PURPOSE: Simple decompression of the ulnar nerve has outcomes similar to anterior transposition for cubital tunnel syndrome; however, there is no consensus on the proper technique for patients with an unstable ulnar nerve. We hypothesized that 1) simple decompression or anterior ulnar nerve transposition, depending on nerve stability, would be effective for cubital tunnel syndrome and that 2) there would be determining factors of the clinical outcome at two years. MATERIALS AND METHODS: Forty-one patients with cubital tunnel syndrome underwent simple decompression (n=30) or anterior transposition (n=11) according to an assessment of intra-operative ulnar nerve stability. Clinical outcome was assessed using grip and pinch strength, two-point discrimination, the mean of the disabilities of arm, shoulder, and hand (DASH) survey, and the modified Bishop Scale. RESULTS: Preoperatively, two patients were rated as mild, another 20 as moderate, and the remaining 19 as severe according to the Dellon Scale. At 2 years after operation, mean grip/pinch strength increased significantly from 19.4/3.2 kg to 31.1/4.1 kg, respectively. Two-point discrimination improved from 6.0 mm to 3.2 mm. The DASH score improved from 31.0 to 14.5. All but one patient scored good or excellent according to the modified Bishop Scale. Correlations were found between the DASH score at two years and age, pre-operative grip strength, and two-point discrimination. CONCLUSION: An ulnar nerve stability-based approach to surgery selection for cubital tunnel syndrome was effective based on 2-year follow-up data. Older age, worse preoperative grip strength, and worse two-point discrimination were associated with worse outcomes at 2 years.
Adult ; Cubital Tunnel Syndrome/*diagnosis/physiopathology/*surgery ; Decompression, Surgical/*methods ; Female ; Follow-Up Studies ; Hand/surgery ; Hand Strength ; Humans ; Male ; Middle Aged ; Neurosurgical Procedures/*methods ; Prospective Studies ; Recovery of Function ; Surveys and Questionnaires ; Treatment Outcome ; Ulnar Nerve/physiopathology/*surgery ; Young Adult

PURPOSE: This study aimed to identify changes in smart device usage trends of young children using two studies conducted in 2015-2016 and 2017 respectively. METHODS: We compared the data of the previous study of 130 children (Group A) and the new study of 162 children (Group B). The children and parents were recruited from kindergartens in Seoul and Guri/Namyangju cities. We used the “Parental questionnaire for smart device usage status.” RESULTS: There were some changes in the smart device usage in young children and parental perception. In the 2017 study, smart device usage time increased during weekends (P < 0.05) and the usage with siblings decreased (P < 0.05). In 2017, the smart device was mostly used when children had to be quiet without disturbing others (36.8%). No significant difference existed in the main purpose of use: watching video clips (79.3% vs 76.6%). Overall control of the usage was still largely exercised by mothers; however, when using applications, mothers still only helped the children on request (51.8% vs 49.7%). Regarding the effect of smart device on children, responses of “not knowing” decreased and “will be negative” and “will be positive” increased (P < 0.05). Additionally, most mothers thought that “Although the smart device is currently unnecessary, it will be needed in future” in 2017 (46.3%). CONCLUSION: Limiting the smart device usage time during the weekends and increasing parental involvements are recommended. Guidelines for smart devices usage in young children are also necessary considering the changes in parental attitudes in recognizing the smart device usage as unavoidable.
Child ; Humans ; Mothers ; Parents ; Seoul ; Siblings ; Smartphone

In recent years, an increasing number of infections with Pasteurella multocida in human have been reported, causing a wide range of systemic illness. Infective endocarditis with P. multocida, however, is still quite rare. Recently we experienced a case of P. multocida endocarditis in a 26-year old man who was admitted because of fever and headache. He denied any recent contact with animals. P. multocida was identified from blood cultures and echocardiography showed mitral regurgitation and vegetation on mitral valve area. He became stuporous on the fourth hospital day and the brain MRI showed acute cerebral infarction. He was treated with penicillin intravenously for six weeks, which successfully controlled clinical features of infections. To our knowledge, this is the first case of P. multocida endocarditis complicated with cerebral infarction in Korea.
Adult ; Animals ; Brain ; Cerebral Infarction* ; Echocardiography ; Endocarditis* ; Fever ; Headache ; Humans ; Korea ; Magnetic Resonance Imaging ; Mitral Valve ; Mitral Valve Insufficiency ; Pasteurella multocida* ; Pasteurella* ; Penicillins ; Stupor

