The dual muscle flap (Latissimus dorsi+ Serratus anterior muscle) based on the thoraco-dorsal vascular system for limb reconstruction has been infrequently reported. We have used this flap as a free flap for limb reconstruction in four patients (3 cases in lower linb, 1 in upper limb). A Latissmusi dorsi muscle or musculocutaneous flap and Serratus anterior muscle flap were used and all cases healed satisfactorily. The indications for this flap are to resurface two separate defects simultaneously or to resurface very large defects. It has the advantage of requiring anastomosis of one vascular pedicle only. This flap is particularly suitable for resurfacing defects wider than their length, in relation to the long axis of the limb.
Axis, Cervical Vertebra ; Extremities* ; Free Tissue Flaps ; Humans ; Myocutaneous Flap

BACKGROUND: Though symptomatic improvements after treatment of donepezil is well documented in Alzheimer's disease (AD), the electrophysiological change have not yet been elucidated. Among the parameters of quantitative electroen-cephalography (q-EEG), high frequency activity, especially gamma rhythm, may play a role in normal cognitive function including the integration of sensory processing, association, coupling or selective attention, which are characteristically impaired in AD. METHODS: In order to define the profile of q-EEG changes including gamma rhythm after donepezil treatment, we followed 17 AD patients for 12 weeks. We analyzed the spectra power taken from 16 derivations by averaging twenty-2-sec epoch in normal controls and AD patients. After logarithmic transformation of spectra power, statistical test was done and the effect of donepezil treatment on q-EEG profile was analyzed during follow up period. RESULTS: Before medication of donepezil, AD patients had a significantly lower alpha spectra power as well as a significant higher delta spectra power, compared with normal control. After medication of donepezil in AD patients, compared to base-line q-EEG, gamma spectra power was significantly increased, whereas delta spectra power was significantly reduced. Compared to absolute power, relative power was more sensitive in detecting change of EEG after donepezil treatment. CONCLUSIONS: This study suggests that donepezil significantly change delta and gamma spectra power in q-EEG, and the increase in gamma rhythm may be correlated with the clinical improvements after donepezil treatment. (J Korean Neurol Assoc 19(3):245~250, 2001)
Alzheimer Disease* ; Electroencephalography* ; Follow-Up Studies ; Humans

BACKGROUND: There is a growing interest in the use of genetic markers in predicting the various types of dementia such as Alzheimer's disease (AD) and vascular dementia (VD). It is important to differentiate AD from other causes of dementia because the early diagnosis of AD or VD could lead to early therapeutic intervention. This study is to confirm the association of the apolipoprotein E (Apo E) epsilon 4 allele with AD and, to confirm the differential diagnostic values of Apo E4 in the various causes of dementia. METHODS: One hundred seventy-seven patients participated in the study. Fifty-one had a diagnosis of AD, 68 with VD, 18 with mixed dementia, 17 with other dementia, and 23 controls with no diagnoses of dementia. Patients with AD and VD met the criteria of NINCDS-ADRDA and NINDS-AIREN respectively. The genomic DNA was isolated from whole blood and the Apo E allele was determined by polymerase chain reactions. RESULTS: The Apo E4 allele frequency in the AD group was 21.6% and was significantly different (p<0.05) from those of non-demented controls (4.3%) or VD (8.1%). The age of onset of AD was delayed by the presence of the Apo E2 allele and by the absence of Apo E4 allele, although was not statistically significant. The severities of dementia assessed by MMSE were not different among groups with different Apo E genotypes, implying that factors other than Apo E might be involved in the progression of AD. CONCLUSIONS: The Apo E genotypes can be a valuable genetic marker for predicting the risk for AD in Korea and also for differentiating AD from VD cases.
Age of Onset ; Alleles ; Alzheimer Disease* ; Apolipoprotein E2 ; Apolipoprotein E4 ; Apolipoproteins E ; Apolipoproteins* ; Dementia ; Dementia, Vascular ; Diagnosis* ; Diagnosis, Differential* ; DNA ; Early Diagnosis ; Gene Frequency ; Genetic Markers ; Genotype ; Humans ; Korea ; Polymerase Chain Reaction

No abstract available.
Aged* ; Humans ; Pneumonia*

No abstract available.
Aged* ; Humans ; Pneumonia*

Bromidrosis is a disorder characterized by rancid body odor which influences a patient's social life and mental health. The therapeutic modalities and the mechanism of bromidrosis have been carefully studied, however, there have been few reports about the genetic inheritance of bromidrosis. We investigated the family history of 42 patients who were operated on for bromidrosis and followed up to the third generation in 10 cases. The results were as follows: Results of investigation which were followed up the second generation. The fathers of five patients and the mothers of 11 patients had bromidrosis in 18 male patients. The fathers of six patients and the mothers of 12 patients had bromidrosis in 24 female patients. Thirty-four patient (81.0%) among a total of 42 have a single parent with bromidrosis. Result of investigation which were followed up to the third generation Bromidrosis was occurred in 17 of 42 patients (40.5%) in the second generation, and 18 of 27 patients (66.7%) in the third generation. In one case, a father transmitted bromidrosis to his three sons, and as a result, X-linked inheritance could be ruled out Bromidrosis was not skipped in every generation of all families. We on conclude that bromidrosis is an autosomal dominant inherited disorder.
Fathers ; Female ; Genes, X-Linked ; Humans ; Male ; Mental Health ; Mothers ; Odors ; Single Parent ; Wills*

