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Objective To systematically translate the Fugl-Meyer Assessment (FMA) into a Korean version of the FMA (K-FMA).Methods We translated the original FMA into the Korean version with three translators and a translation committee, which included physiatrists, physical therapists, and occupational therapists. Based on a test-retest method, each of 31 patients with stroke was assessed by two evaluators twice, once on recruitment, and again after a week. Analysis of intra- and inter-rater reliabilities was performed using the intra-class correlation coefficient, whereas validity was analysed using Pearson correlation test along with the Motricity Index (MI), Motor Assessment Scale (MAS), and Berg Balance Scale (BBS).Results The intra- and inter-rater reliabilities were significant for the total score, and good to excellent reliability was noted in all domains except for the joint range of motion of the lower extremity domain of the K-FMA. The MI and MAS scores were significantly correlated with all domains, all with p

Objective To identify the prevalence and characteristics of neuropathic pain (NP) in patients with spinal cord injury (SCI) and to investigate associations between NP and demographic or disease-related variables.Methods We retrospectively reviewed medical records of patients with SCI whose pain was classified according to the International Spinal Cord Injury Pain classifications at a single hospital. Multiple statistical analyses were employed. Patients aged

We report a 29-year-old female with a one-month history of non-healing multiple erythematous to violaceous plaques with crusts over both legs and feet. Tender, scarring ulcers with surrounding erythema were present. The clinical manifestation, together with histopathologic findings of fibrinoid plugs within vascular lumens and walls, as well as red blood cell extravasation, led to diagnosis of livedoid vasculopathy. The patient experienced recurrent painful violaceous plaques with ulcerations during the two years of treatment with oral pentoxifylline 400 mg three times daily. The cutaneous lesions and symptoms dramatically improved after the treatment regimen changed to oral sulodexide (250 lipasemic units) three times daily. Sulodexide, a highly purified mixture of glycosaminoglycans including dermatan sulfate and low-molecular weight heparin, could be an effective therapy for recalcitrant livedoid vasculopathy. Herein, we report a case of livedoid vasculopathy treated with sulodexide, which has not previously been reported.

Postural change from a steep Trendelenburg position to a supine position (T-off) during robot-assisted laparoscopic prostatectomy (RALP) induces a considerable abrupt decrease in the mean arterial pressure (MAP). We investigated the variables for predicting postural hypotension induced by T-off using esophageal Doppler monitoring (EDM). One hundred and twenty-five patients undergoing RALP were enrolled. Data on the MAP, heart rate, stroke volume index (SVI), cardiac index, peak velocity, corrected flow time, stroke volume variation, pulse pressure variation, arterial elastance (Ea), and dynamic arterial elastance were collected before T-off and at 1, 3, 5, 7, and 10 min after T-off using EDM. MAP P P P 2, and ≤ 1.08 mmHg/mL, respectively. If patients have MAP 2 or Ea ≤ 1.08 mmHg/mL before postural change from T-off during RALP, prompt management for ensuing hypotension should be considered.Trial registration: NCT03882697 (ClinicalTrial.gov, March 20, 2019).

Sang Jun Park,1,2 Kyung Bong Yoon,1,2 Dong Ah Shin,3 Kiwook Kim,1 Tae Lim Kim,1 Shin Hyung Kim1,2 1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; 3Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea Background: A caudal epidural steroid injection (CESI) is a commonly used method to improve symptoms of lumbosacral pain. We compared the achievement of successful epidurograms and patient-reported clinical outcomes following different needle-insertion depths during CESI.Methods: For the conventional method group, the needle was advanced into the sacral canal. For the alternative method group, the needle was positioned immediately after penetration of the sacrococcygeal ligament. Epidural filling patterns and vascular uptake during fluoroscopy were determined to verify successful epidural injection. Procedural pain scores were investigated immediately after the procedure. Pain scores and patient global impression of symptom change were evaluated at 1-month follow-up.Results: Assessments were completed by 127 patients (conventional method, n=64; alternative method, n=63). The incidence of intravascular injection was significantly lower in the alternative method group than in the conventional method group (3.2% vs 20.3%, P=0.005). Procedural pain during needle insertion was significantly lower in the alternative method group (3.7±1.3 vs 5.3±1.2, P

Solitary fibrous tumors (SFT) are uncommon mesenchymal tumors. SFT have several synonyms including localized fibrous tumor, benign mesothelioma, localized fibrous mesothelioma, and submesothelial fibroma. SFT usually occur in the pleura or other serosal surfaces, but SFT can also develop in extrapleural areas including the nasal cavity, orbit, retroperitoneum, and pelvis. Cutaneous SFT is extremely rare, and more likely to occur in the head and neck region. Histologically, this tumor can mimic a variety of benign and malignant tumors such as dermatofibroma, dermatofibrosarcoma protuberans, spindle cell lipoma or other mesenchymal tumors. Most cases of SFT show non-aggressive clinical courses, with low recurrence rates. Herein, we describe a case of primary cutaneous SFT which presented with huge mass on the back.

