Purpose: This study evaluated volumetric analysis using automatic whole-brain segmentation as a potential tool to enhance diagnostic accuracy alongside traditional magnetic resonance imaging (MRI) markers in the diagnosis of idiopathic normal pressure hydrocephalus (INPH). Materials and Methods: Twenty-six patients diagnosed with INPH exhibited progressive symptoms, including gait dysfunction and cognitive impairment, confirmed by MRI evidence of enlarged ventricles and normal cerebrospinal fluid pressure. Automatic segmentation was performed on sagittal T1-weighted volumetric images using LesionQuant. Age- and sex-matched groups with Alzheimer’s disease (AD) and normal control (NC) groups were included. Multinomial logistic regression was applied to predict diagnoses (NC, INPH, or AD) based on volumetric parameters. Results: Compared to the AD and NC groups, enlarged inferior lateral ventricles were observed in the INPH group. The inferior lateral ventricle volume showed a positive linear correlation with the Evans’ index (R2 = 0.639) and a negative linear correlation with the callosal angle (R2 = 0.482). High classification accuracy was achieved, with 87.5% of NC cases, 88.5% of INPH cases, and 76% of AD cases correctly identified. Conclusion Automated volumetric markers appear valuable for diagnosing INPH and distinguishing it from other neurodegenerative diseases.

Purpose: This study evaluated volumetric analysis using automatic whole-brain segmentation as a potential tool to enhance diagnostic accuracy alongside traditional magnetic resonance imaging (MRI) markers in the diagnosis of idiopathic normal pressure hydrocephalus (INPH). Materials and Methods: Twenty-six patients diagnosed with INPH exhibited progressive symptoms, including gait dysfunction and cognitive impairment, confirmed by MRI evidence of enlarged ventricles and normal cerebrospinal fluid pressure. Automatic segmentation was performed on sagittal T1-weighted volumetric images using LesionQuant. Age- and sex-matched groups with Alzheimer’s disease (AD) and normal control (NC) groups were included. Multinomial logistic regression was applied to predict diagnoses (NC, INPH, or AD) based on volumetric parameters. Results: Compared to the AD and NC groups, enlarged inferior lateral ventricles were observed in the INPH group. The inferior lateral ventricle volume showed a positive linear correlation with the Evans’ index (R2 = 0.639) and a negative linear correlation with the callosal angle (R2 = 0.482). High classification accuracy was achieved, with 87.5% of NC cases, 88.5% of INPH cases, and 76% of AD cases correctly identified. Conclusion Automated volumetric markers appear valuable for diagnosing INPH and distinguishing it from other neurodegenerative diseases.

Purpose: This study evaluated volumetric analysis using automatic whole-brain segmentation as a potential tool to enhance diagnostic accuracy alongside traditional magnetic resonance imaging (MRI) markers in the diagnosis of idiopathic normal pressure hydrocephalus (INPH). Materials and Methods: Twenty-six patients diagnosed with INPH exhibited progressive symptoms, including gait dysfunction and cognitive impairment, confirmed by MRI evidence of enlarged ventricles and normal cerebrospinal fluid pressure. Automatic segmentation was performed on sagittal T1-weighted volumetric images using LesionQuant. Age- and sex-matched groups with Alzheimer’s disease (AD) and normal control (NC) groups were included. Multinomial logistic regression was applied to predict diagnoses (NC, INPH, or AD) based on volumetric parameters. Results: Compared to the AD and NC groups, enlarged inferior lateral ventricles were observed in the INPH group. The inferior lateral ventricle volume showed a positive linear correlation with the Evans’ index (R2 = 0.639) and a negative linear correlation with the callosal angle (R2 = 0.482). High classification accuracy was achieved, with 87.5% of NC cases, 88.5% of INPH cases, and 76% of AD cases correctly identified. Conclusion Automated volumetric markers appear valuable for diagnosing INPH and distinguishing it from other neurodegenerative diseases.

