Therapeutic Efficacy of Ultrasound-Guided Selective Nerve Block on Chronic Cervical Radiculopathy.

Background and Objectives: Cervical radiculopathy (CR) manifests as pain and sensorimotor disturbances in the upper extremities, often resulting from nerve root compression due to intervertebral disc herniation, degenerative changes, or trauma. While conservative treatments are initially preferred, persistent or severe cases may require surgical intervention. Ultrasound-guided selective nerve root block (SNRB) has emerged as a promising intervention for alleviating symptoms and potentially obviating the need for surgery. This study evaluates the therapeutic efficacy of ultrasound-guided SNRB in managing chronic CR, aiming to determine its potential in symptom relief and delaying or avoiding surgical procedures. Materials and Methods: A retrospective analysis was conducted on 720 outpatients treated for CR between October 2019 and March 2022. After excluding patients with traumatic CR, previous surgeries, malignancies, progressive neurological symptoms requiring immediate surgery, or inadequate conservative treatment, 92 patients who had experienced cervical radicular pain for more than three months and had failed to improve after more than six weeks of conservative treatment with VAS scores ≥ 5 were included. The patients underwent single or multiple ultrasound-guided SNRB procedures, involving the injection of dexamethasone and lidocaine under real-time ultrasound guidance. Symptom severity was assessed at the baseline, and at 4, 8, and 12 weeks post-procedure using the Visual Analog Scale (VAS). The data collected included age, sex, presence of neck and/or radicular pain, physical examination findings, recurrence of symptoms, improvement in symptoms, and whether surgical intervention was ultimately required. Statistical analyses were performed to identify the factors associated with symptom improvement or recurrence. Results: Significant symptom improvement was observed in 69 (75.0%) participants post-SNRB, with 55 (79.7%) showing improvement at 4 weeks, 11 (15.9%) at 8 weeks, and 3 (4.4%) at 12 weeks. Symptom recurrence, defined by an increase in VAS score accompanied by a pain flare lasting at least 24 h after a pain-free interval of at least one month, was noted in 48 (52.2%) patients. The presence of combined neck and radicular pain was a significant predictor of recurrence (p = 0.008). No significant associations were found between symptom relief and factors such as age, gender, initial pain severity, or MRI findings. Conclusions: Ultrasound-guided SNRB effectively manages chronic CR, providing substantial symptom relief and potentially reducing the need for surgical intervention. This technique offers a promising conservative treatment option, especially given its real-time visualization advantages and minimal radiation exposure.

Evaluation of the Microbiological Status of Cattle Carcasses in Mongolia: Considering the Hygienic Practices of Slaughter Establishments.

The meat industry has received great attention in Mongolia, having over 70 million livestock, and is important to the nation's economy. Systematic microbiological testing of carcasses has not been mandatorily regulated in all abattoir premises, and the efficacy of the introduction of the Good Hygiene Practice and Hazard Analysis Critical Control Points (HACCP) to some plants has not yet been tested microbiologically in Mongolia. Therefore, samples were collected from two establishments: plant A with an HACCP certificate from a third party and plant B without an HACCP certificate. The rates and levels of the total bacterial count (TBC) as overall hygiene indicators, the Enterobacteriaceae count (EBC) as fecal contamination indicators, and the Staphylococcus spp. count (SC) as personal hygiene indicators were determined on different parts of beef carcasses. The contamination rates in most parts were lower in plant A than in plant B (e.g., TBC in the rump and flank: 103-105 and 105-107, in plant A vs. 104-106 and 105-108 in plant B, respectively). Plant A also had a lower EBC and SC (p < 0.001). Furthermore, 2 out of 100 beef carcasses (2%) were positive for enterohemorrhagic Escherichia coli as a foodborne pathogen indicator in plant A.

Usefulness of the Blink Reflex in Diagnosing Isolated Infraorbital Neuropathy Following Midface Augmentation with AlloPlastic Facial Implants: A Case Report.

