Utility of Toe-brachial Index for Diagnosis of Peripheral Artery Disease

BACKGROUND: The ankle brachial pressure index (ABI) is a simple, useful method for diagnosing peripheral artery disease (PAD). Although the ABI is an objective diagnostic method, it has limited reliability in certain scenarios. The aim of the present study was to determine the accuracy and reliability of the toe brachial index (TBI) as a diagnostic tool for detecting stenosis in PAD, associated with normal or low ABI values. METHODS: ABI and TBI values were measured in 15 patients with diabetic gangrene who were suspected of having lower extremity arterial insufficiency. The ABI and TBI values were measured using a device that allowed the simultaneous measurement of systolic blood pressure in the upper and lower extremities. In addition, the ABI and TBI values were compared pre- and post-angiography. RESULTS: Patients with an ABI of 0.9-1.3 showed almost no difference between the 2 measurements. The patients with TBI >0.6 had no arterial insufficiency. The patients with TBI <0.6 required vascular intervention with ballooning. After the angiography, the gangrenous wounds decreased in size more rapidly than they did prior to the intervention. CONCLUSIONS: Our findings suggest that TBI is the method of choice for evaluating lower limb perfusion disorders. This result requires further studies of TBI in a larger number of patients. Future long-term studies should therefore evaluate the utility of TBI as a means of screening for PAD and the present findings should be regarded as preliminary outcomes.

A Case of Herpes Zoster Oticus Involving Unilateral 9th and 10th Cranial Nerves without Facial Palsy / 대한이비인후과학회지

Herpes zoster oticus is a viral disease associated with otalgia, vesicular eruptions, facial paralysis, hearing disturbance, tinnitus, vertigo and other symptoms. Among cranial nerves, trigeminal and facial nerves are the most commonly affected in patients with herpes zoster oticus, but on rare occasions 8th, 9th, 10th, 11th, 12th cranial nerves are influenced as well. Authors ex-perienced a case of herpes zoster oticus involving glossopharyngeal nerve and vagal nerve without facial palsy in a 58-year-old male. We report this case with a review of literatures.

A Clinical Analysis of Facial Bone Fractures Excluding Nasal Bone Fractures / 대한이비인후과학회지

BACKGROUND: The number of facial bone fractures are steadily increasing because of increment of traffic volume and expansion of social activity. Also the forms of the fractures show to be more complicated due to increase of traffic vehicles. Facial region has an important role in human aesthetic and functional aspects. Therefore, it it very important to diagnose accurately and treat promptly and appropriately the fracture, to minimize deformity and functional disturbance in the face and enable the patient to socialize normally. OBJECTIVE: Our objective of this study is to elucidate general characteristics of clinical aspect in the facial bone fractures by analyzing the cases with facial bone fractures who diagnosed and treated at Nam Kwang Hospital for recent 2 years. MATERIALS AND METHODS: The authors reviewed retrospectively the medical records of 115 patients among 200 patients with facial bone fractures, excluding 85 patients who had only nasal bone fractures, diagnosed and treated at Nam Kwang Hospital from Jan. 1995 to Dec. 1996. The records of the cases were examined and analyzed according to sex and age distribution, cause of injury, symptoms and signs, associated injuries, frequency and treatment modality in each region, and complications. Results and CONCLUSIONS: The results were as follows; 1) Ninty cases(78.3%) were male and the peak age group was third decade(33.0%). 2) The most common cause of injury was motor vehicle accident(53.0%). 3) The most common symptoms and signs were pain, tenderness and edema(100%). 4) The most common associated injury was soft tissue injury(58.3%). 5) Single facial bone fracture was more common(68.7%) and among them, mandibular fracture was the most common. 6) The incidences of anatomical locations of facial bone fracture were mandible(45.2%), zygoma(39.1%), maxilla(17.4%) and frontal bone(14.8%), in order of frequency. 7) In zygomatic fractures, arch fracture was the most common(46.7%). 8) In maxillary fractures, complete Le Fort fracture type I was the most common(20.0%). 9) In orbital fractures, pure blow-out fracture was the most common(52.9%). 10) In mandibular fractures, symphysis and parasymphysis were the most common anatomical site(48.1%). 11) The cases treated with surgical approach were 70.4%. 12) The most common complication was infraorbital nerve dysfunction(6.1%).