The 12th rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the 10th rib was not felt, and an image of the rib-cage confirmed that the left 10th rib was severed. When applying pressure from the legs to the 9th rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with 9th rib syndrome, and ultrasound-guided 9th and 10th intercostal nerve blocks were performed around the tips of the severed 10th rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the 9th rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left 10th rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining 10th rib to impinge on the 9th intercostal nerves, causing pain.
Abdomen ; Abdominal Pain ; Aged ; Anesthetics, Local ; Female ; Fractures, Compression ; Humans ; Intercostal Nerves ; Leg ; Muscles ; Neuralgia ; Pain Clinics ; Physical Examination ; Ribs* ; Spine ; Thoracic Wall ; Thorax ; Triamcinolone

PURPOSE: To assess the diagnostic efficacy of magnetic resonance (MR) imaging in the detection of a vertebralartery injury occurring from major cervical spine trauma. MATERIALS AND METHODS: Conventional MR findings of 63patients and 63 control subjects were compared to detect a possible change in the vertebral arteries resulted fromtrauma. Plain films, CT and clinical records were also reviewed to correlate the degree of cervical spine injurywith vascular change. RESULTS: Nine cases of absent flow signals in vessel lumen were observed in eight patientsand one was observed in the control group. Patients more frequently demonstrated other abnormalities such asintraluminal linear signals (n=3) or focal luminal narrowing (n=9) but there was no statistical significance. There was a close relationship between degree of cord damage and occlusion of the vertebral artery. CONCLUSION: Conventional MR imaging is useful in the detection of vertebral artery occlusion resulting from cervical spinetrauma.
Humans ; Magnetic Resonance Imaging ; Phenobarbital ; Spine* ; Vertebral Artery*

No abstract available.
Intracranial Arteriovenous Malformations* ; Radiosurgery*

PURPOSE: To describe the prevalence of vitreoretinal diseases in the Korean population 50 years or older at a health screening center. METHODS: The participants of this study included 11,180 adults 50 years of age and older who visited the Health Promotion Center of Kangbuk Samsung Hospital from January to December 2006. Digital images of non-mydriatic fundus photographs were examined. We calculated the sex- and age-adjusted prevalence of vitreoretinal diseases using the direct standardized method based on the number of resident registrations. RESULTS: The age- and sex-adjusted prevalence of vitreoretinal diseases in Korean adults 50 years of age and older was 9.9%. The prevalence of vitreoretinal diseases significantly increased with age (P=0.000). There was no significant gender difference in the prevalence of vitreoretinal diseases (p=0.553). Age-related macular degeneration was the most common vitreoretinal disease, with an age- and sex-adjusted prevalence of 5.2%. Epiretinal membrane, retinal vein occlusion, and diabetic retinopathy were common vitreoretinal diseases in that order, and the age- and sex-adjusted prevalences were 1.5%, 1.1%, and 0.9%, respectively. CONCLUSIONS: The prevalence of vitreoretinal diseases in a screened Korean population 50 years and older was 9.9%. Vitreoretinal diseases are a major ophthalmic problem in Korea. As the Korean population continues to age and the prevalence of diabetes increases, further investigations about the epidemiology and prevention of vitreoretinal diseases are needed.
Adult ; Diabetic Retinopathy ; Epiretinal Membrane ; Health Promotion ; Humans ; Korea ; Macular Degeneration ; Mass Screening ; Prevalence ; Retinal Vein Occlusion

Purpose: To confirm that the phaco chop method using an illuminated chopper (iChopper; Oculight, Seongnam, Korea) can reduce cataract surgery complications, and that even beginners can safely and effectively perform phaco chop. Methods: We retrospectively analyzed the medical records of the first 30 phaco chop cases using illuminated chopper of four cataract surgeons. Four ophthalmologists had a variety of empirical backgrounds, from those who have experienced more than 10,000 cataract surgery, to beginners who have experienced 20 cataract surgery. Results: Of the total 120 eyes, two eyes (1.67%) had posterior capsule rupture. The chopping method was changed from phaco chop to stop and chop in three eyes (2.5%) including one eye with brown cataract with pseudoexofoliation syndrome and two eyes with nuclear opacity grade ≥5. Conclusions The rates of posterior capsule rupture of phaco chop using an illuminated chopper were very low in four surgeons with various experiences and who became proficient shortly in phaco chop.

