Background: A precise anatomical understanding of the adductor canal (AC) and its neural components is essential for discerning the action mechanism of the AC block. We therefore aimed to clarify the detailed anatomy of the AC using micro-computed tomography (micro-CT), histological evaluation, and immunofluorescence (IF) assays. Methods: Gross dissections of 39 thighs provided morphometric data relevant to injection landmarks. Serial sectional images of the AC were defined using micro-CT and ultrasonography. The fascial and neural structures of the AC proper were histologically evaluated using Masson’s trichrome and Verhoeff-Van Gieson staining, and double IF staining using choline acetyltransferase (ChAT) and neurofilament 200 antibodies. Results: The posteromedial branch insertion of the nerve to vastus medialis (NVM) into the lateral border of the AC proper was lower (14.5 ± 2.4 cm [mean ± SD] above the base of the patella) than the origin of the proximal AC. The AC consists of a thin subsartorial fascia in the proximal region and a thick aponeurosis-like vastoadductor membrane in the distal region. In the proximal AC, the posteromedial branch of the NVM (pmNVM) consistently contained both sensory and motor fibers, and more ChAT-positive fibers were observed than in the saphenous nerve (27.5 ± 11.2 / 104 vs. 4.2 ± 2.6 / 104 [counts/µm2], P < 0.001). Conclusions Anatomical differences in fascial structures between the proximal and distal AC and a mixed neural component of the neighboring pmNVM have been visualized using micro-CT images, histological evaluation, and IF assays.

A one-year-old female sika deer died suddenly with no preliminary signs during exhibition at a zoo. At necropsy, the carcass was emaciated and had dried fur. Examination of the thoracic cavity revealed a diaphragmatic rupture measuring 2 cm in diameter and a fracture in the middle of the right eighth rib. The liver and lungs had irregular circular discolorations caused by diaphragmatic rupture and subsequent herniation. Dark-brown-colored ascitic fluid, hydrothorax, and yellowish hydropericardium were also observed. The cause of death was determined to be diaphragmatic rupture caused by a rib fracture, which led to respiratory imbalance and circulatory disorders.

Intestinal rupture caused by small bowel volvulus was diagnosed in a captive 13-year-old male American black bear. The animal presented with decreased appetite, depression, lethargy, and mild abdominal distention for 3 days. The animal was treated with antibiotics, hypermetabolites, and digestive medicine daily; however, it died on the third day of treatment. The clinical symptoms included hemorrhagic ascites, gaseous extension of the small intestine, and intestinal rupture caused by small bowel volvulus. Hemorrhagic signs were observed in the lungs and heart. This is the first case to describe small bowel volvulus in mammals of the family Ursidae.
Adolescent ; Animals ; Anti-Bacterial Agents ; Appetite ; Ascites ; Depression ; Heart ; Humans ; Intestinal Volvulus* ; Intestine, Small ; Lethargy ; Lung ; Male ; Mammals ; Rupture* ; Ursidae*

Dermatophytosis was found on the right front leg of a 4-month-old female African lion cub (Panthera leo) kept at a zoo with locally marginal alopecia. For diagnosis, culturing on sabouraud dextrose agar was performed and skin scrapings from the lesion were analyzed. The ones from the culture and skin scrapings were identified as Trichophyton mentagrophytes. A zookeeper that had been in contacted with the lion for artificial rearing developed skin lesions with well-defined erythematous plaques on the right arm about 1 month after the lesion in the lion was observed. The ringworm was probably transmitted from the lion through continuous contact.
Agar ; Alopecia ; Arm ; Diagnosis ; Female ; Glucose ; Humans ; Infant ; Leg ; Lions* ; Skin ; Tinea ; Trichophyton*

This study compared long-term speech performance after cochlear implantation (CI) between surgical strategies in patients with chronic otitis media (COM). Thirty patients with available open-set sentence scores measured more than 2 yr postoperatively were included: 17 who received one-stage surgeries (One-stage group), and the other 13 underwent two-stage surgeries (Two-stage group). Preoperative inflammatory status, intraoperative procedures, postoperative outcomes were compared. Among 17 patients in One-stage group, 12 underwent CI accompanied with the eradication of inflammation; CI without eradicating inflammation was performed on 3 patients; 2 underwent CIs via the transcanal approach. Thirteen patients in Two-stage group received the complete eradication of inflammation as first-stage surgery, and CI was performed as second-stage surgery after a mean interval of 8.2 months. Additional control of inflammation was performed in 2 patients at second-stage surgery for cavity problem and cholesteatoma, respectively. There were 2 cases of electrode exposure as postoperative complication in the two-stage group; new electrode arrays were inserted and covered by local flaps. The open-set sentence scores of Two-stage group were not significantly higher than those of One-stage group at 1, 2, 3, and 5 yr postoperatively. Postoperative long-term speech performance is equivalent when either of two surgical strategies is used to treat appropriately selected candidates.
Adult ; Aged ; Cholesteatoma, Middle Ear/epidemiology ; Chronic Disease/therapy ; Cochlear Implantation/*adverse effects ; Cochlear Implants/*adverse effects ; Female ; Hearing Loss, Sensorineural/*surgery ; Humans ; Inflammation/epidemiology ; Male ; Middle Aged ; Otitis Media/*surgery ; Retrospective Studies ; *Speech Articulation Tests ; Treatment Outcome ; Young Adult

