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

PURPOSE: The purpose of this study was to identify factors which predict depression in resdents of geriatric medical and welfare facilities in metropolitan areas. METHODS: The participants were 125 elderly people who resided in geriatric medical and welfare facilities. A structured questionnaires was used to collect data during the period from Sept. 28 to Oct. 23, 2009, and data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and Stepwise Multiple Regression with the SPSS/WIN 15.0 program. RESULTS: The mean score per item for perceived health status was 2.6, and the mean depression score was 3.40. Depression showed a negative correlation with perceived health status (r=-.44, p<.001). Variables that predicted depression were perceived health status, perceived economic status, and attitude of staff towards the elders (33.6%). CONCLUSION: The findings indicate a need to develop, geriatric mental health program to prevent depression in elders who reside in geriatric medical and welfare facilities.
Aged ; Depression* ; Geriatric Nursing ; Humans ; Mental Health ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to analyze the clinical results of medial horizontal suture fixation of Akin osteotomy in hallux valgus and present its advantages. MATERIALS AND METHODS: This study was based on 48 cases of 35 patients with Akin osteotomy, who underwent surgery of hallux valgus between December 2014 and July 2015, and with at least 12 months of follow-up. The mean age of patients was 46.9 years (range, 16~71 years). The mean follow-up duration was 15.9 months (range, 12~18 months). Clinical evaluations included pain visual analogue scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS hallux metatarsophalangeal interphalangeal scale) score, and satisfaction score. Weightbearing anteroposterior radiographs were taken to measure the distal articular set angle (DASA) of the hallux. Radiographic bone union at 6 months follow-up was regarded as a success, while a loss of reduction and nonunion was regarded as a failure. RESULTS: The mean pre- and postoperative pain VAS scores were 4.27 and 1.67, respectively (p<0.05). The mean AOFAS score improved from 59.7 to 80.5 (p<0.05). The DASA was improved from 8.15 to –2.57 (p<0.05). There was no case of skin irritation, cortical breakage, inflammation from the knot, and infection. All patients showed union without fixation failure. CONCLUSION: The clinical and radiological evaluations in this study demonstrate reliable results without complication. The medial horizontal suture fixation of the Akin osteotomy was effective, and the advantage of this procedure was unnecessity of the material removal, preservation of the joint, and no skin irritation.
Ankle ; Follow-Up Studies ; Foot ; Hallux Valgus* ; Hallux* ; Humans ; Inflammation ; Joints ; Osteotomy* ; Pain, Postoperative ; Skin ; Sutures* ; Weight-Bearing

BACKGROUND: Dyspnea is the subjective symptom that means breathing difficulty or discomfort. Clinical evaluation to etiology of dyspnea in elderly patient may be difficult because of underlying disease and physiological change. NT-pro BNP is noted that is good clinical marker to diagnose congestive heart failure and then evaluated clinical efficiency in elderly dyspnea patients. METHODS: Medical records, echocardiogram and laboratoty result including NT-pro BNP were analysed in elderly patients who were admitted due to dyspnea from January 2004 to July 2005 that were finally diagnosed as systolic or diastolic heart failure and exacerbation of chronic obstructive lung disease. RESULTS: The patents were divided into three groups; group 1(systolic heart failure), group 2(diastolic heart failure), group 3 (exacerbation of chronic obstructive lung disease). The mean age and study number were 78.5+/-7.7 yrs(group 1; 24), 79.0+/-8.0 yrs(group 2; 22), 73.8+/-6.7 yrs(group 3; 18). The ejection fraction and left atrial size of group 1, 2, 3 were 42.9+/-7.5%, 69.7+/-9.1%. 66.19.5%(p<0.001) and 4.2+/-0.9 cm, 4.6+/-1.0 cm, 3.7+/-0.7cm(p=0.005). The value of NT-pro BNP were 12912.0+/-13179.9 pg/mL(group 1), 2842.8+/-2014.8pg/mL(group 2) and 168.2+/-148.8pg/mL(group 3)(p<0.001). CONCLUSION: NT-pro BNP can be used to evaluate etiologic disease as systolic heart failure in elderly patients who complain dyspnea as like echocardiogram although more large study is needed to evaluate clinical significance of NT-pro BNP.
Aged* ; Biomarkers ; Dyspnea* ; Heart ; Heart Failure ; Heart Failure, Diastolic ; Heart Failure, Systolic ; Humans ; Lung ; Medical Records ; Pulmonary Disease, Chronic Obstructive ; Respiration

