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Objective@#Subjective pain is experienced differently by each patient; therefore, modalities that can objectify subjective symptoms are useful. Electrophysiology tests and infrared (IR) thermography can present subjective symptoms in an objective manner. This study aimed to compare the effectiveness of electrophysiology tests and IR thermography in patients with intradural extramedullary (IDEM) schwannoma and statistically analyze the results to verify the positive relationship between the subjective neurologic symptoms and test results. @*Methods@#We retrospectively analyzed the data from 23 patients, pathologically confirmed to have IDEM spinal schwannoma after surgery between January 2012 and December 2020. All patients were preoperatively examined using IR thermography and an electrophysiology test. IR thermography was conducted again week after operation. The IR thermography results were classified as either positive or negative. @*Results@#Radiculopathy symptoms were reported in 16 cases and myelopathy in 7 cases. Among the radiculopathy patients, 9 out of 16 (56.2%) showed positive electrophysiology test results. Among the myelopathy patients, 2 out of 7 (28.5%) showed positive electrophysiology test results. In the radiculopathy group, 15 out of 16 (93.7%) patients showed positive IR thermography results. In the myelopathy group, 2 out of 7 (28.5%) patients showed positive IR thermography results. The correlation between the IR thermography and electrophysiology test was analyzed. In the radiculopathy group, positive electrophysiology test result was obtained in 8 out of 15 (53.5%) patients with positive IR thermography result. @*Conclusion@#In patients with IDEM schwannoma presenting radiculopathy symptoms, IR thermography is a complementary tool to objectify the neurological symptoms.
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Purpose@#To investigate the clinical efficacy of MS-Amnion amniotic membrane contact lenses. @*Methods@#MS-Amnion amniotic membrane contact lenses were placed for 1 week in patients with severe superficial punctate keratitis or corneal epithelial defects that did not respond to medical treatment. Eighteen eyes followed-up for ≥3 months were evaluated in terms of the best-corrected visual acuity, tear break-up time, and corneal sensation and opacity before and after application of the MS-Amnion amniotic membrane contact lens. The success and recurrence rates, and complications during follow-up, were recorded. @*Results@#Out of 18 eyes, 15 (83.3%) healed within 2 weeks without any treatment other than the amniotic membrane; three eyes (16.7%) were unresponsive, and thus underwent temporary amniotic membrane transplantation. Recurrence developed in three eyes (20%). The amniotic membrane contact lens dropped out in five eyes (27.8%) and folded over in two (11.1%). The mean best-corrected visual acuity improved from 0.89 to 0.27 logarithm of the minimal angle of resolution after 3 months, while the mean corneal opacity decreased from 0.38 to 0.11 after 3 months; the changes were statistically significant. The tear break-up time and corneal sensation also improved, but they were not statistically significant. We encountered no significant complications. @*Conclusions@#The MS-Amnion amniotic membrane contact lenses can heal the amniotic membrane and do not require suturing when applied in the outpatient clinic. This may be beneficial for patients with intractable ocular surface disorders.
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Desmoid fibromatosis is a locally aggressive myofibroblastic neoplasm. In this study, we report a case of desmoid fibromatosis in the paraspinal muscle that was misdiagnosed as intramuscular schwannoma through incisional biopsy at another hospital. We performed total excision of the mass lesion with a clear margin. We found that for an accurate diagnosis, magnetic resonance imaging, incisional biopsy and excisional biopsy were required.