BACKGROUND AND OBJECTIVES: Hearing in Noise Test (HINT) sentences and Central Institute for the Deaf (CID) sentences are tools that are used for assessing speech cognition. The Korean versions of HINT and CID, KHINT and KCID, have been made and used for the selection of cochlear implant candidates. In this study, we analyzed the compatibility of sentences of KCID and KHINT as testing material for assessing speech performance. MATERIALS AND METHODS: A total of 36 patients selected for the study were divided into 2 groups. Group A, whose mean age was 49.9 years, was composed of 18 patients with hearing aid (range, 24 to 68 years); Group B, whose mean age was 23.5 years, was composed of 18 patients with cochlear implant (range, 10 to 63 years). Open set recognition scores of 2 sentences were compared in each group, by randomly selecting one list each of the KCID and KHINT sentences. Sentences were stimulated using recorded voice and live voice for Group A and B, respectively. RESULTS: There were no statistically significant differences between mean scores of KCID and KHINT sentences in each group (p=0.289, 0.208), respectively. However, there were statistically significant linear correlations between KCID and KHINT sentences in each group and total group (R2=0.961, 0.945, 0.923, respectively; p<0.01, <0.01, <0.01, respectively). CONCLUSION: KCID sentences can be used as a speech performance test material and might serve as a compatible test material for selection of the cochlear implant candidacy.
Cochlear Implants ; Cognition ; Hearing ; Hearing Aids ; Humans ; Noise ; Speech Perception ; Voice

BACKGROUND: There were a few studies which were conducted to know about the behavior of the chronic obstructive pulmonary diseases (COPD) patients. The aims of this study was to explore the behaviour of COPD patients, such as awareness and impact of disease, the pathway of visiting doctors, and the treatment pattern and preference. METHODS: A face-to-face interview of 300 subjects with COPD was conducted. RESULTS: The most concerned symptom which made the respondents to visit the hospital was 'breathlessness' (78%). Only 58% of them knew the exact diagnosis. Seventy-three percent of them visited the hospital 'once a month' or 'once every 2 month'. They have made 12.8 prescheduled visits to the hospital in the past 1 year. Unscheduled visits and hospital stay figured to two in the past year. Only 11% of respondents felt they were currently in good health. 'Severe' and 'very severe' COPD patients perceived their health to be in a worse condition than 'mild' and 'moderate' COPD patients. When conditions worsened, 42% of patients were hospitalized. The most common prescription treatment was a fixed combination of inhaled corticosteroids and long-acting beta2 agonists (48%), followed by a long acting anticholinergics (38%). CONCLUSION: Over forty percent of the patients didn't know exactly about their condition. Most of them had a negative attitude toward their current health status. Doctors need to know more about COPD patients in terms of their attitude toward the disease, impact of the disease, interaction with healthcare professionals and treatment related problems.
Adrenal Cortex Hormones ; Cholinergic Antagonists ; Surveys and Questionnaires ; Delivery of Health Care ; Humans ; Length of Stay ; Lung Diseases, Obstructive ; Prescriptions ; Pulmonary Disease, Chronic Obstructive

