No abstract available.
Hyperostosis, Cortical, Congenital*

Purpose: To evaluate the effects and limitations of lacrimal endoscopy without silicone tube intubation in patients with epiphora. Methods: We conducted a retrospective chart review of 64 eyes in 49 patients who underwent lacrimal endoscopy between May 2021 and May 2022. The clinical characteristics, irrigation test results, lacrimal endoscopic findings, and type of surgery were analyzed. Results: The mean duration of symptoms was 31.2 months, and was significantly longer in the failure group than in the success group (p = 0.043). Irrigation tests showed passage, partial obstruction, and complete obstruction in 20 (31.3%), 16 (25.0%), and 28 (43.7%) eyes, respectively. Lacrimal endoscopy showed narrowing, mucus, fibrosis, granulation, and stones in 41 (64.0%), 12 (18.8%), 6 (9.3%), 3 (4.7%), and 2 (3.1%) eyes, respectively. Following lacrimal endoscopy, 32 (50.0%) eyes each were included in the success and failure groups. Preoperative irrigation test results did not affect the success rate (p = 0.203). Silicone tube intubation and dacryocystorhinostomy were performed in 5 (7.8%) and 8 (12.5%) eyes, respectively, because the symptoms did not improve after lacrimal endoscopy. Conclusions Lacrimal endoscopy, performed without silicone tube intubation, was effective in improving symptoms and may guide the choice of surgical technique, if required.

Accurate estimation of the exposure-response relationship between ambient urban particulate matters (PM) and public health is important for regulatory perspective of ambient urban particulate matters (PM). Ambient PM contains various transition metals and organic compounds. PM10 (aerodynamic diameter less than 10 microgram) is known to induce diverse diseases such as chronic cough, bronchitis, chest illness, etc. However, recent evaluation of PM2.5 (aerodynamic diameter less than 2.5 microgram) against health outcomes has suggested that the fine particles may be more closely associated with adverse respiratory health effects than particles of larger size. This study was performed to evaluate PM2.5-induced oxidative stress in rat lung epithelial cell in order to provide basic data for the risk assessment of PM2.5. PM2.5 showed higher cytotoxicity than PM10. Also, PM 2.5 induced more malondialdehyde (MDA) formation than PM10. In Hoechst 33258 dye staining and DNA fragmentation assay, apopotic changes were clearly detected in PM2.5 treated cells in compared to PM10. Expression of catalase mRNA was increased by PM2.5 rather than PM10. PM2.5 induced higher Mth1 mRNA than PM10. In pBR322 DNA treated with PM2.5, production of single strand breakage of DNA was higher than that of PM10. In Western blot analysis, PM2.5 induced more Nrf-2 protein, associated with diverse transcriptional and anti-oxidative stress enzymes, compared to PM10. Our data suggest that PM2.5 rather than PM10 may be responsible for PM-induced toxicity. Additional efforts are needed to establish the environmental standard of PM2.5.
Air Pollutants/chemistry/*toxicity ; Animals ; Apoptosis/physiology ; Benzimidazoles/metabolism ; Blotting, Western ; Cell Line ; Cell Survival/physiology ; DNA Fragmentation/physiology ; DNA Repair Enzymes/genetics/metabolism ; DNA-Binding Proteins/metabolism ; Epithelial Cells/drug effects/enzymology/pathology ; Formazans/metabolism ; GA-Binding Protein Transcription Factor ; Lipid Peroxides/metabolism ; Lung Diseases/*chemically induced/enzymology/pathology ; Oxidative Stress/*physiology ; RNA, Messenger/chemistry/genetics ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Tetrazolium Salts/metabolism ; Transcription Factors/metabolism