Viral warts are benign proliferations of the epithelium caused by human papilloma virus (HPV) infection. Diverse therapeutic options are available for viral warts, depending on extension and severity of the disease. We report a case of a 19-year-old man who presented with multiple viral warts on hands and feet for 5 years. He was treated at other clinics before visiting our hospital, but there was no improvement. We treated the lesions with a combination therapy of systemic acitretin and diphenylcyclopropenone (DPCP) immunotherapy for 6 months. A significant improvement was observed during the 12th week of therapy. Herein, we report a case of recalcitrant viral warts showing complete regression when a combination therapy of oral acitretin and immunotherapy was administered.

In Chan Baek,1 Kyungeun Park,1 Tae Lim Kim,1 Jehoon O,2 Hun-Mu Yang,2,* Shin Hyung Kim1,* 1Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Department of Anatomy, Yonsei University College of Medicine, Seoul, Republic of Korea *These authors contributed equally to this work. Purpose: The spread patterns between different injectate volumes have not yet been investigated in ultrasound-guided greater occipital nerve (GON) block at the C2 level. This cadaveric study was undertaken to compare the spread pattern and nerve involvements of different volumes of dye using this technique. Materials and methods: After randomization, ultrasound-guided GON blocks with 1 or 5mL dye solution were performed at the C2 level on the right or left side of five fresh cadavers. The suboccipital regions were dissected, and nerve involvement was investigated. Results: Ten injections were successfully completed. In all cases of 5 mL dye, we observed the deeply stained posterior neck muscles, including the suboccipital triangle space. The suboccipital and third occipital nerves, in addition to GONs, were consistently stained when 5-mL dye was used in all injections (100%). Although all GONs were successfully stained in the 1-mL dye cases, three of five injections (60%) concomitantly stained the third occipital nerves. Conclusion: The clinical efficacy of this technique using the 5-mL injectate seems unlikely to arise from the blockade of GON alone. Instead, its efficacy likely arises from the blockade of most nerves originating from the dorsal ramus of the upper cervical spinal nerve at the suboccipital area. Even using 1 mL of injectate may not guarantee blockade of the GON alone. Keywords: obliquus capitis inferior, third occipital nerve, suboccipital nerve, Cruveilhier plexus, suboccipital triangle region, headache

Study objectives The aim of our study was to investigate the risk of alopecia areata occurrence in patients with sleep disorders. Methods This study was a retrospective cohort study based on the National Health Insurance Service-National Sample Cohort database of patients with a sleep disorder, along with age- and sex-matched control subjects from 2003 to 2013. The hazard ratio (HR) of alopecia areata was compared between the patients with sleep disorders and control subjects adjusting comorbid diseases which could affect the incidence of alopecia areata. We also compared the prevalence of comorbid diseases in the patients with sleep disorders and control subjects. Results Among the 25,800 patients with sleep disorders and the 129,000 control subjects, patients with sleep disorders were at a significantly increased risk for alopecia areata when compared with control subjects (adjusted HR 1.651 [95% CI 1.382-1.974]), especially in younger age groups (0-24 and 25-44 years). In a multivariate logistic analysis, sleep disorders were not only associated with alopecia areata (OR 1.913 [95% CI 1.717-2.171]), but also with other comorbid diseases, including solid-organ cancers (OR 1.099 [95% CI 1.049-1.151]), Graves' disease (OR 1.717 [95% CI 1.562-1.886]), Hashimoto thyroiditis (OR 1.641 [95% CI 1.413-1.905]), vitiligo (OR 1.539 [95% CI 1.236-1.917]), and rheumatoid arthritis (OR 1.886 [95% CI 1.780-1.998]). Conclusions This study demonstrated that sleep disorder is an independent risk factor for alopecia areata, especially in individuals under the age of 45 years old.

Magnetic resonance electrical impedance tomography (MREIT) has been developed as a new medical imaging modality providing high-resolution conductivity and current density images. This paper is about MREIT of the breast. To show the feasibility of breast MREIT, we carried numerical simulations and breast phantom experiments. We found that an anomaly with 4 mm diameter can be visualized in a reconstructed conductivity image using 5 mA injection current if the SNR of the corresponding MR magnitude image is at least 150. We propose a desirable electrode configuration and show our first experimental results of the breast MREIT. Developing an RF coil for the breast MREIT, we plan to conduct various experimental studies including tissue phantoms.