Fractures of the lateral process of the talus (LPT) are considered rare, accounting for less than 1% of all ankle injuries in the general population. These fractures are nearly 15 times more likely to occur in snowboarders. Recently, the number of population who started enjoying cable-wakeboard is increasing and this sport may cause fracture of the LPT by axial loading occur on the LPT while boarding or trick. We report on a case of involving LPT fracture during cable-wakeboard trick with successful screw osteosynthesis.
Ankle Injuries ; Skiing ; Sports ; Talus

OBJECTIVES: An automatic needle destroyer (ANDY) was developed to prevent needlestick injuries, and usability tests were conducted in several hospitals. The addition of extra features to the ANDY is in progress, such as data collection and automatic identification of used syringes. Thus, this report describes how the ANDY can be used to track the data of used syringes. METHODS: The motor torque required for barrel separation differs according to syringe diameters. By monitoring the electric current which is consumed for the motor torque, the type of syringe can be identified. Twelve prototypes were produced, and five usability tests were conducted in hospitals. RESULTS: After use, a syringe is inserted into the proposed device, and the needle portion is then cut and separated from the syringe body (barrel) and discarded. The needles are collected in a sharps container for hygienic disposal, and the barrel is dropped into a general medical waste container. CONCLUSIONS: The ANDY can be used to track the syringe used for each patient. The barcode can be read while the syringe rotates in the main body of the ANDY with a built-in omnidirectional scanner. Collection of information during syringe disposal can facilitate stock management. This system could also be extended to other types of consumable medical devices, although it would still be a challenge to differentiate each medical device.
Data Collection* ; Disposable Equipment ; Equipment and Supplies ; Equipment Design ; Humans ; Medical Waste ; Medical Waste Disposal ; Needles ; Needlestick Injuries ; Syringes* ; Torque

Purpose: Optic nerve sheath meningocele is a very rare condition; if the optic nerve is pressed, visual function can deteriorate. We report a patient with optic nerve sheath meningocele treated with optic nerve sheath fenestration.Case summary: We report a 15-month-old male who visited the outpatient clinic due to an orbital tumor in the left eye found by accident. He had no proptosis or relative afferent pupillary defect, and fundus examination revealed a left optic disc pit. On fat-suppressed magnetic resonance imaging (MRI), there was a well-defined 13.5 × 12.7 mm cystic lesion located at the superotemporal aspect of the left optic nerve within the optic nerve sheath. The optic nerve was compressed and displaced inferomedially. Once the diagnosis had been confirmed as optic nerve sheath meningocele, optic nerve sheath fenestration was performed under general anesthesia to relieve optic nerve compression. The compressed left optic disc returned to normal after surgery and the size of the meningocele shrunk to 11.7 × 10.9 mm on MRI. However, it re-expanded to almost the same size as that preoperatively 10 months later. Conclusions We report a case of optic nerve sheath meningocele with an optic disc pit treated with optic nerve sheath fenestration, which has not been reported previously in the Republic of Korea. Because the effect of optic nerve sheath fenestration could be temporary, it is necessary to conduct regular checkups given the possibility of deterioration of visual function.

The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.
Adenoidectomy ; Adenoids ; Child ; Continuous Positive Airway Pressure ; Enuresis ; Failure to Thrive ; Follow-Up Studies ; Humans ; Hypertension ; Hypertrophy ; Palatine Tonsil ; Pulmonary Heart Disease ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Tonsillectomy

Background: Uncontrolled blood pressure (BP) is relatively common despite treatment with antihypertensive medication. This study aimed to investigate factors associated with uncontrolled systolic BP (SBP) and diastolic BP (DBP) separately in hypertensive patients with high medication adherence in Korea. Methods: This population-based cross-sectional study included 3,236 participants in the Korea National Health and Nutrition Examination Survey from 2013 to 2015. Hypertensive patients with high medication adherence were defined when they stated that they were taking antihypertensive medication daily. “Uncontrolled SBP and DBP” were defined as SBP ≥140 mm Hg and DBP ≥90 mm Hg, respectively. Data were analyzed using logistic regression to determine the association between uncontrolled SBP or DBP and various factors. Results: The prevalence of uncontrolled SBP and uncontrolled DBP was 23.3%, and 9.0%, respectively. In multivariate analysis, uncontrolled SBP was positively associated with older age, female sex, blue-collar occupation or no work (vs. white-collar), presence of a spouse, short sleep duration, frequent heavy alcohol drinking, longer hypertension duration, diabetes, stroke, and missing antihypertensive medication on the examination day, but negatively associated with high stress. Uncontrolled DBP was positively associated with frequent heavy alcohol drinking, but negatively associated with older age, blue-collar occupation or no work (vs. white-collar), and diabetes. Conclusion After excluding low medication adherence, we identified various factors associated with uncontrolled SBP or DBP in Korean adults with treated hypertension. There were differences between factors associated with uncontrolled SBP or DBP. Separate analysis of SBP and DBP may help understand the factors involved in BP control.

