We report a 56-year-old female with symptomatic protrusion of the bony lesion in the trapezium. Excision and biopsy of the bony lesion revealed thickened and sclerotic bony trabecula with adjacent zone of fibrocartilage, which is comparable with melorheostosis. This lesion with unique radiologic and histologic findings may be important to differentiate with other bony lesions such as myositis ossifications and osteosarcoma.
Biopsy ; Female ; Fibrocartilage ; Humans ; Melorheostosis* ; Middle Aged ; Myositis ; Osteosarcoma

PURPOSE: To determine whether biothesiometry, bulbocavernous reflex latency(BCRL), and dorsal nerve somatosensory evoked potential(DNSEP) test could predict efficacy of tricyclic antidepressant(TCA) or selective serotonin reuptake inhibitor(SSRI) to prolong the ejaculatory latency in premature ejaculation. MATERIALS AND METHODS: A total of 33 patients with pramature ejaculation(mean age: 44 years) completed the entire study, Patients took each of clomipramine(50mg), sertraline(1 00mg), and fluoxetine(40mg) consecutively during a 4-week period per each agent. We obtained increased intravaginal ejaculatory latency by the most effective drug among 3 drugs. We analyzed correlations of the increased intravaginal ejaculatory latency with vibration threshold of penile shaft and glans, BCRL, and latency and amplitude of DNSEP. RESULTS: According to Pearson's correlation analysis, there was no correlation of intravaginal ejaculatory latency with vibration threshold of penile shaft and glans, BCRL, and latency and amplitude of DNSEP(all p> 0.05). There was no difference in intravaginal ejaculatory latency between the groups of high and low vibration threshold, long and short BCRL, long and short latency of DNSEP, and large and small amplitude at cerebral cortex on DNSEP test(all p> 0.05). CONCLUSIONS: It seems that biothesiometry, BCRL, and DNSEP test can not predict the efficacy of tricyclic antidepressant or selective serotonin reuptake inhibitor to prolong the ejaculatory latency in premature ejaculation.
Cerebral Cortex ; Drug Therapy* ; Humans ; Premature Ejaculation* ; Reflex ; Serotonin ; Vibration

Bilateral vestibulopathy (BV) is characterized by oscillopsia and imbalance during locomotion. Half of the cases of BV are idiopathic, and BV due to brain tumor has been reported only rarely. We report a case of BV due to bilateral cerebellopontine-angle tumors in a patient with neurofibromatosis type 2. Careful history on oscillopsia and imbalance during locomotion, and regular follow-ups using the head-impulse test and dynamic visual acuity are warranted in patients with neurofibromatosis type 2.
Brain Neoplasms ; Cerebellopontine Angle ; Follow-Up Studies ; Humans ; Locomotion ; Neurofibromatoses ; Neurofibromatosis 2 ; Neuroma, Acoustic ; Visual Acuity

PURPOSE: We studied the usefullness of intravenous administration of contrast material to facilitate in situ shock wave lithotripsy(SWL) of ureteral stones in cases that stone localization was difficult as radioluscent, less radiodense, small stone, and interference with visualization by bone or intestinal gas. MATERIALS AND METHODS: From March 1992 to June 1997 we treated 831 patients with ureteral stone by in-situ SWL using EDAP-LT02 piezoelectric lithotriptor which utilizes ultrasono and fluroscopy for stone localization. Among 831 patients, intravenous contrast material were used in 53 cases to facilitate stone localization during SWL treatments. To evaluate the effectiveness of stone localization by the assistance of intravenous contrast media we compared success rate, storages, treatment sessions, durations, and side effects of two groups with or without intravenous contrast material, based on the location and the size of stones. RESULTS: Among 53 patients, stone was localized without ureteral catheterization in 5.7%(25/437) of upper ureteral stone, 18.2%(18/99) of mid-ureteral stone, and 3.4%(10/295) of lower ureteral stone after administration of intravenous contrast material. There were no significant differences in success rate, storages, treatment sessions, and durations(p>0.05). There were no significant complications except dye hypersensitivity in two patients, who were managed conservatively. CONCLUSIONS: The administration of intravenous contrast material during SWL allows effective localization of ureteral stones that otherwise could not be imaged adequately without ureteral catheterization. We believe that the use of intravenous contrast material for localization of ureteral stone in SWL have the benefits of inexpensiveness, noninvasiveness, and painlessness.
Administration, Intravenous ; Contrast Media ; Humans ; Hypersensitivity ; Shock ; Ureter* ; Urinary Catheterization ; Urinary Catheters

