[Objective] The purpose of this study was to determine whether icing treatment has an effect on muscle reaction time and functional performance of a sprained ankle. [Methods] Subjects were six persons (healthy group) and six persons who had an acute ankle sprain (patient group) . Anterior talar translation and talar tilt of the six patient group were evaluated by the stress X-ray measure. Ice treatment was applied for 20 minutes. [Results] The following points were clarified : 1) Reaction times of peroneus longus (PL) and peroneus brevis (PB) for the sprained ankle group (SA) were significantly longer than those for the non-sprained ankle group (NA) (p<0.05) . Length of time of standing on one leg with closed eyes for SA was significantly shorter than for NA (p<0.05) . 2) After icing treatment, reaction time of PL for SA tended to be shorter. Furthermore, PB significantly decreased after icing treatment (p<0.05) . Side-steps for SA were significantly increased after icing treatment (p<0.05) . 3) Reaction times of PL and PB for NA significantly increased after icing treatment (p<0.05) . Standing on one leg with closed eyes for NA significantly decreased after icing treatment (p<0.05) . [Conclusion] It was shown that icing treatment of a sprained ankle leads to a shorter muscle reaction time and an increase in the number of side-steps. Therefore, it was concluded that icing treatment of a sprained ankle might be able to improve incapacitated neuromuscular function and functional performance by acute trauma.

Spontaneous cervical epidural hematoma (SCEH) is a rare condition that causes paraparesis or quadriparesis. As spontaneous resolution is seldom expected, it usually requires surgical treatment for relieve symptoms. Even if spontaneous resolution occurs, relief from symptoms usually requires several hours to days. In contrast, hemiparesis is the most common symptom of a transient ischemic attack (TIA), and usually resolves over minutes to hours. We report here two patients with SCEH who presented with hemiparesis with severe neck pain. Both patients were taking antiplatelet drugs. Their neurological symptoms recovered spontaneously over a very short time. They were initially misdiagnosed as TIA. These cases show that patients with transient hemiparesis may have SCEH if there is severe neck pain and no cranial nerve involvement.

Objectives: The aim of this study is to evaluate relationship of health-related quality of life (HRQoL) with chronotype along with quality and quantity of sleep in Korean middle adults. Methods: Data was derived from the nationwide, cross-sectional study on sleep surveyed 2,501 representative adult Koreans. We collected data from 1,435 participants aged ≥35 years and <65 years to represent Korean middle adults. The Chronotype Questionnaire was used to assess phase and distinctiveness of the circadian rhythm. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Quantity of sleep was investigated by questions regarding sleep habits during workdays and free days. EuroQol-5D 3-level version was used to measure HRQoL. Results: On univariable analyses, eveningness is associated with younger age (47.7±8.2 vs. 51.3±8.1 years, p<0.001), and higher PSQI total score (4.3±2.7 vs. 3.6±2.2, p<0.001) compared with morningness. Strong distinctiveness also associated with higher PSQI total score (4.2±2.3 vs. 3.6±2.5, p< 0.001) compared with weak distinctiveness. Age was not different between the two groups of distinctiveness. On multivariable analyses, strong distinctiveness is an independent factor predicting impairment of pain/discomfort [odd ratio (OR) 1.589, 95% confidence interval (CI) 1.182–2.130] and depression/anxiety (OR 1.412, 95% CI 1.003–1.987). Poor sleep quality was the most powerful independent factor predicting impairments in all five domains of the HRQoL. Conclusions Sleep quality is an important factor independently related to the HRQoL. Among chronotype variables, only distinctiveness has an independent relation with the HRQoL.

Background: We report our 10-year experience with traumatic peripheral arterial injury repair at an urban level I trauma center. Methods: Between January 2007 and December 2016, 28 adult trauma patients presented with traumatic peripheral arterial injuries. Data were retrospectively collected on demographic characteristics, the mechanism of injury, the type of vascular injury, and physiological status on initial assessment. The analysis also included the Mangled Extremity Severity Score (MESS), Injury Severity Score, surgical procedures, and outcome variables including limb salvage, hospital stay, intensive care unit stay, and postoperative vascular complications. Results: Four (14.3%) patients required amputation due to failed revascularization. MESS significantly differed between patients with blunt and penetrating trauma (8.2±2.2 vs.5.8±1.3, respectively; p=0.005). The amputation rate was not significantly different between patients with blunt and penetrating trauma (20% vs. 0%, respectively; p=0.295). The overall mortality rate was 3.6% (1 patient). Conclusion Blunt trauma was associated with higher MESS than penetrating trauma, and amputation was more frequent. In particular, patients with blunt trauma had significantly higher MESS than patients with penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005), and amputation was performed when revascularization failed in cases of blunt trauma of the lower extremity. Therefore, particular care is needed in making treatment decisions for patients with peripheral arterial injuries caused by blunt trauma.