We encountered a rare condition of rice body in subacromial and subdeltoid spaces in a patient with unremarkable medical history. Although it is uncommon, there have been continued reports on its formation in certain type of infective and inflammatory arthritis. However, except for a traumatic event, evaluation yielded no known and conceivable cause for his chronic inflammatory bursitis. Relatively typical findings for rice body on magnetic resonance imaging have been described, and in our case the imaging prompted us to schedule early removal, which is generally accepted as the management of choice to prevent further progression of symptoms. The symptoms of the shoulder showed significant improvement, and a close follow-up schedule has been recommended for observation of recurrence and development of any foreseeable underlying cause.
Appointments and Schedules ; Arthritis ; Bursitis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Shoulder ; Shoulder Joint

Schwannomas are soft tissue sarcomas arising from neurilemma of Schwann cells in peripheral nerves, and is the most frequent type of benign tumor found in these nerves. We report a case of a Schwannoma of the ulnar nerve in the elbow joint, and along this report, give a review of the literature. A 46-year-old male patient was hospitalized with complaints of swelling and pain in the left elbow and a tingling sensation and hypoesthesia of the fourth and fifth fingers. Physical examination of the patient showed he was positive for Tinel's sign, and magnetic resonance imaging results demonstrated the presence of a Schwannoma. Subsequent biopsy and excision of the Schwannoma was carried out. The suspected mass, which had a clear margin separating it from the healthy nerve of the medial left elbow, was removed along with its 2 x 2 x 3 cm capsule after a histological diagnosis of a Schwannoma was made. Pathophysiological results confirmed the excised mass as a Schwannoma. Schwannoma of the ulnar nerve within the elbow joint is rare and differential diagnosis is difficult. Therefore, treatment can only proceed after the presence of Schwannoma has been confirmed by physical and radiological examinations.
Biopsy ; Diagnosis ; Diagnosis, Differential ; Elbow Joint ; Elbow* ; Fingers ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemma ; Neurilemmoma* ; Peripheral Nerves ; Physical Examination ; Sarcoma ; Schwann Cells ; Sensation ; Ulnar Nerve*

This study aimed to analyze infant, maternal, perinatal, and fetal mortality statistics in the Republic of Korea (Korea), 2014. It was based on the open-access data available from the Statistics Korea website (http://kostat.go.kr/portal/eng/index.action). Recent trends in these vital statistics were also examined. The results of this study constitute a descriptive presentation and analysis of the national data. The number of infant deaths was 1,305 out of 435,435 live births in 2014, and the infant mortality rate was 3.0. The number of maternal deaths was 48. The maternal mortality ratio per 100,000 live births was 11.0. The maternal mortality ratio per 100,000 women of child-bearing age (15 to 49 years old) was 0.37. The number of perinatal deaths was 1,365, and the perinatal mortality rate was 3.1. The number of fetal deaths was 5,317. The fetal mortality rate was 12.1. The trends in those vital statistics in recent years were consistent except for a few findings, including a decrease in the maternal mortality ratio of pregnant women 40 years old and older and a change in the proportions of the causes of infant death, with a decrease in mortality due to neonatal respiratory distress and an increase in mortality due to bacterial sepsis. Although these vital statistics were generally consistent, some aspects varied by year. Pregnant women less than 20 years old should be monitored more intensively for their babies' health. Our findings can serve as basic data supporting the establishment of health policies by the Korean government.
Cause of Death ; Female ; Fetal Death ; Fetal Mortality ; Health Policy ; Humans ; Infant Death ; Infant Mortality ; Infant* ; Korea ; Live Birth ; Maternal Death ; Maternal Mortality ; Mortality ; Perinatal Death ; Perinatal Mortality* ; Pregnant Women ; Republic of Korea* ; Sepsis ; Vital Statistics

