Purpose: To evaluate the reliability and validity of the Cataract-related Visual Function Questionnaire (CVFQ). Methods: A prospective cross-sectional study of 141 cataract patients was conducted from March 2022 to June 2022. The questionnaire was created based on a literature review and advice from an expert panel. This study determined its construct validity, criterion validity, internal consistency, and test-retest reliability. Results: The CVFQ consists of 15 items distributed among five categories: overall visual quality, overall visual function, distance vision, near vision, and glare. In the exploratory factor analysis of validity, the first three principal components explained 77.8% of the variance. The p-values in the Spearman correlation test comparing the pre- and postoperative total CVFQ score and best-corrected visual acuity (BCVA) were 0.006 and 0.004, respectively. In the reliability analysis, Cronbach’s alpha was > 0.9 for internal consistency and the p-values of each subcategory were all significant in the analysis of test-retest reliability. Conclusions Our results indicate that the CVFQ is useful for measuring the visual quality and visual function of cataract patients in Korea.

Objective: Muscle depletion in patients undergoing liver transplantation affects the recipients’ prognosis and therefore cannot be overlooked. We aimed to evaluate whether changes in muscle and fat mass during the preoperative period are associated with prognosis after deceased donor liver transplantation (DDLT). Materials and Methods: This study included 72 patients who underwent DDLT and serial computed tomography (CT) scans.Skeletal muscle index (SMI) and fat mass index (FMI) were calculated using the muscle and fat area in CT performed 1 year prior to surgery (1 yr Pre-LT), just before surgery (Pre-LT), and after transplantation (Post-LT). Simple aspects of serial changes in muscle and fat mass were analyzed during three measurement time points. The rate of preoperative changes in body composition parameters were calculated (preoperative ΔSMI [%] = [SMI at Pre-LT - SMI at 1 yr Pre-LT] / SMI at Pre-LT x 100;preoperative ΔFMI [%] = [FMI at Pre-LT - FMI at 1 yr Pre-LT] / FMI at Pre-LT x 100) and assessed for correlation with patient survival. Results: SMI significantly decreased during the preoperative period (mean preoperative ΔSMI, -13.04%, p < 0.001). In the multivariable analysis, preoperative ΔSMI (p = 0.016) and model for end-stage liver disease score (p = 0.011) were independent prognostic factors for overall survival. The mean survival time for patients with a threshold decrease in the preoperative ΔSMI (≤ -30%) was significantly shorter than for other patients (p = 0.007). Preoperative ΔFMI was not a prognostic factor but FMI increased during the postoperative period (p = 0.009) in all patients. Conclusion A large reduction in preoperative SMI was significantly associated with reduced survival after DDLT. Therefore, changes in muscle mass during the preoperative period can be considered as a prognostic factor for survival after DDLT.

Background: Abdominal compartment syndrome (ACS) occurs due to increased abdominal cavity pressure, causes multiple organ damage, and leads to fatal consequences. Increased intraperitoneal pressure due to different reasons generally does not result in serious damage, due to the compliance of the abdominal wall. However, when the pressure exceeds the limit, ACS develops, thereby causing fatal damage to the organs. Case: A patient presented with rapid stomach swelling due to excessive food intake and was known to have bulimia nervosa, which had now resulted in ACS. Mental changes, abdominal distension, color change in the legs, acute kidney injury, and acidosis were seen. The patient expired due to ischemia-reperfusion injury and disseminated intravascular coagulation, which occurred after surgical decompression. Conclusions Under suspected ACS conditions, we should be aware of various symptoms that can occur. Early attempts for decompression are helpful, and it is important to be prepared for reperfusion injury prior to surgical decompression attempts.