No abstract available.
Colorectal Neoplasms* ; Fluorouracil* ; Humans ; Interferon-gamma*

PURPOSE: This study was done to evaluate the effects of 3 times/week and 5 times/week abdominal meridian massage with aroma oils (AMMAO) on the relief of constipation among hospitalized children with disabilities involving the brain lesions (cerebral palsy, epilepsy, and others). METHODS: The participants were 33 hospitalized children with a disability involving the brain (15 were in the 5 times/week of AMMAO group and 18 were in the 3 times/week of AMMAO group). Data were collected from March 21 to May 1, 2011. Chi-square test, t-test, and repeated measures ANOVA with SPSS 18.0 were used to evaluate the effects of AMMAO. RESULTS: While there was no significant difference between the two groups, there was a significant difference within groups between baseline and the end of the intervention period for the following, frequency of suppository use or enemas, amount of stool, and number of bowel movements. CONCLUSION: The results of this study indicate that AMMAO is an effective nursing intervention in relief of constipation for hospitalized children with a disability involving the brain. Therefore it is recommended that AMMAO be used in clinical practice as an effective nursing intervention for relief of constipation to these children.
Abdomen ; Adolescent ; Analysis of Variance ; Aromatherapy ; Brain Diseases/*pathology ; Child ; Child, Hospitalized ; Child, Preschool ; Constipation/*therapy ; Disabled Children ; Female ; Humans ; Male ; *Massage ; Meridians ; Oils/*therapeutic use

Despite may studies of withdrawal of anitepileptic drugs our knowledge of the factor which influence the risk of seizure relapse is poor. So many people with a history of epilepsy continue to take antiepileptic drugs despite of long period of remission. To define prognostic factors and evaluate the possibility of early withdrawl in patients with good prognostic factor, we retrospectively studied the factors influencing their risk of seizure relapse with 66 adult epilepsy patients. Thirty-two of 66 patients remained free from seizure at least for 6 months. Among the rest(34 patients, relapse rate 52 %), 19 patients had recurrence of seizure during the period of tapering drugs, and 15 patients after withdrawI. The recurrence of seizure decreased with younger age of onset(esp, before 15 years old), shorter duration of seizures(esp, less than 5 years) and adequate periods of taping before anticonvulsant withdrawl. It increased with the abnormal neurologic findings. However, it showed no relation with the period free from seizure on anticonvulsant administration. So in patients with such good prognostic factors, the trial of early withdrawal(with short seizure free period) might be worth according to circumstances.
Adult* ; Anticonvulsants ; Epilepsy ; Humans ; Neurologic Manifestations ; Recurrence* ; Retrospective Studies ; Seizures*

During a 9-year period 43 children and adolescents 2 to 18 years old underwent 140 extracorporeal shock wave lithotripsy (ESWL) treatments for 48 calculi. The second generation piezoelectric lithotriptor (LT01) was used in 28 cases (65%) while the remaining cases were treated with the third generation piezoelectric lithotriptor (LT02). LT02 lithotriptor differs from an earlier model LT01 in 2 important respects; a stone localization system consisting of ultrasound and fluoroscopy, and more energy per shock wave. The LT01 necessitated caudal anesthesia in 14 cases (50%) while the LT02 necessitated caudal anesthesia in 2 cases (13%) and intravenous anesthesia in 2 cases (13%). Two upper ureteral stones without ureteral dilatation and 1 mid ureteral stone, which were difficult to detect with ultrasound, could be localized by combined ultrasound and fluoroscopy on LT02. The success rate by LT01 and LT02 ESWL was 92.9% and 100%, respectively. The mean session of LT01 and LT02 ESWL was 3.6+/-.4.09 and 2.6+/-2.47, respectively, and the total storage of LT02 ESWL (93+/-97.8) was much less(p<0.05) than that of LT01 ESWL (363+/-380.3). There were no statistical differences in regard to success and the use of stents, stone size or location between the 2 lithotriptors. Six patients required adjuvant procedures, and ESWL complications were not required admission or surgical management. Therefore, LT02 piezoelectric lithotripsy, in comparison with LT01, is more efficient to localize stones and can lessen total storage by reducing treatment sessions in children and adolescents.
Adolescent* ; Anesthesia, Caudal ; Anesthesia, Intravenous ; Calculi ; Child* ; Dilatation ; Fluoroscopy ; Humans ; Lithotripsy* ; Shock ; Stents ; Ultrasonography ; Ureter ; Urinary Calculi