The central somatosensory conduction time(CCT) was measured by recording the cerebral and spinal evoked potentials following median nerve stimulation in 24 traumatic brain injury patients. The findings of evoked potential study correlated to the functional independence measure(FIM), mini mental status examination(MMSE) and Glasgow outcome scale(GOS). The CCT of head injured patients was prolonged compared to that of the controls. The CCT with stimulation of the affected side was significantly prolonged compared to that with non- affected side. Abnormal CCT was related to the poor functional status measured by FIM and GOS. There`s no significant difference between groups of absent evoked potential and prolonged CCT by FIM score. These results suggest that the CCT correlates with the functional status of head injured patients. Follow up studies are required to evaluate whether the CCT could be a valuable prognostic indicator or not.
Brain Injuries ; Evoked Potentials ; Glasgow Outcome Scale ; Head* ; Humans ; Median Nerve

BACKGROUND: Supporting the elderly population is presented as a social issue, and it affects age discrimination, which forms a negative perception and avoids the elderly. Since age discrimination lowers the quality of life of the elderly and hinders social unity, it may be important to research related factors. This study examined the physical function as a factor that influences discrimination experiences and aimed to identify the relationship between physical function factors and discrimination experiences. METHODS: In this study, we analyzed 20,225 elderly from the 2014 and 2017 survey of living conditions and welfare needs of Korean older persons, conducted nationwide among older than 65 years. Physical function factors are activities of daily living, instrumental activities of daily living, sight discomfort, hearing discomfort, chewing discomfort, and leg strength as factors of interest. We performed multivariable logistic regression that reflected survey characteristics, adjusting for socio-demographic factors, health related factors, and social-support factors. RESULTS: The number of elderly who faced discrimination experiences was 1,175 (5.8%). The results showed that the odds ratio of facing a discrimination experience in the dependent group was significantly higher compared to the independent group when being transferring out of the room (4.05; 95% confidence interval [CI], 1.50–10.88) and difficulty in hearing (1.25; 95% CI, 1.05–1.49). Even with respect to chewing ability, which was significant in models 1 and 2, they face more discrimination experiences (1.30; 95% CI, 1.11–1.53). CONCLUSION These research results indicate that an important strategy for preventing age discrimination is to understand the physical function conditions of the elderly and promote the physical functions of the elderly related to transferring, hearing, and chewing; it is necessary to develop a practical intervention plan that considers these aspects.

Posterolateral rotatory instability of the elbow in the absence of epiphyseal injury is extremely rare in children. We present a case of 12-year-old child in whom recurrent dislocation of the elbow was associated with a stretched lateral ulnar collateral ligament. We performed surgical repair and reefing of a stretched lateral ulnar collateral ligament by using a suture anchor and a continuous locking suture in order to avoid donor site morbidity and damage of the growth plate, which could occur when a transosseous tunnel for reconstruction was made. At 12 months after operation, satisfactory symptom relief was observed with no evidence of recurrence.
Child* ; Collateral Ligaments ; Dislocations ; Elbow* ; Growth Plate ; Humans ; Recurrence ; Suture Anchors ; Sutures ; Tissue Donors

Providing a protocol in the case of multiple food allergies is difficult although the demand of immunotherapy for patients with wheat anaphylaxis is increasing. This case series study aimed to report the wheat oral immunotherapy successfully achieving the maintenance dose along with immunological changes in children with multiple food anaphylaxis. In oral food immunotherapy, personalized therapeutic protocol, which sets the initial dose using the oral food provocation test and increase the dose considering the patients’ needs and compliance, for each patient is essential.

PURPOSE: The purpose of this study was to investigate the effects of transplantation of an in vitro-generated, scaffold-free, tissue-engineered cartilage tissue analogue (CTA) using a suspension chondrocyte culture in a rabbit growth-arrest model. MATERIALS AND METHODS: We harvested cartilage cells from the articular cartilage of the joints of white rabbits and made a CTA using a suspension culture of 2x107 cells/mL. An animal growth plate defect model was made on the medial side of the proximal tibial growth plate of both tibias of 6-week-old New Zealand white rabbits (n=10). The allogenic CTA was then transplanted onto the right proximal tibial defect. As a control, no implantation was performed on the left-side defect. Plain radiographs and the medial proximal tibial angle were obtained at 1-week intervals for evaluation of bone bridge formation and the degree of angular deformity until postoperative week 6. We performed a histological evaluation using hematoxylin-eosin and Alcian blue staining at postoperative weeks 4 and 6. RESULTS: Radiologic study revealed a median medial proximal tibial angle of 59.0degrees in the control group and 80.0degrees in the CTA group at 6 weeks. In the control group, statistically significant angular deformities were seen 3 weeks after transplantation (p<0.05). On histological examination, the transplanted CTA was maintained in the CTA group at 4 and 6 weeks postoperative. Bone bridge formation was observed in the control group. CONCLUSION: In this study, CTA transplantation minimized deformity in the rabbit growth plate injury model, probably via the attenuation of bone bridge formation.
Animals ; *Bone Transplantation ; Cartilage/anatomy & histology ; Cell Culture Techniques ; Cells, Cultured ; Chondrocytes/*cytology/transplantation ; Growth Plate/anatomy & histology/*surgery ; *Mesenchymal Stem Cell Transplantation ; Rabbits ; Tibia/*surgery ; Tissue Engineering ; Transplantation, Autologous/methods ; Transplantation, Homologous