BACKGROUND: This study aims to compare the surgical outcomes of open reduction and internal fixation (ORIF) and minimally invasive plate osteosynthesis (MIPO) using a screw compression method in simple humeral shaft fractures. METHODS: This retrospective study was performed with 50 patients who had surgical interventions for the treatment of simple humeral shaft fractures and had follow-ups of at least 12 months in Ulsan University Hospital between August 2008 and June 2015. Group 1 included 23 patients treated with ORIF and group 2 included 27 patients treated with the MIPO technique using a locking screw plate. The time to clinical/radiographic union, the joint range of motion (ROM), and function were evaluated. RESULTS: The average time to clinical/radiographic bone union was shorter in group 2 (12.0 ± 3.7 weeks/14.8 ± 2.0 weeks in group 1 and 9.4 ± 1.3 weeks/12.0 ± 3.3 weeks in group 2; p = 0.022/p = 0.034). Shoulder and elbow joint function evaluated by joint ROM and visual analogue scale (VAS), Korean Shoulder Elbow Society (KSS), American Shoulder and Elbow Surgeons (ASES), and the University of California at Los Angeles (UCLA) scores was excellent in both groups. On the average shoulder ROM at 12 months after the operation, group 1 had forward elevation of 160°, external rotation of 30° in adduction and lumbar vertebra 10 level in internal rotation and group 2 had forward elevation of 170°, external rotation of 35° in adduction and lumbar vertebra 9 level in internal rotation. The mean VAS, KSS, ASES, and UCLA scores were 2.8, 87.0 ± 0.9, 89.4 ± 0.9, and 31.0 ± 1.4, respectively, in group 1 and 1.7, 89.1 ± 2.7, 91.0 ± 1.6, and 32.4 ± 3.2, respectively, in group 2. There were statistically significant intergroup differences in VAS score (p = 0.011). There were significantly less postoperative infections in group 2 (three cases, 10.7% in group 1 and 0 case in group 2; p = 0.041) although all of them were superficial infections and well-treated by an average 4-week course of antibiotics (range, 2 to 6 weeks). CONCLUSIONS: MIPO using a screw compression method in simple humeral shaft fractures demonstrated superior efficacy to ORIF in terms of the time to clinical/radiographic union, pain score, and postoperative infection rate.
Anti-Bacterial Agents ; California ; Elbow ; Elbow Joint ; Follow-Up Studies ; Fracture Fixation ; Humans ; Humeral Fractures ; Joints ; Methods* ; Range of Motion, Articular ; Retrospective Studies ; Shoulder ; Spine ; Surgeons ; Ulsan

BACKGROUND: There are several different opinions regarding the improvements seen on the transverse plane after soft tissue surgery alone in independently ambulant patients with cerebral palsy. We performed a meta-analysis using data from previous studies to identify the effects of soft tissue surgery alone on pelvic and hip rotation in children with spastic diplegia. METHODS: We conducted a pilot study to evaluate the improvement in pelvic and hip rotation after muscle-tendon lengthening surgery in children with spastic diplegia. We also searched EMBASE and PubMed and selected 2 previous studies using the same test conditions with kinematic data on the pelvis and hip joints. A meta-analysis of the results of these 3 studies, including this pilot study, was then performed. RESULTS: The meta-analysis results showed an external rotation decrease (p = 0.005) in the mean difference of pelvic rotation of -3.61 (95% confidence interval [CI], -6.13 to -1.09) and a mean difference in hip rotation of 6.60 (95% CI, 3.34 to 9.86), indicating a significant increase in the hip external rotation after surgery (p < 0.001). CONCLUSIONS: In independently community-ambulant pediatric patients with spastic diplegia, pelvic retraction and hip internal rotation could be improved after soft tissue surgery.
Cerebral Palsy* ; Child ; Hip Joint ; Hip* ; Humans ; Muscle Spasticity* ; Pelvis ; Pilot Projects

BACKGROUND: There are several different opinions regarding the improvements seen on the transverse plane after soft tissue surgery alone in independently ambulant patients with cerebral palsy. We performed a meta-analysis using data from previous studies to identify the effects of soft tissue surgery alone on pelvic and hip rotation in children with spastic diplegia. METHODS: We conducted a pilot study to evaluate the improvement in pelvic and hip rotation after muscle-tendon lengthening surgery in children with spastic diplegia. We also searched EMBASE and PubMed and selected 2 previous studies using the same test conditions with kinematic data on the pelvis and hip joints. A meta-analysis of the results of these 3 studies, including this pilot study, was then performed. RESULTS: The meta-analysis results showed an external rotation decrease (p = 0.005) in the mean difference of pelvic rotation of -3.61 (95% confidence interval [CI], -6.13 to -1.09) and a mean difference in hip rotation of 6.60 (95% CI, 3.34 to 9.86), indicating a significant increase in the hip external rotation after surgery (p < 0.001). CONCLUSIONS: In independently community-ambulant pediatric patients with spastic diplegia, pelvic retraction and hip internal rotation could be improved after soft tissue surgery.
Cerebral Palsy* ; Child ; Hip Joint ; Hip* ; Humans ; Muscle Spasticity* ; Pelvis ; Pilot Projects