Background: We evaluated the need for arthroscopic capsular release (ACR) in refractory primary frozen shoulder (FS) by comparing clinical outcomes of patients treated with ACR and manipulation under anesthesia (MUA). Methods: We assessed patients with refractory primary FS, 54 patients (group A) who were treated with MUA and 22 patients (group B) who were treated with ACR. In group A, manipulation including a backside arm-curl maneuver was performed under interscalene brachial block. In group B, manipulation was performed only to release the inferior capsule before arthroscopic circumferential capsular release, which was carried out for the unreleased capsule after manipulation. Pain, range of shoulder motion, and American Shoulder and Elbow Society score were recorded at 1 week, 3 months, 6 months, and 1 year after surgery. We compared outcome variables between treatment groups and between diabetics and non-diabetics and also evaluated the numbers of patients receiving additional intra-articular steroid injection. Results: Outcome variables at 3 months after surgery and improvements in outcome variables did not differ between groups. Group A showed significantly better results than group B in the evaluation of pain and range of motion at 1 week. Diabetics showed comparable outcomes to non-diabetics for most variables. Eleven patients required additional steroid injections between 8 to 16 weeks after surgery: 12.2% in group A, 18.2% in group B. Additional injections were given three times more often in diabetics compared to non-diabetics. Conclusions MUA alone can yield similar clinical outcomes to ACR in refractory FS.

OBJECTIVE: The clinical outcomes according to the radiological results after cervical total disc replacement (TDR) are not well established. Here, the authors reviewed the clinical results according to the asymmetry in radiographs. METHODS: This retrospective analysis included patients after TDR (Mobi-C(R) disc) with at least 12 months follow up, and the clinical and radiological data were obtained preoperatively and postoperatively for 12 months. Clinical outcome measures numerical rating scale (NRS) score for neck pain, visual analog scale (VAS) for arm pain, and the Oswestry disability index (ODI) value. The asymmetries of TDRs were evaluated on the anterior-posterior (AP) and the lateral radiographs, and the radiographic adjacent segment degenerations were evaluated for 12 months. RESULTS: A total of 24 patients (one level cervical TDR; 10 male and 14 female; aged 41.50+/-8.35 years) were included in this study. The clinical results including NRS for neck pain, VAS for arm pain, and ODIs were similar between the normal and asymmetrized TDRs in AP and lateral radiographs. The radiographic adjacent segment degenerations were significantly increased in deviated TDRs (AP>10 mm asymmetry and lateral>10 mm asymmetry). CONCLUSION: Asymmetrical location of TDR is not related to the clinical outcomes, but related to the risk of radiographic adjacent disc segment degeneration.
Arm ; Arthroplasty* ; Axis, Cervical Vertebra* ; Female ; Follow-Up Studies ; Humans ; Male ; Neck Pain ; Outcome Assessment (Health Care) ; Retrospective Studies ; Total Disc Replacement ; Visual Analog Scale

An epiglottic cyst is a common form of laryngeal cysts which are rare causes of upper airway obstruction. A congenital laryngeal cyst always causes neonatal respiratory distress, but an acquired cyst shows very wide spectrum of symptoms such as no specific complaints, dysphagia, respiratory difficulty, or even death according to its size, location, or age. From anesthesiologists' point of view, an asymptomatic undiagnosed laryngeal cyst is a major concern. Unexpectedly, it can cause difficult airway such as 'cannnot intubate' or 'cannot intubate and cannot ventilate' situation during anesthesia. Recently we discovered an undiagnosed epiglottic cyst obscuring laryngeal inlet, leading to difficult intubation during general anesthesia for decompression and fusion of lumbar vertebrae. Fortunately, mask ventilation was possible, and after failed attempts of direct laryngoscopy, we could perform oral fiberoptic bronchoscope-aided intubation. He was discharged 10 days later with no harmful events.
Airway Obstruction ; Anesthesia ; Anesthesia, General ; Bays ; Bronchoscopes ; Decompression ; Deglutition Disorders ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Lumbar Vertebrae ; Masks ; Ventilation

Isolated rupture of distal semitendinosus is reported rarely. Here, we report a case of 51-year-old previous healthy working man diagnosed with isolated semitendinosus tendon rupture treated successfully by conservative management.
Athletes ; Humans ; Middle Aged ; Rupture ; Tendons

