Recent studies for the diabetic polyneuropathy have quantified as well as compared the clinical and the electrophysiological findings. Thirty-one diabetic patients were examined with a conventional nerve conduction study, a late response, a somatosensory evoked potential (SEP), a sympathetic skin response (SSR), a R-R interval, and a needle electromyography (EMG) after the clinical examination. The purposes of this study were to evaluate the correlation of clinical features and electrophysiological findings and to provide reliable criteria for the diagnosis of diabetic polyneuropathy. Diabetic polyneuropathy was diagnosed when a nerve conduction study revealed abnormal findings in two or more peripheral nerves. The following parameters were highly correlated with a diabetic polyneuropathy; ankle jerks (Spearman's r=0.92), H reflexes (Spearman's r=0.92), F waves by the tibial nerve stimulation (Spearman's r=0.88), F waves by the peroneal nerve stimulations (Spearman's r=0.84), and amplitudes of a sensory nerve action potential (SNAP) in the sural nerve (Spearman's r=0.79), SEPs by the tibial nerve stimulation (Spearman's r=0.79). Motor nerve conduction of the upper limbs, R-R interval ratios, and blood pressure changes had no significant correlations with a diabetic polyneuropathy. We concluded that these clinical and electrophysiological findings with significantly high correlation values would be good parameters for the diagnosis of diabetic polyneuropathy.
Action Potentials ; Ankle ; Blood Pressure ; Diabetic Neuropathies* ; Diagnosis ; Electromyography ; Evoked Potentials, Somatosensory ; H-Reflex ; Humans ; Needles ; Neural Conduction ; Peripheral Nerves ; Peroneal Nerve ; Polyneuropathies ; Skin ; Sural Nerve ; Tibial Nerve ; Upper Extremity

Myringotomy and ventilation tube insertion are widely performed in pediatric patients with chronic otitis media. This procedure is performed under general anesthesia or sedation with local anesthesia infiltration in pediatric patients. In this case report, we report a case of transient facial paralysis in a pediatric patient who underwent myringotomy and ventilation tube insertion using sevoflurane inhalation and four-quadrant blocks with lidocaine.

PURPOSE: To evaluate the clinical outcomes of small incision lenticule extraction (SMILE) for the treatment of myopia with corneal opacity. METHODS: Thirteen eyes of 13 patients with corneal opacities who underwent SMILE were retrospectively studied. Uncorrected distance visual acuity, spherical equivalence, efficacy index, and safety index were noted at 3 months after the procedure. The density and area of the corneal opacities were measured and compared preoperatively and 3 months postoperatively. RESULTS: All eyes had preoperative corneal opacities within the lenticule formation areas. The mean area and density of corneal opacities were 0.72 ± 0.33 mm2 and 52.46 ± 15.74, respectively. All procedures were uneventful and no intraoperative complications were observed. At 3 months after the procedure, the efficacy and safety indices were 1.01 ± 0.15, and 1.05 ± 0.10, respectively, and the mean densities and areas of corneal opacities were 46.85 ± 14.56 (p = 0.038) and 0.70 ± 0.36 mm2 (p = 0.776), respectively. CONCLUSIONS: The SMILE procedure was effective and safe for the correction of myopic patients with corneal opacities.
Corneal Opacity ; Humans ; Intraoperative Complications ; Myopia ; Retrospective Studies ; Visual Acuity

Objective: The aim of this study is to determine the histologic presence of heterologous component as a prognostic factor in gynecologic carcinosarcoma through a systematic review and meta-analysis. Methods: PubMed, Web of Science, and Embase were searched for publications. Studies that evaluated survival effect of sarcomatous component based on histology in human ovarian or uterine carcinosarcoma were included. Two authors independently reviewed the references based on eligibility criteria and extracted the data including primary tumor site, survival outcome, type of survival outcome, and proportion of each sarcomatous differentiation. The quality of each eligible study was assessed with Newcastle-Ottawa scale. Meta-analysis was conducted using a random-effects model to estimate hazard ratio (HR) and 95% confidence intervals (CIs) of survival outcome for carcinosarcoma with or without heterologous component. Results: Eight studies including 1,594 patients were identified. Overall proportion of carcinosarcoma with heterologous component was 43.3%. Presence of heterologous component was associated with worse overall survival (HR=1.81; 95% CI=1.15–2.85) but not with pooled recurrence-free survival and disease-free survival (HR=1.79; 95% CI=0.85–3.77). Removing multivariate analysis studies, early-stage studies, ovarian tumor study, or studies with large number of patient samples did not affect the significance between heterologous component and overall survival. Conclusion Gynecologic carcinosarcoma is histologically a biphasic tumor which comprise of epithelial and mesenchymal components. Our study emphasizes pathologic evaluation of heterologous component as a prognostic factor in gynecologic carcinosarcoma when all stages were considered.

