Most common signs of human aging often include skin fold and wrinkles in the lateral canthal area. It is called "crow's feet". The accordion-like activity of the orbicularis oculi muscle during movements of facial expression accentuates this phenomenon because the muscle shortens but the skin does not. The purpose of this study is to present the classification of the crow's feet and to look for it's clinical characteristics in Koreans. The pictures of lateral view of the crows feet in 105 patients taken with digital camera are classified by their age, sex, types and degree of direction. Results show that there are three types of crows feet such as upper, lower and bidirectional types. Bidirectional type is the most common type(85%), lower directional type is 15% and upper directional type is 5%. In thirties, bidirectional type is 50% but the rate of this type increases in older groups. So in over sixties, bidirectional type is almost 100%. There are no differences between the two sexes. The degree of the direction of wrinkles increases in thirties and forties, but in fifties or over no difference was seen. In summary, this study could be helpful to decide the procedure in correction of the crow's feet.
Aging ; Classification* ; Crows ; Facial Expression ; Foot* ; Humans ; Skin

This study was undertaken to examine relationship between tooth size and arch dimension in dental crowding. Two groups of dental casts were selected on the basis of dental crowding. One group, consisting of 51 pairs of dental casts (24 male and 27 female), exhibited remarkable dental crowding. A second group, consisting of 60 pairs of dental casts (30 male and 30 female), exhibited little or no crowding. Mean and standard deviation of the following parameters were used to compare two groups: individual and collective mesiodistal tooth diameters, buccal and lingual arch widths and arch area. The following results were obtained. 1. The crowed group revealed larger tooth size than non crowd group. (p<0.01) 2. The crowded group smaller maxillary dental arch dimension than noncrowded group except lingual arch width at canine region. (p<0.01) 3. The crowded group revealed smaller mandibular dental arch dimension than noncrowded group except lingal arch width at second premolar region in the male and buccal arch width at canine, premolar region in the female. (p<0.01) 4. The crowded group revealed smaller arch area than noncrowded group in the female (p<0.01), but there was no significance in the male.
Bicuspid ; Crows ; Dental Arch ; Female ; Humans ; Male ; Malocclusion ; Tooth*

OBJECTIVE: To investigate the characteristics of cognitive deficits in patients with post-stroke dysphagia, and to analyze the relationships between cognitive dysfunction and severity of dysphagia in supratentorial stroke. METHODS: A total of 55 patients with first-ever supratentorial lesion stroke were enrolled retrospectively, within 3 months of onset. We rated dysphagia from 0 (normal) to 4 (severe) using the dysphagia severity scale (DSS) through clinical examinations and videofluoroscopic swallowing studies (VFSS). The subjects were classified either as non-dysphagic (scale 0) or dysphagic (scale 1 to 4). We compared general characteristics, stroke severity and the functional scores of the two groups. We then performed comprehensive cognitive function tests and investigated the differences in cognitive performance between the two groups, and analyzed the correlation between cognitive test scores, DSS, and parameters of oral and pharyngeal phase. RESULTS: Fugl-Meyer motor assessment, the Berg Balance Scale, and the Korean version of the Modified Barthel Index showed significant differences between the two groups. Cognitive test scores for the dysphagia group were significantly lower than the non-dysphagia group. Significant correlations were shown between dysphagia severity and certain cognitive subtest scores: visual span backward (p=0.039), trail making tests A (p=0.042) and B (p=0.002), and Raven progressive matrices (p=0.002). The presence of dysphagia was also significantly correlated with cognitive subtests, in particular for visual attention and executive attention (odds ratio [OR]=1.009; 95% confidence interval [CI], 1.002–1.016; p=0.017). Parameters of premature loss were also significantly correlated with the same subtests (OR=1.009; 95% CI, 1.002–1.016; p=0.017). CONCLUSION: Our results suggest that cognitive function is associated with the presence and severity of post-stroke dysphagia. Above all, visual attention and executive functions may have meaningful influence on the oral phase of swallowing in stroke patients with supratentorial lesions.
Cognition Disorders ; Cognition* ; Crows ; Deglutition ; Deglutition Disorders* ; Executive Function ; Humans ; Retrospective Studies ; Stroke* ; Trail Making Test

