Avulsion fractures of the tibial tuberosity are uncommon and they usually occur in adolescents during sports activities. Ogden et al modified Watson-Jones classification into three types. To our knowledge, only two cases of tibial tuberosity avulsion fractures combined with meniscal tear were reported. We report an Ogden-type III intra-articular fracture of the tibial tuberosity combined with tear of the medial meniscus.
Adolescent ; Classification ; Humans ; Intra-Articular Fractures ; Menisci, Tibial ; Sports

Although the incidence is not high in the general surgical population, pulmonary aspiration of gastric contents can result in serious long-term morbidity and mortality. We report a case of early use of extracorporeal membrane oxygenation (ECMO) to correct severe hypoxemia refractory to conventional mechanical ventilation in a patient with massive aspiration of gastric contents immediately followed by acute lung injury during general anesthesia induction. A 64-year-old woman diagnosed with stomach cancer was scheduled for elective diagnostic laparoscopy. Although there was no sign of gastrointestinal tract obstruction and midnight Nil per Os (NPO) was performed before the operation, pulmonary aspiration occurred during the induction of anesthesia. Despite the endotracheal intubation with mechanical ventilation, severe hypoxemia with hypercapnea persisted. Medical team agreed with applying veno-venous (VV) ECMO, and her blood gas analysis results became stable. ECMO was weaned successfully 9 days after the first aspiration event had occurred. Based on this case, early application of extracorporeal life support can have survival benefits.
Acute Lung Injury ; Anesthesia* ; Anesthesia, General ; Anoxia ; Blood Gas Analysis ; Extracorporeal Membrane Oxygenation* ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Intubation, Intratracheal ; Laparoscopy ; Middle Aged ; Mortality ; Pneumonia, Aspiration ; Respiration, Artificial ; Stomach Neoplasms

No abstract available.
Humans

BACKGROUND: Mirror movements are symmetric, identical, contralateral involuntary movements that accompany vol-untary movements on one side of the body. The aim of this study is to examine the patterns of brain activation during motor and sensory tasks using a functional magnetic resonance imaging (fMRI) and to compare them between normal subjects and a patient with congenital mirror movements. METHODS: A 19 year-old patient with congenital mirror movements and seven normal volunteers (mean age: 29 years old), performed finger-tapping and tactile stimulation tasks with the right, left, and both hands, while gradient echo EPI (echo planar imaging) images were acquired in a 1.5T scanner. RESULTS: During the motor and sensory tasks, the patient showed a bilateral activation of the primary motor and sensory cortices, whereas normal subjects showed only unilateral activations. Activations related to the motor task was observed in the primary sensory cortex, the supplementary motor area, and the cerebellum as well as the primary motor cortex in the case of the patient, while only the primary motor cortex was significantly activated in normal subjects. CONCLUSIONS: These findings suggest that the abnormality underlying congenital mirror movements involves not only the primary motor cortices and interhemispheric connections between them, but also the more extended motor-sensory circuitry including the primary sensory cortex, supplementary motor area, and cerebellum.
Brain ; Cerebellum ; Dyskinesias ; Hand ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Motor Cortex ; Young Adult

BACKGROUND: Mirror movements are symmetric, identical, contralateral involuntary movements that accompany vol-untary movements on one side of the body. The aim of this study is to examine the patterns of brain activation during motor and sensory tasks using a functional magnetic resonance imaging (fMRI) and to compare them between normal subjects and a patient with congenital mirror movements. METHODS: A 19 year-old patient with congenital mirror movements and seven normal volunteers (mean age: 29 years old), performed finger-tapping and tactile stimulation tasks with the right, left, and both hands, while gradient echo EPI (echo planar imaging) images were acquired in a 1.5T scanner. RESULTS: During the motor and sensory tasks, the patient showed a bilateral activation of the primary motor and sensory cortices, whereas normal subjects showed only unilateral activations. Activations related to the motor task was observed in the primary sensory cortex, the supplementary motor area, and the cerebellum as well as the primary motor cortex in the case of the patient, while only the primary motor cortex was significantly activated in normal subjects. CONCLUSIONS: These findings suggest that the abnormality underlying congenital mirror movements involves not only the primary motor cortices and interhemispheric connections between them, but also the more extended motor-sensory circuitry including the primary sensory cortex, supplementary motor area, and cerebellum.
Brain ; Cerebellum ; Dyskinesias ; Hand ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Motor Cortex ; Young Adult