For the preoperative evaluation of infraorbital nerve injury, most clinicians depend on the patient's subjective symptoms or judgements, lacking a generalized and objective evaluation method. Due to the limitations in subjective evaluations for accurate diagnosis of infraorbital nerve injury, we used the blink reflex to objectively evaluate injury to the infraorbital nerve. A 49-year-old female, who had previously undergone midface augmentation with alloplastic implants, presented with sensory loss in the left upper lip, nose tip, and lower palatal area. Physical examination revealed sensation loss in the area innervated by the infraorbital nerve. Facial three-dimensional computed tomography did not identify compression of the infraorbital nerve. The blink reflex study of the infraorbital nerve was evaluated preoperatively. After the patient was diagnosed with injury along the infraorbital nerve pathway from alloplastic facial implants, she underwent facial implant removal with decompression surgery. The patient experienced a significant decrease in hypoesthesia, and her sensory function improved. The blink reflex study was an effective method to objectively diagnose infraorbital neuropathy. Therefore, clinical use of the blink reflex study as an electrophysiological diagnostic tool is recommended to investigate infraorbital nerve injuries.

Associations Between Smartphone Use for Physical Activity by South Korean College Students and Behavioral Change Constructs of the Transtheoretical Model.

We examined associations between smartphone uses to assist physical activity (PA) and change constructs of the transtheoretical model (TTM) among Korean college students. Our participants were 242 college students who completed a cross-sectional survey of their smartphone use, PA, and TTM constructs. We applied Poisson regression models to test the associations between stages of change and smartphone PA use frequencies in four categories over the previous week: 1= watching PA instruction videos; 2 = tracking PA; 3 = searching and booking sites for PA; and 4 = finding and making appointments with PA partners. The associations between these smartphone uses and participants' self-efficacy, decisional balance, processes of change, and PA were tested via ordinary least squares regression models. Results were that participants in the precontemplation and maintenance stages were the least and most frequent users of the smartphones in all four categories, respectively. Category one usage was positively associated with participants' scores on pros (ß = .22, p = .004), cognitive processes of change (ß = .30, p < .001), and behavioral processes of change (ß = .28, p < .001). Category two usage was positively associated with PA (ß = .06, p = .048). While category three usage was not significantly associated with any TTM constructs except for stages of change, category four usage was positively associated with self-efficacy (ß = .28, p < .001), pros (ß = .30, p < .001), cognitive processes of change (ß = .31, p < .001), behavioral processes of change (ß = .06, p <. 001), and PA (ß = .45, p < .001). These findings suggest that (a) active college students are likely to take advantage of smartphone to assist their PA, and (b) smartphones can help motivate college students toward regular PA.

Intracranial Hemorrhage Due to Potential Rupture of an Arteriovenous Malformation after BNT162b2 COVID-19 mRNA Vaccination in a Young Korean Woman: Case Report.

Inoculation with the Pfizer-BioNTech coronavirus infection-19 (COVID-19) vaccine (BNT162b2) has been approved in Korea. Although it is generally safe, several possible side effects have been reported. The present report describes a 28-year-old woman who developed an intracerebral hemorrhage in her right temporal lobe after the first dose of the Pfizer-BioNTech COVID-19 vaccine. The patient complained of a persistent headache for four days after the first dose, along with right third nerve palsy and drowsiness. Non-enhanced brain computed tomography confirmed a 5.0 × 3.7 × 5.0 cm3-sized intracranial hemorrhage in the right temporal lobe due to the rupture of an arteriovenous malformation (AVM). Transfemoral cerebral angiography revealed that blood was supplied to the AVM by the right middle cerebral artery branch and drained into the right transverse sinus. The patient underwent surgical treatment for AVM nidus removal with hematoma evacuation on the day of admission. Her condition stabilized 10 days postoperatively. These findings indicate that clinicians should be aware that cerebral hemorrhage caused by AVM rupture may be a side effect of inoculation with the BNT162b2 mRNA COVID-19 vaccine.

