A Case of Inadvertent Anterior Chamber and Corneal Stromal Injection with Antibiotics during Cataract Operation

Purpose: To report a case of inadvertent anterior chamber and cornea stromal injection with high dose antibiotics and steroids during cataract operation. Methods: During cataract operation on a 78 year-old female patient, high dose gentamicin (20 mg/0.5 ml) and dexamethasone (2 mg/0.5 ml) were inadvertently injected into the anterior chamber and cornea stroma when making cornea edema for sealing of the incision sites. Anterior chamber irrigation with balanced salt solution (BSS) was immediately administered. On postoperative day one, extensive cornea edema was noted, and best-corrected visual acuity was 0.2. Descemet's membrane folds were observed around the corneal incision sites. Topical 5% NaCl and 1% prednisolone were started. Results: Four weeks postoperatively, corneal edema began to reduce significantly. At four months postoperatively, corneal edema fully resolved, and best-corrected visual acuity was 0.8. However, some Descemet's membrane folds still remained, and a decrease in the number of endothelial cells was noted by specular microscope. Conclusions: In this case involving anterior chamber and cornea stromal injection with high dose antibiotics and steroids, immediate anterior chamber irrigation with balanced salt solution seemed an appropriate management, and the patient's long-term visual acuity appears good. To prevent such mistakes, precise labeling of all solutions and use of different syringe needles should be considered.ope

The Pilot Survey of the Perception on the Practice Pattern, Diagnosis, and Treatment on Korean Medicine Insomnia: Focusing on the Difference between Korean Medical Neuropsychiatry Specialists and Korean Medical General Practitioners

Introduction. This study aims to investigate the clinical practice states on the diagnosis and treatment for insomnia between Korean medical general practitioners (KMGPs) and Korean medical neuropsychiatry specialists (KMNPSs). Methods. We distributed questionnaires via email or in person to 1,017 KMGPs and via email to 165 KMNPSs. We collected and analyzed responses from 305 (30.00%) KMGPs and 53 (32.12%) KMNPSs. Results. Most KMGPs and KMNPSs responded that the number of new patients visiting the clinic for treatment of insomnia was less than 10 per month (78.2%). Frequently utilized therapies for insomnia are acupuncture and herbal decoctions. Particularly acupoint GV20 and Guipi decoction were chosen with the highest response rate. There was no difference between KMNPSs and KMGPs in the traditional Korean medical diagnosis methods. However, KMNPSs utilized more various methods to diagnose, treat, and evaluate insomnia and educated more actively sleep hygiene compared to KMGPs. Conclusions. This survey showed how insomnia is currently diagnosed and treated in Korean medical care settings. Moreover, we identified some differences between KMNPSs and KMGPs. Further research is required to explore the underlying reasons for these discrepancies among KMDs and to improve the quality of Korean medical clinical practice in treating insomnia

Effects of core Balance and Plyometric Training on Anaerobic Power and Dynamic Postural Stability in Youth Taekwondo Athletes

Abstracts PURPOSE Muscle strength, power, speed, postural stability, and anaerobic power are important physical fitness factors required to perform well in a taekwondo competition. This study aimed to investigate the effects of 8 weeks of core balance and plyometric training on physical fitness in young taekwondo athletes. METHODS Nine young taekwondo athletes participated in this program. Body composition and relative fitness (muscle power, core strength, agility, postural stability, anaerobic power, and isokinetic muscle function) were measured before and after training. Data were analyzed using IBM SPSS Statistics version 23.0 (IBM Corp., Armonk, NY, USA). A paired t-test (pre vs. post) was used for the analysis. RESULTS The core strength measured by the sit-up count changed significantly after training (p<.05). In case of postural stability, the right absolute reach distance in the Y-balance test improved significantly after training (p<.05). In case of anaerobic power, the mean power (p<.01) and the peak power (p<.01) increased significantly after training. CONCLUSIONS We demonstrated that 8 weeks of core balance and plyometric training enhanced core strength, balance, and anaerobic power in young taekwondo athletes. Our results suggest that core balance and plyometric training are effective in improving muscle strength, core strength, balance, and anaerobic power

Relationship between the Retinal Thickness Analyzer and the GDx VCC Scanning Laser Polarimeter, Stratus OCT Optical Coherence Tomograph, and Heidelberg Retina Tomograph II Confocal Scanning Laser Ophthalmoscopy

