No abstract available.

OBJECTIVE: Acute vertebrobasilar artery occlusion (AVBAO) is a devastating disease with a high mortality rate. One of the most important factors affecting favorable clinical outcome is early recanalization. Mechanical thrombectomy is an emerging treatment strategy for achieving a high recanalization rates. However, thrombectomy alone can be insufficient to complete recanalization, especially for acute stroke involving large artery atheromatous disease. The purpose of this study is to investigate the safety and efficacy of mechanical thrombectomy in AVBAO. METHODS: Fourteen consecutive patients with AVBAO were treated with mechanical thrombectomy. Additional multimodal treatments were intra-arterial (IA) thrombolysis, balloon angioplasty, or permanent stent placement. Recanalization by thrombectomy alone and multimodal treatments were assessed by the Thrombolysis in Cerebral Infarction (TICI) score. Clinical outcome was determined using the National Institutes of Health Stroke Scale (NIHSS) at 7 days and the modified Rankin Scale (mRS) at 3 months. RESULTS: Thrombectomy alone and multimodal treatments were performed in 10 patients (71.4%) and 4 patients (28.6%), respectively. Successful recanalization (TICI 2b-3) was achieved in 11 (78.6%). Among these 11 patients, 3 (27.3%) underwent multimodal treatment due to underlying atherosclerotic stenosis. Ten (71.4%) of the 14 showed NIHSS score improvement of >10. Overall mortality was 3 (21.4%) of 14. CONCLUSION: We suggest that mechanical thrombectomy is safe and effective for improving recanalization rates in AVBAO, with low complication rates. Also, in carefully selected patients after the failure of recanalization by thrombectomy alone, additional multimodal treatment such as IA thrombolysis, balloons, or stents can be needed to achieve successful recanalization.
Angioplasty, Balloon ; Arteries ; Cerebral Infarction ; Combined Modality Therapy ; Constriction, Pathologic ; Humans ; Mortality ; National Institutes of Health (U.S.) ; Stents ; Stroke ; Thrombectomy*

We present the case of a patient who developed pulsatile tinnitus that was found to be associated with a petrous carotid aneurysm. The aneurysm was successfully obliterated using stent-assisted coiling, after which the patient was symptom-free. Although aneurysms arising from the petrous segment of the internal carotid artery are rare, this pathology must be considered as a causative factor in patients with pulsatile tinnitus. Endovascular treatment appears to have been successful in resolving the symptoms associated with this pathology.
Aneurysm* ; Carotid Artery, Internal ; Embolization, Therapeutic ; Humans ; Pathology ; Tinnitus*

The surgical approach to spinal tumors varies not only with the level and location of the tumor, but also with the type and extent of the tumor. Some of the dumbbell neurofibroma(neurilemmoma) can be removed through simple laminectomy, but usually are approached through two separate incisions by two stages. In this report, posterior and anterolateral approaches in a single stage to dumbbell neurofibroma(neurilemmoma) of the spinal region are described. This approach provides full exposure of intra- and paraspinal portions of the tumor, thus permitting safe dissection and total removal. Six patients who underwent this procedure are described to illustrate its application.
Humans ; Laminectomy ; Neurofibroma ; Spine*

Plasmacytoma is a monoclonal neoplastic proliferation of plasma cells derived from bone marrow. Plasmacytoma of the skull base is very rare. Recently, the authors experienced a case of a 50-year-old woman with a tumor like lesion originating from the right sphenoid bone. The patient presented with a 3-month history of right facial pain and paresthesia. She had been diagnosed and treated with multiple myeloma for more than 5 years, although she was in complete remission until recently. Imaging studies including contrast CT scan and MRI, showed a huge, enhanced and irregular shaped lesion in the sphenoid bone along with skull base destruction and intracranial invasion. The patient underwent transnasal endoscopic biopsy under local anesthesia. The pathology was consistent with a plasma cell tumor and it was confirmed as a solitary plasmacytoma of the bone of the skull base. We report this rare case along with a literature review.
Anesthesia, Local ; Biopsy ; Bone Marrow ; Cheek* ; Facial Pain ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Multiple Myeloma* ; Paresthesia* ; Pathology ; Plasma Cells ; Plasmacytoma* ; Skull Base* ; Sphenoid Bone ; Tomography, X-Ray Computed

OBJECTIVES: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. METHODS: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. RESULTS: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. CONCLUSIONS: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.
Brain ; Comorbidity ; Disabled Persons ; Employment ; Female ; Hospitals, General ; Housing ; Humans ; Insurance, Health ; Logistic Models ; Marital Status ; Medicine, East Asian Traditional ; Public Health ; Rehabilitation Centers ; Surveys and Questionnaires

