STUDY DESIGN: Retrospective study of clinical experiences. OBJECTIVES: The correct discrimination of a compressed root is very important for proper decompression. With a foraminal disc herniation, the cephalad root is compressed. The diagnostic importance of the clinical and radiological findings was investigated. SUMMARY OF LITERATURE REVIEW: A compressed root, due to a herniated disc, is known as a caudal root (i. e. L5 root compressed by L4-5 disc herniation). In some cases, a prolapsed disc may compress the cephalad root, resulting in a difficult diagnosis. MATERIAL AND METHOD: The medical records, plain X-ray and MRI of 17 patients were reviewed, and the physical examination and MRI findings were carefully evaluated to retrospectively document the efficacy of the diagnoses. Every MRI image of each patient was graded according to the 4 point ranking system of diagnostic efficacy devised by the authors. The clinical outcomes and postoperative complications were also investigated. RESULTS: Ten, 5 and 2 of the 17 patients had L4-5, L5-S1 and L3-4 foraminal disc herniations, respectively. Eight of 10 L4-5 cases showed a positive femoral nerve stretching test. The knee jerk reflex was diminished in 7 patients, with bilateral hyporeflexia in the other 3. The body-cut axial MRI image was the most effective, and the coronal images were also very helpful, whereas the routine axial images were of least value. Most cases achieved a satisfactory clinical result. CONCLUSIONS: Foraminal disc herniations seem to be reasonably common. For the accurate discrimination of a compressed root, a thorough physical examination seems to be very important. When MRI is performed for these cases, in addition to routine studies, the body-cut axial and coronal MRI images are effective and useful, and their use is strongly recommended.
Decompression ; Diagnosis ; Discrimination (Psychology) ; Femoral Nerve ; Humans ; Intervertebral Disc Displacement ; Knee ; Magnetic Resonance Imaging ; Medical Records ; Physical Examination ; Postoperative Complications ; Reflex ; Reflex, Abnormal ; Retrospective Studies

PURPOSE: Mycoplasma pneumoniae is one of the most common causes of pneumonia in children and adolescents. Though cold agglutinin test and specific antibody test are used in the diagnosis of mycoplasma pneumonia, there are some limitations in early diagnosis. In this study, we evaluated the availability and usefulness of polymerase chain reaction (PCR) in the diagnosis of M. pneumoniae pneumonia and compared it with serologic test. METHODS: One hundred twenty four children who were clinically diagnosed with pneumonia and admitted to Kyunghee Hospital from January 1998 to March 2001 were enrolled. Mycoplasma specific antibody test using commercial kit (Serodia-MYCO II, Fusirebio Inc., Tokyo, Japan) and PCR using mycoplasma DNA obtained from throat swabs were done. The sensitivity and specificity of PCR were evaluated. RESULTS: M. pneumoniae pneumonia was diagnosed when the mycoplasma specific antibody titer was over 1: 160 or when the titer increased more than fourfold during follow-up period. The specificity, sensitivity, false-positive rate and false-negative rates of PCR were 93.0%, 58.3%, 33.3%. and 9.7%, respectively. CONCLUSION: PCR has shown high specificity. But, the positive result in PCR don't correlate with the disease activity and PCR does not have high sensitivity. So PCR must be used alongside with serologic test in the diagnosis of pneumonia. But, it seems possible to improve sensitivity by delicate handling of samples and by improving PCR technology, and PCR will possibly be used in the diagnosis of early infections of M. pneumoniae pneumonia and in the evaluation of treatments in the future.
Adolescent ; Child* ; Diagnosis ; DNA ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pharynx ; Pneumonia* ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Serologic Tests

Pigmented villonodular synovitis (PVNS) is a rare, benign, soft tissue neoplasm affecting the synovium of joints, classified as localized and diffused type. Localized type is more common, arising from synovium of joints, bursae, and tendon sheaths. Diffused type is relatively rare, frequently arising from an extra-articular lesion, and sometimes from an intramuscular or subcutaneous lesion. Although the cause of occurrence is not yet clear, recently it has been known as a benign neoplasm rather than an inflammatory or reactive process. We performed a total excision of the PVNS in a pretibial lesion and achieved a good result. We report on the case with a review of the literature.
Giant Cell Tumors* ; Giant Cells* ; Joints ; Soft Tissue Neoplasms ; Synovial Membrane ; Synovitis, Pigmented Villonodular ; Tendons ; Tenosynovitis* ; Tibia

