ABSTRACT
Cutaneous squamous cell carcinoma (SCC) is the second most common skin malignancy. This report describes the case of an unusual extensive SCC involving the whole hemiface, which required reconstruction with a combination of a dual vascular free transverse rectus abdominis muscle (TRAM) flap and a skin graft. A 79-year-old woman visited our hospital with multiple large ulcerated erythematous patches on her right hemiface, including the parieto-temporal scalp, bulbar and palpebral conjunctiva, cheek, and lip. A preliminary multifocal biopsy was performed in order to determine the resection margin, and the lesion was resected en bloc. Orbital exenteration was also performed. A free TRAM flap was harvested with preserved bilateral pedicles and was anastomosed with a single superior thyroidal vessel. The entire TRAM flap survived. The final pathological examination of the resected specimen confirmed that there was no regional nodal metastasis, perineural invasion, or lymphovascular involvement. The patient was observed for 6 months, and there was no evidence of local recurrence. Usage of a TRAM flap is appropriate for hemifacial reconstruction because the skin of the abdomen matches the color and pliability of the face. Furthermore, we found that the independent attachment of two extra-flap anastomoses to a single recipient vessel can safely result in survival of the flap.
ABSTRACT
OBJECTIVES: To understand the relationship between monthly household income and number of remaining teeth as an indicator of oral health, and to find the differences between middle-aged and older people in this respect. METHODS: This study was conducted on data extracted from the Korean National Health & Nutrition Examination Survey, which surveyed all Korean citizens in 2012. From these data, data of 4502 people about 40 years of age who completed the questionnaires and examination survey were selected and analyzed. This study investigated the main factors affecting the remaining teeth, and analyzed the moderating effect of age on the relationship between income level and remaining teeth. RESULTS: The average number of remaining teeth was 25.17 for middle-aged people and 15.95 for older people, which was significantly different. The number of remaining teeth for middle-aged people showed a significant relationship with income level, education level, and smoking habit. The number of remaining teeth in older people was related to the same factors, along with an additional factor of whether or not they underwent oral examinations. From the interaction analysis conducted to find the moderating effect of age on the relationship between the number of remaining teeth and income level, the number of remaining teeth was more affected by income level in older people than in middle-aged people. CONCLUSIONS: Income level was strongly related to oral health, particularly in older people. Therefore, it can be concluded that an oral health promotion policy is necessary for low-income people, particularly those in the older age group.
Subject(s)
Humans , Diagnosis, Oral , Education , Family Characteristics , Oral Health , Smoke , Smoking , ToothABSTRACT
OBJECTIVES: There have been several previous studies that the pathology of Alzheimer's disease (AD) might be in part caused or exacerbated by metals. But inconsistent results are often seen in evaluation of levels of metals in Alzheimer's disease patient's blood and control group. So, we conducted a systematic review using a comprehensive search strategy to find out whether there is significant difference between cognitive decline elderly people and normal control group. METHODS: Studies were searched in Pubmed, CINAHL and EMBASE with predefined words according to MeSH and purpose of this study. 996 studies were selected as primary screening, and two reviewers extracted relevant data independent of each other. 172 studies fulfilled the inclusion criteria. 32 studies about aluminum, copper, lead, mercury, cadmium finally selected. The Newcastle-Ottawa Scale (NOS) was used for assessing the quality of studies. To synthesize the results of this study, summarized table was made. RESULTS: In most studies, blood levels of mercury were high in cognitive decline group. But the majority study shows lead was not that different between cognitive decline group and control group. Measurements of other metal levels in whole blood, plasma, serum were inconsistent. However, there are not enough evidences to generalize with just number of studies since the studies have various degrees of validity. CONCLUSION: There is lack of evidences, till now, to use blood levels of metals as diagnostic purpose or predicting prognosis. Further studies which are supplemented limitations of previous studies are needed.
