Dual-Task Training Effect on Cognitive and Body Function, β-amyloid Levels in Alzheimer’s Dementia Patients: A Randomized Controlled Trial

Purpose@#Dementia is a disease in which cognitive function declines, leading to deterioration of body functions and activities of daily living. The purpose of this study is to explore the effects of dual-task training, including cognitive tasks, on cognitive and body function and β-amyloid levels in Alzheimer’s dementia patients. @*Methods@#34 inpatients diagnosed with Alzheimer’s dementia at a nursing hospital located in South Korea. The patients were randomly divided into a dual-task group (n=16) and a single-task group (n=18). Each group was trained for 30 minutes three times a week for eight weeks. The MMSE-K was used to measure the patients’ cognitive function. To assess the patients’ static balance ability, their LOS was measured using BioRescue. while dynamic balance was measured using the BBS. The 10MWT were conducted to evaluate the patients’ walking ability. Blood analysis was performed to measure levels of β-amyloid. @*Results@#Both groups exhibited statistically significant improvements in gait function after the training (p<0.05). The dual-task group exhibited statistically significant differences in cognitive function, static and dynamic balance function, and β-amyloid levels after training (p<0.05). A significant difference was observed between the two groups (p<0.05). @*Conclusion@#Dual-task training were found to be effective in improving cognitive and bodily functioning and reducing β-amyloid levels in Alzheimer’s dementia patients. Thus, this may be suggested as an effective exercise method for the treatment and early prevention of Alzheimer’s dementia.

A split-face study evaluating the efficacy of a topical antioxidant cream containing tocotrienol after 1064-nm picosecond Nd:YAG laser treatment for environment-induced skin pigmentation

Background@#This study aimed to evaluate the efficacy and safety of a topical antioxidant cream containing tocotrienol after 1064-nm picosecond neodymium-doped yttrium aluminum garnet (Nd:YAG) laser treatment for environment-induced skin pigmentation. @*Methods@#A split-face study was conducted between December 2020 and March 2021 in 26 patients (25 women and one man) who were treated with a 1064-nm picosecond Nd:YAG laser. On the right side of the face, an antioxidant cream containing tocotrienol was applied after picosecond laser treatment, and on the left side, only picosecond laser treatment was performed. We compared the right and left sides of the face at 4 weeks after laser treatment using an automatic skin analysis device to investigate skin pigmentation. The melasma severity scores of the two sides were evaluated before and 4 weeks after picosecond laser treatment. @*Results@#The skin pigmentation score showed a significant difference between pretreatment and 4 weeks after picosecond laser treatment on both sides of the face (P0.05). @*Conclusions@#Our results show that, for the treatment of environment-induced skin pigmentation, the application of a tocotrienol-containing antioxidant cream after 1064-nm picosecond laser treatment can provide good results without any complications.

A split-face study of moisturizer containing Centella asiatica extract after ablative fractional carbon dioxide laser resurfacing

Background@#Ablative fractional CO2 laser treatment is popular for improving atrophic acne scars; however, complications after laser treatment are unavoidable. The purpose of this study was to investigate the efficacy and safety of a moisturizer containing Centella asiatica extract when applied after ablative fractional CO2 laser resurfacing. @*Methods@#A split-face study was conducted between September 2020 and December 2020 on 34 patients (16 females and 18 males) who were treated with ablative fractional CO2 laser resurfacing. After laser treatment, C. asiatica extract was applied to the right side of the face and purified water was applied to the left side. We compared the right and left sides of the face at various time points after laser treatment using an automatic skin analysis device to investigate the degree of moisture and post-inflammatory hyperpigmentation. @*Results@#No significant difference in the degree of moisture was found between the two sides of the face immediately after laser treatment (P=0.059), but there was a significant difference at 1 and 4 hours after post-laser treatment care (P<0.001). Regarding post-inflammatory hyperpigmentation, there was no significant difference between the two sides of the face before laser treatment (P=0.184), but a significant difference was found at 6 weeks after laser treatment (P<0.001). @*Conclusions@#Our results show that applying C. asiatica extract is a novel post-laser treatment modality that can provide satisfactory results without complications after ablative fractional CO2 laser resurfacing.

