The Akin osteotomy is a complimentary procedure in hallux valgus surgery. Surgical techniques may vary depending on the operators or fixation devices. Suture fixation, for which a removal procedure is not necessary, can often be recommended. However, there is a risk of failure due to the thin cortex of the phalanx. We describe a new technique using Ethibond suture fixation in Akin osteotomy, which can lower the risk of phalangeal cortical failure and articular cartilage irritation. First, the Akin osteotomy was performed on the proximal phalanx 5 to 6 mm distal to the first metatarsophalangeal joint. Then bone holes were drilled from dorsum to plantar parallel to osteotomy with the Kirschner wire. The final procedure involved passing the Ethibond sutures connected to a straight needle through the holes and tying it. This fixation method offers an effective and easy technique for performance of Akin osteotomy.
Cartilage, Articular ; Hallux Valgus ; Metatarsophalangeal Joint ; Needles ; Osteotomy* ; Sutures*

PURPOSE: The purpose of this study was to analyze the clinical results of application of bioabsorbable screws in hallux valgus surgery using modified Mau osteotomy. MATERIALS AND METHODS: We retrospectively reviewed medical records of 25 patients. Operations were performed between May 2013 and January 2014. We performed 33 modified Mau osteotomies and fixed using bioabsorbable screws. Mean age of patients was 52 years (range 19 to 71). Mean follow up duration was 13.2 months (range 12.3 to 18.9). The clinical evaluations included pain visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and satisfaction score. Weight bearing anteroposterior radiographs were taken for measurement of hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA). All radiographs were evaluated in order to detect complications related to bioabsorbable screws such as osteolysis, cyst formation, and fixation failure. RESULTS: The mean pre- and postoperative pain VAS scores were 4.0 and 1.7 (p<0.05). The mean AOFAS score improved from 52.6 to 82.8 (p<0.05). Preoperative HVA and IMA were 31.2 and 13.9, respectively. Postoperative HVA and IMA were 5.2 and 6.2 (p<0.05). The DMAA increased from 7.8 to 9.9 (p<0.05). There was one case of superficial wound infection and one loss of correction, and no case of osteolysis, cystic formation around the screw, or deep infection. All patients showed union without fixation failure. CONCLUSION: The clinical and radiological evaluation of this study demonstrates reliable results without fixation failure or allergic reaction. The use of bioabsorbable screw appears not to be inferior to metal screw fixation in hallux valgus surgery.
Ankle ; Follow-Up Studies ; Foot ; Hallux Valgus* ; Hallux* ; Humans ; Hypersensitivity ; Medical Records ; Metatarsal Bones ; Osteolysis ; Osteotomy* ; Pain, Postoperative ; Retrospective Studies ; Weight-Bearing ; Wound Infection

BACKGROUND: Confirming a successful caudal block is challenging in the pediatric population. Pulse transit time (PTT) may reflect the decrease in arterial resistance and may act as a potential indicator for confirming successful peripheral nerve or axial block. Heart rate variability (HRV) is also a possible candidate because it may be influenced by variation in sympathetic tone. We expected an increasing PTT pattern and change in HRV parameters after caudal block. METHODS: We enrolled 27 male patients (range, 1–4 years old) who were scheduled for urological surgeries. Caudal block was performed with 1 ml/kg of 0.25% ropivacaine and 1 : 200,000 epinephrine under sevoflurane anesthesia after the surgery. Successful block was confirmed by auscultation and ultrasonography. PTT and HRV parameters, such as standard deviation of normal-to-normal intervals, root mean square of successive differences, very low-frequency power, low-frequency power (LF), high-frequency power (HF), LF/HF ratio, approximate entropy (ApEn) were calculated based on electrocardiography from 1 min before to 5 min after the block. Those variables were analyzed by repeated measures analysis of variance. RESULTS: No significant change was found in PTT with time interval after caudal block. Heart rate and ApEn of the R-R interval decreased with time interval (P = 0.001, 0.033, respectively). Some HRV parameters showed notable changes, although statistically insignificant. CONCLUSIONS: The PTT pattern may not be an indicator for successful caudal block. However, heart rate with parameters of HRV analysis may be alternatives.
Anesthesia ; Anesthesia, Caudal ; Anesthesia, General* ; Auscultation ; Child* ; Electrocardiography ; Entropy ; Epinephrine ; Heart Rate* ; Heart* ; Humans ; Male ; Peripheral Nerves ; Pulse Wave Analysis* ; Ultrasonography

