Choice Stepping Reaction Time under Unstable Conditions in Healthy Young and Older Adults: A Reliability and Comparison Study

Purpose@#We aimed to analyze the reliability of the test for choice stepping reaction time (CSRT) under an unstable surface and determine whether there were differences in CSRT between support surface conditions (stable vs. unstable conditions) and between age groups (young adults vs. community-dwelling older adults). @*Methods@#Twenty healthy community-dwelling older adults and twenty young adults performed the stepping task under an unstable condition over two visits. The mean of the two trials measured for each visit was used for the analysis. The test-retest reliability was analyzed using intra-class correlation coefficient (ICC) with a 95% confidence interval, standard error of measurement (SEM), and minimal detectable change (MDC). Differences in CSRT between support surface conditions and age groups were analyzed using the independent t-test with Bonferroni correction. @*Results@#Excellent consistency was observed for ICC > 0.90 in both groups. Moreover, the SEM and MDC values of the CSRT in older and young adults were 0.03 and 0.09 and 0.01 and 0.04, respectively. There was a significant difference in the CSRT between the age groups under stable (p < 0.001) and unstable conditions (p < 0.001). @*Conclusion@#The findings demonstrated that the test for CSRT under an unstable condition had reliable results in both groups. Although older adults demonstrated longer reaction times than younger adults in all surface conditions, increasing the balance control demand by implementing a choice stepping task concomitant with a balance task had no influence on the reaction time in both age groups.

Analysis on Usefulness of Various Free Flaps for Primary Reconstruction on Fourth Degree Burn

Purpose@#A fourth degree burn is a full-thickness burn of the skin usually accompanied by damage to deep structures and commonly results in extensive damage to surrounding tissues which makes the treatment of the wound difficult. Coverage of these wound using free flap is known to effective but not commonly used. The purpose of our study is to review our experience and suggest early application of free flap surgery. @*Methods@#A retrospective review was performed from 2010 to 2019, on a total of 34 fourth degree burn patients undergone free flap surgery as primary treatment in our hospital. We reviewed the location of the injury, etiology, TBSA (%), Presence of osteomyelitis, flap choice, complications, period of injury to surgery and healing. @*Results@#Using free flap as a primary reconstrcuction, the outcome is satisfactory. The treatment period was shortened, and there was less loss of function due to complications. Also the incidence of osteomyelitis and amputation was significantly low. @*Conclusion@#Applying free flap surgery as soon as possible in fourth degree burns is effective, such as reducing complications such as infection, reducing amputation, shortening treatment period, and preventing severe sequelae.

Aging-related changes in the mid-face skin elasticity in East Asian women

BACKGROUND: Age-related changes in facial skin is a major concern in women. This study aimed to objectively evaluate normal skin elasticity and age-related differences in the faces of East Asian women. There are no standard values for data related to normal skin on East Asian women. METHODS: We studied 129 healthy East Asian women without a history of cosmetic procedures or surgeries. Skin elasticity was assessed at the cheek and lower eyelid points, which were assessed on both the right and left sides of the face. RESULTS: The age of the subjects showed significant negative correlations with the R2 and R7 parameters, which represent skin elasticity after deformation. CONCLUSION: We therefore concluded that the primary decrease in skin elasticity in East Asian women occurs in the midface region.

Modified Abbé flap for reconstruction of Cupid’s bow and vermilion tubercle in secondary cleft lip deformity

BACKGROUND: Abbé flap technique is one of the most challenging operations to correct horizontal deficiencies in secondary cleft lip deformity. Since its first introduction, the operative method was dynamically modified from simple variation to complete conceptual change, but conventional Abbé flap has many drawbacks in esthetic and functional aspect. Our purpose was reconstructing the symmetry of Cupid's bow and central vermilion tubercle with minimal sequalae. METHODS: From 2008 to 2016, this technique was applied to 16 secondary cleft lip patients who had total or more than 60% of unilateral deficiency of Cupid's bow and central lip or tubercle pouting deficiency. A quadrangular-shaped flap was transferred from vermilion including skin and white line of central or contralateral lower lip. Pedicle division and insetting were made at 9 (unilateral) or 10 (bilateral) days after transfer. Secondary lip revision was done with open rhinoplasty after wound maturation. RESULTS: Overall satisfaction was high with modified technique. Scar was minimally noticeable on both upper and lower lip especially. Balanced Cupid's bow and symmetric vermilion tubercle were made with relatively small size of flap compared to conventional Abbé flap. An accompanying benefit was reduced ectropion of lower lip, which made balanced upper and lower lip protrusion with more favorable profile. CONCLUSION: A new modified Abbé flap technique showed great satisfaction. It is worth considering in secondary cleft lip patient who has central lip shortage and asymmetry of upper lip vermilion border line. Our technique is one of the substitutes for correction of horizontal and central lip deficiency with asymmetric Cupid's bow.

