Cerebellar degeneration is a group of diseases that manifests as progressive ataxia, that finally led to death without specific treatment. We report here two patients with cerebellar degeneration, who had shown an improvement and less progressive course, which is associated with panax ginseng intake. Patient 1 was a 60-year-old woman with multisystem atrophy (MSA) type C with 5 year history of ginseng ingestion. Patient 2 was a 54-year-old woman with spinocerebellar ataxia (SCA) type 6, who had a history of ginseng intake for 30 months. Both the patients showed atrophic change in the cerebellum by brain magnetic resonance imaging. Cerebellar functions had been semi-quantified by International Cooperative Ataxia Rating Scale (ICARS) and monitored before and after the ginseng ingestion every 6 to 12 months. In Patient 1 with MSA type C, ICARS had improved from 21 to 17.5 ± 1.8 in the following 5 years. In Patient 2 with SCA, ICARS also showed an improvement from 22 to 6.0 ± 1.0 over 30 months. However, when she stopped taking ginseng, it progressed up to 13 points in two years. These observations provide a potential disease-modifying effect of ginseng on patients with cerebellar degeneration.
Cerebellar Ataxia ; Cerebellar Diseases

BACKGROUND: The size of the baseplate used in reverse total shoulder arthroplasty (RTSA) tends to be larger than the average size of the glenoid in the Korean population. The mismatch between the sizes of the baseplate and the patient's glenoid may result in improper fixation of the glenoid baseplate. This in turn may lead to the premature loosening of the glenoid component. Thus, we evaluated the short-term results of using a 25-mm baseplate in RTSA. METHODS: Seventeen patients with cuff tear arthropathy underwent RTSA with a 25-mm baseplate. The mean age of the patients was 70.1 years, and the mean follow-up period was 14.0 months. We evaluated clinical outcomes preoperatively and postoperatively: the range of shoulder motion, the American Shoulder and Elbow Surgeons (ASES) score, and the Korean Shoulder Society (KSS) score. RESULTS: We found that the mean ASES score and KSS improved from 35.0 to 74.4 (p<0.001) and from 46.9 to 71.8 (p<0.001) with RTSA. The mean forward elevation and abduction, external rotation also improved from 78.6degrees to 134.3degrees (p<0.05) and from 66.6degrees to 125.0degrees (p<0.05), from 20.2degrees to 28.4degrees (p=0.43). Postoperative complications were seen in 12% of patients, but neither the loosening of the glenoid baseplate nor inferior scapular notching were observed. CONCLUSION: In sum, the results of using a 25-mm baseplate in RTSA were similar to those of previous reports. Even though the outcomes are those of a short-term follow-up, neither the loosening of the glenoid baseplate nor the scapular notching were observed.
Arthroplasty* ; Elbow ; Follow-Up Studies ; Humans ; Postoperative Complications ; Shoulder* ; Tears

This case report draws attention to the possibility of symptomatic and asymptomatic intraarticular ganglion cyst which was situated adjacent to the insertion sites of the anterior or posterior cruciate ligament. In many reports and our case, MR imaging is recommended as the modality of choice in diagnosing method and the cyst, if encountered, is successfully treated with arthroscopie technique. We report one case of symptematic ganglion cyst of the posterior cruciate ligament with review of literatures.
Ganglion Cysts* ; Knee ; Magnetic Resonance Imaging ; Posterior Cruciate Ligament*

Purpose: The electronic frailty index (eFI), which is derived from electronic health records, has been recommended as screening tool for frailty due to its accessibility and ease of use. The objective of this systematic review was to identify the prevalence of frailty assessed by the eFI and its influence on health outcomes in older adults with chronic diseases. Methods: We searched PubMed, Embase, Web of Science, CINAHL, SCOPUS, Cochrane, Google search, and nursing journals in Korean from January 2016 to December 2022. Results: Twelve studies were analyzed. The eFI score, based on routine clinical data, was associated with adverse health outcomes. The most frequent outcome studied was mortality, and the eFI was associated with increased mortality in nine studies. Other outcomes studied included hospitalization, length of stay, readmission, and institutionalization in relation to hospital care usage, and cardiovascular events, stroke, GI bleeding, falls, and instrumental activities of daily life as health conditions. Conclusion Early identification of frailty in older adults with chronic diseases can decrease the burden of disease and adverse health outcomes. The eFI has a good discriminative capacity to identify frail older adults with chronic diseases.

