Purpose: This study examined the difference in bone union time according to the fracture gap after minimally invasive plate osteosynthesis (MIPO) for simple distal femoral fractures in elderly patients. Materials and Methods: From January 2010 to December 2019, patients aged 60 years or older who underwent surgical treatment for distal femoral fractures due to a low-energy injury were investigated retrospectively. Forty patients were enrolled in the study. The patients were divided into two groups according to the fracture gap after reduction: no more than 2 mm (Group A) and more than 2 mm (Group B) in the anteroposterior and lateral plane. The demographic, operation time, presence or absence of cerclage wiring, plate screw density, plate span ratio, plate length, bone union period, non-union, and complications were evaluated. Results: No statistical differences in operation time, cerclage wiring, plate screw density, plate span ratio, and plate length were observed between the two groups, and the bone union was achieved in all patients without complication. The bone union period was 17.24±1.48 weeks in Group A and 24.53± 5.20 weeks in Group B, which was statistically significant (p<0.001). Conclusion The bone union time in treating geriatric simple distal femur fractures using the MIPO tech-nique was significantly shorter in the 2 mm or less fracture gap than in the greater than 2 mm group.

The purpose of this study was to identify factors that could be used as standardized criteria for evaluating occupational diseases in initial assessments or requests for examination. Using 100 administrative litigation cases on the work-relatedness of cerebrovascular diseases (CVDs) by the Seoul Branch of the Korea Labor Welfare Corporation (KLWC) from 1997 to 2002, we estimated the relationship between the investigated variables and designation of the work-relatedness of the CVD. As for the age, the odds ratio of the acceptance rate of a case as work-related in subjects over 60 yr of age was 0.08 (95% CI, 0.01-0.75), which was compared to subjects under 30 yr of age. Regarding working hours, the odds ratio of the acceptance rate of a case as work-related in CVDs in those over 56 hr was 9.50 (95% CI, 1.92-47.10) when compared to those less than 56 hr. As for the benefit type, the odds ratio of the acceptance rate of a case as work-related in medical benefits was 5.74 (95% CI, 1.29-25.54), compared to survivor benefits. As for the criteria for defining situations as work overload, the odds ratio of the acceptance rate of a case as work-related in injured workers was 12.06 (95% CI, 3.12-46.62), compared to that in non-injured workers. Our findings show that the criteria for defining situations of work overload played an important role in assessing the work-relatedness of CVDs in administrative litigation, and it is necessary to make the scientific evidence on judgement of workrelatedness on overwork.
Adult ; Cerebrovascular Disorders/*classification/*etiology ; Employment ; Female ; Humans ; Jurisprudence ; Male ; Middle Aged ; Occupational Diseases/*classification/*etiology ; Occupational Health ; Odds Ratio ; Regression Analysis ; Work Schedule Tolerance ; Workers' Compensation ; Workplace

OBJECTIVES: Obsessive-compulsive disorder (OCD) is a disabling psychiatric disorder, and more attention is recently paid on the quality of life (QoL) in OCD patients. The Euro-QoL-5D (EQ-5D) is a widely used self-report to calculate a single score which represents ‘health utilities’. The aim of this study was to assess the health-related QoL for patients with OCD using the EQ-5D and to examine the relationship between health-related QoL and symptom severity. METHODS: Seventy-three patients with a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of OCD were recruited from the outpatient clinic in Seoul National University Hospital. Symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and QoL was assessed with the EQ-5D-5L questionnaire. Using Korean valuation study, a single score of QoL was calculated. RESULTS: Most of the OCD patients were relatively young (< 45 years) with the mean YBOCS total score of 19.33. The mean EQ-5D score was 0.71 and significantly correlated with symptom severity (r = -0.483, p < 0.001). 25% of the EQ-5D score was predicted by the YBOCS total score (b = -0.011, p < 0.001) by regression analysis. CONCLUSIONS: OCD patients suffer from lower health-related QoL and QoL significantly decreased as symptom severity increased. The results of the EQ-5D would enable further studies on QoL comparison across medical disease and mental disorders.
Ambulatory Care Facilities ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mental Disorders ; Obsessive-Compulsive Disorder* ; Quality of Life* ; Seoul

