Background: Although almost all interventional pulmonologists agree that rigid bronchoscopy is irreplaceable in the field of interventional pulmonology, less is known about the types of diseases that the procedure is used for and what difficulties the operators face during the procedure. The purpose of this study is to evaluate what diseases rigid bronchoscopy is used for, whether it is widely used, and what challenges the operators face in Korea. Methods: We enrolled 14 hospitals in this retrospective cohort of patients who underwent rigid bronchoscopy between 2003 and 2020. An online survey was conducted with 14 operators to investigate the difficulties associated with the procedure. Results: While the number of new patients at Samsung Medical Center (SMC) increased from 189 in 2003–2005 to 468 in 2018–2020, that of other institutions increased from 0 to 238.The proportion of SMC patients in the total started at 100% and steadily decreased to 59.2%.The proportion of malignancy as the indication for the procedure steadily increased from 29.1% to 43.0%, whereas post-tuberculous stenosis (25.4% to 12.9%) and post-intubation stenosis (19.0% to 10.9%) steadily decreased (all P for trends < 0.001). In the online survey, half of the respondents stated that over the past year they performed less than one procedure per month. The fewer the procedures performed within the last year, the more likely collaboration with other departments was viewed as a recent obstacle (Spearman correlation coefficient, r s = −0.740, P = 0.003) and recent administrative difficulties were encountered (r s = −0.616, P = 0.019). Conclusion This study demonstrated that the number of patients undergoing rigid bronchoscopy has been increasing, especially among cancer patients. For this procedure to be used more widely, it will be important for beginners to systematically learn about the procedure itself as well as to achieve multidisciplinary consultation.

BACKGROUND: Virtual environments have brought the use of realistic training closer to many different fields of education. In medical education, several visualization methods for studying inside the human body have been introduced as a way to verify the structure of internal organs. However, these methods are insufficient for realistic training simulators because they do not provide photorealistic scenes or offer an intuitive perception to the user. In addition, they are used in limited environments within a classroom setting.METHODS: We have developed a virtual dissection exploration system that provides realistic three-dimensional images and a virtual endoscopic experience. This system enables the user to manipulate a virtual camera through a human organ, using gesture-sensing technology. We can make a virtual dissection image of the human body using a virtual dissection simulator and then navigate inside an organ using a virtual endoscope. To improve the navigation performance during virtual endoscopy, our system warns the user about any potential collisions that may occur against the organ's wall by taking the virtual control sphere at the virtual camera position into consideration.RESULTS: Experimental results show that our system efficiently provides high-quality anatomical visualization. We can simulate anatomic training using virtual dissection and endoscopic images.CONCLUSION: Our training simulator would be helpful in training medical students because it provides an immersive environment.

BACKGROUND: Virtual environments have brought the use of realistic training closer to many different fields of education. In medical education, several visualization methods for studying inside the human body have been introduced as a way to verify the structure of internal organs. However, these methods are insufficient for realistic training simulators because they do not provide photorealistic scenes or offer an intuitive perception to the user. In addition, they are used in limited environments within a classroom setting. METHODS: We have developed a virtual dissection exploration system that provides realistic three-dimensional images and a virtual endoscopic experience. This system enables the user to manipulate a virtual camera through a human organ, using gesture-sensing technology. We can make a virtual dissection image of the human body using a virtual dissection simulator and then navigate inside an organ using a virtual endoscope. To improve the navigation performance during virtual endoscopy, our system warns the user about any potential collisions that may occur against the organ's wall by taking the virtual control sphere at the virtual camera position into consideration. RESULTS: Experimental results show that our system efficiently provides high-quality anatomical visualization. We can simulate anatomic training using virtual dissection and endoscopic images. CONCLUSION Our training simulator would be helpful in training medical students because it provides an immersive environment.

Common peroneal nerve (CPN) injury associated with multiple-ligament knee injury is relatively rare. A 38-year-old male presented with left knee pain occurred during ssireum (Korean wrestling). The patient exhibited positive Lachman, grade 3 varus stress, and also positive dial testing at 30°. Sensory loss of some area of left foot and foot drop were observed. Magnetic resonance imaging showed complete anterior cruciate ligament (ACL) rupture and posterolateral corner (PLC) injury. Motor nerve conduction velocity indicated left CPN palsy. ACL and PLC reconstructions were performed 10 days after injury and nerve exploration was done simultaneously. Neurolysis and primary repair were also performed. At 26 months after injury, muscle power of the tibialis anterior and extensor hallucis longus improved to grade 3, and sensation in CPN area recovered to about 60%. There was good stability in injured knee. To the best of our knowledge, this is the first case report describing CPN palsy with multiple-ligament knee injury during ssireum.
Adult ; Anterior Cruciate Ligament ; Foot ; Humans ; Knee Injuries ; Knee* ; Ligaments* ; Magnetic Resonance Imaging ; Male ; Neural Conduction ; Paralysis* ; Peroneal Nerve* ; Rupture ; Sensation

