Objectives: . Vocal fold injection (VFI) via the cricothyroid (CT) membrane is used to treat various diseases affecting the vocal folds. The technical challenges of this technique are mainly related to the invisibility of the needle. Real-time light-guided VFI (RL-VFI) was recently developed for injection under simultaneous light guidance in the CT approach. Herein, we present the first clinical trial of RL-VFI, in which we investigated the feasibility and safety of this new technique in unilateral vocal fold paralysis (VFP). Methods: . This prospective pilot study enrolled 40 patients, who were treated with RL-VFI for unilateral VFP between September 2020 and August 2021. Adverse events were monitored during the procedure and for 4 weeks postoperatively. The Voice Handicap Index-10, the GRBAS (grade, roughness, breathiness, asthenia, and strain) scale, aerodynamic studies, and acoustic analyses were evaluated to compare the voice improvement after 4 weeks with the baseline values. Results: . The needle tip was intuitively identified by the red light. The mean procedure time was 95.6±40.6 seconds for the initial injection, while the additional injection required 79.2±70.5 seconds. The injection was performed under light guidance without additional manipulation after the needle reached the intended point. No acute or delayed adverse events were reported. Among the 40 patients, 36 completed voice analyses after 4 weeks. Subjective and objective voice parameters, including the Voice Handicap Index-10, GRBAS scale, maximum phonation time, mean expiratory airflow, fundamental frequency, jitter, shimmer, and noise-to-harmonics ratio improved significantly after RL-VFI (P<0.05), while the expiratory volume was maintained. Conclusion . RL-VFI is feasible and safe for treating patients with unilateral VFP. This technique is anticipated to improve the precision and safety of the CT approach in the treatment of unilateral VFP. This study provides a rationale for further structured clinical studies.

STUDY DESIGN: A retrospective study. OBJECTIVES: To evaluate the association between smoking and osteoporotic vertebral fractures (OVFs) in postmenopausal women. SUMMARY OF LITERATURE REVIEW: Several studies have examined the relationship of smoking with hip fractures, but few studies have analyzed the relationship of smoking with spine fractures in women thus far. MATERIALS AND METHODS: This study considered 1255 postmenopausal women aged 50 years and older (enrollment from April 2008 to January 2009) from 62 study sites in a nationwide hospital. The amount of smoking was calculated in pack-years. Further, OVFs were diagnosed using a semi-quantitative method. To analyze the relationship between smoking and OVFs, we used a paired t-test, a χ2-test, and a binary logistic regression analysis. RESULTS: The past history of smoking was 7.2% in the patient group and 4.3% in the control group (p=0.025). The mean pack-years of smoking was 0.34 in the control group and 0.62 in the patient group (p=130). The mean T-score in the lumbar bone mass density (BMD) was –1.64 in the control group and –2.19 in the patient group (p=0.409). Smoking was a risk factor of vertebral fractures in postmenopausal women (odd's ratio=1.68, 95% confidence interval=1.020–2.759, p=0.042) irrespective of the lumbar BMD and the medical treatment for osteoporosis and obesity. CONCLUSIONS: Smoking is a risk factor for osteoporotic vertebral fractures in postmenopausal women independently without regard to lumbar BMD. Therefore, cessation of smoking is important for the prevention of OVFs in postmenopausal women.
Bone Density ; Female ; Hip Fractures ; Humans ; Logistic Models ; Obesity ; Osteoporosis ; Retrospective Studies ; Risk Factors ; Smoke* ; Smoking* ; Spine

Lemierre's syndrome is a rare acute medical condition characterized by anaerobic oropharyngeal infections leading to septic thrombophlebitis of the internal jugular vein. The illness is often complicated by septic pulmonary emboli and distant metastatic infections. Treatment consists of long-term intravenous antibiotic therapy and surgical drainage of purulent collections. Although Lemierre's syndrome is rare, it is potentially fatal and remains an important entity for clinicians to recognize and treat appropriately. We report a 19-year-old female of Lemierre`s syndrome complicated with bacterial meningitis and multiple cranial neuropathies. (J Korean Neurol Assoc 19(5):529~532, 2001)
Cranial Nerve Diseases* ; Cranial Nerves* ; Drainage ; Female ; Humans ; Jugular Veins ; Lemierre Syndrome* ; Meningitis, Bacterial ; Thrombophlebitis ; Young Adult

