No abstract available.
Humans ; Outpatients* ; Psychotherapy*

Plastic surgeons have frequently encountered wide and long skin defects which require flap coverage. These include defects that occur after radical tumor resection of the head and neck region, release of severe bum scar contracture, and defects with exposure of the bone or tendons in upper and lower extremities. Lateral thigh fasciocutaneous flap, first introduced by Baek in 1983, has a long and wide skin territory. By using this flap, we performed 6 cases of burn scar contractures and 2 cases of head and neck cancer defects. In the flap elevation, it is not necessary to change the patient's position, therefore, the two-team approach shortens the operating time. The donor site can be closed primarily if the width of flap is not over 8 cm. The donor scar of the thigh is easily concealed. The lateral thigh flap can also be used as a composite or sensate flap. We conclude that, due to the lateral thigh flap being a thin and pliale fasciocutaneous flap which has a long and wide skin territory, it is very useful for reconstruction of large skin defects.
Burns ; Cicatrix ; Contracture ; Free Tissue Flaps* ; Head ; Head and Neck Neoplasms ; Humans ; Lower Extremity ; Neck ; Skin* ; Tendons ; Thigh* ; Tissue Donors

OBJECTIVES: We investigated the prevalence and composite score of the neuropsychiatric symptoms in patients with mild cognitive impairment(MCI), and dementia of Alzheimer's type(AD). The aim of this study is to analyze the correlation between the result of Korean Neuropsychiatric Inventory(K-NPI) and cognitive function. METHODS: A total of 163 patients diagnosed with MCI or AD was divided into three groups(55 MCI patients, 56 dementia patients with mild stage, and 52 dementia patients with moderate, severe stage). We examined neuropsychiatric symptoms by K-NPI and compared the prevalence and composite score of each subdomain in K-NPI among three groups. RESULTS: The most common symptoms in the MCI group were depression/dysphoria, sleep/night-time behavior, anxiety, and irritability/lability. In mild AD group, the most frequent disturbance was agitation/aggression, depression/dysphoria, anxiety, apathy/indifference, and sleep/night-time behavior. In moderate to severe AD group, the most frequent disturbance was apathy/indifference, depression/dysphoria, agitation/aggression, and delusion. The frequencies of delusion, hallucination, agitation/aggression, apathy/indifference, aberrant motor behavior, appetite/eating change were statistically significant. The total NPI score showed a negative correlation with MMSE-KC and a positive correlation with GDS. CONCLUSIONS: Neuropsychiatric symptoms are common features of MCI and AD. These symptoms observed in MCI are similar to those of mild AD. Psychosis is most common in moderate to severe AD, leading to a faster rate of cognitive decline. Therefore, proper management according to the neuropsychiatric symptoms of MCI and three stages of dementia is needed.
Anxiety ; Delusions ; Dementia ; Hallucinations ; Humans ; Mild Cognitive Impairment ; Prevalence ; Psychotic Disorders

OBJECTIVES: Mild cognitive impairment(MCI) and dementia of Alzheimer's type(AD) are characterized by progressive decline of cognitive abilities and a wide range of neuropsychiatric symptoms like depression. Among various diagnostic tools of AD, many studies showed that elevated levels of serum total homocysteine are associated with increased risk of developing Alzheimer's disease, depression and other neuropsychiatric disorders. We investigated whether elevated homocysteine concentrations are associated with depressive symptoms in MCI and AD. METHODS: A total of 86 patients diagnosed with MCI or AD participated. Total serum homocysteine levels in fasting blood samples were measured. We examined cognitive symptoms by MMSE-KC, Global Deterioration Scale(GDS), Clinical dementia rating(CDR) and depressive symptoms by Korean version of Geriatric Depression Scale(K-GDS). RESULTS: The total serum homocysteine levels were significantly higher in MCI with depression than in MCI without depression. There was no significant difference in the mean homocysteine levels between AD patients with depression and AD patients without depression. The total homocysteine levels showed a negative correlation with MMSE-KC and a positive correlation with CDR, GDS. CONCLUSIONS: These findings suggest that elevated homocysteine level is a risk factor for the decline of cognitive function and depression. We found a significant relationship between elevated serum homocysteine level and depressive symptoms in MCI. But our study had several limitations, thus more research is needed to confirm this finding.
Alzheimer Disease ; Dementia* ; Depression* ; Fasting ; Homocysteine* ; Humans ; Mild Cognitive Impairment* ; Neurobehavioral Manifestations ; Risk Factors