Objective: To investigate the action observation effects of functional electrical stimulation (FES) on the communication between motor cortex and muscle through corticomuscular coherence (CMC) analysis. Methods: Electroencephalogram (EEG) and electromyogram (EMG) of 27 healthy, nonathlete subjects were measured during action observation, FES, and action observation with FES, which lasted for 7sper session for 10 times. All trials were repeated for 30 times. Simultaneously measured EEG raw data and rectified EMG signals were used to calculate CMC. Only confidence limit values above 0.0306 were used for analysis. CMC was divided into three frequency domains, andthe grand average coherence and peak coherence were computed. Repeated ANOVA was performed to analyze the coherence value difference for each condition’s frequency band. Results: CMC showed significant differences in peak coherence and average coherence between the conditions (p<0.05). Action observation application with FES in all frequency band showed the highest peak and average coherence value. Conclusions The results of this study are assumed to be the combination of increased eccentric information transfer from the sensory-motor cortex by action observation and an increased in concentric sensory input from the peripheral by the FES, suggesting that these are reflecting the sensorimotor integration process.

Purpose: This study examined the effects of the right or left knee lift during push up plus in the quadruped position on the serratus anterior (SA) muscle activity. Methods: Twenty-one subjects (male 11, female 10) performed the quadruped position on push up plus. The muscle activities of the lower trapezius (LT), SA, and upper trapezius (UT) were measured by surface electromyography. Repeated measurements of one-way ANOVA were performed for statistical analysis of the data, and the criterion for statistical significance was set to p<0.05 and comparative analysis of the UT and SA ratio using a Paired t-test. Results: The right SA increased the muscle activity of the right knee lift during quadruped position push up plus (p<0.05). In particular, the right SA muscle activity was higher than the left. In addition, comparative analysis of the UT and SA ratio to the right knee lift during quadruped position push up plus was performed (p<0.05). The right was found to be a significant statistic compared to the left, but the left SA increased the muscle activity of the left knee lift during quadruped position push up plus (p<0.05). The left SA muscle activity was higher than right. In addition, comparative analysis of UT and SA ratio to the left knee lift during quadruped position push up plus was performed (p<0.05). The left was found to be a significance statistic than the right. In addition, the interaction effect between the groups showed significant differences (p<0.05). Conclusion Knee lift during push up plus is recommended for the selective activation of a research exercise protocol of one side of the serratus anterior.

Purpose: This study aimed to investigate the evidence that therapeutic horseback riding can improve balance, muscle, ADL, equivalenc, GMFM, gait, emotion with developmental disabilities and neural patients. Methods: To conduct meta-analysis, the search focused on studies that employed therapeutic horseback riding for developmental disabilities and neural patients for which eight databases (KIS, RISS, DBpia, National Assembly Library, Pubmed, Embase, Google scholar and Cochrane Library) were used to extract literature published from 2002 to September 2019. The data were analyzed the RevMan 3.5.3 program. Results: As a result of meta-analysis, therapeutic horseback riding total effect size is 0.552 for children with developmental disabilities and neural patients. And effect size result of according to assessment type variable first, balance effect size is 0.594. Second, muscle activities effect size is 0.425. Third, ADL effect size is 0.430. Fourth, equivalance effect size is 0.640. Fifth, GMFM effect size is 0.482. Sixth, gait effect size is 0.400 and seventh emotion effect size is 0.876. Conclusion These findings is horseback riding is effective The effect size by outcome was observed to be the effective for children with developmental disabilities and neural patients. and also the horseback riding provided the positive effects of balance, muscle activities, ADL, equivalance, GMFM, gait, emotion for children with developmental disabilities and neural patients. It is hoped that this study will contribute to the development of effective treatments for children with developmental disabilities and neural patients therapeutic horseback riding and the development of study.

Purpose: This study examined the effects of changes in the intensity of Functional Electrical Stimulation (FES) on CorticoMuscular Coherence (CMC) during action observation. This paper presents a neurophysiological basis for the effective intensity of FES. Methods: Twenty-seven healthy volunteers were asked to observed a video with FES. The FES was provided with a sensory stimulation level, nerve stimulation level, and motor stimulation level. Simultaneously, an electroencephalogram (EEG) of the sensorimotor cortex and electromyogram (EMG) from the wrist extensor muscle were recorded. The peak CMC and average CMC were analyzed to compare the differences caused by the FES intensity. Results: The peak CMC showed a significant increase in the alpha band during motor stimulation (p<0.05). The average CMC showed a significant increase in the beta band during motor stimulation (p<0.05). Conclusion The intensity of FES, which causes actual movement, increased the CMC during action observation. These results show that the intensity of the FES can affect the functional connection between the sensorimotor cortex and muscle.