BACKGROUND AND OBJECTIVES: Various drugs can be used for treatment of laryngopharyngeal reflux disease (LPRD). However, the optimal medical treatment regimen is still controversial. This study was performed to determine the optimal medical treatment regimen and duration for LPRD. SUBJECTS AND METHOD: We studied 172 patients who were diagnosed as LPRD by reflux symptom index (RSI) or reflux finding scores (RFS). The study group was divided into 4 groups according to the medication regimen: proton pump inhibitor (PPI), PPI and prokinetics, PPI and H2 blocker, and double dose PPI groups. All patients took medicines for 3 months or more. Clinical remission was defined as 70% improvement of initial RSI scores. RESULTS: 36 (20.9%) patients were prescribed PPI only, 65 (37.8%) patients PPI with prokinetics, 51 (29.6%) patients PPI with H2 blocker, 20 (11.6%) patients double dose PPI. Pretreatment with RSI and RFS did not differ among the four groups. RSI was improved after one month of medication in all of the groups. RSI and RFS tended to decrease during the treatment in all groups (p for trend <0.001). The mean clinical remission time was 2.3 months in patients receiving PPI alone, 2.6 months in PPI and prokinetics group, 2.5 months in the PPI and H2 blocker group and 1.8 months in the double dose PPI group. About 70% of patients reached clinical remission within 3 months. CONCLUSION: PPI with or without prokinetics or H2 blocker is effective treatment for LPRD, and the appropriate duration of medication seems to be about 3 months. Double dose PPI can be used for those whom normal dose PPI is ineffective.
Humans ; Laryngopharyngeal Reflux* ; Proton Pumps

BACKGROUND AND OBJECTIVES: Pulmonary thromboembolism (PTE) after surgery is one of the rare but fatal complications causing sudden respiratory failure. This study was performed to evaluate PTE after head and neck surgery and to report our recent experience with review of the literature. SUBJECTS AND METHOD: We retrospectively analyzed 1096 patients who underwent head and neck surgery from January 2011 to June 2013 in a tertiary hospital. We evaluated the incidence and characteristics of PTE and risk factors of PTE such as smoking, body mass index, comorbidities, coronary artery disease, coagulation disorder and Caprini risk assessment model. RESULTS: PTE occurred in five of 1096 patients (0.46%; two were male and three were female, with a mean age of 56.2 year). All patients with PTE were categorized into high risk group of PTE by Caprini model. The mean Caprini risk score were 6.6 and 4.6 in the PTE patients and non-PTE patients, respectively. The significant risk factors were long operative time, cancer patients and high Caprini score in this study. One PTE patient underwent cardiopulmonary resuscitation due to respiratory arrest, afterwards received thromboembolectomy by thoracotomy. Four patients received anticoagulation therapy only. CONCLUSION: Risk stratification for PTE is necessary in patients who receive long operation for head and neck cancer or have high Caprini score.
Body Mass Index ; Cardiopulmonary Resuscitation ; Comorbidity ; Coronary Artery Disease ; Female ; Head and Neck Neoplasms ; Head* ; Humans ; Incidence ; Male ; Neck* ; Operative Time ; Pulmonary Embolism* ; Respiratory Insufficiency ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Smoke ; Smoking ; Tertiary Care Centers ; Thoracotomy ; Venous Thrombosis

OBJECTIVE: To document our experience of the vascular anomalies or variants in paraaortic region and intend to increase vigilance among the gynecological surgeons for presence of variable vascular anomalies or variants. METHODS: We conducted a retrospective chart review of 280 patients with various gynecologic malignancies who had undergone systemic laparotomic or laparoscopic paraaortic lymphadenectomy between November 2003 and July 2011. RESULTS: We discovered total nine patients of vascular anomalies during the surgery. Seven patients had an accessory polar renal artery. One patient had a duplicated inferior vena cava and the other had a right paravertebral vein. There were no vascular complications such as tearing, ligation or transection. CONCLUSION: It is not uncommon to encounter vascular anomalies in paraaortic region during the lymphadenectomy. Hence, the gynecological surgeons must be cognizant of various vascular anomalies occurring within this area to reduce the vascular accidents.
Humans ; Ligation ; Lymph Node Excision ; Renal Artery ; Retrospective Studies ; Veins ; Vena Cava, Inferior

The authors report a case of 42-year-old woman with an intraventricular tumor in the trigone of the left lateral ventricle. The first operation achieved a microscopically complete resection. The tumor was histologically atypical meningioma. After 26 months, there were recurrences of intraventricular meningioma. Complete resection of the tumor and adjuvant radiation therapy were performed, and the histological diagnosis was malignant meningioma. Sixteen months after the second operation, spinal metastasis in cervicolumbar lesion was diagnosed and a subtotal removal of cervical intradural extramedullary mass was performed. We describe an unusual case of intraventricular malignant meningioma with cerebrospinal fluid-disseminated spinal metastases with review of the clinical courses of previous reports.
Adult ; Cerebral Ventricle Neoplasms ; Female ; Humans ; Lateral Ventricles ; Meningioma ; Neoplasm Metastasis ; Recurrence