This study assessed the current concepts of pediatric elbow fractures. PubMed and Embase databases were searched for publications in English on elbow fractures. Papers believed to yield significant findings to this area were included in this review. The supracondyle of humerus, lateral condyle of the humerus, proximal radius, and proximal ulna fractures were included. Sixteen papers and textbooks were selected. Pediatric elbow fractures should be evaluated for combined injuries. Treatment should be done accurately for each fracture for the further growth of children.

PURPOSE: Circumcision in childhood is widely practiced in Korea, but the Korean attitude to circumcision has not been well studied. Our aim was to evaluatethe knowledge and general opinion of Korean adult males toward circumcision. MATERIALS AND METHODS: One thousand five hundred self-completed questionnaires were distributed to adult males of five major age groups from 10s' to 50s' divided into decades. Questions asked about the responders' opinions regarding the necessity, reasons, potential benefits, and disadvantages for circumcision, and also asked if there was any peer pressure when deciding upon circumcision. The responses were collected and analyzed statistically. RESULTS: The response rate was 62.7% (936). Of 836 responders, 611 (73.1%) believed that circumcision is necessary, while 59 (7.1%) believed it to be unnecessary. The principal reason for circumcision was improvement of penile hygiene (77.9%). Of 921 responders, 768 (83.4%) believed that the smegma is a dirty material infected by microorganisms. Of 901 responders, 619 (68.7%) didn't prefer the neonatal period regardless of age. The major reason was pain (36.9%). Peer pressure was one of the most influencing factors when deciding upon circumcision: 540 (60.8%) of 888 responders believed that they might be ridiculed by their peer group unless they were circumcised and the younger, the more frequent (p<0.05). Of 917 responders, 616 (62.7%) thought that circumcision would prevent genital tract infection of the sexual partner. Responders with lower education or older responders were prone to emphasize the improvement in sexual potency (p<0.05). CONCLUSIONS: Our study indicates that common beliefs held by adult males about the prepuce or circumcision are homogeneous according to age. It is critical to tailor education about the potential benefits and disadvantages of circumcision.
Adult* ; Circumcision, Male* ; Education ; Female ; Humans ; Hygiene ; Korea ; Male ; Male* ; Peer Group ; Phimosis ; Surveys and Questionnaires* ; Reproductive Tract Infections ; Sexual Partners ; Smegma

STUDY DESIGN: Retrospective study. OBJECTIVES: To identify the implementation of self-exercise therapy and analyze the effects of exercise therapy after lumbar discectomy. MATERIALS AND METHODS: Studied 47 patients who underwent partial lumbar discectomy and laminectomy from January, 2009 to December, 2009. They were instructed on 16 kinds of exercise therapy in total from postoperative 1day to postoperative 6weeks. Group A (n=25), whose frequency of outpatient clinic visit is above the average, and Group B (n=22), whose frequency of visit is relatively low;, below 5 times. We tested the visual analog scale (VAS scale) of back, Oswestry disability index and the strength of the two groups before surgery and at postoperative 3, 6, and 12 months. RESULTS: The degree of pain was significantly different (26.6+/-9.4 and 53.5+/-18.6) between group A and group B at postoperative 6 months. Function of daily life and strength test were significantly different (6.6+/-4.8 and 11.3+/-4.0 at group A, 3.6+/-0.9 and 3.0+/-1.1 at group B) between the two groups at postoperative 12 months. The characteristics of low compliance patients are low accessibility to the hospital and lack of knowledge on the importance of exercise according to the degree of pain. CONCLUSION: These results suggested that postoperative exercise program has significant effects on the pain, the function of daily life. It also increases flexibility and strengthens the muscle of patients with high compliance of outpatient clinic visit. The factors influencing the results are the age of patients, the willingness to exercise, and the environment in which each patient lives/resides.
Ambulatory Care Facilities ; Compliance ; Diskectomy* ; Exercise Therapy ; Humans ; Laminectomy ; Muscles* ; Pliability ; Retrospective Studies ; Visual Analog Scale

OBJECTIVES: We investigated the significance of interoceptive fear in assessment of panic disorder (PD) patients. METHODS: 102 patients affected by PDs with (n=68) or without (n=34) agoraphobia according to DSM-IV criteria completed self-report questionnaires, such as Albany Panic and Phobia Questionnaire (APPQ), The Expanded Anxiety Sensitivity Index (ASI-R), Agoraphobic Cognitions Questionnaire (ACQ), Body Sensation Questionnaire (BSQ), Beck Anxiety Inventory (BAI), and Panic Disorder Severity Scale (PDSS). Pearson correlation analysis, stepwise regression analysis, paired t-test and independent t-test were used. RESULTS: All variables except BSQ were significantly correlated with panic severity. In stepwise regression analysis, interoceptive fear and catastrophic cognition were the most significant predicting variables for panic severity. After 3-months medication, all variables significantly diminished, but interoceptive fear and catastrophic cognition of panic patients were still significantly higher than normal control. CONCLUSION: Interoceptive fear is the fear of automatic sensations that are similar to those of a panic attack and is the most significant variable in predicting panic severity. After 3-months medication, interoceptive fear significantly decreased, but still was higher than the control group.
Agoraphobia ; Anxiety ; Cognition ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Panic Disorder* ; Panic* ; Phobic Disorders ; Surveys and Questionnaires ; Sensation

