From September 1992 to April 1994, we reviewed 7 patients after arthroscopic surgery for anterior impingement in the ankle, who complained ankle pain and limitation of motion. All patients were mem and main symptoms were severe pain at full dorsiflexion of ankle and limitation of motion. Bony spur was located on the anterior aspect of tibia, and it was possible to resect the tibial bony spur arthroscopically without distraction devices. Mean operation time was 55 minutes. Pain, swelling and limitation of motion were much improved. There was no postoperative complication. Arthroscopic resection of the anterior tibial bony spur is an effective treatment for anterior impingement in the ankle.
Ankle ; Arthroscopy ; Humans ; Postoperative Complications ; Tibia

Objectives: Obstructive sleep apnea (OSA) is a common clinical disease which has been associated with cardiovascular disease and sudden death. Positive airway pressure (PAP) is the most effective treatment for OSA; however, most patients experience difficulties in tolerating machines, masks, or economic burdens. In Korea, National Health Insurance (NHI) application for PAP started in July 2018. Therefore, this study aimed to evaluate the PAP adherence and factors contributing to good adherence after NHI coverage in Korea. Methods: A retrospective study was performed to examine 89 patients with OSA who were treated with PAP in 2019. All medical records were analyzed to obtain demographic and clinical data, including personal history, polysomnographic data, and PAP results. Results: A total of 66 participants were included, of which 56 (84.8%) were maintained on PAP therapy after 3 months, and 32 of 42 (76.1%) were maintained on PAP therapy after 6 months; prolonged rapid eye movement (REM) sleep latency, increased nonREM (NREM) apnea-hypopnea index (AHI), and supine AHI significantly contributed to good PAP adherence for 3 months. At 6 months, prolonged REM sleep latency, increased NREM AHI, supine AHI, and increased arousal index significantly contributed to good PAP adherence. However, comorbid hypertension contributed to poor PAP compliance. Conclusions PAP adherence in patients with OSA was 84.8% after 3 months, and 76.1% after 6 months after NHI coverage in a regional tertiary sleep center in Korea. Prolonged REM sleep latency and increased supine AHI and NREM AHI significantly contributed to good adherence, whereas comorbid hypertension was a factor for poor PAP compliance.

Objectives: Obstructive sleep apnea (OSA) is a common clinical disease which has been associated with cardiovascular disease and sudden death. Positive airway pressure (PAP) is the most effective treatment for OSA; however, most patients experience difficulties in tolerating machines, masks, or economic burdens. In Korea, National Health Insurance (NHI) application for PAP started in July 2018. Therefore, this study aimed to evaluate the PAP adherence and factors contributing to good adherence after NHI coverage in Korea. Methods: A retrospective study was performed to examine 89 patients with OSA who were treated with PAP in 2019. All medical records were analyzed to obtain demographic and clinical data, including personal history, polysomnographic data, and PAP results. Results: A total of 66 participants were included, of which 56 (84.8%) were maintained on PAP therapy after 3 months, and 32 of 42 (76.1%) were maintained on PAP therapy after 6 months; prolonged rapid eye movement (REM) sleep latency, increased nonREM (NREM) apnea-hypopnea index (AHI), and supine AHI significantly contributed to good PAP adherence for 3 months. At 6 months, prolonged REM sleep latency, increased NREM AHI, supine AHI, and increased arousal index significantly contributed to good PAP adherence. However, comorbid hypertension contributed to poor PAP compliance. Conclusions PAP adherence in patients with OSA was 84.8% after 3 months, and 76.1% after 6 months after NHI coverage in a regional tertiary sleep center in Korea. Prolonged REM sleep latency and increased supine AHI and NREM AHI significantly contributed to good adherence, whereas comorbid hypertension was a factor for poor PAP compliance.

