The most common complication of total ankle arthroplasty is skin problem including delayed wound healing, skin necrosis, and superficial wound infection. In the present study, we aimed to reduce the wound complications associated with total ankle arthroplasty using a curvilinear incision. We examined 5 patients with ankle osteoarthritis who underwent total ankle arthroplasty using a curvilinear incision from September 2012 to January 2013. Wound dehiscence was noted in 1 case, which was treated with a re-repair procedure at 13 days after the initial surgery. The use of a curvilinear incision in total ankle arthroplasty may reduce the associated wound complications.
Ankle* ; Arthroplasty* ; Humans ; Necrosis ; Osteoarthritis ; Skin ; Wound Healing ; Wound Infection ; Wounds and Injuries

Exhaled nitric oxide (eNO) from the lower respiratory tract is used commonly in diagnosis and treatment monitoring of asthma patients. However, nasal nitric oxide (nNO) has not been widely used in patients with upper airway inflammatory diseases due to its lack of standardized measurement methods. Nasal nitric oxide is produced mainly by the paranasal sinus mucosa and partially by the nasal mucosa and increases with inflammation. Nasal nitric oxide not only locally supports the defensive mechanism of the upper respiratory tract, but also remotely controls pulmonary function by acting as an aerocrine. Nasal NO can be affected by various physiologic and pathologic factors of the upper respiratory tract. This article will review the origin of nNO, its function, various measurement methods, and difference in presentation among upper respiratory tract inflammatory diseases such as allergic rhinitis, upper respiratory tract infection, nasal polyp, rhinosinusitis, primary ciliary dyskinesia, cystic fibrosis, Young’s syndrome, diffuse panbronchiolitis, empty nose syndrome, and obstructive sleep apnea. Future studies should identify the mechanism of action of nNO in various upper respiratory tract inflammatory diseases and obtain highly reproducible normal values of nNO based on a standardized measurement method with a deeper understanding of factors affecting nNO. Then, nNO will be useful for more rapid and simpler diagnosis of various upper respiratory tract diseases and for monitoring their treatment.

Exhaled nitric oxide (eNO) from the lower respiratory tract is used commonly in diagnosis and treatment monitoring of asthma patients. However, nasal nitric oxide (nNO) has not been widely used in patients with upper airway inflammatory diseases due to its lack of standardized measurement methods. Nasal nitric oxide is produced mainly by the paranasal sinus mucosa and partially by the nasal mucosa and increases with inflammation. Nasal nitric oxide not only locally supports the defensive mechanism of the upper respiratory tract, but also remotely controls pulmonary function by acting as an aerocrine. Nasal NO can be affected by various physiologic and pathologic factors of the upper respiratory tract. This article will review the origin of nNO, its function, various measurement methods, and difference in presentation among upper respiratory tract inflammatory diseases such as allergic rhinitis, upper respiratory tract infection, nasal polyp, rhinosinusitis, primary ciliary dyskinesia, cystic fibrosis, Young’s syndrome, diffuse panbronchiolitis, empty nose syndrome, and obstructive sleep apnea. Future studies should identify the mechanism of action of nNO in various upper respiratory tract inflammatory diseases and obtain highly reproducible normal values of nNO based on a standardized measurement method with a deeper understanding of factors affecting nNO. Then, nNO will be useful for more rapid and simpler diagnosis of various upper respiratory tract diseases and for monitoring their treatment.

PURPOSE: Endonasal dacryocystorhinostomy (DCR) has been performed commonly in patients with chronic epiphora due to nasolacrimal duct obstruction. The most frequent cause of DCR failure is obstruction of the osteotomy site due to inflammation and granuloma. We used postoperative nasal steroid spray to suppress inflammation, and growth of granuloma, and to increase the success rate. METHODS: Between November 2002 and August 2003, 48 patients (55 eyes) underwent endonasal DCR in Hanyang University Guri Hospital. The patients were classified into two groups: those who took nasal steroid spray and those who did not. RESULTS: Thirteen cases showed recurrent epiphora. The total success rate of endonasal DCR was 76.4% (42/55). The success rate of the steroid group at 83.9% (26/31), was higher than that of the non-steroid group at 66.7% (16/24), but the difference was not statistically significant (P=0.20, x2 test). CONCLUSIONS: The nasal steroid spray failed to increase the patency rates in endonasal DCR.
Dacryocystorhinostomy* ; Granuloma ; Humans ; Inflammation ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct ; Osteotomy