Subject(s)
Aged , Humans , Aluminum , Alzheimer Disease , Cadmium , Copper , Mass Screening , Metals , Plasma , PrognosisABSTRACT
OBJECTIVES: To develop a physical functioning instrument for older adults living in the community. METHODS: A representative sample of 979 people aged 65 years or over were interviewed in-person. Of these, 199 people also completed a detailed in-hospital examination. The scale items were selected based on the frequency of endorsement, along with the item-total and inter-item correlations. The associations of the scale with their physical performance and clinical examination were analyzed to evaluate the criterion-related validity. Construct validity was assessed using factor analysis, and internal consistency through Cronbach's alpha and item-total correlations. Test-retest reliability was measured by agreement between the household survey and the repeat survey at the in-hospital examination. RESUJLTS: Initially, 23 items on the level of difficulty, ranging from no difficulty to an inability to complete a task, with the specific mobility and self-care tasks were included. Those with a high frequency of endorsement and a low inter-item or item-total correlations were excluded, resulting in a 10-item Physical Functioning (PF) scale. Equal weights were given to each item and a summated score was calculated. Significant associations were found between the PF scores and the physical performance, survey and clinical data. The scale revealed a 2-factor (mobility and self-care) structure. Cronbach's alpha was 0.92 and the item-total correlations were in the 0.63 to 0.78 range. Pearson's correlations for the test-retest ranged between 0.56 and 0.61. CONCLUSIONS: The newly developed Physical Functioning (PF) scale showed good psychometric properties in older people. Further work, however, is needed to improve its sensitivity to discriminate higher levels of functioning, in addition to assessing its predictive value in detecting changes in health.
Subject(s)
Adult , Humans , Family Characteristics , Geriatric Assessment , Psychometrics , Reproducibility of Results , Self Care , Weights and MeasuresABSTRACT
OBJECTIVES: To develop a physical functioning instrument for older adults living in the community. METHODS: A representative sample of 979 people aged 65 years or over were interviewed in-person. Of these, 199 people also completed a detailed in-hospital examination. The scale items were selected based on the frequency of endorsement, along with the item-total and inter-item correlations. The associations of the scale with their physical performance and clinical examination were analyzed to evaluate the criterion-related validity. Construct validity was assessed using factor analysis, and internal consistency through Cronbach's alpha and item-total correlations. Test-retest reliability was measured by agreement between the household survey and the repeat survey at the in-hospital examination. RESUJLTS: Initially, 23 items on the level of difficulty, ranging from no difficulty to an inability to complete a task, with the specific mobility and self-care tasks were included. Those with a high frequency of endorsement and a low inter-item or item-total correlations were excluded, resulting in a 10-item Physical Functioning (PF) scale. Equal weights were given to each item and a summated score was calculated. Significant associations were found between the PF scores and the physical performance, survey and clinical data. The scale revealed a 2-factor (mobility and self-care) structure. Cronbach's alpha was 0.92 and the item-total correlations were in the 0.63 to 0.78 range. Pearson's correlations for the test-retest ranged between 0.56 and 0.61. CONCLUSIONS: The newly developed Physical Functioning (PF) scale showed good psychometric properties in older people. Further work, however, is needed to improve its sensitivity to discriminate higher levels of functioning, in addition to assessing its predictive value in detecting changes in health.
Subject(s)
Adult , Humans , Family Characteristics , Geriatric Assessment , Psychometrics , Reproducibility of Results , Self Care , Weights and MeasuresABSTRACT
No abstract available.
Subject(s)
Delivery of Health Care , Democratic People's Republic of KoreaABSTRACT
Among 130 cholera patients treated in Seohae Hospital in 1991, 86 were cholera bacilli positive and remaining 44 were negative. All cholera bacilli 'positive' patients were confirmed bacteriologically by National Institute for Health team. Cholera related symptoms and laboratory findings were gathered by interviews and medical records surveys. Symptoms and some serological laboratory findings are compared between cholera bacilli 'positive' and 'negative' patients in 1991 cholera epidemic. Results are as follows: 1. There were no differences in symptoms distribution and in mean values of all serological laboratory tests done between two groups. These facts support that both cholera bacilli 'positive' and 'negative' patients are persons who have cholera bacilli infection. 2. The age distribution of the cholera bacilli 'negative' group tended to be much younger than that of 'positive' group. The infection source of this group is believed to be the environmental reservoir. This findings suggests that cholera bacilli 'negative' patients have the possibility of endemic characteristics. We think it is worth investigating Vibrio cholera antibody titers of people in area with frequent cholera epidemics in Korea.