We present a case of a 19-year-old male with portal vein gas embolism resulting from accidental ingestion of 35% hydrogen peroxide. Hydrogen peroxide is a commonly used germicidal cleansing agent. When it is applied to tissues, catalase causes its rapid molecular decomposition with the release of oxygen bubbles. The patient recovered without sequelae. Hyperbaric oxygenation may be of benefit in patients with respiratory compromise or central nervous system symptoms from gas embolism in hydrogen peroxide ingestion.
Catalase ; Central Nervous System ; Detergents ; Eating* ; Embolism, Air* ; Humans ; Hydrogen Peroxide* ; Hydrogen* ; Hyperbaric Oxygenation ; Male ; Oxygen ; Portal Vein* ; Young Adult

Hantaviruses are members of the family Bunyaviridae, the etiologic agents of Hemorrhagic fever with renal syndrome (HFRS) and Hantavirus Pulmonary Syndrome (HPS). They are negative-sense, single-stranded RNA viruses possessing a large (L), medium (M) and small (S) genomic segment which encodes a viral polymerase, envelope glycoproteins (G1 and G2) and a nucleocapsid (N) protein, respectively. Seoul (SEO) virus, the causative agent of clinically mild HFRS in worldwide, was isolated from lung tissues of urban rat (Rattus norvegicus) captured in Seoul, Korea, 1982. To clarify the antigenic characteristics and the differentiation of serotypes of hantavirus, 8 hybridoma cell lines secreting monoclonal antibodies (MAbs) against SEOV 80-39 strain were produced by fusion of SP2/0-Ag14 mouse myeloma cells with spleen cells of BALB/c mice, immunized with SEOV. Reactivities of these MAbs were examined by the indirect immunofluorescence assay (IFA), enzyme linked immunosorbent assay (ELISA), immunoblot, high density particle agglutination (HDPA) and plaque reduction neutralization test (PRNT). Eight out of 235 hybridomas secreted MAbs of Seoul virus 80-39 continuously, and these eight MAbs were all IgG. The isotypes of these 8 MAbs are; one clone (F3-3C) was IgG1, six (F1-1B9B, F1-3B, F1-3D, F4-1E, F4-3F, F4- 6C) were IgG2a and one (F1-1B9F) was IgG2b. Seven MAbs (F1-1B9B, F1-1B9F, F1-3B, F1- 3D, F3-3C, F4-1E, F4-3F) reacted with nucleocapsid protein (M.W. 50K) of SEOV by immunoblot. All eight MAbs were cross-reacted with Hantaan (HTN) virus, one (F4-3F) was cross-reacted with Puumala (PUU) virus and two (F1-1B9B, F1-3B) were cross-reacted with Prospect Hill (PH) virus by IFAT. None of these 8 MAbs had neutralizing activity.
Agglutination ; Animals ; Antibodies, Monoclonal* ; Bunyaviridae ; Cell Line ; Clone Cells ; Enzyme-Linked Immunosorbent Assay ; Fluorescent Antibody Technique, Indirect ; Glycoproteins ; Hantavirus ; Hantavirus Pulmonary Syndrome ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Hybridomas ; Immunoglobulin G ; Korea ; Lung ; Mice ; Neutralization Tests ; Nucleocapsid ; Nucleocapsid Proteins ; Rats ; RNA Viruses ; Seoul virus* ; Seoul* ; Spleen

STUDY DESIGN: This is a retrospective study. OBJECTIVE: We analyzed the clinical and radiographic results of surgical treatment for patients with tuberculous spondylitis. MATERIAL AND METHODS: Our study included 18 active tuberculous spondylitis patients (12 males and 6 females) who underwent anterior curettage, strut bone grafting and posterior instrumentation. Their average age was 50.1 years (age range: 24-76 years). The mean follow-up was 43 months. Vertebral bodies from T5 to L5 were involved. The anterior column support was iliac autograft in 10 patients and titanium mesh in 4. All the patients had transpedicular instrumentation with an additional hook in 3 and anterior instrumentation in 1. Except for one paraplegic patient, all the others were able to ambulate wearing TLSO. The mean duration of Anti-Tbc medication was 13.3 months (range: 12 to 18 months). The clinical and radiographic results were analyzed, and they included the segmental kyphotic angle and the complications of instrumentation on the involved vertebrae. RESULT: The subjective satisfaction was greater than good except for 2 patients. These 2 patients' satisfaction was fair due to incomplete neurologic recovery and persistent BG-donor site pain. The three paraplegic patients fully recovered postoperatively. The mean correction of the segmental kyphosis was 13 degrees. The mean correction loss was 0.7 degrees at the final follow-up. Pedicle screws were inserted in the involved vertebrae for 10 patients (n = 30). There was no loosening of instrumentation nor spread or recurrence of infection. One case was complicated by pneumonia. CONCLUSION: For the surgical treatment of active tuberculous spondylitis, anterior column support with strut grafting and posterior instrumentation is mandatory in the destabilized spine after anterior debridement or the correction of kyphosis.
Autografts ; Bone Transplantation ; Curettage ; Debridement* ; Follow-Up Studies ; Humans ; Kyphosis ; Male ; Pneumonia ; Recurrence ; Retrospective Studies ; Spine ; Spondylitis* ; Titanium ; Transplants*

