic shock patients, the odds ratio was 39.99. The AUC of the IVC diameter ratio for the 28-day survival was 0.831; the cut-off value, sensitivity, and specificity was 1.90:1, 75.9%, and 81.8%, respectively. The positive and negative predictive values were 78.6% and 79.4% respectively. CONCLUSION: The IVC diameter ratio (maximal transverse-to-maximal anteroposterior diameter) is associated with the 28-day mortality in sepsis or septic shock patients who have undergone abdomen CT.
Abdomen* ; Area Under Curve ; Humans ; Logistic Models ; Mortality ; Odds Ratio ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Sepsis* ; Shock, Septic* ; Survivors ; Tomography, X-Ray Computed ; Vena Cava, Inferior*