OBJECTIVE: The purpose of this study was to perform a clinical analysis of nine patients with giant aneurysms managed with endovascular embolization. METHODS: From March 2000 to September 2009, nine cases of giant intracranial aneurysms were treated (five unruptured and four ruptured). The nine patients included two males and seven females who were 47 to 72 years old (mean, 59.2 years old). The types of giant intracranial aneurysms were eight internal carotid artery aneurysms and one vertebral artery aneurysm. Treatment for each aneurysm was chosen based on anatomic relationships, aneurysmal factors, and the patients' clinical state. Three patients underwent endovascular coiling with stent and six initially underwent endovascular coiling alone. Medical records, operation records, postoperative angiographies, and follow-up angiographies were reviewed retrospectively. RESULTS: Eight out of nine patients showed good clinical outcomes. (six were excellent and two were good) after a mean follow-up period of 27.9 months. Six (67%) of the nine patients had a near-complete occlusions on the post-operative angiogram (mean, 13.5 months after the procedure). Occlusion rates of 90% or higher were obtained for eight (89%) of all the patients. One patient died due to multiple organ failure. Stents were ultimately required at some point for managing four aneurysms. Two patients needed additional procedures because of aneurysm regrowth. CONCLUSION: Endovascular treatment could be an alternative option for managing giant aneurysms adjuvant to surgical intervention.
Aneurysm ; Angiography ; Carotid Artery, Internal ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; Male ; Medical Records ; Multiple Organ Failure ; Stents ; Vertebral Artery

The formation of cysts in the parameatal area has been reported as rare. A parameatal urethral cyst is a congenital anomaly and has been reported even more rarely in adults. In this study, we present two cases of parameatal urethral cyst and aim to investigate their causes and treatment methods. The extent of cyst spread was assessed using a urethroscope prior to cyst excision, and the excision range was determined accordingly. Complete excision of the cyst was performed as the treatment for parameatal urethral cyst. Both patients were adults who presented with urinary symptoms related to the cyst, necessitating the excision of the congenital parameatal urethral cyst.

OBJECTIVE: To assess the effect of recombinant human leukemia inhibitory factor on in vitro development of 1-cell ICR mouse embryo. MATERIALS AND METHOD: ICR mice were superovulated with PMSG/hCG and 1-cell stage mouse embryos were recruited. 1-cell mouse embryo were cocultured on human oviductal cells in a CO2 incubator (coculture group) and were cultured on 0.4% BSA+HTF media (control group). And anti-hLIF Ab was added the cocultured group in a different concentration (1pg, 10pg, 100pg, 1ng) and developmental rate was compaired to the control group, and rhLIF was added to the preincubated 0.4% BSA+HTF media in a different concentration (2000U, 1000U, 100U, 10U) and its developmental rate was compaired to group which was cultured on 0.4% BSA+HTF media only. RESULT: 1. The cleavage rate of 2-cell mouse embryo co-cultured with human tubal epithelial cell was significantly higher than that of cultured with media alone (HTF with 0.4% BSA) (p<0.05). 2. When LIF antibody was added to the medium with human tubal epitherlial cell, the mouse embryo could not cleave more than 2-cell in 1 ng of LIF antibody, and less than 1 ng, the cleavage rate was lower than cultured without LIF antibody group(p<0.05). 3. Two cell blocked ICR mouse embryos were developed into four cells under LIF(p<0.05), but no further development was observed. CONCLUSIONS: These results shows that LIF enhances the development of preimplantation embryo, and when rhLIF is applicated in vitro, it has positive effects on the development of early mouse embryo and can help overcoming the two-cell block.
Animals ; Blastocyst* ; Coculture Techniques* ; Embryonic Structures ; Epithelial Cells ; Humans ; Incubators ; Leukemia Inhibitory Factor* ; Leukemia* ; Mice ; Mice, Inbred ICR ; Oviducts

BACKGROUND: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a “knot-ache”. This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications. METHODS: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed. RESULTS: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3. CONCLUSIONS: The knots of suture anchor maybe a possible etiology of the pain, which we termed a “knot-ache”. Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, “knot-ache”. Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.

PURPOSE: To evaluate the changes of tear osmolarity and protein after silicone punctal plug insertion in dry eye. METHODS: We collected tear from 21 dry eyes (11 males and 10 females) with porous polyester rod(Transorb(R)) before silicone punctal occlusion and 2 weeks after the procedure. Tear osmolarity was measured by Fiske 2400 Osmometer(R). Total tear protein concentration was analyzed by Bradford's assay. The concentration of human serum albumin (HSA), lactoferrin, lysozyme were measured by Bio-Rad Gel Doc 2000(R). RESULTS: The tear osmolarity was changed from 364.48+/41.39 mOsm/L to 327.48+/-27.24 mOsm/L after the punctal occlusion (P<0.05). There were no changes of total protein concentration, Human serum albumin, lactoferrin, but lysozyme was increased statistically significantly (P<0.05). CONCLUSION: Silicone punctal occulusion decreases tear osmolarity in dry eye. This decrease is associated with a decrease in ocular surface disease due to high tear osmolarity. Only lysozyme except HSA and lactoferrin was increased significantly. Silicone punctal plug is an effective procedure for dry eye patients, but further investigation of the effects on tear proteins is needed.
Humans ; Lactoferrin ; Male ; Muramidase ; Osmolar Concentration* ; Polyesters ; Serum Albumin ; Silicones*

