Otologic complaints, including otalgia, tinnitus, vertigo, and hearing loss, are known to be related to temporomandibular disorders (TMDs). There have been several hypotheses regarding the clinical correlation between otologic complaints and TMDs, based on clinical phenomena with corresponding symptoms, the close neurological relationship between otic and masticatory structures, and anatomical features of the tympanic cavity and jaw joint. Function of the tensor tympani muscle seems to be crucial to understanding TMD-related otologic symptoms. The tensor tympani inserts into the handle of the malleus and it modulates sound transduction in situations of excessive noise. This muscle is innervated by the trigeminal nerve, like the masticatory muscles. Voluntary eardrum movement by pathological tensor tympani contraction results in various otologic symptoms. Thus, co-contraction of the tensor tympani with the masticatory muscle could be a possible cause of TMD-related otologic symptoms. The tensor tympani is rather unrelated to the acoustic reflex, in which the stapedius is strongly involved. The tensor tympani seem to be controlled by proprioceptive information from the trigeminal sensory nucleus. The peripheral innervation pattern of the tensor tympani and masticatory muscles is also supposed to be interconnected. The middle ear structure, including the malleus, incus, and tensor tympani, of mammals had been adapted for acoustic function and lacks the masticatory role seen in non-mammalian jawed vertebrates. The tensor tympani in non-mammals is one of the masticatory muscles and plays a role in the modulation of sound transduction and mastication. After the functional differentiation of the mammalian middle ear, the nervous connection of the tensor tympani with other masticatory apparatus still remains. Through this oto-stomatognathic vestige, the tensor tympani seems to contract unnecessarily in some pathological conditions of the TMD in which the masticatory muscles contract excessively. We hypothesized that the phylogenic relationship between the tensor tympani and masticatory apparatus is a significant and logical reason for TMD-related otologic complaints.
Acoustics ; Ear, Middle ; Earache ; Hearing Loss ; Incus ; Jaw* ; Joints ; Logic ; Malleus ; Mammals ; Mastication ; Masticatory Muscles ; Noise ; Reflex, Acoustic ; Stapedius ; Temporomandibular Joint Disorders ; Tensor Tympani* ; Tinnitus ; Trigeminal Nerve ; Tympanic Membrane ; Vertebrates ; Vertigo

BACKGROUND: The treatment of vitiligo requires several months of treatment and often results in disappointing outcomes. Recently, narrow band UVB phototherapy has been reported to be an effective and safe therapeutic option in patients with vitiligo. OBJECTIVE: We attempted to evaluate the clinical efficacy and safety of narrow band UVB phototherapy in vitiligo patients. METHODS: In an open trial, thirteen vitiligo patients were treated twice weekly with narrow band UVB phototherapy for at least six months. The degree of repigmentation was divided into 4 categories(below 25%, 26-50%, 51-75%, and above 75%). The disease activity by history was scored by means of the "vitiligo disease activity score (VIDA score)" before and 12 months after therapy. RESULTS: In the majority of the patients(85%), more than 25% repigmentation was observed. More than 75% repigmentation was seen in 7 patients(54%). The disease activity, as represented by VIDA scores, was significantly decreased after narrow band UVB therapy(P<0.05). Adverse effects were mild erythema and pruritus in 4 patients. CONCLUSION: According to our results, narrow band UVB phototherapy is an effective therapy which is convenient and safe in vitiligo patients.
Erythema ; Humans ; Phototherapy* ; Pruritus ; Vitiligo*

No abstract available.
Angina, Unstable*

Using three different types of the ankle joint, i.e., the fixed, single-axis, and multi axis type, the gait characteristics of transfemoral amputees were investigated to understand the biomechanics of ankle joint motion during gait of transfemoral amputees with a SNS (swing and stance phase) control prosthesis controlling the flexion-extension of knee in the stance phase unlike conventional swing control prostheses. The socket pressure was measured to explain the resulting gait characteristic of the transfemoral amputees for different ankle joint components. Based on the results from the gait characteristics, socket pressure, knee flexion-extension behavior, and ground reaction vector, the fixed type ankle joint could be considered as the most appropriate ankle joint for the transfemoral amputees using the SNS control prosthesis.
Amputees* ; Ankle Joint ; Ankle* ; Axis, Cervical Vertebra ; Freedom* ; Gait* ; Humans ; Knee ; Prostheses and Implants*

Using three different types of the ankle joint, i.e., the fixed, single-axis, and multi axis type, the gait characteristics of transfemoral amputees were investigated to understand the biomechanics of ankle joint motion during gait of transfemoral amputees with a SNS (swing and stance phase) control prosthesis controlling the flexion-extension of knee in the stance phase unlike conventional swing control prostheses. The socket pressure was measured to explain the resulting gait characteristic of the transfemoral amputees for different ankle joint components. Based on the results from the gait characteristics, socket pressure, knee flexion-extension behavior, and ground reaction vector, the fixed type ankle joint could be considered as the most appropriate ankle joint for the transfemoral amputees using the SNS control prosthesis.
Amputees* ; Ankle Joint ; Ankle* ; Axis, Cervical Vertebra ; Freedom* ; Gait* ; Humans ; Knee ; Prostheses and Implants*

