No abstract available.
Axilla* ; Paget Disease, Extramammary*

PURPOSE: To report a case of failed sealing of full-thickness macular hole associated with an entrapped microbubble in the hole after vitrectomy, peeling of the internal limiting membrane and C3F8 (14%) gas injection. CASE SUMMARY: A 69-year-old female visited our clinic for decreased visual acuity in her right eye. The best corrected visual acuity (BCVA) was 20/200 in the right eye. The fundoscopy and spectral domain optical coherence tomography (SD-OCT) showed a full-thickness macular hole. She had a history of spine surgery and, thus was unable to maintain a prone position after surgery. The patient underwent pars plana vitrectomy, peeling of the internal limiting membrane and C3F8 (14%) gas injection in a sitting position postoperatively. Three weeks postoperatively, fundoscopy showed an entrapped microbubble within the macular hole, which was not sealed as observed on SD-OCT. We thought the entrapped microbubble within the macular hole prevented closure of the hole and removed it during the repeated surgery. At 2 weeks after the microbubble removal, fundoscopy and SD-OCT in the right eye showed the closure of the macular hole and the BCVA was improved to 20/40. CONCLUSIONS: We experienced a failed sealing of full-thickness macular hole due to an entrapped microbubble within the hole after macular hole surgery and observed the closure of the macular hole after removal of the microbubble. Based on our results, early microbubble removal operation should be considered in the treatment of an entrapped microbubble within the hole.
Aged ; Female ; Humans ; Membranes ; Microbubbles* ; Prone Position ; Retinal Perforations* ; Spine ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

Monitoring fetal movement serves as an indirect rneasure of fetal well-being, especially for central nervous system integrity and function. Methods to monitor fetal movement vary from the simple approach of having the mother chart perceived movement to highly specialized methods. However there were no reliable objective monitoring methods in Korea. For development of objective method for evaluating fetal movement, during pregnancy, one-hundred and two pregnant patients were entered to this study. All patients were divided into following 3 groups and each type of monitoring methods were applied. Group 1(N=20): Type I using portable FHR Doppler unit(IFD-100 model, Intermed, Korea). Group 2(N=20): Type II using FHR Microphone(Prenatal Listening Kit, Model FS002, Unisar Inc., US). Group 3(N=62): Type III using conventional ultrasound transducer(Corometric 115 Model, US). In this study, accurate counting of the fetal movementutus were best performed using Type III, because of monitoring fetal movements has its greatest efficiency when using conventional ultrasound transducer of fetal monitor. It was also attractive to doctors and nurses as a convenient methods because it needed only single transducer when compared to Type I and II. Although monitoring fetal body movement permits a general assessment of well-being, no perfect technique is still reliable. Futher techniques would be developed using the results of this study for improvement of several factors such as accuracy and objectiveness
Central Nervous System ; Fetal Monitoring ; Fetal Movement* ; Humans ; Korea ; Mothers ; Pregnancy* ; Transducers ; Ultrasonography

No abstract available.
Keratosis, Seborrheic* ; Poroma* ; Scalp*

BACKGROUND: Ski injuries depend on many factors which involve the skier's skill, the skiing environment, and skier's equipment. The purpose of this study was to determine the factors associated with fractures by skiing accident. SUBJECT: We evaluated 566 patients with ski injuries who visited to the emergency post located in the YongPyong Ski Resorts from Nov. 1996 to Feb. 1997. Among the patients,379 patients had no fracture(group I) and 187 patients had fracture(group II). RESULT: There was no differences in mean age and sex ratio between two groups. Fractures of the lower extremities were more common than the upper extremities. Slipping was the most common injury mechanism. arming-up was done in 40% of group I and in 17% of group II. The fracture injuries were more common in the skier with intermediate(45%) skill than the beginner(29%) and the ones with advanced skill(12%). The slope with intermediate difficulty was the most frequent site of fracture accidents. The fracture group tended to choose the slope beyond their skiing ability. CONCLUSION: Our results suggest that fracture during skiing can be prevented if skiers do warming-up prior to skiing and choose slope appropriate to their skiing skill.
Emergencies ; Health Resorts ; Humans ; Lower Extremity ; Sex Ratio ; Skiing ; Upper Extremity

PURPOSE: Acute abdominal pain can be the result of many different pathophysiological processes. Among the many possible causes, acute mesenteric ischemia is a life threatening condition if the diagnosis is delayed. Generally, the mortality rate for other disease has gradually decreased; however, the mortality rate for acute mesenteric ischemia has not changed significantly and it continues to be 75% to 80% for acute mesenteric arterial embolism or thrombosis and 44% for acute mesenteric venous thrombosis. The aim of this study was to conduct an analysis of the clinical characteristics and mortality of the patients with acute mesenteric ischemia according to the etiology. METHOD: From 1989 to 2004, 43 patients were treated for acute mesenteric ischemia. Their mean age was 59 years, ranging from 24 to 81, and the male to female gender ratio was 24:19. We retrospectively analyzed their initial symptoms, the age and gender distribution, the treatment modalities and the mortality rates. RESULT: The causes of acute mesenteric ischemia were arterial embolism in 27 cases, arterial thrombosis including arterial dissection in 7 cases and venous thrombosis in 9 cases. Almost all of the patients complained of acute abdominal pain and abdominal tenderness. The overall mortality rate was 30.2% and the rates were 37.0% for mesenteric artery embolism, 42.9% for mesenteric artery thrombosis and 0% for mesenteric venous thrombosis. CONCLUSION: In this study, the causes of acute mesenteric ischemia were mesenteric artery embolism and thrombosis, including dissection and mesenteric venous thrombosis. The factors influencing the mortality were the cause of the acute mesenteric ischemia, the extent of involvement of the mesenteric vessels and the extent of bowel necrosis. Thus the most important things for the treatment of acute mesenteric ischemia are early diagnosis and proper treatment.
Abdominal Pain ; Diagnosis ; Early Diagnosis ; Embolism ; Embolism and Thrombosis ; Female ; Humans ; Ischemia* ; Male ; Mesenteric Arteries ; Mortality ; Necrosis ; Retrospective Studies ; Thrombosis ; Venous Thrombosis