New economical and simple device for intraoperative expansion on small and medium sized soft tissue defects

Intraoperative expansion has been used to cover small to large defects without disadvantages of the conventional tissue expanders. Various materials, for example, expanders and Foley catheters are being used. We introduce a new, convenient and economical device immediately available in the operating room, according to the defect size for intraoperative expansion, with latex gloves or balloons. The retrospective study was done with 20 patients who presented with skin and soft tissue defects. During the operation, expansion was done with latex gloves or balloons inflated with saline through an intravenous line and a three-way stopcock. After the inflation, the glove was removed and skin was covered with expanded tissue. A careful decision was made regarding the inflation volume and placement of the expander according to the defect size. There were no postoperative complications. The skin contracture and tension was minimal with a texture similar to the adjacent tissue. The new intraoperative expansion devices with latex gloves and balloons were cheap and made easily right in the operation room. The reconstruction of small to large sized skin defects can be done successfully, functionally and aesthetically without using expensive commercial materials.

Percutaneous Acutrak Screw Fixation of Intra-articular Tongue Type Fracture of Calcaneus / 대한족부족관절학회지

PURPOSE: To evaluate the results of treatments by percutaneous Acutrak screw fixation for intra-articular tongue type fracture of calcaneus, especially in elderly patient or patients with underlying disease including diabetes mellitus. MATERIALS AND METHODS: Seven cases with intra-articular tongue type fracture of calcaneus, from November 2003 to February 2005, were reviewed. There were 6 males and 1 female with 65 years old mean age (range: 61~71 years old). The average follow-up period was 16 months (range: 10~25 months). Two Steinmann pins were used for closed reduction. After closed reduction was done like Essex-Lopresti's method, two Acutrak screws were inserted. The third Acutrak screw was inserted at the sustentaculum tali away from sinus tarsi to fix the primary fracture line. The patients were evaluated with Salama scale, the extent of recovery of Bohler angle, state of subtalar joint. RESULTS: Clinical results according Salama scale were excellent in 5 cases, and good in 2 cases. Average preoperative Bohler angle was 13 degrees (range: 12~15 degrees). Average postoperative Bohler angle was 31o (range: 23 degrees - 40 degrees). There were no soft tissue complications. There were two mild subtalar arthritis. CONCLUSIONS: We think that percutaneous Acutrak screw fixation is a good option for tongue type fracture of calcaneus in elderly patient or patients with underlying disease including diabetes mellitus.

Usefulness of MRI in Distal Femoral Intra-articular Fracture

PURPOSE: Preoperative recognition of an associated injuries including ligament disruptions of the knee and Hoffa fracture in the cases of the intra-articular distal femoral fractures affects surgical planning. The purpose of this study is to identify the usefulness of MRI in distal femoral intraarticular fracture. MATERIALS AND METHODS: Over a 7 years period from January 1995 to December 2001, all patients with an intra-articular fracture of the distal femur were collected from a prospectively designed orthopaedic database and reviewed. Seventy five patients with intra-articular distal femoral fractures were collected. There were 49 male and 26 female patients ranging from 15 to 91 in age. Because these injuries usually result from high-energy trauma, we should also exclude associated injuries of pelvis, hip, patella, tibial plateau fractures, popliteal vessel injuries, and ligament disruptions of the knee. So we checked knee MRI of patients with distal femoral fractures to rule out associated knee injuries. RESULTS: There were 12 Hoffa's fractures, 6 anterior cruciate ligament injuries, 6 posterior cruciate ligament injuries, 10 medial collateral ligament injuries and 3 lateral collateral ligament injuries. Five patients of 12 Hoffa's fractures associated with intra-articular distal femoral fractures that were not diagnosed in patients with conventional radiographs were confirmed after MRI evaluation. CONCLUSION: Knee MRI for intra-articular distal femoral fracture is necessary to rule out associated ligament injuries and Hoffa fractures in case of high-energy trauma patients.

