We presented two cases of entrapment neuropathy which were confused with herniated lumbar disc syndrome. One was "meralgia paresthetica in association with lumbar disc herniation", and "the other inguinal neuritis along with obturator neuritis". Syndromes of these entrapment neuropathies were confirmed by subcidence of pain and creation of progressively longer pain-free intervals after analgesic blocks of the corresponding nerves by infiltration of Xylocaine and prednisolone.
Lidocaine ; Nerve Compression Syndromes ; Neuritis ; Prednisolone

PURPOSE: The aim of this study was to evaluate the surface properties and biological response of an anodized titanium surface by cell proliferation and alkaline phosphatase activity analysis. METHODS: Commercial pure titanium (Ti) disks were prepared. The samples were divided into an untreated machined Ti group and anodized Ti group. The anodization of cp-Ti was formed using a constant voltage of 270 V for 60 seconds. The surface properties were evaluated using scanning electron microscopy, X-ray photoelectron spectroscopy, and an image analyzing microscope. The surface roughness was evaluated by atomic force microscopy and a profilometer. The contact angle and surface energy were analyzed. Cell adhesion, cell proliferation, and alkaline phosphatase activity were evaluated using mouse MC3T3-E1 cells. RESULTS: The anodized Ti group had a more porous and thicker layer on its surface. The surface roughness of the two groups measured by the profilometer showed no significant difference (P>0.001). The anodized Ti dioxide (TiO2) surface exhibited better corrosion resistance and showed a significantly lower contact angle than the machined Ti surface (P>0.001). Although there was no significant difference in the cell viability between the two groups (P>0.001), the anodized TiO2 surface showed significantly enhanced alkaline phosphatase activity (P<0.001). CONCLUSIONS: These results suggest that the surface modification of Ti by anodic oxidation improved the osteogenic response of the osteoblast cells.
Alkaline Phosphatase ; Animals ; Cell Adhesion ; Cell Proliferation ; Cell Survival ; Corrosion ; Dental Implants ; Durapatite ; Mice ; Microscopy, Atomic Force ; Microscopy, Electron, Scanning ; Osteoblasts ; Photoelectron Spectroscopy ; Surface Properties ; Titanium

OBJECTIVE: To determine the effect of robotic-assisted gait training (RAGT) compared to conventional overground training. METHODS: Sixty patients with motor incomplete spinal cord injury (SCI) were included in a prospective, randomized clinical trial by comparing RAGT to conventional overground training. The RAGT group received RAGT three sessions per week at duration of 40 minutes with regular physiotherapy in 4 weeks. The conventional group underwent regular physiotherapy twice a day, 5 times a week. Main outcomes were lower extremity motor score of American Spinal Injury Association impairment scale (LEMS), ambulatory motor index (AMI), Spinal Cord Independence Measure III mobility section (SCIM3-M), and walking index for spinal cord injury version II (WISCI-II) scale. RESULTS: At the end of rehabilitation, both groups showed significant improvement in LEMS, AMI, SCIM3-M, and WISCI-II. Based on WISCI-II, statistically significant improvement was observed in the RAGT group. For the remaining variables, no difference was found. CONCLUSION: RAGT combined with conventional physiotherapy could yield more improvement in ambulatory function than conventional therapy alone. RAGT should be considered as one additional tool to provide neuromuscular reeducation in patient with incomplete SCI.
Gait* ; Humans ; Lower Extremity ; Prospective Studies ; Recovery of Function ; Rehabilitation ; Robotics ; Spinal Cord ; Spinal Cord Injuries* ; Spinal Injuries ; Walking

Background: Smoking increases total mortality and the risk of complications in patients with diabetes; however, smokers tend to smoke persistently even after the diagnosis of diabetes mellitus. The purpose of this study was to analyze risk factors predicting persistent smoking in Korean adults with diabetes. Methods: This study included 265 persistent-smokers and 146 quit-smokers among the participants with diabetes from the seventh Korea National Health and Nutrition Examination Survey. The subjects were smokers at the time of diagnosis of diabetes and were categorized into two groups according to the change in smoking status between the time of diabetes diagnosis and survey. Factors associated with persistent smoking were evaluated using multiple logistic regression analysis. Results: The prevalence of persistent-smokers with diabetes in this study was 65.3%. After adjusting for covariates, persistent smoking in Korean adults with diabetes was significantly associated with a history of cancer (adjusted odds ratio [aOR], 0.322; 95% confidence interval [CI], 0.116–0.889), strength exercise (aOR, 2.753; 95% CI, 1.361–5.566), stress (aOR, 2.036; 95% CI, 1.046–3.950), non-medical treatment for diabetes (aOR, 6.814; 95% CI, 1.661–27.957), and duration of diabetes (aOR, 0.952; 95% CI, 0.919–0.987). Conclusion Identifying the risk factors related to persistent smoking among Korean adults with diabetes can help in developing effective smoking cessation strategies.