BACKGROUND: I-gel is a recently developed supraglottic airway device with many advantages. Like laryngeal mask airway (LMA), I-gel is an easier and quicker intubation alternative to endotracheal intubation in certain situations. In this study, we assessed the ease of I-gel insertion and compared the clinical performance of anesthetsiology residents (group R) experienced in endotracheal intubation versus that of interns (group I) with little intubation experience. METHODS: This prospective and randomized study included 60 patients. The ease of insertion, number of I-gel insertion attempts, presence of air leakage, and postoperative complications such as bleeding, dental trauma, hoarseness, and sore throat were evaluated in each group. RESULTS: Insertion was successful on the initial attempt in 29 of 30 cases in group R. In group I, 24 initial insertions were successful. The mean insertion times were 12.5 +/- 4.8 and 27.9 +/- 12.5 seconds for group R and group I, respectively (P < 0.001). No significant differences were observed between the two groups regarding postintubational air leakage. Regarding complications, two cases of bleeding, one case of dental trauma, and two cases of sore throat were recorded. No significant differences were observed between the two groups for any of the complications examined. CONCLUSIONS: I-gel is a suitable alternative insertion device that enables rapid and easy intubation by physicians who are experienced with endotracheal intubation. Moreover, this device also enables efficient and safe insertion during emergent situations for novice clinicians, even those who have little experience in intubation.
Airway Management ; Anesthesiology* ; Hemorrhage ; Hoarseness ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngeal Masks ; Pharyngitis ; Postoperative Complications ; Prospective Studies

Wilson's disease is a rare genetic disorder that has abnormal copper metabolism. Although the disease's main problems are found in liver and brain, some studies revealed manifestation of various musculoskeletal problems in the patients. In this report, we encountered a young patient who had fracture in the forearm bone. Initially, exception to a previous history of fracture from a motorcycle accident, the patient did not have any medical or drug use history, and laboratory work-ups were insignificant. However, with suspicion on his bone's integrity, bone densitometry was recommended and revealed osteopenic change. To disclose a cause for the change, questions were made to recall any particular history or event, and his complaint of recent vision loss led to ophthalmologic consultation where under slit-lamp test found Kayser-Fleischer ring. Further laboratory work-up found low levels of serum copper and ceruloplasmin and high copper level in 24-hr urine sample that led to the diagnosis of Wilson's disease. Although Wilson's disease has been frequently noticed with considerable musculoskeletal manifestation, it rarity makes the diagnosis illusive to a physician. Hence, despite of its rarity, it is imperative to remember the disease's bony manifestation, and it should be suspected in young patients with demineralized bone when the reason for brittle bone cannot be answered with other better known conditions.
Brain ; Ceruloplasmin ; Copper ; Densitometry ; Diagnosis* ; Forearm ; Hepatolenticular Degeneration* ; Humans ; Liver ; Male ; Metabolism ; Motorcycles

We encountered a rare condition of rice body in subacromial and subdeltoid spaces in a patient with unremarkable medical history. Although it is uncommon, there have been continued reports on its formation in certain type of infective and inflammatory arthritis. However, except for a traumatic event, evaluation yielded no known and conceivable cause for his chronic inflammatory bursitis. Relatively typical findings for rice body on magnetic resonance imaging have been described, and in our case the imaging prompted us to schedule early removal, which is generally accepted as the management of choice to prevent further progression of symptoms. The symptoms of the shoulder showed significant improvement, and a close follow-up schedule has been recommended for observation of recurrence and development of any foreseeable underlying cause.
Appointments and Schedules ; Arthritis ; Bursitis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Shoulder ; Shoulder Joint

Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint. However, there are cases of even greater rarity in which chronic shoulder dislocations are asymptomatic with minimal functional or structural degeneration in the joint. These patients are usually left untreated, and most show good tolerance to their condition without developing disabling symptoms or significant functional loss over time. We report on one such patient who had a chronic shoulder dislocation for more than 2 years without receiving treatment.
Accidental Falls ; Aged ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography ; Range of Motion, Articular ; Recurrence ; *Rotator Cuff Injuries/diagnosis/diagnostic imaging/physiopathology ; *Shoulder/diagnostic imaging/pathology/physiopathology ; *Shoulder Dislocation/diagnosis/diagnostic imaging/physiopathology