BACKGROUND: During the last few years, the in vivo study of the physiological parameters of the skin by non-invasive methods has been considerably developed. So far, there have been some reports on the skin characteristics only in parts, but there has not been any criteria to classify those of normal subjects. OBJECTIVE: The aim of the present study was to investigate the skin characteristics of healthy Korean subjects according to sex and sites using non-invasive methods. METHODS: To determine normal levels of sebum, skin hydration, transepidermal water loss (TEWL), skin elasticity and skin color according to sex, 163 subjects (male; 124, female; 39) were used to investigate 5 different anatomical sites. 6 different instruments were used: The Sebummeter SM 410, Corneometer CM 820, Evaporimeter EP1, Cutometer SEM 474, Chromameter CR-121, and Mexameter MX 16, for evaluating sebum excretion rate, capacitance, TEWL, mechanical property and skin color respectively. RESULTS: Differences were noticed depending on the anatomical sites and sex. Most of the measuring parameters were significantly different according to sites and sex. The values of sebum levels, capacitance and TEWL were higher in the males on the cheek, forehead and crows foot, whereas in the females, higher values were observed on the dorsum of the hand. The skin elasticity varied considerably among the nine-parameters but, for the elastic ratio (R2, R5), the females showed significantly higher values than the males in all sites except the forehead. Skin lightness (L* value) was higher in the females, whereas the males showed lugher values in the category of redness (a* value) and yellowness (b* value). The values of the eqrthema index (EI) and melanin index (MI) were also higher in the males on all sites. Correlations between the skin parameters mentioned above were calculated. A negative, correlation between capacitance and TEWL was observed only on the cheek (male/female, r =-0.2/ r =-0.4, p<0.05). The L* value correlated negatively with MI. Mioreover the values between a* and El also showed sipificant correlations in the male (cheek and dorsum of hand, y =0.2, forehead and crows foot, r =0.3, p<0.05). There were considerably significant correlations between the visual pigmentation score and instrumental skin parameters in the males (visual pigmentation score vs. L* value measured by Chromameter ; cheek/crows foot, r = -0.3/y =-0.4, visual pigmentation score vs. MI by Mexameter ; cheek/crows foot, r =0.2/ r =0.4, viisual winkle score vs. sebum excretion rate measured by Sebumeter ; cheek, r=0.2, visual winkle score vs. elasticity parameters measured by Cutometer ; cheek, R2/R5/R7, r =-0.3/ r =-0.2/ r =-0.3, p<0.05). CONCLUSION: Skin physiological parameters can be evaluated by non-invasive skin bioengineering methods which show quantitative modifications in physiological conditions in relation to sites and sex.
Bioengineering* ; Cheek ; Crows ; Elasticity ; Female ; Foot ; Forehead ; Hand ; Humans ; Male ; Melanins ; Pigmentation ; Sebum ; Skin*

The present clinical study was attempted to estimate the frequency of tuberous sclerosis using a paradigm. similar to the one employed by Crowe et al and to determine the genetic charaeteristics of the people of Chonnam Pravince regarding said disease. In addition other clinical manifestations were observed. Twenty-five subjects had visited the Department of Dermatology of Chonnam Medical University Hospital between 1970 and l980. Relatives of the subjects were examined whenever possible. The results of this study show that the incidence of this syndrome m Chonnam Province is probably in the region of l/80, 000~90,000. The sex ratio was nearly equal,12 males to 13 females. The mean age at first visit was about fifteen. OnIy 20 per cent of the cases have a familial history of the disease but the correct, incidence is probably higher since some patients provided incomplete family histories This clinical study suggests that tuberous sclerosis is an autosomal dominant inheritance disease with variable expressivity evidenced by the fact that although five of eleven of the groups offspring developed tuberosus sclerosis There were differences in the clinical features between the parent and the chiid.
Crows ; Dermatology ; Female ; Humans ; Incidence ; Jeollanam-do ; Male ; Parents ; Sclerosis ; Sex Ratio ; Tuberous Sclerosis* ; Wills

