Neurosensory dysfunction of the injured inferior alveolarnerve(IAN) is a common and distrssing consequence of traumatic or iatrogenic injury. Conventional neurosensory testing has been used to detect and monitor sensory impairments of the injured IAN. However, these tests had low reliability and are not qualitative at best because they are based on solely on the patient's subjective assesment of symptoms. Consequently, there is need for more reliable, sensitive, and objective test measures to document and to monitor sensory dysfunction of the trigeminal nerve. This study was to investigate DITI's (digital infrared thermographic imaging) potential as a diagnostic alternative for evaluating of the nerve injures and sensory disturbance. Subjects were 30 patients who had been referred to Ewha Medical Center due to sensory disturbance of the lower lip and chin followed after unobserved inferior alveolar nerve injuries. The patients were examined by clinical neurosensory tests as SLTD (static light touch discrimination), MDD (moving direction discrimination), PPN (pin prick nociception) and DITI (digital infrared thermographic imaging). The correlation between clinical sensory dysfunction scores(Sum of SLTD, MDD, PPN, NP, Tinel sign) and DITI were tested by Spearman nonparametric rank correlation anaylsis & Kruskal-Wallis test, Wilcoxon 2-sample test. This study resulted in as follows; 1) The difference of thermal difference between normal side and affected side was as delta-3.2+/-0.13. 2) The DITI differences of the subjects presenting dysesthesia of the lip and chin were correlated significantly with the neurosensory dysfunction scores(r=0.419, p=0.021)and SLTD (r=0.429, p < 0.05). 3) The MDD, PPN, NP, Tinel sign, duration, gender were not correlated with DITI(p > 0.05). Therefore, the DITI(digital infrared thermographic imaging) can be an option of the useful objective diagnostic methods to evaluate the injured inferior alveolar nerve and sensory dysfunction of trigerminal nerve.
Chin* ; Equidae ; Humans ; Lip* ; Mandibular Nerve ; Paresthesia* ; Trigeminal Nerve

PURPOSE: This study was conducted to assess optimal needle length for gluteal intramuscular injections (IM) via simple skinfold thickness (SFT). METHODS: For this study, 190 healthy adults were recruited and grouped into eight groups according to gender and body mass index (BMI) (kg/m2). The Korean Society for the Study of Obesity criteria defines a BMI under 20 as underweight, 20.1-22.9 as normal, 23-24.9 as overweight and over 25 as obese. For each participant, the SFT of dorsoguteal (DG) and ventrogluteal (VG) sites were measured using a caliper. Subcutaneous tissue thickness was acquired through ultrasonic images. RESULTS: For men in the overweight and obese groups at the DG site, for the obese group at the VG site, and for women in the normal weight, overweight and obese groups at both sites, the mean subcutaneous tissue thickness exceeded 1.84 cm, the minimal length for a 1 inch needle used for IM. At the DG site, optimal intramuscular needle length (OINL) was 1.4 times in women and 1.0 times in men compared to SFT. At the VG site, OINL was 1.3 times in women and 0.9 times in men compared to SFT. CONCLUSION: The results of this study suggest that SFT is a reliable index to determine optimal needle length with minimal effort prior to IM.
Adolescent ; Adult ; Aged ; Body Mass Index ; Equipment Design ; Female ; Humans ; Injections, Intramuscular/*instrumentation ; Male ; Middle Aged ; Needles ; Republic of Korea ; Sex Factors ; *Skinfold Thickness ; Subcutaneous Fat/ultrasonography

Therapeutic hypothermia in cardiac arrest patients is associated with favorable outcomes mediated via neuroprotective mechanisms. We report a rare case of a 32-year-old male who demonstrated complete recovery of signal changes on perfusion-weighted imaging after therapeutic hypothermia due to cardiac arrest. Brain MRI with perfusion-weighted imaging, performed three days after ending the hypothermia therapy, showed a marked decrease in relative cerebral blood flow (rCBF) and delay in mean transit time (MTT) in the bilateral basal ganglia, thalami, brain stem, cerebellum, occipitoparietal cortex, and frontotemporal cortex. However, no cerebral ischemia was not noted on diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) sequences. A follow-up brain MRI after one week showed complete resolution of the perfusion deficit and the patient was discharged without any neurologic sequelae. The mechanism and interpretation of the perfusion changes in cardiac arrest patients treated with therapeutic hypothermia are discussed.
Adult ; Basal Ganglia ; Brain ; Brain Ischemia ; Brain Stem ; Cerebellum ; Cerebrovascular Circulation ; Follow-Up Studies ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Magnetic Resonance Imaging ; Male ; Perfusion

Intracranial chordoma is a rare tumor, originating from embryonic remnants of the primitive notochord. It typically appears as an enhancing extradural midline tumor with bone involvement. We introduce a rare case of a 27-year-old male who had a nonenhancing intradural chordoma showing paramedian location, involving the left cavernous sinus, Meckel's cave, and prepontine cistern. The pathologic diagnosis was confirmed as an intradural chordoma. The imaging findings of this unusual case of a nonenhancing intradural paramedian chordoma will be presented with the differential diagnosis focused on the epidermoid cyst.