No abstract available.
Catheters* ; Humans

BACKGROUND: The addition of clonidine to local anesthetics for regional block has been shown to increase the duration of anesthesia and analgesia. This study was designed to determine whether the addition of clonidine to bupivacaine would produce an extension of the analgesic effect after intercostal nerve block (ICNB). METHODS: After informed consent, 30 ASA 1 or 2 patients undergoing appendectomy under general anesthesia were randomly divided into two groups. Before induction of anesthesia, ICNB using a posterior approach was performed with 15 ml of 0.25% bupivacaine plus epinephrine 1:200,000 with (Group BEC; n = 15) or without (Group BE; n = 15) clonidine 75 microgram. Analgesia was assessed by cold testing at 1/min intervals until cold sensation decreased. The duration of analgesia (time between injection and onset of pain) was recorded. We also recorded the visual analogue scale (VAS) of pain, the number of supplemental analgesics, heart rate and blood pressure, and side effects over 24 hours postoperatively. RESULTS: The onset time, duration of analgesia, number of analgesics, and heart rate and blood pressure were comparable in both groups. VAS scores were significantly lower in Group BEC than in Group BE at 12, 16, and 20 hours postoperatively. CONCLUSIONS: The addition of clonidine to bupivacaine with epinephrine may be a useful adjunct and can prolong the duration of analgesia after ICNB without significant side effects.
Analgesia ; Analgesics ; Anesthesia ; Anesthesia and Analgesia ; Anesthesia, General ; Anesthetics, Local ; Appendectomy ; Blood Pressure ; Bupivacaine* ; Clonidine* ; Epinephrine ; Heart Rate ; Humans ; Informed Consent ; Intercostal Nerves* ; Pain, Postoperative* ; Sensation

OBJECTIVE: We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. METHODS: We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. RESULTS: PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were 3.6+/-2.9 and 5.4+/-6.4 in the unresected PARS group, 5.8+/-2.1 and 11.3+/-7.1 in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. CONCLUSION: The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.
Arthrodesis ; Body Mass Index ; Humans ; Neurologic Manifestations ; Spine

Objective: The purpose of this study was to examine whether attachment insecurity, stigma, and certain demographic and medical factors predict depression and anxiety in people living with HIV (PLWH). Methods: Participants were 147 PLWH who visited the outpatient infection clinic in Kyungpook National University Hospital (KNUH; Daegu, South Korea) between June 2020 and January 2021. We measured HIV-related stigma, attachment anxiety and avoidance, depressive symptoms, and anxiety symptoms. Results: Logistic regression analysis showed that unemployment, longer time receiving antiretroviral therapy, higher attachment avoidance, and higher attachment anxiety were significant predictors of depression. Results also showed that longer time receiving antiretroviral therapy, higher attachment anxiety, and concern with public attitudes were significant predictors of anxiety. Conclusion In addition to education to reduce public stigma, interventions to reduce PLWH’s self-stigma should continue. We suggest attachment-based psychotherapy as an effective intervention to improve PLWH’s mental health.

OBJECTIVE: To evaluate the clinical usefulness of the Korean Developmental Screening Test (K-DST) via comparison with Korean Ages and Stages Questionnaire (K-ASQ) for the diagnosis of developmental delay in pediatric patients. METHODS: The K-DST and K-ASQ were used to screen pediatric patients who visited the hospital for evaluation and diagnosis of delayed development. Korean Bayley Scales of Infant Development-II (K-BSID-II) or Korean Wechsler Preschool and Primary Scale of Intelligence III (K-WPPSI-III) were used for the standardized assessment. Moreover, the final clinical diagnosis was confirmed by three expert physicians (rehabilitation doctor, psychiatrist, and neurologist). The sensitivity and specificity of each screening tool for the final diagnosis were investigated and correlated with standardized assessments. RESULTS: A total of 145 pediatric consultations were conducted, which included 123 developmental disorders (40 autism spectrum disorders, 46 global developmental delay/intellectual disability, and 37 developmental language disorders) and another 22 that were not associated with any such disorders. The sensitivity and specificity of K-DST based on the final clinical diagnosis were 82.9% and 90.9%, respectively, which were not significantly different from that of K-ASQ (83.7% and 77.3%). Both K-DST and K-ASQ showed good correlation with K-BSID-II and K-WPPSI-III. No significant difference was found between the K-DST and K-ASQ measures. CONCLUSION: K-DST is an excellent screening tool and is expected to replace K-ASQ with high validity.
Autism Spectrum Disorder ; Communication Disorders ; Developmental Disabilities ; Diagnosis ; Humans ; Infant ; Intellectual Disability ; Intelligence ; Mass Screening ; Motor Skills Disorders ; Psychiatry ; Referral and Consultation ; Sensitivity and Specificity ; Weights and Measures