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Gossypiboma, an infrequent surgical complication, describes a mass of cotton material inadvertently left in the body cavity after an operation. It is an extremely rare iatrogenic complication of nasal surgery, with only a few cases reported in literature to date. Here we present a case of gossypiboma in the nasal septum of a 35-year-old male patient who previously underwent septorhinoplasty fourteen years prior. He was treated by endoscopic endonasal surgery to remove the lesion. Pathologic findings showed a foreign body (gauze filament) with a giant cell reaction. This report will be helpful for treating patients with similar histories in the future.

Olfaction is an important aspect of quality of life, beyond simply smelling food and recognizing danger. Recently, research has focused on its association with various diseases, such as neurodegenerative diseases or viral infections. The evaluation of olfactory function must take into consideration the cultural experience of the target group. A new Korean culturefriendly olfactory function test, the YSK olfactory function test (YOF test, Kimex Co.), uses safe odorants, such as phenyl-ethyl alcohol (PEA) (not n-butanol), for the threshold test. Furthermore, odorants in the YOF identification test reflect each of eight major chemical functional groups. The diagnostic cut-off for anosmia was a Threshold Discrimination Identification (TDI) score of ≤14.5 and that for hyposmia was 14.5

The objective of this study was to understand the existing practices and attitudes regarding inpatient sleep at the 2020 US News and World Report (USNWR) Honor Roll pediatric (n = 10) and adult (n = 20) hospitals. Section chiefs of Hospital Medicine from these institutions were surveyed and interviewed between June and August 2021. Among 23 of 30 surveyed physician leaders (response rate = 77%), 96% (n = 22) rated patient sleep as important, but only 43% (n = 10) were satisfied with their institutions' efforts. A total of 96% (n = 22) of institutions lack sleep equity practices. Fewer than half (48%) of top hospitals have sleep-friendly practices, with the most common practices including reducing overnight vital sign monitoring (43%), decreasing ambient light in the wards (43%), adjusting lab and medication schedules (35%), and implementing quiet hours (30%). Major themes from qualitative interviews included: importance of universal sleep-friendly cultures, environmental changes, and external incentives to improve patient sleep.

Infrared stealth technology used in aircraft is applied to reduce the infrared signal by controlling surface temperature and emissivity using internal heat sink, low emissivity material or metamaterial. However, there is one part of the aircraft where the use of this technology is limited, and that is the radome. Especially, radome should have transmittance for the specific radio frequency, therefore, common stealth technology such as emissivity control surfaces cannot be applied to radome surface. In this study, we developed metal nano-coating for infrared stealth which is applicable to radome surface. We designed slot-type pattern for frequency selective transmission in X-band, and also controlled thickness of metal nano-coating for long wavelength infrared emissivity control. As a result, our infrared stealth surface for radome has 93.2 % transmittance in X-band and various infrared emissivities from 0.17 to 0.57 according to nano-coatings thickness. Also, we analyzed infrared signature of radome through numerical simulation, and finally reduced contrast radiant intensity by 97.57 % compared to polyurethane surface.

The incidence of postoperative symptomatic venous thromboembolism (VTE) in western colorectal cancer is 1.1-2.5%. Anticoagulation and mechanical devices are recommended for moderate-to high-risk patients. Hospital stay and immobilization, as risk factors for VTE, are reduced by enhanced recovery after surgery (ERAS). This study aimed to evaluate short- and long-term outcomes for a VTE prophylaxis program after minimally invasive colorectal cancer surgery with ERAS protocol. In addition, predicting factors associated with VTE were investigated.We included 1043 patients diagnosed with colorectal cancer who required surgical treatment between January 2017 and December 2019 at a single institution. The patients enrolled followed the VTE prophylaxis program.Five (0.5%) patients developed symptomatic VTE, and the median follow-up period was 21 months. The Caprini score for all VTE patients was ≤8 points; thus, only mechanical prophylaxis was applied. The incidence rate of postoperative symptomatic VTE was only 0.5%. There was no association between variables considered as associated with VTE onset, such as age, perioperative complication, and length of postoperative day. TNM staging (OR 2.44, 95% CI 1.4-4.16, p = 0.001) and the Caprini score (OR 1.75, 95% CI 1.1-2.8, p = 0.001) were associated with VTE onset.Although pharmacological prophylaxis was only performed for Caprini scores ≥9, the VTE incidence rate of patients with colorectal cancer undergoing VTE prophylaxis program was 0.6%; 0.7% is the incidence criterion of the moderate group recommended for pharmacological prophylaxis. Continuous follow-up is required for patients with advanced-stage colorectal cancer with high-risk Caprini scores.

