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Patients with pelvic or sacral pain can be easily encountered in outpatient clinic settings. Since the cause of pain can be originated from the lumbar spinal region, or sometimes directly from the pelvis or sacral region, it is essential to differential diagnose where the pain is coming from. Caudal epidural steroid injection, sacroiliac joint injection, and piriformis injection are not only therapeutic, but are often used diagnostically, therefore they would be more useful in the outpatient clinic.Ultrasound-guided injections have similar clinical effects and the advantage of having shorter procedure times and no radiation exposure compared with fluoroscopic image-guided injection. Therefore, it is recommended to safely perform pelvic or sacral injections using ultrasound guidance.
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In this study, a fungal strain KNUF-22-025 belonging to the genus Botryotrichum was isolated from the soil in Korea. The cultural and morphological characteristics of this strain differed from those of closely related species. On malt extract agar, strain KNUF-22-025 showed slower growth than most of the related species, except B. domesticum. The conidia size (9.6– 21.1 Â 9.9–18.4 mm) of strain KNUF-22-025 was larger than those of B. piluliferum, B. domesticum, and B. peruvianum but smaller than those of B. atrogriseum and B. iranicum. Conidiophores in strain KNUF-22-025 (137 mm) were longer than those in other closely related species but shorter than those in B. atrogriseum. Multi-locus analysis of molecular markers, such as ITS, 28S ribosomal DNA, RBP2, and TUB2 revealed that strain KNUF-22-025 was distinct from other Botryotrichum species. Thus, this strain is proposed as a novel species based on morphological characteristics along with molecular phylogeny and named Botryotrichum luteum sp. nov.
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In this study, fungal strains designated as KNUF-22-14A and KNUF-22-15A were isolated from soil samples in Korea. These two strains were identified based on cultural and morphological characteristics as well as phylogenetic analyses and were found to be morphologically and phylogenetically identical. Upon their morphological comparison with closely related species, such as Tolypocladium album, T. amazonense, T. endophyticum, T. pustulatum,and T. tropicale, a difference in the size of short phialides [0.6–2.4(–9.3) Â 0.8–1.4 mm] was observed. Meanwhile, these strains had larger conidia (1.2–3.0 Â 1.2–3.0 mm) than T. album, T.amazonense, T. endophyticum, and T. tropicale and smaller conidia than T. pustulatum. Phylogenetic analyses using a multi-locus datasets based on ITS, LSU, and SSU showed that KNUF-22-14A and KNUF-22-15A formed a distinct cluster from previously identified Tolypocladium species. Thus, these fungal strains isolated from soil in Korea are proposed as a novel species according to their characteristics and are named Tolypocladium globosum sp. nov.
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The fungal strain belonging to the genus Monochaetia of the family Sporocadaceae was isolated from hairy long-horned toad beetle (Moechotypa diphysis) during the screening of microfungi associated with insects from Gangwon Province, Korea. The strain KNUF-6L2F produced white, light brown to dirty black surface, and olivaceous green colonies with the higher growth, while the closest strain M. ilicis KUMCC 15–0520 T were light brown to brown, and M.schimae SAUCC 212201 T light brown to brown toward center. The strain KNUF-6L2F produced shorter (5.7–14.0 lm) apical appendages thanM. ilicis (6.0–24.0 lm), but similar to M. schimae (7.0–12.5 lm). Three median cells of KNUF-6L2F were light brown to olivaceous green, whereas brown and olivaceous cells were observed from M. ilicis and M. schimae, respectively. And the strain KNUF-6L2F produced larger conidiogenous cells than M. ilicis and M. schimae. Additionally, phylogenetic analyses based on molecular datasets of internal transcribed spacer (ITS) regions, translation elongation factor 1-alpha (TEF1α), and b-tubulin (TUB2) genes corroborated the strain’s originality. Thus, the strain is different from other known Monochaetia species, according to molecular phylogeny and morophology, hence we suggested the new species Monochaetia mediana sp. nov. and provided a descriptive illustration.