No abstract available.
Animals ; Cattle ; Encephalopathy, Bovine Spongiform/epidemiology ; Meat/*analysis ; United States

Vulvodynia is a chronic pain syndrome in female genitalia in the absence of visible infectious, inflammatory, or neoplastic findings or a clinically identifiable neurological disorder. We report a case of vulvodynia successfully treated with dry needling using a specially designed round needle (Ahn's needle). A 50-year-old woman was seen with 20-year-history of left-sided vulvar pain in the absence of infectious, inflammatory, neoplastic, or neurological disorder. We diagnosed her condition as vulvodynia and conducted dry needling using an Ahn's needle. Dry needling was performed along left upper and middle labiocrural fold. She reported 50% improvement of vulvodynia after the first treatment and 100% improvement after the second treatment. She remained symptom free 9 months after treatment. Our report suggests that dry needling using an Ahn's needle have clinical significance in managing vulvodynia.
Chronic Pain ; Female ; Genitalia ; Genitalia, Female ; Humans ; Middle Aged ; Needles ; Nervous System Diseases ; Vulvodynia

No abstract available.
Lymphoma* ; Primary Myelofibrosis*

OBJECTIVES: Nocturnal sleep disruption has been considered as a risk factor for cognitive impairment in the elderly. And the frontal lobe dysfunction was suggested to predict the progression to dementia. We aimed to illustrate the relationship of nocturnal sleep with frontal lobe function in mild cognitive impairment (MCI) patients. METHODS: Thirty MCI patients and 30 age- and sex-matched normal control (NC) subjects were selected. Frontal lobe function tests including Stroop Test, Similarity Test, Digit Span Test (DST), and Benton Visual Retention Test (BVRT) were administrated. Nocturnal polysomnography was done for each subject. RESULTS: There was no significant difference in the sleep parameters and diagnostic distributions of sleep disorders between the MCI and NC groups. In MCI patients, the mean hypopnea index (HI) of the ApoE4 positive group was higher than that of ApoE4 negative group. In the NC group, the wake time after sleep onset (WASO) was negatively correlated with the DST score (r=-0.545). In the MCI group, WASO tended to be negatively correlated with the Similarity Test score (r=-0.376, p=0.053), and slow wave sleep amount (SWS) was negatively correlated with the error score of BVRT (r=-0.489). CONCLUSION: Although there was no difference in the sleep quality and frequency of SAS between the MCI and NC groups, the severity of SDB was higher in MCI patients with ApoE4 compared to those without ApoE4. In the MCI group, the difficulty in maintaining sleep was associated with decreased executive function, and the decreased SWS was associated with impaired working memory. The relationship of nocturnal sleep with the frontal lobe function in MCI patients appears to be different from that of normal elderly subjects.
Aged ; Apolipoprotein E4 ; Dementia ; Executive Function ; Frontal Lobe ; Humans ; Memory, Short-Term ; Mild Cognitive Impairment ; Phenothiazines ; Polysomnography ; Retention (Psychology) ; Risk Factors ; Sleep Wake Disorders ; Stroop Test

We examined time trend and age-period-cohort effects on acute myocardial infarction (AMI) mortality in Korean adults from 1988 to 2007. Annual AMI mortality data and population statistics from 1988 to 2007 were obtained from the STATISTICS KOREA website. Age adjusted mortality for four 5-yr calendar periods (1988-1992 to 2003-2007) was calculated by direct standardization using the Year 2000 WHO world standard population. A log-linear Poisson regression model was used to estimate age, period, and cohort effects on AMI mortality. In both genders, age-adjusted AMI mortality increased from period one (1988-1992) to period three (1998-2002) but decreased in period four (2003-2007). An exponential age effect was noted in both genders. The rate ratio of the cohort effect increased up to the 1943 birth cohort and decreased gradually thereafter, and the rate ratio of the period effect increased up to period three (1998-2002) and decreased thereafter. Our results suggest that AMI mortality in Korean adults has decreased since the period 1998-2002 and age, period, and cohort effects have influenced on AMI mortality.
Adult ; Age Distribution ; Age Factors ; Aged ; Cohort Effect ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*mortality ; Republic of Korea/epidemiology ; Time Factors