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Background@#There are no guidelines for the optimal incubation time or temperature to improve pregnancy outcomes in testicular sperm extraction-intracytoplasmic sperm injection (TESE-ICSI) cycles. We aimed to evaluate whether a 24-hour in vitro culture of testicular spermatozoa affects pregnancy outcomes in TESE-ICSI cycles. @*Methods@#This was a retrospective study of 83 TESE-ICSI cycles using testicular spermatozoa in 46 couples with male partners suffering from nonobstructive or obstructive azoospermia. Sperm retrieval was performed either on the oocyte retrieval (OR) day (65 cycles in 33 couples; group A) or on the day before OR (18 cycles in 13 couples; group B) followed by in vitro culture for 24 hours. The clinical characteristics and pregnancy outcomes, including the number of retrieved oocytes, fertilization rates, embryo transfer rates, implantation and clinical pregnancy rates, were compared between the two groups. @*Results@#There were no differences in terms of clinical characteristics except for the levels of luteinizing hormone (LH) in males. Group B had higher LH levels than group A (4.56±1.24 IU/L vs. 3.67±1.07 IU/L, p=0.017). Group B showed higher fertilization rate (72.4±32.1% vs. 59.2±21.7%, p=0.045), implantation rate (35.0±34.1% vs. 14.0±21.5%, p=010), pregnancy rate per cycle (80% vs. 39%, p=0.033), and clinical pregnancy rate per cycle (80% vs. 37.5%, p=0.024) than those of group A. @*Conclusion@#Testicular sperm retrieval performed on the day before OR followed by in vitro culture can potentially improve pregnancy outcomes.
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Objectives@#. The relationship of estrogen (the primary female sex hormone) with hearing function has been studied in both humans and animals. However, whether estrogen levels affect hearing remains uncertain. Therefore, in this study, we investigated changes in the vulnerability of hearing to acoustic overexposure in ovariectomized female rats. @*Methods@#. Eighteen 8-week-old female Sprague-Dawley rats were separated into four groups as follows: sham ovariectomy (OP), OP only, and OP treated with low (10 µg/kg) or high doses (100 µg/kg) of estrogen. Rats in the estrogen replacement groups were given two intraperitoneal injections. Hearing thresholds were measured before noise exposure, and at 1 day and 2 weeks after exposure. @*Results@#. The hearing thresholds of the sham OP and OP-only groups were not significantly different. However, both estrogen groups showed a lower threshold shift than the OP-only group. Histological immunostaining analyses showed that hair cell loss in the 32 kHz region was more severe in the sham OP group than in the OP-only group. Furthermore, there was little or no hair cell loss in either estrogen replacement group and significantly more hair cell loss in the OP-only group. @*Conclusion@#. These results suggest that estrogen replacement may reduce the vulnerability of hearing to noise exposure in menopausal women.
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Background and Objectives@#The gap prepulse inhibition of the acoustic startle response has been used to screen tinnitus in an animal model. Here, we examined changes in the auditory late response under various conditions of gap prepulse inhibition. @*Subjects and Methods@#We recruited 19 healthy adults (5 males, 14 females) and their auditory late responses were recorded after various stimuli with or without gap prepulsing. The N1 and P2 responses were selected for analysis. The gap prepulse inhibition was estimated to determine the optimal auditory late response in the gap prepulse paradigm. @*Results@#We found that the gap per se generated a response that was very similar to the response elicited by sound stimuli. This critically affected the gap associated with the maximal inhibition of the stimulus response. Among the various gap-stimulus intervals (GSIs) between the gap and principal stimulus, the GSI of 150 ms maximally inhibited the response. However, after zero padding was used to minimize artifacts after a P2 response to a gap stimulus, the differences among the GSIs disappeared. @*Conclusions@#Overall, the data suggest that both the prepulse inhibition and the gap per se should be considered when using the gap prepulse paradigm to assess tinnitus in humans.
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Hearing loss is very common and economically burdensome. No accepted therapeutic modality for sensorineural hearing loss is yet available; most clinicians emphasize rehabilitation, placing hearing aids and cochlear implants. Photobiomodulation (PBM) employs light energy to enhance or modulate the activities of specific organs, and is a popular non-invasive therapy used to treat skin lesions and neurodegenerative disorders. Efforts to use PBM to improve hearing have been ongoing for several decades. Initial in vitro studies using cell lines and ex vivo culture techniques have now been supplanted by in vivo studies in animals; PBM protects the sensory epithelium and triggers neural regeneration. Many reports have used PBM to treat tinnitus. In this brief review, we introduce PBM applications in hearing research, helpful protocols, and relevant background literature.