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The fungal strain KNUF-22-18B, belonging to Cucurbitariaceae, was discovered from a stink bug (Hygia lativentris) during the investigation of insect microbiota in Chungnam Province, South Korea. The colonies of the strain KNUF-22-18B were wooly floccose, white to brown in the center on oatmeal agar (OA), and the colonies were buff, margin even, and colorless, reverse white to yellowish toward the center on malt extract agar (MEA). The strain KNUF-22-18B produced pycnidia after 60 days of culturing on potato dextrose agar, but pycnidia were not observed on OA. On the contrary, N. keratinophila CBS 121759 T abundantly formed superficial pycnidia on OA and MEA after a few days. The strain KNUF-22-18B produced chlamydospores subglobose to globose, mainly in the chain, with a small diameter of 4.4– 8.8 lm. At the same time, N. keratinophila CBS 121759 T displayed a globose terminal with a diameter of 8–10 lm. A multilocus phylogeny using the internal transcribed spacer regions, 28S rDNA large subunit, b-tubulin, and RNA polymerase II large subunit genes further validated the uniqueness of the strain. The detailed description and illustration of the proposed species as Neocucurbitaria chlamydospora sp. nov. from Korea was strongly supported by molecular phylogeny.
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Objective@#To investigate the relationship between Trunk Impairment Scale (TIS) and lumbar spine bone mineral density (BMD) in subacute stroke patients. @*Methods@#Twenty-three subacute male stroke patients under the age of 65 were prospectively enrolled to exclude both postmenopausal and senile effects on BMD. The TIS, Berg Balance Scale, the Korean version of the Modified Barthel Index, and manual muscle test were measured at admission and 3 months after stroke onset. BMD of the bilateral lower extremities and lumbar vertebrae was measured by dual-energy X-ray absorptiometry 3 months after stroke onset. @*Results@#TIS at baseline (TIS_B) and TIS at 3 months after stroke (TIS_3m) showed significant correlations with lumbar BMD (TIS_B, r=0.522; TIS_3m, r=0.517). Through multiple regression analysis, the TIS_B was associated with lumbar BMD (adjusted R2=0.474). However, BMD of the bilateral lower extremities was not correlated with any clinical measurements except body mass index. @*Conclusion@#We found a relationship between TIS_B and lumbar BMD in subacute young male stroke patients. Stroke patients with poor trunk control in the early subacute stage would have low BMD of vertebral bones at 3 months. The TIS can be useful for estimating bone fragility in the lumbar vertebrae of subacute stroke patients.
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Objective@#To determine correlations of alternation motor rate (AMR), sequential motor rate (SMR), and maximum phonation time (MPT) with the severity of dysphagia in subacute stroke patients. @*Methods@#This was a retrospective chart review study. Data of 171 subacute stroke patients were analyzed. Patient’s AMR, SMR, and MPT data were collected from their language evaluations. Video fluoroscopic swallowing study (VFSS) was done. Data of dysphagia scales including penetration-aspiration scale (PAS), American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA-NOMS) scale, clinical dysphagia scale (CDS), and videofluoroscopic dysphagia scale (VDS) were obtained. AMR, SMR, and MPT were compared between a non-aspirator group and an aspirator group. Correlations of AMR, SMR, and MPT with dysphagia scales were analyzed. @*Results@#AMR ("ka"), SMR, and modified Rankin Scale were significant associated factors between non-aspirator group and aspirator group, while AMR ("pa"), AMR ("ta"), and MPT were not. AMR, SMR, and MPT showed significant correlations with PAS score, ASHA-NOMS scale, CDS, VDS oral, and VDS pharyngeal scores. The cut-off value for distinguishing non-aspirator group and aspiration group was 18.5 for AMR ("ka") (sensitivity of 74.4%, specificity of 70.8%) and 7.5 for SMR (sensitivity of 89.9%, specificity of 61.0%). AMR and SMR were significantly lower in before-swallow aspiration group. @*Conclusion@#Articulatory diadochokinetic tasks that can be easily performed at the bedside would be particularly helpful in determining the oral feeding possibility of subacute stroke patients who cannot undergo VFSS, which is the gold standard for dysphagia assessment.
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To exploit insect-derived fungi, insects were collected from seven different regions in Korea, including Gyeongbuk, Goryeong, and several fungi were isolated from them. A fungal strain designated 21-64-D was isolated from riparian tiger beetle (Cicindela transbaicalica) and morphologically identified as a species belonging to the genus Oidiodendron. Phylogenetic analysis using the nucleotide sequences of internal transcribed spacer (ITS) regions and the partial sequence of the large subunit of the nuclear ribosomal RNA (LSU) gene revealed the distinct phylogenetic position of the isolate among recognized Oidiodendron species including its closest neighbors O. chlamydosporicum, O. citrinum, O. maius, and O. pilicola. The hyphal and conidial morphology of the strain, particularly club-shaped hyphae, clearly differentiated it from its close relatives. Results indicated that 21-64-D is a novel species in the genus Oidiodendron, for which the name Oidiodendron clavatum sp. nov. is proposed.
