BACKGROUND: The purpose of this study was to identify the clinical and radiological outcomes of hook plate fixation for lateral end fracture of the clavicle and acromioclavicular dislocation. METHODS: There were a total of 20 cases with lateral end fracture of the clavicle and 16 cases with acromioclavicular dislocation. All patients were evaluated for range of motion, functional score by using Constant score, and American Shoulder and Elbow Surgeons shoulder index at just before implant removal and at final follow-up. Coracoclavicular distance was measured in acromioclavicular dislocation and bony union was evaluated in the lateral end fracture of the clavicle. RESULTS: The clinical outcomes and range of motion were increased at the final follow-up compared with just before implant removal in both the lateral end fracture of the clavicle and acromioclavicular dislocation. In acromioclavicular dislocation, all cases—except one—showed maintenance of reduction after implant removal. Moreover, in the lateral end fracture of the clavicle, all cases—except one—showed bony union. CONCLUSIONS: Hook plate fixation in the lateral end fracture of the clavicle and acromioclavicular dislocation resulted in good clinical and radiological results.
Clavicle* ; Dislocations* ; Elbow ; Follow-Up Studies ; Humans ; Range of Motion, Articular ; Shoulder ; Surgeons

BACKGROUND: This study compared the clinical and radiological outcomes of the single calcar screw plate and Polarus nail techniques for the treatment of the proximal humerus fractures. METHODS: Seventy-two patients diagnosed with displaced proximal humerus fracture were enrolled for the study. Of these, 50 patients underwent the locking plate surgery with a single calcar screw (plate group), whereas 22 patients underwent the Polarus nail surgery (nail group). The plate group was further divided into plate 1 group (with medial support), and plate 2 group (without medial support). The radiological and functional results of both groups were compared to the nail group. RESULTS: The α angle 1 year after surgery was significantly different between plate 1 and plate 2, and plate 2 and nail groups (p=0.041, p=0.043, respectively). The ratio that does not satisfy the reference value of γ angle was 2.8% in plate 1, 7.1% in plate 2 and 22.7% in nail group (p=0.007); there was a significant difference between plate 1 and nail group, and plate 2 and nail group (p=0.014, p=0.033, respectively). CONCLUSIONS: No significant differences were observed in the clinical results between locking plate and Polarus nail. However, in the plate 2 group and nail group, the rate of failure to maintain reduction during the 1-year period after surgery was statistically and significantly higher than the plate 1 group (level of evidence: level IV, case series, treatment study).
Humans ; Humeral Fractures ; Humerus* ; Reference Values

Drooling is defined as the unintentional flow of saliva out of the mouth or to the back of the pharynx due to salivary control problems and swallowing difficulties. Drooling is caused by posture, oral sensori-motor and cognitive problems, and medical symptoms. Treatments of drooling are defined under two criteria: 1) non-invasive treatment, which includes posture and oral motor therapy, and 2) invasive treatment, including botox injection and surgery.Drooling treatment should be initiated non-invasively and in a step-wise manner in all individuals. This mode of treatment is safe, age-free, and is considered the first line of therapy, before subjecting to invasive treatment.Clinical professionals provide non-invasive treatment via manual approaches, through passive sensori-motor stimulation to active oral motor activities. Comprehensive therapy protocols such as oral motor facilitation technique (OMFT) for oral sensory normalization, head and neck postural control, and oral motor function improvements, are required to help control drooling. Clinical professionals therefore need to deeply understand the reason for drooling, and provide qualified non-invasive treatment for intensifying drooling control.

Drooling is defined as the unintentional flow of saliva out of the mouth or to the back of the pharynx due to salivary control problems and swallowing difficulties. Drooling is caused by posture, oral sensori-motor and cognitive problems, and medical symptoms. Treatments of drooling are defined under two criteria: 1) non-invasive treatment, which includes posture and oral motor therapy, and 2) invasive treatment, including botox injection and surgery.Drooling treatment should be initiated non-invasively and in a step-wise manner in all individuals. This mode of treatment is safe, age-free, and is considered the first line of therapy, before subjecting to invasive treatment.Clinical professionals provide non-invasive treatment via manual approaches, through passive sensori-motor stimulation to active oral motor activities. Comprehensive therapy protocols such as oral motor facilitation technique (OMFT) for oral sensory normalization, head and neck postural control, and oral motor function improvements, are required to help control drooling. Clinical professionals therefore need to deeply understand the reason for drooling, and provide qualified non-invasive treatment for intensifying drooling control.

The definition of drooling is very broad, Drooling is characterized by saliva flowing out of the mouth or moving behind the pharynx unintentionally due to various reasons. Drooling is affected by increased salivation, and oral motor and swallowing functions. The amount depends on the situation, place, mood, and concentration. There is a need for comprehensive evaluation and treatment since drooling could be stimulated by various causes, such as sensory, motor, cognitive, and behavioral. Drooling evaluation is divided into objective and subjective evaluations. The objective evaluation mainly measures the amount of saliva secretion using a towel, a container, and a dental swab, and assessing the frequency of drooling at a fixed time. Subjective evaluation usually evaluates the subject’s severity and frequency of drooling during certain periods. A comprehensive evaluation that identifies the effects of salivation on the subject’s daily life, social interaction, psychology, and self-esteem, and evaluates the degree of drooling according to various postures, situations, and conditions, also needs to be considered. Nevertheless, there are several difficulties in developing standardized drooling assessment tools. The evaluation contents and results may vary depending on the treatment approach, such as botulinum toxin treatment or oral exercise therapy. The current article will help understand and select drooling assessment tools for identifying and measuring outcomes in clinical settings and studies.