This article presents recent trends and statistical indicators related to mortality in the Republic of Korea by analyzing the 2014 cause-of-death statistics. Specifically, we assessed the number of deaths, the crude death rate, the ranking of causes of death, and trends in the death rate from the major causes of death. Causes of death were classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision, as recommended by the World Health Organization. In order to determine the ranking of causes of death, Statistics Korea used the selection list of 56 causes of death from the 80 causes of death list for tabulation mortality statistics recommended by World Health Organization to better fit the Korean situation. The 10 leading causes of death were, in order, cancer, heart disease, cerebrovascular disease, suicide, pneumonia, diabetes mellitus, chronic lower respiratory disease, liver disease, transport accidents, and hypertensive diseases. The top 10 causes of death accounted for 70.5% of all Korean deaths. The ranking of cancer types as causes of death was lung, liver, stomach, colon, and pancreatic cancer. Death rates for heart disease increased from the third in 2013 to the second leading cause in 2014 and the rank of pneumonia moved up from the sixth in 2013 to the fifth in 2014. The mortality rate due to stomach cancer has decreased continuously over time.. This finding may reflect changes in Korean society involving population structure, epidemiological patterns, and lifestyles, including dietary habits.
Cardiovascular Diseases ; Cause of Death ; Colon ; Diabetes Mellitus ; Food Habits ; Heart Diseases ; International Classification of Diseases ; Korea ; Life Style ; Liver ; Liver Diseases ; Lung ; Pancreatic Neoplasms ; Pneumonia ; Republic of Korea* ; Stomach ; Stomach Neoplasms ; Suicide

OBJECTIVE: We aimed to describe electrocardiographic (ECG) findings in spontaneous pneumothorax patients before and after closed thoracostomy. METHODS: This is a retrospective study which included patients with spontaneous pneumothorax who presented to an emergency department of a tertiary urban hospital from February 2005 to March 2015. The primary outcome was a difference in ECG findings between before and after closed thoracostomy. We specifically investigated the following ECG elements: PR, QRS, QTc, axis, ST segments, and R waves in each lead. The secondary outcomes were change in ST segment in any lead and change in axis after closed thoracostomy. RESULTS: There were two ECG elements which showed statistically significant difference after thoracostomy. With right pneumothorax volume of greater than 80%, QTc and the R waves in aVF and V5 significantly changed after thoracostomy. With left pneumothorax volume between 31% and 80%, the ST segment in V2 and the R wave in V1 significantly changed after thoracostomy. However, majority of ECG elements did not show statistically significant alteration after thoracostomy. CONCLUSION: We found only minor changes in ECG after closed thoracostomy in spontaneous pneumothorax patients.
Electrocardiography* ; Emergency Service, Hospital ; Hospitals, Urban ; Humans ; Pneumothorax* ; Retrospective Studies ; Thoracostomy*

Schwannomas are soft tissue sarcomas arising from neurilemma of Schwann cells in peripheral nerves, and is the most frequent type of benign tumor found in these nerves. We report a case of a Schwannoma of the ulnar nerve in the elbow joint, and along this report, give a review of the literature. A 46-year-old male patient was hospitalized with complaints of swelling and pain in the left elbow and a tingling sensation and hypoesthesia of the fourth and fifth fingers. Physical examination of the patient showed he was positive for Tinel's sign, and magnetic resonance imaging results demonstrated the presence of a Schwannoma. Subsequent biopsy and excision of the Schwannoma was carried out. The suspected mass, which had a clear margin separating it from the healthy nerve of the medial left elbow, was removed along with its 2 x 2 x 3 cm capsule after a histological diagnosis of a Schwannoma was made. Pathophysiological results confirmed the excised mass as a Schwannoma. Schwannoma of the ulnar nerve within the elbow joint is rare and differential diagnosis is difficult. Therefore, treatment can only proceed after the presence of Schwannoma has been confirmed by physical and radiological examinations.
Biopsy ; Diagnosis ; Diagnosis, Differential ; Elbow Joint ; Elbow ; Fingers ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neurilemma ; Neurilemmoma ; Peripheral Nerves ; Physical Examination ; Sarcoma ; Schwann Cells ; Sensation ; Ulnar Nerve