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Background and Objectives@#Traditionally, transoral laser microsurgery (TLM) is commonly used to treat early glottic cancer. However, the long-term oncologic results have not been thoroughly investigated. Therefore, this study aimed to analyze long-term oncologic outcomes of TLM for early glottic cancer.Subjects and Method We retrospectively studied 132 patients who underwent TLM for early glottis cancer from January 2001 to August 2020. We assessed overall and disease-free survival according to the T classification and types of cordectomy proposed by the European Laryngological Society in 2007. @*Results@#Of the 132 patients, 125 were male and 7 female. The mean age was 61.6±9.3 years. We found 5 (3.8%), 112 (84.8%), and 15 (11.3%) patients staged as CIS, T1, and T2, respectively. For the cordectomy types, there were 6 in type I, 22 in type II, 83 in type III, 6 in type IV, 13 in type V, and 2 in type VI. Ten-year overall and disease-free survival rates were 99.2% and 87.1%, respectively. Overall and disease-free survival curves were not different according to different T classification and cordectomy types. @*Conclusion@#TLM is an excellent treatment modality for the long-term oncologic control of early glottic cancer.
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During the screening of Korean microflora, a fungal strain (KNU-PT-1804) belonging to the genus Pestalotiopsis was isolated from persimmon tree (Diospyros kaki) bark collected from North Gyeongsang Province, Korea. The strain, KNU-PT-1804, produced smaller conidia compared with related species P. kenyana, P. neglecta, and P. telopeae. The novelty of the strain was confirmed based on phylogenetic analysis using molecular datasets of internal transcribed spacer (ITS) regions, b-tubulin (TUB2), and translation elongation factor 1-alpha (TEF1α) genes. Molecular phylogeny strongly supports that the strain is distinct from previously known Pestalotiopsis species, and we proposed the novel species, Pestalotiopsis kaki sp. nov., and provide a detailed description and illustration.
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Two fungal strains (KNU-JJ-1827 and KNU-JJ-1829) belonging to the class Dothideomycetes were discovered from Jeju Island, Korea during this investigation of soil microfungi. Strain KNU-JJ-1827 showed fewer conidial septations, larger conidiogenous cells, and smaller conidia compared to the previously identified closest species of Didymocyrtis. Strain KNU-JJ-1829 revealed the similar characteristics of the nearest certain species of the genus Parathyridaria with the production of conidiogenous cells and conidia, because no asexual morphs were detected from the closest type strain Parathyridaria rosae. The novelty of the strains was also confirmed by analyzing molecular data using internal transcribed spacer regions and 28S rDNA. The molecular phylogeny also strongly support the detailed description and illustration for each proposed species as Didymocyrtis septata sp. nov. (KNU-JJ-1827) and Parathyridaria ellipsoidea sp. nov. (KNU-JJ-1829) isolated from soil in Korea.
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Background and Objectives@#Toxoplasmosis is a disease caused by an intracellular parasite, Toxoplasma gondii. There has been only a few studies done on cervical toxoplasma lymphadenitis, and this study was performed to evaluate its clinical characteristics and outcomes.Subjects and Method We retrospectively reviewed the patients diagnosed with cervical toxoplasma lymphadenitis from January 2010 to December 2019. We investigated clinical pathologic findings, treatment and clinical outcomes. @*Results@#Enrolled in the study were 21 patients who were confirmed with typical pathologic findings in an excisional biopsy (16/21) and core needle biopsy (5/21). Nine patients were male and 12 patients were female, with the mean age of 46.1±13.59 (19-70). All patients complained of neck masses and 5 (23.8%) patients showed pain or tenderness. Only one (4.8%) patient had mild fever. Fine needle aspiration cytology was performed in 5 patients, with no resulting pathognomonic outcomes in any one of the patients. CT scan was performed in 15 patients, with 8 (53.3%) patients showing multiple nodal enlargements but 7 (46.6%) patients showing a single enlarged lymph node. The most frequently involved location was level I (53.3%), followed by level II (46.6%), level V (46.6%), level III (40.0%), and level IV (20.0%). The serologic test for toxoplasma revealed positive IgG (100%) and IgM (85.7%). Treatments were excision only (61.9%) and excision with pharmacologic treatment using sulfonamide or pyrimethamine (38.1%). There was no case of recurrence after treatment. @*Conclusion@#Cervical toxoplasma lymphadenitis can be diagnosed by biopsy but needle aspiration has little role. It shows favorable clinical outcomes after treatment.