In this study, the cause, diagnosis, and treatment of common lower limb injuries during the sports activities were presented. Sports injuries of the lower limbs are the most common injuries in the sports medicine field due to the high level of use of the lower limbs during sports activities. The common causes of leg injuries in athletes are traumatic force over the critical limit of normal tissue, repetitive microtrauma, and overuse. Common hip and pelvis problems encountered by the authors include trochanteric bursitis, snapping hip syndrome, and labral tears. The anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, and meniscus have been most frequently involved in sports injuries affecting the knees. Lateral ankle sprain represents one of common injuries in the athletic population. Common overuse injuries are tendinopathies, stress fractures, chronic exertional compartment syndrome, and shin splints. Athletic activity provides a variety of positive benefits to participants' health. To safely continue those activities, an injury prevention program focusing on injuries that may occur in specific sports activities is recommended for participants. Early diagnosis and proper treatment are also important in promoting prompt recovery and preventing secondary injuries.
Animals ; Ankle ; Athletes ; Athletic Injuries ; Bursitis ; Collateral Ligaments ; Compartment Syndromes ; Cumulative Trauma Disorders ; Early Diagnosis ; Femur ; Fractures, Stress ; Hip ; Humans ; Knee ; Leg Injuries ; Lower Extremity ; Medial Tibial Stress Syndrome ; Orthopedics ; Pelvis ; Posterior Cruciate Ligament ; Sports ; Sports Medicine ; Sprains and Strains ; Tendinopathy

PURPOSE: To evaluate dynamic three-dimensional (3D) kinematic properties of the anterior cruciate ligament (ACL)-insufficient knees and healthy contralateral knees in awake patients during the Lachman test using biplane fluoroscopy. MATERIALS AND METHODS: Ten patients with unilateral ACL-insufficient knees and healthy contralateral knees were enrolled in this study. Each patient underwent the Lachman test three times in the awake state. The knee joint motions were captured using biplane fluoroscopy. After manual registration of 3D surface data from 3D-computed tomography to biplane images, dynamic 3D kinematic data were analyzed. RESULTS: The average anteroposterior (AP) translation of the medial femoral epicondyle of the ACL-insufficient knees (11.5+/-4.2 mm) was significantly greater than that of the contralateral knees (7.7+/-3.5 mm) (p<0.05). However, there was no statistically significant side-to-side difference in the average AP translation of the lateral femoral epicondyle. During the Lachman test, the distal femur was more externally rotated than the proximal tibia, which showed significant difference between both sides. CONCLUSIONS: During the Lachman test, the medial femoral epicondyle of the ACL-insufficient knee exhibited greater AP motion than that of the contralateral knee, whereas there was no significant side-to-side difference with regard to the AP motion of the lateral femoral epicondyle.
Anterior Cruciate Ligament ; Femur ; Fluoroscopy ; Humans ; Knee ; Knee Joint ; Tibia

