Comparison of the characteristics and injury severity of passengers in motor vehicle accidents between urban and rural cities in South Korea

Objective@#To analyze motor vehicle accidents in two different traffic environments and compare differences in severity between both regions. @*Methods@#Injury data were collected by the Emergency Medicine and Traffic Accident Research Team as part of the Korean In-Depth Accident Study. Patients admitted to emergency medical centers located in Wonju, Gangwon province (population 345,143, rural, group A) and Bucheon, Gyeonggi province (population 870,735, urban, group B) between January 2011 and December 2017 were included for analysis. Injury severity was classified into four categories based on Injury Severity Score (ISS): minor (1≤ <9), moderate (9≤ <15), major (15≤ <25), and critical (≥25). @*Results@#Overall, 1,807 patients were included (group A, 1,484; group B, 323). There was a higher proportion of daytime accidents, accidents involving larger cars, passenger injuries, and accidents involving lack of seat belt use in group A than in group B. The mean ISS value was 8.98 in group A and 4.62 in group B (P<0.001). Minor (20.4% vs. 10.8%) and major/critical (15.7% vs. 5.0%) injuries were more frequent in group A than group B (P<0.001). Patient ratios (A/B) for each ISS classification were 0.76 (minor), 1.89 (moderate), 3.43 (major), and 2.77 (critical). The factors showing a significant relationship with severity were driver’s seat (P=0.037) and no seat belt (P<0.001). @*Conclusion@#Patients in a rural city who visited the emergency room owing to motor vehicle accidents had more severe injuries than those in an urban city.

Idiopathic Hypertrophic Spinal Pachymeningitis with Spinal Cord Lesion: A Case Report / 대한신경손상학회지

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare, diffuse inflammatory fibrosis of the dura mater that can lead to spinal cord compression. Though the optimal treatment is controversial, some reports recommend decompressive surgery and postoperative steroid therapy. However, we encountered a case of pachymeningitis that worsened after decompressive surgery. A 79-year-old woman presented with gait disturbance and bilateral lower extremity weakness that began 6 months prior. She had radiating pain on the C5 and T1 dermatomes and clumsiness in both hands. Magnetic resonance imaging (MRI) revealed diffuse thickening of the posterior longitudinal ligament of C6 to T4/5 and ligamentum flavum of C3/4 to T4/5, causing central canal stenosis and compressive myelopathy. She underwent posterior decompressive laminectomy from C4 to T1 total (T2 subtotal) and cervicothoracic screw fixation. During surgery, we found severe adhesion of the posterior longitudinal ligament and ligamentum flavum to the dura mater. Chronic inflammation with fibrosis and lymphoplasmacytic infiltration were present. After surgery, the patient's motor weakness worsened. Despite steroid treatment, her symptom severity fluctuated. Follow-up MRI obtained 3 months postoperation revealed high signal intensity from C5 to T2, possibly indicating aggravated compressive myelopathy. Thus, in this case, decompressive surgery and steroid therapy were detrimental.

Posterior Facetectomy with Fusion Using a Pedicle Screw for Parallelshaped Cervical Foraminal Stenosis / 대한신경손상학회지

Objective@#To assess the efficacy and safety of posterior facetectomy with fusion using pedicle screw (PF using FPS) for severe cervical foraminal stenosis of parallel shape. @*Methods@#Patients (n=8) with 1- or 2-level parallel-shaped cervical foraminal stenosis who underwent posterior facetectomy with fusion using cervical pedicle screw between March 2012 and August 2016 were enrolled. Patients were followed up immediately postoperatively and at 1, 3, 6, and 12 months postoperatively. We assessed arm and neck pains and clinical outcomes using a numeric rating scale (NRS) and neck disability index (NDI). We determined cervical Cobb's and segmental angles by radiological evaluations. We identified screw breech as a neurovascular complication. @*Results@#Neck and arm pains were significantly reduced postoperatively (neck visual analog scale [VAS]: 4.9±3.7 [preoperative] to 0.4±1.1 [final follow-up]; arm VAS: 9.0±0.8 to 0.4±1.1). Cobb's angle for cervical sagittal alignment improved from 11.1±8.4 to 17.0±5.9. Segmental angle of index surgery was maintained (3.4±7.0–4.9±5.6). NDI was also remained from 36.1±26.3 to 13.8±8.4. There are no injuries to the vertebral arteries and neural tissues because of screw insertion. @*Conclusion@#PF using FPS is a practical treatment option for parallel-shaped cervical foraminal stenosis.

A Case Report of Juvenile Hypertrophy of the Breast in a 15-Year-Old Girl: Presented with Asymmetric Breast Enlargement and a Focal Mass-like Lesion

Juvenile hypertrophy of the breast is a rare condition, leading to hyperplastic breast anomalies in adolescents. Here, we report a case involving a 15-year-old girl, presented with asymmetric enlargement of the left breast. Pronounced parenchymal thickening was found on initial ultrasonography (US). MRI and second-look US revealed a focal mass-like lesion on the left mid-lateral breast, confirmed as juvenile hypertrophy of the breast on pathology.

A Quick and Easy Technique for Lateral Canthoplasty Using Reverse V-Y Advancement: A Case Report

Cosmetic lateral canthoplasty has become popular among Asians in the last few decades, but few techniques have withstood the test of time to be accepted as both effective and noninvasive, with minimal complications. Novel techniques have been developed, but are not free from complications. Moreover, these methods often have limited indications and may require a rather long learning curve to master. Herein, the authors present their experiences performing a simple lateral canthoplasty procedure in 61 patients using a slightly modified V-Y advancement flap, previously known as the Uchida method.

