Objectives: The aim of this study was to determine the most effective treatment approach by comparing the impacts of various otolith reduction techniques in patients with apogeotropic lateral semicircular canal benign paroxysmal positional vertigo (LC-BPPV). Methods: We performed a multicenter randomized prospective study from January to December 2015, involving 72 consecutive patients with apogeotropic LC-BPPV. The patients were divided into three treatment groups: therapeutic head-shaking (group A), the Gufoni-Appiani maneuver (group B), and the cupulolith repositioning maneuver (CuRM; group C). Each group underwent evaluation and treatment up to the fourth week. Treatment success was defined as the disappearance of positional vertigo and nystagmus. Results: This study included 72 patients (49 male and 23 female), with a mean (±standard deviation) age of 55.4±13.5 years. The mean duration of vertigo experienced prior to treatment was 3.9±4.4 days. The mean latency and duration of nystagmus were 2.7±3.0 seconds and 47.9±15.8 seconds, respectively. The overall treatment frequency was 2.0±0.9. The number of treatments differed significantly among the three groups (P<0.05). After 4 weeks, the success rates for groups A, B, and C were 90.5%, 92.3%, and 100%, respectively. No significant difference was observed in the success rate across treatment methods and periods (P>0.05). However, CuRM was the only method with a 100% treatment success rate. Conclusion While no clear difference was observed among the three treatments for LC-BPPV, CuRM was found to be superior to the other approaches in the long term.

Thyroid hormones have an important physiological role in maintaining adult bone structure and strength. Therefore, thyroid dysfunction is inevitably associated with various degrees of skeletal consequences. Endogenous overt hyperthyroidism is an established cause of high bone turnover with accelerated bone loss, resulting in osteoporosis and an increased risk of fractures. Hyperthyroidism induced by thyroid stimulating hormone suppression therapy in patients with differentiated thyroid cancer also has emerged as a contributing factor to osteoporosis and fragility fractures. While, there is lack of evidence that hypothyroidism negatively affects bone health. Although there is growing clinical evidence of the importance of bone health in hyperthyroidism, clinical guidelines on how to evaluate and manage bone health in these diseases have not yet been published worldwide. The Task Force from the Korean Thyroid Association Committee of Clinical Practice Guideline has developed this position statement for the evaluation and management of bone health in patients with thyroid diseases, particularly focused on endogenous hyperthyroidism and thyroid stimulating hormone suppression therapyassociated hyperthyroidism in patients with differentiated thyroid cancer.

Growth hormone (GH) deficiency is caused by congenital or acquired causes and occurs in childhood or adulthood. GH replacement therapy brings benefits to body composition, exercise capacity, skeletal health, cardiovascular outcomes, and quality of life. Before initiating GH replacement, GH deficiency should be confirmed through proper stimulation tests, and in cases with proven genetic causes or structural lesions, repeated GH stimulation testing is not necessary. The dosing regimen of GH replacement therapy should be individualized, with the goal of minimizing side effects and maximizing clinical improvements. The Korean Endocrine Society and the Korean Society of Pediatric Endocrinology have developed a position statement on the diagnosis and treatment of GH deficiency. This position statement is based on a systematic review of evidence and expert opinions.