BACKGROUND: This study was undertaken to investigate the trends in domestic publications on bone metabolism during the last decade, and to document the characteristics of articles in South Korea. METHODS: Articles on bone metabolism including osteoporosis published between 1998 and 2012 were evaluated, in terms of title, type of articles, subspecialty, and authors' affiliations. We used descriptive statistics for presenting the characteristics of domestic publication on bone metabolism. RESULTS: Total of 247 articles, published articles between 1998 and 2012, were reviewed. Over a total study period of 14 years, the number of articles which was initially 109 in the first half term increased to 247 during the period of second half. Of these 247 articles, 52 were on basic research, and 195 were on clinical research. Although the types of article were added in the later 7 years were much diverse than that of the earlier 7 years, the proportion of original articles has decreased. CONCLUSIONS: Our findings presented the characteristics and trends of domestic publication on bone metabolism in South Korea, and concerns for editorial boards in future.
Osteoporosis ; Publications ; Republic of Korea

The forensic medicine department of the National Institute of Scientific Investigation (NISI) designed a form of forensic laboratory information sheet for autopsy practice in 2006. The forensic laboratory information sheet consists of three parts of checklist; the first part concerns death circumstance-related investigatory facts, the second part displays a table of checklist regarding types of forensic scientific tests to be done, and the third describes brief presumptive results of forensic autopsy. This laboratory information sheet reminds forensic pathologists and other forensic medicine staffs to perform appropriate tissue sampling, helps reduce the probability of errors during interdepartmental flow of sampled tissues, and contributes to produce better forensic science results on the basis of good communication. We suggest that this communication form between forensic medicine and science departments should be now considered efficient and actuated especially in areas outside NISI.
Autopsy ; Checklist ; Forensic Medicine ; Forensic Sciences

The industrial complexes built during the course of economic development in South Korea played a pivotal role in the country's rapid economic growth. However, this growth was accompanied by health problems due to the pollutants released from the industrial complexes inevitably located near residential areas, given the limited land area available in South Korea. This study was conducted to evaluate the exposure to each pollutant emanating from industrial complexes for residents living in nearby areas, and to determine the substances requiring priority attention in future surveys. Pollutants were comprehensively categorized according to their emission and exposure levels based on data previously collected from the study areas. The emission, ambient concentration, and biomarker concentration levels of major pollutants emitted from eight national industrial complexes (Ulsan, Pohang, Gwangyang, Yeosu, Chungju, Daesan, Sihwa, and Banwol) were determined and tabulated. Each of the values was compared with the national/local average values, reference values, or control area concentrations depending on availability. Substances with completed exposure pathways and with high values for emissions, ambient concentrations, and biomarker concentrations were considered the substances posing exposure risks to the residents living near the corresponding industrial complex. The substances requiring continuous monitoring or supplementary exposure investigation were also categorized and presented. Lead and benzene had higher values for emissions, ambient concentrations, and biomarker concentrations in the Ulsan Industrial Complex area; thus, they were most likely to pose exposure risks to residents living in the area's neighborhoods. In other areas, styrene, xylene, cadmium, nitrogen oxide, trichloroethylene, nickel, manganese, and chromium required continuous monitoring, and arsenic, nickel, manganese, and chromium required biomarker measurements. In conclusion, the substances identified and categorized in this study need to be given appropriate attention in future surveys on exposure risks and health effects related to industrial complexes.
Arsenic ; Benzene ; Cadmium ; Chromium ; Chungcheongbuk-do ; Economic Development ; Environmental Pollutants* ; Gyeongsangbuk-do ; Jeollanam-do ; Korea ; Manganese ; Nickel ; Nitrogen ; Reference Values ; Residence Characteristics ; Styrene ; Trichloroethylene ; Ulsan ; Xylenes

