No abstract available.

Although osteochondral lesions are well-described in previous literature, lesions located at the proximal phalangeal base of the hallux are extremely rare. Here, the authors report the case of a 21-year-old male who presented with chronic right great toe pain, which was eventually diagnosed as an osteochondral lesion at the proximal phalangeal base of the hallux. The diagnosis presented herein should be kept in mind and included in the differential diagnosis when patients complain of chronic pain in the great toe.

Many radiopharmaceuticals have been developed and wildy used in the imaging cardiac function. Myocardial perfusion imaging (MPI) is a well established noninvasive method of assessing coronary blood flow and has been widely used in patients diagnosed or suspected with coronary artery diseases. The innovation of radiopharmaceuticals used in the cardiac imaging is one of the most important contributors to the development of nuclear cardiology. Thallium-201 and various technetium-99m agents have been globally used for myocardial perfusion SPECT, and N-13 ammonia (13NH3), rubidium-82 (82Rb), O-15 water (H215O) for myocardial perfusion PET. As well as the cardiac perfusion studies, new radiopharmaceuticals that visualize fat metabolism or receptors of the sympathetic nervous system have successfully been applied to clinical practice. Useful information can be obtained for diagnosing coronary artery disease, evaluating patients' condition, or assessing therapeutic effects. In this review, we describe the characteristics and clinical usefulness of radiopharmaceuticals used for cardiac SPECT and PET.
Ammonia ; Cardiology ; Coronary Artery Disease ; Humans ; Myocardial Perfusion Imaging ; Perfusion ; Radiopharmaceuticals ; Sympathetic Nervous System ; Tomography, Emission-Computed, Single-Photon ; Water

PURPOSE: To investigate the diurnal variation of subjective visual symptoms of diabetic patients and to evaluate its correlation with visual acuity, blood pressure, blood glucose and OCT-measured macular thickness. METHODS: Fifty-five diabetic patients (56 eyes) who were hospitalized for the operation of the fellow eye were enrolled in the study. They underwent optical coherence tomography (OCT) measurements of macular thickness with retinal mapping protocol of OTI/SLO OCT at 5PM, 8PM on operation day, and at 7AM, 10AM on following day. Visual acuity (log MAR), refraction, intraocular pressure, blood glucose and blood pressure were also measured at each time. We surveyed the patients' symptomatic visual variation and its pattern if there is any change over a day. RESULTS: Thirteen patients (25%) had reported changes in their subjective visual symptom over a day according to their blood glucose level. Among twenty-four cases with changes in their subjective visual acuity throughout the exam, only ten showed their real visual acuity change in accordance with their symptoms. CONCLUSIONS: One fourth of our diabetic patients stated fluctuation in their vision according to their blood glucose level, but there were no correlations between visual acuity, blood glucose level and macular thickness.
Blood Glucose ; Blood Pressure ; Diabetic Retinopathy ; Eye ; Humans ; Intraocular Pressure ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity

No abstract available.
Child* ; Fibroma* ; Frontal Bone* ; Humans

Objective: To investigate and compare the slot sizes and parallelism of metal injection molding (MIM) and computerized numerical control (CNC) brackets. Methods: The following four MIM bracket series with 0.022-inch (in) slots were selected for investigation: Di MIM mini Twin (Ortho Organizers), Mini Diamond Roth (Ormco), Gemini MBT (3M Unitek), and Formula R Roth (Tomy).The following four CNC bracket series with 0.022-in slots were selected for investigation: Econoline MBT (Adenta), Legend mini MBT (GC Orthodontics), Crown mini MBT (Adenta), and Evolve MBT (DB Orthodontics). The slot dimensions were measured using an optical microscope (XTCam-D310M;Mitutoyo) with a resolution of 1 μm. The results were statistically analyzed using one-way analysis of variance and the Tukey post-hoc test with a significance level of 0.05. Results: The results indicated that all the investigated slot sizes were oversized with respect to the manufacturers’ specifications (0.022 in). Among the eight bracket series, the Di MIM bracket (MIM) was the most oversized by 10.4%, whereas the Evolve bracket (CNC) was the least oversized by 2.6%. The slots in seven of the bracket series had divergent walls instead of parallel ones. The Evolve bracket alone had parallel slot walls. Conclusions Regardless of the manufacturing method, all the slot sizes of the brackets investigated in this study were significantly oversized; most of the slot walls were nonparallel, except for those of the Evolve bracket. This study could not establish that the CNC method was more accurate than the MIM method in manufacturing bracket slots.

Background: Little is known about capsule endoscopy (CE) findings in patients with intestinal tuberculosis who exhibit small bowel lesions. The aim of the present study was to distinguish between Crohn’s disease (CD) and intestinal tuberculosis based on CE findings. Methods: Findings from 55 patients, who underwent CE using PillCam SB CE (Given Imaging, Yoqneam, Israel) between February 2003 and June 2015, were retrospectively analyzed. Results: CE revealed small bowel lesions in 35 of the 55 patients: 19 with CD and 16 with intestinal tuberculosis. The median age at diagnosis for patients with CD was 26 years and 36 years for those with intestinal tuberculosis. On CE, three parameters, ≥10 ulcers, >3 involved segments and aphthous ulcers, were more common in patients with CD than in those intestinal tuberculosis. Cobblestoning was observed in five patients with CD and in none with intestinal tuberculosis. The authors hypothesized that a diagnosis of small bowel CD could be made when the number of parameters in CD patients was higher than that for intestinal tuberculosis. The authors calculated that the diagnosis of either CD or intestinal tuberculosis would have been made in 34 of the 35 patients (97%). Conclusion The number of ulcers and involved segments, and the presence of aphthous ulcers, were significantly higher and more common, respectively, in patients with CD than in those with intestinal tuberculosis. Cobblestoning in the small bowel may highly favor a diagnosis of CD on CE.

