Daegu Fatima Hospital

Background: To evaluate the effect of the COVID-19 pandemic on myopic progression defined in terms of refractive change and axial length elongation in Korean children with myopia using 0.01% atropine eye drops. Methods: A retrospective review was performed on the medical records of 73 children aged 4 to 15 years with a baseline myopia of -0.50 diopters (D) or more who had used 0.01% atropine eye drops for more than 12 months before the onset of the COVID-19 pandemic in South Korea. The rate of myopic progression was compared between two periods: the pre- and post-pandemic eras, the latter of which was defined by the initiation of remote schooling in March 2020. At each visit, cycloplegic autorefraction and axial length were measured using a Zeiss IOL Master. Patients answered a questionnaire regarding their time spent on near work (computer, smartphone, reading, homework, after-school workbooks, drawing, etc.) and outdoors. Results: During the pandemic, in terms of refraction, myopia progressed at an average rate of -0.45 D/y, which was significantly faster than before the pandemic of -0.22D/y (p = 0.037). In contrast, axial length elongation was 0.22 mm/y and 0.19 mm/y before and after the pandemic, respectively, which was not significantly different (p = 0.546). Time spent on using computers, smartphones, and other near work significantly increased, while outdoor time had significantly decreased after the pandemic (paired t-test, all p < 0.001). The change in annual refractive myopic progression rate during the pandemic compared to the pre-pandemic period did not significantly correlate with changes in computer time, smartphone time, or other near work time (p = 0.134, 0.210, 0.863, respectively). However, the change in outdoor time showed a negative correlation with the change in annual myopic progression rate (r = -0.239, p = 0.041). Conclusions: Among Korean children aged 4 to 15 years receiving 0.01% atropine, the rate of myopic progression increased significantly in terms of refraction during the COVID-19 pandemic compared with the pre-pandemic period, whereas axial length progression did not change significantly.

The Outerbridge-Kashiwagi (O-K) procedure has been widely used to treat elbow osteoarthritis by improving range of motion and alleviating mechanical impingement. Supercharged end-to-side (SETS) anterior interosseous nerve (AIN) transfer has emerged as a promising technique for restoring hand muscle function in patients with ulnar nerve palsy. However, no previous studies have evaluated the combined use of these procedures in patients with both elbow arthritis and severe ulnar neuropathy presenting with intrinsic hand muscle atrophy. We hypothesized that the combination of the O-K procedure and SETS AIN transfer would improve both elbow mobility and hand motor strength. A retrospective analysis was performed on 22 patients treated between 2019 and 2023 who underwent a miniopen O-K procedure, cubital tunnel release with anterior transposition, and SETS AIN-to-ulnar motor branch transfer. Inclusion criteria included McGowan grade 3 cubital tunnel syndrome, limited elbow range of motion (ROM) below functional thresholds, and ulnar-innervated intrinsic muscle weakness (MRC grade 0-3) with axonal loss on electromyography. Functional outcomes were evaluated using elbow ROM, MRC grading of the first dorsal interosseous (FDI), grip and pinch strength, index and little finger abduction/adduction strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. At final follow-up, significant improvements were observed in elbow ROM (from 80.9° to 106.5°, P < 0.001), FDI-MRC grade (2.32-3.23, P < 0.001), grip and pinch strength, and DASH scores (P < 0.001). Notably, greater improvement in DASH scores was seen in cases involving the dominant hand. Radiographic assessment revealed sustained fenestration, and no surgical complications were reported. This combined approach addresses both mechanical impingement and motor deficits, offering a feasible and effective strategy for restoring upper extremity function in this patient population. Preoperative electrophysiologic assessment plays a key role in optimizing candidate selection and outcomes.

Traumatic pseudoaneurysm of the middle meningeal artery (MMA) is a rare but potentially life-threatening condition, typically resulting from a laceration of the arterial wall due to adjacent skull fractures. We report an unusual case of a traumatic MMA pseudoaneurysm presenting with a large intracerebral hemorrhage (ICH) and significant subfalcine herniation that was successfully treated with preoperative glue embolization followed by decompressive craniectomy. This case emphasizes the importance of early vascular evaluation in traumatic ICH and highlights the value of endovascular embolization for achieving hemostatic control prior to surgery.