Dual-Task Training Effect on Cognitive and Body Function, β-amyloid Levels in Alzheimer’s Dementia Patients: A Randomized Controlled Trial

Purpose@#Dementia is a disease in which cognitive function declines, leading to deterioration of body functions and activities of daily living. The purpose of this study is to explore the effects of dual-task training, including cognitive tasks, on cognitive and body function and β-amyloid levels in Alzheimer’s dementia patients. @*Methods@#34 inpatients diagnosed with Alzheimer’s dementia at a nursing hospital located in South Korea. The patients were randomly divided into a dual-task group (n=16) and a single-task group (n=18). Each group was trained for 30 minutes three times a week for eight weeks. The MMSE-K was used to measure the patients’ cognitive function. To assess the patients’ static balance ability, their LOS was measured using BioRescue. while dynamic balance was measured using the BBS. The 10MWT were conducted to evaluate the patients’ walking ability. Blood analysis was performed to measure levels of β-amyloid. @*Results@#Both groups exhibited statistically significant improvements in gait function after the training (p<0.05). The dual-task group exhibited statistically significant differences in cognitive function, static and dynamic balance function, and β-amyloid levels after training (p<0.05). A significant difference was observed between the two groups (p<0.05). @*Conclusion@#Dual-task training were found to be effective in improving cognitive and bodily functioning and reducing β-amyloid levels in Alzheimer’s dementia patients. Thus, this may be suggested as an effective exercise method for the treatment and early prevention of Alzheimer’s dementia.

A split-face study evaluating the efficacy of a topical antioxidant cream containing tocotrienol after 1064-nm picosecond Nd:YAG laser treatment for environment-induced skin pigmentation

Background@#This study aimed to evaluate the efficacy and safety of a topical antioxidant cream containing tocotrienol after 1064-nm picosecond neodymium-doped yttrium aluminum garnet (Nd:YAG) laser treatment for environment-induced skin pigmentation. @*Methods@#A split-face study was conducted between December 2020 and March 2021 in 26 patients (25 women and one man) who were treated with a 1064-nm picosecond Nd:YAG laser. On the right side of the face, an antioxidant cream containing tocotrienol was applied after picosecond laser treatment, and on the left side, only picosecond laser treatment was performed. We compared the right and left sides of the face at 4 weeks after laser treatment using an automatic skin analysis device to investigate skin pigmentation. The melasma severity scores of the two sides were evaluated before and 4 weeks after picosecond laser treatment. @*Results@#The skin pigmentation score showed a significant difference between pretreatment and 4 weeks after picosecond laser treatment on both sides of the face (P0.05). @*Conclusions@#Our results show that, for the treatment of environment-induced skin pigmentation, the application of a tocotrienol-containing antioxidant cream after 1064-nm picosecond laser treatment can provide good results without any complications.

A split-face study of moisturizer containing Centella asiatica extract after ablative fractional carbon dioxide laser resurfacing

Background@#Ablative fractional CO2 laser treatment is popular for improving atrophic acne scars; however, complications after laser treatment are unavoidable. The purpose of this study was to investigate the efficacy and safety of a moisturizer containing Centella asiatica extract when applied after ablative fractional CO2 laser resurfacing. @*Methods@#A split-face study was conducted between September 2020 and December 2020 on 34 patients (16 females and 18 males) who were treated with ablative fractional CO2 laser resurfacing. After laser treatment, C. asiatica extract was applied to the right side of the face and purified water was applied to the left side. We compared the right and left sides of the face at various time points after laser treatment using an automatic skin analysis device to investigate the degree of moisture and post-inflammatory hyperpigmentation. @*Results@#No significant difference in the degree of moisture was found between the two sides of the face immediately after laser treatment (P=0.059), but there was a significant difference at 1 and 4 hours after post-laser treatment care (P<0.001). Regarding post-inflammatory hyperpigmentation, there was no significant difference between the two sides of the face before laser treatment (P=0.184), but a significant difference was found at 6 weeks after laser treatment (P<0.001). @*Conclusions@#Our results show that applying C. asiatica extract is a novel post-laser treatment modality that can provide satisfactory results without complications after ablative fractional CO2 laser resurfacing.