Purpose: Insulin is known to induce relaxation in various vasculatures by increasing the release of nitric oxide or the expression of nitric oxide synthase. However, its action mechanisms on the corpus cavernosum remain to be uncovered. This study aimed to investigate the relaxative responses and the mechanism of normal cavernous smooth muscles to insulin. Methods and Materials: Rabbit corpus cavernous tissues were prepared in 2x2x8 mm sized strip for isotonic tension recording. The dose-dependent relaxation responses of norepinephrine (10(-4)M)-precontracted strips to insulin (10(-6)M)were measured. The relaxation responses of NE (10(-4)M)-precontracted strips to insulin (10(-6)M) were measured under low to high glucose concentrations (0, 0.1, 1 and 11mM) in physiological solution. The relaxation responses of the NE-precontracted strips to insulin (10(-6)M) were also observed after endothelial denudation, 30-minute preincubation with L-NAME (5mM) or 30-minute preincubation with indomethacin (10(-4)M). Results: The cavernosal strips were relaxed by insulin in a dose-dependent manner. The insulin-induced relaxation was dose-dependently increased by glucose. The endothelial denudation or indomethacin pretreatment almost abolished the insulin-induced relaxation, but L-NAME rarely affected the relaxation. Conclusions: Insulin induces an endothelium-dependent relaxation of rabbit cavernous smooth muscles, which is mostly NO-independent, but seems to be related with prostaglandins or their metabolites.
Glucose ; Indomethacin ; Insulin ; Muscle, Smooth* ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Norepinephrine ; Prostaglandins ; Relaxation*

BACKGROUND: The development and use of human embryonic stem cells (hESCs) in regenerative medicine have been revolutionary, offering significant advancements in treating various diseases. These pluripotent cells, derived from early human embryos, are central to modern biomedical research. However, their application is mired in ethical and regulatory complexities related to the use of human embryos.METHOD: This review utilized key databases such as ClinicalTrials.gov, EU Clinical Trials Register, PubMed, and Google Scholar to gather recent clinical trials and studies involving hESCs. The focus was on their clinical application in regenerative medicine, emphasizing clinical trials and research directly involving hESCs. RESULTS: Preclinical studies and clinical trials in various areas like ophthalmology, neurology, endocrinology, and reproductive medicine have demonstrated the versatility of hESCs in regenerative medicine. These studies underscore the potential of hESCs in treating a wide array of conditions. However, the field faces ethical and regulatory challenges, with significant variations in policies and perspectives across different countries. CONCLUSION The potential of hESCs in regenerative medicine is immense, offering new avenues for treating previously incurable diseases. However, navigating the ethical, legal, and regulatory landscapes is crucial for the continued advancement and responsible application of hESC research in the medical field. Considering both scientific potential and ethical implications, a balanced approach is essential for successfully integrating hESCs into clinical practice.

PURPOSE: We present four cases of welding arc maculopathy as observed using spectral-domain optical coherence tomography (SD-OCT).CASE SUMMARY: Four patients, who performed welding without wearing protective eye gear, presented to the hospital due to poor visual acuity. The mean visual acuity of the patients was 0.6. Fundus photographs of the four patients revealed a yellowish retinal scar at the fovea. SD-OCT images of the four patients showed photoreceptor inner segment/outer segment junction (IS/OS junction) disruption and retinal pigment epithelium injury. We diagnosed the patients with welding arc maculopathy, and three of them were treated with oral steroids or antioxidants. The IS/OS junctions were restored in two patients, who had short welding arc exposures. The disrupted IS/OS junction recovered partially in one of the other two patients, who had a longer duration of exposure, and the IS/OS junction disruption remained in another patient. CONCLUSIONS We report four cases of welding arc maculopathy caused by welding light exposure evaluated using SD-OCT and treated with oral steroids and antioxidants.

BACKGROUND: Treatment for chronic hepatitis B aims to suppress virus replication and virus sequestration in hepatocytes. Covalently closed circular (ccc) DNA is the template for transcription of viral genes and is responsible for viral persistence. However, limited data are available for quantification of hepatitis B surface antigen (HBsAg) in Korea. METHODS: We evaluated the Elecsys HBsAg II quant assay (Roche Diagnostics, USA) for within-run, between-run, and between-day precisions, linearity, carryover, and clinical specificity. In total, 156 serum samples were evaluated for correlation between HBsAg and hepatitis B virus (HBV) DNA. Serial samples were obtained from 10 patients at 0, 12, 24, 48, 72, and 96 weeks during follow-up. RESULTS: The assay detected HBsAg in a linear range of 0.5-48,696 IU/mL. Within-run, between-run, and between-day CVs were 2.9-4.1%, 0-1.5%, and 1.5-4.9%, respectively. Cross-reactivity between potentially interfering substances was absent, and the carryover rate was 0.00002%. The correlation of measurements between the Elecsys assay and HBV DNA PCR was weak (r=0.438, P=0.002). For predicting virologic response, cutoff values of 10,275 IU/mL and 3,846 IU/mL at 12 and 24 weeks after treatment initiation showed positive predictive values of 77.1% and 85% and negative predictive values of 84.6% and 50%, respectively. CONCLUSIONS: The Elecsys HBsAg II quant assay showed good performance for precision, linearity, carryover rate, and specificity. HBsAg level at baseline, 12 weeks, and 24 weeks after treatment initiation can predict virologic response, and the assay can be used for HBsAg quantification in clinical practice.