The purpose of this study was to investigate effects of nutrition education program and pamphlet for the lower grades elementary students focused on individual daily needed food exchange units using Food Exchange System. Program consisted of four lessons (40 min/lesson), "5 major nutrients & function", "6 food group and sources", "daily needed food exchange units for normal body weight", and "smart snack choice and exercise". Pamphlet as activity book was developed for the program. The subjects were 3rd grade elementary students (educated group, 31 vs. non-educated group, 31). Educated group were lessoned as group and/or individual. We examined the differences in nutrition knowledge, dietary attitudes, dietary intakes and satisfaction of the program and pamphlet. In educated group, there were positive improvements on nutrition knowledge score "function and foods of 5 nutrients" and on dietary attitudes "type of breakfast and snacks". In the evaluation of dietary intakes according to KDRI, there were positive improvements on intakes level of riboflavin, vit. C, folate, Ca, P, Fe and Zn in educated group. In satisfaction with the program and pamphlet, contents, font size, visual, figure, difficulty and program curriculum were over 2.90/3.0. It showed that the developed nutrition education program and pamphlet focused on individual daily needed food exchange units using Food Exchange System improved nutrition knowledge, dietary attitudes and nutrients intake level in the lower grades elementary students.
Breakfast ; Curriculum ; Folic Acid ; Humans ; Pamphlets ; Riboflavin ; Snacks

No abstract available.
Child* ; Humans ; Hyperhidrosis*

No abstract available.
Neurofibroma* ; Pilomatrixoma*

The Ross operation, a procedure of replacement of the diseased aortic valve with an autologous pulmonary valve, has many advantages such as no need for anticoagulation therapy and similar valve function and growth potential as native valves. However secondary aortic disease has emerged as a significant complication and indication for reoperation. We report a 48-year-old woman who had Ross operation in 1997 for a damaged bicuspid aortic valve and severe aortic regurgitation due to subacute bacterial endocarditis complicated by aortic root abscess. In 2009, 12 years later, progressive severe aortic regurgitation with incomplete coaptation and mild dilatation of the aortic root was shown on echocardiography and contrasted CT, while the pulmonary homograft retained normal function. She subsequently underwent aortic valve replacement. Histopathological examination of the explanted neo-aortic valve and neo-arterial wall revealed pannus formation at the nodulus Arantii area of the three valve cusps, ventricularis, and arterialis. The amount of elastic fibres in the neo-aorta media was less than usual for an aorta of this patient's age but was similar to a pulmonary artery. The pathological findings were not different from other studies of specimens removed between 7 to 12 years after Ross operation. However, the pathophysiology and long-term implications of these findings remain debatable. Considering the anatomical and physiological changes induced by the procedure, separate mechanisms for aortic dilatation and regurgitation are worthy of consideration.
Aorta/*pathology ; Aortic Valve/*surgery ; Aortic Valve Insufficiency/*etiology ; Cardiovascular Surgical Procedures/*adverse effects ; Dilatation, Pathologic ; Heart Valve Diseases/*surgery ; Prostheses and Implants ; Pulmonary Valve/*transplantation

The presence of epicanthal folds in Asian eyelids is one of their unique features, in combination with the lack of supratarsal folds. Western culture has influenced many people to prefer to eliminate the prominent epicanthal fold. A number of surgical techniques have been suggested for their correction. However, difficulty with design, excessive and prominent scarring of medial canthal and nasal area, recurrence, and rigidity of application are potential problems associated with many procedures. This paper describes a epicanthoplasty with three-dimensional Z-plasty. Through epicanthal fold incision, the medial canthal tecdon is medially advanced and sutured to the periosteum of nasal bone. After the transposition of the flaps, trimming of the flap is usually required. Three-dimensional Z-plasty crates the attactive eyes. From March, 1995 to March, 1997, the technique was applied to 37 patients with epicanthal fold and was performed with or without double-fold operation. There were 34 females and 3 males with ages ranging from 17 to 30 years. Through 2 years follow-up, this techniques has delivered esthetically good results with minimal postoperative scar and could made the reduction of ICD from 40 +/- 2.13mm to 34 +/- 1.98mm. The advantages of epicanthoplasty procedure using three-dimensional Z-plasty(Yoon's method) are as follows; 1) simple in design 2) minimal postoperative scar in the medial canthal area 3) versatile in its application 4) no recurrence 5) no hypertrophic scar 6) preserving ethnic identity.
Asian Continental Ancestry Group ; Cicatrix ; Cicatrix, Hypertrophic ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Male ; Nasal Bone ; Periosteum ; Recurrence