Purpose: The purpose of this study was threefold: to explore the causal attributions of breast cancer, examine underlying factors of the attributes, and determine their relationship to quality of life among Korean breast cancer survivors. Methods: The study used a descriptive correlational design, which included quantitative survey questionnaires and an open-ended question to complement the study. Three hundred and three breast cancer survivors were recruited from two university hospitals in South Korea, between January and April 2018. The causal attributions were explored using the Illness Perception Questionnaire Revised and an open-ended question. The survivors' quality of life was assessed using the Functional Assessment of Cancer Therapy for Breast Cancer. The quantitative analysis was performed using the SPSS 25.0 software package; the ATLAS.ti 8 software was used for thematic analysis. Results: Quantitative and qualitative data of 321 and 238 breast cancer survivors, respectively, were analyzed. “Stress and worry” and “diet or eating habits” were believed to be the two most likely causes of breast cancer. Eleven new causal attributes emerged from the analysis. Being diagnosed with breast cancer at an older age (p < .05), having received chemotherapy (p < .05), and holding nonbehavioral causal attributes (p < .001), were significantly related to lower quality of life. Conclusion There were differences between the survivors' beliefs on their causes of disease, and causal factors available from the literature. As the survivors' causal attributes were significantly related to their quality of life, healthcare providers should individually assess and incorporate these attributes into their care.

Purpose: The purpose of this study was threefold: to explore the causal attributions of breast cancer, examine underlying factors of the attributes, and determine their relationship to quality of life among Korean breast cancer survivors. Methods: The study used a descriptive correlational design, which included quantitative survey questionnaires and an open-ended question to complement the study. Three hundred and three breast cancer survivors were recruited from two university hospitals in South Korea, between January and April 2018. The causal attributions were explored using the Illness Perception Questionnaire Revised and an open-ended question. The survivors' quality of life was assessed using the Functional Assessment of Cancer Therapy for Breast Cancer. The quantitative analysis was performed using the SPSS 25.0 software package; the ATLAS.ti 8 software was used for thematic analysis. Results: Quantitative and qualitative data of 321 and 238 breast cancer survivors, respectively, were analyzed. “Stress and worry” and “diet or eating habits” were believed to be the two most likely causes of breast cancer. Eleven new causal attributes emerged from the analysis. Being diagnosed with breast cancer at an older age (p < .05), having received chemotherapy (p < .05), and holding nonbehavioral causal attributes (p < .001), were significantly related to lower quality of life. Conclusion There were differences between the survivors' beliefs on their causes of disease, and causal factors available from the literature. As the survivors' causal attributes were significantly related to their quality of life, healthcare providers should individually assess and incorporate these attributes into their care.

Metastasizing mixed tumors (MMT) of salivary glands are inexplicably metastasize maintaining benign histology. There is no pathologic and flow cytometric analysis criteria to predict the metastasis. MMT is known to metastasize by local implantation, vascular and lymphatic embolization after multiple surgery to local recurrences of primary tumor. However, multiple metastasis including cranium and spine occurred even without surgery to the primary tumor in this case. No pathological evidence of malignancy could be found in both primary and metastatic tumor. MMT is considered as an low grade malignancy based on clinical behavior rather than histologic evidence, such as low mortality rate, long delay of metastasis after primary lesion. Cranial metastasis is also extremely rare and only two cases have been reported. We report this unusual case with a literature review.
Mortality ; Neoplasm Metastasis* ; Recurrence ; Salivary Glands* ; Skull ; Spine

BACKGROUND: Obstructive sleep apnea (OSA) is a common disease, but there are few studies about the quality of life (QOL) of Korean patients with OSA. The aims of the present study were compare the QOL of patients with OSA and healthy controls, and to determine the factors that influence the QOL in these patients. METHODS: This was a casecontrol study comparing the QOL of 136 OSA patients and 126 healthy controls. For all of the subjects, QOL and the severity of subjective symptoms were evaluated using various questionnaires, including the Korean versions of the Medical Outcome Study Short Form-36 (SF-36), the Pittsburg Sleep Quality Index (PSQI-K), the Epworth Sleepiness Scale (KESS), the Insomnia Severity Index (ISI), the Beck Depression Inventory (KBDI)-2, and the Hospital Anxiety Scale (HAS). RESULTS: The QOL was worse in patients with OSA than in the controls, but there was no association between the severity of OSA and the degree of worsening of QOL. Multiple stepwise regression analysis revealed that the strongest associations were found between QOL and HAS, ISI and BDI-2 scoring in OSA patients. CONCLUSIONS: These findings demonstrate that OSA represents a considerable burden on the QOL of Koreans, and suggest that the impairment in QOL of Koreans with OSA is related to the degree of anxiety, insomnia and depression that they suffer.
Anxiety ; Depression ; Humans ; Outcome Assessment (Health Care) ; Quality of Life* ; Surveys and Questionnaires ; Sleep Apnea, Obstructive* ; Sleep Initiation and Maintenance Disorders

