Acute isolated sphenoid sinusitis is a rare disease, and accounts for less than 3% of all sinusitis, especially in young children. Delayed diagnosis or misdiagnosis can occur frequently due to atypical clinical presentations. This can lead to serious complications because of the involvement of anatomically related intracranial structures. Therefore, nasal endoscopy, computed tomography (CT), and magnetic resonance imaging (MRI) are important diagnostic tools to confirm the diagnosis. We report two cases of a previously healthy 6-year-old girl and a 13-year-old boy, whose chief complaints were uncontrolled headache and high fever over 38°C. Physical examination and initial laboratory test results of blood, urine, and cerebrospinal fluid were normal. The diagnosis was made after a brain MRI revealed isolated sphenoid sinusitis. The girl was treated with third generation cephalosporins intravenously. The boy, however, had to undergo an emergent endoscopic sinus surgery as his headache and eyeball-pain symptoms did not resolve by medical treatment alone. Both cases had good outcomes, without neurological sequelae.

The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.
Arteries ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Humans ; Percutaneous Coronary Intervention ; Radial Artery ; Spasm

The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.

Extra-pulmonary tuberculosis usually progresses as a secondary infection from pulmonary tuberculosis, and tuberculosis of the head and neck region. Tuberculosis of ocular and periocular areas, however, is a rare disease. Among ocular tuberculosis involving the adnexal structures, a few lacrimal sac tuberculosis has been reported. We recently experienced a case of lacrimal sac tuberculosis presenting as epiphora. Examination revealed bilateral nasolacrimal duct obstruction and the patient underwent endoscopic endonasal dacryocystorhinostomy. During the operation, a biopsy taken from the unhealthy looking lacrimal sac filled with caseous necrotic tissue was suggestive of tuberculosis. Histopathological features and further systemic evaluation confirmed tuberculosis. She was treated medically with anti-tubercular agents. The new opening of the lacrimal sac was patent and epiphora was resolved successfully at a year follow up. This report highlights the requirement of high suspicion of tuberculosis, even in the nasolacrimal drainage system.

Purpose: This study aimed to compare the dose characteristics of the volumetric modulated arc therapy (VMAT) and dynamic conformal arc (DCA) techniques for metastatic brain tumor treatment using various indices to evaluate the quality of the plan and provide insights into the clinical implications of each approach. Methods: Twelve patients with single metastatic brain tumors treated with VMAT were retrospectively analyzed. For comparison with DCA, identical geometric parameters (excluding multileaf collimators) were applied. Dose coverage, normal tissue sparing, and treatment efficiencywere evaluated using indices such as CILIM98 , CIICRU , CIRTOG , QCRTOG , CISALT , HTCISALT , and CIPADDIC .These indices were statistically assessed to evaluate the differences between VMAT and DCA. Results: VMAT was superior to DCA in most indices for both small and large planning targetvolumes (PTVs). DCA plans for large PTVs showed a higher V12Gy , exceeding 10 mL and failing tomeet the recommended criteria (<10 mL). However, DCA required nearly half the monitor units(MUs) of VMAT, resulting in shorter treatment times. All indices, except for QCRTOG , demonstratedsignificant differences between VMAT and DCA. Conclusions Careful consideration is necessary for larger PTVs when deciding a plan becauseDCA can occasionally result in V12Gy of a brain minus PTV >10 mL. Conversely, DCA provides theadvantage of shorter treatment times because of its lower MU. This study highlights the importance of using a combination of indices to comprehensively assess treatment plan quality.