Background: Recent studies have reported the burden of attention deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and depressive disorder. Also, there is mounting evidence on the effects of environmental factors, such as ambient air pollution, on these disorders among children and adolescents. However, few studies have evaluated the burden of mental disorders attributable to air pollution exposure in children and adolescents. Methods: We estimated the risk ratios of major mental disorders (ADHD, ASD, and depressive disorder) associated with air pollutants among children and adolescents using time-series data (2011–2019) obtained from a nationwide air pollution monitoring network and healthcare utilization claims data in the Republic of Korea. Based on the estimated risk ratios, we determined the population attributable fraction (PAF) and calculated the medical costs of major mental disorders attributable to air pollution. Results: A total of 33,598 patients were diagnosed with major mental disorders during 9 years. The PAFs for all the major mental disorders were estimated at 6.9% (particulate matter < 10 μm [PM10 ]), 3.7% (PM2.5 ), and 2.2% (sulfur dioxide [SO2 ]). The PAF of PM10 was highest for depressive disorder (9.2%), followed by ASD (8.4%) and ADHD (5.2%). The direct medical costs of all major mental disorders attributable to PM10 and SO2 decreased during the study period. Conclusion This study assessed the burden of major mental disorders attributable to air pollution exposure in children and adolescents. We found that PM10, PM2.5 , and SO2 attributed 7%, 4%, and 2% respectively, to the risk of major mental disorders among children and adolescents.

Background: Recent studies have reported the burden of attention deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and depressive disorder. Also, there is mounting evidence on the effects of environmental factors, such as ambient air pollution, on these disorders among children and adolescents. However, few studies have evaluated the burden of mental disorders attributable to air pollution exposure in children and adolescents. Methods: We estimated the risk ratios of major mental disorders (ADHD, ASD, and depressive disorder) associated with air pollutants among children and adolescents using time-series data (2011–2019) obtained from a nationwide air pollution monitoring network and healthcare utilization claims data in the Republic of Korea. Based on the estimated risk ratios, we determined the population attributable fraction (PAF) and calculated the medical costs of major mental disorders attributable to air pollution. Results: A total of 33,598 patients were diagnosed with major mental disorders during 9 years. The PAFs for all the major mental disorders were estimated at 6.9% (particulate matter < 10 μm [PM10 ]), 3.7% (PM2.5 ), and 2.2% (sulfur dioxide [SO2 ]). The PAF of PM10 was highest for depressive disorder (9.2%), followed by ASD (8.4%) and ADHD (5.2%). The direct medical costs of all major mental disorders attributable to PM10 and SO2 decreased during the study period. Conclusion This study assessed the burden of major mental disorders attributable to air pollution exposure in children and adolescents. We found that PM10, PM2.5 , and SO2 attributed 7%, 4%, and 2% respectively, to the risk of major mental disorders among children and adolescents.

Background: Recent studies have reported the burden of attention deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and depressive disorder. Also, there is mounting evidence on the effects of environmental factors, such as ambient air pollution, on these disorders among children and adolescents. However, few studies have evaluated the burden of mental disorders attributable to air pollution exposure in children and adolescents. Methods: We estimated the risk ratios of major mental disorders (ADHD, ASD, and depressive disorder) associated with air pollutants among children and adolescents using time-series data (2011–2019) obtained from a nationwide air pollution monitoring network and healthcare utilization claims data in the Republic of Korea. Based on the estimated risk ratios, we determined the population attributable fraction (PAF) and calculated the medical costs of major mental disorders attributable to air pollution. Results: A total of 33,598 patients were diagnosed with major mental disorders during 9 years. The PAFs for all the major mental disorders were estimated at 6.9% (particulate matter < 10 μm [PM10 ]), 3.7% (PM2.5 ), and 2.2% (sulfur dioxide [SO2 ]). The PAF of PM10 was highest for depressive disorder (9.2%), followed by ASD (8.4%) and ADHD (5.2%). The direct medical costs of all major mental disorders attributable to PM10 and SO2 decreased during the study period. Conclusion This study assessed the burden of major mental disorders attributable to air pollution exposure in children and adolescents. We found that PM10, PM2.5 , and SO2 attributed 7%, 4%, and 2% respectively, to the risk of major mental disorders among children and adolescents.