The Efficacy and Safety of Cryolipolysis for Subcutaneous Fat Reduction

No abstract available.

Aesthetic Correction of Severe Facial Asymmetry in a Deformational Plagiocephaly Patient: A Case Report and Literature Review

Deformational plagiocephaly (DP) (also referred to as positional plagiocephaly) has long posed challenges for plastic surgeons because it is difficult to differentiate from several other diseases, such as unilateral coronal synostosis, hemifacial microsomia, and unilateral lambdoidal craniosynostosis. These diseases can actually masquerade as DP or vice versa. Only in recent years has the differential diagnosis among these diseases become possible through improved imaging modalities, such as computed tomography, and a greater understanding of their pathophysiology. Herein, we report a rather rare, yet severe, form of DP that can easily be confused with the aforementioned diseases.

Angiomyolipoma of the Glabellar Region

Angiomyolipomas are hamartomatous lesions consisting of smooth muscle bundles, thick-walled blood vessels, and mature adipocytes. They are usually found in the kidneys of tuberous sclerosis patients and more rarely in other organs, such as the liver, the oral cavity, the sinonasal tract, the heart, the large intestines, the lungs, and the skin. Cutaneous angiomyolipoma has shown to be very rare and generally occurs at the ends of the digits, the elbows, the ears, and the nose. Herein, we report the first documented case of angiomyolipoma of the glabellar region.

Ectopic Preauricular Sinus in a Facial Cleft and Microtia Patient

Preauricular sinus is a congenital malformation that is very commonly encountered among the general population and it has especially high prevalence among Asians when compared to other ethnic groups. It can often go unnoticed or easily overlooked by the patient or even by doctors because most of them are asymptomatic and is most of the time only a tiny pit that can be trivial in terms of aesthetics. We report a very rare and unique case that has no precedence what so ever; hence no reported case in the literature: an ectopic preauricular sinus in a facial cleft and microsomia patient.

Ectopic Preauricular Sinus in a Facial Cleft and Microtia Patient

Preauricular sinus is a congenital malformation that is very commonly encountered among the general population and it has especially high prevalence among Asians when compared to other ethnic groups. It can often go unnoticed or easily overlooked by the patient or even by doctors because most of them are asymptomatic and is most of the time only a tiny pit that can be trivial in terms of aesthetics. We report a very rare and unique case that has no precedence what so ever; hence no reported case in the literature: an ectopic preauricular sinus in a facial cleft and microsomia patient.

Acellular Dermal Matrix to Treat Full Thickness Skin Defects: Follow-Up Subjective and Objective Skin Quality Assessments

BACKGROUND: There are several options for replacement of the dermal layer in full-thickness skin defects. In this study, we present the surgical outcomes of reconstruction using acellular dermal substitutes by means of objective and subjective scar assessment tools. METHODS: We retrospectively reviewed the medical records of 78 patients who had undergone autologous split-thickness skin graft with or without concomitant acellular dermal matrix (CGDerm or AlloDerm) graft. We examined graft survival rate and evaluated postoperative functional skin values. Individual comparisons were performed between the area of skin graft and the surrounding normal skin. Nine months after surgery, we compared the skin qualities of CGDerm graft group (n=25), AlloDerm graft group (n=8) with skin graft only group (n=23) each other using the objective and subjective measurements. RESULTS: The average of graft survival rate was 93% for CGDerm group, 92% for AlloDerm group and 86% for skin graft only group. Comparing CGDerm grafted skin to the surrounding normal skin, mean elasticity, hydration, and skin barrier values were 87%, 86%, and 82%, respectively. AlloDerm grafted skin values were 84%, 85%, and 84%, respectively. There were no statistical differences between the CGDerm and AlloDerm groups with regard to graft survival rate and skin functional analysis values. However, both groups showed more improvement of skin quality than skin graft only group. CONCLUSION: The new dermal substitute (CGDerm) demonstrated comparable results with regard to elasticity, humidification, and skin barrier effect when compared with conventional dermal substitute (AlloDerm).

An Intra-Abdominal Abscess as a Late Complication of Laparoscopic Cholecystectomy / 대한내과학회지

Laparoscopic cholecystectomy is the treatment of choice for cholelithiasis. It is used more commonly than open cholecystectomy because of the convenience of a short hospital stay and earlier return to work, and for aesthetic reasons. Nevertheless, there are complications that are encountered more frequently than in open cholecystectomy due to the smaller operating window. Here, we report the case of a 73-year-old woman who underwent a laparoscopic cholecystectomy 15 years earlier and now presented with abrupt abdominal pain. Abdominal computed tomography (CT) revealed a past cholecystectomy with an abscess pocket abutting the abdominal wall, with a stone inside it. Incision and drainage were done and the stone was removed laparoscopically. This case shows that late complications, such as abscess formation due to lost GB stones during laparoscopic cholecystectomy, can occur, even after 15 years.

A case of pelvic desmoplastic small round cell tumor in a old aged woman / 대한산부인과학회지

Peritoneal desmoplastic small round cell tumor is a very rare and highly aggressive neoplasm that predominantly strikes male children and young adults. It frequently presents as a large abdominal mass with widespread peritoneal involvement at diagnosis. We report one case of desmoplastic small round cell tumors in the pelvis in a old aged woman with a brief review of literature.

A spontaneous pregnancy and Cesarean delivery in a Turner mosaic with previous recurrent miscarriages / 대한산부인과학회지

Ovarian failure and infertility are typical features in Turner syndrome. Conception without ovum donation is very rare. We experienced one case of pregnancy and Cesarean delivery in a Turner mosaic with previous recurrent miscarriages.