Clinical characteristics and prevalence of adrenal insufficiency in hemodynamically stable patients with cirrhosis.

It is well known that adrenal insufficiency is common in septic shock or hemodynamically unstable patients. But, there is as yet no sufficient clinically significant data about the exact prevalence or differences in the cause of cirrhosis with adrenal insufficiency. To investigate adrenal insufficiency prevalence in hemodynamically stable patients with cirrhosis and determine differences based on cirrhosis severity or etiology.From July 2011 to December 2012, 69 hemodynamically stable patients with cirrhosis without infection admitted at Hallym University Medical Center were enrolled. Adrenal insufficiency was defined as a peak cortisol level < 18 µg/dL, 30 or 60 minutes after 250 µg Synacthen injection.The study included 55 male patients (79.7%), and the mean age was 57.9 ±â€Š12.9 years. Cirrhosis etiology was alcohol consumption, HBV, HCV, both viral and alcohol related, and cryptogenic in 49, 15, 7, 11, 9 patients, respectively. Adrenal insufficiency occurred in 24 patients (34.8%). No differences were found in age, sex, mean arterial pressure, heart rate, HDL, cirrhosis etiology, degree of alcohol consumption, encephalopathy, variceal bleeding history, or hepatocellular carcinoma between patients with or without adrenal insufficiency. Serum albumin level was lower (P < .05), and INR was higher (P < .05) in patients with than in those without adrenal insufficiency. However, multivariate analysis revealed no independent adrenal insufficiency predictor. Significant negative correlations were found between Child-Pugh score and peak cortisol levels (γ=-0.365, P = .008).Adrenal insufficiency was frequent even in hemodynamically stable patients with cirrhosis and tended to be associated with only liver disease severity, being unrelated to cirrhosis etiology.

An online questionnaire survey on preferred timing for the diagnosis and management of thyroid carcinoma in general population in Korea.

PURPOSE: An optimal timing for diagnosis and management of papillary thyroid microcarcinoma (PTMC) has become the subject for much controversy. The aim of the present study is to analyze people's preference in Korea for timing of diagnosis and management of PTMC using an online questionnaire. METHODS: The questionnaire consists of 3 questions about preference for the diagnosis and management of PTMC and 3 additional questions about respondents' personal information. An online survey was conducted from March 3 to June 3 in 2015 using Google Survey (http://goo.gl/forms/b81yEjqNUA). RESULTS: A total 2,308 persons (1,246 males, 1,053 females) answered the questionnaire. Respondents' ages varied widely from teenagers to 70-year-olds. If there was a suspicious thyroid nodule from PTMC measuring less than 1 cm in diameter, 95.7% of respondents want to know a cytological diagnosis for it. If a thyroid nodule turned out to be a PTMC, 59.5% of respondents wanted it removed immediately. For surgical management of PTMC, 53.0% of respondents were worried more about recurrences than complications. In subgroup analyses, respondents younger than 40 years old more often want immediate surgery than others: 66.7% vs. 32.7% (P < 0.05). Respondents who underwent thyroid cancer surgery (n = 91) were worried more about recurrences than others: 69.2% vs. 52.4% (P < 0.05). CONCLUSION: Almost all respondents in the present study wanted diagnosis of suspicious thyroid nodules immediately. However, there were opposing opinions about the preferred timing for surgical treatment and surgical extents. A patient's right to know their disease status and decision on treatments should be emphasized all the more.

Compact soft x-ray transmission microscopy with sub-50 nm spatial resolution.

In this paper, the development of compact transmission soft x-ray microscopy (XM) with sub-50 nm spatial resolution for biomedical applications is described. The compact transmission soft x-ray microscope operates at lambda = 2.88 nm (430 eV) and is based on a tabletop regenerative x-ray source in combination with a tandem ellipsoidal condenser mirror for sample illumination, an objective micro zone plate and a thinned back-illuminated charge coupled device to record an x-ray image. The new, compact x-ray microscope system requires the fabrication of proper x-ray optical devices in order to obtain high-quality images. For an application-oriented microscope, the alignment procedure is fully automated via computer control through a graphic user interface. In imaging studies using our compact XM system, a gold mesh image was obtained with 45 nm resolution at x580 magnification and 1 min exposure. Images of a biological sample (Coscinodiscus oculoides) were recorded.

