Objectives: Dextrose prolotherapy is one of the most promising minimally invasive interventions for temporomandibular disorder (TMD), particularly in refractory cases where other conservative treatments have failed. The purpose of this study was to demonstrate the efficacy of a new treatment, temporomandibular joint (TMJ) prolotherapy, in patients with TMD to alleviate symptoms. Materials and Methods: A retrospective analysis was conducted on TMD patients with chronic pain who did not respond to conventional treatments. TMJ prolotherapy was performed using hypertonic dextrose in the TMJ area, targeting the retrodiscal attachment tissue, anterior disc attachment tissue, lateral capsule, origin of the masseter muscle, and the stylomandibular ligament. Pain or discomfort intensity in the TMJ was evaluated using a numerical rating scale (NRS). Maximum mouth opening and subjective satisfaction were also analyzed. Results: Nineteen patients (6 males, 13 females, average age 43 years) participated in this study. All patients experienced pain improvement with a maximum of three prolotherapy sessions. The initial mean NRS was 5.7, which ultimately decreased to a final mean TMJ discomfort score of 1.7 postintervention. The patients’ maximum mouth opening increased from an initial 34.5 mm to 38.8 mm, and they reported positive satisfaction with the prolotherapy treatment. The clinical outcomes were positive regardless of main origin of TMD symptoms. Conclusion Hypertonic TMJ prolotherapy is an effective minimally invasive intervention for TMJ disorders with chronic pain.

Objectives: Dextrose prolotherapy is one of the most promising minimally invasive interventions for temporomandibular disorder (TMD), particularly in refractory cases where other conservative treatments have failed. The purpose of this study was to demonstrate the efficacy of a new treatment, temporomandibular joint (TMJ) prolotherapy, in patients with TMD to alleviate symptoms. Materials and Methods: A retrospective analysis was conducted on TMD patients with chronic pain who did not respond to conventional treatments. TMJ prolotherapy was performed using hypertonic dextrose in the TMJ area, targeting the retrodiscal attachment tissue, anterior disc attachment tissue, lateral capsule, origin of the masseter muscle, and the stylomandibular ligament. Pain or discomfort intensity in the TMJ was evaluated using a numerical rating scale (NRS). Maximum mouth opening and subjective satisfaction were also analyzed. Results: Nineteen patients (6 males, 13 females, average age 43 years) participated in this study. All patients experienced pain improvement with a maximum of three prolotherapy sessions. The initial mean NRS was 5.7, which ultimately decreased to a final mean TMJ discomfort score of 1.7 postintervention. The patients’ maximum mouth opening increased from an initial 34.5 mm to 38.8 mm, and they reported positive satisfaction with the prolotherapy treatment. The clinical outcomes were positive regardless of main origin of TMD symptoms. Conclusion Hypertonic TMJ prolotherapy is an effective minimally invasive intervention for TMJ disorders with chronic pain.

Objectives: Dextrose prolotherapy is one of the most promising minimally invasive interventions for temporomandibular disorder (TMD), particularly in refractory cases where other conservative treatments have failed. The purpose of this study was to demonstrate the efficacy of a new treatment, temporomandibular joint (TMJ) prolotherapy, in patients with TMD to alleviate symptoms. Materials and Methods: A retrospective analysis was conducted on TMD patients with chronic pain who did not respond to conventional treatments. TMJ prolotherapy was performed using hypertonic dextrose in the TMJ area, targeting the retrodiscal attachment tissue, anterior disc attachment tissue, lateral capsule, origin of the masseter muscle, and the stylomandibular ligament. Pain or discomfort intensity in the TMJ was evaluated using a numerical rating scale (NRS). Maximum mouth opening and subjective satisfaction were also analyzed. Results: Nineteen patients (6 males, 13 females, average age 43 years) participated in this study. All patients experienced pain improvement with a maximum of three prolotherapy sessions. The initial mean NRS was 5.7, which ultimately decreased to a final mean TMJ discomfort score of 1.7 postintervention. The patients’ maximum mouth opening increased from an initial 34.5 mm to 38.8 mm, and they reported positive satisfaction with the prolotherapy treatment. The clinical outcomes were positive regardless of main origin of TMD symptoms. Conclusion Hypertonic TMJ prolotherapy is an effective minimally invasive intervention for TMJ disorders with chronic pain.