Objectives: This study aimed to describe the current public programs for community walking in Korea and to discuss their challenges.Method: We identified the literature related to community walking including five laws, 22 white papers from government departments and 84 program reports from the Seoul Metropolitan Government. Results: Korean law guarantees legal rights and validity to create safe, convenient and equitable environments for community walking. The government department, which has jurisdiction over legislation relating to community walking, has dominated community walking programs, and the role of public health department has been insufficient. Almost all sectors in the department of Seoul Metropolitan Government were involved in community walking programs. However, inter-sectoral cooperation system for community walking was insufficient. Conclusion It is necessary to revise the condolences of the National Health Promotion Act to establish the role and perspective of public health in community walking promotion. Institutional efforts should be made to expand the network structure between sectors of community walking programs by establishing an organizational, budget, and performance sharing system for inter-sectoral approach.

Gemellae is a gram positive cocci that forms part of the oropharyngeal microflora in humans and is anaerobic to aerotolerant. Unlike the other members of the same genus, G. morbillorum rarely causes human infections. Recently, we experienced a case of tubo-ovarian abscess caused by G. morbillorum which was initially suspected to be actinomycosis associated with intrauterine device. This is the first case in the world on tubo-ovarian abscess with G. morbillorum as the culprit.
Abscess ; Actinomycosis ; Gemella ; Gram-Positive Cocci ; Humans ; Intrauterine Devices

Gemellae is a gram positive cocci that forms part of the oropharyngeal microflora in humans and is anaerobic to aerotolerant. Unlike the other members of the same genus, G. morbillorum rarely causes human infections. Recently, we experienced a case of tubo-ovarian abscess caused by G. morbillorum which was initially suspected to be actinomycosis associated with intrauterine device. This is the first case in the world on tubo-ovarian abscess with G. morbillorum as the culprit.
Abscess ; Actinomycosis ; Gemella ; Gram-Positive Cocci ; Humans ; Intrauterine Devices

Sixty patients, treated with postoperative radiation therapy following radical hysterectomy and pelvic lymphadenectomy for stage lb carcinoma of the uterine cervix between Jan. 1980 and Dec. 1984 at Department of Radiation Oncology, Yonsei University College of Medicine, were retrospectively analysed. The minimum follow-up period was 5 years. The indications for postoperative radiotherapy were positive pelvic lymph node (34 pts), a large tumor size more than 3 cm in longest diameter (18 pts), positive surgical margin (10 pts), deep stromal invasion (10 pts), and lymphatic permeation (9 pts). The overall 5-year survival rate was 81.8%. The univariate analysis of prognostic factors disclosed tumor size (less than 3cm, greater than or equal to 3cm) and the status of the surgical margin (positive, negative) as significant factors (tumor size; 88.1% vs 6.3%, surgical margin; 85.5% vs 60%, p less than 0.05). Age (less than or equal to 40, greater than 40 yrs) was marginally significant (90.2% vs 73.1%, p less than 0.1). Multivariate analysis clarified two independent prognostic factors; tumor size (p = 0.010) and surgical margin (p = 0.004). Analysis of the tumor factors with the radiation dose disclosed a better survival rate for patients with a positive surgical margin who were given over 50 Gy than for those who were given below 50 Gy in patients (4/4, 100% vs 2/6, 33.4%; p = 0.06). Significant complications requiring surgical correction were not observed. In conclusion, it is believed that the status of the surgical margin and tumor size both have important prognostic significance, and that a radiation dose over 50 Gy is advisable for patients with a positive surgical margin.
Adult ; Carcinoma/mortality/*radiotherapy/surgery ; Cervix Neoplasms/mortality/*radiotherapy/surgery ; Combined Modality Therapy ; Female ; Human ; Hysterectomy ; Lymph Node Excision ; Lymphatic Metastasis ; Prognosis ; Retrospective Studies ; Support, Non-U.S. Gov't