Neurophysiological recordings in freely moving monkeys.

Recordings of neuronal activity in freely moving rats are common in experiments where electrical signals are transmitted using cables. Such techniques are not common in monkeys because their prehensile abilities are thought to preclude such techniques. However, analysis of brain mechanisms underlying spatial navigation and cognition require the subject to walk. We have developed techniques for recordings in freely moving monkeys in two different situations: a 5 x 5 m testing laboratory and in a 50 m2 open field environment. Neuronal signals are sent to amplifiers and data acquisition systems using cables or telemetry. These techniques provide high quality recordings of single neurons during behaviors such as foraging, walking, and the performance of memory tasks and thus provide a unique opportunity to study primate behavior in a semi-natural situation.

An automated food delivery system for behavioral and neurophysiological studies of learning and memory in freely moving monkeys.

We describe a custom-built feeder based on stepping motor technology controlled by a laboratory computer. The feeder dispenses a wide range of foods: any fruit, vegetable, or nut. The feeder allows the investigator to reward monkeys with different foods within a single experimental day. The monkey's motivation to perform tasks is high and does not rely upon food regulation. The avoidance of regulation, as well as the palatability and variety of the rewards dispensed by our device, distinguishes it from commercially available products. We also describe the use of the feeder in the context of novel behavioral and neurophysiological studies in freely moving monkeys.

Amelioration of dural granulation tissue growth for primate neurophysiology.

Four methods were tried in order to reduce the growth of granulation tissue on the dura. The best results were obtained using white petrolatum jelly, which almost completely suppressed the growth of granulation tissue when the recording chamber was filled with petrolatum. Collagen and acrylic seals were very effective in one monkey. Panalog ointment slowed the growth of granulation tissue; preformed silicon sheets had no apparent effect. We conclude that long-term application of petrolatum jelly has no adverse effects and achieves striking suppression of the growth of granulation tissue.

Spatially directed movement and neuronal activity in freely moving monkey.

The abilities to plan a series of movements and to navigate within the environment require the functions of the frontal and ventromedial temporal lobes, respectively. Neuropsychological studies posit the existence of egocentric (prefrontal) and allocentric (ventromedial temporal) spatial frames of reference that mediate these functions. To examine neural mechanisms underlying egocentric and allocentric guidance of movement, we have developed behavioral and neurophysiological techniques for freely moving monkey. In this chapter, we provide evidence that the dorsolateral prefrontal cortex is important for egocentric spatial tasks in both the visual and tactile modalities, but it does not contribute to performance of an allocentric spatial task. Moreover, neurophysiological recordings indicate that prefrontal neurons are involved in monitoring the spatial nature of behavioral sequences in an egocentric memory task. In contrast, hippocampal neurons are active during spatially directed locomotion, apparently reflecting the monkey's location in a testing room. This discharge is independent of the task's contingencies.

A microelectrode drive for long term recording of neurons in freely moving and chaired monkeys.

An electrode drive is described for recordings of neurons in freely moving and chaired monkeys during the performance of behavioural tasks. The electrode drives are implanted for periods of up to 6 months, and can advance up to 42 electrodes using 14 independent drive mechanisms. The drive samples 288 points within a 12 mmx12 mm region, with 15 mm of electrode travel. Major advantages are that recordings are made in freely moving monkeys, and these recordings can be compared with those in chaired experiments; waveforms of single neurons are stable, enabling prolonged recordings of the same neurons across periods of days; recordings can be made throughout the brain, including the dorsolateral prefrontal cortex and hippocampus; the drive accommodates both sharp microelectrodes and fine wire assemblies such as tetrodes.