Fibrodysplasia ossificans progressiva (FOP) syndrome is caused by mutation of the gene ACVR1, encoding a constitutive active bone morphogenetic protein type I receptor (also called ALK2) to induce heterotopic ossification in the patient. To genetically correct it, we attempted to generate the mutant ALK2-iPSCs (mALK2-iPSCs) from FOP-human dermal fibroblasts. However, the mALK2 leads to inhibitory pluripotency maintenance, or impaired clonogenic potential after single-cell dissociation as an inevitable step, which applies gene-correction tools to induced pluripotent stem cells (iPSCs). Thus, current iPSC-based gene therapy approach reveals a limitation that is not readily applicable to iPSCs with ALK2 mutation. Here we developed a simplified one-step procedure by simultaneously introducing reprogramming and gene-editing components into human fibroblasts derived from patient with FOP syndrome, and genetically treated it. The mixtures of reprogramming and gene-editing components are composed of reprogramming episomal vectors, CRISPR/Cas9-expressing vectors and single-stranded oligodeoxynucleotide harboring normal base to correct ALK2 c.617G>A. The one-step-mediated ALK2 gene-corrected iPSCs restored global gene expression pattern, as well as mineralization to the extent of normal iPSCs. This procedure not only helps save time, labor and costs but also opens up a new paradigm that is beyond the current application of gene-editing methodologies, which is hampered by inhibitory pluripotency-maintenance requirements, or vulnerability of single-cell-dissociated iPSCs.
Bone Morphogenetic Proteins ; Fibroblasts ; Gene Expression ; Genetic Therapy ; Humans ; Induced Pluripotent Stem Cells ; Miners ; Myositis Ossificans ; Ossification, Heterotopic

BACKGROUND: With increasing life expectancy, the number of injured elderly patients has been increasing. We evaluated the clinical characteristics of severely injured elderly patients who presented to the Emergency Department and identified risk factors associated with mortality. METHODS: Injured patients over 18 years of age who visited the Emergency Department with trauma team activation were investigated. We divided the patients into two groups according to age, an older adult group (> or =65 years) and a younger adult group (<65 years). We compared the mechanism of injuries, injury severity score (ISS), abbreviated injury scale > or =3 of each body area, and mortality between the two groups. RESULTS: Among 177 severely injured patients, there were 138 younger adults (78%) and 39 older adults (22%). The average ISS of the older adults was higher than the younger adults (20.66 vs. 16.37). The incidences of severe injuries (ISS>15) in the younger adults and the older adults were 50.0% and 71.1%, respectively, and critical injuries (ISS>25) were 16.7% and 36.8%, respectively. Chest injuries and subdural hematoma occurred more often in the older adults. Mortality was higher in the older adults (28.2%) than in the younger adults (8.7%). CONCLUSION: The average ISS was higher in older adults than in younger adults, and older adults were significantly more likely to suffer severe trauma, especially chest injuries and subdural hematoma. The rate of mortality was greater for older adults (28.2%) than younger adults (8.7%).
Abbreviated Injury Scale ; Adult ; Aged* ; Emergencies* ; Emergency Service, Hospital* ; Hematoma, Subdural ; Humans ; Incidence ; Injury Severity Score ; Life Expectancy ; Mortality ; Risk Factors* ; Thoracic Injuries

PURPOSE: To evaluate the efficacy of optical coherence tomography (OCT) on diagnosis and follow-up in patients with ethambutol-induced optic neuropathy and to evaluate the prognosis of ethambutol-induced optic neuropathy. METHODS: Seven patients (14 eyes) with a history of ethambutol-induced optic neuropathy underwent best corrected visual acuity measurement (BCVA), visual field exam, fundus exam, and OCT at their first visit and again six months later. RESULTS: There was an overall statistically significant improvement in vision (p=0.001); however, two patients (four eyes) showed no improvement. A decrease in RNFL thickness was observed in all eyes. Additionally, there was a statistically significant decrease of 6.4 +/- 5.37 micrometer (6.8%) in the mean RNFL thickness (p=0.003), with the greatest decrease in the temporal quadrant, which showed a mean decrease of 6.1 +/- 5.31 micrometer (9.2%) (p<0.001). CONCLUSIONS: Optical coherence tomography may be not only a valuable tool in the quantitative and structural analysis of RNFL thickness in patients with ethambutol-induced optic neuropathy, but may also provide objective information on diagnosis and follow-up. Toxicity from ethambutol is reversible with discontinuation of the drug, and vision recovers gradually. However, impaired vision can remain even with cessation of ethambutol due to retinal nerve fiber damage.
Ethambutol ; Eye ; Follow-Up Studies ; Humans ; Nerve Fibers ; Optic Nerve Diseases ; Prognosis ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity ; Visual Field Tests