Subject(s)
Animals , Cell Line , Cochlear Implants , Culture Techniques , Epithelium , Hearing Aids , Hearing Loss , Hearing Loss, Sensorineural , Hearing , In Vitro Techniques , Low-Level Light Therapy , Neurodegenerative Diseases , Regeneration , Rehabilitation , Skin , TinnitusABSTRACT
Bell's palsy, also known as idiopathic facial palsy, is one of the most common causes of peripheral facial nerve palsy. Many studies of the cause and treatment of Bell's palsy have been performed, but the results are still controversial. Clinical cases of other forms of cranial nerve paralysis after influenza vaccination have also been reported. We herein report a review of literature and a case of a 95-year-old female patient who developed left facial paralysis following influenza vaccination.
Subject(s)
Female , Humans , Bell Palsy , Cranial Nerves , Facial Nerve , Facial Paralysis , Influenza, Human , Paralysis , VaccinationABSTRACT
BACKGROUNDS/AIMS: Laparoscopic cholecystectomy (LC) has become a standard procedure for treatment of benign gallbladder diseases. There has been a small proportion of gallbladder cancer (GBC) which was incidentally found in the gallbladder specimen, and LC has been tried in some patients with faintly suspected GBC. This study intended to analyze the prognosis of patients with pT1b/T2 GBC who have undergone LC and the outcome of extended re-operation. METHODS: After analyzing the institutional profiles of 500 GBC patients who have undergone surgical resection, we selected 64 patients who underwent LC initially from January 1996 to December 2008 and whose gallbladder pathology was confined to pT1b or pT2 lesions. Of them, 34 patients (53.1%) underwent extended reoperation. Their medical records were reviewed retrospectively. RESULTS: In the LC only group (n=30), mean age of the 16 pT1 patients was 65.7+/-12.5 years and mean age of the 14 pT2 patients was 66.7+/-10.1 years. In the reoperation group (n=34), mean age of the 8 pT1b patients was 52.6+/-9.9 years and in 26 pT2 patients, mean age was 59.2+/-7.9 years. The reoperation group showed a younger patient age pattern than the LC only group (p=0.001). The types of reoperation were liver resection with lymph node (LN) dissection in 17, bile duct resection with LN dissection in 2, and hepatectomy and bile duct resection with LN dissection in 15. In the LC only group, the 5-year survival rate (5-YSR) was 70.3% in pT1b and 43.2% in pT2. In the reoperation group, 5-YSR was 62.5% in pT1b (n=8) and 59.5% in pT2 (n=26). A survival comparison between the two groups showed no significant survival gain in pT1 patients (p=0.69) and in pT2 patients (p=0.14). In our whole database analysis, 5-YSR of pT1bNx lesions was 70% after cholecystectomy and 78% after extended cholecystectomy. Lymph node metastasis was identified in 11% of pT1b lesions. For pT2N0 lesions, overall 5-YSR was 62% after R0 resection, showing no survival difference between primary extended surgery and LC-redo operation (p=0.45). CONCLUSIONS: The survival gain of reoperation was not evident in pT1b lesions. In contrast, some noticeable but not statistically significant survival difference was observed in pT2 lesions. Thus, reoperation for pT1b/T2 GBC following LC is indicated for individualized reasons, especially in patients with pT1b lesions. Old age was one of the important factors in deciding not to reoperate.
Subject(s)
Humans , Bile Ducts , Cholecystectomy , Cholecystectomy, Laparoscopic , Gallbladder , Gallbladder Diseases , Gallbladder Neoplasms , Hepatectomy , Liver , Lymph Nodes , Medical Records , Neoplasm Metastasis , Prognosis , Recurrence , Reoperation , Survival RateABSTRACT
Herpes zoster oticus is a common inflammatory disease caused by reactivation of varicella zoster virus in the dorsal root ganglia. Its symtpoms include unilateral distribution of the vesicular eruptions, neuralgia and various type of cranial nerve palsy depending on the involving site of head and neck region. Most commonly affected cranial nerves are facial nerve (VII) and vestibulocochelar nerve (VIII), but on rare occasions cranial nerves V, IX, X, XI are affected as well. Although neurologic symptom of herpes zoster was commonly reported, zoster associated hiccups is very rare. We experienced one case of herpes zoster oticus involving multiple cranial nerve palsy with intractable hiccups. We report our case with a review of literature.
