Leisure Time Use, Meaning of Life, and Psychological Distress: Comparing Canadian and Korean Older Adults

Older adults’ day-to-day leisure time activities both reflect and stimulate physical, cognitive, and social capacities that contribute to their quality of life. To better understand how leisure activity choices and possible impacts vary across two cultures, this questionnaire-based study compared leisure time use, perceived meaning of life, and psychological distress for 617 older adults in Canada (n=298) and the Republic of Korea (Korea) (n=319). Compared to Koreans, Canadian respondents spent more time overall in leisure activities and devoted a higher percentage of their total leisure time to active, rather than passive, activities. They spent significantly more of their time on cognitively active activities, while Koreans preferred socially and physically active ones and scored significantly higher on both meaning of life and psychological distress. Both groups spent more of their time watching television than on any other single reported activity. Age group, retirement status, health, education, and income varied across the two countries and were significantly associated with aspects of leisure time use for each group. The results identify areas for improvement if Canadian and Korean older adults’ leisure time use is to effectively support their aging well

Aberrant Perfusion of the Serratus Anterior Muscle Flap: Report of Two Cases and a Review of the Literature

Free serratus anterior muscle flap, classified as Mathes-Nahai type III, is a versatile and frequently preferred choice for soft tissue coverage of small to moderate-sized defects owing to its reliable circulation pattern; however, some anatomic variations in the flap vascularity can result in partial flap loss. Here we present two cases with free serratus anterior muscle transfer where the distalmost portion of the flap was not perfused by the thoracodorsal pedicle. The most likely explanation seems to be the large flap size and the lack of distal interconnections between lateral thoracic artery and thoracodorsal artery branches. Our clinical experience suggests that anatomic variations of serratus anterior muscle circulation might end up with distal perfusion loss if a large flap is to be harvested

A new classification system and an algorithm for the reconstruction of nasal defects

A new, comprehensive system for scoring and classification of nasal defects is proposed in this article. The soft tissue coverage of the nose is in continuity with the cheeks, glabella and upper tip and the osteocartitaginous infrastructure is in continuity with the two nasofrontat buttresses, the frontal bar and the palate. Soft tissues and the skeletal framework are divided into sub-units and these anatomic features are schematized on a logo. The sub-units are graded on the logo, depending on their gravity in reconstructive strategies. Any given nasal defect is described by shading the involved sub-units on the Logo and the sum of the points appended each sub-unit gives the total score of defect. The severity of the tissue toss is assessed according to a Classification System which is derived from this scoring system. Nasal defects are classified into one of four main Types corresponding to their scores. One hundred twenty seven patients who were operated on for various nasal. pathologies have been reviewed and nasal defects are scored and classified according to the proposed system. Application of this system to the spectrum of cases encountered in a 6 years period shows that it is based on anatomic grounds, easy to document and efficient transmission of objective information becomes possible. It also offers a useful algorithm to approach the reconstruction of nasal defects. (c) 2006 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved

STERNOCLEIDOMASTOID REGION RESTORATION WITH LATERAL HEMISOLEUS MUSCLE INCORPORATIED IN FREE FIBULAR FLAP FOR RECONSTRUCTION OF RADICAL NECK DISSECTION AND HEMIMANDIBULECTOMY

In the treatment of head and neck carcinoma, radical cervical lymphadenectomy leaves the affected side of the neck devoid of the sternocleidomastoid muscle, thus more vulnerable to the unwanted side effects of the adjuvant radiotherapy. It also causes asymmetry and cosmetically unpleasant appearance of the cervical region. In the reported case with widely ulcerated squamous-cell carcinoma over mandible, hemimandibulectomy and radical neck dissection was performed. Following the mandibular reconstruction, the lateral hemisoleus muscle of the harvested osteomyocutaneous fibula flap was utilized to restore the ipsilateral sternocleidomastoid region. This new application promises to be a useful method, which can aid in the restoration of the aesthetic contour of the neck and provide protection against unwanted effects of the adjuvant radiotherapy on the ipsilateral carotid artery. (C) 2011 Wiley-Liss, Inc. Microsurgery 31:401-403, 2011

Outcome After Breast Reduction Considering Body Mass Index and Resection Amount

Background: It is presumed that breast reduction improves patients' quality of life and promotes weight loss. Preoperative body mass index (BMI) and the amount of breast tissue (breast reduction amount [BRA]) in proportion to the patient's body weight are important variables to affect the breast reduction outcome. Objective: This study was designed to evaluate the short and long-term effects of breast reduction from the perspective of BMI and BRA. Methods: One hundred fifty-seven consecutive patients were invited to participate in the study. All clinical information was recorded on a breast surgery form. Patients completed a standardized questionnaire preoperatively, at postoperative year 1, and after postoperative year 5. Patients were grouped according to their BMI as normal weight and overweight and according to BRA as minor/moderate reductions and major reductions. The differences in the BMI values and the life scores were compared between the BMI and BRA groups. Results: Sixty-four patients were included in the study. Postoperative year 1 BMIs were significantly lower than both the preoperative BMIs and postoperative year 5+ BMIs. The year 1 BMI decrease in the major reduction group was higher than the decrease in the minor/moderate reduction group. The postoperative life scores of all subgroups were better than the preoperative life scores. Conclusions: Reduction mammaplasty has a significant effect on short-term weight loss and the improvement in lifestyle. Patients tend to return to their original body weight in the long term. BRA is a significant variable in short-term weight loss, but neither BMI nor BRA has any other significant effect on the outcome in any time section