Extracorporeal Shock Wave Therapy in Musculoskeletal Disorders / 대한정형외과학회잡지

The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles, and extracorporeal shock wave therapy (ESWT) appears to have mechanical and biological effects on tissue healing. The application of ESWT to musculoskeletal disorders has been around for more than a decade and is used primarily in the treatment of calcific or non-calcific tendinitis of the shoulder, lateral and medial epicondylitis of the elbow, patellar tendinopathy, Achilles tendinitis or proximal plantar fasciitis of the heel, myofascial pain syndrome, etc. ESWT is also used in the treatment of delayed union or non-union of long bone fractures, avascular necrosis of the femoral head, and chronic diabetic ulcers. The vast majority of papers have reported positive and beneficial effects with few complications. The clinical application of ESWT has increased steadily. This article reviews the current status of ESWT in musculoskeletal disorders.

Gutter Splint for Ingrown Toe Nail in Young Patients / 대한족부족관절학회지

PURPOSE: Ingrown toenails are a common disease in the adolescent period and the treatments could be more conservative for this early stage of the disease. This study is a case series on the results of a gutter splint for an adolescent ingrown toe nail as a simple, comfortable treatment method. MATERIALS AND METHODS: From 2011 to 2018, 22 patients (mean age, 12.2 years; range, 8~15 years) with ingrown toenails were treated with a gutter splint. There were 16 boys and 6 girls with 7 patients on both great toes, and additional 4 both corners of a nail, giving a total of 33 splints. Flat, plastic straws and glue or suture were used to protect the nail corners under local anesthesia. The medical records were reviewed retrospectively and phone calls were made to obtain the long-term results. RESULTS: Fifteen splints were fixed with a suture and the other 18 splints were fixed with glue. There were 9 cases of recurrence out of 33 gutter splints, 8 out of 15 sutured splints and 1 out of 18 glued splints (p=0.010). There was no gender (p=0.383) or age (p=0.305) difference in the number of recurrences. CONCLUSION: For growing people, ingrown nails can be cured easily by conservative treatment for a transiently shortened or broken toenail. The glued gutter splint had a reasonable success rate as a first line treatment.

A case of autoimmune hepatitis type-1 with p-ANNA strong positivity / 대한내과학회지

Autoimmune hepatitis (AIH) is an undissolved inflammatory process of the liver characterized by the periportal hepatitis on histological examination and serum autoantibody. AIH seems to be partly responsible for chronic liver disease of unknown etiology in Korea. Perinuclear-Antineutrophil nuclear antibody (p-ANNA) are detected in up to 88% of patient with primary sclerosing cholangitis (PSC) and presence of p-ANNA in PSC makes them a reasonable diagnostic maker in conjuction with standard diagnostic test. But p-ANNA in AIH is rare and it's role remain unclear. We report the first case of 39 year-old-female patient with AIH type-1 with p-ANNA strong positivity.

A Case of Orbital Apex Syndrome Caused by Mucocele in the Sphenoid Sinus / 대한이비인후과학회지

Orbital complications of sinus disease continue to appear in clinical practice. Acute visual loss may occur in association with sinusitis either as a complication of orbital cellulitis or, less frequently, as a part of the orbital apex syndrome. The classification which defines the degree of orbital extension is valuable, therapeutically and prognostically. The orbital apex syndrome is associated with an affection of the vessels and nerves passing through the superior orbital fissure and the optic foramen and characterized by visual loss and ophthalmoplegia. But it has minimal or no signs of orbital inflammation such as proptosis, chemosis, or lid edema. We experienced a case of temporary monocular visual loss and ophthalmoplegia caused by mucocele in the sphenoid sinus. Thus, we report, with a review of literature, a case of orbital apex syndrome caused by mucocele in the sphenoid sinus in a 53 year-old male patient.

Two Cases of Postobstructive Pulmonary Edema / 대한이비인후과학회지

Pulmonary edema is a potentially life-threatening complication of acute airway obstruction. Occasionally, patients experience sudden, unexpected and severe pulmonary edema during treatment of upper airway obstruction. Two forms of postobstructive pulmonary edema (POPE) have been identified. Type I POPE follows a sudden, severe episode of upper airway obstruction and type II POPE develops soon after the relief of chronic upper airway obstruction. The pathogenesis of POPE is multifactorial. The application of moderate continuous positive airway pressure in conjunction with the administration of diuretics usually clears pulmonary edema in these clinical settings within 24 hours. Awareness of this uncommon condition is crucial for the otolaryngologist to make an early diagnosis and initiate successful treatment. We present two cases of postobstructive pulmonary edema after treatment for upper airway obstruction.