Adenocarcinoma ; pathology ; therapy ; Choriocarcinoma, Non-gestational ; pathology ; therapy ; Combined Modality Therapy ; Female ; Humans ; Lung Neoplasms ; secondary ; Middle Aged ; Neoplasms, Germ Cell and Embryonal ; pathology ; therapy ; Urinary Bladder Neoplasms ; pathology ; therapy ; Uterine Neoplasms ; pathology ; therapy

PURPOSE: Thumb is the most important part of the hand. That requires reconstruction as a top priority. The operative methods for thumb reconstruction have been developed variously to the microsurgical technique. For better functional and cosmetic effects of the thumb, many studies and reports on toe transfer for thumb reconstruction have been conducted. Great toe transfer for thumb reconstruction was first reported by Cobbett in 1969. Since then, the second toe transfer also has been reported by Dongyue in 1979. Author report about advantages and disadvantages of the second toe transfer for thumb reconstruction. MATERIALS AND METHODS: The second toe transfer had been conducted transfer for nine patients from March 1998 to February 2007. The patient's age ranged from 18 to 52, averaging 30 years old. The levels of defect were classified as two proximal portion of proximal phalanx,five metacarpo-phalangeal joints, and two distal portion of metacarpal bone. The causes of thumb defect were classified as six trauma, two electrical burn, and one malignant tumor cases. The results were evaluated with sensation and strength the reconstructed thumb, cometic effect of recipient site, aesthetic effects at donor sites, and gait problem, at mean 32 months after the operation. RESULTS: After the second toe transfer, the reconstructed thumb's sense was measured as average 8.2 mm at 2 point discrimination test and it's pinching power measured average 81.7% compared to normal thumbs. The degree of cosmetic satisfaction of both donor & recipient sites appeared at 3.4 and 4.7, respectively. CONCLUSIONS: When choosing an operative method for the thumb reconstruction, we have to consider functional and cosmetic effect as well as the socio-cultural background. If we apply the second toe transfer according to the amputation level of the thumb, it would be a good satisfying operative method.
Amputation ; Burns ; Cosmetics ; Discrimination (Psychology) ; Gait ; Hand ; Humans ; Joints ; Sensation ; Thumb ; Tissue Donors ; Toes

PURPOSE: Incomplete syndactyly, due to either congenital or acquired, is uncommon. Many different surgical methods have been descirbed. We introduce the modification of seven flap-plasty for incomplete syndactyly and report functional improvement after correction by modified seven flap-plasty without skin graft. MATERIALS AND METHODS: Twelve patients with an incomplete syndactyly who underwent modified seven flap-plasty were analyzed. Age ranged from one to 40-year-old (average age 21). There were 8 males and 4 females, and the degree of syndactyly was near proximal interphalangeal joint. Two different operative methods were performed. Modification I modified two half-Z flaps in parallelogram shape, and modification II modified V flap of V-M flap in Y-V flap. Functional improvements was measured by maximal abduction distance and maximal abduction angle change. RESULTS: All cases were corrected by using the modified seven flap plasty. Flap tip necrosis was found in two cases of severe burn scar patients, but did not require additional surgery. There was no specific complications. Maximal abduction distance was increased in 6 mm, and maximal abduction angle was increased in 5.8degrees. CONCLUSION: Incomplete syndactyly near proximal interphalangeal joint was corrected by modified seven flap plasty and was able to get a satisfactory result.
Adult ; Burns ; Cicatrix ; Female ; Humans ; Joints ; Male ; Necrosis ; Skin ; Syndactyly

PURPOSE: To assess the refractive change and prediction error after temporary intraocular lens (IOL) removal in temporary polypseudophakic eyes using IOL power calculation formulas and Gills' formula. METHODS: Four consecutive patients (7 eyes) who underwent temporary IOL explantation were enrolled. Postoperative refractions calculated using IOL power calculation formulas (SRK-II, SRK-T, Hoffer-Q, Holladay, and the modified Gills' formula for residual myopia and residual hyperopia) were compared to the manifest spherical equivalents checked at 1 month postoperatively. RESULTS: The mean ages of temporary piggyback IOL implantation and IOL removal were 6.71 +/- 3.68 months (range, 3 to 12 months) and 51.14 +/- 18.38 months (range, 29 to 74 months), respectively. The average refractive error was -13.11 +/- 3.10 diopters (D) just before IOL removal, and improved to -1.99 +/- 1.04 D after surgery. SRK-T showed the best prediction error of 1.17 +/- 1.00 D. The modified Gills' formula for myopia yielded a relatively good result of 1.47 +/- 1.27 D, with only the variable being axial length. CONCLUSIONS: Formulas to predict refractive change after temporary IOL removal in pediatric polypseudophakia were not as accurate as those used for single IOL implantation in adult eyes. Nonetheless, this study will be helpful in predicting postoperative refraction after temporary IOL removal.
Cataract/*congenital ; *Cataract Extraction ; *Device Removal ; Female ; Humans ; Hyperopia/etiology/*surgery ; Infant ; Lens Implantation, Intraocular/*methods ; Lenses, Intraocular ; Male ; Myopia/etiology/*surgery ; Prospective Studies

