Urethral calculi are relatively unusual. Moreover, to the best of our knowledge, there is no report in the literature of abscess formation related to calculus-induced urethral rupture. We report a case of a 57-year-old man with a periurethral abscess at the penoscrotal junction caused by urethral stones.
Abscess ; Calculi ; Humans ; Middle Aged ; Rupture ; Urethra ; Urogenital System

No abstract available.
Coronary Vessels*

BACKGROUND: Selective lumbar nerve root block (SNRB) is generally accepted as an effective treatment method for back pain with sciatica. However, it requires devices producing radioactive materials such as C-arm fluoroscopy. This study evaluated the usefulness of the longitudinal view of transverse process and needles for medial branch block as landmarks under ultrasonography. METHODS: We performed selective nerve root block for 96 nerve roots in 61 patients under the guidance of ultrasound. A curved probe was used to identify the facet joints and transverse processes. Identifying the lumbar nerve roots under the skin surface and ultrasound landmarks, the cephalad and caudal medial branch blocks were undertaken under the transverse view of sonogram first. A needle for nerve root block was inserted between the two transverse processes under longitudinal view, while estimating the depth with the needle for medial branch block. We then injected 1.0 mL of contrast medium and checked the distribution of the nerve root with C-arm fluoroscopy to evaluate the accuracy. The visual analog scale (VAS) was used to access the clinical results. RESULTS: Seven SNRBs were performed for the L2 nerve root, 15 for L3, 49 for L4, and 25 for L5, respectively. Eighty-six SNRBs (89.5%) showed successful positioning of the needles. We failed in the following cases: 1 case for the L2 nerve root; 2 for L3; 3 for L4; and 4 for L5. The failed needles were positioned at wrong leveled segments in 4 cases and inappropriate place in 6 cases. VAS was improved from 7.6 +/- 0.6 to 3.5 +/- 1.3 after the procedure. CONCLUSIONS: For SNRB in lumbar spine, the transverse processes under longitudinal view as the ultrasound landmark and the needles of medial branch block to the facet joint can be a promising guidance.
Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Female ; Humans ; Low Back Pain/etiology/*therapy ; Lumbar Vertebrae/anatomy & histology/*ultrasonography ; Male ; Middle Aged ; Nerve Block/*methods ; Sciatica/etiology/*therapy ; Spinal Stenosis/complications/*diagnosis ; Zygapophyseal Joint/anatomy & histology/ultrasonography

BACKGROUND: Nasalance is used to evaluate the velopharyngeal incompetence in clinical diagnoses using a nasometer. The aim of this study is to find the nasalance differences between Vietnamese cleft palate children and Korean cleft palate children by measuring the nasalance of five oral vowels. METHODS: Ten Vietnamese cleft palate children after surgery, three Vietnamese children for the control group, and ten Korean cleft palate children after surgery with the same age participated in this experimentation. Instead of Korean control, the standard value of Korean version of the simplified nasometric assessment procedures (kSNAP) was used. RESULT: The results are as follows: (1) the highest nasalance score among the Vietnamese normal vowels is the low vowel /a/; however, that of Korean normal vowels is the high vowel /i/. (2) The average nasalance score of Korean cleft palate vowels is 18% higher than that of Vietnamese cleft palate vowels. There was a nasalance score of over 45% among the vowels /e/ and /i/ in Vietnamese cleft palate patients and /i/, /o/, and /u/ in Korean cleft palate patients. CONCLUSION: These different nasalance scores of the same vowels seem to cause an ethnic difference between Vietnamese and Korean cleft palate children.
Asian Continental Ancestry Group* ; Child ; Cleft Palate* ; Diagnosis ; Humans ; Velopharyngeal Insufficiency

Fourteen compounds were isolated from the stem of Angelica polymorpha. On the basis of spectral data, these compounds were identified as isoimperatorin (1), phellopterin (2), bergapten (3), xanthyletin (4), cnidilin (5), geijerine (6), (−)-3'-acetyl hamaudol (7), 7-demethylsuberosine (8), dehydrogeijerin (9), (−)-hamaudol (10), (+)-visamminol (11), divaricatol (12), scopoletin (13), and decursidate (14), respectively. Among them, compounds 4 - 6, 8, 9, 13, and 14 were isolated for the first time from A. polymorpha. Dehydrogeijerin (6) and geijerin (9) were isolated for the first time from genus Angelica. All isolates tested for inhibitory activity against acetylcholinesterae. Compounds 1 to 13 showed acetylcholinesterase inhibitory activity with IC₅₀ values ranging from 1.4 to 37.5 µM.
Acetylcholinesterase* ; Angelica* ; Cholinesterase Inhibitors* ; Chromones ; Coumarins ; Scopoletin

