PURPOSE: The purpose of this study was to evaluate the clinical outcome of a modified Kidner procedure using a suture bridge technique in symptomatic type II accessory navicular. MATERIALS AND METHODS: Between January 2013 and December 2014, a total of 35 cases with symptomatic type II accessory navicular were treated with a modified Kidner procedure using the suture bridge technique. The patients were evaluated preoperatively, 3 months after surgery, and at the latest follow-up (at least six months postoperatively) clinically via the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, visual analogue scale (VAS), and the self-subjective satisfaction score. RESULTS: The mean AOFAS midfoot score demonstrated significant improvement from a mean of 45.3 preoperatively to a mean of 89.2 at 3 months after surgery. At the latest follow-up, the mean AOFAS midfoot score was 92.6 (p<0.001). The mean VAS also improved significantly, decreasing from 6.7 out of 10 preoperatively to 1.8 at 3 months after surgery. At the latest follow-up, the VAS was 1.2 (p<0.001). The mean time of a single-limb heel raise was 4.6 months postoperatively and the self-subjective satisfaction score was 1.4 out of 4 at the latest follow-up. CONCLUSION: The short-term surgical results of the modified Kidner procedure with a suture bridge technique for symptomatic type II accessory navicular were good to excellent in terms of pain, functional and clinical assessments. In conclusion, the modified Kidner procedure with the suture bridge technique is a reasonable treatment option for symptomatic type II accessory navicular.
Ankle ; Follow-Up Studies ; Foot ; Heel ; Humans ; Sutures*

We present a case of bilateral serous retinal detachment (SRD) as a presenting sign of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). A 45-year-old woman presented with decreased vision and was found to have bilateral serous retinal detachment. Peripheral blood smears revealed leukocytosis of 53.9x10(3)/microliter with 64.6% lymphoblasts. A bone marrow aspirate revealed the presence of lymphoblasts. Cytogenetic and molecular genetic analysis detected a reciprocal translocation between chromosome 9 and 22, t(9;22) (q34;q11). A diagnosis of Ph+ ALL was made. Following systemic chemotherapy, the bilateral SRD resolved completely with full recovery of vision. The sudden appearance of SRD should raise suspicion for leukemia. Prompt recognition of this disease is important for early systemic treatment and restoration of visual function.
Antineoplastic Agents/therapeutic use ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*complications/diagnosis/drug therapy ; Recovery of Function ; Retinal Detachment/diagnosis/*etiology/physiopathology ; Tomography, Optical Coherence ; Visual Acuity/physiology

We report three cases of neovascular glaucoma secondary to central retinal artery occlusion (CRAO) which were effectively managed with intravitreal bevacizumab (IVB) followed by panretinal photocoagulation (PRP). Neovascular glaucoma without peripheral anterior synechiae developed between one and five weeks following CRAO onset. All patients received 0.75 mg (0.03 ml) IVB. In all patients, complete regression of the iris and anterior chamber angle neovascularization was confirmed within one week. PRP was applied two weeks after the injection. The follow-up period was four to seven months (average, five months). Intraocular pressure was controlled in all patients using topical antiglaucoma medications alone. However, one patient experienced a recurrence of neovascularization three months after the initial combination treatment. This patient received another IVB injection and additional PRP, and the recurrent neovascularization resolved. There were no local or systemic adverse events in any patients. Therefore, intravitreal bevacizumab may be an effective adjunct in the treatment of neovascular glaucoma associated with CRAO.
Aged ; Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Female ; Glaucoma, Neovascular/*drug therapy/*etiology ; Humans ; Injections ; Male ; Middle Aged ; Recurrence ; Retinal Artery Occlusion/*complications ; Retreatment ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Vitreous Body