Background: Recent studies have reported the burden of attention deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and depressive disorder. Also, there is mounting evidence on the effects of environmental factors, such as ambient air pollution, on these disorders among children and adolescents. However, few studies have evaluated the burden of mental disorders attributable to air pollution exposure in children and adolescents. Methods: We estimated the risk ratios of major mental disorders (ADHD, ASD, and depressive disorder) associated with air pollutants among children and adolescents using time-series data (2011–2019) obtained from a nationwide air pollution monitoring network and healthcare utilization claims data in the Republic of Korea. Based on the estimated risk ratios, we determined the population attributable fraction (PAF) and calculated the medical costs of major mental disorders attributable to air pollution. Results: A total of 33,598 patients were diagnosed with major mental disorders during 9 years. The PAFs for all the major mental disorders were estimated at 6.9% (particulate matter < 10 μm [PM10 ]), 3.7% (PM2.5 ), and 2.2% (sulfur dioxide [SO2 ]). The PAF of PM10 was highest for depressive disorder (9.2%), followed by ASD (8.4%) and ADHD (5.2%). The direct medical costs of all major mental disorders attributable to PM10 and SO2 decreased during the study period. Conclusion This study assessed the burden of major mental disorders attributable to air pollution exposure in children and adolescents. We found that PM10, PM2.5 , and SO2 attributed 7%, 4%, and 2% respectively, to the risk of major mental disorders among children and adolescents.

OBJECTIVE: To study the neonatal outcomes of pregnancies complicated with preterm premature rupture of the membranes (PPROM) and to assess the prognostic factors for poor neonatal outcomes. METHODS: We performed a retrospective study of pregnancies registered and managed in Korea from Jan 1st, 2000 to Dec 31st, 2005. The 217 women with preterm premature rupture of membranes in singleton pregnancies from 16 to 36 gestational weeks were enrolled in this study. We investigated respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and neonatal infection for poor neonatal outcomes. Prognostic variables included for analysis were age, BMI, parity, history of PPROM, history of preterm labor, preterm labor, amniotic fluid index, tocolysis, antibiotics, antenatal steroid, hemoglobin, WBC, CRP, gestational age at PPROM, interval from PPROM to delivery, gestational age at delivery, placental findings, and etc. We compared the characteristics of those who developed neonatal morbidity (n=144) with those who did not (n=65) using the Student t test for continuous variables, and the Pearson's chi-square or the Fisher exact test for categorical variables. RESULTS: Total of 217 cases of PPROM were registered and treated expectantly during the study period. The majority of cases were delivered within 48 hours of PPROM. There were 64 cases diagnosed with RDS, 21 with IVH, 3 with NEC, 117 with neonatal infection and 8 neonatal mortalities. The gestational age at PPROM (p<0.000), interval from PPROM to delivery (p<0.036), gestational age at delivery (p<0.000), decreased amniotic fluid index (p<0.048), and high level of WBC, CRP (p<0.010, p<0.049) were significantly correlated with poor neonatal outcomes. Birth weight (p<0.000) and APGAR (p<0.000) score at 5 minute were significantly lower in cases resulting in neonatal morbidity. CONCLUSION: Neonatal outcomes of pregnancies with preterm premature rupture of membranes are related to gestational age at PPROM, interval from PPROM to delivery, and gestational age at delivery. The decreased amniotic fluid index, and high level of WBC, CRP presented before delivery are significantly correlated with poor neonatal outcomes. Birth weight and APGAR scores at 5 minute are significantly lower in cases resulting in neonatal morbidity.
Amniotic Fluid ; Anti-Bacterial Agents ; Birth Weight ; Enterocolitis, Necrotizing ; Female ; Gestational Age ; Hemorrhage ; Humans ; Infant ; Infant Mortality ; Korea ; Membranes* ; Obstetric Labor, Premature ; Parity ; Pregnancy* ; Retrospective Studies ; Rupture* ; Tocolysis

OBJECTIVES: Kienbock's disease, which is characterized by osteonecrosis of the lunate bone, causes progressive chronic pain and dysfunction of the hand and wrist. Even though occurrence of the disease was reported approximately 100 years ago and it is suspected to be work-related to some degree, the etiology has not been clearly discribed and the disease has rarely been considered as an occupation-related disease. As such, we submit this case as the first report of Kienbock's disease in Korea, with clinical findings, x-ray, MRI (magnetic resonance imaging) and strain index results along with a literature review. METHODS: The patient was carefully interviewed and her medical records were properly reviewed by the authors with her consent. The authors also visited her factory work site to inspect and videotape the working environment and to conduct an ergonomic evaluation with a strain index. RESULTS: Excessively repeated contact stress was found to be concentrated on her right hand and the environment was discovered to be hazardous from an ergonomic standpoint. The literature review revealed that heavy loads on the hand might be related to the cause or deterioration associated with Kienbock's disease. ; therefore, it is very likely that her disease is related to her work. CONCLUSIONS: There is much evidence to suggest that heavy workloads involving hand and wrist intensive tasks may cause and worsen Kienbock's disease. However, to date epidemiologic studies clarifying the etiology of the disease have not been sufficiently reported. Therefore, further research focusing on the etiology and prevention of the disease are required. In addition, practical guidelines for hand and wrist intensive tasks are needed to prevent disease development and worsening.
Chronic Pain ; Glycogen Storage Disease Type VI ; Hand ; Humans ; Korea ; Lunate Bone ; Medical Records ; Occupational Diseases ; Osteonecrosis ; Sprains and Strains ; Videotape Recording ; Workplace ; Wrist