Using a paradigm similar to the one employed by Crowe et al., this study was undertaken to determine the genetic characteristics of multiple neurofibromatosis in Korean people. Thirty three subjects were used in this study. All subjects were identified through an exarnination of the records of all patients who had visited the Department of Dermatology of Chonnam Medical University Hospital between 1967 and 1976. Relatives of subjects were examined whenever possible, The results of the study projected that the total number of persons in Chonriarn Province afflicted with multiple neurofibromatosis lies sornewhere between 880 and 16,500. Crowe estimated that between 2500 and 3300 patients could be found on Michigans lower peninsula. Sixty percent of this studys subjects presented as sporadic patients, a condition thought to be the resu.lt of a genetic mutation. They had no blood relatives who demonstrated the disease. Fifty percent of Crowes subject were found to be sporadic patients, and a similar study by a Japanese investigator revealed a sporadic patient rate of sixty percent. In this study, the rernaininp 40% of the subject group conformed to the expected genetic frequency, thus pointing toward the fact that rnultiple neurofibrornatosis is a highly penetrant autosomal dorninant disease. This was demonstrted by the fact that, of the 79 offspring bad by this group, 82 persons demonstrated multiple neurofibromatosis. This study also suggested somatic mutation in 3 of the 20 sporadic patients. Because this nutation did not occur at the germinal level, the patient is much less likely to transmit this disease to his offspring, One patient showed the usual clinical and family traits but the chromosome analysis was negative. Genetic issues associated with multiple neurofibromatosis are also discussed in this sturly.
Asian Continental Ancestry Group ; Crows ; Dermatology ; Humans ; Jeollanam-do ; Michigan ; Neurofibromatoses* ; Research Personnel

PURPOSE: The purpose of this study is to evaluate the results of total hip replacement arthroplasty (THRA) in sequelae of the infected hip with dislocation and severe shortening. MATERIALS AND METHODS: We reviewed 22 cases of THRA performed from January 1985 to March 1995, for painful, dislocated hips secondary to infection in childhood, with shortening of the limb more than 5 cm. Among 22 cases, seventeen were pyogenic infection sequelae, and five were tuberculous infection sequelae. RESULTS: Mean followup period was 44 months (range: 24-111 months) . The mean value of the Harris score was increased to 86.7, which had been 61. The mean postoperative limb-length discrepancy was 1.8 cm and amount of correction ranged from 2.5 cm to 6.1 cm (average : 4.2 cm) . There was remarkable difference between the Crowe Group I and combined Group II and III in correction of shortening. The incidence of radiological loosening was not related to preoperative morbid period or the age of patients. CONCLUSION: The main resistant factor in lengthening of the affected limb was soft tissue contracture related to old age or long term after infection, and complication rate (14%) was higher than that in the other kinds of disease on hip.
Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Contracture ; Crows ; Dislocations* ; Extremities ; Follow-Up Studies ; Hip* ; Humans ; Incidence