PURPOSE: To investigate the changes of epiblepharon by evaluating the severity of epiblepharon before and after induction of general anesthesia (GA) with a muscle relaxant and total intravenous anesthesia (TIVA) without a muscle relaxant. METHODS: Thirteen pediatric patients (26 eyes) underwent surgery for epiblepharon under GA using a muscle relaxant and 19 pediatric patients (38 eyes) underwent surgery for epiblepharon under TIVA without a muscle relaxant. The severity of epiblepharon in each eye was scored according to skin-fold height (scored 1-4) and area of ciliocorneal touch (scored 1-3) while the patient was in the supine position before induction and after induction of GA. RESULTS: Skin-fold height scores and ciliocorneal touch area scores decreased after induction of GA with a muscle relaxant (skin-fold height score before GA: 2.42 ± 0.86, after GA: 1.87 ± 0.88 p-value < 0.001; ciliocorneal touch area score before GA: 2.05 ± 0.70, after GA: 1.61 ± 0.68, p-value < 0.001). In the TIVA group, skin-fold height scores and ciliocorenal touch area scores were not statistically different before and after GA (skin-fold height score before GA: 2.23 ± 1.18, after GA: 2.38 ± 1.10, p-value = 0.212; ciliocorneal touch area score before GA: 2.06 ± 0.74, after GA: 1.94 ± 0.80, p-value = 0.161). CONCLUSIONS: The change of epiblepharon severity was significantly reduced by induction of TIVA without a muscle relaxant and there was no recurrence of epiblepharon 3 months after surgery. When using TIVA without a muscle relaxant, the change of epiblepharon severity was reduced and thus, this method can help prevent its undercorrection.
Anesthesia, General ; Anesthesia, Intravenous* ; Humans ; Recurrence ; Supine Position

PURPOSE: To investigate the changes of epiblepharon by evaluating the severity of epiblepharon before and after induction of general anesthesia (GA) with a muscle relaxant and total intravenous anesthesia (TIVA) without a muscle relaxant. METHODS: Thirteen pediatric patients (26 eyes) underwent surgery for epiblepharon under GA using a muscle relaxant and 19 pediatric patients (38 eyes) underwent surgery for epiblepharon under TIVA without a muscle relaxant. The severity of epiblepharon in each eye was scored according to skin-fold height (scored 1-4) and area of ciliocorneal touch (scored 1-3) while the patient was in the supine position before induction and after induction of GA. RESULTS: Skin-fold height scores and ciliocorneal touch area scores decreased after induction of GA with a muscle relaxant (skin-fold height score before GA: 2.42 ± 0.86, after GA: 1.87 ± 0.88 p-value < 0.001; ciliocorneal touch area score before GA: 2.05 ± 0.70, after GA: 1.61 ± 0.68, p-value < 0.001). In the TIVA group, skin-fold height scores and ciliocorenal touch area scores were not statistically different before and after GA (skin-fold height score before GA: 2.23 ± 1.18, after GA: 2.38 ± 1.10, p-value = 0.212; ciliocorneal touch area score before GA: 2.06 ± 0.74, after GA: 1.94 ± 0.80, p-value = 0.161). CONCLUSIONS: The change of epiblepharon severity was significantly reduced by induction of TIVA without a muscle relaxant and there was no recurrence of epiblepharon 3 months after surgery. When using TIVA without a muscle relaxant, the change of epiblepharon severity was reduced and thus, this method can help prevent its undercorrection.
Anesthesia, General ; Anesthesia, Intravenous* ; Humans ; Recurrence ; Supine Position

The Marcus ankle arthrodesis was carried out in 16 patients at department of orthopaedic surgery of Korea Veterans Hospital from January 1989 to December 1993. All of patients were reviewed and evaluated with subjective and functional rating scales according to the Mazur scoring system. The average follow up was 23 months, ranging from 12 months to 60 months. The Marcus ankle arthrodesis involves a chevron osteotomy, tibial onlay graft medially, internal fixation with staples and screws. According to the Mazur score, the results were 6 cases of Excellent, 7 cases of Good. The average Mazur score was 75.1. There were 4 cases of complication, a non-union, a superficial wound infection, a bursitis, and a tendon injury. In summary the Marcus ankle arthrodesis by chevron osteotomy seems to be a good procedure, which gives solid bony union with short duration, relief of pain, normal looking ankle configuration without leg length discrepancy and good function with few complications.
Ankle ; Arthrodesis ; Bursitis ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Inlays ; Korea ; Leg ; Osteotomy ; Tendon Injuries ; Transplants ; Weights and Measures ; Wound Infection

Metastasis to the skin from the urinary bladder carcinoma are very rare and their incidence is 1% to 2% of the cutaneous metastasis. A 78-year-old man developed cutaneous metastasis 2 years later after the diagnosis of carcinoma of the bladder had been made. He visited our department with skin colored, soft, tender, subcutaneous nodule on the lower abdomen which had been detected 5 days ago. Histologic examination of the skin lesion showed atypical cells having hyperchromatic and pleomorphic nuclei. Herein we report a case of cutaneous metastasis from carcinoma of the urinary bladder in a 78-year-old man.
Abdomen ; Aged ; Diagnosis ; Humans ; Incidence ; Neoplasm Metastasis* ; Skin ; Urinary Bladder*

No abstract available.
Hypothyroidism* ; Myasthenia Gravis*