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal disorder of the hematopoietic stem cells characterized by chronic intravascular hemolysis, venous thrombosis, deficient hematopoiesis. Kidney involvement is usually benign and secondary to chronic deposition of hemosiderin. However, acute kidney injury may rarely occur in association with a hemolytic crisis or thrombotic complication. Hemolytic crisis is precipitated by nonspecific factors, such as infection, surgery and transfusion. A 35-year-old woman, who developed hemolytic crisis and acute kidney injury was admitted to our hospital presenting with acute gastroenteritis. After being treated by hemodialysis and oral low dose steroid, she was discharged with recovered renal function. Renal biopsy demonstrated acute tubular necrosis with considerable hemosiderin deposition without evidence of vascular thrombosis. A review of Korean cases showed that most of the cases featured severe renal dysfunction to such an extent to require a hemodialysis although there were no definite etiologies other than the deposition of blood iron due to massive hemolysis unlike the foreign cases. It also showed that the disease duration was longer. It can therefore be inferred that the early diagnosis and active treatment will be mandatory for the treatment of Korean patients with PNH. We reported a case of PNH with acute kidney injury and hemolytic crisis and documented by renal biopsy with review of Korean literature.
Acute Kidney Injury ; Adult ; Biopsy ; Early Diagnosis ; Female ; Gastroenteritis ; Hematopoiesis ; Hematopoietic Stem Cells ; Hemoglobinuria, Paroxysmal ; Hemolysis ; Hemosiderin ; Humans ; Iron ; Kidney ; Korea ; Necrosis ; Renal Dialysis ; Thrombosis ; Venous Thrombosis

Inveon PET is a recently developed preclinical PET system for small animal. This study was conducted to measure the performance of Inveon PET as recommended by the NEMA NU 4-2008. We measured the spatial resolution, the sensitivity, the scatter fraction and the NECR using a F-18 source. A 3.432 ns coincidence window was used. A 1 mm3 sized F-18 point source was used for the measurement of spatial resolution within an energy window of 350~625 keV. PET acquisition was performed to obtain the spatial resolution from the center to the 5 cm offset toward the edge of the transverse FOV. Sensitivity, scatter fraction, and NECR were measured within an energy window of 350~750 keV. For measuring the sensitivity, a F-18 line source (length: 12.7 cm) was used with concentric 5 aluminum tubes. For the acquisition of the scatter fraction and the NECR, two NEMA scatter phantoms (rat: 50 mm in diameter, 150 mm in length; mouse: 25 mm in diameter, 70 mm in length) were used and the data for 14 half-lives (25.6 hr) was obtained using the F-18 line source (rat: 316 MBq, mouse: 206 MBq). The spatial resolution of the F-18 point source was 1.53, 1.50 and 2.33 mm in the radial, tangential and axial directions, respectively. The volumetric resolution was 5.43 mm3 in the center. The absolute sensitivity was 6.61%. The peak NECR was 486 kcps @121 MBq (rat phantom), and 1056 kcps @128 MBq (mouse phantom). The values of the scatter fraction were 20.59% and 7.93% in the rat and mouse phantoms, respectively. The performances of the Inveon animal PET scanner were measured in this study. This scanner will be useful for animal imaging.
Aluminum ; Animals ; Mice ; Rats