BACKGROUND: Intraosseous lipoma is a very rare lesion that constitutes no more than 0.1% of all bone tumors. We analyzed 21 cases of intraosseous lipoma at a single institution for clinical and radiographic characteristics. METHODS: A retrospective study was performed on 21 pathologically confirmed intraosseous lipomas treated in our hospital from 2000 to 2017. Simple X-ray and magnetic resonance imaging findings and medical records were reviewed. Patients' age, sex, and clinical symptoms were investigated. From the radiographic images, the site of the lesion, calcification, bony expansion, and stage of the lesion were evaluated. Correlations between the degree of involution and clinical symptoms were analyzed. RESULTS: The mean age of patients was 50 years (range, 20 to 67 years), and there were 13 males and eight females. The mean lesion size was 6.1 cm (range, 2.5 to 13.6 cm). The most common anatomical site of the lesion was the femur (seven cases), and three cases occurred in flat bones such as the ilium and scapula. Visual analogue scale score for pain was 3 to 6 in 15 patients. There were no complaints of functional limitation. There was no correlation between the degree of degeneration and clinical symptoms (p = 1.000). Curettage was performed as a surgical treatment in 20 patients, and bone graft was performed using a bone chip. Excision was performed in one patient. Pain was resolved in seven of 11 patients with a complaint of preoperative pain; intermittent pain remained in four cases. There was no local recurrence or malignant change during the follow-up. CONCLUSIONS: There was no correlation between the degree of degeneration and clinical symptoms. Pain was the most common clinical symptom, but it was rarely accompanied by functional limitation. However, it is important to distinguish it from other pain-inducing disorders. The incidence of intraosseous lipomas is low, and detection based on various imaging findings can be difficult. Clear understanding of the radiographic findings and symptoms of intraosseous lipoma is helpful for diagnosis and differentiation.
Bone Neoplasms ; Curettage ; Diagnosis ; Female ; Femur ; Follow-Up Studies ; Humans ; Ilium ; Incidence ; Lipoma* ; Magnetic Resonance Imaging ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Scapula ; Transplants

Background and Objectives: The diagnosis of hearing impairment is based on repeated audiometry, including pure tone audiometry (PTA), speech reception threshold test (SRT), and speech discrimination test (SDT). SDT results particularly show a wide discrepancy upon repeated testing, while malingering is suspected when having more than 12% difference between 3 individual SDT results. Therefore, in this study, we compared the proportion of malingering found in repeated SDT with that found in other audiometric tests and analyzed the characteristics of malingering group in order to reevaluate the current criteria of defining malingering.Subjects and Method We retrospectively assessed the audiometry results of 113 patients (226 ears) with hearing impairment. Each ear was divided into a malingering group and a true hearing loss group. The proportion of ears corresponding to each malingering criterion was compared using a chi-square test. An independent sample t-test was performed to identify the differences between the characteristics between the two groups. Results: The number of ears that met the malingering criteria were 19 (8.41%) in PTA, 15 (6.64%) in SRT, and 75 (33.19%) in SDT. There was a significant difference in the proportion of malingering between the 3 hearing test modalities (p<0.001). There was no significant difference in auditory brainstem response, mean age and sex distribution between the malingering group and the true hearing loss group. Conclusion When conducting repeated SDT, there is a risk of misdiagnosing an actual hearing loss patient as a malingering patient under the current malingering criteria. Therefore, the current criteria on SDT requires reevaluation.

Background and Objectives: There is no clear standard for the difference in the thresholds of auditory brainstem response (ABR) and pure tone audiometry (PTA) when using ABR to evaluate the reliability of PTA. Therefore, we assessed the difference in the thresholds of ABR and PTA for each frequency. Consequently, we present here the actual difference values between the two tests that can be used as a reference in the clinic.Subjects and Method We retrospectively assessed the audiometry results of 129 ears. Ears in which the hearing thresholds of each frequency continuously declined were classified as the downward group. We compared the average of differences between the two tests by frequency. The differences were compared for each hearing level from 50 dB or higher. Results: For all ears, the appropriate range of difference value was ±5 dB at 2 kHz. At 1 kHz, the ABR threshold was 10 dB higher than PTA, and it was 10 dB less than PTA at 4 kHz. In the downward group, the difference value increased by 10 dB at 1 kHz and 4 kHz. In the subgroups at each hearing level, the difference value showed similar results (p<0.05). Conclusion The difference in the threshold, regardless of the severity or tendency of hearing loss, was the smallest at 2 kHz and the range was ±5 dB. ABR was 10 dB higher at 1 kHz and and 10 dB lower at 4 kHz than PTA. In the downward group, the difference at 1 kHz and 4 kHz increased by 10 dB each.