Influence of Head-Neck Rotation on Elbow Flexor and Extensor Muscle Activity and Strength in Normal Adults

Purpose@#This study examined the effects of the directions of neck rotation position on the muscle activity and strength of the elbow flexor and extensor muscle. @*Methods@#Forty-one healthy adults participated in this study. The subjects were asked to their elbow 90° flexion in three different neck rotations (neutral, ipsilateral, and contralateral) in the sitting position. The muscle activities of the biceps and triceps brachii muscle were measured using surface electromyography. And the muscle strength of the elbow flexor was measured using dynamometer. One way repeated measures ANOVA was used to compare the muscle activity and strength of the elbow flexor and extensor depending on the different neck turning directions. @*Results@#There were significant differences between contralateral neck rotation and ipsilateral neck rotation, contralateral neck rotation and neutral position. But, there was no significant difference in the triceps brachii muscle activity in comparison with the neck rotation. There were significant differences between contralateral neck rotation and ipsilateral neck rotation, contralateral neck rotation and neutral position. @*Conclusion@#To summarize this study, the elbow flexor and extensor muscle activity and strength was highest in the contralateral neck rotation position. In other words, it was possible to confirm the effect of Asymmetrical Tonic Neck Reflex in healthy adults whose primitive reflexes were inhibition, and head and neck positions should be considered during clinical evaluation and treatment.

The Association Between Lung Function and Type 2 Diabetes in Koreans

ObjectivesThis study was performed to test the association between lung function and type 2 diabetes mellitus (T2DM) in Korean patients.MethodsData from the 6th Korea National Health and Nutrition Examination Survey (2013 to 2015) was used in this study. There were 3,466 individuals aged between 40 and 80 years, with T2DM, who had a smoking and alcohol status listed, and blood analysis (including blood pressure), were included in this study. Lung function, measured by spirometer ventilatory dysfunction was categorized into 3 patterns: normal, restrictive ventilatory dysfunction, and obstructive ventilatory dysfunction (OVD).ResultsBased on multivariate logistic regression analysis, individuals with restrictive ventilatory dysfunction had an increased odds ratio (OR 1.615, 95% CI 1.137–2.294) for T2DM compared with individuals with normal ventilatory function, whereas OVD had no increase in the odds ratio (OR 1.169, 95 % CI 0.857–1.594). Model 1, which adjusted for age and gender, showed that the probability of having restrictive disorder was 1.559 times (95% CI 1.617–2.082) higher for prediabetes patients, and 2.320 times (95% CI 1.611–3.343) higher for T2DM patients, compared to normal individuals. For Model 4, which was fully adjusted for variables, the probability of having a restrictive disorder was 1.837 times higher for T2DM patients (95% CI 1.260–2.679).ConclusionRestrictive ventilatory dysfunction, but not OVD, was associated independently with T2DM.

Influence of Head-Neck Rotation on Elbow Flexor and Extensor Muscle Activity and Strength in Normal Adults

Purpose@#This study examined the effects of the directions of neck rotation position on the muscle activity and strength of the elbow flexor and extensor muscle. @*Methods@#Forty-one healthy adults participated in this study. The subjects were asked to their elbow 90° flexion in three different neck rotations (neutral, ipsilateral, and contralateral) in the sitting position. The muscle activities of the biceps and triceps brachii muscle were measured using surface electromyography. And the muscle strength of the elbow flexor was measured using dynamometer. One way repeated measures ANOVA was used to compare the muscle activity and strength of the elbow flexor and extensor depending on the different neck turning directions. @*Results@#There were significant differences between contralateral neck rotation and ipsilateral neck rotation, contralateral neck rotation and neutral position. But, there was no significant difference in the triceps brachii muscle activity in comparison with the neck rotation. There were significant differences between contralateral neck rotation and ipsilateral neck rotation, contralateral neck rotation and neutral position. @*Conclusion@#To summarize this study, the elbow flexor and extensor muscle activity and strength was highest in the contralateral neck rotation position. In other words, it was possible to confirm the effect of Asymmetrical Tonic Neck Reflex in healthy adults whose primitive reflexes were inhibition, and head and neck positions should be considered during clinical evaluation and treatment.

