BACKGROUND: Exercise has shown to slow down the progression from mild cognitive impairment (MCI) to dementia. In particular, not only resistance exercise has been verified to improve physical performance and muscle strength, leading to the prevention of fall-related injuries in the frail elderly, but also cognitive function. In this study, we investigated how high-speed elastic band training, applied using a high-speed power training protocol, affects cognition, physical performance and muscle strength of female elderly individuals with MCI. METHODS: Thirty-nine subjects diagnosed with MCI from one senior college using a Korean version of mini-mental state examination (MMSE-K) and a Korean version of the Montreal Cognitive Assessment (MoCA-K) were randomly divided into exercise group (n=20) and control group (n=19). The exercise group completed a 12-week high-speed resistance elastic band exercise program and was encouraged to exercise at home as well during the intervention period. RESULTS: The results showed significant increases in cognitive function, physical performance and muscle strength assessed by digit span forward test (P<0.001), digit span backward test (P=0.003), the Stroop test B (P=0.031), SPPB scores (P=0.010), right knee 60degrees extensor peak torque (P=0.004), 60degrees flexor peak torque (P=0.001), 180degrees extensor peak torque (P=0.020) and grip strength (P=0.025). CONCLUSIONS: Our study showed that participants with MCI who continued the high-speed elastic band training program for 12 weeks showed improvements in cognitive function, physical performance and muscle strength.
Aged ; Cognition ; Dementia ; Education ; Female ; Frail Elderly ; Hand Strength ; Humans ; Knee ; Mild Cognitive Impairment* ; Muscle Strength* ; Resistance Training ; Stroop Test ; Torque

PURPOSE: To report a case of delayed orbital cellulitis with subperiosteal abscess after orbital floor fracture repair using an absorbable sheet implant (Macropore®, Medtronic Inc., Minneapolis, MN, USA). CASE SUMMARY: A 16-year-old male visited the oculoplastic clinic for left eye pain, lower eyelid swelling and vertical diplopia for 1 day. The patient had a history of inferior orbital wall fracture repair surgery using Macropore® 20 months prior. The orbital computed tomography scan showed a subperiosteal cystic mass with surrounding infiltration at the left orbital floor, and ethmoidal and maxillary sinusitis; however, sheet implant was not clearly observed. Despite systemic antibiotic treatment for 3 days, his clinical findings did not improve, thus we decided to drain the subperiosteal abscess through a transconjunctival approach. Intraoperatively, the Macropore® sheet was almost dissolved, but small pieces remained. The culture of drained contents showed no microorganisms. Systemic antibiotics were continued for 18 days after surgery, and clinical symptoms completely improved. CONCLUSIONS: Delayed orbital cellulitis should be considered in patients with extraocular muscle movement limitation and painful orbital swelling if the patient has a history of orbital wall fracture repair, even if a bioresorbable implant was used. Prompt imaging evaluation should be emphasized for early diagnosis and proper treatment.
Abscess ; Absorbable Implants* ; Adolescent ; Anti-Bacterial Agents ; Diplopia ; Early Diagnosis ; Eye Pain ; Eyelids ; Humans ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Orbit* ; Orbital Cellulitis* ; Orbital Fractures

Industrial Accident Compensation Insurance (IACI) has a history of about 50 yr, and is the oldest social insurance system in Korea. After more than 20 times of revision improvements in benefits, its contents and claim systems have been upgraded. It became the protector of injured workers and their families, and at the same time became the system which could cope with both financial burden of employers and their responsibilities. However, there are some issues to be reformed to upgrade the IACI: 1) the problems in the approval system of occupational diseases, 2) quality improvement of workers' compensation medical care, 3) vocational rehabilitation and return to work, 4) workers' compensation premiums and out-of-pocket money of injured workers, 5) issues in application of IACI. Growth of IACI cannot be achieved by an effort of an individual. Efforts by workers, owners, and government, in addition to physicians and welfare professionals toward the same goal are required for the next level improvement of IACI.
Humans ; Industry/economics ; Insurance, Accident/*economics ; Occupational Diseases/economics ; Rehabilitation, Vocational/economics ; Workers' Compensation/*economics

The balloon-assisted enteroscope has been regarded as the standard device for direct visualization of deep small bowels and allows for the diagnosis and treatment of small bowel disease. At the beginning, its application was focused on the diagnosis of obscure gastrointestinal bleeding, inflammatory bowel disease, and small bowel tumor. However, the indications are being expanded to various therapeutic procedures, not only confined to bleeding control. With the expansion of the indications, the need to perform enteroscopy effectively and safely is increasing. Recent studies have been focused on the diagnostic yield, therapeutic yield, and long-term outcomes of the device. However, with the increasing number of procedures, procedural guidelines and quality indicators are also needed.
Diagnosis ; Double-Balloon Enteroscopy ; Endoscopy* ; Hemorrhage ; Inflammatory Bowel Diseases