OBJECTIVE: There is no acceptable indication and treatment of choice for infantile and child subdural hygroma and there are only a few reports about that in Korea. So the authors studied the clinical findings of infantile and child patients with subdural hygroma to improve the understanding and to suggest a standard treatment method. METHODS: The authors retrospectively evaluated the causes, preoperative symptoms, radiological thicknesses, and postoperative results of 25patients with subdural hygroma who received surgical therapy. RESULTS: There were 16boys and 9girls whose median age was 6months(range 2~120months). The main clinical manifestations were seizures, increased intracranial pressure, macrocrania and alteration of consciousness. Radiological thicknesses of the subdural hygroma varied from 7mm to 42mm and postoperative changes of thickness(y) could be expressed with the factor of month(x): y = -1.32 x +11.8 in subdural drainage, and y = -1.52 x +14.9 in subduroperitoneal shunts. Of the 25patients, 2 (50%) were successfully treated by aspiration, 13 (59%) by subdural drainage, and 9 (69%) by subduroperitoneal shunt. CONCLUSION: It is suggested that the diagnosis and treatment of subdural hygroma in infants and children should be carefully addressed because of its high prevalence in children, and especially in infants. It is also suggested that the subdural drainage could be primary initial treatment method because it is simpler than a shunt, and since our data show that there is no statistical difference in postoperative recovery duration between the two operative methods.
Child* ; Consciousness ; Diagnosis ; Drainage ; Hematoma, Subdural ; Humans ; Infant* ; Intracranial Pressure ; Korea ; Prevalence ; Retrospective Studies ; Seizures ; Subdural Effusion*

BACKGROUND: Recently, patients' demands for emergency medicine are increasing, and most of prehospital medical care, including basic life support, cardiopulmonary resuscitation and triage, are provided by paramedics or emergency medical technicians. Evaluation of the adequacy of prehospital management and triage has become important for improving the quality and the effectiveness of the emergency medical system. METHODS: The 202 patients who were transferred by ambulance with paramedics, nurses, or emergency medical technicians to the Emergency Department in Gil Medical Center from July 1, 1999, to September 31, 1999, were enrolled. This study was conducted prospectively by using the emergency physician's log and newly devised protocols recorded by paramedics or nurses. RESULTS: 1) Male to female ratio was 1:0.8, and the peak age of the patients were the 4th(18.8%) and 6th decade(15.3%). 2) Of the 202 patients, 84 patients were transferred for trauma and 118 for medical problems. The mean transfer time was 6+/-1.73 minutes. 3) The validities of prehospital triage and decisions using the trauma severity measure and the disease severity measure, were 33.3% in trauma patients and 57.6% in medical patients. 4) The results for the adequacy rate in prehospital management analyzed by using the rate of necessity of treatment, performance of treatment, and adequate treatment were as follows: oxygen supply, 38.1/41.6/93.8; wound dressing, 19.3/71.8/92.9; immobilization of the cervical spine, 15.8/56.3/92.9; application of a spinal board, 12.9/42.3/72.7; application of a splint, 9.9/50.0/60.0; manual maintenance of an airway, 9.9/55.0/63.6; and CPR, 4.5/66.7/0.5) Kind of ALS(Advanced Life Support) were not conducted(peripheral IV, EKG, intubation medical administration, defibrillation, pacing). The rates of necessity of treatment were as follows: peripheral IV, 40.6%; ECG monitoring, 23.3%; endotracheal intubation, 8.9%; medical administration, 8.9%; defibrillation, 3.5%; and pacing, 1.5%. CONCLUSION: The adequacy of prehospital triage and decisions using trauma and disease severity measures was relatively low. To improve the adequacy of BLS(Basic Life Support) and to increase the performance of ALS(Advanced Life Support), we must create challenges to develop new protocols and to supplement new equipment.
Allied Health Personnel ; Ambulances ; Bandages ; Cardiopulmonary Resuscitation ; Electrocardiography ; Emergencies ; Emergency Medical Technicians ; Emergency Medicine ; Emergency Service, Hospital ; Female ; Humans ; Immobilization ; Intubation ; Intubation, Intratracheal ; Male ; Oxygen ; Prospective Studies ; Spine ; Splints ; Triage* ; Wounds and Injuries