A prospective, comparative evaluation of axillary hair removal with an 808-nm diode laser at different fluences

BACKGROUND: Diode lasers are the gold standard for removing unwanted hair. Lowering the energy should result in less pain and could theoretically affect therapeutic efficacy. This study evaluated the efficacy of an 808-nm diode laser at different fluences for permanent axillary hair removal in Korean women. METHODS: Twenty-four Korean women were divided into two groups. Each patient received laser treatment at both axillae, which were divided into upper and lower parts. Each part received different fluence from an HR808 prototype diode at 1-month intervals: 8, 10, 12, and 14 J/cm². Hair count and thickness were recorded at each follow-up visit and at a 3-month follow-up after the final laser treatment by photography and using a folliscope. At the final visit, pain and patient satisfaction were surveyed. Three plastic surgeons assessed the results on photographs. RESULTS: The mean hair follicle density reduction was 62.18%, 65.28%, 73.08%, and 78.29% on the right upper side, right lower side, left upper side, and left lower side, respectively. The mean hair follicle thickness reduction was 45%, 48%, 54%, and 59% on the right upper side, right lower side, left upper side, and left lower side, respectively. In the plastic surgeons' assessment, the left upper and lower sides scored 2.71. The right upper and lower sides scored 2.38 and 2.04, respectively. CONCLUSIONS: High-fluence (14 J/cm²) treatment with an HR 808 prototype diode laser efficiently removed unwanted hair. No significant difference in comfort was reported compared to the low-fluence mode (8–10 J/cm²).

Usefulness of Optical Coherence Tomography in the Preoperative Assessment of Nail Deformities

Secondary nail deformities are often seen at some time after fingertip and nail bed injuries. A proper evaluation of the fingernail enables appropriate diagnosis and treatment, especially in patients who need surgical management. To date, ultrasound and magnetic resonance imaging are the only diagnostic tools that most surgeons use in cases of nail deformities. Herein, we report the case of a patient with a nail deformity who underwent successful correction based on the preoperative use of real-time optical coherence tomography.

Surgical treatment of velopharyngeal insufficiency

Velopharyngeal insufficiency (VPI) is a common complication after primary palatoplasty. Although the several surgical treatments of VPI have been introduced, there is no consensus guide to select the optimal surgical treatment for VPI patients. The selection of surgical treatment for VPI depends on a multimodal patient evaluation, such as perceptual speech evaluation, nasometery and nasoendoscopy. We can provide more adequate treatment for VPI through the deeper understanding of anatomy and physiology in VPI.

Changes in Implant Thickness after Rhinoplasty Using Surgiform

BACKGROUND: Gore-Tex implants started out as a product with the distinct advantage of producing a natural nose shape, but using Gore-Tex, it is difficult to predict the height of the nose after rhinoplasty because Gore-Tex contracts over time, making the nose shrink. However, Surgiform, a new form of expanded polytetrafluoroethylene (ePTFE) implant, enables prediction of the height of the nose after rhinoplasty because the implant does not change in thickness even after many years. Thus, we investigated whether changes in implant thickness occurred after rhinoplasty using Surgiform implants. METHODS: This study enrolled 12 patients who had Surgiform nasal implants removed for any reason after receiving rhinoplasty in 2007 or later. After the Surgiform implants were removed, we measured the thickness of the central part of the implants using calipers. RESULTS: At the time of the initial operation, the mean implant thickness was 4.48±0.30 mm at the supra-tip. At the time of implant removal, the mean thickness was 4.32±0.29 mm. The implants maintained 96.5% of their initial thickness. There was a negligible reduction in the Surgiform implants' thickness over time. CONCLUSIONS: Surgiform implants maintained their shape after rhinoplasty, making it possible to predict the height of the nose. Thus, Surgiform is more useful for nasal implants than other ePTFE implants.

The Efficacy of a Q-Switched 694-nm Ruby Fractional Laser for Treating Acquired Bilateral Nevus of Ota-Like Macules

