Background/Aims: Intragastric balloon (IGB) is the only available endoscopic bariatric and metabolic therapy in Korea. End-ball (Endalis) has the longest history of clinical use among the IGBs available in Korea. However, little clinical data on this system have been reported. In this study, we aimed to evaluate the efficacy and safety of End-ball in Korea. Methods: We performed a retrospective cohort study of patients who underwent IGB insertion (End-ball) from 2013 to 2019. Demographic and anthropometric data were collected. The efficacy and safety of IGB treatment were analyzed. Results: In total, 80 patients were included. Mean age was 33.7 years and 83.8% were female. Initial body mass index was 34.48±4.69 kg/m2. Body mass index reduction was 3.72±2.63 kg/m2 at the time of IGB removal. Percent of total body weight loss (%TBWL) was 10.76%±6.76%. Percentage excess body weight loss was 43.67%±27.59%. Most adverse events were minor, and 71.4% of participants showed nausea, vomiting, or abdominal pain. Conclusions IGB treatment showed good efficacy and safety profile in Korean patients with obesity. In terms of %TBWL and percentage excess body weight loss, the efficacy was similar to that in the Western population.

PURPOSE: The present study was designed to examine the clinical fit of fixed dental prosthesis fabricated by the milling-sintering method using a presintered cobalt-chromium alloy. MATERIALS AND METHODS: Two single metal-ceramic crowns were fabricated via milling-sintering method and casting method in each of the twelve consecutive patients who required an implant-supported fixed prosthesis. In the milling-sintering method, the prosthetic coping was designed in computer software, and the design was converted to a non-precious alloy coping using milling and post-sintering process. In the casting method, the conventional manual fabrication process was applied. The absolute marginal discrepancy of the prostheses was evaluated intraorally using the triple-scan technique. Statistical analysis was conducted using Mann-Whitney U test (α=.05). RESULTS: Eight patients (66.7%) showed a lower marginal discrepancy of the prostheses made using the milling-sintering method than that of the prosthesis made by the casting method. Statistically, the misfit of the prosthesis fabricated using the milling-sintering method was not significantly different from that fabricated using the casting method (P=.782). There was no tendency between the amount of marginal discrepancy and the measurement point. CONCLUSION: The overall marginal fit of prosthesis fabricated by milling-sintering using a presintered alloy was comparable to that of the prosthesis fabricated by the conventional casting method in clinical use.
Alloys ; Clinical Study ; Crowns ; Dental Prosthesis ; Humans ; Methods ; Prostheses and Implants

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of remote cerebellar hemorrhage (RCH) as a complication of spinal surgery. SUMMARY OF LITERATURE REVIEW: Remote cerebellar hemorrhage is rare but lethal as a complication of spinal surgery. Interestingly, dural tears and cerebrospinal fluid (CSF) leakage are reported in all published cases of RCH. MATERIALS AND METHODS: A 67-year-old man had posterior lumbar decompression and posterolateral fusion for spinal stenosis at L4/5/S1. Intraoperatively, the dura was torn and there was a loss of CSF. The dural tear was sutured immediately in a water-tight manner. After surgery, the patient complained of headache and dizziness. On postoperative day 44, brain magnetic resonance imaging (MRI) showed meningeal enhancement suggesting meningitis. On postoperative day 54, brain computed tomography (CT) showed cerebellar edema and hemorrhage, and external ventricular derivation was performed. RESULTS: The patient died. CONCLUSIONS: Special attention should be paid to prevent dural damage during spinal surgery or minimize CSF leakage in the case of dural damage and tears during spinal surgery, and CT and MRI should be promptly performed for symptomatic patients.
Aged ; Brain ; Cerebrospinal Fluid* ; Decompression ; Dizziness ; Edema ; Headache ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Meningitis* ; Spinal Stenosis ; Tears