Objective: This study was undertaken to identify the effect of Oral Motor Facilitation Technique (OMFT) on the drooling control ability of children afflicted with Cerebral Palsy (CP). Methods: Totally, 21 CP children with drooling problems participated in the study. OMFT was provided for 16 weeks (30 minutes, 1 session a week, 16 sessions). The drooling control ability was assessed by determining the severity and frequency using the Drooling Severity and Frequency Scale (DSFS) before, at 8 weeks, and 16 weeks after OMFT administration. The effectiveness of OMFT was analyzed at the time intervals using the Friedman test. Post hoc analyses were conducted by the Wilcoxon signed rank test and Kruskal Wallis test. Results: Drooling control ability showed significant improvement after 16 weeks of OMFT. Although the severity of drooling significantly increased after 8 weeks, the frequency was unchanged. Our results indicate that OMFT is a useful oral motor treatment protocol to manage the drooling control ability of children with CP. We recommend at least 8 weeks of OMFT administration. Conclusion Drooling is an important problem in dysphagia. Clinicians need to show more importance in controlling drooling, and a comprehensive oral motor treatment like OMFT should be considered for children afflicted with CP.

No abstract available.
Child* ; Humans

We present a very rare case of spontaneous cervical spondylodiscitis and epidural abscess caused by Klebsiella pneumonia. A 45-year-old man presented with severe posterior neck pain radiating down both arms with decreased range of motion of the neck. He also complained of paresthesia of the upper extremities and a subjective weakness of his right arm. Magnetic resonance imaging (MRI) revealed spondylodiscitis and epidural abscess on the C5 and C6. In order to obtain adequate drainage of the abscess and complete removal of granulation tissues we performed a total decompressive corpectomy of C5 and C6. After drainage of the abscess, single stage autologous iliac bone graft was performed. The patient was followed by three months with antibiotic treatment confirmed to be sensitive to the organism. Klebsiella pneumonia was cultured postoperatively from the surgical biopsy samples. The patient recovered with no complications and the postoperative MRI showed improvement of the lesions.
Abscess ; Arm ; Biopsy ; Decompression ; Discitis ; Drainage ; Epidural Abscess ; Granulation Tissue ; Humans ; Klebsiella ; Magnetic Resonance Imaging ; Middle Aged ; Neck ; Neck Pain ; Paresthesia ; Pneumonia ; Range of Motion, Articular ; Transplants ; Upper Extremity

BACKGROUND: It has been suggested that human papillomavirua(HPV) infection has been implicated in the pathogenesis of between disease and squamous cell cacoma of the skin, particularly of snogenital area. There is little knowledge about etiologic characteriscs of the development of Bowens disease and squamous cell earcinoma of the skin in Korean patients. OBJECTIVE: This study is intended to evaluate Bowens disease and squamous cell carcinoma of the skin in Korean patients for the presence of HPV. METHODS: Fifteen cases of Bowens disease and fifteen cases of cutaneous squamous cell carcinoma were investigated. All cases developed on a nongenital site. In situ lybridization and polymerase chain reaction(PCR) were used for detection of HPV DNA in paraffinem bedded tissue sections. The clinical records and slides of these cases were reviewed for the analysis of clinicopathologic characteristiqs of HPV DNA positive eases. RESULTS: By in situ hybidization HPV 16 was detected in thrw cases(20%) with Bowens disease. By PCR HPV 16 was detected in six cases(40% ) of Bowens digreae and five cases(33.3) of squamous cell carcinoma of the skin. No specific clinicopathologic fetetues were found to be indicative of the presence or absence of HPV. CONCLUSION: These data suggest a role for HPV in the evolution of Bowens disease and squamous cell carcinoms of the skin in Korean patients.
Bowen's Disease ; Carcinoma, Squamous Cell* ; DNA* ; Human papillomavirus 16 ; Humans* ; Polymerase Chain Reaction ; Skin*

OBJECTIVES: The previous studies have suggested genetic vulnerability to restless legs syndrome (RLS) development. The occurrence of antipsychotic-related RLS could also be attributable to differences in genetic susceptibility. This study aimed to investigate whether Retinoid-related orphan receptor A (RORA) gene polymorphism is associated with antipsychotic-related RLS in schizophrenia. METHODS: We assessed symptoms of antipsychotic-induced RLS in 190 Korean schizophrenic patients and divided the subjects into two groups according to the International Restless Legs Syndrome Study Group diagnostic criteria : 1) subjects that met all of the criteria (n=44) and 2) the remaining subjects who were not considered to be RLS patients (n=146). Single-nucleotide polymorphism in the RORA gene was genotyped by PCR in 190 individuals. The chi2-test was conducted to compare differences between two groups. RESULTS: The frequencies of genotype (chi2=0.066, p=0.968) of the RORA gene (rs11071547) did not differ significantly between schizophrenic patients with and without RLS. The difference of allele frequencies (chi2=0.008, p=0.927) of the RORA gene (rs 11071547) between the schizophrenic patients with and without RLS were not significant. CONCLUSION: These results suggest that RORA gene polymorphism does not play a major role in susceptibility to antipsychotic-related RLS in schizophrenia.
Child ; Child, Orphaned ; Circadian Rhythm ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Restless Legs Syndrome* ; Schizophrenia*