PURPOSE: To analyze the results of a minimum of three-year follow-up in patients with a severely deformed sequelae pyogenic hip, who had undergone total hip arthroplasty with a simultaneous limb length correction. MATERIALS AND METHODS: The postoperative complication, clinical and the radiographic results were analyzed in 74 out of 102 patients, who were followed for a minimum of three years between December 1987 and May 2003. The average age was 42.8 years. The average follow-up duration was 4 years and 11 months. There were 50 tuberculosis infections, 24 pyogenic infections, and 23 fused hip cases. The average leg length shortening was 4.1 cm (range, 1.0-10.0 cm). RESULTS: Preoperative Harris hip score improved to 90.2 postoperatively from 65.0 (range, 25-92.5) preoperatively. Leg length shortening was corrected by 0.4 cm (0.0-3.0 cm). Radiographically, excluding the 3 revisions, no case met the criteria of definite loosening. The postoperative complications included the recurrence of tuberculosis (2 cases), and variable nerve palsies, including femoral nerve (3 cases), and a sciatic nerve (3 cases). These patients completely recovered from nerve palsy. B-K amputation, after the postoperative exacerbation of circulation to the affected limb, was needed in one case with a preoperatively undetected femoral artery occlusion. CONCLUSION: Although, restoring the normal limb length in the severely deformed pyogenic hip sequelae patients requires highly demanding surgical techniques, with a relatively higher incidence of postoperative complications, it is possible to achieve a higher level of patient satisfaction and definite gait improvement.
Amputation ; Arthroplasty, Replacement, Hip* ; Extremities ; Femoral Artery ; Femoral Nerve ; Follow-Up Studies ; Gait ; Hip* ; Humans ; Incidence ; Leg ; Paralysis ; Patient Satisfaction ; Postoperative Complications ; Recurrence ; Sciatic Nerve ; Tuberculosis

PURPOSE: This study conducted a comparative analysis on 49 hips treated with a core decompression procedure and 19 hips treated with a Sugioka's transtrochanteric rotational osteotomy for a osteonecrosis of the femoral head (ONFH). MATERIALS AND METHODS: This study evaluated the relationship between the Ficat and Arlet Stage and the extent of the necrotic lesion (using Shimizu's Grade Classification), and the clinical outcome of each procedure. The patient's outcomes were assessed after a mean follow-up of 46 months (range=36-82 months) after the core decompression and 53 months (range=37-108 months) after the Sugioka's transtrochanteric rotational osteotomy. The results were considered successful if the patients were asymptomatic with no disease progression, and unsuccessful if there was radiographic (progression of the stage or collapse) or clinical failure (the need for an arthroplasty or subsequent salvage operation). RESULTS: Twenty one out of 49 cases (43%) in the core decompression group and 14 out of 19 (74%) in the rotational osteotomy group showed successful outcomes. In the core decompression group, among the 22 F-A Stage I hips, 15 (68%) hips had survived according to radiological criteria. All four (100%) Shimizu's Grade A hips of the F-A Stage I had successful results, which is in contrast to the 11 hips out of 18 hips (61%) of the Shimizu's Grade B and C hips (p<0.01). Six (38%) out of 16 F-A Stage IIA hips and two (25%) out of eight IIB hips in the core decompression group had successful results, while 11 (85%) out of 13 IIA and two (50%) out of four stage IIB hips in the rotational osteotomy group had successful results. In the F-A Stage III hips, all 2 hips in the Sugioka transtrochanteric rotational osteotomy treatment group had survived, while none of the three Shimizu's Grade C hips in the core decompression group were successful. CONCLUSION: A core decompression is effective only in the earliest stages of osteonecrosis (F-A Stage I), which means that its success strongly depends on the location and extent of the femoral head necrosis. Sugioka's transtrochanteric rotational osteotomy is a more dependable procedure than a core decompression for treating large lesions of nonsteroidal ONFH, particularly for patients under the age of 50.
Arthroplasty ; Decompression* ; Disease Progression ; Follow-Up Studies ; Head* ; Hip ; Humans ; Necrosis ; Osteonecrosis* ; Osteotomy*