OBJECTIVES: The aim of this study was to find out the psychological changes associated with internet addiction between before and after the military drill among the young male army recruits. METHODS: All 1091 participants were army recruits aged from 19 to 22 years who participated in the 5-week military drill. They were assessed with some self-reported questionnaires [Sociodemographic questionnaires, Young's Internet Addiction Scale (IAS), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI), the Barratt Impulsiveness Scale (BIS), the Attention-Deficit/Hyperactivity Disorder Self-Rated Scale (ASRS)]. They were divided into two groups, One is the internet addiction tendency group and the other is non-addiction group according to the IAS score. And the severity of the internet addiction tendency, depression, anxiety and impulsiveness were evaluated by the IAS, the STAI, the BDI, the BIS, the ASRS before and after military drill. RESULTS: The result of the paired t-test shows that the IAS, the STAI, the BDI, the BIS, the ASRS scores decreased after military drill in both non-addiction group and internet addiction tendency group. The result of the repeated measures ANOVA shows that there is an interaction effect between the changes of ASRS-hyperactivity (F = 23.437, p < 0.001), ASRS-impulsiveness (F = 4.896, p = 0.027), BIS-total (F = 4.057, p = 0.044), BIS-motor impulsiveness (F = 13.609, p < 0.001) scores and groups. The result of the generalized estimating equation shows that internet addiction tendency is associated with ASRS-inattention (beta = 0.075, p < 0.001), ASRS-hyperactivity (beta = 0.092, p = 0.002), STAI-trait anxiety (beta = 0.046, p < 0.001), BIS-motor impulsiveness (beta = 0.119, p = 0.028). CONCLUSIONS: The results show that psychopathologies such as internet addiction tendency, depression, anxiety, impulsiveness may improve after military drill regardless of the groups. Internet addiction tendency may be related to the ASRS-inattention, ASRS-hyperactivity, STAI-trait anxiety, motor-impulsiveness. So these findings may be considered in the treatment of internet addiction in terms of the impulsiveness control.
Anxiety ; Depression ; Humans ; Internet* ; Male* ; Military Personnel

BACKGROUND: After burn patients are discharged from the hospital, they may continue to feel pain and paresthetic sensations at the site of a healed burn and these problems may persist for years. This study was designed to describe the characteristics of these symptoms in terms of intensity, frequency, and influencing factors. METHODS: Patients that developed paresthetic sensations at sites of a healed burn were recruited from the pain management center from January 2003 to April 2006. Data was collected using a structured interview protocol. RESULTS: Fifty one adults, with a total body surface area burned (TBSA) of 21.1 +/- 16.3% aged 42.0 +/- 12.9 years were studied. A paresthetic sensation was reported to be present every day in 52.9% (27/51) of the subjects. A variation in the intensity was most commonly related to changes in the weather. A tight sensation and itching types of sensations were significantly more frequent in patients with more extensive injuries. CONCLUSIONS: Recognition and understanding of the chronic paresthetic sensation that many burn patients continue to experience at sites of a healed burn deserve further attention. Not only do clinicians need to be aware of these problems but also strategies for prevention and alleviation shoul\d be explored.
Adult ; Body Surface Area ; Burns* ; Cicatrix, Hypertrophic ; Humans ; Pain Management ; Pruritus ; Sensation ; Weather

Background: This study aimed to investigate the prevalence and management of diabetes mellitus, risk-factor control, and comorbidities among Korean adults. Methods: We conducted a cross-sectional analysis of data from the Korea National Health and Nutrition Examination Survey to assess the prevalence, treatment, risk factors, comorbidities, and self-management behaviors of diabetes mellitus from 2019 to 2020. We also analyzed data from the Korean National Health Insurance Service to evaluate the use of antidiabetic medications in people with diabetes mellitus from 2002 through 2018. Results: Among Korean adults aged 30 years or older, the estimated prevalence of diabetes mellitus was 16.7% in 2020. From 2019 through 2020, 65.8% of adults with diabetes mellitus were aware of the disease and treated with antidiabetic medications. The percentage of adults with diabetes mellitus who achieved glycosylated hemoglobin (HbA1c) <6.5% was 24.5% despite the increased use of new antidiabetic medications. We found that adults with diabetes mellitus who achieved all three goals of HbA1c <6.5%, blood pressure (BP) <140/85 mm Hg, and low-density lipoprotein cholesterol <100 mg/dL were 9.7%. The percentage of self-management behaviors was lower in men than women. Excess energy intake was observed in 16.7% of adults with diabetes mellitus. Conclusion The prevalence of diabetes mellitus among Korean adults remained high. Only 9.7% of adults with diabetes mellitus achieved all glycemic, BP, and lipid controls from 2019 to 2020. Continuous evaluation of national diabetes statistics and a national effort to increase awareness of diabetes mellitus and improve comprehensive diabetes care are needed.

OBJECTIVE: To investigate the relationships between respiratory muscle strength and conventional sarcopenic indices such as skeletal muscle mass and limb muscle strength. METHODS: Eighty-nine young adult volunteers who had no history of medical or musculoskeletal disease were enrolled. Skeletal muscle mass was measured by bioelectrical impedance analysis and expressed as a skeletal muscle mass index (SMI). Upper and lower limb muscle strength were evaluated by hand grip strength (HGS) and isometric knee extensor muscle strength, respectively. Peak expiratory flow (PEF), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were evaluated using a spirometer to demonstrate respiratory muscle strength. The relationships between respiratory muscle strength and sarcopenic indices were investigated using Pearson correlation coefficients and multiple linear regression analysis adjusted by age, height, and body mass index. RESULTS: MIP showed positive correlations with SMI (r=0.457 in men, r=0.646 in women; both p<0.01). MIP also correlated with knee extensor strength (p<0.01 in both sexes) and HGS (p<0.05 in men, p<0.01 in women). However, PEF and MEP had no significant correlations with these sarcopenic variables. In multivariate regression analysis, MIP was the only independent factor related to SMI (p<0.01). CONCLUSION: Among the respiratory muscle strength variables, MIP was the only value associated with skeletal muscle mass.
Body Mass Index ; Electric Impedance ; Extremities ; Female ; Hand ; Hand Strength ; Humans ; Knee ; Linear Models ; Lower Extremity ; Male ; Muscle Strength ; Muscle, Skeletal ; Musculoskeletal Diseases ; Respiratory Muscles* ; Sarcopenia ; Spirometry ; Volunteers ; Young Adult*