BACKGROUND: Particulate matter may be toxic to human tissue. Ambient air particulate matter < or =10micrometer in aerodynamic size (PM10), which changes under different environmental conditions, is a complex mixture of organic and inorganic compounds. The Asian dust event caused by meteorological phenomena can also spread unique particulate matter in affected areas. We evaluated production of ROS, TGF-beta, fibronectin, and NF kappa B by exposing normal epithelial cells to Asian dust particulate matter. METHODS: Bronchial epithelial cells were exposed to 0, 50, 100microgramg/ml of a suspension of PM10 for 24 h. ROS were detected by measurement of DCF release from DCF-DA by FACScan. TGF-beta, fibronectin, and NF kappa B were detected by western blotting. RESULTS: PM10 exposure increased the expression of TGF-beta, fibronectin, and NF kappa B. ROS production and TGF-betalevels were significantly higher with 50 or 100microgram/ml PM10. Fibronectin and NF kappa B production were significantly higher after 100microgram/ml of PM10. CONCLUSION: PM10 from Asian dust particles might have fibrotic potential in bronchial epithelial cells via ROS induction after PM10 exposure.
Asian Continental Ancestry Group ; Blotting, Western ; Dust ; Epithelial Cells ; Fibronectins ; Humans ; NF-kappa B ; Particulate Matter ; Pulmonary Fibrosis ; Reactive Oxygen Species ; Transforming Growth Factor beta

Desmoid fibromatosis is a very slowly growing benign fibroblast tumor. Locally aggressive and non-metastasizing, it is a well-differentiated, unencapsulated monoclonal myofibroblastic proliferation that has a tendency for local invasion and recurrence. About 15% of all desmoidtype fibromatosis develops within the head and neck. The majority of head and neck desmoid tumor is located in the neck, but less frequently in the face, scalp, oral cavity, mandible, paranasal sinuses, orbit, ear and other structures. We report a very rare case in a 55-year-old female of a desmoid fibromatosis arising from the lateral nasal wall of anterior portion of uncinated process. We discuss the clinicopathologic features and successful treatment of nasal desmoid tumor with a literature review.

In the anterior portion of the inferior turbinate, immune response originates actively from sustained allergenic stimulation. This response can lead to the development of a hyperplastic mass on the anterior portion of the inferior turbinate. The majority of such cases are benign chronic inflammatory lymphoid hyperplasia, but sometimes lymphoma occurs by malignant lymphocyte proliferation. The authors of this study evaluated seven patients who had a small mass on the inferior turbinate. As the result of excisional biopsy, MALT lymphoma was diagnosed in two patients and lymphoid hyperplasia in five. Immunohistochemistry is important for differential diagnosis. Complete excision was performed for initial diagnosis and treatment. Mucosa-associated lymphoid tissue lymphoma patients need to be evaluated for metastasis.
Biopsy ; Diagnosis, Differential ; Humans ; Hyperplasia ; Immunohistochemistry ; Lymphocytes ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Nasal Cavity ; Neoplasm Metastasis ; Turbinates