Subject(s)
Cranial Nerve Diseases , Cranial Nerves , Facial Nerve , Ganglia, Spinal , Head , Herpes Zoster , Herpes Zoster Oticus , Herpesvirus 3, Human , Hiccup , Neck , Neuralgia , Neurologic ManifestationsABSTRACT
Several complications are possible after a lumbar epidural block. However pneumocephalus are rare. In this case, we report a case of pneumocephalus. A 68-year-old male patient received lumbar epidural block with the loss of resistance technique using air, and after 35 minutes, apnea, unconsciousness, hypotension, and bradycardia occurred. Immediately, brain CT was done, and we found pneumocephalus. The patient complained of severe occipital headache and itchiness due to pneumocehalus. After conservative treatment, the patient recovered without neurologic complications, and on the seventh day of his hospitalization, he was discharged from the hospital.
Subject(s)
Aged , Humans , Male , Apnea , Bradycardia , Brain , Headache , Hospitalization , Hypotension , Pneumocephalus , UnconsciousnessABSTRACT
Chylothorax is defined as the accumulation of chyle-containing lymphatic fluid within the pleural space. The causes of chylothorax are various and usually attributable to 1 of 4 categories: malignancy, trauma (including surgery), miscellaneous disorders, and idiopathy. Occurrence of chylothorax in patients on hemodialysis is very uncommon and it may have resulted from multiple iatrogenic vascular trauma conducive to venous thrombosis and stenosis when hemodialysis catheters required frequent changes or long term indwelling. Local thrombosis and stenosis may increase the venous hydrostatic pressure and hinder the discharge of thoracic duct lymph into the venous system. Hence, chylous lymphatic fluid leak into the pleural space. Treatment of chylothorax may range from nonoperative management to elective surgery. We report a case of a patient on hemodialysis who developed chylothorax secondary to a subclavian vein stenosis without any other symptoms such as arm edema and successfully treated with nonoperative management.
Subject(s)
Humans , Arm , Catheters , Chylothorax , Constriction, Pathologic , Edema , Hydrostatic Pressure , Renal Dialysis , Subclavian Vein , Thoracic Duct , Thrombosis , Venous ThrombosisABSTRACT
Antineutrophil cytoplasmic antibodies (ANCA) directed against either proteinase-3 or myeloperoxidase are associated with a limited group of small vessel vasculitic syndromes. C-ANCA is regarded as highly specific for idiopathic ANCA-associated vasculitis (AAV). However, C-ANCA is not specific for Wegeners granulomatosis and has been reported in the course of a variety of infectious conditions. Sub-acute bacterial endocarditis is a notable concern because it may be associated with C-ANCA. The misdiagnosis of bacterial endocarditis as AAV and the administration of immunosuppressive treatment could aggravate the infection. We describe a patient with sub-acute bacterial endocarditis who presented with features mimicking vasculitis and positive C-ANCA by indirect immunofluorescence and for anti-PR3 antibodies by antigen-specific ELISA.
Subject(s)
Humans , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis , Antibodies , Antibodies, Antineutrophil Cytoplasmic , Cytoplasm , Diagnostic Errors , Endocarditis, Bacterial , Fluorescent Antibody Technique, Indirect , Glycosaminoglycans , Peroxidase , VasculitisABSTRACT
Many drugs have been known to induce lupus-like syndrome, composing approximately 10% of all SLE cases. Isoniazid-induced lupus erythematosus affects either sex equally and the most common presenting feature is arthralgia or arthritis with anemia. Fever and pleuritis occur in approximately half of the cases, and pericarditis in approximately 30% of cases. We discribe a 28-year-old woman receiving antituberculous medications including isoniazid for one month. She was hospitalized with fever, arthralgia and newly developed pleural effusion The analysis of pleural fluid and serum revealed an elevated level of antinuclear antibody. We suspected of drug induced lupus and stopped isoniazid medication. After discontinuation of isoniazid and short course of prednisolone treatment, her symptoms and pleural effusion disappeared. This case is to our knowledge, the fist report of isoniazid induced SLE in Korea.