BACKGROUND: We investigated whether the calcar femorale, a cortical septum in the region of the lesser trochanter of the femur, correlates with results of femoral stem implantation in patients with osteoarthritis of the hip secondary to developmental dysplasia using computed tomography. METHODS: This retrospective study included 277 hips (41 males and 236 females; age, 37 to 92 years) of patients who had presented to Okayama Medical Center with hip pain. Of these, a total of 219 hips (31 males and 188 females) had previously undergone total hip arthroplasty. According to the Crowe classification, 147 hips were classified as Crowe grade I, 72 hips as Crowe grade II–IV, and 58 hips as normal. RESULTS: The calcar femorale was identified in 267 hips (96.4%). The calcar femorale was significantly shorter and more anteverted in Crowe grade II–IV hips than in Crowe grade I or normal hips. Significant differences in the shape of the calcar femorale were found according to the severity of hip deformity. Three stem designs were analyzed: single-wedge (59 hips), double-wedge metaphyseal filling (147 hips), and modular (13 hips). Single-wedge stems were inserted more parallel to the calcar femorale rather than femoral neck anteversion, while other types of stems scraped the calcar femorale. CONCLUSIONS: The angle of the calcar femorale differs according to the severity of hip deformity, and the calcar femorale might thus serve as a more useful reference for stem insertion than femoral neck anteversion in total hip arthroplasty using a single-wedge stem.
Arthroplasty, Replacement, Hip ; Classification ; Congenital Abnormalities ; Crows ; Female ; Femur ; Femur Neck ; Hip Dislocation ; Hip* ; Humans ; Male ; Osteoarthritis* ; Retrospective Studies

The purpose of this study was to investigate the interrelationship of the maxillary interincisal diastema, spacing and crowing to the type of superior labial frenum and the type of intermaxillary suture by analyzing histories, intraoral radiographs, orthopantomographs, intraoral slide films, and dental casts. The data for this study were compiled from 500 outpatients of the Department of Orthodontics, Infirmary of Dental College, Seoul National University. The following conclusions were obtained: 1. The occurrence of maxillary interincisal diastema in the permanent dentition decreased rapidly compared with that in the mixed dentition. And there was no sex difference in the occurrence of diastema in the both dentitions. 2. Frenum attachment remained relatively constant between the two dentitions but assumed a highter level in the permanent dentition than in the mixed dentition. 3. Except suture type D which was not yet fused completely, there was no significant difference in the distribution of suture type between the mixed dentition and the permanent dentition. 4. Frenum and suture type were highly related; frenum types 5 and 6 were associated with suture type III and V. 5. In the permanent dentition, frenum type 5 and 6 and suture types III and IV occurred more frequently in the spacing group than in the normal or crowding group. 6. The relationship between the diastema and frenum types 5 and 6 and suture types III and IV showed a strong correlation.
Crowding ; Crows ; Dentition ; Dentition, Mixed ; Dentition, Permanent ; Diastema* ; Humans ; Labial Frenum ; Orthodontics ; Outpatients ; Seoul ; Sex Characteristics ; Sutures

PURPOSE: The aim of this study was to objectively evaluate the abnormal gait patterns and gait improvements after a total hip arthroplasty (THA) in patients with hip dysplasia and osteonecrosis of the femoral head (ONFH). MATERIALS AND METHODS: Thirty-four patients (mean age of 43.7 years) with hip dysplasia who underwent THA were divided into the Crowe types (15 type 1, 11 type 2, 3 type 3, and 5 type 4), and gait analyses of these patients were performed using the Vicon 370 motion analysis system. The results of this group were compared with those of 39 age and gender matched patients with ONFH who received a THA and a group of 24 individuals with normal hips. RESULTS: Preoperatively, the gait pattern of the hip dysplasia group did not differ significantly from that of the ONFH group with respect to the temporal gait measurement parameters, kinematics, and kinetics. However, the hip dysplasia group had a different gait pattern than the normal control group and one year after surgery, there were significant differences in the moments and powers of the hip flexors and abductors of patients with severe hip dysplasia (Crowe types 3 and 4) compared with those of the ONFH patients. CONCLUSION: There were less postoperative gait improvements in the patients with severe hip dysplasia than in those with ONFH who had a relatively normal anatomy. These observations might be the result of their weakened hip muscles, particularly the flexors and abductors, despite their increased range of motion after surgery. Perioperative muscle strengthening exercises may be needed to improve gait patterns in patients with hip dysplasia.
Arthroplasty, Replacement, Hip* ; Biomechanical Phenomena ; Crows ; Exercise ; Gait* ; Head* ; Hip Dislocation* ; Hip* ; Humans ; Kinetics ; Muscles ; Osteonecrosis* ; Range of Motion, Articular