BACKGROUND: Residual pleural thickening (RPT) is the most frequent complication of tuberculous pleurisy (TP), and this can happen despite of administering adequate anti-tuberculous (TB) therapy. Yet there was no definite relation between RPT and other variables. The aim of this study was to examine matrix metalloproteinases (MMPs) and the inhibitors of metalloproteinases (TIMPs) and to identify the factors that can predict the occurrence of RPT. METHODS: The patients with newly-detected pleural effusions were prospectively enrolled in this study from January 2004 to June 2005. The levels of MMP-1, -2, -8 and -9, and TIMP-1 and -2 were determined in the serum and pleural fluid by ELISA. The residual pleural thickness was measured at the completion of treatment and at the point of the final follow-up with the chest X-ray films. RESULTS: The study included 39 patients with pleural fluid (PF). Twenty-three had tuberculous effusion, 7 had parapneumonic effusion, 7 had malignant effusion and 2 had transudates. For the 17 patients who completed the anti-TB treatment among the 23 patients with TP, 7 (41%) had RPT and 10 (59%) did not. The level of PF TIMP-1 in the patients with RPT (41,405.9+/-9,737.3 ng/mL) was significantly higher than that of those patients without RPT (29,134.9+/-8,801.8) at the completion of treatment (p=0.032). In 13 patients who were followed-up until a mean of 8+/-5 months after treatment, 2 (15%) had RPT and 11 (85%) did not. The level of PF TIMP-2 in the patients with RPT (34.4+/-6.5 ng/mL) was lower than that of those patients without RPT (44.4+/-15.5) at the point of the final follow-up (p=0.038). CONCLUSION: The residual pleural thickening in TP might be related to the TIMP-1 and TIMP-2 levels in the pleural fluid.
Enzyme-Linked Immunosorbent Assay ; Exudates and Transudates ; Follow-Up Studies ; Humans ; Matrix Metalloproteinases ; Metalloproteases ; Pleural Effusion ; Pleurisy ; Prospective Studies ; Thorax ; Tissue Inhibitor of Metalloproteinase-1 ; Tissue Inhibitor of Metalloproteinase-2 ; Tuberculosis, Pleural ; X-Ray Film

OBJECTIVE: The present study aimed to report the initial seizure threshold (IST) of a brief-pulse bilateral electroconvulsive therapy (BP-BL ECT) in Korean patients with schizophrenia/schizoaffective disorder and to identify IST predictors. METHODS: Among 67 patients who received ECT and diagnosed with schizophrenia/schizoaffective disorder based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, we included 56 patients who received 1-millisecond BP-BL ECT after anesthesia with sodium thiopental between March 2012 and June 2018. Demographic and clinical information was gathered from electronic medical records, and a multiple regression analysis was conducted to identify predictors of the IST. RESULTS: The mean age of the patients was 36.9±12.0 years and 30 (53.6%) patients were male. The mean and median IST were 105.9±54.5 and 96 millicoulombs (mC), respectively. The IST was predicted by age, gender, and dose (mg/kg) of sodium thiopental. Other physical and clinical variables were not associated with the IST. CONCLUSION: The present study demonstrated that the IST of 1-ms BP-BL ECT following sodium thiopental anesthesia in Korean patients was comparable to those reported in previous literature. The IST was associated with age, gender, and dose of sodium thiopental.
Anesthesia ; Diagnostic and Statistical Manual of Mental Disorders ; Electroconvulsive Therapy ; Electronic Health Records ; Humans ; Male ; Psychotic Disorders ; Schizophrenia ; Seizures ; Sodium ; Thiopental

Cervical pregnancy is a rarely life-threatening form of ectopic pregnancy in which the implantation of the developing conceptus in the cervical canal. The cervix is composed predominantly of the fibrous tissue. Therefore cervical pregnancy can be massive hemorrhagic occurrence from the eroded blood vessels within the cervical tissue. In the past, as a result of life-threatening hemorrhage, the diagnosis of a cervical ectopic pregnancy frequently led to hysterectomy. Currently, several conservative treatments are possible with the hope of preserving future reproductive potential, including preoperative uterine artery embolization before dilatation and evacuation. We report a case of cervical pregnancy which was treated sucessfully with preoperative selective uterine artery embolization before dilatation and currettage.
Blood Vessels ; Cervix Uteri ; Cytochrome P-450 CYP1A1 ; Diagnosis ; Dilatation ; Female ; Hemorrhage ; Hope ; Hysterectomy ; Pregnancy* ; Pregnancy, Ectopic ; Uterine Artery Embolization* ; Uterine Artery*