PURPOSE: The Korean Society of Radiation Oncologists (KOSRO) conducted the Patterns of Care Study (PCS) of radiotherapy (RT) for spine metastases in 2009. The current study was conducted to investigate current practice patterns and compare them with the results of the PCS. MATERIALS AND METHODS: The survey questionnaire was composed of 10 questions regarding general information and seven questions for each of two clinical scenarios. RESULTS: Fifty-four members of the KOSRO answered at least one question on the web-based questionnaire. The yearly number of patients treated who underwent palliative spine RT was greater than 200 in 14 (25.9%), 51 to 100 in 13 (24.1%), and 31 to 50 in 11 respondents (20.4%). Scenario 1 described a patient presenting with cord compressive spine metastasis in multiple bones and liver metastasis from non-small cell lung cancer. Thirty gray (Gy) in 10 fractions was chosen by 35 respondents (64.8%). Scenario 2 described a case of a single spine metastasis without progression after targeted therapy. Thirty Gy in 10 fractions was chosen by 19 respondents (35.2%), and a single fraction or less than four fractions of stereotactic ablative radiotherapy (SABR) were selected by 18 respondents (33.3%). When compared with the 2009 PCS, practice patterns of Korean radiation oncologists had not changed significantly over 5 years, except that SABR emerged as a new treatment modality in the selected population. CONCLUSION: The 2014 PCS demonstrated that multiple fraction RT is still preferred in a considerable proportion of Korean radiation oncologists.
Carcinoma, Non-Small-Cell Lung ; Data Collection ; Humans ; Korea ; Liver ; Neoplasm Metastasis* ; Practice Patterns, Physicians' ; Radiotherapy ; Spine* ; Surveys and Questionnaires

The present study was to investigate in more detail the changes of reproductive function in the male rat following myocardial infarction (MI). Ligation of the left coronary artery was performed in male Sprague-Dawley male rats at 60 days of age. Control rats were obtained sham-operated animals. MI rats were sacrificed at 1, 3, 5, 7, 14, and 30 day after ligation of left anterior descending coronary artery. Control rats were sacrificed on 30 day after thoracotomy. Myocardial infarct size was assessed by planimetry and perimetry. Testes of rats were fixed by whole body perfusion using a fixative containing 2.5% glutaraldehyde in cacodylate buffer, processed and embedded in Epon-araldite. Using 1 micro sections stained with methylene blue-azure II, qualitative and quantitative (stereological) morphological studies were performed. Testosterone levels in the incubation medium of luteinizing hormone-stimulated (100 ng/mL) testosterone secretion per testis in vitro, and in serum were determined by radioimmunoassay. Sperm production was measured by routine technique. Mean infarct size was 29.5~33.5% of the left ventricle after coronary occlusion in experimental groups. No changes were observed in testis volume, absolute volume of Leydig cell, Leydig cell size, and number of Leydig cell per testis in MI rats compared to sham-operated animals. Serum testosterone, LH-stimulated testicular testosterone production, and daily sperm production in MI rats were not significantly different (P>0.05) from sham-operated animals. These results demonstrate that under the experimental conditions employed here, experimental chronic myocardial infarction does not exert adverse effects on the reproductive function of male rats.
Adult* ; Animals ; Cacodylic Acid ; Cell Size ; Coronary Occlusion ; Coronary Vessels ; Glutaral ; Heart Ventricles ; Humans ; Ligation ; Lutein ; Male* ; Myocardial Infarction* ; Perfusion ; Radioimmunoassay ; Rats* ; Rats, Sprague-Dawley ; Spermatozoa ; Testis ; Testosterone ; Thoracotomy ; Visual Field Tests

OBJECTIVE: To investigate the association of genetic background between MTHFR C677T genotype and infertile females with polycystic ovarian syndrome. MATERIALS AND METHODS: We compared 86 infertile females with polycystic ovarian syndrome (PCOS) with 100 healthy fertile females with one or more offspring. Pyrosequencing analysis for MTHFR C677T variation was performed on polymerase chain reaction (PCR) product of study group. To validate pyrosequencing data of C677T variation for randomly selected 50 samples, we compared the pyrosequencing result with the PCR-RFLP (Restriction Fragment Length Polymorphism) result of MTHFR C677T genotype. RESULTS: The prevalence of the C677T mutant homozygous (TT) was significantly lower (p=0.0085) in females with PCOS (8.14%) than in fertile females (21.00%). MTHFR 677 TT genotype had a decreased risk (3.7-fold) of PCOS compared with wild type (MTHFR 677 CC). CONCLUSION: Our data support a role for MTHFR mutant homozygous (677 TT) genotype in reducing risk in Korean infertile females with Polycystic ovarian syndrome.
Female* ; Genotype ; Humans ; Korea* ; Oxidoreductases* ; Polycystic Ovary Syndrome* ; Polymerase Chain Reaction ; Prevalence