Factors Affecting the Occurrence of Distal Radioulnar Joint Arthritis after Ulnar Shortening Osteotomy

PURPOSE: Ulnar shortening osteotmy is a common operation for the treatment of ulnar impaction syndrome. The purpose of this study was to evaluate factors that may affect the occurrence of distal radioulnar joint (DRUJ) arthritis after ulnar shortening osteotomy. METHODS: From September 2005 to August 2012, we performed 81 ulnar shortening osteotomies for ulnar impaction syndrome, and evaluated occurrence or deterioration of DRUJ arthritis in 58 patients with a minimum follow-up of 1 year. We analyzed potential factors that may affect the occurrence of DRUJ arthritis, such as, age, sex, hand dominance, pre- and postoperative ulnar variance, preexisting DRUJ arthritis, types of radial sigmoid notch, amount of ulnar shortening, and follow up period. RESULTS: DRUJ arthritis occurred or deteriorated in 32 out of the 58 patients. Regression analysis indicated a significant correlation between the type of radial sigmoid notch (type 1) and DRUJ arthritis. Other factors were not found to be correlated with occurrence or deterioration of DRUJ arthritis. CONCLUSION: This study suggests that patients with type 1 radial sigmoid notch (ulnar inclination of more than 10 degrees) are more likely to develop DRUJ arthritis after ulnar shortening osteotomy.

Treatment of Side Effects Caused by Electrically Powered Medical Skin Care Equipment / 대한피부과학회지

Radio frequency and iontophoresis are two commonly used types of medical skin care equipment, utilizing electrical energy. Radio frequency technology has become an important treatment in aesthetic medicine, and has many applications, including non-ablative tightening of the cutaneous tissue to improve skin laxity and to reduce wrinkles. Iontophoresis on the other hand uses a small electric charge to deliver medicine or other chemicals through the stratum corneum, the principle barrier to percutaneous absorption, without the use of a needle. It is used mainly for aesthetic reasons, including treatment of melasma, and for anti-aging therapy. Effective cosmetic results have been demonstrated for both these techniques in a number of studies. However, recklessness and incorrect use of the machines by unqualified practitioners can cause side effects. Here, we review the possible side effects and related coping strategies associated with radio frequency and iontophoresis.

The Principle and Clinical Application of Radiofrequency Devices in Dermatology / 대한피부과학회지

Radiofrequency (RF) device is a novel non-ablative technology which differs from laser devices that uses an electric current rather than a light source. RF device can deliver thermal energy to the dermis and stimulate neocollagenesis and dermal collagen remodeling, so that it is frequently used in cosmetic dermatology for skin rejuvenation. However, some questions remain regarding the optimal treatment parameter such as energy levels and number of passes. Unwanted adverse effects like burn and erythema with edema would occur at any time during the procedures. Therefore, it is very important that RF should be performed by skilled and well-trained clinicians. In this review, we summarized the basic principles of RF and its use to determine the evidence-based efficacy. In addition, various adverse effects and management of them will be addressed in this article.

Finite element analysis of the effect of cantilever and implant orientation on stress distribution in a mandibular implant-supported bar overdenture / 대한치과보철학회지

STATEMENT OF PROBLEM: Implant inclination and cantilever loading increse loads distributed to implants, potentially causing biomechanical complications. Controversy exists regarding the effect of the intentionally distal-inclined implant for the reduction of the cantilever length. PURPOSE: This study investigated the stress distribution at the bone/implant interface and prostheses with 3D finite element stress analysis by using four different cantilever lengths and implant inclinations in a mandibular implant-supported bar overdenture. MATERIAL AND METHODS: Four 3-D finite element models were created in which 4 implants were placed in the interforaminal area and had four different cantilver lengths(10, 6.9, 4 and 1.5mm) and distal implant inclinations(0degrees, 15degrees, 30degrees and 45degrees) respectively. Vertical forces of 120N and oblique forces of 45N were applied to the molar area. Stress distribution in the bone around the implant was analysed under different distal implant inclinations. RESULTS: Analysis of the von Mises stresses for the bone/implant interfaces and prostheses revealed that the maximum stresses occurred at the most distal bone/implant interface and the joint of bar and abutment, located on the loaded side and significantiy incresed with the implant inclinations, especially over 45degrees. CONCLUSION: Within the limitations of this study, it was suggested that too much distal inclination over 45 degrees can put the implant at risk of overload and within the dimension of the constant sum of a anterior-posterior spread and cantilever length, a distal implant inclination compared to cantilever length had the much larger effect on the stress distribution at the bone/implant interface.