Purpose: This study aimed to compare the dose characteristics of the volumetric modulated arc therapy (VMAT) and dynamic conformal arc (DCA) techniques for metastatic brain tumor treatment using various indices to evaluate the quality of the plan and provide insights into the clinical implications of each approach. Methods: Twelve patients with single metastatic brain tumors treated with VMAT were retrospectively analyzed. For comparison with DCA, identical geometric parameters (excluding multileaf collimators) were applied. Dose coverage, normal tissue sparing, and treatment efficiencywere evaluated using indices such as CILIM98 , CIICRU , CIRTOG , QCRTOG , CISALT , HTCISALT , and CIPADDIC .These indices were statistically assessed to evaluate the differences between VMAT and DCA. Results: VMAT was superior to DCA in most indices for both small and large planning targetvolumes (PTVs). DCA plans for large PTVs showed a higher V12Gy , exceeding 10 mL and failing tomeet the recommended criteria (<10 mL). However, DCA required nearly half the monitor units(MUs) of VMAT, resulting in shorter treatment times. All indices, except for QCRTOG , demonstratedsignificant differences between VMAT and DCA. Conclusions Careful consideration is necessary for larger PTVs when deciding a plan becauseDCA can occasionally result in V12Gy of a brain minus PTV >10 mL. Conversely, DCA provides theadvantage of shorter treatment times because of its lower MU. This study highlights the importance of using a combination of indices to comprehensively assess treatment plan quality.

Purpose: This study aimed to compare the dose characteristics of the volumetric modulated arc therapy (VMAT) and dynamic conformal arc (DCA) techniques for metastatic brain tumor treatment using various indices to evaluate the quality of the plan and provide insights into the clinical implications of each approach. Methods: Twelve patients with single metastatic brain tumors treated with VMAT were retrospectively analyzed. For comparison with DCA, identical geometric parameters (excluding multileaf collimators) were applied. Dose coverage, normal tissue sparing, and treatment efficiencywere evaluated using indices such as CILIM98 , CIICRU , CIRTOG , QCRTOG , CISALT , HTCISALT , and CIPADDIC .These indices were statistically assessed to evaluate the differences between VMAT and DCA. Results: VMAT was superior to DCA in most indices for both small and large planning targetvolumes (PTVs). DCA plans for large PTVs showed a higher V12Gy , exceeding 10 mL and failing tomeet the recommended criteria (<10 mL). However, DCA required nearly half the monitor units(MUs) of VMAT, resulting in shorter treatment times. All indices, except for QCRTOG , demonstratedsignificant differences between VMAT and DCA. Conclusions Careful consideration is necessary for larger PTVs when deciding a plan becauseDCA can occasionally result in V12Gy of a brain minus PTV >10 mL. Conversely, DCA provides theadvantage of shorter treatment times because of its lower MU. This study highlights the importance of using a combination of indices to comprehensively assess treatment plan quality.

Purpose: This study aimed to compare the dose characteristics of the volumetric modulated arc therapy (VMAT) and dynamic conformal arc (DCA) techniques for metastatic brain tumor treatment using various indices to evaluate the quality of the plan and provide insights into the clinical implications of each approach. Methods: Twelve patients with single metastatic brain tumors treated with VMAT were retrospectively analyzed. For comparison with DCA, identical geometric parameters (excluding multileaf collimators) were applied. Dose coverage, normal tissue sparing, and treatment efficiencywere evaluated using indices such as CILIM98 , CIICRU , CIRTOG , QCRTOG , CISALT , HTCISALT , and CIPADDIC .These indices were statistically assessed to evaluate the differences between VMAT and DCA. Results: VMAT was superior to DCA in most indices for both small and large planning targetvolumes (PTVs). DCA plans for large PTVs showed a higher V12Gy , exceeding 10 mL and failing tomeet the recommended criteria (<10 mL). However, DCA required nearly half the monitor units(MUs) of VMAT, resulting in shorter treatment times. All indices, except for QCRTOG , demonstratedsignificant differences between VMAT and DCA. Conclusions Careful consideration is necessary for larger PTVs when deciding a plan becauseDCA can occasionally result in V12Gy of a brain minus PTV >10 mL. Conversely, DCA provides theadvantage of shorter treatment times because of its lower MU. This study highlights the importance of using a combination of indices to comprehensively assess treatment plan quality.