Purpose: This study aimed to estimate the unmet demand for INCS and the number of needed beds for fulfillment. Methods: Annual data from the Korea Health Panel (2015~2018), Health Insurance Statistical Yearbook (2015~ 2019), and published statistical data (2015~2019) were used. To measure the unmet demand, the utilization of informal nursing care services, which can be a market substitute for INCS, was used. The number of needed beds was calculated by dividing the demand by the bed occupancy rate multiplied by 365 days. Results: The unmet demand decreased every year and was estimated to be 31~47 million person-day as of 2019. It was the highest in Gyeonggi (6~8 million) and the lowest in Jeju (160~220 thousand), while the fulfilled rate was the highest in Incheon (52~61%) and the lowest in Jeonbuk (6~8%). For each type, general hospitals showed the highest unmet demand (6~10 million), followed by hospitals (5~8 million) and tertiary hospitals (4~7 million). Gyeonggi province (37,212~48,882) and general hospitals (54,955~70,962) were most needed additional INCS beds. Conclusion Tailored bed expansion strategies are necessary to satisfy each region's and hospital’s demand. Considering the multi-layered causes of unmet demand, a healthcare system reform that increases the regional self-sufficiency of INCS is required.

Purpose: This study examines the factors influencing 30-day in-hospital mortality in elderly patients with community-acquired pneumonia (CAP) and compares them to those in adult patients. Methods: This secondary analysis used discharge data from the Korea Disease Control and Prevention Agency, covering the period from January 1, 2020, to December 31, 2022. Statistical methods included χ² tests, t-tests, the Cox proportional hazards model for calculating adjusted hazard ratios (HR), and Kaplan-Meier analysis. Results: The study found that older age (Adjusted HR=2.40, 95% CI=2.01-2.85, p<.001) and Emergency Room admissions (Adjusted HR=2.24, 95% CI=1.94-2.59, p<.001) are significantly associated with increased mortality in elderly patients. Other contributing factors include residency area (Adjusted HR=1.73, 95% CI=1.04-2.87, p=.035), hospital setting (Adjusted HR=1.34, 95% CI=1.05-1.70, p=.017), and the number of hospital beds (Adjusted HR=1.27, 95% CI=1.11-1.46, p=.001). Conclusion These findings underscore the importance of improving community health screenings and developing respiratory infection prevention programs for elderly patients, especially those in high-risk areas.

Purpose: This study examines the factors influencing 30-day in-hospital mortality in elderly patients with community-acquired pneumonia (CAP) and compares them to those in adult patients. Methods: This secondary analysis used discharge data from the Korea Disease Control and Prevention Agency, covering the period from January 1, 2020, to December 31, 2022. Statistical methods included χ² tests, t-tests, the Cox proportional hazards model for calculating adjusted hazard ratios (HR), and Kaplan-Meier analysis. Results: The study found that older age (Adjusted HR=2.40, 95% CI=2.01-2.85, p<.001) and Emergency Room admissions (Adjusted HR=2.24, 95% CI=1.94-2.59, p<.001) are significantly associated with increased mortality in elderly patients. Other contributing factors include residency area (Adjusted HR=1.73, 95% CI=1.04-2.87, p=.035), hospital setting (Adjusted HR=1.34, 95% CI=1.05-1.70, p=.017), and the number of hospital beds (Adjusted HR=1.27, 95% CI=1.11-1.46, p=.001). Conclusion These findings underscore the importance of improving community health screenings and developing respiratory infection prevention programs for elderly patients, especially those in high-risk areas.

Purpose: This study examines the factors influencing 30-day in-hospital mortality in elderly patients with community-acquired pneumonia (CAP) and compares them to those in adult patients. Methods: This secondary analysis used discharge data from the Korea Disease Control and Prevention Agency, covering the period from January 1, 2020, to December 31, 2022. Statistical methods included χ² tests, t-tests, the Cox proportional hazards model for calculating adjusted hazard ratios (HR), and Kaplan-Meier analysis. Results: The study found that older age (Adjusted HR=2.40, 95% CI=2.01-2.85, p<.001) and Emergency Room admissions (Adjusted HR=2.24, 95% CI=1.94-2.59, p<.001) are significantly associated with increased mortality in elderly patients. Other contributing factors include residency area (Adjusted HR=1.73, 95% CI=1.04-2.87, p=.035), hospital setting (Adjusted HR=1.34, 95% CI=1.05-1.70, p=.017), and the number of hospital beds (Adjusted HR=1.27, 95% CI=1.11-1.46, p=.001). Conclusion These findings underscore the importance of improving community health screenings and developing respiratory infection prevention programs for elderly patients, especially those in high-risk areas.