BACKGROUND: Examination of peripheral blood smear (PBS) is the gold standard for the diagnosis of malaria; however, its diagnostic utility will be dependent on the examiner's microscopic experience, the quality of the smear, and the degree of parasitemia. Therefore, it is essential to have available a rapid and simple test that is as sensitive and specific as PBS, at a small-middle range medical center, a health care center, and a military hospital in a malaria endemic area. METHODS: Malaria antigen and antibody tests were performed on 120 febrile patients who were requested for complete blood count (CBC) and PBS at two military hospitals from May 2004 to August 2005. RESULTS: Of the 45 patients who were diagnosed with malaria by examination of peripheral blood smears, 42 were positive on both malaria antigen and antibody tests, and 2 were positive on either antigen or antibody test. Only 1 patient was negative on the both test. Furthermore, all 75 patients with negative microscopic examinations also had negative malaria antigen and antibody tests. CONCLUSIONS: The results of this study show that a rapid differential diagnosis of malaria can be made by performing malaria antigen and antibody tests on febrile patients at hospitals in malaria endemic areas. Moreover, the test is simple and convenient enough to be performed without any special equipment or experience.
Blood Cell Count ; Delivery of Health Care ; Diagnosis ; Diagnosis, Differential* ; Fever of Unknown Origin* ; Fever* ; Hospitals, Military ; Humans ; Malaria* ; Malaria, Vivax* ; Parasitemia

OBJECTIVE: Non-adherence to medication is a recognized problem in psychiatric patients and may be one of the most challenging aspects of treatment for patients with schizophrenia. Failure of follow-up care after discharge greatly increases non-adherence to prescribed medications, relapse and rehospitalization. However, it is still unknown whether and how much outpatient follow-up visits can mitigate the risk of rehospitalization. Therefore we sought to investigate the continuity and effectiveness of outpatient care after inpatient discharge and its effect on rehospitalization of patients with schizophrenia. METHODS: Data were extracted from National Health Insurance Claim Database covering the period from 2007 through 2010. We identified 10,246 patients aged 18 years or older who were admitted in psychiatric facilities with the diagnosis of schizophrenia between January 1 and December 31 in 2007. The number of outpatient visits within 60 days after discharge from index admission was defined as the indicator for the continuous care and rehospitalization was inspected during the following 36-month period. Cox's proportional hazard model was used to examine the factors affecting the risk of rehospitalization including the number of outpatient visits, age, sex, comorbidities, antipsychotics, and characteristics of medical institution. RESULTS: We found that 12.7% (n=1,327) of the patients visited psychiatric outpatient department once within 60 days after hospital discharge, 34.8% (n=3,626) twice, and 27.8% (n=2,900) more than three times. Patients taking atypical antipsychotics showed higher proportion in 2 or more outpatient visits, whereas patients taking typical antipsychotics showed higher proportion in one or no outpatient visits. Cox hazard ratios of rehospitalization for the factor of 3 or more outpatient visits referenced to that of no follow-up visit were 0.567 (0.428-0.750, 95% confidence interval) within 90 days, 0.673 (0.574-0.789) within 180 days, 0.800 (0.713-0.898) within a year, 0.906 (0.824-0.997) within 2 years, and 0.993 (0.910-1.084) within 3 years. CONCLUSION: Although continuous outpatient treatment is important for relapse prevention, patients with schizophrenia showed a low rate of outpatient visit as 62.6% of total patients in 2 or more visits within 60 days after discharge. Lack of follow-up treatment might lead to increase psychotic symptoms and raised risk of relapse and rehospitalization. Our data suggest that the number of outpatient visits within 60 days after discharge in patients with schizophrenia is an important indicator of rehospitalization within a year. Therefore, further efforts to examine factors affecting failure of outpatient follow-up after discharge are warranted.
Ambulatory Care ; Antipsychotic Agents ; Comorbidity ; Diagnosis ; Follow-Up Studies* ; Humans ; Inpatients ; Insurance, Health ; National Health Programs ; Outpatients* ; Proportional Hazards Models ; Recurrence ; Schizophrenia*