The thousands of serial images used for medical pedagogy cannot be included in a printed book; they also cannot be efficiently handled by ordinary image viewer software. The purpose of this study was to provide browsing software to grasp serial medical images efficiently. The primary function of the newly programmed software was to select images using 3 types of interfaces: buttons or a horizontal scroll bar, a vertical scroll bar, and a checkbox. The secondary function was to show the names of the structures that had been outlined on the images. To confirm the functions of the software, 3 different types of image data of cadavers (sectioned and outlined images, volume models of the stomach, and photos of the dissected knees) were inputted. The browsing software was downloadable for free from the homepage (anatomy.co.kr) and available off-line. The data sets provided could be replaced by any developers for their educational achievements. We anticipate that the software will contribute to medical education by allowing users to browse a variety of images.
Body Image ; Cadaver ; Dataset ; Education, Medical ; Educational Status ; Hand Strength ; Learning* ; Stomach ; Teaching ; Visible Human Projects

Adenosine is a short-acting coronary vasodilator, and it is widely used during pharmacological stress myocardial perfusion imaging. It has a well-established safety profile, and most of its side effects are known to be mild and transient. Until now, coronary vasospasm has been rarely reported as a side effect of adenosine during or after adenosine stress test. This study reports a case of coronary vasospasm which was documented on stress myocardial perfusion CT imaging during adenosine stress test.
Adenosine/*adverse effects/metabolism ; Aged ; Coronary Vasospasm/*chemically induced/pathology ; Humans ; Male ; Myocardial Perfusion Imaging/*methods ; Sensitivity and Specificity ; Tomography, X-Ray Computed/*methods ; Vasodilator Agents/*adverse effects/metabolism

PURPOSE: This study prospectively investigated the effects of biofeedback therapy on objective anorectal function and subjective bowel function in patients after sphincter-saving surgery for rectal cancer. METHODS: Sixteen patients who underwent an ileostomy were randomized into two groups, one receiving conservative management with the Kegel maneuver and the other receiving active biofeedback before ileostomy closure. Among them, 12 patients (mean age, 57.5 years; range, 38 to 69 years; 6 patients in each group) completed the study. Conservative management included lifestyle modifications, Kegel exercises, and medication. Patients were evaluated at baseline and at 1, 3, 6, and 12 months after ileostomy closure by using anal manometry, modified Wexner Incontinence Scores (WISs), and fecal incontinence quality of life (FI-QoL) scores. RESULTS: Before the ileostomy closure, the groups did not differ in baseline clinical characteristics or resting manometric parameters. After 12 months of follow-up, the biofeedback group demonstrated a statistically significant improvement in the mean maximum squeezing pressure (from 146.3 to 178.9, P = 0.002). However, no beneficial effect on the WIS was noted for biofeedback compared to conservative management alone. Overall, the FI-QoL scores were increased significantly in both groups after ileostomy closure (P = 0.006), but did not differ significantly between the two groups. CONCLUSION: Although the biofeedback therapy group demonstrated a statistically significant improvement in the maximum squeezing pressure, significant improvements in the WISs and the FI-QoL scores over time were noted in both groups. The study was terminated early because no therapeutic benefit of biofeedback had been demonstrated.
Biofeedback, Psychology* ; Exercise ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Ileostomy* ; Life Style ; Manometry ; Pilot Projects* ; Prospective Studies ; Quality of Life ; Rectal Neoplasms*

We intended to determine that virtual endoscopy and laparoscopy of the stomach based on serially sectioned cadaver images is beneficial. Therefore, the outlines between the gastric wall and lumen were traced using the new female data of the Visible Korean to build a volume model. While the outlines were expanded at appropriate thicknesses, the stomach was observed endoscopically and laparoscopically in comparison with a chosen sectioned image. Four layers (mucosa, submucosa, muscular layer, and serosa) of the stomach were discernible by their proper colors in the sectioned images. All layers except the submucosa were identified in the endoscopic and laparoscopic views by using consistent colors. The stepwise expansion of the outlines revealed thickness of each layer as well as whether the thickness was uniform. Our ideas and the Visible Korean images could be a robust resource of virtual reality learning for medical students and clinicians.
Adult ; Cadaver ; Female ; *Gastroscopy ; Humans ; Imaging, Three-Dimensional ; *Laparoscopy ; Models, Anatomic ; Stomach/*pathology

In this article, the sixth author's affiliation was misprinted unintentionally.

While it is reasonably well known that certain dental procedures increase the temperature of the tooth's surface, of greater interest is their potential damaging effect on the pulp and tooth-supporting tissues. Previous studies have investigated the responses of the pulp, periodontal ligament, and alveolar bone to thermal irritation and the temperature at which thermal damage is initiated. There are also many in vitro studies that have measured the temperature increase of the pulp and tooth-supporting tissues during restorative and endodontic procedures. This review article provides an overview of studies measuring temperature increases in tooth structures during several restorative and endodontic procedures, and proposes clinical guidelines for reducing potential thermal hazards to the pulp and supporting tissues.
Periodontal Ligament ; Root Canal Obturation ; Tooth ; Tooth Preparation ; Ultrasonics