Factors associated with long head of the biceps tendon tear severity and predictive insights for grade II tears in rotator cuff surgery

In rotator cuff repair, the long head of the biceps tendon (LHB) is commonly used as graft material. However, factors influencing LHB tear severity are poorly understood, and predicting grade II LHB tears is challenging. This study aimed to identify these factors preoperatively. Methods: The demographics, medical parameters, and pain severity of 750 patients who underwent arthroscopic surgery from January 2010 to February 2021 were evaluated to determine the factors associated with LHB tear severity and grade II tears. Both overall and largeto-massive rotator cuff tear (RCT) cohorts underwent ordinal and binary logistic regression analyses. Predictive accuracy for grade II LHB tears was determined using the area under the receiver operating characteristic curve (AUC). Results: In the overall cohort, high-sensitivity C-reactive protein (hs-CRP) >1 mg/L (P1 mg/L, subscapularis tear, and Patte retraction degree were significantly associated with grade II LHB tears (P1 mg/L, hypertension, and age ≥50 years (P1 mg/L (P1 mg/L demonstrated good predictive accuracy for grade II LHB tears (AUCs: 0.72 and 0.70). Conclusions: Serum hs-CRP >1 mg/L is associated with LHB tear severity and serves as a reliable predictor of grade II LHB tears, facilitating preoperative assessment of the LHB as potential graft material in arthroscopic rotator cuff repair. Level of evidence: III.

The Association between Urine Albumin to Creatinine Ratio and Osteoporosis in Postmenopausal Women with Type 2 Diabetes

BACKGROUND: Osteoporosis is a progressive bone disease that is characterized by a decrease in bone mass density and destruction of microstructure, which can lead to an increased risk of fracture. Although many studies have been published about the relationship between end-stage renal disease and osteoporosis, research on the relationship between proteinuria and the prevalence of osteoporosis is still lacking. METHODS: We assessed 91 postmenopausal women with type 2 diabetes who visited our hospital from January 2009 to January 2012. RESULTS: Among 91 patients, the prevalence of osteoporosis and osteopenia was 35.2% (32 cases) and 32.9% (30 cases) according to bone mineral density. The patients with microalbuminuria and macroalbuminuria (urine albumin-to-creatinine ratio [UACR] > or = 30) had a significantly higher incidence of osteoporosis compared to subjects with normoalbuminuria (P<0.05). CONCLUSIONS: This study indicates that UACR may be a useful biomarker for increased risk of osteoporosis in postmenopausal women with type 2 diabetes who have been linked to higher UACR levels.

Two cases of female hydrocele of the canal of nuck / 소아과

The processus vaginalis within the inguinal canal forms the canal of Nuck, which is a homolog of the processus vaginalis in women. Incomplete obliteration of the processus vaginalis causes indirect inguinal hernia or hydrocele of the canal of Nuck, a very rare condition in women. Here, we report 2 cases of hydrocele of the canal of Nuck that were diagnosed with ultrasonography in both cases and magnetic resonance imaging in 1 case to confirm the sonographic diagnosis. High ligation and hydrocelectomy were conducted in both patients. In 1 patient, 14 months later, the occurrence of contralateral inguinal hernia was suspected, but did not require surgery. The other patient had a history of surgery for left inguinal hernia 11 months before the occurrence of right hydrocele of the canal of Nuck. In both cases, the occurrence of an inguinal hernia on the contralateral side was noted.

Four Children with Multidrug-resistant Acinetobactor baumanii Infections in the Intensive Care Units of a University Hospital / 소아감염

The Multidrug-resistant Acinetobactor baumanii (MDRAB) is an opportunistic pathogen. Patients with long periods of hospital stay and/or under intensive care unit (ICU) receiving invasive management are more susceptible to this pathogen. In this report, four children with MDRAB infection are reviewed and described their clinical characteristics. There had been concurrent outbreaks of MDRAB infection in adult patients in the ICU at this period of time. The first child had received a craniotomy and epidural hematoma evacuation. The second child was admitted for status epilepticus with hydrocephalus. The third child had pneumonia with status epilepticus with hydrocephalus. The fourth child had poor activity due to hypoxic ischemic encephalopathy and convulsive disorder. Except the fourth child, all had not been exposed to carbapenem prior to infection of MDRAB. That imply the cause of MDRAB infections may be associated with invasive management and prolonged hospitalization together with the previous exposure to carbapenem in our cases. We would like to emphasize the importance and minimizing the spread of hospital infection in patients under prolonged intensive care management regardless of the use of carbapenem.

A Case of Benign Multiple Pulmonary Nodules in a Patient with Osteosarcoma / 임상소아혈액종양

When pulmonary nodules are detected in children receiving chemotherapy for osteosarcoma, it is often assumed that they have metastatic disease. However, these pulmonary nodules do not always represent metastatic disease. There are considerable similarities in the computed tomography (CT) images of benign pulmonary nodules and those of malignant nodules. Therefore, we have to be careful when diagnosing pulmonary metastases based on chest CT scan alone. We report a case of benign multiple pulmonary nodules in a patient with osteosarcoma.

Short term outcomes of topiramate monotherapy as a first-line treatment in newly diagnosed West syndrome / 소아과

PURPOSE: To investigate the efficacy of topiramate monotherapy in West syndrome prospectively. METHODS: The study population included 28 patients (15 male and 13 female children aged 2 to 18 months) diagnosed with West syndrome. After a 2-week baseline period for documentation of the frequency of spasms, topiramate was initiated at 2 mg/kg/day. The dose was increased by 2 mg/kg every week to a maximum of 12 mg/kg/day. Clinical assessment was based on the parents' report and a neurological examination every 2 weeks for the first 2 months of treatment. The baseline electroencephalograms (EEGs) were compared with the post-treatment EEGs at 2 weeks and 1 month. RESULTS: West syndrome was considered to be cryptogenic in 7 of the 28 patients and symptomatic in 21 patients. After treatment, 11 patients (39%) became spasm-free, 6 (21%) had more than 50% spasmsreduction, 3 (11%) showed less than 50% reduction, and 8 (29%) did not respond. The effective daily dose for achieving more than 50% reduction in spasm frequency, including becoming spasm-free, was found to be 5.8+/-1.1 mg/kg/day. Nine patients (32%) showed complete disappearance of spasms and hypsarrhythmia, and 11 (39%) showed improved EEG results. Despite adverse events (4 instances of irritability, 3 of drowsiness, and 1 of decreased feeding), no patients discontinued the medication. CONCLUSION: Topiramate monotherapy seems to be effective and well tolerated as a first line therapy for West syndrome and is not associated with serious adverse effects.

A Case of Benign Multiple Pulmonary Nodules in a Patient with Osteosarcoma / 임상소아혈액종양

When pulmonary nodules are detected in children receiving chemotherapy for osteosarcoma, it is often assumed that they have metastatic disease. However, these pulmonary nodules do not always represent metastatic disease. There are considerable similarities in the computed tomography (CT) images of benign pulmonary nodules and those of malignant nodules. Therefore, we have to be careful when diagnosing pulmonary metastases based on chest CT scan alone. We report a case of benign multiple pulmonary nodules in a patient with osteosarcoma.