PURPOSE: To assess the relationship between the retinal thickness analyzer (RTA) parameters, and those of the GDx VCC scanning laser polarimeter (GDx VCC), Stratus OCT optical coherence tomography (Stratus OCT), and Heidelberg retinal tomograph II confocal scanning laser ophthalmoscopy (HRT II). METHODS: Twenty-nine primary open-angle glaucoma patients were retrospectively included in this study. Measurements were obtained using the RTA, GDx VCC, Stratus OCT, and HRT II. We calculated the correlation coefficients between the parameters of RTA and those of the other studies. RESULTS: Among the optic disc parameters of RTA, the cup volume was best correlated with Stratus OCT (R=0.780, p<0.001) and HRT II (R=0.896, p<0.001). Among the posterior pole retinal thickness parameters, the posterior pole abnormally thin area (PPAT) of the RTA and the inferior average of the GDx VCC were best correlated (R=-0.596, p=0.001). The PPAT of the RTA and the inferior maximum of the Stratus OCT were best correlated (R=-0.489, p=0.006). The perifoveal minimum thickness (PFMT) of the RTA and the cup shape measurement of the HRT II were best correlated (R=-0.565, p=0.004). CONCLUSIONS: Many RTA optic disc parameters were significantly correlated with those of the Stratus OCT and HRT II. The RTA posterior pole retinal thickness parameters were significantly correlated with those of the GDx VCC, Stratus OCT and HRT II. The RTA optic disc and posterior pole retinal thickness parameters may be valuable in the diagnosis of glaucomaope

Volumetric change of the latissimus dorsi muscle after immediate breast reconstruction with an extended latissimus dorsi musculocutaneous flap

Background In immediate breast reconstruction using an extended latissimus dorsi musculocutaneous (eLDMC) flap, the volume of the flap decreases, which causes a secondary deformity of the breast shape. Since little research has investigated this decrease in muscle volume, the authors conducted an objective study to characterize the decrease in muscle volume after breast reconstruction using an eLDMC flap. Methods Research was conducted from October 2011 to November 2016. The subjects included 23 patients who underwent mastectomy due to breast cancer, received immediate reconstruction using an eLDMC flap without any adjuvant chemotherapy or radiotherapy, and received a computed tomography (CT) scan from days 7 to 10 after surgery and 6 to 8 months postoperatively. In 10 patients, an additional CT scan was conducted 18 months postoperatively. Axial CT scans were utilized to measure the volumetric change of the latissimus dorsi muscle during the follow-up period. Results In the 23 patients, an average decrease of 54.5% was observed in the latissimus dorsi muscle volume between the images obtained immediately postoperatively and the scans obtained 6 to 8 months after surgery. Ten patients showed an average additional decrease of 11.9% from 6–8 months to 18 months after surgery. Conclusions We studied changes in the volume of the latissimus dorsi muscle after surgery using an eLDMC flap performed after a mastectomy without adjuvant chemotherapy or radiotherapy. In this study, we found that immediate breast reconstruction using a latissimus dorsi muscle flap led to a decrease in muscle volume of up to 50%

Classification of Focal Prostatic Lesions on Transrectal Ultrasound (TRUS) and the Accuracy of TRUS to Diagnose Prostate Cancer

Objective: To improve the diagnostic efficacy of transrectal ultrasound (TRUS)-guided targeted prostatic biopsies, we have suggested the use of a new scoring system for the prediction of malignancies regarding the characteristics of focal suspicious lesions as depicted on TRUS. Materials and Methods: A total of 350 consecutive patients with or without prostate cancer who underwent targeted biopsies for 358 lesions were included in the study. The data obtained from participants were randomized into two groups; the training set (n = 240) and the test set (n = 118). The characteristics of focal suspicious lesions were evaluated for the training set and the correlation between TRUS findings and the presence of a malignancy was analyzed. Multiple logistic regression analysis was used to identify variables capable of predicting prostatic cancer. A scoring system that used a 5-point scale for better malignancy prediction was determined from the training set. Positive predictive values for malignancy prediction and the diagnostic accuracy of the scored components with the use of receiver operating characteristic curve analysis were evaluated by test set analyses. Results: Subsequent multiple logistic regression analysis determined that shape, margin irregularity, and vascularity were factors significantly and independently associated with the presence of a malignancy. Based on the use of the scoring system for malignancy prediction derived from the significant TRUS findings and the interactions of characteristics, a positive predictive value of 80% was achieved for a score of 4 when applied to the test set. The area under the receiver operating characteristic curve (AUC) for the overall lesion score was 0.81. Conclusion: We have demonstrated that a scoring system for malignancy prediction developed for the characteristics of focal suspicious lesions as depicted on TRUS can help predict the outcome of TRUS-guided biopsies.This study was supported by the Seoul National University Bundang Hospital Research Fund (Grant No. 02-2006-031).Mitterberger M, 2007, J UROLOGY, V178, P464, DOI 10.1016/j.juro.2007.03.107Djavan B, 2007, WORLD J UROL, V25, P11, DOI 10.1007/s00345-007-0151-1Shim HB, 2007, TUMORI, V93, P178Toi A, 2007, J UROLOGY, V177, P516, DOI 10.1016/j.juro.2006.09.061Lee HJ, 2006, J ULTRAS MED, V25, P815Elabbady AA, 2006, EUR UROL, V49, P49, DOI 10.1016/j.eururo.2005.08.013Halpern EJ, 2005, CANCER, V104, P2373, DOI 10.1002/cncr.21440Ozden E, 2005, J CLIN ULTRASOUND, V33, P5, DOI 10.1002/jcu.20080Kuligowska E, 2001, RADIOLOGY, V220, P757Lavoipierre AM, 1998, AM J ROENTGENOL, V171, P205Plawker MW, 1997, J UROLOGY, V158, P1853Cornud F, 1997, UROLOGY, V49, P709NEWMAN JS, 1995, RADIOLOGY, V195, P86LITTRUP PJ, 1992, CA-CANCER J CLIN, V42, P198HAMPER UM, 1991, RADIOLOGY, V180, P101LEE F, 1991, CANCER, V67, P1132RIFKIN MD, 1988, RADIOLOGY, V166, P619