PURPOSE: The purpose of this study was to compare the curative effect of Proximal Femoral Nail Antirotation (PFNA) with a Proximal Femoral Nail (PFN) for the treatment of intertrochanteric fracture of the femur. MATERIALS AND METHODS: This study compared 58 cases of 57 patients who were treated by PFNA from June 2007 to February 2009 with 60 cases of 58 patients who were treated by PFN from July 2005 to May 2007. The mean duration of follow-up was 17.2 months (range: 12-31 months). All the fractures were classified according to the AO/ASIF systems. The operative time, the average number of days of hospitalization, the amount of bleeding, the incidence of complications, the union time as assessed on radiologic examinations, the tip apex distance (TAD), the outcome according to the Cleveland index, the change of the neck shaft angle and the amount of sliding at the end of follow-up were compared between the two groups. The clinical outcomes were compared according to the mobility score of Parker, Palmer, Jensen. The results were analyzed using the Student T-test and chi-square tests. RESULTS: There was no significant difference in blood loss during surgery, the number of hospitalization days, radiographic bone union and TAD (p>0.05). Compared with PFN, the operation time, the postoperative sliding and the neck shaft angle change were significantly less in the PFNA group (p<0.05). For the postoperative complications, there was 1 case of cutting out and 1 case of superficial infection in the PFNA group, and there were 4 cases of cutting out, 2 cases of back out, 2 cases of varus collapse, 1 case of nonunion and 1 case of superficial infection in the PFN group. CONCLUSION: Using the PFNA had relatively satisfying clinical results for the treatment of intertrochanteric fracture, as compared with those of using PFN.
Follow-Up Studies ; Hemorrhage ; Hip Fractures ; Hospitalization ; Humans ; Incidence ; Nails ; Neck ; Operative Time ; Postoperative Complications

OBJECTIVES: P1 is a robust positivity at a latency of 50-150 msec in the auditory evoked potential of young children. It has been reported that over the first 2-3 years of life, there is a rapid decrease of the latency and the mean P1 latency in adults with normal hearing is approximately 60 msec. This study was designed to evaluate the change of the P1 latency in Koreans with normal hearing according to age and to compare this with the P1 latency of young patients with profound sensorineural hearing loss before and/or after cochlear implantation. METHODS: Among the patients who visited the Department of Otorhinolaryngology at Seoul National University Hospital from June 2007 to September 2009, the P1 response was recorded in 53 patients in the normal hearing group, in 13 patients in the pre-cochlear implantation (CI) group and in 10 patients in the post-CI group. A synthesized consonant-vowel syllable /ba/ was used to elicit the evoked responses. The evoked responses were collected using the center of the frontal head. For each subject, an individual grand average waveform was computed by averaging the ten recordings. The P1 latency was visually identified as a robust positivity in the waveform. RESULTS: For the normal hearing group, the P1 latency showed the pattern of shortening as the age increased (coefficient, -0.758; P<0.001). For the pre-CI group, 10 cases showed delayed latencies and 3 cases did not show the P1 wave. For the post-CI group, the P1 latencies showed a less delayed tendency than those of the pre-CI group, but this was not statistically different. CONCLUSION: This report provides the standard value of the P1 latency at each age in Koreans for the first time and the findings support that the maturation of the central auditory pathways could be measured objectively using the P1 latency.
Adult ; Auditory Pathways ; Child ; Cochlear Implantation ; Evoked Potentials, Auditory ; Head ; Hearing ; Hearing Loss, Sensorineural ; Humans ; Otolaryngology

BACKGROUND AND OBJECTIVES: The purpose of this study was to analyze the survival rate treatment modalities and certain prognostic factors in patients with external auditory canal (EAC) cancer using the University of Pittsburgh TNM Staging System. SUBJECTS AND METHOD: Medical records and radiological findings of 33 patients treated for EAC cancer between January 1995 and January 2009 were reviewed retrospectively. The median follow-up period was 65 months (range, 12-182 months). RESULTS: The most common histological type was squamous cell carcinoma (19 patients; 57.6%), followed by adenoid cystic carcinoma (9 patients; 27.3%), basal cell carcinoma (1 patient), adenocarcinoma (1 patient), rhabdomyosarcoma (1 patient), undifferentiated carcinoma (1 patient) and malignant small round cell tumor (1 patient). Seven of 33 patients died of EAC cancer and the overall survival rate was 70.6%. There was a significant difference in the survival rate with respect to TNM stages (p=.031). The 10 yr-survival rate of patients with stage I disease was 100.0%, whereas those of stages II, III and IV were 50.0, 80.0 and 58.3%, respectively. Five of 7 patients with recurrence had a history of initial positive resection margin. CONCLUSION: Early detection and proper surgical treatment with sufficient resection margin are essential for disease-specific survival and prevention of recurrence in patients with EAC cancer.
Adenocarcinoma ; Aminocaproic Acids ; Carcinoma ; Carcinoma, Adenoid Cystic ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Ear Canal ; Follow-Up Studies ; Humans ; Medical Records ; Neoplasm Staging ; Prognosis ; Recurrence ; Retrospective Studies ; Rhabdomyosarcoma ; Survival Rate ; Treatment Outcome