IntroductionThe olfactory epithelium (OE) and olfactory bulb (OB) are the major components of the olfactory system and play critical roles in olfactory perception. However, the embryonic development of OE and OB by using the olfactory specific genes has not been comprehensively investigated yet. Most previous studies were limited to a specific embryonic stage, and very little is known, till date, about the development of OE.MethodsThe current study aimed to explore the development of mouse olfactory system by spatiotemporal analysis of the histological features by using the olfactory specific genes of olfactory system from the prenatal to postnatal period.ResultsWe found that OE is divided into endo-turbinate, ecto-turbinate, and vomeronasal organs, and that putative OB with putative main and accessory OB is formed in the early developmental stage. The OE and OB became multilayered in the later developmental stages, accompanied by the differentiation of olfactory neurons. Remarkably, we found the development of layers of olfactory cilia and differentiation of OE to progress dramatically after birth, suggesting that the exposure to air may facilitate the final development of OE.DiscussionOverall, the present study laid the groundwork for a better understanding of the spatial and temporal developmental events of the olfactory system.

Toxoplasma gondii, a major zoonotic pathogen distributed worldwide, causes severe infections in humans, animals, and birds. However, limited information is available regarding T. gondii infection in livestock in the Republic of Korea (ROK). Herein, we determined the prevalence of T. gondii infection in livestock in the ROK and identified animal species that can potentially transmit T. gondii to humans. B1 gene-targeting nested polymerase chain reaction detected T. gondii DNA in 3.3% (2/61), 2.9% (3/105), 14.1% (11/78), and 15.4% (14/91) of dairy cattle, beef cattle, Boer goats, and Korean native goats, respectively. The prevalence of T. gondii was significantly higher (p = 0.002) in goats than in cattle. The risk of contracting T. gondii infection was significantly higher by 6.18-fold in Korean native goats (95% confidence interval [CI]: 1.72–22.27%, p = 0.005) and by 5.58-fold in Boer goats (95% CI: 1.50–20.76%, p = 0.010) than in beef cattle. Our T. gondii DNA sequences exhibited 97.1–100% homology with those obtained from various hosts in other countries. To the best of our knowledge, this is the first study to report T. gondii infection using the blood samples of domestic ruminants in the ROK. The results revealed that the prevalence of T. gondii infection is higher in goats than in cattle as determined by molecular detection. Thus, these findings suggest that T. gondii can be transmitted from ruminants to humans via meat consumption.

Cryptosporidium spp. are important enteric protozoan parasites that infect humans and other animals throughout the world. Cryptosporidium infection in cattle industry leads to substantial economic losses due to diarrhea, growth retardation, weight loss, and possibly death. Most studies have focused on C. parvum, and studies on other Cryptosporidium spp. and calf diarrhea are limited. Therefore, this study aimed to investigate the occurrence of Cryptosporidium spp. in pre-weaned calves, to determine the risk factors for Cryptosporidium spp. infection such as age and season, and to identify subtypes of C. parvum circulating in the Republic of Korea (ROK). A total of 510 fecal samples were collected from calves with diarrhea and divided by age and season. Cryptosporidium spp. were first screened using PCR targeting the small subunit (SSU) rRNA gene and further the 60-kDa glycoprotein gene for subtyping of C. parvum. Out of 510 fecal samples, 71 (13.9%) were positive for Cryptosporidium spp. in pre-weaned calves with diarrhea. C. andersoni (2.8%), C. bovis (30.9%), C. parvum (29.6%), and C. ryanae (36.6%) were identified. C. ryanae was the most predominant in calves in the ROK. Calf age was a significant risk factor for C. bovis (χ2 = 13.83, P = 0.001), C. parvum (χ2 = 7.57, P = 0.023), and C. ryanae (χ2 = 20.18, P = 0.000) occurrence. Additionally, C. parvum was detected 3.1-fold more frequently in pre-weaned calves with diarrhea in fall (95% CI: 1.23–7.81; P = 0.016) than in spring, whereas C. ryanae was 8.9-fold more frequently detected in summer (95% CI: 1.65–48.68; P = 0.011) than in spring. Three subtypes (IIaA17G4R1, IIaA18G3R1, and IIaA20G3R1) of C. parvum were identified. Of them, IIaA17G4R1 was the most common, whereas IIaA20G3R1 was not previously detected in calves in the ROK. To our knowledge, this is the first report of C. andersoni in pre-weaned calves in the ROK. The occurrence of Cryptosporidium spp. appears to be age-dependent in calves. Season had a significant effect on the occurrence of C. parvum and C. ryanae. Taken together, C. bovis and C. ryanae along with C. parvum are detected in pre-weaned calves with diarrhea and these two pathogens should not be overlooked in the diagnosis of calf diarrhea.