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of epidermoid cyst in the spinal canal. SUMMARY OF LITERATURE REVIEW: Epidermoid cyst in the spinal canal is rare. Idiopathic epidermoid cyst in the spinal canal not associated with a trauma or infection is even rarer. MATERIAL AND METHODS: A 73 year-old female presented with a 1 year history of progressive paresthesia and motor weakness of both lower extremeties. MRI showed a cystic mass on the 7th thoracic canal. We performed total laminectomy at the T6-T8 level. The cystic mass was excised after durotomy using a posterior approach. RESULTS: We confirmed the presence of an epidermoid cyst for histopathology. CONCLUSION: Idiopathic epidermoid cyst in the spine is very rare and requires accurate differential diagnosis. Preoperative MRI scans are necessary to differentiatie epidermoid cysts from other intradural masses. Confirmative diagnosis can be done by histopatholoty.
Diagnosis ; Diagnosis, Differential ; Epidermal Cyst* ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Paresthesia ; Spinal Canal ; Spine

No abstract available.
Finasteride* ; Risk Factors ; Venous Thrombosis*

PURPOSE: Inter-hospital transport poses a number of challenging issues, including prolonging the time interval from symptoms to optimal reperfusion therapy after ischemic stroke. It is unclear whether urbanization is associated with outcomes of inter-hospital transfer including length of stay at the referring hospital (D1LOS). METHODS: A prospective stroke registry from 23 Emergency Departments (ED) from 2007 to 2012 over the nation was collected. Ischemic stroke patients who arrived at the first ED within 24 hours of onset (S2D1) were enrolled. Patients were excluded if time intervals or address were incorrect or missing. Main exposure was urbanization level; urban > or =10,000 and rural <10,000 population. Primary outcome was D1LOS. The secondary outcomes were symptoms to door of the first ED (S2D1) and transfer time to the final ED (T2D2). We compared the D1LOS, S2D1, and T2D2 with median and inter-quartile range (IQR) by urbanization level. RESULTS: Of 5,909 patients transferred from other hospitals, 2,289 patients were analyzed; 1,441 (63%) patients in urban areas, 848 (37%) patients in rural areas were included. The D1LOS and S2D1 in urban was longer than those in rural; 100 minutes (IQR 50~208) for urban VS 82.5 minutes (IQR 48~170.5) for rural (p=0.01) and 66 minutes (IQR 30~240) for urban VS 90 minutes (IQR 30~330) for rural (p=0.001). T2D2 in urban was shorter than that in rural; 54 minutes (IQR 36~78), 40 minutes (IQR 25~65) (p< or =0.00), respectively. CONCLUSION: Urban EDs showed longer D1LOS before transferring patients to the hospital for definite care. Strategy for reducing delay due to inter-hospital transport should differ according to urbanization.
Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Length of Stay ; Patient Transfer ; Reperfusion ; Stroke* ; Urbanization*

OBJECTIVE: To know the effectiveness of a custom molded fitting chair between pre- and post-chair status through comparison of musculoskeletal indices in severely disabled children. METHODS: We researched 34 severely disabled patients who had used a custom molded fitting chair continuously for more than a year. There were 27 cerebral palsy patients and 7 patients with other kinds of diseases that affect the brain such as chromosomal disease or metabolic disease. By radiographic studies, Cobb's angle, the femoral neck-shaft angle of the femur, and Reimers migration percentage were measured. The indices are analyzed before and after application. RESULTS: The average period of application was 24 months. There was a significant reduction in the angles of femur neck-shaft, 163.4 degree before and 158.2 degree after the use of the chair (p<0.05), and 23 of 34 had demonstrated a reduced angle. Cobb's angle and Reimers migration percentage increased but the difference of pre- and post-chair status was not statistically significant. Seventeen of 33 children showed reduced Cobb's angle. Also, 19 of 37 showed a reduced degree of dislocation of the hip joints. CONCLUSION: In spite of the use of a custom molded fitting chair, a significant improvement did not emerge for musculoskeletal deformity indices in severely disabled children. However, there was no significant aggravation of Cobb's angle or Reimers migration percentage in developing children. Therefore, it is thought be helpful to prevent rapid aggravation of musculoskeletal deformities.
Brain ; Cerebral Palsy ; Child ; Congenital Abnormalities ; Disabled Children ; Dislocations ; Femur ; Fungi ; Hip ; Humans ; Metabolic Diseases ; Musculoskeletal System ; Orthotic Devices