STUDY DESIGN: Retrospective evaluation. PURPOSE: To analyze the effect of T1 slope on degree of degeneration in patients with cervical disc degeneration. OVERVIEW OF LITERATURE: The T1 slope is well known parameter that may be very useful in evaluating sagittal balance. There are no reports on the analysis of the relationship between T1 slope and cervical disc degeneration. We hypothesized that T1 slope has an effect on the degree of cervical degeneration. METHODS: Sixty patients who had cervical spine magnetic resonance imaging (MRI) in our orthopedic clinic were enrolled. Patients were divided into two groups according to T1 slope. Radiologic parameters obtained from radiography and cervical spine MRI were compared between low T1 slope group (< or =25) and high T1 slope group (>25). RESULTS: Among low T1 slope group, average degeneration grade of each cervical segment was 2.65 in C2-3, 2.50 in C3-4, 2.62 in C4-5, 3.23 in C5-6, and 2.81 in C6-7. And that of high T1 group was 2.35 in C2-3, 2.32 in C3-4, 2.59 in C4-5, 2.79 in C5-6, and 2.32 in C6-7. Grade of degeneration of low T1 group was significantly higher, as compared with high T1 group in C5-6 (p=0.028) and C6-7 (p=0.009). Percentage of high grade degeneration of more than grand III was 65.4% in low T1 group and 32.4% in high T1 group (p=0.018). Risk of high grade degeneration of C6-7 was significantly higher in low T1 group (odds ratio, 5.63; 95% confidence interval, 1.665-19.057; p=0.005). CONCLUSIONS: Patients with low T1 slope had higher grade of degeneration regardless of age and gender. Low T1 slope is a potential risk factor of cervical spondylosis especially in the C6-7 cervical segment.
Humans ; Intervertebral Disc Degeneration* ; Magnetic Resonance Imaging ; Orthopedics ; Radiography ; Retrospective Studies ; Risk Factors ; Spine ; Spondylosis

Alveolar soft part sarcoma (ASPS) is a rare soft tissue tumor that accounts for 5% of pediatric non-rhabdomyosarcoma soft tissue sarcomas. The disease presents as a indolent asymptomatic mass and affects primarily younger patients. The clinical course is often indolent and late metastases can develop even after prolonged disease-free intervals. Radiotherapy and chemotherapy play a very limited role in the treatment. We report a pediatric case of ASPS with a brief review of the literature.
Child* ; Drug Therapy ; Humans ; Neoplasm Metastasis ; Radiotherapy ; Sarcoma ; Sarcoma, Alveolar Soft Part* ; Viperidae

Cerebral palsy (CP) usually arises in the prenatal period, interferes with normal development of the brain and presents as a disorder of motor dysfunction. It is a common cause of severe neurologic disability in children with incidence of 2 per 1000 live births in Canada. Presently, with the persistent increase in premature births and improved care in the perinatal period, the incidence of CP is strikingly augmented. According to neurologically impaired motor ability, they commonly have feeding difficulties, like swallowing, leading to frequent aspiration pneumonia and gastroesophageal reflux. Therefore, improvement of feeding techniques should be an urgent requirement to correct the risk of poor growth. We report a case of CP due to kernicterus who have recurrent pneumonia and growth failure, experience a jejunostomy to overcome the feeding problems.
Brain ; Canada ; Cerebral Palsy* ; Child ; Deglutition ; Gastroesophageal Reflux ; Humans ; Incidence ; Jejunostomy* ; Kernicterus ; Live Birth ; Pneumonia ; Pneumonia, Aspiration* ; Premature Birth

STUDY DESIGN: Retrospective evaluation. PURPOSE: To compare quality of life in postmenopausal women with osteoporotic vertebral fractures (OVFs) who underwent vertebroplasty (VP) or kyphoplasty (KP). OVERVIEW OF LITERATURE: Patient with OVFs who do not respond to conservative treatment can be treated with VP or ballon KP for faster pain relief. There are controversies on which procedure is more effective. METHODS: Five hundred twenty-eight postmenopausal women in nationwide hospitals with age of 50 years or older who underwent VP of KP for OVFs were enrolled in this study. Health related quality of life was measured using the European Quality of Life 5 Domains (EQ-5D) and visual analogue scale (VAS). RESULTS: In the VP group, average EQ-5D dimension was 1.95 in mobility, 1.86 in self care, 2.02 in usual activity, 2.19 in pain, 1.69 in anxiety or depression. In the KP group, average EQ-5D dimension was 1.83 in mobility, 1.78 in self care, 1.98 in usual activity, 2.03 in pain, 1.55 in anxiety or depression. Quality of life of KP group was significantly better than that of the VP group in mobility (p=0.016), pain (p=0.001), and anxiety or depression (p=0.008). Average EQ-5D index of the VP and the KP group was 0.353 (+/-0.472) and 0.485 (+/-0.357), respectively. The EQ-5D index of the KP group was significantly (p<0.001) higher than that of the KP group. The difference of VAS between VP and KP group was not statistically significant (p=0.580). CONCLUSIONS: Quality of life in patient with OVFs who underwent KP was significantly better than that of patients who underwent VP.
Anxiety ; Depression ; Female ; Humans ; Kyphoplasty* ; Quality of Life* ; Retrospective Studies ; Self Care ; Vertebroplasty*