Objective: During the coronavirus disease 2019 (COVID-19) pandemic, the use of mechanical chest compression (meCC) devices for cardiopulmonary resuscitation (CPR) in emergency departments might have increased. However, there are few reports yet of such an increase in use. This study aimed to assess the current status of meCC device utilization in emergency medical institutions nationwide through a survey. Methods: This cross-sectional study conducted a survey from August 20, 2022 to September 29, 2022, using emails and text messages to target 287 out of a total of 409 emergency medical institutions nationwide for which contact information was obtained. Results: Of the 287 emergency medical institutions, 127 responded (44.2% response rate). Of these, 74 (58.3%) reported using meCC devices. The utilization rates were highest in the regional emergency medical center, followed by local emergency medical centers and local emergency medical agencies (93.3% vs. 67.3% vs. 27.1%, respectively; P<0.001). The most common reason for device purchases was to reduce rescuer fatigue and ensure high-quality CPR. The second reason was personnel shortages, while the regional emergency medical center gave a higher priority to the protection of medical staff from COVID-19. The meCC device group reported significantly higher cases of CPR (100 or more cases per year) compared to the non-meCC device group (64.9% vs. 24.6%; P<0.001) although no difference was shown in the total number of medical staff participated in CPR between the groups. Also, 90.5% of the meCC group expressed satisfaction with using the device. Conclusion More than 50% of emergency medical institutions used meCC devices in CPR, citing reasons such as reducing rescuer fatigue and ensuring high-quality CPR.

Objective: In this study we investigated whether current mood states of patients with bipolar disorder have an influence on the screening accuracy of the Mood Disorder Questionnaire (MDQ). Methods: A total of 452 patients with mood disorder (including 192 with major depressive disorder and 260 with bipolar disorder completed the Korean version of the MDQ. Patients with bipolar disorder were subdivided into three groups (bipolar depressed only, bipolar euthymic only, bipolar manic/hypomanic only) according to current mood states. The screening accuracy of the MDQ including sensitivity, specificity and area under the curve (AUC) of receiver operating characteristic (ROC) curves were evaluated according to current mood states. Results: The optimal cutoff of MDQ was 5 in this study sample. Sensitivity and specificity were not significantly different according to current mood states. Significant differences in AUCs of four independent ROC curves were not found (ROC 1st curve included all bipolar patients; ROC 2nd curve included only bipolar depressed patients; ROC 3rd curve included only bipolar manic/hypomanic patients; ROC 4th curve included only bipolar euthymic patients). Conclusion The study results showed that current mood states (either euthymic state, depressed or manic/hypomanic) did not significantly influence the screening accuracy of the MDQ suggesting that the MDQ could be a useful screening instrument for detecting bipolar disorder in clinical practice regardless of the current mood symptoms of subjects.

BACKGROUND/AIMS: Radiofrequency ablation (RFA) is an established curative therapeutic modality for unresectable hepatocellular carcinoma (HCC), and transarterial chemoembolization (TACE) has been used as a palliative treatment for inoperable HCC. It is still unknown whether RFA and TACE are equally effective for improving the survival of patients with unresectable HCC that is amenable to either treatment. The aim of this retrospective study was to compare the clinical impacts of two treatments, and analyze the prognostic factors for recurrence and survival. METHODS: Ninety-three patients with a single HCC smaller than 4 cm who showed complete responses (complete ablation or complete lipiodol tagging) after treatment with RFA (n=43) or TACE (n=50) between January 2002 and February 2009 were investigated. Univariate and multivariate analyses were performed for 13 potential prognostic factors using the Cox proportional-hazards model. RESULTS: The time-to-recurrence rates at 1, 2, and 3 years after treatment were 32.9%, 44.3%, and 55.4%, respectively, for the RFA group, and 42%, 68.3%, 71.7% for the TACE group. The probability of survival at 1, 2, and 3 years was 97.7%, 77.4%, and 63.1%, respectively, for the RFA group, and 95.9%, 76.1%, and 60.2% for the TACE group. The time-to-recurrence and overall survival rates did not differ significantly between the two treatment groups. A multivariate Cox proportional-hazards model revealed that a tumor size larger than 3 cm and lower serum albumin levels were independent risk factors for recurrence, and that being male, being seropositive for hepatitis B surface antigen, and having a higher serum albumin level were independent favorable prognostic factors for survival. CONCLUSIONS: TACE and RFA exhibited similar therapeutic effects in terms of recurrence and survival for patients with a single HCC smaller than 4 cm, if they could exhibited complete responses.
Adult ; Aged ; Carcinoma, Hepatocellular/mortality/surgery/*therapy ; *Catheter Ablation ; *Chemoembolization, Therapeutic ; Data Interpretation, Statistical ; Female ; Hepatitis B/complications ; Humans ; Liver Neoplasms/mortality/surgery/*therapy ; Male ; Middle Aged ; Prognosis ; Recurrence ; Retrospective Studies ; Risk Factors ; Serum Albumin/analysis ; Severity of Illness Index ; Sex Factors ; Survival Rate