Forward Head Posture: Relationship between Spinal Alignment Indicies and Myoelectrical Activities of the Paraspinal Muscles

OBJECTIVE: We evaluated the effects of forward head posture on the myoelectrical activities of the paraspinal muscles. METHOD: 15 healthy persons who were pain-free and didn't have the history of neuromuscular disease were participated in this study. Measurements were taken in three different sitting positions (relaxed, erect and forward head posture) with staring forward and arms hanging at the side. Paraspinal myoelectrical activities were measured by surface electrodes in paracervical, paralumbar, sternocleidomastoid (SCM) and levator scapular (LS) muscles. Simultaneously whole spine lateral X-ray including skull was taken. We measured cranio-cervical spinal alignment indicies (craniovertical, craniocervical, cervicohorizontal and upper cervical angles) introduced by Huggare and Gonzalez, lower cervical angle, lumbar lordosis angle and myoelectrical activity of each muscle in three different sitting positions. RESULTS: The analysis of relationship between lumbar lordosis and cranio-cervical spinal alignment index showed significant results. The more the lumbar lordosis increased, the head forward displacement decreased. But, the myoelectrical activities of paraspinal muscles were not influenced by the posture. CONCLUSION: Maintaining lumbar lordosis is very important to correct forward head posture and research for the distraction force loaded to soft tissue of the neck in forward head posture is needed.

Clinical Profile of Duchenne Muscular Dystrophy

OBJECTIVE: To evaluate clinical features in general and possible complications in Duchenne muscular dystrophy (DMD) which could be used for comprehensive rehabilitation management. METHOD: One hundred and seventy-two patients with DMD were followed over 3 year period to provide clinical profile causing impairment and disability. We measured height, weight and manual muscle testing (MMT) when the patients visited the hospital. And we could measure pulmonary function, electrocardiogram (EKG), and intelligence quotient (IQ) test in cooporative patients. RESULTS: The median height and weight of DMD boys were normally distributed before age 12, but during the second decade height was markedly reduced, and weight was no longer normally distributed. The MMT measurement showed loss of strength in a fairly linear fashion according to increasing age, and extensor of lower extremities were weaker than flexors showing typical contractures of legs. There was a direct relationship between pulmonary function and MMT scores of upper extremities. There was a high occurrence (40%) of abnormal EKG, but none of the patients had a history of cardiovascular complication. DMD children suffered wide spectrum of psychological disturbance such as somatic complaints, attention and emotional problems in addition to expected psychological problems due to chronic disease and its progression, and 50.9% of them were below average on the IQ test. CONCLUSION: These data on DMD subjects provide clinicians with useful information regarding the prevalence and severity of measurable impairment at different stages of the disease.

Behavioral and Emotional Problems for the Patient with Duchenne Muscular Dystrophy

OBJECTIVE: To identify psychological disturbance occurring in Duchenne Muscular Dystrophy (DMD) children. METHOD: Fifty one DMD children aged from 5 up to 14 years and 51 age matched healthy children were evaluated. Korean child behavioral cheak list (K-CBCL) was used to evaluate psychological problems in DMD and healthy control children. Korean Wechsler Intelligence Scale for children were performed in DMD children to evaluate cognitive function. To evaluate children's functional level, Brooke's scale for upper extremities and Vignos' scale for lower extremities were used. A correlational analysis was performed between age and total IQ score and K-CBCL subscales. RESULTS: K-CBCL profiles of the DMD children and control group revealed that DMD children obtained significantly lower scores on social, school, total social competence scales (P<0.01) and significantly higher scores on withdrawn, somatic complaints, anxious/depressed, immaturity, attention problems, internalizing problem, total behavior problems and emotional ability (P<0.01). Correlations of the age and functional level of the DMD group with each social scale of the CBCL resulted in significant negative relationship on social, school, and total social competence scales (P<0.01) and significant positive relationship on withdrawn, somatic complaints, anxious/depressed, immaturity, internalizing problems and total behavior problems (P<0.01). Correlational analysis of IQ score of the DMD group and each scale of the CBCL revealed no significant relationships except school (P<0.05) and total behavioral problem (P<0.05). CONCLUSION: We concluded that DMD children suffer from wide spectrum of psychological disturbance such as somatic complaints, attention and emotional problems in addition to expected psychological problems due to chronic disease and its progression. Thus, for the successful rehabilitation, these various emotional disturbances need proper treatment.