Subject(s)
Adult , Female , Humans , Anemia , Antibodies, Antinuclear , Arthralgia , Arthritis , Fever , Isoniazid , Korea , Lupus Erythematosus, Systemic , Pericarditis , Pleural Effusion , Pleurisy , PrednisoloneABSTRACT
Localized amnesia is characterized by a failure to recall events that occurred during a circumscribed period of time. Localized amnesia is the most common type of dissociative amnesia. It is assumed that this is a disorder of memory retrieval. Recent neuroimaing studies reported that posterior cingulate cortex may play a important role in memory(autobiographical) retrieval. The authors reported a case of localized amnesia with mass on left posterior cingulate cortex.
Subject(s)
Humans , Amnesia , Gyrus Cinguli , MemoryABSTRACT
PURPOSE: To evaluate the results of Cable plate fixation for the treatment of periprosthetic femoral fracture after hip arthroplasty. MATERIALS AND METHODS: We reviewed 10 cases of periprosthetic femoral fractures after hip arthroplasty between Nov. 2002 and May 2004. The mean follow up periods were 20 months. The fractures were classified according to Vancouver classification. Seven cases of type B1, one case of type B3 and two cases of type C were treated with open reduction and internal fixation with Cable plate. Evaluation of results was based on mean union time, postoperative complications and Harris hip score. RESULTS: The mean time for bony union was 4.8 months in type B1, 6 months in type B3 and 8 months in type C fracture. As for complications, there were refracture, metal breakage and nonunion. The postoperative mean Harris hip score was 91.5 points for type B1, 85 points for type B3 and 72.5 points for type C fracure. CONCLUSION: Cable plate can be useful for treatment of periprosthetic femoral fractures after hip arthroplasty, but the selection of treatment methods should be cautiously made according to the type of fracture and status of patients.
Subject(s)
Humans , Arthroplasty , Classification , Femoral Fractures , Femur , Follow-Up Studies , Hip , Postoperative ComplicationsABSTRACT
Peak expiratory flow meter(PEFM) is a portable medial device used for home health care of chronic respiratory diseases such as asthma. PEFM adapts spring principle for convenient measurement of expiratory peak flow rate, however linear scale could lead to a substantial measurement e rror. The pre sent study identified inherent er ror of the device by theore tical ana lysis, and accurately measured the error of a patented commercial PEFM. Consistent error was observed mainly due to non-linearity of the flow-to-distance conversion principle, which could be fitted to a quadratic formula with satisfactory accuracy. A simple error compensation technique was accordingly proposed based on quadratic error modeling, which decreased measurement error down to less than 1/3 of before- compensation corresponding to only an error of less than 15LPM over a wide range of flow(100-500LPM). Error compensation table was constructed for convenient use of patients. The present error compensation technique is simple and convenient not only to enhance home health care quality but also for the manufacturers to build more accurate PEFM devices.
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A optical endoscope has disadvantages; giving pain and not applying to a postoperative patient. If it substitutes for a virtual endoscope, noninvasive observation can be gained. This paper describes a developed viewer, using Visual C++ 6.0 and Openlnventor2.5.2 (object-oriented 3D toolkit) library, for the manipulation of 3D anatomy object model. It is named Anatomy Viewer. The viewer is implemented under the PC environment. It can rotate, zoom in and out, and fly through anatomy models on 3D space and translate into a interested area, and then save as a TGA image file like a real endoscope. Also, as it is improved in the network, we exchange data and discuss with someone who is in the other place. This viewer is very useful to understand the anatomy structure, to diagnose, and to make a surgical plan in preoperative step. We verified its usefulness by observing a 3D bronchus model that is reconstructed with CT image slices.