The industrial complexes built during the course of economic development in South Korea played a pivotal role in the country's rapid economic growth. However, this growth was accompanied by health problems due to the pollutants released from the industrial complexes inevitably located near residential areas, given the limited land area available in South Korea. This study was conducted to evaluate the exposure to each pollutant emanating from industrial complexes for residents living in nearby areas, and to determine the substances requiring priority attention in future surveys. Pollutants were comprehensively categorized according to their emission and exposure levels based on data previously collected from the study areas. The emission, ambient concentration, and biomarker concentration levels of major pollutants emitted from eight national industrial complexes (Ulsan, Pohang, Gwangyang, Yeosu, Chungju, Daesan, Sihwa, and Banwol) were determined and tabulated. Each of the values was compared with the national/local average values, reference values, or control area concentrations depending on availability. Substances with completed exposure pathways and with high values for emissions, ambient concentrations, and biomarker concentrations were considered the substances posing exposure risks to the residents living near the corresponding industrial complex. The substances requiring continuous monitoring or supplementary exposure investigation were also categorized and presented. Lead and benzene had higher values for emissions, ambient concentrations, and biomarker concentrations in the Ulsan Industrial Complex area; thus, they were most likely to pose exposure risks to residents living in the area's neighborhoods. In other areas, styrene, xylene, cadmium, nitrogen oxide, trichloroethylene, nickel, manganese, and chromium required continuous monitoring, and arsenic, nickel, manganese, and chromium required biomarker measurements. In conclusion, the substances identified and categorized in this study need to be given appropriate attention in future surveys on exposure risks and health effects related to industrial complexes.
Arsenic ; Benzene ; Cadmium ; Chromium ; Chungcheongbuk-do ; Economic Development ; Environmental Pollutants ; Gyeongsangbuk-do ; Jeollanam-do ; Korea ; Manganese ; Nickel ; Nitrogen ; Reference Values ; Residence Characteristics ; Styrene ; Trichloroethylene ; Ulsan ; Xylenes

BACKGROUND/AIMS: To determine the changes in body weight and bone mineral density in patients with ankylosing spondylitis (AS) receiving anti-tumor necrosis factor-alpha (TNF-alpha) treatment. METHODS: Thirty-one patients with AS (25 males and 6 females) who fulfilled the Modified New York Criteria for AS were included in this retrospective study. All patients had active disease that eventually required anti-TNF-alpha treatment. Each patient received anti-TNF-alpha treatment (etanercept 25 mg twice weekly or adalimumab 40 mg twice monthly) for more than 2 years. Body weight, disease activity as Bath ankylosing spondylitis disease activity index (BASDAI), C-reactive protein, erythrocyte sedimentation rate (ESR), lumbar bone mineral density (LBMD), and femoral bone mineral density (FBMD) were measured at baseline and at 1 and 2 years after initiating anti-TNF-alpha treatment. RESULTS: There was a significant increase in mean body weight at 1 year (1.1 +/- 3.8 kg) and at 2 years (1.7 +/- 4.8 kg) compared with baseline. The gains in mean BMD of the lumbar spine were significant at 1 year (0.4 +/- 0.4) and 2 years (0.5 +/- 0.7) compared with baseline. Mean BMD of the femur was also increased at 1 year (0.08 +/- 0.7) and 2 years (0.1 +/- 0.8) compared with baseline, but these differences were not statistically significant. There were significant decreases in BASDAI at 1 year (-3.3 +/- 2.8) and at 2 years (-3.6 +/- 2.8) compared with baseline. CONCLUSIONS: This study showed significant increases in body weight, lumbar BMD, and BASDAI at 1 year and 2 years in patients with ankylosing spondylitis after receiving anti-TNF-alpha treatment.
Antibodies, Monoclonal, Humanized ; Baths ; Blood Sedimentation ; Body Weight* ; Bone Density* ; C-Reactive Protein ; Cachexia ; Femur ; Humans ; Male ; Necrosis* ; Retrospective Studies ; Spine ; Spondylitis ; Spondylitis, Ankylosing* ; Adalimumab