Background: Early recognition and prompt intramuscular epinephrine administration are critical for the treatment of anaphylaxis. The special emergency medical service team (SEMST) is a reorganization plan that incorporates first-level emergency medical technicians (EMTs) and nurses from Korea to give the authority to administer epinephrine. This study evaluates the experience of SEMST and aims to investigate further needs in the pre-hospital management of anaphylaxis. Methods: An online survey of 29 questions on the Gangwon-do 119 EMST was conducted.IBM SPSS Statistics ver. 20.0 (IBM Co., Armonk, NY, USA) and R ver.4.0.3. were used for statistical analysis. Results: A total of 428 (44.6%) participants responded to the questionnaire, and 55.6% (238/428) experienced anaphylaxis. The common presumed cause was insect sting/animal bites at 84.5% (201/238), followed by food (7.6%, 18/238), and drugs (6.3%, 15/238). The frequency of occurrence was highest for tourist attractions (58.6%, 167/285), followed by homes (31.9%, 91/285) and workplace (3.5%, 10/285). Among 136 medical personnel (31.8%) who were currently active or had been active as the SEMST, 95 (70.0%) experienced anaphylaxis, and 58 (61.1%) used epinephrine, which was significantly lower in the nonSEMST group (n = 36, 25.2%). The biggest difficulty in pre-hospital treatment was the limitation of drug administration authority (23.4%, 22/95). The lack of experience and tricky treatment are the chief difficulties in pediatric anaphylaxis. The percentage of correct answers regarding anaphylaxis awareness was significantly higher in the educated (n = 374) than in the non-educated group (n = 54), both for diagnosis (24.9% vs. 11.1%) and treatment (73.5% vs. 37.0%). Conclusion Proper administration of epinephrine is particularly important for pre-hospital anaphylaxis management in rural areas. Expanding SEMST and conducting periodic education using virtual experiences is necessary.

Lunate revascularization with the vascularized bone grafts is a current concept in the treatment of Kienbock disease. The aim of this study is to present our experience and preliminary results of the treatment using the fourth extensor compartment artery (4 ECA) vascularized bone graft for Kienbock disease. Between May 2009 and June 2010, five patients (3 men and 2 women) with Kienbock disease were treated with 4 ECA vascularized bone grafts. The mean age was 32.8 years and mean follow-up time was 13 months. The patients were composed of two patients in stage II and three patients in stage IIIa according to Lichtman's classification. Modified Mayo wrist score including pain, grip strength, range of motion and functional status and radiographic parameters such as carpal height ratio and radioscaphoid angle were evaluated at a final follow-up. Pain was markedly diminished and modified Mayo wrist score was 82 at last follow up period. There were no or little changes in carpal height ratio and radioscaphoid angle. All patients showed satisfactory bony union and no further lunate collapse on follow-up radiographs. The 4 ECA vascularized bone graft is a reliable alternative procedures among revascularization procedures for treatment of Kienbock's disease. It is less invasive and has low risk of kinking of pedicle compared to the 4+5 ECA vascularized bone graft. However, long term follow-up and MRI evaluation at follow up period should be needed for the future.
Arteries ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Osteonecrosis ; Range of Motion, Articular ; Transplants ; Wrist

A traumatic carpometacarpal joint dislocation of the thumb accounts for less than 1% of all hand injuries. Optimal treatment strategies for this injury are still a subject of debate. In this article, we report a case of bilateral thumb carpometacarpal joint dislocations: a unique combination of injuries. We believe our case is the second report of bilateral carpometacarpal joint dislocation regarding the thumb in English literature. It was successfully treated with closed reduction and percutaneous K-wires fixation on one side, and an open reduction and reconstruction of the ligament on the other side.
Bone Wires ; Carpometacarpal Joints/*injuries/*surgery ; Dislocations/*surgery ; Hand Injuries/*surgery ; Humans ; Male ; Middle Aged ; Thumb/*injuries/*surgery

When hand injuries caused by human bite are overlooked and they can progress to pyogenic arthritis. Pyogenic arthritis is difficult to treat and can make severe sequelae in the joints. We report a case of pyogenic arthritis of the hand that occurred after human bite injury in adolescent treated with wide debridement and external fixator. Our literature searches revealed that the use of external fixator is good treatment option for the treatment of pyogenic arthritis of the hand.
Adolescent* ; Arthritis* ; Bites, Human ; Debridement ; External Fixators ; Hand ; Hand Injuries ; Humans ; Joints ; Metacarpophalangeal Joint*

STUDY DESIGN: A retrospective study. PURPOSE: To assess the radiological, clinical features and surgical outcomes of six patients of elementary school age with lumbar disc herniation (LDH). OVERVIEW OF LITERATURE: LDH is common in people in their fourth and fifth decades. However, the condition is extremely rare in children of elementary school age. Moreover, the clinical symptoms and treatments are different from those of adults. METHODS: We reviewed a series of 6 patients under the age of 12 years, who underwent surgery for LDH at our institution between 1992-2002. Initially, all patients were treated conservatively. The indications for surgery were failure of conservative treatment for 3 months, intractable pain and/or progressive neurological impairment. RESULTS: The surgical findings revealed a protruding disc in five cases and a ruptured disc in one. In addition, separation of the vertebral ring apophysis was observed in 3 cases. The symptoms had disappeared completely at the last follow-up. At the last follow-up, the Japanese Orthopaedic Association score was 10 points in 5 cases and 9 points in 1, and the Kirkaldy-Willis criteria was excellent in all patients. No intervertebral disc space narrowing was observed in any patient at last follow up. In addition, there were no degenerative changes in the vertebral endplate and facet joint. CONCLUSIONS: Patients with symptoms that persist for more than 3 months or those with a progressive neurological deficit must be considered for surgical discectomy.
Adult ; Asian Continental Ancestry Group ; Child ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Pain, Intractable ; Retrospective Studies ; Zygapophyseal Joint