Purpose: This study examined the effects of the support surface height on the activation of the vastus medialis oblique (VMO), vastus lateralis (VL), and biceps femoris (BF) during single-leg squat (SLS) exercises.A height variation is proposed as a strategy to enhance knee stabilization through selective muscle activation.Methods: Forty healthy adults participated in the study.Surface electromyography (sEMG) electrodes were attached to the VMO, VL, and BF.The participants performed the SLS at three randomized support surface heights: 0 cm, 15 cm, and 25 cm after a brief practice session.Each condition was measured three times, and the average value was used for analysis.The EMG data were normalized to the maximum voluntary isometric contraction (MVIC) for each muscle.One-way repeated measures ANOVA was performed for each muscle separately to analyze the differences in muscle activation according to support surface height.Results: One-way repeated measures ANOVA revealed the significant main effects of support surface height for the vastus lateralis (VL) (F= 11.514, p< 0.001) and vastus medialis oblique (VMO) (F= 30.425, p< 0.001), but not for the biceps femoris (BF) (F= 0.638, p> 0.05).Post hoc comparisons suggested that VL and VMO activation were significantly greater at 25 cm compared to the 0 cm and 15 cm conditions (p< 0.017).No significant differences were found between the 0 cm and 15 cm conditions.BF muscle activation remained unchanged across all height conditions.Conclusion: Modifying the support surface height during SLS can selectively increase activation in specific thigh muscles.These findings have practical implications for designing targeted rehabilitation and injury prevention programs.In particular, gradually increasing the squat height may enhance the activation of the VMO and VL, contributing to improved knee joint stabilization.

Facet joint injections (FJIs) and medial branch blocks (MBBs) are commonly used interventions for chronic spinal pain, but their comparative effectiveness remains unclear. This meta-analysis aimed to compare the pain relief, functional improvement, complications, and patient satisfaction associated with FJI and MBB. A systematic review and meta-analysis of randomized controlled trials and observational studies were conducted. Primary outcomes included pain relief (numerical rating scale) and functional improvement (Oswestry Disability Index [ODI]/Neck Disability Index). Secondary outcomes assessed adverse effects and patient satisfaction. The differences in characteristics between patients who were readmitted and those who were not were identified and analyzed using the Review Manager software. FJI resulted in lower pain and ODI scores compared to MBB, but the differences were not statistically significant. However, patient satisfaction was significantly higher in the FJI group (odds ratio, 1.81; 95% confidence interval, 1.02-3.24; p=0.04). Additionally, FJI had fewer adverse effects than MBB. Both FJI and MBB are effective for chronic spinal pain, but FJI may be preferred for patients seeking immediate pain relief with fewer complications. Further high-quality studies are needed to refine treatment guidelines.

BackgroundMyopia is a prevailing refractive disorder and rapidly increases the risk of vision-threatening conditions. Earlier intervention is crucial to suppress myopia progression; however, the pharmacological and non-pharmacological therapies currently available have limitations. SAT-001 is a novel digital therapeutic software developed for myopia control and is designed to overcome the limitations of existing therapies. The present study aims to evaluate the efficacy and safety of the software as a medical device, SAT-001, for the inhibition of myopia progression and treatment in pediatric patients with myopia.MethodsThis clinical trial is a two-arm, prospective, randomized, open-label study with a duration of approximately 25 months, comprising a maximum of 52 weeks of participant participation. We will enroll 110 pediatric patients with myopia aged 5 to < 9 years, each with a spherical equivalent of − 0.75 D to − 5.75 D in each eye. Eligible participants will be randomly assigned in a 1:1 ratio to either the study group using SAT-001 with single-vision spectacles or the control group using single-vision spectacles alone. The change in the spherical equivalent refractive error (SER) at 48 weeks from baseline serves as the primary endpoint. The change in SER at 24 weeks and axial length at every 12 weeks from baseline will be the secondary endpoints. Each change will be assessed depending on the myopic severity. Treatment emergent adverse events will be evaluated for the safety analysis.DiscussionThis randomized controlled trial aims to confirm the efficacy and safety of SAT-001 in slowing pediatric myopia progression. The findings of this study could establish SAT-001 as an easily accessible, convenient, and non-invasive treatment option with minimal side effects, offering long-term myopia control from an early stage. Further research is needed to validate the effectiveness of SAT-001 for moderate to high myopia and concurrent conditions like astigmatism and to improve user engagement, diversify the program, and integrate with hospital-based treatments.Trial registrationClinicalTrials.gov: NCT06344572; date of registration: April 12, 2024 (retrospectively registered).