Background: A high incidence (40–73%) of postoperative nausea and vomiting (PONV) has been reported following orthognathic surgery, and various risk factors have been associated with it. Identifying PONV risk factors based on initial onset time will help establish preventive measures. This study aimed to identify factors that are significantly related to PONV based on the initial onset time after orthognathic surgery. Methods: This study included 590 patients who underwent orthognathic surgery. Multivariate logistic regression analysis was performed to identify the risk factors that are significantly related to PONV. The objective variables were classified into three categories: no PONV, early PONV (initial onset time: 0–2 h after anesthesia), and late PONV (initial onset time: 2–24 h after anesthesia). The explanatory variables included relevant risk factors for PONV, as considered in previous studies. Results: Total intravenous anesthesia with propofol was a significant depressant factor for early PONV (adjusted odds ratio [aOR] = 0.340, 95% confidence interval [CI] = 0.209–0.555) and late PONV (aOR = 0.535, 95% CI = 0.352–0.814). The administration of a combination of intraoperative antiemetics (vs. no administration) significantly reduced the risk of early PONV (aOR = 0.464, 95% CI = 0.230–0.961). Female sex and young age were significant risk factors for late PONV (aOR = 1.492, 95% CI = 1.170–1.925 and unit aOR = 1.033, 95% CI = 1.010–1.057, respectively). Conclusion We identified factors that are significantly related to PONV based on the initial onset time after orthognathic surgery. Total intravenous anesthesia with propofol significantly reduced the risk of PONV not only in the early period (0–2 h after anesthesia) but also in the late period (2–24 h after anesthesia).

A sixteen-year-old girl with neuropsychological dysfunction after cerebral encephalopathy came to our hospital for evaluation of her cognitive impairment and ability to acquire compensatory skills for communicative dysfunction. Neuropsychological examinations revealed low scores on FSIQ, VCI, WMI and PSI by WISC-Ⅳ. We intervened using a process-orientated speech-language-hearing therapy to improve her cognitive, language and communicative skills for a year. After that, we evaluated her cognitive ability by WISC-Ⅳ and LCSA. As a result of our intervention, her word knowledge, idiom and mental expression, sentence expression and reading social condition and expression scores in LCSA performance were improved but each IQ by WISC-Ⅳ was preserved. In ST intervention for pediatric neuropsychological dysfunction, the patient evaluation should be made not only using IQ by WISC-IV but also by measuring other communicative skills such as by LCSA.

We performed a prospective study to determine whether the walking pattern of children with flatfoot can be influenced by using shoes and custom-modeled insoles. One hundred and thirty-two children (mean age ; 4.20±2.53) who had been referred by a physiatrist, and who were diagnosed with flatfoot at the brace clinic in our institute, were assigned to three groups : The first group was asked to walk barefoot, the second one to walk with shoes without insoles and the last one to walk with shoes with insoles. We measured walking speed, cadence, step length, step width, the duration of right and left stance phases, both double-limb stance phases, both swing phases, walking angle, and toe angle using a 2.4 m sheet-type Gait Analyzer, the Walk Way MW-1000 ^TM, at the individual's self-selected speed. Compared with the barefoot group, a significant increase was observed in the group using shoes with custom-modeled insoles in both walking speed and step length on both sides, and there were reductions in swing phase and walking angle on both sides (paired t-test ; p<0.002).

Objectives : In Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), full scale intelligence quotient (FSIQ) and the index scores are thought to be solely important and supplemental subtests are not taken into account in the score.However, in assessment by intelligent tests it is required that we analyze the result from many directions. Accordingly, the factor of “Cancellation” was taken up and the importance of adding a focus on the qualitative side of the test results was examined. Methods : Some 412 children who received WISC-IV in our developmental evaluation center were divided into three groups according to their intellectual level, and of these, 30 persons were assigned to each group [total of 90] selected at random to comprise the sample. By comparing the index scores and the scaled scores for each group,we have classified the procedures of deletion into six types. Results : The more the intellectual level increases, the lower the “Cancellation” scaled score becomes compared to the other subtests. Further, the scaled score was lower in the type of deletion procedure such as systematic linear strategy. Conclusion : In the high intellect level group, the scaled “Cancellation” score was lower than the other subtests, it was thought to be because there were many “order type” subjects using a systematic linear strategy. It was also considered that attention to the qualitative aspects as well as quantitative is important in “Cancellation”. Therefore, when assessing high intellect children with developmental disabilities in the future, a clinical examination that incorporates “Cancellation” to detect executive function disabilities such as persistence or poor planning ability is desirable.

We report a rare case of spontaneous thrombosis of a ruptured deep femoral artery aneurysm. An 85-year-old man presented two days after onset of acute swelling and pain in the left groin. Computed tomography demonstrated rupture of a deep femoral artery aneurysm and thrombosis of the aneurysm. After 1 month of observation, surgical intervention was performed as the local pain persisted. Opening of the aneurysm sac confirmed that thrombosis was complete. Simple ligation and drainage of the aneurysmal sac was performed. His postoperative course was uneventful.