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Polylactic acid (PLA) and polycaprolactone (PCL) are commercially available bioplastics that are exploited worldwide, and both are biodegradable. The PLA and PCL polymer-degrading activity of 30 fungal strains that were isolated from terrestrial environments were screened based on the formation of a clear zone around fungal colonies on agar plates containing emulsified PLA or PCL. Among them, five strains yielded positive results of biodegradation.Strains Korean Agricultural Culture Collection (KACC) 83034BP and KNUF-20-PPH03 exhibited PCL degradation; two other strains, KACC 83035BP and KNUF-20-PDG05, degraded PLA; and the fifth strain, KACC 83036BP, biodegraded both tested plastics. Based on phylogenetic analyses using various combinations of the sequences of internal transcribed spacer (ITS) regions, RPB2, LSU, CAL, and b-TUB genes, the above-mentioned strains were identified as Apiotrichum porosum, Penicillium samsonianum, Talaromyces pinophilus, Purpureocillium lilacinum, and Fusicolla acetilerea, respectively. Based on our knowledge, this is the first report on (i) plastic biodegraders among Apiotrichum and Fusicolla species, (ii) the capability of T. pinophilus to degrade biodegradable plastics, (iii) the biodegradative activity of P. samsonianumagainst PCL, and (iv) the accurate identification of P. lilacinum as a PLA biodegrader. Further studies should be conducted to determine how the fungal species can be utilized in Korea.
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Objective@#The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. @*Conclusion@#This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.
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Objective@#The incidence of hip fractures is increasing worldwide with the aging population, causing a challenge to healthcare systems due to the associated morbidities and high risk of mortality. After hip fractures in frail geriatric patients, existing comorbidities worsen and new complications are prone to occur. Comprehensive rehabilitation is essential for promoting physical function recovery and minimizing complications, which can be achieved through a multidisciplinary approach. Recommendations are required to assist healthcare providers in making decisions on rehabilitation post-surgery. Clinical practice guidelines regarding rehabilitation (physical and occupational therapies) and management of comorbidities/complications in the postoperative phase of hip fractures have not been developed. This guideline aimed to provide evidence-based recommendations for various treatment items required for proper recovery after hip fracture surgeries. Methods Reflecting the complex perspectives associated with rehabilitation post-hip surgeries, 15 key questions (KQs) reflecting the complex perspectives associated with post-hip surgery rehabilitation were categorized into four areas: multidisciplinary, rehabilitation, community-care, and comorbidities/complications. Relevant literature from four databases (PubMed, EMBASE, Cochrane Library, and KoreaMed) was searched for articles published up to February 2020. The evidence level and recommended grade were determined according to the grade of recommendation assessment, development, and evaluation method. Results A multidisciplinary approach, progressive resistance exercises, and balance training are strongly recommended. Early ambulation, weigh-bearing exercises, activities of daily living training, community-level rehabilitation, management of comorbidities/complication prevention, and nutritional support were also suggested. This multidisciplinary approach reduced the total healthcare cost. @*Conclusion@#This guideline presents comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery.
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We report a case of neurolymphomatosis of lumbosacral plexus. A 63-year-old man, who had no past history except for diabetes mellitus, complained of severe pain and weakness on left lower extremity. Idiopathic lumbosacral plexopathy was diagnosed by electromyography. There were no abnormal findings except for FDG-PET/CT and MRI. They showed high uptake and thickening lesion in sciatic nerve and sacral plexus. However, about 7 months later, mass like lesion in left thigh was detected by FDG-PET/CT and MRI. Also, multiple hypermetabolic lesions were found in brain. Through brain biopsy, diffuse large B-cell lymphoma was confirmed. When a patient with idiopathic lumbosacral plexopathy complains of severe pain, it is necessary to consider FDG-PET/CT and MRI to differentiate neurolymphomatosis, even in patients who have no past history of lymphoma before. Especially, if FDG-PET/CT and MRI show sciatic and/or lumbosacral plexus lesion, neurolymphomatosis of lumbosacral plexus should be considered.