Group G beta-hemolytic Streptococcus is a normal flora of skin, pharynx, female genital tract, and intestine. Group G beta-hemolytic Streptococcus has been reported to cause a variety of human infections, such as pharyngitis, soft tissue infection, arthritis, osteomyelitis, respiratory infection, endocarditis, meningitis, puerperal infection, neonatal sepsis and peritonitis. But liver abscess caused by group G beta-hemolytic Streptococcus has not been reported to date. We report two cases of liver abscess caused by group G beta-hemolytic Streptococcus. One patient with underlying neurofibromatosis presented with fever and diarrhea; the other patient presented with fever and pain on the right upper quadrant of abdomen. Hepatic abscess was diagnosed by computerized tomography and confirmed by percutaneous needle aspiration. Cultures of pus obtained by aspiration revealed group G beta-hemolytic Streptococcus, which were susceptible all tested antibiotics, including penicillin.
Abdomen ; Anti-Bacterial Agents ; Arthritis ; Diarrhea ; Endocarditis ; Female ; Fever ; Humans ; Intestines ; Liver Abscess* ; Liver* ; Meningitis ; Needles ; Neurofibromatoses ; Osteomyelitis ; Penicillins ; Peritonitis ; Pharyngitis ; Pharynx ; Puerperal Infection ; Sepsis ; Skin ; Soft Tissue Infections ; Streptococcus* ; Suppuration

Purpose: Larynx-preserving surgery (LPS) have recently gained popularity and achieved comparable oncologic outcomes to conventional radical surgery for localized hypopharyngeal cancer (HPC). In the current study, the role of LPS has been assessed thoroughly in comparison with upfront radiation therapy (RT). Materials and Methods: We retrospectively reviewed 185 candidates for LPS with cT1-2 disease; 59 patients underwent upfront LPS while 126 patients received upfront RT, respectively. Oncological and functional outcomes were investigated and compared. Results: Following LPS, safe margin (≥ 5 mm) was achieved in 37.3% of patients. Overall, better clinical outcomes at 5 years were achieved following upfront LPS than those following upfront RT: overall survival (OS) (72.7% vs. 59.0%, p=0.045), disease-free survival (DFS) (59.8% vs. 45.0%, p=0.039), and functional laryngeal preservation (100% vs. 89.7%, p=0.010). Although similar outcomes were observed in patients with cT1 disease, better 5-year DFS was achieved following upfront LPS in patients with cT2 disease (57.0% vs. 36.4%, p=0.023) by virtue of better local control. Despite frequent cN2-3 disease in upfront LPS group, comparable outcomes were observed between upfront RT and LPS group. However, multivariable analyses revealed that performance status and double primary cancer diagnosed within 6 months of HPC diagnosis affected OS significantly, while treatment modality per se did not. Conclusion Although upfront LPS could provide better local control than upfront RT in patients with cT2 disease, overall outcomes were comparable following either modality. Treatment selection of larynx-preserving approach for HPC should be individualized based on tumor and patient factors.

Solid organ transplantation has been established as an accepted treatment modality for end-stage diseases. Although the prognosis for organ recipients has improved with the development of surgical technical skills and the application of newly developed immunosuppressive agents, opportunistic infections remain the major cause of death in these patients. Invasive aspergillosis is one of the most common fungal infections in solid organ transplantation, and it carries a high mortality rate. In Korea, eight sporadic cases of invasive aspergillosis after kidney or heart transplantation have been reported. Recently, we experienced five cases of invasive aspergillosis after liver or heart transplantation over a four year period. Among these five patients, three died of uncontrollable aspergillosis and one died of heart failure and graft rejection. Early diagnosis and treatment are essential for the improvement of the prognosis for invasive aspergillosis after solid organ transplantation.
Aspergillosis* ; Cause of Death ; Early Diagnosis ; Graft Rejection ; Heart Failure ; Heart Transplantation ; Humans ; Immunosuppressive Agents ; Kidney ; Korea ; Liver ; Mortality ; Opportunistic Infections ; Organ Transplantation* ; Prognosis ; Transplants*