The active von Frey filament test: A new technique to evaluate hand tactile sensation in continuous variable units.

The von Frey filament test (vF) is a mainstay of clinical examination. However, its results can be affected by touch speed and other potentially confounding factors. Moreover, the differences between two adjacent filament levels are too large to detect subtle changes. Active vF (AvF) was developed to induce in-depth sensory change. The present study hypothesized that AvF produces different patterns of fingertip sensation; consequently, it could be used as a new assessment tool for neural impairment. The aim of the study was to provide preliminary normative comparative vF and AvF data. This study prospectively examined 32 healthy participants, using AvF and vF. The index and the fifth finger volar pad were examined using AvF and vF, without visual stimulation. The correlation between AvF and vF measurements was evaluated. In addition, differences according to innervation zone, right versus left hand, and gender, and the correlation between AvF values and subjects' age were analyzed. Mean AvF value was significantly higher and had greater variance than vF (111.3 ± 46.9 vs. 24.1 ± 9.8; P < 0.01). The Spearman correlation coefficient between AvF and vF was 0.341. Values were similar in the index and fifth fingers and right and left hands. However, values were significantly different between women and men. The correlation between age and AvF values was 0.259. AvF provided more precise values, with continuous units for tactile sensation, excluding tester-dependent factors. Furthermore, AvF and vF values may not be correlated.

Analysis of the Change Patterns of Sagittal Alignment Values After Selective Thoracic Fusion in Lenke 1 Adolescent Idiopathic Scoliosis According to Preoperative Thoracic Kyphosis Status.

STUDY DESIGN: This was a retrospective study. OBJECTIVE: The objective of this study was to demonstrate the different change patterns in reciprocal sagittal alignment values after selective thoracic fusion (STF) in Lenke type 1 adolescent idiopathic scoliosis (AIS) according to preoperative thoracic kyphosis (TK). SUMMARY OF BACKGROUND DATA: Several studies have found significant increase in TK after STF, while other studies have reported decrease in TK postoperatively. Similar inconclusive results on changes in lumbar lordosis (LL) have been reported, showing LL increase, decrease, or no change. MATERIALS AND METHODS: Ninety-three patients presenting with Lenke type 1 AIS treated by posterior STF with a minimum follow-up of 2 years were included in this study. Using whole spine radiographs, sagittal parameters including TK, LL, and upper lumbar lordosis (ULL) were compared preoperatively and at the last follow-up between a hypokyphosis group (preoperative TK<20 degrees) and a normokyphosis group (preoperative TK≥20 degrees). Health-related quality of life (HRQOL) was assessed using scoliosis research society health-related quality of life-30 (SRS-30) and short from health survey-36 questionnaire at the last visit. RESULTS: The mean follow-up duration was 74.9 months. In the hypokyphosis group (35 patients), TK, LL, and ULL statistically significantly increased after surgery by mean 7.7, 5.1, and 3.7 degrees (P<0.001, <0.001, and 0.001). In the normokyphosis group (58 patients), these parameters did not show significant changes after STF. Final TK was significantly lower in hypokyphosis group than that in the normokyphosis group (21.2 vs. 30.9 degrees, P<0.001) while final LL did not differ between 2 groups (52.4 vs. 54.6 degrees, P=0.194). HRQOL did not differ significantly between the 2 groups. CONCLUSIONS: After STF in Lenke 1 AIS, TK, and LL statistically significantly increased through an increase in the mean ULL in the hypokyphosis group while those mean values did not change in the normokyphosis group. Despite the final mean value of the TK in the hypokyphosis group increasing by 7.7 degrees, it was statistically significantly lower than the final mean TK value in the normokyphosis group which did not increase after STF surgery by posterior approach. However, HRQOL showed no significant difference between the 2 groups.

High Temperature Deformation Characteristics of Al-Zn-Mg Alloy Modified with CaO-Added Mg.