This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively.Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques.There has been a decrease in intravenous thrombolysis rates, from 12% in 2017–2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for noncardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.

Background: This study investigated the impact of premorbid functional dependency on post-stroke mortality in patients with anterior circulation stroke (ACS) and posterior circulation stroke (PCS). Methods: This study enrolled 9,698 patients who experienced ischemic stroke between January 2011 and December 2022. The patients were classified into the ACS and PCS groups. Premorbid functional dependency was defined as modified Rankin Scale of ≥3. The risks of premorbid functional dependency and mortality at 3 months and 1-year post-stroke were assessed. A subgroup analysis was further performed to evaluate the risk of premorbid functional dependency in patients who underwent intravenous thrombolysis and endovascular treatment (EVT). Results: Among 6,358 patients with ACS and 3,340 with PCS, those with premorbid dependency were older, predominantly female, and had a higher proportion of vascular risk factors and stroke severity. Premorbid functional dependency was associated with increased mortality at both 3 months and 1 year in the PCS (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.00–3.13; P=0.04 and OR, 2.87; 95% CI, 1.86–4.38; P<0.001, respectively), but not in the ACS (OR, 1.08; 95% CI, 0.77–1.51; P=0.639 and OR, 1.22; 95% CI, 0.93–1.59; P=0.140, respectively) group. Among patients who underwent EVT, premorbid functional dependency increased the risk of mortality at 1 year in the ACS group (OR, 1.80; 95% CI, 1.04–3.08; P=0.034), but was not associated with the risk in the PCS group (OR 2.56; 95% CI 0.64–10.15; P=0.176). Conclusion Premorbid functional dependency increases the risk of mortality in patients with PCS.

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.

BACKGROUND AND PURPOSE: Thrombectomy within 24 hours can improve outcomes in selected patients with a clinical-infarct mismatch. We devised an easy-to-use visual estimation tool that allows infarct volume estimation in centers with limited resources. METHODS: We identified 1,031 patients with cardioembolic or large-artery atherosclerosis infarction on diffusion-weighted images (DWIs) obtained before recanalization therapy and within 24 hours of onset, and occlusion of the internal carotid or middle cerebral artery. Acute DWIs were mapped onto a standard template and used to create visual reference maps with known lesion volumes, which were then used in a validation study (with 130 cases) against software estimates of infarct volume. RESULTS: The DWI reference map chart comprises 144 maps corresponding to 12 different infarct volumes (0.5, 1, 2, 3, 5, 7, 9, 11, 13, 15, 17, and 19 mL) in each of 12 template slices (Montreal Neurological Institute z-axis –15 to 51 mm). Infarct volume in a patient is estimated by selecting a slice with a similar infarct size at the corresponding z-axis level on the reference maps and then adding up over all slices. The method yielded good correlations to software volumetrics and was easily learned by both experienced and junior physicians, with approximately 1 to 2 minutes spent per case. The sensitivity, specificity, and accuracy for detecting threshold infarct volumes ( < 21, < 31, and < 51 mL) were very high (all about >90%). CONCLUSIONS: We developed easy-to-use reference maps that allow prompt and reliable visual estimation of infarct volumes for triaging patients to thrombectomy in acute stroke.
Atherosclerosis ; Cerebral Infarction ; Decision Making ; Diffusion Magnetic Resonance Imaging ; Humans ; Infarction ; Medical Staff, Hospital ; Methods ; Middle Cerebral Artery ; Sensitivity and Specificity ; Stroke ; Thrombectomy

