• Clinical and Experimental Pediatrics
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• v.51 no.12
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• pp.1342-1345
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• 2008

Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is a rare white matter disorder, first described in the early 1990s. The brain in patients with MLC appears swollen on MRI, with diffuse white matter abnormalities; in addition, there is an invariable presence of subcortical cysts, primarily in the anterior temporal region sparing the deep white matter, basal ganglia, thalami, and cerebellum. Patients with MLC present with macrocephaly and neurological abnormalities such as motor deterioration, ataxia, spasticity, and cognitive deficits. We report a twenty-month-old boy who presented with seizures and macrocephaly, delay in development, and abnormal brain MRI findings compatible with the diagnosis of MLC. The brain MRI revealed bilateral hypersignal intense subcortical white matter regions in the frontal, temporal, and parietal lobes on T2-weighted images, which were not yet associated with cystic changes. During follow-up, the frequency of seizures decreased after anticonvulsant medication was started, but the head circumference remained above the 97th percentile, and the patient continued to have developmental delay.

• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.201-206
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• 2011

Purpose: Subtalar distraction arthrodesis is useful treatment option for restore hindfoot alignment. but, using structural autograft have high risk of donor site morbidity. Recently, by replacing the structural allograft has been reported satisfactory clinical results. Therefore, the authors reviewed the results of subtalar distraction arthrodesis using a structural allograft, retrospectively. Materials and Methods: From January 2008 to May 2010, 12 patients (12 feets; 9 male, 3 female) underwent subtalar distraction arthrodesis using frozen structural allograft. 9 cases were calcaneal malunion, 2 were nonunion or malunion after subtalar arthrodesis, 1 was other cause. Mean age was 38.9 (12~66) years old and follow up period was 16.5 (12~36) months. Surgical was performed with posterolateral approach and tricortical allobone block of frozen femoral neck was used. Analysis was done with retorspective manner to evaluate preoperative, postoperative, and final follow up radiologic measurement and AOFAS ankle-hindfoot scale. Results: There was statistically significant increase (p<0.05) of ankle-hindfoot scale from preoperative 27.5 points to postoperative 72.5 points, talocalcaneal height by 6.62 mm, calcaneal pitch angle by 5.73 degrees, lateral talocalcaneal angle by 6.38 degrees and significant decrease (p<0.05) of tali-1st metatarsal angle by 5.23 degrees. 11 feet (91.7%) acquired bony union and it takes average 5.1 months. Final post-operative result revealed talocalcaneal height changed by 2.57 mm, calcaneal pitch anble, lateral talocalcaneal angle, talar-1st metatarsal angle were changed by 2.63 degrees, 1.62 degrees, 1.18 degrees, respectively (p<0.05). 3 cases of partial osteonecrosis of posterior facet of calcaneus were observed in operation field, 4 cases of complication were developed (1 case of nonunion, 1 collapse of allobone graft, 1 screw loosening, 1 superficial skin necrosis). Conclusion: Subtalar distraction arthrodesis using frozen structural allobone graft is useful alternative treatment method of arthrodesis with structural autobone graft.

• Journal of Korean Foot and Ankle Society
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• v.20 no.3
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• pp.126-130
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• 2016