Hot torsion tests were performed on an Al-Zn-Mg alloy modified with CaO-added Mg to investigate the effects of the Mg additive on the high temperature deformation characteristics. Effective stress- strain curves and processing maps were established from the experimental results under a range of deformation conditions. The fracture strain of the CaO-added Al-Zn-Mg alloy was higher than that of the Al-Zn-Mg alloy. The CaO-added Al-Zn-Mg alloy did not show an instability region in the processing map but the commercial Al-Zn-Mg alloy exhibited adiabatic shear bands at low temperatures and at a high strain rate. The results shown in this study were attributed to the reduction of the second phase by the addition of CaO-added Mg.

Evaluation of the Hot Workability of Commercially Pure Ti Using Hot Torsion Tests.

Optimum processing conditions were obtained by evaluating the hot working behavior of commercially pure Ti using hot torsion tests. Hot torsion tests were conducted at temperatures ranging from 800 °C-1000 °C and strain rates ranging from 0.1-10 s-1. The flow curves show that the peak stress increases as the temperature decreases and the strain rate increases. The optimum processing conditions were derived by comparing the processing and activation energy maps. The microstructure was characterized based on various regions of the processing map. The activation energy for plastic deformation was obtained using the constitutive equation. The activation energy differs depending on the constituent phases.

A case of pemphigus vulgaris associated with ulcerative colitis.

Pemphigus vulgaris is an autoimmune bullous disorder characterized by the production of autoantibodies against the intercellular space of the epithelium. It has rarely been reported in association with inflammatory bowel disease. Ulcerative colitis is one of the forms of inflammatory bowel disease. A 62-year-old woman who had been treated for ulcerative colitis for 16 years developed pruritic bullae on the skin of her face and body. Histological findings and direct immunofluorescence examination of the skin showed pemphigus vulgaris. She was treated with systemic steroids, mesalazine, and azathioprine. Her cutaneous lesions have remained in remission and her ulcerative colitis has remained well-controlled. The relationship between pemphigus vulgaris and ulcerative colitis is unclear. An autoimmune response has been suspected in the pathogenesis of ulcerative colitis. Pemphigus vulgaris is also associated with an autoimmune mechanism. To our knowledge, this is the first case of ulcerative colitis associated with pemphigus vulgaris reported in Korea. The association may be causal.

Effect of the Spray Distance on the Properties of High Velocity Oxygen-Fuel (HVOF) Sprayed WC-12Co Coatings.

In this study influence of spray distance on the properties of WC-12Co coatings deposited by HVOF was investigated. WC-12Co coating was sprayed at spray distance of 300, 385 and 450 mm. From microstructure observation, it is confirmed that the porosity of coatings increases with increasing the spray distance. The X-ray diffraction patterns indicate that the coatings consist of pure WC, W, and Co as well as W2C and Co6W6C phases. The increase of the spray distance accelerated the decarburization of coatings. From micro hardness tests, it was found that the hardness and the fracture toughness decreased with increasing spray distance. These mechanical properties would be related with not only porosity but also the degree of decarburization.

Hot Deformation Behavior of Hot-Extruded AA7175 Through Hot Torsion Tests.

The hot deformation behavior of hot-extruded AA7175 was investigated with flow curves and processing maps through hot torsion tests. The flow curves and the deformed microstructures revealed that dynamic recrystallization (DRX) occurred in the hot-extruded AA7175 during hot working. The failure strain was highest at medium temperature. This was mainly influenced by the dynamic precipitation of fine rod-shaped MgZn2. The processing map determined the optimal deformation condition for the alloy during hot working.

Effect of Zn on Pore Characteristics in Lotus-Type Porous Cu.