Purpose: Traumatic duodenal injury is uncommon and due to its difficult diagnosis and accessibility there is an increased risk of mortality and morbidity. Methods: Electronic medical records of a single center were reviewed retrospectively from March 2008 to December 2020 and a total of 7 cases of traumatic duodenal injury were managed by surgical exploration. The site of duodenal perforation, injury mechanisms, operation method, and postoperative outcomes were assessed. Results: The mean age was 55.72 years (range, 34-78), and there were 5 men in the study. The most common mechanism was in-car traffic accident (4 cases), and 1 case each of pedestrian accident, accident during work, and self-injured stab wound. The most common site of injury was between the 3rd and 4th portion (3 cases), followed by the bulb and 1st portion (2 cases), and 2nd portion (2 cases). Segmental resection of the duodenum and primary anastomosis was performed in the 3rd and 4th portion perforation. In cases of 1st and 2nd portion, injury was managed by primary repair or pylorus preserving pancreaticoduodenectomy. Complications developed in 4 patients, and the most common complication was a problem with the wound; wound seromas developed in 4 cases, entero-cutaneous fistula in 1, and biliary complications in 2 cases. Two patients suffered from intraperitoneal abscess or fluid collection managed by percutaneous drainage. The mean duration of hospital stay was 34 days, and postoperative mortality did not develop. Conclusion Favorable clinical outcomes were observed in patients with traumatic duodenal injury managed by various surgical approaches.

OBJECTIVE: The maternal stress measurement from the heart rate variability and the fetal stress measurement from the fetal heart rate variability in non-stress test (NST) were conducted and the correlation between two measurements was calculated. METHODS: From June 2004 to August 2004, 30 cases who visited for antenatal care and admitted at our hospital above 27 weeks of pregnancy were analyzed for tests. The test consists of simultaneous 20-minute non-stress test and 5-minute stress test in stable state of supine position. From measurement and analysis of fetal heart rate variability in NST and maternal stress, three factors -- balance of an autonomic nervous system, an activity of a sympathetic nervous system, and an activity of a parasympathetic nervous system -- were calculated and analyzed. RESULTS: A Pearson correlation coefficient of the LF/HF ratio of mother and fetus did not show the high significance for the whole population (whose value was -0.014), but after clustering the population according to the gestational age, LF/HF ratio, norm LF, and norm HF for mothers in 38 weeks of pregnancy showed highly positive correlation -- the values were 0.760 (p-value 0.011), 0.569, and 0.569, respectively; the cluster of mothers in 38 weeks was the largest one in the population. And value of a mother in four different week also showed positive correlation (0.801). CONCLUSION: A noninvasive method for measurement of fetal stress was suggested and positive correlation between maternal stress and fetal stress was observed. Thus positive feedback may be expected by maternal stress relieving methods, such as aroma therapy and psychosocial support, and the possibility and basis for the evaluation of the effectiveness on maternal and fetal stability by prenatal education was settled.
Aromatherapy ; Autonomic Nervous System ; Exercise Test ; Female ; Fetus* ; Gestational Age ; Heart Rate* ; Heart Rate, Fetal ; Heart* ; Humans ; Mothers* ; Parasympathetic Nervous System ; Pregnancy ; Prenatal Education ; Supine Position ; Sympathetic Nervous System

Akinetic mutism (AM) is a rare complication of spontaneous subarachnoid hemorrhage (SAH). It is characterized by mutism and general hypokinesis in a patient superficially fully awake in that the eyes remain open and follow objects. Most common cause of AM in patients with SAH is secondary infarction in the distal anterior cerebral artery (DACA) territory. Sometimes post-SAH hydrocephalus has also been implicated in a delayed form of AM because of disruption of dopaminergic pathway. We report a case of 64-year-old woman who presented with sudden bursting headache without neurologic deficit. She was referred from the other hospital with a diagnosis of spontaneous SAH on head computed tomography (CT) which showed high density on sylvian, interhemispheric fissures and basal cistern. We performed computed tomographic cerebral angiography (CTA) and trans-femoral catheter cerebral angiography (TFCA), that revealed no definitive intracranial aneurysm, arterial dissection, or other vascular abnormality of the SAH. During admission period, she developed mutism and motor weakness of all limbs without spontaneous movement. We performed brain magnetic resonance (MR) image and RI cisternography. Also we prescribed levodopa. On the 33th hospital day, she had neurological recovery with drowsy mentality and grade 4 weakness of all limbs, but she was observed to suddenly develop general weakness and became cardiac arrest on the 55th hospital day. Efforts to resuscitate her failed, no more treatment could not be applied. In our case, we couldn't find infarction in the DACA terriority, midbrain or cerebellum except communicating hydrocephalus. This case may alert neurosurgeon to recognize the possibility of such rare complication after spontaneous SAH.
Akinetic Mutism ; Anterior Cerebral Artery ; Brain ; Catheters ; Cerebellum ; Cerebral Angiography ; Extremities ; Eye ; Female ; Head ; Headache ; Heart Arrest ; Humans ; Hydrocephalus ; Infarction ; Intracranial Aneurysm ; Levodopa ; Magnetic Resonance Spectroscopy ; Mesencephalon ; Middle Aged ; Mutism ; Neurologic Manifestations ; Subarachnoid Hemorrhage