Background: Tobacco smoking is associated with several diseases and deaths in older Koreans. This study aimed to evaluate the factors associated with smoking cessation in older Koreans. Methods: We selected 579 subjects who started smoking before the age of 65 years from the Korea National Health and Nutrition Examination Survey 2016–2018. We excluded the subjects who quit smoking before the age of 65 years, and then categorized the rest of subjects into those who stopped smoking after the age of 65 years and those who are constant smokers. Multivariable logistic analysis was performed to evaluate the factors related to smoking cessation among older Koreans. Results: Among the participants, 66.1% were persistent smokers. After multivariable analysis, the factors significantly associated with smoking cessation were as follows: being in the age group of 75–79 years (adjusted odds ratio [aOR], 4.07; 95% confidence interval [CI], 2.12–7.83), being in the age group of 70–74 years (aOR, 3.10; 95% CI, 1.72–5.61), a family history of ischemic heart disease (aOR, 3.36; 95% CI, 1.09–10.35), and having had no cancer screening (aOR, 0.36; 95% CI, 0.18–0.70). Conclusion Further efforts to identify the factors related to smoking cessation will help formulate a smoking cessation policy.

Background: Tobacco smoking is associated with several diseases and deaths in older Koreans. This study aimed to evaluate the factors associated with smoking cessation in older Koreans. Methods: We selected 579 subjects who started smoking before the age of 65 years from the Korea National Health and Nutrition Examination Survey 2016–2018. We excluded the subjects who quit smoking before the age of 65 years, and then categorized the rest of subjects into those who stopped smoking after the age of 65 years and those who are constant smokers. Multivariable logistic analysis was performed to evaluate the factors related to smoking cessation among older Koreans. Results: Among the participants, 66.1% were persistent smokers. After multivariable analysis, the factors significantly associated with smoking cessation were as follows: being in the age group of 75–79 years (adjusted odds ratio [aOR], 4.07; 95% confidence interval [CI], 2.12–7.83), being in the age group of 70–74 years (aOR, 3.10; 95% CI, 1.72–5.61), a family history of ischemic heart disease (aOR, 3.36; 95% CI, 1.09–10.35), and having had no cancer screening (aOR, 0.36; 95% CI, 0.18–0.70). Conclusion Further efforts to identify the factors related to smoking cessation will help formulate a smoking cessation policy.

BACKGROUND: The aim of lower-extremity reconstruction has focused on wound coverage and functional recovery. However, there are limitations in the use of a local flap in cases of extensive defects of the lower-extremities. Therefore, free flap is a useful option in lower-extremity reconstruction. METHODS: We performed a retrospective review of 49 patients (52 cases) who underwent lower-extremity reconstruction at our institution during a 10-year period. In these patients, we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis, survival rate, and complications. RESULTS: There were 42 men and 10 women with a mean age of 32.7 years (range, 3-72 years). The sites of defects included the dorsum of the foot (19), pretibial area (17), ankle (7), heel (5) and other sites (4). The types of free flap included latissimus dorsi muscle flap (10), scapular fascial flap (6), anterolateral thigh flap (6), and other flaps (30). There were four cases of vascular complications, out of which two flaps survived after intervention. The overall survival of the flaps was 96.2% (50/52). There were 19 cases of other complications at recipient sites such as partial graft loss (8), partial flap necrosis (6) and infection (5). However, these complications were not notable and were resolved with skin grafts. CONCLUSIONS: The free flap is an effective method of lower-extremity reconstruction. Good outcomes can be achieved with complete debridement and the selection of appropriate recipient vessels and flaps according to the recipient site.
Animals ; Ankle ; Debridement ; Female ; Foot ; Free Tissue Flaps ; Heel ; Humans ; Lower Extremity ; Male ; Microsurgery ; Muscles ; Necrosis ; Retrospective Studies ; Skin ; Survival Rate ; Thigh ; Transplants