BACKGROUND: Acquired bilateral nevus of Ota-like macules (ABNOM) are a common form of hyperpigmentation in Asian populations, characterized by brownish-blue or slate-gray pigmentation in the bilateral malar regions. The purpose of this study was to evaluate the efficacy and complications of a Q-switched (QS) fractional ruby laser in the treatment of ABNOM. METHODS: Forty-four patients with ABNOM treated with a QS fractional ruby laser from January 2014 to February 2016 were enrolled in this study. Patients received up to 10 treatment sessions, at intervals ranging from 3 to 4 weeks. An automatic skin diagnosis system was used before and after laser treatment to evaluate the efficacy of the laser treatment. To evaluate the complications of the laser treatment, a retrospective chart review was conducted. RESULTS: Forty-one patients were female, and 3 were male. The mean age of the patients was 47.2 years, and the mean follow-up period was 14 months. The median skin pigmentation score was 5 (interquartile range [IQR], 5–6) before laser treatment and 3 (IQR, 3–4) after laser treatment. A statistically significant difference (P < 0.01) was found in the skin pigmentation score before and after laser treatment. CONCLUSIONS: This study suggests that, although multiple sessions are required, QS ruby fractional lasers can be considered an effective and less invasive form of treatment of ABNOM.

Clinical Study on Percutaneous Intramedullary Bioresorbable Pin Fixation for Fourth and Fifth Metacarpal Bone Fracture

PURPOSE: Metacarpal fracture of a ring and little finger occurs frequently. Percutaneous intramedullary fixation is a simple and effective method with a low incidence of complications. To date, Kirschner wire (K-wire) fixation has been widely used, but this has problems such as pin infection. Moreover it is difficult to start early active motion exercise. So, we replaced the K-wire with a bioresorbable implant and evaluated the results. METHODS: This study was conducted from 2014 to 2016 and involved 10 consecutive patients with 10 metacarpal neck fractures. All cases underwent percutaneous intramedullary fixation using the ActivaPin (Bioretec Ltd.) within 7 days after injury, and the average follow-up period was 13 months. At the final follow-up, all cases were assessed in terms of total active motion (TAM), bony union and angular deformity based on plain radiographs. RESULTS: The patients started active motion exercise within 1 week and regained a full range of motion after average 4 weeks. The TAM results were excellent at 250° to 270° in all cases. Regarding radiographic findings, fractures united in all cases and there were no malunion and knuckle deformity. CONCLUSION: Replacement of a K-wire with a bioresorbable pin prevented soft tissue damage and dorsal scarring. And our percutaneous intramedullary bioresorbable pin fixation technique resulted in early recovery of range of motion and correction of deformity. The patients regained range of motion and returned to daily life early.

Four Limb Shaped Auricular Chondrocutaneous Composite Graft for the Alar and the Columellar Defects

BACKGROUND: Composite grafts have advantages for small nasal defect coverage. However, if the the outer skin defect and the inner skin defect have a different location, conventional composite grafts encounter considerable limitations. Therefore, we devised a 4-limbed graft to overcome this limitation by use of soft tissue transposition. METHODS: Over the course of 5 years, this auricular composite graft was used in 10 cases of reconstruction. We harvested skin and cartilage from the helix. The composite graft had 2 limbs of soft tissue to cover the nasal defect and another 2 limbs of cartilage to support nasal framework. The cartilage limbs extended 3 to 5 mm beyond the margin of the skin. The direction of each limb was modified according to defect position. RESULTS: All 10 composite grafts survived completely. All composite grafts shrank by a small percentage of their bulk. Nonetheless, the nasal framework was maintained to an acceptable extent because of the cartilage limbs. CONCLUSIONS: This technique was capable not only of covering defects in the alar and columellar area, but also of maintaining a satisfactory external appearance, because the 2 limbs of cartilage included in the graft strengthened the nasal framework and provided modest support to the nostril margin. The 2 limbs of soft tissue covered the defect area. Our 4-limbed auricular chondrocutaneous composite graft is reliable option for the reconstruction of alar and columellar defects in a single-stage procedure.

The Effect of Acellular Dermal Matrix in Implant-Based Immediate Breast Reconstruction with Latissimus Dorsi Flap