With the increased use of cell therapy in the veterinary sector, there is a growing demand for the development of cell-based medicinal products and the determination of their safety. Currently, the Korean Animal and Plant Quarantine Agency has established a guideline for evaluating the safety of cell-based medicinal products for animal use. The guideline includes items related to definition, classification, management, manufacturing procedure and quality control (standard and test method), stability testing, toxicity testing, pharmacological testing, and performance of clinical trials. In addition, testing protocols related to safety assessment of animal cell-based products such as chromosome karyotyping, tumorigenicity testing, confirmatory testing of biodistribution and kinetics, and target animal safety testing are described in detail. Moreover, because cell-based medicinal products are novel therapies, deviations from traditional designs may be justified in order to obtain relevant safety information on the treatment. Additionally, this guideline can be amended on the basis of new scientific findings.
Animals ; Carcinogenicity Tests ; Cell- and Tissue-Based Therapy ; Classification ; Karyotyping ; Kinetics ; Plants ; Quality Control ; Quarantine ; Toxicity Tests

PURPOSE: The goal of this study was to evaluate the clinical outcome of single short implants, less than 8 mm in length, placed in the posterior area. MATERIALS AND METHODS: A total of 128 patients (75 male and 53 female, mean age: 52.6±11.2 years) with 154 implants participated. Implant marginal bone loss, and survival and success rates were measured. RESULTS: The mean follow-up period was 51.35±24.97 months. A total of 128 implants, 8 mm in length, were placed in patients who had mean marginal bone loss of 0.75 mm. These implants had a survival rate of 95.3%. Twenty-six implants, 7 mm in length, were placed in areas with a mean marginal bone loss of 0.78 mm and had a survival rate of 96.2%. Both marginal bone loss and survival rate were not statistically different among the groups. In the maxilla, 34 implants showed a mean marginal bone loss of 0.77 mm and a survival rate of 97.1%. In the mandible, 120 implants showed a mean marginal bone loss of 0.75 mm and a survival rate of 95.0%. The average marginal bone loss around all implants was 0.76±0.27 mm at the last follow-up review after functional loading. The survival rate was 95.6% and success rate was 93.5%. CONCLUSION: In our study, single short implants less than 8 mm in length in the posterior areas had favorable clinical outcomes.
Clinical Study ; Female ; Follow-Up Studies ; Humans ; Male ; Mandible ; Maxilla ; Retrospective Studies ; Survival Rate

BACKGROUND: Primary spontaneous pneumothorax (PSP) affects patients without clinically apparent lung disorder found in tall and thin young male. Scoliosis refers to curves exceeding 10° Cobb angle observed through chest X-ray and affects 2% to 4% of adolescents. Both conditions are commonly encountered in primary health care setting. The aim of this study is to access the correlation of thoracic scoliosis and PSP in adolescent. METHODS: A retrospective analysis was conducted for patients diagnosed for PSP in Konyang University Hospital between January 2010 and March 2017. Chest X-rays of 222 patients and 155 normal control (NC) cases were reviewed to measure the Cobb angle. Greater than 10° of Cobb angle is diagnosed as scoliosis. RESULTS: Scoliosis in patient with PSP has higher incidence than that of NC group (p < 0.001). Median value of Cobb angle is 12.9° in PSP group and 14.7° in NC group. Directional relationship between scoliosis and pneumothorax in PSP group is also observed; 40.5% cases are ipsilateral and 59.5% are contralateral. CONCLUSION: PSP patients tend to have thoracic scoliosis more commonly compared with normal healthy adolescent. Scoliosis may contribute to heterogeneity of alveolar pressure which exacerbates subpleural bleb formation that can cause pneumothorax. The causal relationship is unclear and further studies are needed in the future.
Adolescent ; Blister ; Humans ; Incidence ; Lung ; Male ; Pneumothorax* ; Population Characteristics ; Primary Health Care ; Retrospective Studies ; Scoliosis* ; Thorax