Japanese-B viral encephalitis (JE) usually has a monophasic illness pattern. A 45-year-old woman in an altered mentality had improved over 1 month. About 1 week after the initial improvement, the patient became comatose with aggravated EEG and MRI findings. Assays of cerebrospinal fluid and serum were positive for the IgM antibody to Japanese-B virus. After intravenous immunoglobulin (IVIG) infusion, the patient recovered. We report a patient with JE who showed a biphasic illness pattern and recovered after IVIG therapy.
Cerebrospinal Fluid ; Coma ; Electroencephalography ; Encephalitis, Viral* ; Female ; Humans ; Immunization, Passive* ; Immunoglobulin M ; Immunoglobulins ; Immunoglobulins, Intravenous ; Magnetic Resonance Imaging ; Middle Aged

PURPOSE: The current TNM staging system for papillary thyroid cancer (PTC), which is based on tumor diameter, may not precisely reflect the true tumor burden. Therefore, we investigated whether preoperative tumor volume might more accurately reflect tumor burden and predict prognosis in patients with T1N0 PTC than preoperative tumor diameter. MATERIALS AND METHODS: We retrospectively reviewed data from 1,659 patients with T1N0 PTC, and after exclusion, a total of 1,081 patients were ultimately included. Tumor volume (V) was calculated for all patients using preoperative ultrasonography, and patients were grouped according to tumor diameter (T1a vs. T1b) and tumor volume (V1a vs. V1b). The recurrence-free survival (RFS) rates were then compared for these groups. RESULTS: The mean follow-up time was 66.12±28.75 months, and 97.2% of the cohort experienced RFS. The optimal volume cut-off was defined as 0.545 cm³. There were no differences in RFS rates between T1a/T1b groups (all ages) and V1a/V1b groups (< 45 years of age). However, ≥ 45-year-old patients in the V1b group had a significantly poorer RFS rate than those in the V1a group. These results were confirmed by multivariate analysis. CONCLUSION: Our results indicate that preoperative tumor volume may be more useful for predicting prognosis than tumor diameter in ≥ 45-year-old patients with T1N0 PTC.
Cohort Studies ; Follow-Up Studies ; Humans ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Tumor Burden* ; Ultrasonography

The combination of melanocytic nevus with other tumors of epidermal or adnexal origin has been described since the first case reported by Andresen and Enos in 1952. Most of reported cases are melanocytic nevi combined with common epidermoid cysts. The combination of nevus and cyst could possibly be misdiagnosed clinically as a malignant melanoma upon initial examination. A 58-year-old woman presented with an asymptomatic, solitary, skin-colored, erythematous 1.0 cm-diameter pedunculated nodule on the occipital scalp which had been present childhood. The histopathologic specimen of the nodule showed a solitary cyst surrounded by intradermal melanocytic nevus. The cyst was located in the dermis lined by squamous epithelium, which was ruptured and inflamed. It contained degenerated keratin materials and multiple transversely and obliquely cut vellus hairs. We herein report a rare case of melanocytic nevus combined with a vellus hair cyst.
Bone Cysts ; Dermis ; Epidermal Cyst ; Epithelium ; Female ; Hair* ; Humans ; Melanoma ; Middle Aged ; Nevus ; Nevus, Pigmented* ; Scalp