OBJECTIVES: Alzheimer's disease(AD) and mild cognitive impairment(MCI) affect several nervous structures involved with the autonomic nervous system. Association between neuropsychiatric deficits and heart rate variability has been observed. But cardiac autonomic function in AD has been scarcely studied and the results reported are conflicting. We investigated autonomic function in normal control, MCI, AD using heart rate variabil-ity(HRV) technique. METHODS: Time and frequency-domain variability of 5-min R-R interval series was comparatively evaluated in 26 normal control subjects, 22 MCI subjects and 34 AD subjects. Analysis of variance(ANOVA) was used to compare the differences across groups. Correlations between MMSE-KC and HRV components were performed using Pearson's correlation coefficient. RESULTS: No significant difference was observed among the groups in time, frequency-domain analysis of HRV (p>0.05). HRV were not found to be significantly correlated with the degree of cognitive impairment. CONCLUSIONS: There were no differences in HRV with MCI, AD subjects when compared with normal controls. Further investigation is required to use HRV technique as noninvasive parameters of MCI and AD.
Alzheimer Disease ; Autonomic Nervous System ; Heart ; Heart Rate ; Mild Cognitive Impairment

Orthopantomogram is commonly used to evaluate root parallelism. "Good parallelism" between roots is widely accepted as one of the guidelines of a successful orthodontic treatment. In case there was a large angle between crown axis and root axis, and if we valued only the position of crown in establishing occlusal relationship without considering of the situation of root, the problem of root arrangement between adjacent teeth would be occurred. The estimate of root parallelism in mesiodistal direction before and after orthodontic treatment must be emphasized. The intent of this study was to determine the clinical importance and correlation of the angle between crown axis and root axis. Orthopantomograms of 105 orthodontic patients being treated in Yonsei university were used in this study. Twenty-eight teeth in both maxilla and mandible were selected and analyzed quantitively to evaluate the angle between crown axis and root axis, and obtain the correlationship among the individual teeth. The results are as follows: 1. Among the teeth presenting normal distribution, the maxillary right canine showed the largest mean valuer 5.73+/-4.42degrees), which was composed of the crown-root angles, and the mandibular left lateral incisor showed the smallest mean valuer 0.60+/-3.76degrees). 2. The crown-root angles of the maxillary incisors and the first molars, and the mandibular central incisors and the first molars didn`t show normal distribution and the ranges of these angles were dispersed. 3. Significant differences were present between the crown axis and the root axis except for lower first premolars. (p<0.05) 4. No significant difference was present for the crown-root angle between right and left side. (p<0.05) 5. No significant difference was present for the crown-root angle between male and female except for lower left first premolar. (p<0.05) 6. In the upper right quadrant, significant correlations were present between crown-root angles of the central incisor and lateral incisor, lateral incisor and canine. In the upper left quadrant, significant correlations were present between crown-root angles of the central incisor and lateral incisor. In the lower right quadrant, significant correlations were present between crown-root angles of the central incisor and lateral incisor, first molar and second molar. In the lower left quadrant, significant correlations were present between crown-root angles of the central incisor and lateral incisor, lateral incisor and canine, first molar and second molar. (p<0.05)
Axis, Cervical Vertebra* ; Bicuspid ; Crowns* ; Female ; Humans ; Incisor ; Male ; Mandible ; Maxilla ; Molar ; Tooth

Low back pain and sciatica is one of the most frequent and troublesome problem in the orthopedic field. A study of the effectivity and reliability of the anterior interbody fusion with autoiliac bone graft for the spondylogenic and Discogenic back pain was done on 166 patients who had been hospitalized from January 1978 to December 1984. The approach to the lesion was retroperitoneal with anterior approach. The anterior interbody fusion was performed by using one block or two block from autoiliac bone. The status of the spine fusion after operation was decided by the plane roentgenogram or clinical sign, and the tomogram or dynamogram in some case. We analysed 116 patients having anterior fusionto study whether fusion rate has any relation with the number of the grafted bone, preoperative diagnosis and the level of fusion. At 9 months after operation, the clinical result was assesed and was compared between the group of the preoperative diagnosis. The following results were obtained from analysis of the cases studied. 1. The fusion rate for the grafted bone was 92.2%. There was no difference in fusion rates between the group of patients operated using one block and two-block. 2. The fate of the grafted bone could be categorized into 5 different types. 3. In patients with spondylolisthesis or spondylolysis, there was high incidence of non union.Also in terms of the vertebral level, the fusin between the L5-Sl showed high incidence of non union. 4. High fusion rate was obtained by using back brace without cast immobilization. The average duration of brace wearing was 6.6 months. 5. Overall clinical results were as follows:excellent or good 64.6%, fair 31.9%, poor 3.5%,and spondylolisthesis showed better clinical results than other diseases. 6. Post sympathectomy symptoms were noticed in 12 patients after operation and there were no permanent genitourinary problem.
Arthrodesis ; Back Pain ; Braces ; Diagnosis ; Equidae ; Humans ; Immobilization ; Incidence ; Low Back Pain ; Orthopedics ; Receptors, CXCR4 ; Sciatica ; Spine ; Spondylolisthesis ; Spondylolysis ; Sympathectomy ; Transplants

No abstract available.
Audiometry, Evoked Response* ; Brain Stem* ; Humans

No abstract available.
Reference Values* ; Vestibular Function Tests*

No abstract available.
Humans ; Inpatients*