BACKGROUND: Capsular contracture is the most frequently reported complication after implant-based breast reconstruction. This study was first undertaken to present our experience with acellular dermal matrix for prevention of capsular contracture in implant-based immediate breast reconstruction with latissimus dorsi flap, and to assess the final aesthetic outcome. METHODS: We performed a retrospective review of all patients who underwent immediate latissimus dorsi flap breast reconstruction in combination with implant and acellular dermal matrix from January 2014 to December 2015. Demographics and clinical characteristics and postoperative complications, especially focused on capsular contracture, were assessed. They were also analyzed as the potential risk factors for the development of capsular contracture. The aesthetic outcome of the overall reconstruction and the final outcome of the inframammary fold were evaluated. RESULTS: During the study period, a total of 30 patients (30 breasts) were reviewed. The mean Baker grades for all 29 breasts (one breast was dropped out due to implant loss), evaluated at one year after reconstruction, was 1.21±0.49 capsular contracture. None of risk factors except seroma/hematoma (P=0.033) were significantly associated with the development of capsular contracture. Overall aesthetic outcome was 8.2±1.2 and aesthetic outcome of the inframammary fold was 3.5±0.6 for physician and 3.4±0.6 for patients. CONCLUSIONS: In this study, we have shown the ability of acellular dermal matrix to prevent capsular contracture observed in implant-based immediate breast reconstruction with latissimus dorsi flap and its use was proven to create superior aesthetic results.

Evaluation of Elastic Lift for Neck Rejuvenation

BACKGROUND: The neck is not only the first area to show aging but it also represents the persona of the individual. The understanding of the aging process of the neck is essential for neck rejuvenation. The purpose of this study was to evaluate the outcomes and safety of elastic lift in relation to neck region lifting. METHODS: Forty-seven patients with sagging and laxity of the neck skin treated by elastic lift were enrolled in this study from November 2015 to February 2016. To evaluate the safety of elastic lift, a retrospective chart review was conducted. We used an automatic skin diagnosis system to evaluate the efficacy of elastic lift. RESULTS: Forty-five patients were female and 2 patients were male. The mean age of the patients was 45.3 years and their mean follow-up period was 3 months. There were no major complications requiring the removal of the elastic thread during the follow-up period. The median skin laxity grade score was 5 (4-5) preoperatively; the median skin laxity grade score was 3 at 3 months postoperatively. In comparing the skin grade score at these two points in time, there was a statistically significant difference (P < 0.01). CONCLUSIONS: Neck rejuvenation using elastic lift is a safe and effective procedure in selected patients with moderate sagging and laxity of the neck skin.

Evaluation of Elastic Lift for Facial Rejuvenation

BACKGROUND: Thread lift is a minimally invasive procedure for facial rejuvenation, but complications of thread lift have been reported. The purpose of this study was to evaluate outcomes and safety associated with elastic lift in relation to midface and upper mandibular region lifting. METHODS: Thirty-eight patients with sagging and laxity of the facial skin treated with elastic lift from September 2015 to October 2015 were enrolled in this study. Treatment was performed following the manufacturer's recommended protocol that called for 300 treatment lines. To evaluate elastic lift safety, a retrospective chart review was conducted. We used an automatic skin diagnosis system to evaluate the efficacy of elastic lift. RESULTS: Thirty-seven patients were female, and one patient was male. The mean age of the patients was 40.4 years, and their mean follow-up period was 3 months. There were no major complications manifesting in removal of the elastic thread during the follow-up period. The median skin laxity grade score was 5 (3-6) before surgery; the median skin laxity grade score was 3 (2-4) 3 months post-surgery, resulting in a statistically significant difference in skin grade score (P<0.01). CONCLUSIONS: Facial rejuvenation using elastic lift is an effective and safe procedure in select patients with midface ptosis and moderate jowls.

The Effectiveness of Ablative Fractional Carbon Dioxide Laser with Autologous Platelet Rich Plasma Combined Resurfacing for Hypertrophic Scar of the Shoulder

Laser treatment for scars has improved over the past three decades. Autologous platelet-rich plasma (PRP) derived from whole blood is immunologically inert and contains a proper ratio of growth factors and cytokines. Here we describe the case of a 29-year-old female patient with a hypertrophic scar on her right shoulder caused by an operation performed in 2012. The patient underwent 11 laser therapy sessions with a fractional carbon dioxide (CO2) ablative laser system (LineXel) and two PRP injections. Her scar was evaluated with the Vancouver Scar Scale (VSS), and the baseline and post-treatment scores were 11 and 3, respectively. After treatment, the dimensions and volume of the scar were diminished, and contour, texture, and pigmentation had also improved compared to baseline. The patient reported less pain, swelling, and pigmentation following PRP combination ablative laser therapy. This case provides further evidence of the potential benefits of PRP as an adjuvant to fractional laser in reducing hypertrophic scars.