OBJECTIVE: To compare an objective assessment scale for "come-to-sit" in stroke patients with the previously established subjective assessment scales of "performance-based assessment" and the "ability for basic movement scale". METHOD: A specifically designed jacket was used to determine the objective degree of assistance needed for patients to perform the task. While patients were sitting up, the investigator evaluated the amount of assistance needed in a fully dependent state (A) and with maximal effort (B). Using this measure, we obtained an objective scale, {(A-B)/A} x100. In addition, patients were tested in two starting positions: hemiplegic-side lying and sound-side lying. We then compared the objective scale with subjective scales and other parameters related to functional outcomes. RESULTS: For both starting positions, the objective assessment scale showed high correlation with the previously established subjective scales (p<0.01). Only the hemiplegic-side lying-to-sit objective scale showed a significant correlation with the parameters used to assess functional outcomes (p<0.05). In terms of Brunnstrom stages, only the leg stage showed a significant correlation with the objective "come-to-sit" scale (p<0.01). CONCLUSION: The objective scale was comparable to established subjective assessment scales when used by an expert. The hemiplegic-side lying-to-sit maneuver had a high correlation with patient's functional recovery. Specifically, balance and lower extremity function appear to be important factors in the "come-to-sit" activity.
Deception ; Humans ; Leg ; Lower Extremity ; Research Personnel ; Stroke ; Weights and Measures

PURPOSE: The incidence of secondary malignancies in hematologic patients is known to be higher than it is in other patients. However, the characteristics of secondary malignancy and surveillance have not yet been established for colorectal cancer in leukemic patients. METHODS: From 1995 to 2007, 6,030 patients who were diagnosed with acute myeloid leukemia (AML), acute lymphoid leukemia (ALL), chronic myeloid leukemia (CML), chronic lymphoid leukemia (CLL), and multiple myeloma (MM) were enrolled in this study. Among them, 9 patients were diagnosed with colorectal cancer at St. Mary's Hospital and were analyzed retrospectively. RESULTS: Three of the 2,570 patients with AML, 1 of the 1,158 patients with CML, 2 of the 83 patients with CLL, 2 of the 422 patients with MM, and none of the 1,797 patients with ALL were found to have colorectal cancer. There were no operative mortalities, but 2 patients refused to have surgery. The ratio of observed to expected subsequent colorectal cancer in CLL was higher than it was in the other groups, indicating that the relative risk of colorectal cancer is higher in patients with CLL. CONCLUSION: Compared to the Surveillance, Epidemiology and End-Result (SEER) program at the National Cancer Institute (NCI) in the United State, we have the same high relatively risk in CLL patients. Careful attention should be paid to the possibility of colorectal cancer in CLL patients.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Hematologic Diseases ; Humans ; Incidence ; Leukemia ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Multiple Myeloma ; National Cancer Institute (U.S.) ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies

Cases of intracranial complication following infections of head and neck have been reported rarely, but the case of intracranial complication following tubo-ovarian abscess has not been reported yet. In this case, the 35-year-old women patient with lower abdominal pain and mild headache that was diagnosed as pelvic inflammatory disease was admitted to our hospital and was cared. In the course of admission, headache was aggravated and lateral deviation of eyeballs occurred. She was diagnosed as intracranial abscess following tubo-ovarian abscess in the result of neurological surgery department consultation. So we report it with brief review of literatures.
Abdominal Pain ; Abscess ; Adult ; Brain Abscess ; Female ; Head ; Headache ; Humans ; Neck ; Ovary ; Pelvic Inflammatory Disease