Atypical facial pain (AFP) is a type of facial pain which does not fulfill any other diagnosis. It has several features such as no objective signs, no obvious explanation of the cause and poor response to treatments. We report a case of a female patient with AFP on the left maxillary area. The pain was increased by cold innocuous stimulation and thermography showed that the temperature on the painful area was significantly decreased. The pain was successfully alleviated by stellate ganglion block (SGB). Therefore, SGB can be effectively used to treat AFP.
Diagnosis ; Facial Pain* ; Female ; Humans ; Stellate Ganglion* ; Thermography

PURPOSE: To compare the clinical outcome of combined small incision lenticule extraction and collagen cross-linking (SMILE Xtra) with SMILE. METHODS: This study included 30 eyes from 15 patients who had undergone SMILE Xtra and a random sample of 30 eyes from 15 patients receiving SMILE alone during the same period. We obtained the following parameters from all patients: uncorrected (UDVA) and corrected distance visual acuity (CDVA), spherical equivalent (SE), efficacy and safety index, and corneal high-order aberrations. RESULTS: The SMILE Xtra group had higher preoperative SE and thinner central corneal and residual stromal bed thickness and optic zone diameter compared to the control group (p < 0.001). At 6 months, there was no significant difference in UDVA or CDVA between the two groups. The efficacy indices were 0.97 ± 0.16 and 1.05 ± 0.17 in the SMILE Xtra and control groups, respectively (p = 0.044), and there was no significant difference in safety index between the two groups during the follow-up period. Total corneal high-order aberrations numbered 2.59 ± 0.56 and 2.02 ± 0.41 in the SMILE Xtra and control groups, respectively (p < 0.001), and there was significant increase in spherical aberration and horizontal corneal aberration in both groups compared to preoperative results. Corneal haze was observed in 20% of eyes in the SMILE Xtra group, and no complication such as corneal ectasia was observed during the follow-up period. CONCLUSIONS: SMILE Xtra had good early clinical outcome compared to SMILE alone. It appears that SMILE Xtra can be a good modality when the cornea is thin or SE is high. However, postoperative corneal haze should be considered.
Collagen* ; Cornea ; Dilatation, Pathologic ; Follow-Up Studies ; Humans ; Visual Acuity

PURPOSE: To compare the clinical outcome of combined small incision lenticule extraction and collagen cross-linking (SMILE Xtra) with SMILE. METHODS: This study included 30 eyes from 15 patients who had undergone SMILE Xtra and a random sample of 30 eyes from 15 patients receiving SMILE alone during the same period. We obtained the following parameters from all patients: uncorrected (UDVA) and corrected distance visual acuity (CDVA), spherical equivalent (SE), efficacy and safety index, and corneal high-order aberrations. RESULTS: The SMILE Xtra group had higher preoperative SE and thinner central corneal and residual stromal bed thickness and optic zone diameter compared to the control group (p < 0.001). At 6 months, there was no significant difference in UDVA or CDVA between the two groups. The efficacy indices were 0.97 ± 0.16 and 1.05 ± 0.17 in the SMILE Xtra and control groups, respectively (p = 0.044), and there was no significant difference in safety index between the two groups during the follow-up period. Total corneal high-order aberrations numbered 2.59 ± 0.56 and 2.02 ± 0.41 in the SMILE Xtra and control groups, respectively (p < 0.001), and there was significant increase in spherical aberration and horizontal corneal aberration in both groups compared to preoperative results. Corneal haze was observed in 20% of eyes in the SMILE Xtra group, and no complication such as corneal ectasia was observed during the follow-up period. CONCLUSIONS: SMILE Xtra had good early clinical outcome compared to SMILE alone. It appears that SMILE Xtra can be a good modality when the cornea is thin or SE is high. However, postoperative corneal haze should be considered.
Collagen* ; Cornea ; Dilatation, Pathologic ; Follow-Up Studies ; Humans ; Visual Acuity

No abstract available.
Anesthesia, General ; Child ; Humans ; Mitochondrial Myopathies ; Neuromuscular Blockade

Inverted papilloma (Schneiderian-type papilloma) involving the middle ear is extremely rare. Most of cases originate from the mucosa of the lateral nasal wall, extending into the paranasal sinuses and orbits. Inverted papilloma involving the middle ear has a high recurrence rate and a possibility of malignant change. We experienced a case of inverted papilloma of the middle ear secondary to congenital cholesteatoma surgery. A nine-year old male who was diagnosed with congenital cholesteatoma was treated with intact canal wall tympanomastoidectomy. Nine months later, he underwent a second look operation. In the second surgery, a 3 mm round pinkish mass which was located at the tympanic orifice of Eustachian tube was identified as inverted papilloma. There was no recurrence of cholesteatoma or inverted papilloma four months after the 2nd operation.
Cholesteatoma ; Ear, Middle ; Eustachian Tube ; Humans ; Male ; Mucous Membrane ; Orbit ; Papilloma, Inverted ; Paranasal Sinuses ; Recurrence

Background: Fusobacterium nucleatum has been identified to promote tumor progression in colorectal cancer (CRC). However, association between F. nucleatum and prognostic or clinicopathological features has been diverse among studies, which could be affected by type of biospecimen (formalin-fixed paraffin-embedded or fresh frozen [FF]). Methods: Articles were systemically reviewed for studies that included the correlation between F. nucleatum and prognosis or clinicopathological features in CRC. Results: Ten articles, eight studies with survival-related features involving 3,199 patients and nine studies with clinical features involving 2,655 patients, were eligible for the meta-analysis. Overall survival, disease-free survival, and cancer-specific survival were all associated with worse prognosis in F. nucleatum–high patients (p<.05). In subgroup analysis, only studies with FF tissues retained prognostic significance with F. nucleatum. In meta-analysis of clinicopathological variables, F. nucleatum level was associated with location within colon, pT category, MLH1 hypermethylation, microsatellite instability status, and BRAF mutation regardless of type of biospecimen. However, lymph node metastasis and KRAS mutation was only associated with F. nucleatum level in FF-based studies. Conclusions In conclusion, type of biospecimen could affect the role of F. nucleatum as a biomarker associated with clinicopathological features and prognosis.