Intrathecal injection of human umbilical cord blood-derived mesenchymal stem cells for the treatment of basilar artery dissection: a case report

<p>Abstract</p> <p>Introduction</p> <p>Basilar artery dissection is a rare occurrence, and is significantly associated with morbidity and mortality. To the best of our knowledge, we report the first case of basilar artery dissection treated with mesenchymal stem cells.</p> <p>Case presentation</p> <p>We present the case of a 17-year-old Korean man who was diagnosed with basilar artery dissection. Infarction of the bilateral pons, midbrain and right superior cerebellum due to his basilar artery dissection was partially recanalized by intrathecal injection of human umbilical cord blood-derived mesenchymal stem cells. No immunosuppressants were given to our patient, and human leukocyte antigen alloantibodies were not detected after cell therapy.</p> <p>Conclusions</p> <p>This case indicates that intrathecal injections of mesenchymal stem cells can be used in the treatment of basilar artery dissection.</p

Asymmetry of the cross-sectional area of paravertebral and psoas muscle in patients with degenerative scoliosis

PURPOSE: This study was undertaken to assess the change of psoas and paravertebral muscles in patients with degenerative scoliosis.METHODS: Eighty-five patients with degenerative scoliosis were evaluated with simple radiography for the location and direction of the apex of scoliosis, coronal Cobb's angle, rotational deformity and lumbar lordosis, and with magnetic resonance imaging scan at the apex level of each patient, the cross-sectional area (CSA) and the fatty infiltration rate (FI) of bilateral paravertebral and psoas muscles were measured and the values of convex and concave side were compared.RESULTS: Fifty-three patients had apex of curves on the left side and thirty-two patients on the right. The mean Cobb's angle was 17.9°. The difference index of CSA (CDI) of psoas and multifidus muscle at apex of curvature level was significantly larger in convex side rather than that in concave side (by 6.3 and 8.4 % with P = 0.019 and 0.000, respectively). FI of each muscle showed no significant difference.CONCLUSIONS: Hypertrophy of the muscles on the convex side is suggested as the explanation of this asymmetry rather than atrophy of the muscles on the concave side as muscle atrophy is known to be associated with increased fatty infiltration.OAIID:oai:osos.snu.ac.kr:snu2013-01/102/0000004226/7SEQ:7PERF_CD:SNU2013-01EVAL_ITEM_CD:102USER_ID:0000004226ADJUST_YN:NEMP_ID:A076317DEPT_CD:801CITE_RATE:1.965FILENAME:esj-2013_kim_asymmetry of the cross-sectional area of paravertebral and psoas muscle.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM:

Prospective Analysis on the Relation between Pain and Prostate Volume during Transrectal Prostate Biopsy

OBJECTIVE: We wanted to assess the relationship between pain and the prostate volume during transrectal ultrasound (TRUS) guided biopsy. MATERIALS AND METHODS: Between July and September 2006, 71 patients scheduled for TRUS biopsy of the prostate were considered for inclusion to this study. These patients underwent periprostatic neurovascular bundle block with lidocaine prior to biopsy. Pain was assessed using a Visual Analogue Scale (VAS) during periprostatic neurovascular bundle block (VAS 1), during biopsy (VAS 2), and 20 minutes after biopsy (VAS 3). The mean pain scores were analyzed in the large prostate group (prostate volume > 40 cc) and the small prostate group (prostate volume< or =40 cc). P values < 0.05 were considered significant. RESULTS: The mean prostate volume was 42.2 cc (standard deviation: 8.6). The mean pain scores of VAS 1, 2 and 3 were 4.70+/-1.61, 3.15+/-2.44 and 1.05+/-1.51, respectively. In the large prostate group, the mean pains scores of VAS 1, 2 and 3 were 4.75+/-1.76, 3.51+/-2.76 and 1.29+/-1.70, respectively, whereas in the small prostate group, the means pain scores were 4.66+/-1.46, 2.77+/-2.0, and 0.80+/-1.26, respectively. Although there were no statistical differences of VAS 1, the larger prostate group revealed higher pain scores of VAS 2 and 3 compared with the small prostate group (p < 0.05). CONCLUSION: Patients with larger prostate volumes tend to feel more pain during and after TRUS guided prostate biopsy. Our findings suggest that additional analgesic strategies may be necessary when the patients with larger prostate undergo TRUS guided prostate biopsy.This work was supported by a grant from the Korea Research Foundation, which is funded by the Korean Government (MOEHRD, Basic Research Promotion Fund) (KRF-2006-331-E00248)