Obstructive sleep apnea (OSA) is a common disorder characterized by upper airway obstruction during sleep. To reduce the morbidity of OSA, sleep specialists have explored various methods of managing the condition, including manifold positive airway pressure (PAP) techniques and surgical procedures. Nasal obstruction can cause significant discomfort during sleep, and it is likely that improving nasal obstruction would enhance the quality of life and PAP compliance of OSA patients. Many reliable studies offer evidence to support this assumption. However, few comprehensive guidelines for managing OSA OSA through nasal surgery encompass all this evidence. In order to address this gap, the Korean Society of Otorhinolaryngology–Head and Neck Surgery and the Korean Society of Sleep and Breathing designated a guideline development group (GDG) to develop recommendations for nasal surgery in OSA patients. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a pre

Among the materials used for dorsal augmentation rhinoplasty (DAR), cross-linked human acellular dermal matrix (ADM) has been claimed for its low risk of infection and extrusion. The aim of this study was to compare the effectiveness of ADM in subjects undergoing primary versus revision dorsal augmentation rhinoplasties.Using a retrospective cohort study design, the investigators enrolled a cohort set of DAR patients operated by a single surgeon during a 65-month interval. The predictor variable was the treatment group (primary or revision DAR). The main outcome variables were postoperative changes with regard to the degree of augmentation (ratio of the dorsal height [DH] and radix height [RH] to the nasal length) and patients' and surgeons' satisfaction with the aesthetic and functional results. Other study variables were grouped into the following categories: demographic, surgical, and pathological. Descriptive, uni-, and bivariate statistics were computed using P ≤ 0.05 as a cutoff value.The study cohort comprised 145 subjects (75.2% with primary DAR; 39.3% females) with a mean age of 30.7 ± 9.4 years (range, 19-58). DAR was linked to the significant changes in DH and RH in both the treatment groups. Comparison of the two groups revealed that there was no significant difference in DH and RH between both the groups. Surgeons' and patients' satisfaction rates were comparable between the two surgery groups, neither of which experienced serious complications. Microscopic findings of the removed ADM showed abundant collagen tissue with newly formed vessels without signs of foreign body reaction.Despite significant differences in patient characteristics (age; number of osteotomy, tip plasty, and hump reduction surgeries), the results of this study suggest that ADM can be used in both primary and revision DAR, with minimal complications.

Background and Objectives: Osteomas are the most common benign tumors of the nasal cavity and paranasal sinuses (PNSs). In this study, clinical features and imaging findings were analyzed in patients with osteoma confirmed by ostiomeatal unit (OMU) computed tomography (CT) and PNS CT, and the surgical treatment performed at our hospital was introduced.Methods: The Severance Clinical Research Analysis Portal (SCRAP) service of Severance Hospital was used to collect research data. A total of 128 cases of osteomas of the nasal cavity or PNSs confirmed by OMU CT or PNS CT was retrospectively reviewed, including the location and size of the osteoma, clinical features, accompanying findings on imaging tests, and cases of surgical treatment.Results: In this study, osteomas were found in about 0.55% of patients who underwent computed tomography. Osteomas were most frequently found in the ethmoid sinus, followed by the frontal sinus, fronto-ethmoid sinus, maxillary sinus, intranasal sphenoid sinus, and maxillary sinus-ethmoid sinus. Patients with osteomas complained of symptoms such as rhinorrhea, postnasal drip, nasal congestion, hyposmia, headache, visual disturbance, and lacrimal duct obstruction.Conclusion: Surgical treatment was considered for patients presenting with severe headache, visual field symptoms, or accompanying rhinosinusitis. Surgery was performed by endoscopic or external approaches depending on location and size of the osteoma.