PURPOSE: To assess the refractive change and prediction error after temporary intraocular lens (IOL) removal in temporary polypseudophakic eyes using IOL power calculation formulas and Gills' formula. METHODS: Four consecutive patients (7 eyes) who underwent temporary IOL explantation were enrolled. Postoperative refractions calculated using IOL power calculation formulas (SRK-II, SRK-T, Hoffer-Q, Holladay, and the modified Gills' formula for residual myopia and residual hyperopia) were compared to the manifest spherical equivalents checked at 1 month postoperatively. RESULTS: The mean ages of temporary piggyback IOL implantation and IOL removal were 6.71 +/- 3.68 months (range, 3 to 12 months) and 51.14 +/- 18.38 months (range, 29 to 74 months), respectively. The average refractive error was -13.11 +/- 3.10 diopters (D) just before IOL removal, and improved to -1.99 +/- 1.04 D after surgery. SRK-T showed the best prediction error of 1.17 +/- 1.00 D. The modified Gills' formula for myopia yielded a relatively good result of 1.47 +/- 1.27 D, with only the variable being axial length. CONCLUSIONS: Formulas to predict refractive change after temporary IOL removal in pediatric polypseudophakia were not as accurate as those used for single IOL implantation in adult eyes. Nonetheless, this study will be helpful in predicting postoperative refraction after temporary IOL removal.
Cataract/*congenital ; *Cataract Extraction ; *Device Removal ; Female ; Humans ; Hyperopia/etiology/*surgery ; Infant ; Lens Implantation, Intraocular/*methods ; Lenses, Intraocular ; Male ; Myopia/etiology/*surgery ; Prospective Studies

PURPOSE: Myositis ossificans is a benign condition of heterotopic bone formation that still requires more of its pathologic explanation. The lesions are localized predominantly to the high-risk sites of injury, involving flexor muscles of the upper limbs and thigh, but rarely in the head and neck area. METHODS: A case of a 44-year-old male patient presented with a palpable hard mass on nasal dorsum. The patient experienced a similar lesion on upper limb few years ago. On computed tomographic image, the lesion presented focal definite increase in opacity compatible to adjacent bone densitiy on nasal dorsum. RESULTS: The lesion was excised under open rhinoplasty incision. The pathologic report revealed focal bone formation and calcification within skeletal muscle. CONCLUSION: We describe a unique and only case of a myositis ossificans on nasal dorsum which is indifferent from previous concept.
Adult ; Head ; Humans ; Male ; Muscles ; Myositis ; Myositis Ossificans ; Neck ; Nose ; Osteogenesis ; Rhinoplasty ; Thigh ; Upper Extremity

The adverse drug reaction(ADR) monitoring is very critical in healthcare. However, the number of actual reported cases on ADR has been extremely low in Korea compared to other countries. This study was designed to find out a way to expedite ADR reporting in a general hospital, where many drugs are used daily. In this study, a newly developed ADR monitoring system has been implemented and was evaluated for its outcome. In addition, a survey was conducted for two groups, 50 ADR reporters and 100 non-reporters, to identify factors which can affect the ADR reporting. The new system was a multidisciplinary program based on a voluntary reporting involving doctors, nurses and pharmacists. The reporting methods were diversified such as ADR report sheet, computerized Order Communication System(OCS) consultation and drug refund reports. After a year since the system has been implemented, the number of reported cases was 158, which was 131 times higher than that of the pre-implementation period. Doctors reported the most(75 .3%), and ADR report sheet was used most frequently(57%). In terms of severity of ADR 74.7% was mild, 22.8% moderate and 2.5% severe. The unexpected ADRs were 7.6%. Both groups had a high degree of awareness of the necessity of monitoring and basic knowledge of ADR. Important factors affecting ADR reporting were frequency of ADR findings(p<0.01), awareness of the fact that the institution was designated as an ADR monitoring institution(p<0.001) and participation in the education program(p<0.01). In conclusion, modification of the reporting system and ongoing and systematic education are needed to improve ADR monitoring in a general hospital.
Delivery of Health Care ; Drug-Related Side Effects and Adverse Reactions* ; Education ; Hospitals, General* ; Humans ; Korea ; Pharmacists