STUDY DESIGN: A case report. OBJECTIVES: To report a case of thoracic spinal meningioma and lumbar spinal schwannoma found in one patient. SUMMARY OF LITERATURE REVIEW: patients with different types of spinal cord tumor, specifically meningioma and schwannoma, are rare in medical literature. MATERIALS AND METHODS: A 66 year-old female presented with complaints of walking difficulty. She had masses on the thoracic and lumbar spine and underwent open excision and biopsy. RESULTS: Three months after operation, the patient could walk independently and no recurrence was found at 1-year follow up. CONCLUSIONS: Thoracic spinal meningioma and lumbar spinal schwannoma occurring in one individual were treated successfully by operative management.
Female ; Humans ; Meningioma ; Neurilemmoma ; Recurrence ; Spinal Cord ; Spinal Cord Neoplasms ; Spine ; Walking

The characteristics of hand trauma are changing due to automation of industrial facilities, improved access to health care, and the aging population. Since the inception of hand surgery as a subspecialty, hand defects have been reconstructed with the restoration of the original functionality as the primary goal. With advancement and maturation of surgical techniques, however, restoration of aesthetics also began to take hold as an important aspect of hand surgery practice. After the first successful replantation of an amputated digit, the rapid development of microsurgical techniques had a significant impact on the field of reconstructive hand surgery. In the first two decades, the success of replantation was evaluated by the survival rate for a single operator or a specialized institution. These days, however, microsurgical techniques have been widely adopted, with digital replantation possible even for infants. In addition to various local flaps, the evolution of free flaps has vastly expanded the repertoire of reconstructive options for hand surgeons. With the wide variety of free flaps available, it is possible for a severely injured hand to be salvaged and restored to its original functional and aesthetic status. In South Korea, hand surgery is becoming an established profession with a separate subspecialty certification. Hand surgery has a bright outlook, with future research directed at new biocompatible materials and novel reconstructive methods.
Aging ; Automation ; Biocompatible Materials ; Certification ; Esthetics ; Free Tissue Flaps ; Hand* ; Health Services Accessibility ; Humans ; Infant ; Korea ; Microsurgery ; Replantation ; Survival Rate

STUDY DESIGN: A retrospective study. PURPOSE: To evaluate the prevalence and risk factors of asymptomatic cervical or thoracic lesions in elderly patients who have undergone surgery for lumbar spinal stenosis. OVERVIEW OF LITERATURE: Concurrent multiple spinal lesions have been reported in many studies with a varied prevalence, and described the characteristics of the disease and its treatment options. However, the cervical or thoracic lesions without apparent symptoms in patients with symptomatic lumbar stenosis had not been evaluated. METHODS: A total of 101 elderly patients (aged 65 or more), who had undergone surgery for lumbar spinal stenosis from January 2005 to December 2005, were enrolled in this study. All patients underwent lumbar magnetic resonance imaging (MRI) along with T2-weighted cervical and thoracic sagittal MRI prior to surgery. The concurrent cervical or thoracic lesions were classified according to the disease entity, and the severity of the lesions was graded from grade 0 (no lesion) to grade 4 (any lesion compressing the cord with a signal change). The prevalence of concurrent cervical and thoracic lesions was then analyzed. In addition, the risk factors for the development of concurrent lesions were evaluated, and the risk factors affecting the severity of the concurrent lesion were analyzed individually. RESULTS: Seventy-seven (76.2%) and 30 (29.7%) patients had a concurrent cervical and thoracic lesion, respectively. Twenty-six patients (25.7%) had both a cervical and thoracic lesion. There was a positive correlation between the symptom duration of lumbar stenosis and the prevalence of both cervical (p = 0.044) and thoracic (p = 0.022) lesions. CONCLUSIONS: The incidence of asymptomatic cervical or thoracic lesions is apparently high in elderly patients who have undergone surgery for lumbar spinal stenosis, particularly in those with longer symptom duration. This highlights the need for a preoperative evaluation of the cervical and thoracic spine in these patients.
Aged ; Constriction, Pathologic ; Humans ; Incidence ; Magnetic Resonance Imaging ; Prevalence ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spine