STUDY DESIGN: This is a prospective study. PURPOSE: To develop a methodological approach for conducting ultrasound-guided lumbar facet nerve block by defining essential ultrasound-guided landmarks in order to assess the feasibility of this method. OVERVIEW OF LITERATURE: The current role of ultrasound guidance for musculoskeletal intervention treatments has been reported upon in previous literature. METHODS: Ultrasound-guided facet nerve block was done in 95 segments for 50 patients with chronic back pain by facet arthropathy. After the surface landmarks of the spinous process and iliac crest line were confirmed, longitudinal facet views were obtained by a curved array transducer to identify the different spinal segments. The spinous process and facet joint with transverse process were delineated by transverse sonograms at each level and the target point for the block was defined as lying on the upper edge of the transverse process. The needle was inserted toward the target point. After a contrast injection, the placement of the needle and contrast was checked by fluoroscopy. RESULTS: Eighty-seven segments (91.6%) could be guided successfully to the right facet nerve block by using ultrasound. After fluoroscopic control, 8 needles had to be corrected because of problems with other segments (3 cases) and lamina placements (5 cases). For the 42 patients who underwent successful block by ultrasound, however, the mean visual analogue score for back pain was improved from 6.2 +/- 0.9 before the block to 4.0 +/- 1.0 after the block (p = 0.001). CONCLUSIONS: Ultrasound-guided longitudinal facet view and the surface landmarks of the spinous process and iliac crest line seems to be a promising guidance technique for the lumbar facet nerve block technique.
Back Pain ; Deception ; Fluoroscopy ; Humans ; Lumbosacral Region ; Needles ; Nerve Block ; Prospective Studies ; Transducers ; Zygapophyseal Joint

Since the first hemodialysis and peritoneal dialysis were performed in humans in the early 1900s, the survival rates of patients with end-stage renal disease have increased. The number of patients in need of renal replacement therapy (RRT) is increasing, and there have been substantial advances in RRT modalities and technologies. To improve the patient outcomes requiring RRT, progress has been made to improve the efficiency and biocompatibility of dialysis in both hemodialysis and peritoneal dialysis. This review covers the basic principles of dialysis and the history of technological advances in hemodialysis and peritoneal dialysis. In addition, it includes the benefits of hemodiafiltration, new peritoneal dialysis solutions and automated peritoneal dialysis.
Dialysis ; Hemodiafiltration ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Renal Dialysis ; Renal Insufficiency, Chronic ; Renal Replacement Therapy ; Survival Rate

Chronic granulomatous infection of the skin and soft tissue by nontuberculous mycobacteria in patients with normal immune system is rarely reported. This case was about a child patient, with normal immune system, whose lower leg was lacerated after a slip down in the Philippines and it was previously treated at a hospital in the Philippines. After a couple of surgical debridement of the wound, the cause of the soft tissue infection was found to be a combined infection of nontuberculous mycobacteria and mycobacterium tuberculosis. We present a case that has been rare in Korea, but common overseas.
Child ; Debridement ; Humans ; Immune System ; Korea ; Leg ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria ; Philippines ; Skin ; Soft Tissue Infections

Purpose: This study investigated the impact of liver stiffness measurements (LSM) made using 2-dimensional (2D) shear wave elastography (SWE) on the diagnosis and grading of hepatic fibrosis and liver cirrhosis (LC) using grayscale ultrasonography (US). Methods: This retrospective study included 46 patients who underwent liver biopsy for chronic liver disease and 33 non-biopsied subjects with no or mild fibrosis (an aspartate aminotransferase-to-platelet ratio index <0.50 and a Forns score <4.21). Two abdominal radiologists reviewed randomized grayscale hepatic sonogram sets with and without LSM, separated by a 4-week interval. They graded the features of echogenicity, echotexture, surface nodularity, and edge blunting and classified patients by fibrosis grade. Interobserver agreement and correlations with the fibrosis grades were compared before and after the reviewers were informed regarding LSM, and the impact of LSM on diagnostic performance was evaluated. Results: The standard diagnoses were no or mild fibrosis (F0-1, n=39), moderate to advanced fibrosis (F2-3, n=23), or LC (n=17). The correlations between US and the diagnostic reference standard increased significantly with LSM incorporation (0.499 and 0.312 to 0.782 and 0.804, P<0.01 for both reviewers), as did interobserver agreement (0.318 to 0.753, P<0.01). The areas under the receiver operating characteristic curve (AUCs) for the diagnosis of significant fibrosis increased when LSM was included (0.682 and 0.591 to 0.855 and 0.907, P<0.01 for both reviewers), while the AUCs for the diagnosis of LC did not change significantly (0.891 and 0.783 to 0.904 and 0.900, P=0.849 and P=0.166). Conclusion Incorporating LSM values obtained by 2D-SWE improved the diagnostic accuracy and interobserver agreement of grayscale US for hepatic fibrosis.

PURPOSE: We analyzed the usefulness of vacuum-assisted closure (VAC) dressing to facilitate the healing of difficult wounds by comparing the results of conventional dressings. MATERIALS AND METHODS: We selected 20 cases for the experimental group (VAC group) and 20 cases for the control group (conventional dressing), and investigated the change in wound size, formation of granulation tissue, and duration of wound healing in the two groups. RESULTS: In the VAC group, the size of wound decreased from 60.2+/-59.1 cm2 to 29.7+/-18.8 cm2 (p=0.001). In the control group, it decreased from 60.3+/-83.3 cm2 to 34.4+/-47.6 cm2 (p=0.04). For formation of granulation, it increased from 1.2+/-0.4 to 2.7+/-0.6 (p=0.001) in the VAC group and from 1.2+/-0.4 to 2.4+/-0.5 in the control group. For the duration of healing, it took 17.5+/-8.3 days for the VAC group and 22.9+/-22.0 days in the control group (p=0.857). However there were no statistically significant differences in all the parameters between the 2 groups (p>0.05). CONCLUSION: The clinical application of VAC to difficult wound yield comparable results in terms of a decrease in wound size, formation of granulation, and the duration of healing. VAC dressing could be an alternative treatment option for a difficult wound considering the advantage of saving medical human resources.
Bandages ; Granulation Tissue ; Humans ; Imidazoles ; Negative-Pressure Wound Therapy ; Nitro Compounds ; Wound Healing