The Changes of Foot Pressure Distribution after Orthotic Shoes Wearing in Flatfoot

Flatfoot is a common foot disorder. Some modifications by orthotic shoes for the flatfoot have been prescribed, however their effectivenesses are not fully proven yet. We have tried to validate the effectivenesses of conventional orthotic shoes for the flatfoot patients. We assessed the static and dynamic pressure, dynamic pressure-time integral, and relative impulse with and without wearing orthotic shoes. Thirteen subjects with the flatfoot were included in this study. The results showed the positive effects of orthotic shoes for the subjects. Especially the dynamic pressure-time integral values revealed the significantly reduced values at the medial side of midfoot, which meant the functional improvement of flatfoot status. We have concluded that the use of conventional orthotic shoes for the flat foot patients would be effective for properly selected patients, if there is no other associated abnormality.

Ischemic Preconditioning in Isolated Rabbit Heart : Effect on Left Ventricular Function, Infarct Size, and Protein Kinase C*

BACKGROUND: It has been demonstrated that ischemic preconditioning(IP, repetitive brief period of ischemia and reperfusion) enhances recovery of post-ischemic contractile dysfunction and reduces incidences of reperfusion-arrhythmia and infarct size after a prolonged ischemia. A lot of mechanisms have been proposed, however, controversies still remain. Recent studies suggested that IP could activate protein kinase C(PKC). Therefore, we measured left ventricular function, myocardial creatinin and PKC activities, and infarct size to assess whether IPs cardioprotective effect is related to PKC activation using isolated rabbit hearts. METHODS AND RESULTS: Hearts isolated from New Zealand White rabbits(1.5-2.0kg body weight) were perfused with Tyrode solution by Langendorff technique. After stabilization of baseline hemodynamics, the hearts were subjected to 60-min ischemia followed by 120-min reperfusion with IP(IP group, n=15) or without IP(control group, n=14), IP was induced by 4 cycles of 5-min global ischemia and 5-min reperfusion. Left ventricular function including developed pressure(LVEDP), dp/dt, heart rate(HR), and coronary flow(CF) was measured to determine the recovery of LVEDP, RPP(rate-pressure product, HRXLVEDP) and CF to baseline measurement. Frequency of arrhythmia was counted on reperfusion. Myocardial CK-MB, myocardial cytosolic and membrance PKC were measured and the infarct size was determined by staining with tetrazolium salt and planimetry. Data were analyzed by one-way ANOVA, Tukey's post-hoc test and t-test. There was no significant differences in the recovery of LVEDP, dp/dt, RPP, and CF and frequency of arrhythmia during reperfusion between the control and the IP groups. In comparison with the control groups, however, CK-MB was significantly lowered in the IP group(P < 0.05). Cytosolic PKC was significantly decreased but membrance PKC was increased(p < 0.05). These findings indicate that PKC was translocated and activated by IP. Furthermore infarct size was smaller and limited to the antero-lateral or posterior wall and papillary muscle in the IP group(p < 0.05). CONCLUSION: These results indicate that IP dose not improve post-ischemic contractile dysfunction after a prolonged ischemia of 60 minutes but has an infarct-limiting effect. This cardioprotective effect of IP may be related to PKC activation.

The incidence and management of cervical radiculopathy in patients with shoulder pain

No abstract available.

A case of laryngeal cleft

Laryngotracheoesophageal cleft is a rare congenital anomaly characterized by a midline defect of variable length between the posterior larynx and trachea and the anterior wall of the esophagus which was first reported by Richter in 1792. The male, birth weight 2780 gm, was born our hospital, After birth the infant breathed spontaneously, cried immediately but weak and did well initially but after minutes appeared moderate amount of mucus in the mouth, and sterile water was given but immediately vomited with chocking, cough and cyanosis. A nasogastric tube was inserted through the esophagus without resistance and kinking. Esophagogram was showed spillage of contrast media simultaneously into trachea and esophagus. In direct laryngoscopy, there appeared to be small laryngeal cleft posteriorly, to the level of vocal cord. But bronchoscopy could not be performed due to narrow tracheal orifice. So we confirmed the laryngeal cleft by means of CT and MRI of neck. CT and MRI scan of neck demonstrated a cleft in interarytenoid lesion and connection between esophagus and laryngeal lumen.

External sphincterotomy in spinal cord injured patients

No abstract available.