Purpose: The aim of this study was to evaluate the result of extraarticular dorsal closing wedge osteotomy in Freiberg's disease. Materials and Methods: Between February 2012 and July 2014, total 10 patients who underwent dorsal closing wedge osteotomy and followed up more than 1 year were selected for inclusion. Average age was 16.3 years, and average follow-up period was 15.5 months. The diagnosis was made using magnetic resonance imaging of those with a limitation in walking or usual activity due to pain in the metatarsal head. During operation, we removed loose body, and synovectomy was done. Osteotomy at the metatarsal neck and fixation with Kirschner wire were performed. X-ray was taken to check shortening of 2nd metatarsal and bone union. Moreover, we checked the active range of motion of 2nd metatarsophalangeal joint before and after surgery. At the last follow-up, the shortening of metatarsal, American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS), and patient's subjective satisfaction were evaluated. Results: According to the Smillie's stage, there were 3 cases of stage II, 4 cases of stage III, and 3 cases of stage IV. Average bone union time on the osteotomy site was 8 weeks. Average shortening of metatarsal was 2.53 mm. Average AOFAS score improved significantly from 56.9 to 82.8 points at final follow-up (p<0.05), and average VAS score also improved significantly from 6.4 to 1.4 points at final follow-up (p<0.05). Average active range of motion at metatarsophalangeal joint improved from $28.0^{\circ}$ preoperatively to $46.5^{\circ}$ at the final follow-up. Other complications, such as metatarsalgia and arthritis, were not found; however, there was 1 case of delayed union with no symptom. Conclusion: In Freiberg's disease, dorsal closing wedge osteotomy is recommended for the improvement of clinical symptoms and range of motion.

• Journal of Korean Foot and Ankle Society
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• v.23 no.3
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• pp.105-109
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• 2019

Purpose: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. Materials and Methods: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. Results: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. Conclusion: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.

• Clinical and Experimental Pediatrics
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• v.50 no.4
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• pp.348-354
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• 2007

Purpose : Perinatal hepatitis B viral infection is decreasing; however, 10% of babies to HBeAg positive mothers still become chronic carriers despite perinatal prophylaxis. Although, the cause of prophylaxis failure is still unclear, an importance of maternal HBV-DNA level at the delivery time has been suggested. This study was established to certify if it would be a useful predictable factor for the outcome of perinatal prophylaxis. Methods : Twenty-nine HBeAg positive mothers whose babies had known outcomes of prophylaxis were selected. To determine the amount of maternal HBV-DNA, a quantitative PCR was performed with the WHO International Standard for HBV DNA NAT assays. Results : The mean logarithm HBV-DNA level of mothers with failed outcomes was significantly higher than that of mothers with succeessful outcomes (7.99 vs. 6.72, P=0.015). The predictable maternal HBV-DNA cut-off level to prophylaxis outcome was $2.83{\times}10^7copies/mL$ (100 pg/mL). None out of the case 16 (0%) who had below this level, and 5 out of 13 (38.5%) who had above this level of maternal HBV-DNA failed in perinatal prophylaxis. Conclusion : Mothers with higher levels of HBV-DNA at delivery time would be prone to a worse outcome of prophylaxis using the conventional approach. Perinatal prophylaxis failure rate can be reduced, if we try to introduce more potent prophylactic treatment into the cases with this risk factor.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.2
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• pp.103-107
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• 2008

Purpose: This paper describes a electron field presence of magnetic field, intensity and shape surface dose variation to clinical application possibility. Materials and Methods: The using 6 MeV electron and $10{\times}10\;cm^2$ field size, 9 hole to shielding block make the by measure the film, when the magnetic field position inside and outside of the X-Omat film and parallel plate ionization chamber using the surface dose measured. Results: Present of 4 cm to the side at angle about 3 degree from beam center, use of ring type magnetic is 0.9% increase the surface dose, lens block located in the magnetic field the surface dose 1.58% increase, half magnetic field's position on the side of them at the field center of the 3.6% increase of the surface dose. Conclusion: Surface dose variation is with magnetic field about the mean electron beam of progress direction change, orbit region patient's is inconvenient without surface dose increase percentage case goodness will be used as a useful way.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.105-109
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• 2007

Purpose: The lateral epicondylitis is very common around elbow joint. We investigated the effectiveness of arthroscopic treatment. Materials and Methods: From Oct. 2002 to Feb. 2006, a total of 14 patients who were diagnosed with lateral epicondylitis and treated with arthroscopy were used in this study. The average symptom durations before receiving treatment was 27.3 months (9 to 47 months) and the average follow-up periods was 13.6 months (8 to 22 months). Results: The mean preoperative VAS scores was 8.3 (7 to 10 points) and the mean postoperative scores was 1.6 (0 to 4 points). The lesions of extensor carpi radialis brevis were classified using Baker's classification system. Type 1 lesion was found in 7 cases, type 2 in 4 cases, type 3 in 1 case Patients were able to return to their normal life style by 12.3 days (6 to 27 day). Conclusion: The Clinical outcomes of patients who received arthroscopic treatment were found to be good. Patients experienced lesser pain, and shorter recovery time. Therefore, when conservative treatment is ineffective in treating the lateral epicondylitis, arthroscopic treatment is considered af another option available for patients.