OBJECTIVE: To compare the visibility and procedural parameters between a standard spinal needle and a new laser-etched needle (LEN) in real-time ultrasonography guided lumbar medial branch access in a phantom of the lumbosacral spine. METHODS: We conducted a prospective single-blinded observational study at a rehabilitation medicine center. A new model of LEN was manufactured with a standard 22-gauge spinal needle and a laser etching machine. Thirty-two inexperienced polyclinic medical students performed ultrasonography-guided lumbar medial branch access using both a standard spinal needle and a LEN with scanning protocol. The outcomes included needle visibility score, needle elapsed time, first-pass success rate, and number of needle sticks. RESULTS: The LEN received significantly better visibility scores and shorter needle elapsed time compared to the standard spinal needle. First-pass success rate and the number of needle sticks were not significantly different between needles. CONCLUSION: A new LEN is expected to offer better visibility and enable inexperienced users to perform an ultrasonography-guided lumbar medial branch block more quickly. However, further study of variables may be necessary for clinical application.
Humans ; Needles* ; Needlestick Injuries ; Observational Study ; Phantoms, Imaging ; Prospective Studies ; Rehabilitation ; Spine ; Students, Medical ; Ultrasonography ; Zygapophyseal Joint

No abstract available.

No abstract available.

PURPOSE: Prader-Willi syndrome (PWS) is a complex genetic disorder, caused by the deletion of the paternally derived 15q11-13 region or the maternal uniparental disomy of chromosome 15 (mUPD(15)). In this study, we compared phenotypic differences between those patients whose disease was caused by microdeletion and those caused by mUPD(15). In addition, a comparison of the efficacy of growth hormone (GH) therapy between these two PWS genotypes was analyzed. METHODS: Fifty-three patients were diagnosed as having PWS based on molecular and cytogenetic analyses and clinical features. Data that included maternal age, birth weight, a feeding problem in the neonatal period, cryptorchidism, developmental delay or mental retardation, short stature, hypopigmentation, changes in height, weight, and body mass indexes (BMI) before and after GH treatment were obtained by a retrospective review of medical records. The data from the patients with microdeletion were compared with those from the patients with mUPD(15). RESULTS: Of the 53 patients with genetically confirmed PWS, 39 cases had microdeletion and 14 mUPD(15). Maternal ages were significantly higher in the mUPD(15) group, and hypopigmentation and a feeding problem in the neonatal period were more frequent in the microdeletion group. Growth hormone was administered to 20 patients [14 with microdeletion, 6 with mUPD(15)]. There were no differences between the two groups in height velocity, weight and height SDS, and BMI after GH therapy. CONCLUSION: Phenotype and genotype correlations were observed in Korean PWS patients, such as more advanced maternal ages in the mUPD(15) group and more feeding problems and hypopigmentations in the microdeletion group. Further long-term prospective studies are needed to correlate other aspects of the phenotypes.
Birth Weight ; Body Mass Index ; Child ; Chromosomes, Human, Pair 15 ; Cryptorchidism ; Cytogenetic Analysis ; Genotype ; Growth Hormone ; Humans ; Hypopigmentation ; Intellectual Disability ; Male ; Maternal Age ; Medical Records ; Phenotype ; Prader-Willi Syndrome ; Retrospective Studies ; Uniparental Disomy

No abstract available.
Fallopian Tubes* ; Female ; Mucous Membrane* ; Sterilization*

Deep skin and soft tissue defects with exposed bone and tendon is difficult to treat, because skin graft rarely survives and flap surgery is sacrifice of donor site. Since "Stage I" membrane was developed by Yannas and Bruke in 1980, numerous kinds of artificial skin have been developed. The adaptability of "Terudermis", developed by the Terumo Co., as an artificial skin composed of sponge made of a fibrillar atelocollagen and a heat-denatured atelocollagen, was clinically evaluated on application to 13 cases presenting deep skin and soft tissue defect with exposed bones and tendons from October 1997 to march 1998. Terudermis has the advantage of allowing early incorporation of fibroblasts and capillaries into its collagen sponge due to very weak dehydrothermal cross-linking. Before Terudermis graft, several days of wet dressing and debridement were required to prepare healthy well-vascularized bed because Terudermis was weak on unsanitary wounds. After bed preparation, Terudermis was grafted like usual skin graft. Tie-over bolster dressing or compressive dressing was used case by case. The dressing was opened 2~3 days after Terudermis grafting. Wet dressing was done daily until the skin graft was done. Autologous skin graft was done 2-3 weeks after Terudermis graft. Our clinical results indicated that Terudermis was beneficial in treating 77% of our patients. Through the use of this new method, treatment of severe skin and soft tissue defects that are usually treated by musculocutaneous or other conventional skin flaps can be replaced by Terudermis as an new artificial dermis.
Bandages ; Capillaries ; Collagen ; Debridement ; Dermis ; Fibroblasts ; Humans ; Membranes ; Porifera ; Skin ; Skin, Artificial ; Tendons ; Tissue Donors ; Transplants ; Wounds and Injuries*