PURPOSE: In-vivo conductivity reconstruction using transmit field (B1+) information of MRI was proposed. We assessed the accuracy of conductivity reconstruction in the presence of statistical noise in complex B1 + map and provided a parametric model of the conductivity-to-noise ratio value. MATERIALS AND METHODS: The B1+ distribution was simulated for a cylindrical phantom model. By adding complex Gaussian noise to the simulated B1+ map, quantitative conductivity estimation error was evaluated. The quantitative evaluation process was repeated over several different parameters such as Larmor frequency, object radius and SNR of B1+ map. A parametric model for the conductivity-to-noise ratio was developed according to these various parameters. RESULTS: According to the simulation results, conductivity estimation is more sensitive to statistical noise in B1+ phase than to noise in B1+ magnitude. The conductivity estimate of the object of interest does not depend on the external object surrounding it. The conductivity-to-noise ratio is proportional to the signal-to-noise ratio of the B1+ map, Larmor frequency, the conductivity value itself and the number of averaged pixels. To estimate accurate conductivity value of the targeted tissue, SNR of B1+ map and adequate filtering size have to be taken into account for conductivity reconstruction process. In addition, the simulation result was verified at 3T conventional MRI scanner. CONCLUSION: Through all these relationships, quantitative conductivity estimation error due to statistical noise in B1+ map is modeled. By using this model, further issues regarding filtering and reconstruction algorithms can be investigated for MREPT.
Evaluation Studies as Topic ; Magnetic Resonance Imaging ; Noise* ; Radius ; Signal-To-Noise Ratio

OBJECTIVES: To increase the booster vaccination rate, the Korean government legislated a measles vaccination for elementary school students in 2001, requiring parents to submit a certificate of vaccination upon the admission of the students to elementary school. The purpose of this study was to evaluate the validity of measles vaccination certificates which were issued to parents. METHODS: Using questionnaire survey data of 890 general practitioners and 9,235 parents in 2005, we investigated the evidence for booster vaccination certificates of measles. RESULTS: In the survey of general practitioners, 59.5% of the certificates depended on the medical records of clinic, 13.5% was immunization booklets, 23.7% was re-immunizations, 1.9% was confirmation of record of other clinics, and 1.4% was parents' statements or requests without evidence. In the survey of parents, 36.2% of the certificates depended on the medical records of clinic, 43.4% was immunization booklets, 18.0% was reimmunizations, and 2.4% was parents statements or requests without evidence. CONCLUSIONS: Our findings show that a majority of the booster vaccination certificates of measles was issued on the basis of documented vaccinations and it means that the implementation of the law requiring the submission of elementary school students' vaccination certificates has been very successful in Korea.
Adult ; Aged ; *Certification ; Documentation ; Female ; Humans ; Korea ; Male ; Measles Vaccine/*administration & dosage ; Medical Records ; Middle Aged ; Parents ; Questionnaires ; *Schools ; Vaccination/legislation & jurisprudence/*standards/statistics & numerical data

OBJECTIVES: This study assessed the factors that have an influence on the residents exposed to heavy metals, and we utilized the findings to establish the proper management of abandoned metal mines in the future. METHODS: For a total of 258 residents who lived close to abandoned mines in Gangwon-province and Gyeonggi-province, the exposure factors and biomarkers in their blood and urine were comparatively analyzed via multiple regression analysis. RESULTS: The blood levels of lead and mercury and the cadmium levels in urine were found to be higher in the study group than that in the average Korean. For the blood levels of heavy metals according to each exposure factor, all of them were found to be significantly higher in both of the group residing for a longer period of time and the group living closer to the source of pollutants. Multiple regression analysis disclosed that all the heavy metals, except lead, in their blood were significantly reduced in proportion to the increased distance of inhabitancy from the mines. Their other biomarkers were within the normal ranges. CONCLUSIONS: We found that the distance between the residential village and the mines was a factor that affects the blood level of heavy metals in the villagers. This finding could be an important factor when developing a management model for the areas that surround abandoned metal mines. (ED note: I much like this important study.)
Biological Markers/blood/urine ; Cadmium/blood/urine ; Cluster Analysis ; Environmental Exposure/*adverse effects ; Humans ; Lead/blood/urine ; Mercury/blood/urine ; Metals, Heavy/*blood/*urine ; Mining ; Republic of Korea ; Water Pollutants, Chemical/analysis ; Water Supply/analysis