OBJECTIVES: This study was designed to assess the change of heart rate variability (HRV) at resting, upright, and psychological stress states in depressive disorder patients. METHODS: HRV was measured at resting, upright, and psychological stress states in 62 depressive disorder patients. We used visual analogue scale (VAS) score to assess tension and stress severity. Beck depression inventory (BDI) and state trait anxiety inventories I and II (STAI-I and II) were used to assess depression and anxiety severity, respectively. Differences between HRV indices and VAS score were evaluated using paired t-tests. Gender difference analysis was conducted with ANCOVA. RESULTS: SDNN (standard deviation of normal to normal intervals), LF/HF (low frequency/high frequency), and VLF (very low frequency) were significantly increased, while NN50 and pNN50 were significantly decreased in the upright position compared to resting state. SDNN, RMSSD (root mean square of the differences of successive normal to normal intervals), and VLF were significantly increased, while pNN50 was significantly decreased in the psychological stress state compared to resting state. SDNN, NN50, and pNN50 were significantly lower in an upright position compared to a state of psychological stress, and LF, HF, and LF/HF showed no significant differences CONCLUSION: The LF/HF ratio was significantly increased after physical stress in depressive disorder. However, the LF/HF ratio was not significantly increased after psychological stress, and the change in LF/HF ratio after physical stress and psychological stress did not significantly differ from each other. Significant increase in SDNN, NN50, and pNN50 in an upright posture compared to psychological stress suggests that depressive patients react more sensitively to physical stress than psychological stress.
Anxiety ; Autonomic Nervous System ; Depression ; Depressive Disorder ; Equipment and Supplies ; Heart Rate ; Heart ; Humans ; Posture ; Stress, Psychological

Thirteen patients with coronavirus disease 2019 (COVID-19) visited a university hospital in Seoul before recognizing their disease infections, causing contact with 184 hospital workers. We classified the patients into four risk levels and provided corresponding management measures. At 31 days after the last event, all screening laboratory results were negative, and no symptoms/signs were reported.

Agenesis of the dorsal pancreas is a rare congenital anomaly that arises from the failure of the dorsal pancreatic bud of endodermal cells to form the body and tail of the pancreas and can manifest as diabetes. A 24-year-old man, who had been treated with insulin for 7 years, presented with epigastric pain, vomiting, and watery diarrhea. Abdominal computed tomography showed only the head of the pancreas without visualization of the pancreatic body and tail. Left renal agenesis and absence of the left vertebral pedicle in T12 were also observed. The duct of Santorini and the duct in the body and tail were not visible in magnetic resonance cholangiopancreatography. The associated anomalies reported here are very rare globally. We report a case of complete agenesis of the dorsal pancreas with multiple congenital abnormalities and diabetes mellitus.
Cholangiopancreatography, Magnetic Resonance ; Congenital Abnormalities ; Diabetes Mellitus ; Diarrhea ; Endoderm ; Head ; Humans ; Insulin ; Kidney ; Kidney Diseases ; Pancreas ; Pancreatic Ducts ; Vomiting ; Young Adult

BACKGROUND: In contrast to fillers made from artificial substances, platelet-rich fibrin matrix (PRFM) filler does not cause hypersensitivity reactions or foreign body reactions. PRFM is also highly accessible in terms of cost. Hence, in this study, the efficacy of PRFM for soft tissue augmentation and volume maintenance was evaluated in an animal experiment. METHODS: Twenty nude mice were injected with hyaluronic acid filler, fibrin glue, PRFM filler, and normal saline (control). The remaining volume was measured 4 times over the course of 8 weeks using the volumetric taping bowl method and magnetic resonance imaging. RESULTS: All nude mice survived and showed no signs of infection, such as erythema or edematous changes, during the study period. Migration of the injected substance was not detected at 2, 4, or 8 weeks after the procedure. The remaining volumes of normal saline at 2, 4, and 8 weeks were 10.50%, 2.00%, and 0.00%; fibrin glue, 20.50%, 9.00%, and 2.50%; hyaluronic acid filler, 82.00%, 35.00%, and 17.33%; and PRFM filler, 70.31%, 26.75%, and 14.37%, respectively. CONCLUSIONS: PRFM filler had a high soft-tissue filling capacity compared with the control. It also showed a similar effect to hyaluronic acid filler. Thus, PRFM filler could be a good alternative for correcting soft-tissue deficits.
Animal Experimentation ; Animals ; Cosmetic Techniques ; Erythema ; Fibrin Tissue Adhesive ; Fibrin* ; Foreign Bodies ; Hyaluronic Acid ; Hypersensitivity ; Magnetic Resonance Imaging ; Methods ; Mice ; Mice, Nude* ; Platelet-Rich Plasma