Dulaglutide, a weekly injectable glucagon-like peptide-1 receptor agonist, has demonstrated effectiveness when combined with basal insulin. We examined whether the efficacy of dulaglutide is comparable to that of prandial insulin in kidney transplant (KT) recipients with type 2 diabetes mellitus (T2DM) undergoing multiple daily insulin injection (MDI) therapy. Thirty-seven patients, who switched from MDI therapy to basal insulin and dulaglutide, were retrospectively analyzed. Changes in glycosylated hemoglobin (HbA1c) and fasting plasma glucose (FPG) levels, body weight, and basal insulin dose were evaluated over 6 months. Dulaglutide was comparable to three injections of prandial insulin in terms of glycemic control (HbA1c 7.1% vs. 7.0%; 95% confidence interval [CI], –0.53 to 0.28; P=0.53). The basal insulin and dulaglutide combination resulted in a reduction in FPG levels by 9.7 mg/dL (95% CI, 2.09 to 41.54; P=0.03), in body weight by 4.9 kg (95% CI, 2.87 to 6.98; P<0.001), and in basal insulin dose by 9.52 IU (95% CI, 5.80 to 3.23; P<0.001). Once-weekly dulaglutide may be an effective alternative for thrice-daily prandial insulin in KT recipients with T2DM currently receiving MDI therapy.

PURPOSE: To confirm the effect of water exercise program for treating the gestational edema. METHODS: Both low leg volume, body weight and urine specific gravity were measured in thirty women with gestational edema before and after water exercise program. Fetal heart rate, maternal heart rate and maternal blood pressure were measured before and after water exercise program. RESULTS: Right leg volume was decreased by 286 ml from 1714 to 1428 mL (P<.0001), left leg volume was decreased by 267 mL from 1,644 to 1,377 mL (P<0.0001), and total leg volume was decreased by 553 mL from 3,359 to 2,805 mL (P<0.0001). Urine specific gravity was decreased by 0.0047 from 1.0197 to 1.0150 (P=0.004). Maternal body weight, heart rate, blood pressure, and fetal heart rate were showed no significant change. CONCLUSION: Water exercise program is effective and safe method for treating the gestational edema.
Blood Pressure ; Body Weight ; Edema ; Female ; Heart Rate ; Heart Rate, Fetal ; Humans ; Leg ; Pregnancy ; Specific Gravity

OBJECTIVE: To investigate the effects of obturator nerve blocks with ultrasound guided intraneural alcohol injection. METHOD: Nine quadriplegic patients suffering hip adductor spasticity were included in this study. The obturator nerve was identified at just below inguinal ligament area on anteromedial surface of upper leg at supine position. An 23 G needle was inserted into anterior branch of obturator nerve under real time ultrasonography. The 50% alcohol solution was injected 3~5 ml at a time within the epineurium of the anterior branch of obturator nerve until the expanding nerve was visualized. We examed modified Ashworth scale (MAS) of hip adductor and passive range of movement of hip abduction at supine position at study entry, 1, 4, and 12 weeks after ultrasound guided intraneural injection. RESULTS: There were statistically significant improvement was seen in MAS of hip adductors and hip abduction angle at 1, 4, and 12 weeks after ultrasound guided intraneural injection, compared with parameters measured at previous injection (p<0.05). CONCLUSION: Ultrasound guided intraneural alcohol injection into anterior branch of obturator nerve for treatment of hip adductor spasticity in patients with quadriplegia is an effective and safe procedure for relieving localized spasticity of the hip adductors.
Hip ; Humans ; Leg ; Ligaments ; Muscle Spasticity ; Needles ; Obturator Nerve ; Peripheral Nerves ; Quadriplegia ; Stress, Psychological ; Supine Position

OBJECTIVE: The aim of the study was to evaluate the effectiveness of ultrasouond-guided salivary gland injection of botulinum toxin A (BTX-A) for posterior drooling. METHOD: 11 patients with brain lesion (9 cerebral palsy, 1 hypoxic ischemic encephalopathy and 1 mental retardation) with posterior drooling (an initial PDAS score greater than 2) and related pulmonary problems were recruited. Drooling severity was measured at baseline, 4 weeks, 3 months and 6 months after botulinum toxin A injection, by using Teacher Drooling Scale (TDS), Visual Analogue Scales (VAS), Drooling Score System (DSS)-severity, frequency and Posterior Drooling/Aspiration System (PDAS). RESULTS: The TDS, DSS-severity, DSS-frequency, VAS, PDAS were significantly reduced at 4 weeks and 3 months after BTX-A injection into salivary glands compared to pre-injection (p<0.05). However, there were no significant changes at 6 months compared to pre-injection level. CONCLUSION: BTX-A injection into salivary glands may improve anterior drooling in patients with brain lesions. Furthermore BTX-A injection into salivary glands may also decrease the posterior drooling which might related to respiratory symptoms in aspiration pneumonia.
Botulinum Toxins ; Botulinum Toxins, Type A ; Brain ; Cerebral Palsy ; Humans ; Hypoxia-Ischemia, Brain ; Pneumonia, Aspiration ; Salivary Glands ; Sialorrhea ; Sorbitol ; Stress, Psychological ; Tyramine ; Weights and Measures