The effect of Zn on pore characteristics in lotus-type porous Cu alloy was investigated. The lotustype porous Cu-Zn alloys were fabricated with Zn content from 0.01 to 0.1 at% by the centrifugal casting method. The results demonstrated that the porosity was rarely affected by Zn content. However, the average pore diameter and pore number density of the lotus type porous Cu-Zn alloys were significantly affected by the Zn content. The average pore diameter decreased as the Zn content increased up to 0.01 at%, and then increased as the Zn content increased up to 0.1 at%. In contrast, the variations in the pore number density of the lotus-type porous Cu-Zn alloys showed the reversed tendency with respect to that of the average pore diameter. The increase in heterogeneous nucleation sites for pores attributed to the decreased average pore diameter and the increased pore number density.

Pore Characteristics of Lotus-Type Porous Cu-Fe and Cu-Cr Alloys Fabricated by Unidirectional Solidification.

Lotus-type porous Cu-Fe and Cu-Cr with long cylindrical pores was fabricated by centrifugal casting under hydrogen atmosphere and the effect of alloying elements on pore characteristics of lotus-type porous Cu was investigated. For the lotus type porous Cu-Fe alloy, the porosity slightly decreased and the average pore diameter slightly increased with increasing Fe content. For the lotus-type porous Cu-Cr alloy, the porosity sharply decreased and the average pore diameter drastically increased with an increase in the Cr content. From these results, it was found that the pore evolution and growth are affected by alloying element and this leads to the change in the pore characteristics of lotus-type porous Cu-Fe and Cu-Cr alloys.

Peripheral facial nerve palsy after therapeutic endoscopy.

Peripheral facial nerve palsy (FNP) is a mononeuropathy that affects the peripheral part of the facial nerve. Primary causes of peripheral FNP remain largely unknown, but detectable causes include systemic infections (viral and others), trauma, ischemia, tumor, and extrinsic compression. Peripheral FNP in relation to extrinsic compression has rarely been described in case reports. Here, we report a case of a 71-year-old man who was diagnosed with peripheral FNP following endoscopic submucosal dissection. This case is the first report of the development of peripheral FNP in a patient undergoing therapeutic endoscopy. We emphasize the fact that physicians should be attentive to the development of peripheral FNP following therapeutic endoscopy.

Double primary hepatic cancer (sarcomatoid carcinoma and hepatocellular carcinoma): A case report.

Primary liver sarcomatoid carcinoma (SC) is a rare and aggressive tumor exhibiting rapid growth and a high recurrence rate following resection. To date, there have been no reports of primary liver SC occurring simultaneously with hepatocellular carcinoma (HCC). This is the case report of a 54-year-old man with liver cirrhosis due to hepatitis B virus (HBV) infection and alcoholic hepatitis. The abdominal computed tomography and magnetic resonance imaging revealed two distinct hepatic masses in a background of hepatic cirrhosis and esophageal varices. Following a clinical diagnosis of two HCCs, a right hepatic lobectomy was performed. Grossly, two distinct lesions were identified: the larger mass was gray to white and well-demarcated, sized 2.5×2.0 cm, located in S5-6, whereas the other was a gray to whitish nodule, sized 1.3×1.0 cm, located in S8. The microscopic analysis revealed that the larger mass was a primary liver SC, which was immunoreactive for cytokeratin (CK) and vimentin (VMT) and negative for hepatocyte-specific antigen (HSA). The other nodule was histologically diagnosed as HCC, which was positive for HSA and CK and negative for HSA, VMT, CK7 and CK19. There was no transition or intermingling lesion between the two tumors. To the best of our knowledge, this is the first case report of double primary liver cancer comprising an SC and a HCC.

Scrub typhus and cerebrovascular injury: a phenomenon of delayed treatment?

Abstract. Three patients diagnosed with scrub typhus through serology and polymerase chain reaction tests, experienced delayed administration of effective antibiotics after the appearance of symptoms, presented with subdural hemorrhage, intracerebral hemorrhage, or cerebral infarction in the late acute phase. Orientia tsutsugamushi should be considered as a causal or provoking factor for cerebrovascular accidents in regions where scrub typhus is endemic, especially in those who receive delayed treatment.