OBJECTIVE: To investigate the effect of extracorporeal shock wave therapy (ESWT) on painful stump neuroma. METHODS: Thirty patients with stump neuroma at the distal end of an amputation site were assigned randomly to the ESWT group (n=15) and the transcutaneous electrical nerve stimulation (TENS)+desensitization+pharmacological treatment group (n=15). For 3 weeks, the ESWT group received a weekly session involving 1,500 pulses at 0.10 mJ/mm2, while the control group was treated 10 times each, 40 minutes per day with TENS and desensitization treatment, and daily medication for 3 weeks. ESWT stimulation was given by focusing on the area at the neuroma site clearly identified by ultrasound. RESULTS: The changes in the McGill pain questionnaire were 38.8+/-9.0 prior to treatment and 11.8+/-3.1 following the treatment. The corresponding values for the control group were 37.2+/-7.7 and 28.5+/-10.3. The changes between groups were significantly different (p=0.035). The change in visual analog scale prior to and after treatment was 7.0+/-1.5 and 2.8+/-0.8 in the ESWT group, respectively, and 7.2+/-1.4 and 5.8+/-2.0 in the control group. These changes between the groups were also significantly different (p=0.010). The outcome in the pain rating scale also showed significant differences between groups (p<0.001). Changes in neuroma size and pain pressure threshold (lb/cm2) were not significantly different between groups (p>0.05). CONCLUSION: The study findings imply that ESWT for stump neuroma is superior to conventional therapy.
Amputation ; Amputation Stumps ; Humans ; Neuroma* ; Pain Measurement ; Shock* ; Transcutaneous Electric Nerve Stimulation ; Ultrasonography ; Visual Analog Scale

BACKGROUND/AIMS: Small core biopsy samples can occasionally be obtained with conventional endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA). Although most studies have focused on the cytological analysis of specimens, data regarding histological assessment is scarce. The aim of this study was to determine whether core biopsies by conventional EUS-FNA could increase the accuracy of EUS-guided sampling when combined with cytology in the absence of an on-site cytopathologist. METHODS: In the 95 consecutive patients (98 lesions) undergoing EUS-FNA of solid pancreatic masses and intra-abdominal lymphadenopathy, tissue coils from the needle were harvested for histology, and residual tissue was examined by cytology. RESULTS: Adequate samples were obtained by EUS-FNA cytology, histology, and combined cytology-histology in 91.8%, 65.3%, and 94.8% of patients, respectively. From the pancreas (n=67), adequate samples for histology were obtained by EUS-FNA in 68.7% of cases, compared with 58.0% from non-pancreatic cases (n=31), respectively (p>0.05). The overall sensitivity and accuracy of EUS-FNA was 78.0% and 81.6% for cytology alone, 63.4% and 69.4% for histology alone, and 84.1% and 86.7% for combined cytology-histology, respectively. CONCLUSIONS: Combined cytology and histology analysis for diagnosing pancreatic masses and intra-abdominal lymphadenopathy may increase the diagnostic yield of conventional EUS-FNA without on-site cytology.
Biopsy ; Biopsy, Fine-Needle ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Humans ; Lymphatic Diseases ; Needles ; Pancreas

The etiology of allergic diseases has been considered multi-factorial, comprising genetic, epigenetic, developmental, and environmental factors, as well as their complex interactions. The rising prevalence of allergic disease in recent decades could be explained by changes in environmental factors rather than genetic factors. Climate change has many significant impacts on aeroallergens such as pollen and mold. Therefore, climate changes are considered to be a key environmental factor affecting not only the prevalence but also the severity of allergic disease. In addition, these environmental factors might be more important for young children than for adults. While the concept that environmental factors including climate change would affect the characteristics of allergic disease is generally accepted, it is not enough to explain the mechanisms of the increase in the prevalence and severity of allergic diseases. Nevertheless, evidence exists that climate change has spurred changes in aeroallergens such as pollen and outdoor fungi, and that these changes are associated with the increased incidence of pediatric allergic disease.
Adult ; Child ; Climate ; Climate Change ; Epigenomics ; Fungi ; Humans ; Incidence ; Pollen ; Prevalence