Duodenal duplication cyst is a rare anomaly, totaling only 4% to 12% of gastrointestinal duplications, and is usually encountered during infancy or in early childhood. Most are commonly located posterior to the first or second portion of the duodenum. Presenting signs and symptoms include vomiting, decreased oral intake, periumbilical tenderness, abdominal distention, obstructive jaundice, acute pancreatitis, and gastrointestinal bleeding. The traditional treatment of a duodenal duplication cyst has been complete surgical resection, but very few cases of endoscopic treatment have been reported in the literature. Here, we report a case of duodenal duplication cyst that was manifested by a duodenal polyp.
Duodenum ; Hemorrhage ; Jaundice, Obstructive ; Pancreatitis ; Polyps ; Vomiting

BACKGROUND/AIMS: C-reactive protein (CRP) is an easily measured index of disease activity, but its ability to predict clinical course is controversial. We therefore designed a study to determine whether the CRP level at Crohn's disease (CD) diagnosis is a valuable indicator of the disease phenotype, activity, and clinical course. METHODS: We retrospectively analyzed 705 CD patients from 32 institutions. The patients were classified into two groups according to CRP level. The patients' demographic and clinical characteristics and their use of immunosuppressive or biological agents were recorded. Disease location and behavior, hospitalization, and surgery were analyzed. RESULTS: A high CRP was associated with younger age, steroid use, colonic or ileocolonic location, high CD activity index, and active inflammation at colonoscopy (p<0.001). As the disease progressed, patients with high CRP were more likely to exhibit strictures (p=0.027). There were significant differences in the use of 5-aminosalicylic acid, antibiotics, corticosteroids, azathioprine, and infliximab (p<0.001, p<0.001, p<0.001, p<0.001, and p=0.023, respectively). Hospitalization was also more frequent in patients with high CRP. CONCLUSIONS: The CRP level at diagnosis is useful for evaluating the phenotype, activity, and clinical course of CD. Closer follow-up strategies, with early aggressive treatment, could be considered for patients with high CRP.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Azathioprine ; Biological Factors ; C-Reactive Protein* ; Colon ; Colonoscopy ; Constriction, Pathologic ; Crohn Disease* ; Diagnosis* ; Follow-Up Studies ; Hospitalization ; Humans ; Inflammation ; Infliximab ; Mesalamine ; Phenotype* ; Retrospective Studies

While endovascular aneurysm repair (EVAR) is prevailing for the treatment of abdominal aortic aneurysm (AAA) in modern vascular practice, PURPOSE: we conducted nationwide questionnaire survey to investigate the current status of AAA treatment and their results in Korea. METHOD: We reviewed the replies from 28 hospitals (33 departments) to the questionnaire inquiring annual number, clinical features, mode of treatment and results of AAA patients during the period from Jan. 2000 to Jul. 2004. Results: 980 AAA patients were reported including 292 ruptured AAA (29.8%) and 688 non-ruptured AAA (70.2%). For treatment of AAA, 834 (85.1%) surgical repairs (SRs) and 111 (11.3%) endovascualr aneurysm repairs (EVARs) were performed while 35 patients (3.6%) died of AAA rupture before operation. The locations of AAA were infrarenal in 889 (90.7%), juxtarenal in 62 (6.3%), and suprarenal in 29 patients (3.0%). Among 834 patients undergoing SR, 577 patients (69.2%) had non-ruptured AAAs and 257 patients (30.8%) had ruptured AAAs. Mean operative mortality rate was 4.1% after elective SRs, 30.7% after SR for ruptured AAAs, and 2.3% after EVARs. The reported brand name of stent graft devices were various including domestic custom-made in 56 (50.5%), imported brand in 18 (16.2%) while 37 (33.3%) stent grafts were not reported their brand name. The frequencies of type I and III endoleaks after EVAR were reported 5.8% and 5.8% respectively in 86 patients with an available data. CONCLUSION: SR has been used as a major treatment option in Korea for the treatment of AAA patients while EVAR is increasing. The mortality rate of SR of AAA was comparable to western multi-center trial reports but mortality or morbidity rates of EVAR were unable to know in this questionnaire survey.
Aneurysm ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Blood Vessel Prosthesis ; Endoleak ; Humans ; Korea* ; Mortality ; Questionnaires* ; Rupture ; Treatment Outcome