HYPOTHESIS The concentration of leukocytes influences the quality of platelet-rich plasma (PRP). However, there is no consensus on which type of PRP based on the concentration of leukocytes is the best for lateral epicondylitis (LE). METHODS We systematically searched the MEDLINE, Embase, and Cochrane Library databases up to March 1, 2020. Studies involving randomized controlled trials (RCTs), patients with LE, and treatment with PRP injections were included. PRP was classified into leukocyte-poor (LP)-PRP and leukocyte-rich (LR)-PRP. LR-PRP was defined as PRP with a white blood cell (WBC) concentration exceeding that of whole blood (4.0-10.0 per uL3), while LP-PRP was defined as PRP with a lower WBC concentration than whole blood. The efficacy of PRP was assessed using the visual analog scale (VAS) and success rates. RESULTS Eleven RCTs (six LP-PRP and five LR-PRP) were eligible for inclusion in this review. Eight studies were included in the meta-analysis to evaluate the VAS score. Regarding short-term follow-up, there was no difference in the VAS scores between the LP-PRP and control groups (standard mean difference [SMD], 0.01; 95% confidence interval [CI], -0.29-0.30; p=0.97), with no heterogeneity (I2=0%). There was also no difference in the VAS scores between the LR-PRP and control groups (SMD, -0.19; 95% CI, -0.57-0.20; p=0.34), with substantial heterogeneity (I2=56.7%). Regarding long-term follow-up, there was no difference in the VAS scores between the LP-PRP and control groups (SMD, -0.73; 95% CI, -1.69-0.23; p=0.134) with substantial heterogeneity (I2=88.4%). The LR-PRP groups had lower VAS scores than the control groups (SMD, -1.06; 95% CI, -2.02--0.09; p=0.032), with substantial heterogeneity (I2=92%). In the LP-PRP group, there was no significant difference in the success rate (odds ratio [OR], 1.08; 95% CI, 0.07-16.47; p=0.956) with substantial heterogeneity (I2=87.7%). In the LR-PRP group, however, the patients who received PRP had a higher success rate than those in the control group (OR, 2.85; 95% CI, 1.67-4.85; p

Proton pump inhibitors are widely used throughout the world for the treatment of gastrointestinal disorders that are related to acid secretion, such as peptic ulcer disease and dyspepsia. Another common indication for proton pump inhibitors is stress ulcer prophylaxis. Proton pump inhibitors have proven efficacy for the treatment of acid-related gastrointestinal disorders, but there is concern that their use may be associated with the development of significant complications, such as fractures, Clostridium difficile infection, acute kidney injury, chronic kidney disease, and hypomagnesemia. Proton pump inhibitors are overused in the hospital setting, both for stress ulcer prophylaxis and gastrointestinal bleeding, and then they are often inappropriately continued after discharge from the hospital. This narrative review article outlines the evidence surrounding appropriate proton pump inhibitor use for stress ulcer prophylaxis and peptic ulcer bleeding.

OBJECTIVE To compare the results of interbody fusion in patients undergoing minimally invasive lateral lumbar interbody fusion (LLIF) using demineralized bone matrix (DBM) alone versus DBM+recombinant human bone morphogenetic protein-2 (rhBMP2). METHODS This retrospective case-controlled study was conducted in patients undergoing minimally invasive LLIF (n = 54) for lumbar interbody fusion; they were divided into 2 groups: DBM-only group and DMB+rhBMP2 group. The improvements of segmental and lumbar lordosis and restoration of disc height were measured, and the interbody fusion rates were determined using a modified Bridwell grading system. Clinical outcomes after surgery, such as visual analog scale scores of back pain and leg pain, and Oswestry disability index were compared. RESULTS There were no significant differences in disc height, lumbar and segmental lordosis, or interbody fusion rate between the 2 groups. However, the proportion of Bridwell grade 1 as complete interbody bridging was higher in the DBM+rhBMP2 group than in the DBM-only group at both 6 and 12 months (P < 0.001). Clinical parameters showed equally significant improvement during follow-up in both groups, with no significant differences between the groups. CONCLUSION In minimally invasive LLIF, adding Escherichia coli-derived rhBMP2 to DBM did not affect clinical outcomes or radiation parameters, but increased the speed of fusion and interbody bony bridging rate.