• Archives of Plastic Surgery
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• v.41 no.4
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• pp.387-393
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• 2014

Background Reconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores. Methods We retrospectively analyzed data from 14 patients (16 ischial sores) whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course. Results All flaps survived the entire follow-up period. Seven patients (50%) had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years). The mean follow-up period was 27.9 months (range, 3-57 months). In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%), wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%), but resolved with conservative treatment. Among 16 cases, there was only one (6%) recurrence at 34 months. Conclusions The combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2000.11a
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• pp.81-87
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• 2000

Beat-to-beat changes in heart period (heart period variability, HPV) are mediated by fluctuations in autonomic activity. Spectral analysis is used to quantify such fluctuations in the range of 0.15-0.40 Hz (high frequency, HF), which are influenced primarily by parasympathetic factors. These fluctuations are often referred to as RSA (respiratory sinus arrhythmia), the physiological phenomenon extracted by spectral analysis and other methods including histograms of heart rate ( HR), deviations of HR etc. Respiratory sinus arrhythmia indexing with peak-to-valley method suggested by Grossman et at., (1981) yields a simple range statistic and is quantified on breath-by-breath basis, thus being quite sensitive and less dependent on recording time as compared to spectral analysis. It is strongly recommended to use at least 1 min epoch to asses HF component of HPV and at least 2 min fer low frequency (LF) of HPV and even 5 min far valid clinical assessment. Peak-to-valley statistic is limited to RSA index only, but has its pragmatic advantages. Most important is possibility of its application far relatively small epoch analysis. We used short periods (20,30, 40 sec only) and off-line analysis of RSA using ECG and respiration curve this method of assessment and proved that this method is more practically effective. The RSA index was not so far dependent on respiration pattern differences and reflected actual vagal control of HR and were accompanied by low HR under some high stress conditions and in an aversive affective visual stimulation experiments. Another factor that might modulate cardiac chronotropic response is the interaction of sympathetic and parasympathetic inputs on sino-atrial (SA) node level, because responses to vagal influences are known to be proportional to ongoing sympathetic activity, that is so called accentuated antagonism. Since sympathetic outflow (increment of influences on SA) under negative emotions or stress was high in almost all physiological responses, vagal effects on HR could be therefore potentiated, leading to masking of output cardiac response seen in HPV, In the case of moderate sympathetic activation, on the other hand, autonomic interactions in cardiac control appear to be minimal. Thus RSA index appears to be an effective alternative method to assess and measure spectral HPV.

• Journal of Veterinary Clinics
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• v.23 no.2
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• pp.183-185
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• 2006

Four pigeons which lived together of same cage were referred due to excessive feather loss, severe itching, and erythema on the head, neck and flank regions. They had behavioral problem with feather bloating and plucking. Although they were mildly depressed, appetite was normal. On microscopic examination of feather picking, prominent external parasite infection was found. Mite infection was diagnosed with morphological confirmation. On analysis of complete blood count (CBC), eosinophilia was evident. The patients were treated with ivermectin (apply 200 mcg/kg topically two times per every other week and spray 200 mcg/ml solution every week). Clinical signs of four, pigeons were improved 45 days following first therapy. This case report indicates that mite infection is accompanied with severe feather loss, itching, and generalized erythema on the skin and behavioral problem with feather bloating and plucking. And this infection can be managed with topical and spray application of Ivermectin without injection.