PURPOSE: To evaluate the efficacy and safety of the combination of cataract surgery and intravitreal bevacizumab injection in patients with cataract and diabetic macular edema. METHODS: Patients received an intravitreal injection of bevacizumab(1.25 mg) combined with phacoemulsification and implantation of a posterior chamber intraocular lens. Best corrected visual acuity (BCVA, LogMAR) and, central macular thickness (CMT) were measured using OCT at baseline and at one week, one, three, and six months after surgery, and adverse events were recorded. RESULTS: The mean baseline LogMAR BCVA was 0.84+/-0.50 and mean CMT was 337.1+/-57.50 micrometer. At one week, one, three, and six months after surgery, the mean BCVAs were 0.52+/-0.40, 0.51+/-0.42, 0.52+/-0.34, and 0.46+/-0.37, and the mean CMTs were 356.4+/-86.44 micrometer, 338.8+/-138.4 micrometer, 349.0+/-122.9 micrometer, and 334.2+/-100.4 micrometer, respectively. No adverse events associated with cataract surgery or intravitreal bevacizumab injection were observed. CONCLUSIONS: The short-term results from the present study suggest the combination of cataract surgery and intravitreal bevacizumab injection are safe and effective for the prevention of macular edema aggravation for one month, but has little effect on prevention of macular edema aggravation three months after surgery for diabetic macular edema patients.
Antibodies, Monoclonal, Humanized ; Cataract ; Humans ; Intravitreal Injections ; Lenses, Intraocular ; Macular Edema ; Phacoemulsification ; Visual Acuity ; Bevacizumab

PURPOSE: Painful plantar callosities under the second, third or fourth metatarsal head have been controverted about its treatment mordalities. We performed the vertical chevron osteotomy in patients with painful callosities on the second and third metatarsal head, and evaluated the outcome clinically. MATERIALS AND METHODS: Fourteen cases from 10 patients who had plantar keratosis were operated by vertical chevron osteotomy from March 2005 to October 2008. We used K-wire fixation for all cases. We evaluated the clinical results by the patients' satisfaction and disappearance of plantar lesion. RESULTS: The plantar keratosis was completely disappeared in 8 cases and partially in 5 cases. In 2 cases, patients expresses their pain caused by constant metatarsalgia that was suspected to be dorsal incisional pain and joint capsulitis. Transmetatarsalgia was not appeared. CONCLUSION: We consider vertical chevron osteotomy as a good surgical method for treatment of plantar keratosis.
Callosities ; Head ; Humans ; Joints ; Keratosis ; Metatarsal Bones ; Metatarsalgia ; Osteotomy

PURPOSE: Painful plantar callosities under the second, third or fourth metatarsal head have been controverted about its treatment mordalities. We performed the vertical chevron osteotomy in patients with painful callosities on the second and third metatarsal head, and evaluated the outcome clinically. MATERIALS AND METHODS: Fourteen cases from 10 patients who had plantar keratosis were operated by vertical chevron osteotomy from March 2005 to October 2008. We used K-wire fixation for all cases. We evaluated the clinical results by the patients' satisfaction and disappearance of plantar lesion. RESULTS: The plantar keratosis was completely disappeared in 8 cases and partially in 5 cases. In 2 cases, patients expresses their pain caused by constant metatarsalgia that was suspected to be dorsal incisional pain and joint capsulitis. Transmetatarsalgia was not appeared. CONCLUSION: We consider vertical chevron osteotomy as a good surgical method for treatment of plantar keratosis.
Callosities ; Head ; Humans ; Joints ; Keratosis ; Metatarsal Bones ; Metatarsalgia ; Osteotomy

Although abundant biology data have been accumulated in public biology databases, such as GenBank and PIR, few easy-interface services are provided for users to access or update them. We have developed a system, named BioStore, that is composed of several programs to aid users to not only access public data but also share their own data easily. The service can be used for maintaining a local database as a repository of raw data files of several public databases and distributing the data files to other users. Currently, BioStore manipulates major bio-databases and will expand to include more databases and more useful interfaces.
Biology ; Databases, Nucleic Acid ; Formycins ; Ribonucleotides ; Information Storage and Retrieval