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Background The goal of reconstruction is to provide coverage of exposed vital structures with well-vascularized tissue for optimal restoration of form and function. Here, we present our clinical experience with the use of the scapular fascial free flap to correct facial asymmetry and to reconstruct soft tissue defects of the extremities. Methods We used a scapular fascial free flap in 12 cases for soft tissue coverage of the extremities or facial soft tissue augmentation. Results The flaps ranged in size from 3x 12 to 13x 23 cm. No cases of total loss of the flap occurred. Partial loss of the flap occurred in 1 patient, who was treated with a turnover flap using the adjacent scapular fascial flap and a skin graft. Partial loss of the skin graft occurred in 4 patients due to infection or hematoma beneath the graft, and these patients underwent another skin graft. Four cases of seroma at the donor site occurred, and these cases were treated with conservative management or capsulectomy and quilting sutures. Conclusions The scapular fascial free flap has many advantages, including a durable surface for restoration of form and contours, a large size with a constant pedicle, adequate surface for tendon gliding, and minimal donor-site scarring. We conclude that despite the occurrence of a small number of complications, the scapular fascial free flap should be considered to be a viable option for soft tissue coverage of the extremities and facial soft tissue augmentation. [ABSTRACT FROM AUTHOR]

Backgrounds: House-dust mites are the main cause of allergic rhinitis in Asia, for which immunotherapy (SLIT) is a currently accepted treatment. However, few studies have evaluated the efficiency of SLIT on Asian children with allergic rhinitis for a period longer than one year. The aim of this study was to investigate the efficacy and safety of SLIT for Asian children with allergic rhinitis due to house-dust mites over a 2-year period. Materials and Method: This study included 65 patients who had allergic rhinitis due to Dermatophagoides pteronyssinus and Dermatophagoides farinae. All patients were treated with SLIT (StaloralⓇ). Symptom scores and quality of life were evaluated by using questionnaires over two years. The medication score was assessed monthly by a diary medication card and serologic tests were evaluated before and two years after the start of treatment. Adverse effects and dropout rates were also investigated. Results: All nasal and non-nasal symptoms and quality of life were significantly improved after two years of treatment. Furthermore, the total medication score decreased significantly and the serologic tests showed a significant change two years after the start of SLIT. Although minor adverse effects were reported, no systemic reactions were observed. The dropout rate was 40%. Conclusion: SLIT is an efficient and safe therapeutic tool for a period of two years in Asian children with allergic rhinitis to house-dust mites. [ABSTRACT FROM AUTHOR]

Objectives: We compared the results of nasal sound spectral analysis (NSSA) with the results of peak nasal inspiratory flow (PNIF) testing and use of a visual analog scale in patients with allergic rhinitis with nasal obstruction. Methods: We performed NSSA and PNIF testing on 38 patients with allergic rhinitis and 35 healthy subjects. A diagnostic decongestion test was performed on the patients (not on the control subjects). Twenty minutes after decongestant was sprayed into the nostrils, NSSA and PNIF testing were performed again. Results: There was a significant difference in the PNIF values and the nasal inspiratory sound intensities before and after decongestion (p < 0.001 ). There was a correlation between the NSSA results at the frequency range of 2 to 4 kHz and the PNIF results. The calculated cutoffs between normal and pathological values were 14.8 dB (2 to 4 kHz) for NSSA and 116 ± 14.1 L/min for PNIF testing. No significant differences were computed between NSSA and PNIF testing in terms of sensitivity (0.71 versus 0.76) or specificity (0.74 versus 0.80). Conclusions: Use of NSSA and PNIF testing together for assessment of nasal obstruction in allergic rhinitis provides clinical relevance in that it allows a fair degree of reliability. Such testing can be performed as a surrogate for rhinoma- nometry. [ABSTRACT FROM AUTHOR]

Objectives: We compared the results of nasal sound spectral analysis (NSSA) with the results of peak nasal inspiratory flow (PNIF) testing and use of a visual analog scale in patients with allergic rhinitis with nasal obstruction. Methods: We performed NSSA and PNIF testing on 38 patients with allergic rhinitis and 35 healthy subjects. A diagnostic decongestion test was performed on the patients (not on the control subjects). Twenty minutes after decongestant was sprayed into the nostrils, NSSA and PNIF testing were performed again. Results: There was a significant difference in the PNIF values and the nasal inspiratory sound intensities before and after decongestion (p < 0.001 ). There was a correlation between the NSSA results at the frequency range of 2 to 4 kHz and the PNIF results. The calculated cutoffs between normal and pathological values were 14.8 dB (2 to 4 kHz) for NSSA and 116 ± 14.1 L/min for PNIF testing. No significant differences were computed between NSSA and PNIF testing in terms of sensitivity (0.71 versus 0.76) or specificity (0.74 versus 0.80). Conclusions: Use of NSSA and PNIF testing together for assessment of nasal obstruction in allergic rhinitis provides clinical relevance in that it allows a fair degree of reliability. Such testing can be performed as a surrogate for rhinoma- nometry. [ABSTRACT FROM AUTHOR]

AbstractA new system for nasal sound analysis via Internet to cellular phone was investigated. Spectral analysis of the nasal sound with frequency domain and dB is an important factor in the investigation of nasal airflow pattern. This study included 10 patients and 10 healthy subjects. Patients underwent nasal septoplasty surgery for treatment of nasal septal deviation. This nasal sound analysis was performed on subjects at 1 month postsurgery. This study was performed using an investigator-developed software that sends real-time frequency and spectral analysis video of a patient's nasal sound to an otolaryngologist's cellular phone. Sound intensity was observed at over 25 dB with high range of frequency (2–4 kHz) and less than 10 dB with low (500–1,000 Hz) and medium (1–2 kHz) frequency from 10 patients with nasal obstruction symptoms (group A). In 10 healthy subjects without nasal obstruction symptoms (group B), sound intensity was observed at high frequencies below 5 dB; however, low and medium frequencies were above 15 dB. A statistically significant difference in sound intensity was observed between group A and group B. It was ascertained that use of the new technique will help patients to avoid an unnecessary return to the hospital and will also save money and time. [ABSTRACT FROM AUTHOR]