Purpose: This study aimed to compare symptoms, social support, and quality of life across different stages of survival in patients with lung cancer. Methods: The study included 145 participants: 49 in the acute survival phase (less than 2 years), 50 in the extended survival phase (2~5 years), and 46 in the lasting survival phase (> 5 years). A structured questionnaire was utilized to assess symptoms, social support, and quality of life. Analysis of covariance was used to control for demographic and disease-related variables. Results: Quality of life was significantly higher in the lasting survival stage (F=5.05, p=.008). The severity of symptoms was highest in the acute survival stage, followed by the extended survival stage, and lowest in the lasting survival stage (F=15.79, p<.001). Symptom interference with life was greater in the extended survival stage than in the lasting survival stage (F=11.11, p<.001). Social support was the lowest in the extended survival stage (F=10.03, p<.001). Notably, the extended survival stage had the highest scores for symptoms affecting daily activities, relationships, walking, and work (p<.001). Conclusion This study highlights the differences in symptoms, social support, and quality of life in patients with lung cancer across their survival stages. Tailored interventions are essential for each survival stage to improve the quality of life, with emotional and social support being critical in the extended survival phase, whereas symptom management is key in the acute phase.

Purpose: This study aimed to compare symptoms, social support, and quality of life across different stages of survival in patients with lung cancer. Methods: The study included 145 participants: 49 in the acute survival phase (less than 2 years), 50 in the extended survival phase (2~5 years), and 46 in the lasting survival phase (> 5 years). A structured questionnaire was utilized to assess symptoms, social support, and quality of life. Analysis of covariance was used to control for demographic and disease-related variables. Results: Quality of life was significantly higher in the lasting survival stage (F=5.05, p=.008). The severity of symptoms was highest in the acute survival stage, followed by the extended survival stage, and lowest in the lasting survival stage (F=15.79, p<.001). Symptom interference with life was greater in the extended survival stage than in the lasting survival stage (F=11.11, p<.001). Social support was the lowest in the extended survival stage (F=10.03, p<.001). Notably, the extended survival stage had the highest scores for symptoms affecting daily activities, relationships, walking, and work (p<.001). Conclusion This study highlights the differences in symptoms, social support, and quality of life in patients with lung cancer across their survival stages. Tailored interventions are essential for each survival stage to improve the quality of life, with emotional and social support being critical in the extended survival phase, whereas symptom management is key in the acute phase.

Purpose: This study examines the factors influencing 30-day in-hospital mortality in elderly patients with community-acquired pneumonia (CAP) and compares them to those in adult patients. Methods: This secondary analysis used discharge data from the Korea Disease Control and Prevention Agency, covering the period from January 1, 2020, to December 31, 2022. Statistical methods included χ² tests, t-tests, the Cox proportional hazards model for calculating adjusted hazard ratios (HR), and Kaplan-Meier analysis. Results: The study found that older age (Adjusted HR=2.40, 95% CI=2.01-2.85, p<.001) and Emergency Room admissions (Adjusted HR=2.24, 95% CI=1.94-2.59, p<.001) are significantly associated with increased mortality in elderly patients. Other contributing factors include residency area (Adjusted HR=1.73, 95% CI=1.04-2.87, p=.035), hospital setting (Adjusted HR=1.34, 95% CI=1.05-1.70, p=.017), and the number of hospital beds (Adjusted HR=1.27, 95% CI=1.11-1.46, p=.001). Conclusion These findings underscore the importance of improving community health screenings and developing respiratory infection prevention programs for elderly patients, especially those in high-risk areas.