BACKGROUND/AIMS: To determine the changes in body weight and bone mineral density in patients with ankylosing spondylitis (AS) receiving anti-tumor necrosis factor-alpha (TNF-alpha) treatment. METHODS: Thirty-one patients with AS (25 males and 6 females) who fulfilled the Modified New York Criteria for AS were included in this retrospective study. All patients had active disease that eventually required anti-TNF-alpha treatment. Each patient received anti-TNF-alpha treatment (etanercept 25 mg twice weekly or adalimumab 40 mg twice monthly) for more than 2 years. Body weight, disease activity as Bath ankylosing spondylitis disease activity index (BASDAI), C-reactive protein, erythrocyte sedimentation rate (ESR), lumbar bone mineral density (LBMD), and femoral bone mineral density (FBMD) were measured at baseline and at 1 and 2 years after initiating anti-TNF-alpha treatment. RESULTS: There was a significant increase in mean body weight at 1 year (1.1 +/- 3.8 kg) and at 2 years (1.7 +/- 4.8 kg) compared with baseline. The gains in mean BMD of the lumbar spine were significant at 1 year (0.4 +/- 0.4) and 2 years (0.5 +/- 0.7) compared with baseline. Mean BMD of the femur was also increased at 1 year (0.08 +/- 0.7) and 2 years (0.1 +/- 0.8) compared with baseline, but these differences were not statistically significant. There were significant decreases in BASDAI at 1 year (-3.3 +/- 2.8) and at 2 years (-3.6 +/- 2.8) compared with baseline. CONCLUSIONS: This study showed significant increases in body weight, lumbar BMD, and BASDAI at 1 year and 2 years in patients with ankylosing spondylitis after receiving anti-TNF-alpha treatment.
Antibodies, Monoclonal, Humanized ; Baths ; Blood Sedimentation ; Body Weight* ; Bone Density* ; C-Reactive Protein ; Cachexia ; Femur ; Humans ; Male ; Necrosis* ; Retrospective Studies ; Spine ; Spondylitis ; Spondylitis, Ankylosing* ; Adalimumab

Objectives: It is crucial to establish the characteristics of coronavirus disease 2019 (COVID-19) outbreaks at army training centers to develop preventive measures. Therefore, this study aimed to determine the COVID-19 transmission patterns and risk factors in a sequence of outbreaks at an army training center from June to August 2021. Methods: This study included 1,324 trainees at an army training center where outbreaks occurred from June to August 2021. The outbreak was qualitatively analyzed according to the period, attack rate, demographic characteristics, vaccination history, and living areas. An aerodynamic experiment was performed to evaluate aerosol transmission in living areas. Results: Three outbreaks occurred at the army training center from June to August 2021. The first, second, and third outbreaks lasted for 32, 17, and 24 days, and the attack rates were 12.8%, 18.1%, and 8.9%, respectively. Confirmed cases were distributed in all age groups. Recruits and the unvaccinated were at higher risk for COVID-19. The aerodynamic experiment verified the possibility of aerosol transmission within the same living area. Conclusion COVID-19 transmission at army training centers should be minimized through quarantine and post-admission testing during the latency period as part of integrated measures that include facility ventilation, vaccination, indoor mask-wearing, and social distancing.