Dysfunctional emotional processing affects social functioning in patients with schizophrenia. However, the relationship between emotional perception and response in social interaction has not been elucidated. Twenty-seven patients with schizophrenia and 27 normal controls performed a virtual reality social encounter task in which they introduced themselves to avatars expressing happy, neutral, or angry emotions while verbal response duration and onset time were measured and perception of emotional valence and arousal, and state anxiety were rated afterwards. Self-reported trait-affective scale scores and the Positive and Negative Syndrome Scale (PANSS) ratings were also obtained. Patient group significantly underestimated the valence and arousal of angry emotions expressed by an avatar. While valence and arousal ratings of happy avatars were comparable between groups, patient group reported significantly higher state anxiety in response to happy avatars. State anxiety ratings significantly decreased from encounters with neutral to happy avatars in normal controls while no significant decrease was observed in the patient group. The Social Anhedonia Scale and PANSS negative symptom subscale scores (blunted affect, emotional withdrawal, and passive/ apathetic social withdrawal items) were significantly correlated with state anxiety ratings of the encounters with happy avatars. These results suggest that patients with schizophrenia have interference with the experience of pleasure in social interactions which may be associated with negative symptoms. [ABSTRACT FROM AUTHOR]

Objectives The multimodal telepresence systems have been adopted in a variety of applications, such as telemedicine, space or underwater teleoperation and videoconference. Multimedia, one of the telepresence systems, has been used in various fields including entertainment, education and communication. The degree of subjective telepresence is defined as the probability that a person perceives to be physically in the remote place when he/she experiences a multisensory feedback from the multimedia. The current study aimed to explore the neural mechanism of telepresence related to multisensory feedback in patients with schizophrenia. Methods Brain activity was measured using functional magnetic resonance imaging while fifteen healthy controls and fifteen patients with schizophrenia were experiencing filmed referential conversation at various distances (1 m, 5 m and 10 m). Correlations between the image contrast values and the telepresence scores were analyzed. Results Subjective telepresence was not significantly different between the two groups. Some significant correlations of brain activities with the telepresence scores were found in the left postcentral gyrus, bilateral inferior frontal gyri, right fusiform gyrus, and left superior temporal sulcus. There were no main effects of group and distance. Conclusion These results suggest that patients with schizophrenia experience telepresence as appropriately as healthy people do when exposed to multimedia. Therefore, patients with schizophrenia would have no difficulty in immersing themselves in multimedia which may be used in clinical training therapies. [ABSTRACT FROM AUTHOR]

Background and Objectives: To review our experience with lacrimal sac tumors in an effort to identify features, to evaluate the results of various methods of management and to compare our data with previous studies. Methods: We reviewed the medical records of all patients with lacrimal sac tumors who were managed in our institution between January 1990 and December 2015. The pre-operative clinical data, imaging, operation notes and follow-up records were reviewed for each patient. Results: The study group consisted of four men and six women with a mean age of 47.6 years. Most patients experienced long-standing epiphora, for a mean period of 20 months. Two of the tumors were benign and eight of them were malignant. The benign tumors were treated with dacryocystectomy. All but one malignant tumor were treated with medial or total maxillectomy. Adjuvant radiotherapy was administered to four patients with malignant tumors. In the eight patients with malignant tumors, the mean follow-up period was 65 months. Conclusions: Important characteristics of lacrimal sac tumors include dacryocystitis, epiphora and in some cases, a palpable medial canthal area mass. Wide en bloc resection via medial or total maxillectomy and/or postoperative radiotherapy are proper treatments for malignant lesions of the lacrimal sac. [ABSTRACT FROM AUTHOR]

Orbital complications after endoscopic sinus surgery (ESS), such as optic nerve or medial rectus injuries, are well known, but isolated complete oculomotor nerve palsy has never been reported. In this case, a 31-year-old male was transferred to our hospital after ESS. Physical examination showed complete left oculomotor nerve palsy, with a bony defect on the sellar foor, which had not fully recovered after more than 1 year. We hypothesized that blunt trauma could be the main cause of the oculomotor palsy. Surgeons performing ESS must keep in mind the possibility of oculomotor palsy due to blunt trauma, especially when operating around the sphenoid and posterior ethmoid sinus. [ABSTRACT FROM AUTHOR]

Decision making in an emotionally conflicting situation is important in social life. We aimed to address the similarity and disparity of neural correlates involved in processing ambivalent stimuli in patients with schizophrenia and patients with depression. Behavioral task-related hemodynamic responses were measured using [15O]H2O positron emission tomography (PET) in 12 patients with schizophrenia and 12 patients with depression. The task was a modified word-stem completion task, which was designed to evoke ambivalence in forced and non-forced choice conditions. The prefrontal cortex and the cerebellum were found to show increased activity in the healthy control group. In the schizophrenia group, activity in these two regions was negligible. In the depression group, the pattern of activity was altered and a functional compensatory recruitment of the inferior parietal regions was suggested. The prefrontal cortex seems to be associated with the cognitive control to resolve the conflict toward the ambivalent stimuli, whereas the cerebellum reflects the sustained working memory to search for compromise alternatives. The deficit of cerebellar activation in the schizophrenia group might underlie the inability to search and consider compromising responses for conflict resolution. [ABSTRACT FROM AUTHOR]