Purpose: This study aimed to compare the dose characteristics of the volumetric modulated arc therapy (VMAT) and dynamic conformal arc (DCA) techniques for metastatic brain tumor treatment using various indices to evaluate the quality of the plan and provide insights into the clinical implications of each approach. Methods: Twelve patients with single metastatic brain tumors treated with VMAT were retrospectively analyzed. For comparison with DCA, identical geometric parameters (excluding multileaf collimators) were applied. Dose coverage, normal tissue sparing, and treatment efficiencywere evaluated using indices such as CILIM98 , CIICRU , CIRTOG , QCRTOG , CISALT , HTCISALT , and CIPADDIC .These indices were statistically assessed to evaluate the differences between VMAT and DCA. Results: VMAT was superior to DCA in most indices for both small and large planning targetvolumes (PTVs). DCA plans for large PTVs showed a higher V12Gy , exceeding 10 mL and failing tomeet the recommended criteria (<10 mL). However, DCA required nearly half the monitor units(MUs) of VMAT, resulting in shorter treatment times. All indices, except for QCRTOG , demonstratedsignificant differences between VMAT and DCA. Conclusions Careful consideration is necessary for larger PTVs when deciding a plan becauseDCA can occasionally result in V12Gy of a brain minus PTV >10 mL. Conversely, DCA provides theadvantage of shorter treatment times because of its lower MU. This study highlights the importance of using a combination of indices to comprehensively assess treatment plan quality.

PURPOSE: The interest has been growing in the investigation and management of lower urinary tract symptoms, but their prevalence in the general population has so far been based on the estimates made in selected groups of women in Korea. The object of this study was to determine the prevalence of stress urinary incontinence and bladder irritative symptoms of women in rural region in Korea through a community based survey. Also, we investigated the relationship between age, parity, oral contraception, smoking, menopause and obesity and the prevalence of stress urinary incontinence. MATERIALS AND METHODS: A questionnaire survey was performed in a sample of randomly selected 1162 women aged 30 years and over, in 31 villages in the town of Jeong-Eup, Korea. From February 4th to February 22nd, 1997, trained field workers visited every home and interviewed every eligible individual with the questionnaires, which included data on stress urinary incontinence, bladder irritative symptoms, quality of life, reproductive and menstrual history, and use of oral contraceptives. Among 1162 women, 857 responded to questionnaires, and 827 questionnaires were available for analysis. The response rate was 73.5%. The prevalence of stress urinary incontinence was defined as the proportion of the women in the population surveyed who experienced stress urinary incontinence at least twice a week. We defined diurnal frequency as the episodes of voiding again within 2 hours after initial voiding in the series of 5 consecutive voidings during one month period. The urgency was defined as she found it difficult to hold urination, once or more in the series of 5 consecutive voidings and nocturia twice or more per night. RESULTS: The prevalence of stress urinary incontinence was 20.4%. Only seven(4.1%) women carried a sanitary towel or diaper as protection against urinary leakage. The prevalence of stress incontinence among age groups revealed no significant difference. Statistically significant correlation was noted between obesity and the prevalence of stress incontinence. Diurnal frequency was recorded by 375 women(45.3%); 171(20.6%) experienced this symptom more than three times. Urgency was reported by 268 women(32.4%) and 63(7.6%) were always troubled by this symptom. Nocturia 3 times or more every night was recorded by 341 women(42.2%) and 83(10.0%) had nocturia 5 times or more. The severity of nocturia increased significantly with age. CONCLUSIONS: The prevalence of stress urinary incontinence and irritative symptoms in this study is similar to previous studies performed in other countries while the rate of nocturia is much higher in this study. Although stress urinary incontinence and bladder irritative symptoms are relatively common in this community, only few people are seeking for care of these symptoms. Therefore, it is very important to educate the public and promote awareness of this medical problem in this community.
Contraception ; Contraceptives, Oral ; Female ; Health Personnel ; Humans ; Jeollabuk-do ; Korea ; Lower Urinary Tract Symptoms ; Menopause ; Nocturia ; Obesity ; Parity ; Prevalence* ; Quality of Life ; Surveys and Questionnaires ; Smoke ; Smoking ; Urinary Bladder* ; Urinary Incontinence* ; Urination