A case of Diffuse Neonatal Hemangiomatosis / 대한피부과학회지

Diffuse neonatal hemangiomatosis is rare and a life-threatening disorder characterized by multiple cutaneous and visceral hemangiomas. The organs most commonly affected are the liver, lung. brain, GI tract. The complications are high output cardiac failure, hemorrhage, Kassabach-Meritt syndrome, etc. A 30-day-old girl was diagnosed to have diffuse neonatal hemangiomatosis by her multiple cutaneous and hepatic hemangiomas. She was treated with corticosteroid and interferon alfa-2a. During the treatment the number and size of hemangiomas were markedly reduced.

Urinary Tract Infection in Febrile Infants

No abstract available.

A Case Report of the Hypertrophic Cardiomyopathy

The 26 year old male with the hypertrophic cardiomyopathy confirmed by M-mode and 2-D echocardiography is reported with the review of the literatures.

A Computerized Axial Tomographic Study on the Measurements of Cerebral Ventricles and Sulci in Chronic Alcoholics

The authors measured the lateral & 3rd ventricles and cortical sulci in computerized axial tomographic films of 15 male patients with chronic alcoholism and 16 controls, who had been admitted to Kyng Hee University Hospital from Jan. 1, 1979 to Mar. 31, 1983. The results were as following: 1. The average age of patients was 47.5 yrs., and that of conntrols was 34.5 yrs. The average duration of habitual drinking was 11.6 yrs., and complicated with delirium tremens, head trauma, liver diseases (46.7% each other) and seizure (33.3%). 2. The sulcal widening was found in 9 cases (60.0%) of patients (mean +/- S.D. = 6.7 +/- 1.76mm) and no cases in control group (mean +/- S.D. = 2.3 +/- 0.88mm). The difference between patients and control group was statistically significant, especially in twenties (P<0.05). 3. The lateral ventricular enlargement was seen in 12 cases (80.0%) of patients (mean +/- S.D. = 17.1 +/- 0.93mm), and 8 cases (50.0%) of control group (mean +/- S.D. = 14.7+/- 1.46mm). There was statistical significance, especially in forties (P<0.05). There were no statistical significance except cella media index (P<0.05), according to various measuring indices. The width of 3rd ventricle was 1.88 +/- 0.152mm (mean+/-S.D.) in patients and 1.12+/-0.311mm (mean +/- S.D.) in control group. And the difference was statistically significant. 4. Cerebral atrophy was noticed in 10 cases (67.0%) among 15 taken C.A.T. of brain.

The Electrocardiographic Changes in the Anemia

The electrocardiography was performed to the 95 patients(58 male, 37 female) with chronic anemia in Department of Internal Medicine, Busan City Hospital, Busan University Hospital, Busan paik Hospital In-Je Medical College, Busan korea between April 1978 and March 1981. The hemoglobin levels were 4 Gm%-10Gm%, and the symptoms such as dizziness, palpitation, weakness, and appetite loss were continued for 6 months or more. The results were as following: 1. The abnormal electrocardiographic changes were observed in 49 of the 95 chronic anemic patients. 2. Prolonged QTc interval was observed in 12(12.6%) of 95 cases, depressed ST segment in 48(50.5%), inverted T wave in 32(33.7%), LVH in 31(32.6%), low voltage in 5(5.3%), and Rt. B.B.B. in 5(5.3%). 3. In the Hb level of 4.0~5.9Gm% 20% of the total 95 patients revealed prolonged QTc interval, 86.7% depressed ST segment, 40% inverted T wave, 20% LVH, 6.7% Rt. B.B.B., in the Hb level of 6.0~7.9Gm 10.6% prolonged QTc interval, 39.3% depressed St segment, 42.9% inverted T wave, 39.3% LVH, 3.6% low voltage and in the Hb level of 8.0-9.9Gm% 11.5% prolonged QTc interval, 46.1% depressed ST segment, 27% inverted T wave, 32.7% LVH and 7.7% low voltage.