Background: Decreased acetabular version and posterior acetabular coverage of the femoral head have been regarded as the leading causes of sport-related posterior hip dislocation or subluxation. This study aimed to examine the posterior acetabular coverage of the femoral head in 21 patients who sustained posterior hip dislocation or subluxation during sport activities. Methods: The anterior and posterior acetabular rims on 3-dimensional computed tomography (3D-CT) images were delineated on the normal side in these patients. Radiologic signs, including crossover and posterior wall signs, were examined. The fracture center level (FCL) of the posterior acetabular wall was identified on axial CT images of the injured hip and the level was marked on the normal side. The difference in the femoral head coverage by posterior and anterior acetabular rims was measured by measuring the horizontal distance between anterior and posterior acetabular rims at the FCL (posterior-anterior [P-A] index). The acetabular version was measured at the femoral head and FCL using axial CT images of the normal side. Femoral head coverage by the posterior acetabular wall on the normal side was measured using 3D-CT (areal coverage). Results: The crossover and posterior wall signs were positive in 14 and 10 patients, respectively, in 3D-CT images. The FCL was evenly distributed in the proximal half of the posterior acetabular wall. Seven patients had a P-A index of ≤ 0, and all were positive for the crossover sign. The anterior acetabular rim was relatively prominent in these patients. The acetabular version was lower at the FCL than at the femoral head center (p < 0.001). The proximal half areal coverage of the posterior acetabular wall was significantly smaller than the whole areal coverage (p = 0.003). Conclusions Superior–posterior coverage of the femoral head by the posterior acetabular wall was insufficient in patients who sustained hip posterior dislocation or subluxation during sports activities.

Background: Decreased acetabular version and posterior acetabular coverage of the femoral head have been regarded as the leading causes of sport-related posterior hip dislocation or subluxation. This study aimed to examine the posterior acetabular coverage of the femoral head in 21 patients who sustained posterior hip dislocation or subluxation during sport activities. Methods: The anterior and posterior acetabular rims on 3-dimensional computed tomography (3D-CT) images were delineated on the normal side in these patients. Radiologic signs, including crossover and posterior wall signs, were examined. The fracture center level (FCL) of the posterior acetabular wall was identified on axial CT images of the injured hip and the level was marked on the normal side. The difference in the femoral head coverage by posterior and anterior acetabular rims was measured by measuring the horizontal distance between anterior and posterior acetabular rims at the FCL (posterior-anterior [P-A] index). The acetabular version was measured at the femoral head and FCL using axial CT images of the normal side. Femoral head coverage by the posterior acetabular wall on the normal side was measured using 3D-CT (areal coverage). Results: The crossover and posterior wall signs were positive in 14 and 10 patients, respectively, in 3D-CT images. The FCL was evenly distributed in the proximal half of the posterior acetabular wall. Seven patients had a P-A index of ≤ 0, and all were positive for the crossover sign. The anterior acetabular rim was relatively prominent in these patients. The acetabular version was lower at the FCL than at the femoral head center (p < 0.001). The proximal half areal coverage of the posterior acetabular wall was significantly smaller than the whole areal coverage (p = 0.003). Conclusions Superior–posterior coverage of the femoral head by the posterior acetabular wall was insufficient in patients who sustained hip posterior dislocation or subluxation during sports activities.

Background: Decreased acetabular version and posterior acetabular coverage of the femoral head have been regarded as the leading causes of sport-related posterior hip dislocation or subluxation. This study aimed to examine the posterior acetabular coverage of the femoral head in 21 patients who sustained posterior hip dislocation or subluxation during sport activities. Methods: The anterior and posterior acetabular rims on 3-dimensional computed tomography (3D-CT) images were delineated on the normal side in these patients. Radiologic signs, including crossover and posterior wall signs, were examined. The fracture center level (FCL) of the posterior acetabular wall was identified on axial CT images of the injured hip and the level was marked on the normal side. The difference in the femoral head coverage by posterior and anterior acetabular rims was measured by measuring the horizontal distance between anterior and posterior acetabular rims at the FCL (posterior-anterior [P-A] index). The acetabular version was measured at the femoral head and FCL using axial CT images of the normal side. Femoral head coverage by the posterior acetabular wall on the normal side was measured using 3D-CT (areal coverage). Results: The crossover and posterior wall signs were positive in 14 and 10 patients, respectively, in 3D-CT images. The FCL was evenly distributed in the proximal half of the posterior acetabular wall. Seven patients had a P-A index of ≤ 0, and all were positive for the crossover sign. The anterior acetabular rim was relatively prominent in these patients. The acetabular version was lower at the FCL than at the femoral head center (p < 0.001). The proximal half areal coverage of the posterior acetabular wall was significantly smaller than the whole areal coverage (p = 0.003). Conclusions Superior–posterior coverage of the femoral head by the posterior acetabular wall was insufficient in patients who sustained hip posterior dislocation or subluxation during sports activities.