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We report a case of neurolymphomatosis of lumbosacral plexus. A 63-year-old man, who had no past history except for diabetes mellitus, complained of severe pain and weakness on left lower extremity. Idiopathic lumbosacral plexopathy was diagnosed by electromyography. There were no abnormal findings except for FDG-PET/CT and MRI. They showed high uptake and thickening lesion in sciatic nerve and sacral plexus. However, about 7 months later, mass like lesion in left thigh was detected by FDG-PET/CT and MRI. Also, multiple hypermetabolic lesions were found in brain. Through brain biopsy, diffuse large B-cell lymphoma was confirmed. When a patient with idiopathic lumbosacral plexopathy complains of severe pain, it is necessary to consider FDG-PET/CT and MRI to differentiate neurolymphomatosis, even in patients who have no past history of lymphoma before. Especially, if FDG-PET/CT and MRI show sciatic and/or lumbosacral plexus lesion, neurolymphomatosis of lumbosacral plexus should be considered.
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Polylactic acid (PLA) and polycaprolactone (PCL) are commercially available bioplastics that are exploited worldwide, and both are biodegradable. The PLA and PCL polymer-degrading activity of 30 fungal strains that were isolated from terrestrial environments were screened based on the formation of a clear zone around fungal colonies on agar plates containing emulsified PLA or PCL. Among them, five strains yielded positive results of biodegradation.Strains Korean Agricultural Culture Collection (KACC) 83034BP and KNUF-20-PPH03 exhibited PCL degradation; two other strains, KACC 83035BP and KNUF-20-PDG05, degraded PLA; and the fifth strain, KACC 83036BP, biodegraded both tested plastics. Based on phylogenetic analyses using various combinations of the sequences of internal transcribed spacer (ITS) regions, RPB2, LSU, CAL, and b-TUB genes, the above-mentioned strains were identified as Apiotrichum porosum, Penicillium samsonianum, Talaromyces pinophilus, Purpureocillium lilacinum, and Fusicolla acetilerea, respectively. Based on our knowledge, this is the first report on (i) plastic biodegraders among Apiotrichum and Fusicolla species, (ii) the capability of T. pinophilus to degrade biodegradable plastics, (iii) the biodegradative activity of P. samsonianumagainst PCL, and (iv) the accurate identification of P. lilacinum as a PLA biodegrader. Further studies should be conducted to determine how the fungal species can be utilized in Korea.
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Objective@#To determine the most optimal needle insertion point of extensor indicis (EI) using ultrasound. @*Methods@#A total 80 forearms of 40 healthy volunteers were recruited. We identified midpoint (MP) of EI using ultrasound and set MP as optimal needle insertion point. The location of MP was suggested using distances from landmarks. Distance from MP to medial border of ulna (MP-X) and to lower margin of ulnar head (MP-Y) were measured. Ratios of MP-X to Forearm circumference (X ratio) and MP-Y to forearm length (Y ratio) were calculated. In cross-sectional view, depth of MP (Dmp), defined as middle value of superficial depth (Ds) and deep depth (Dd) was measured and suggested as proper depth of needle insertion. @*Results@#Mean MP-X was 1.37±0.14 cm and mean MP-Y was 5.50±0.46 cm. Mean X ratio was 8.10±0.53 and mean Y ratio was 22.15±0.47. Mean Dmp was 7.63±0.96 mm. @*Conclusion@#We suggested that novel optimal needle insertion point of the EI. It is about 7.6 mm in depth at about 22% of the forearm length proximal from the lower margin of the ulnar head and about 8.1% of the forearm circumference radial from medial border of ulna.
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Two fungal species of ascomycetes were discovered during the screening of soil microflorafrom the Gangwon Province in Korea: Didymella chlamydospora sp. nov. (YW23-14) andMicrodochium salmonicolor sp. nov. (NC14-294). Morphologically, YW23-14 produces smallerchlamydospores (8.0–17.07.0–15.0 mm) than D. glomerata and D. musae. The strain NC14-294 was characterized by smaller conidiogenous cells (4.9–8.82.0–3.2 mm) compared withthe closest strains M. fisheri and M. phragmitis. The detailed descriptions, illustrations, anddiscussions regarding the morphological and phylogenetical analyses of the closely relatedspecies are provided to support the novelty of each species. Thus, YW23-14 and NC14-294are described here as newly discovered species.