PURPOSE: To compare the accuracy of three intraocular lens (IOL) power calculation formulas (SRK/T, Barrett Universal II, and T2) in cataract surgery patients.METHODS: In total, 73 eyes of 73 patients who underwent uneventful cataract surgery were retrospectively reviewed. IOL power was determined using SRK/T, Barrett Universal II, and T2 preoperatively. The findings were compared with the actual refractive outcome to obtain the prediction error. The mean prediction error (ME) and mean absolute error (MAE) of each formula were compared. The MAE was defined as the difference between the postoperative spherical equivalence (SE) and the preoperatively predicted SE. The ME and MAE of each formula 3 months after surgery were compared with preoperatively predicted SE. Eyes were classified into subgroups based on axial length (AL) and average keratometry (K).RESULTS: The ME and MAE for the three formulas were SRK/T [−0.08 ± 0.45 diopters (D) and 0.35 ± 0.40 D, respectively], Barrett Universal II (−0.01 ± 0.44 D and 0.33 ± 0.30 D, respectively), and T2 (0.04 ± 0.45 D and −0.34 ± 0.30 D, respectively), but no statistically significant differences were detected. Similar results were obtained in groups with a long AL or a large average K. In groups with an AL ≥ 26 mm or with an average K ≥ 47 D, the Barrett Universal II formula yielded the smallest standard deviation and a ME closest to zero, but these differences were not statistically significant.CONCLUSIONS: No significant differences were observed between the three formulas regarding ME or MAE. However, recent formulas such as the Barrett Universal II could provide certain benefits in predicting IOL power for patients with a long AL (> 26 mm) or larger average K. Further research with a larger sample size is recommended for more evaluation.
Cataract ; Humans ; Lenses, Intraocular ; Retrospective Studies ; Sample Size

Purpose: This study was designed to analyze the risk factors for poor survival after recurrence of hepatocellular carcinoma after liver transplantation. Methods: Patients who underwent liver transplantation for hepatocellular carcinoma during the period of 2007 to 2018 were reviewed and patients who experienced recurrence were included. Multivariable Cox proportional hazard ratios were performed for potential risk factors for survival after recurrence. Results: A total of 151 recipients experienced hepatocellular carcinoma recurrence after liver transplantation. The median of the recurrence-free period was 9.3 months (0.89–97.25 months). The median follow-up after recurrence was 13.4 months (0.59–118.28 months). One-, 3-, and 5-year survival after recurrence were 65.2%, 34.0% and 20.5%, respectively.Multivariable Cox analysis showed that, graft from living donor (hazard ratio [HR], 0.430; 95% confidence interval [CI], 0.210–0.882; P = 0.021), recurrence-free interval of ≥9 months (HR, 0.257; 95% CI, 0.164–0.403; P < 0.001), alphafetoprotein of ≥100 ng/mL at the time of recurrence (HR, 1.689; 95% CI, 1.059–2.695; P = 0.028), and recurrence in bone (HR, 2.304; 95% CI, 1.399–3.794; P = 0.001) and everolimus within 3 months after recurrence (HR, 0.354; 95% CI, 0.141–0.889; P = 0.027) were related to survival after recurrence. Conclusion Although survival was generally poor after recurrence of hepatocellular carcinoma in liver transplantation recipients, prolonged survival can be achieved in certain patients with better prognostic factors.

Purpose: This study was designed to analyze the risk factors for poor survival after recurrence of hepatocellular carcinoma after liver transplantation. Methods: Patients who underwent liver transplantation for hepatocellular carcinoma during the period of 2007 to 2018 were reviewed and patients who experienced recurrence were included. Multivariable Cox proportional hazard ratios were performed for potential risk factors for survival after recurrence. Results: A total of 151 recipients experienced hepatocellular carcinoma recurrence after liver transplantation. The median of the recurrence-free period was 9.3 months (0.89–97.25 months). The median follow-up after recurrence was 13.4 months (0.59–118.28 months). One-, 3-, and 5-year survival after recurrence were 65.2%, 34.0% and 20.5%, respectively.Multivariable Cox analysis showed that, graft from living donor (hazard ratio [HR], 0.430; 95% confidence interval [CI], 0.210–0.882; P = 0.021), recurrence-free interval of ≥9 months (HR, 0.257; 95% CI, 0.164–0.403; P < 0.001), alphafetoprotein of ≥100 ng/mL at the time of recurrence (HR, 1.689; 95% CI, 1.059–2.695; P = 0.028), and recurrence in bone (HR, 2.304; 95% CI, 1.399–3.794; P = 0.001) and everolimus within 3 months after recurrence (HR, 0.354; 95% CI, 0.141–0.889; P = 0.027) were related to survival after recurrence. Conclusion Although survival was generally poor after recurrence of hepatocellular carcinoma in liver transplantation recipients, prolonged survival can be achieved in certain patients with better prognostic factors.