Background: Decreased acetabular version and posterior acetabular coverage of the femoral head have been regarded as the leading causes of sport-related posterior hip dislocation or subluxation. This study aimed to examine the posterior acetabular coverage of the femoral head in 21 patients who sustained posterior hip dislocation or subluxation during sport activities. Methods: The anterior and posterior acetabular rims on 3-dimensional computed tomography (3D-CT) images were delineated on the normal side in these patients. Radiologic signs, including crossover and posterior wall signs, were examined. The fracture center level (FCL) of the posterior acetabular wall was identified on axial CT images of the injured hip and the level was marked on the normal side. The difference in the femoral head coverage by posterior and anterior acetabular rims was measured by measuring the horizontal distance between anterior and posterior acetabular rims at the FCL (posterior-anterior [P-A] index). The acetabular version was measured at the femoral head and FCL using axial CT images of the normal side. Femoral head coverage by the posterior acetabular wall on the normal side was measured using 3D-CT (areal coverage). Results: The crossover and posterior wall signs were positive in 14 and 10 patients, respectively, in 3D-CT images. The FCL was evenly distributed in the proximal half of the posterior acetabular wall. Seven patients had a P-A index of ≤ 0, and all were positive for the crossover sign. The anterior acetabular rim was relatively prominent in these patients. The acetabular version was lower at the FCL than at the femoral head center (p < 0.001). The proximal half areal coverage of the posterior acetabular wall was significantly smaller than the whole areal coverage (p = 0.003). Conclusions Superior–posterior coverage of the femoral head by the posterior acetabular wall was insufficient in patients who sustained hip posterior dislocation or subluxation during sports activities.

Background: Citric acid (CA) and sodium hypochlorite (NaOCl) have been used to disinfect animals to protect them against avian influenza and foot-and-mouth disease. Objectives: We performed a good laboratory practice (GLP)-compliant animal toxicity study to assess the acute toxic effects of CA and NaOCl aerosol exposure in Sprague-Dawley rats. Methods: Groups of five rats per sex were exposed for 4 h to four concentrations of the two chemicals, i.e., 0.00, 0.22, 0.67, and 2.00 mg/L, using a nose-only exposure. After a single exposure to the chemicals, clinical signs, body weight, and mortality was observed during the observation period. On day 15, an autopsy, and then gross findings, and histopathological analysis were performed. Results: After exposure to CA and NaOCl, body weight loss was observed but recovered.Two males died in the CA 2.00 mg/L group and, two males and one female died in the 2.00 mg/L NaOCl group. In the gross findings and histopathological analysis, discoloration of the lungs was observed in the CA exposed group and inflammatory lesions with discoloration of the lungs were observed in the NaOCl exposed group. These results suggest that the lethal concentration 50 (LC50) of CA is 1.73390 mg/L for males and > 1.70 mg/L for females. For NaOCl, the LC50 was 2.22222 mg/L for males and 2.39456 mg/L for females. Conclusions The Globally Harmonized System is category 4 for both CA and NaOCl. In this study, the LC50 results were obtained through a GLP-based acute inhalation toxicity assessment. These results provide useful data to reset safety standards for CA and NaOCl use.

Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention.Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9–10 points increased from 64% in 2019 to 69% in 2020. Conclusion The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction.Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

Ichthyosis follicularis, atrichia, and photophobia (IFAP) syndrome is a rare genetic disorder caused by mutations in the MBTPS2 gene. It is characterized by ichthyosis and alopecia from birth. Photophobia may be present in infancy or early childhood. Its mode of inheritance is X-linked recessive; thus, it mostly affects male. The disease severity varies, ranging from mild cases limited to the skin to the severe variant involving multiple extracutaneous features. A 7-year-old boy presented with scanty hair on scalp and eyebrows at birth. On physical examination, scaly patches were observed on the whole body and spiky follicular hyperkeratotic papules were observed on the face and trunk. He also suffered from severe photophobia. Histopathological examination of the scalp showed miniaturized hair follicles without perifollicular fibrosis. Genetic analysis revealed a novel mutation in the MBTPS2 gene which was a homozygous missense mutation of c.245T>C leading to an amino-acid substitution from phenylalanine to serine (p.Phe82Ser). We diagnosed this patient with IFAP syndrome. To date, 25 pathogenic MBTPS2 gene mutations have been identified. To our knowledge, c.245T>C is a novel homozygous missense mutation in the MBTPS2 gene, which has not been reported in Human Gene Mutation Database, ClinVar Database, and Leiden Open Variation Database. Previous reports suggested genotype-phenotype correlations in the MBTPS2 gene mutations. Supported by a previous notion that genotype correlates with phenotype, this novel mutation can be a predictive factor for the mild form of IFAP syndrome, restricted to the classic symptom triad.

Erosive adenomatosis of the nipple (EAN), also known as nipple adenoma, florid papillomatosis, or papillary adenoma of the nipple, is a benign neoplasm originating from a lactiferous duct of the breast. Although the potential for malignant change is invariably negligible, the nature of the disease is quite intractable despite several treatment methods. Surgical excision is known as the treatment of choice, but this invasive approach is generally not acceptable to the vast majority of patients due to the cosmetic outcomes. Cryosurgery could be an alternative choice to preserve the structure of the nipple-areola complex, though its application has not been studied due to the paucity of cases. A 22-year-old female presented with a unilateral, crater-like erosion of the left nipple with serosanguineous discharge. The skin biopsy revealed proliferation of tubular structures, which corresponded to EAN. She was treated with 4 sessions of cryosurgery (open cryospray with liquid nitrogen) over 6 months, and the skin lesion resolved completely without any recurrence for 12 months. Although further study is required to determine the optimal treatment regimen for EAN, cryosur-gery should be considered as an effective option to surgical excision.

Neuroleptic malignant syndrome (NMS) is a life-threatening neurologic emergency associated with the use of dopamine receptor-antagonist properties or the rapid withdrawal of dopaminergic medications. NMS is characterized by refractory hyperpyrexia, altered mental state, dysautonomia, and rigor. If hyperpyrexia persists, it can result in multiorgan failure. Herein, we report a case of NMS occurring after metoclopramide administration in a patient with pontine hemorrhage, which was successfully treated with targeted temperature management using a surface cooling device.

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is known as a maternally inherited mitochondrial disease with a m.3243A>G mutation in the MT-TL1 gene. Here, we report a case of targeted temperature management in a MELAS patient who had a cardiac arrest and severe lactic acidosis after recurrent seizures.