Background and Objectives: Patients with hearing loss and tinnitus experience difficulty in engaging in daily conversations. However, only few studies have examined how tinnitus affects individual speech discrimination to comprehend speech. This study aimed to analyze the correlation between tinnitus frequency and speech discrimination in patients with hearing loss and tinnitus.Subjects and Method A total of 275 ears with hearing impairment were retrospectively analyzed via audiometry and tinnitogram. The ears were divided into three groups depending on the frequency of their tinnitus. Average pure tone audiometry (PTA), hearing threshold of tinnitus frequency, speech discrimination test (SDT), degree of discrepancy between tinnitus frequency and worst PTA frequency were collected and compared among the three groups. Results: No significant difference was observed in PTA in the three patient groups. Hearing threshold of tinnitus frequency was the highest at 78.27 dB in the high-frequency group and the lowest at 45.14 dB in the low-frequency group. SDT was significantly lower (53.69%) in the low-frequency group. The correlation between tinnitus loudness and SDT was the strongest in the low-frequency group. The degree of discrepancy between tinnitus frequency and worst PTA frequency was also significantly observed in the low-frequency group. Conclusion Patients who are severely affected by tinnitus are found to have significant discrepancy between tinnitus frequency and worst PTA frequency, indicating decreased SDT.

Walking can have a positive impact on cognitive function in adolescents.This study aimed to compare the effects of walking with sneakers and barefoot on cognitive ability in adolescents. Fifty-nine adolescent male students were included in the study and assigned to the control (n = 20), sneaker (n = 19), and barefoot (n = 20) groups. The barefoot and sneakers group performed a 40-min walking exercise four times a week for 12 weeks during the morning physical activity time, while the control group performed self-study. Electroencephalogram (EEG) and brain activity variables were measured before and after the exercise program. The results showed that after 12 weeks, the barefoot group had a significant decrease in Gamma and H-beta waves and a significant increase in sensorimotor rhythm (SMR) and Alpha waves. Conversely, the control group showed a significant decrease in SMR waves and increase in Theta waves. The sneaker group showed a significant decrease in SMR waves alone. In an eyes-open resting state, the barefoot group showed a significant increase in H-beta, M-beta, SMR, and Alpha waves. The barefoot group also had a significant increase in cognitive speed and concentration and a significant decrease in brain stress. Taken together, barefoot walking can effectively enhance cognitive ability in adolescents, as demonstrated by the significant variation in EEG activity.This research highlights the potential benefits of barefoot walking as a simple and effective form of exercise for enhancing cognitive function in adolescents.

PURPOSE: The purpose of this study was to determine whether chemoradiation (CCR) is efficient for improving prognosis, compared with systemic chemotherapy (SC), in patients with stage IVB cervical cancer who have distant lymphatic metastasis. MATERIALS AND METHODS: Among 2,322 patients with cervical cancer between January 2000 and March 2010, 43 patients (1.9%) had stage IVB disease. After exclusion of 19 patients due to insufficient data and hematogenous metastasis, 24 patients (1%) who received CCR (n=10) or SC (n=14) were enrolled. We compared tumor response, progression-free survival (PFS) and overall survival (OS), and disease recurrence between CCR and SC. RESULTS: Complete response rates were 60% and 0% after CCR and SC (p<0.01). Grade 3 or 4 leukopenia was more common in patients treated with CCR (24.4% vs. 9.1%, p=0.03), whereas grade 3 or 4 neuropenia was more frequent in those treated with SC (28.4% vs. 11.1%, p=0.03). Development of grade 3 proctitis occurred as a late radiotherapy (RT)-related toxicity in only one patient (10%) treated with CCR. In addition, squamous cell carcinoma and CCR were favorable prognostic factors for improvement of PFS (adjusted hazard ratios [HRs], 0.17 and 0.12; 95% confidence intervals [CIs], 0.04 to 0.80 and 0.03 to 0.61), and only CCR was significant for improvement of OS (adjusted HR, 0.15; 95% CI, 0.02 to 0.90). However, no differences in the rate and pattern of disease recurrence were observed between CCR and SC. CONCLUSION: CCR may be more effective than SC for improving survival, and can be regarded as a feasible method with some caution regarding late RT-related toxicity for treatment of stage IVB cervical cancer with distant lymphatic metastasis.
Carcinoma, Squamous Cell ; Disease-Free Survival ; Humans ; Leukopenia ; Lymphatic Metastasis ; Neoplasm Metastasis ; Proctitis ; Prognosis ; Recurrence ; Uterine Cervical Neoplasms