PURPOSE: This study was conducted in order to investigate the therapeutic effect of closed reduction according to a classification in patients with nasal bone fracture. METHODS: The study was conducted retrospectively on 186 patients with a mean age of 38 years (range: 7 to 80 years). All patients were diagnosed by clinical and radiologic examination, and then classified according to Hwang's classification by computed tomography. The patients were further classified by their age, gender, causes of fracture, operation timing after fracture, concurrent facial bone fracture, and complications. All patients underwent the same reduction and treatment protocol and were then followed up regularly for at least three months. RESULTS: The cause of the fracture was slip down, and the highest prevalence was shown in the 20s. The mean operation timing after fracture was 4.1 days (range: 1 to 14 days), and it tended to be longer in the case of defected septal bone or more severe fracture. The most common concurrent facial bone fracture was orbital blow-out fracture, and zygomaticomaxillary complex and maxillary fracture occured frequently. The largest number of complications occurred in class III and IIBs patients, and the main complication was postoperative pain. CONCLUSION: Results of nasal bone closed reduction on the 186 patients showed that serious complications rarely occurred. Closed reduction is generally an effective treatment for nasal bone fracture. However, in the case of severe concurrent septal bone fracture or comminuted fracture with depression, open reduction should be considered. Further study with a larger number of patients and further classification is required.
Classification ; Clinical Protocols ; Depression ; Facial Bones ; Fractures, Bone ; Fractures, Comminuted ; Humans ; Maxillary Fractures ; Nasal Bone* ; Orbit ; Orbital Fractures ; Orthopedics ; Pain, Postoperative ; Prevalence ; Retrospective Studies*

Osmotic demyelination syndrome (ODS) is a demyelinating disorder related to the rapid correction of hyponatremia. It usually affects the pontine area; hence, the name central pontine myelinolysis (CPM). However, it rarely occurs with the correction of hypernatremia and hyperosmolarity and involves extrapontine areas. A 56-year-old chronic alcoholic had been admitted with a history of confusion. He had been in alcohol withdrawal for 4 days. Laboratory examinations showed severe hypernatremia and hyperosmolarity. After serum sodium level was normalized; however, his clinical course did not improve and deteriorated to semicoma progressively. Magnetic resonance imaging (MRI) revealed abnormal signal intensity in the pontine and extrapontine areas, including the basal ganglia, thalamus, and cerebral cortices. This is the first case report of combined central pontine and extrapontine demyelination after alcohol withdrawal and correction of hypernatremia in a chronic alcoholic.
Alcoholics* ; Basal Ganglia ; Cerebral Cortex ; Demyelinating Diseases ; Humans ; Hypernatremia* ; Hyponatremia ; Magnetic Resonance Imaging ; Middle Aged ; Myelinolysis, Central Pontine* ; Sodium ; Thalamus

In clinical practice a serious sciatic nerve injury may result from an errornous injection of commonly used antibiotics and other therapeutic or prophylactic agents into the gluteal region which can occur at any age, especially common in infants, children and small debilitated patients. Although many isolated cases and several large series of injuries have been reported, the pathogenesis, pathology and its physiology of injection injury of the peripheral nerves in man have been poorly studied. This experimental study was conducted in order to observe the changes and degree of the functional disability of the sciatic nerve following injection of various drugs such as Rheumapyrine, Chloromycetin, Penicillin and physiological normal saline solution. Fourty-three normal adult rabbits were divided into four groups depending on injected materials and also divided into two groups of acute and chronic stages. The drugs were injected into the right sciatic nerve intraneurally and around the left sciatic nerve perineurally. For the functional study in the nerve, contractability of the calf muscle was recorded on a physiograph at intervals of 1, 3, 5, 15 and 30 minutes after the injection of the drugs. Rheobase, chronaxie and strength-duration curve of both extensor and flexor muscles of fet were recorded and measured on a chronaxie meter at intervals of 1, 2, 3 and 4 weeks after the injection. The physiogram showed the greatest reduction in contractability of the muscles in Rheumapyrine, moderate reduction in Penicillin and the least reduction in Chloromycetin group. In the measurements of rheobase and chronaxie there were marked increase of values in group of Rheumapyrine injection. There was no significant differences in values among the group of Penicillin, Chloromycetin and saline injections in comparison with those in the control group. In the analysis of strength-duration curve, it showed a pattern of complete denervation in 3 cases and a pattern of partial denervation in 3 out of 8 cases with Rheumapyrine injection, and a pattern of partial denervation in 3 out of 6 cases with Penicillin and 2 out of 8 cases with Chloromycetin injection. There was no significant differences in values of rheobase, chronaxie and strength-duration curve as time elapsed following the injury. It was postulated the functional and physiological disabilities were developed after the injection when there was a severe degree of nerve damages on the basis of histopathological study.
Adult ; Anti-Bacterial Agents ; Buttocks ; Child ; Chloramphenicol ; Chronaxy ; Denervation ; Humans ; Infant ; Muscles ; Pathology ; Penicillins ; Peripheral Nerves ; Physiology ; Rabbits ; Sciatic Nerve* ; Sodium Chloride