Objectives: Sleep disturbance in the elderly is associated with cognitive decline. Sleep quality is known to deteriorate with age, and prospective studies seldom have examined the relationship between sleep quality and cognitive function. This study investigates the relationship between early sleep quality and cognitive function based on six-year follow-up data of community individuals older than 60 years. Methods: The participants included 622 community elderly people older than 60 years from Jinju-Si. The final analysis comprised 322 elderly people. Pittsburgh sleep quality index (PSQI) and the Korean version of Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-K) were used to assess early sleep quality and cognitive function after six years. Multiple linear regression analysis was performed to investigate the association between early sleep quality and cognitive function in the elderly. Results: Early sleep quality (PSQI) was significantly associated with the results of the digit span test, clock drawing test (clox 1), and word recall test after six years. Sleep quality (PSQI) decreased significantly after six years, and lower quality of sleep (PSQI) score was associated with higher digit span test score (β = -0.167, p = 0.026) and higher clock drawing test score (β = -0.157, p = 0.031). Lower quality of sleep (PSQI) score was associated with higher word recall test (β = -0.140, p = 0.039). Conclusion The digit span test, word recall test, and clock drawing task (CLOX 1) shown to be significantly associated to sleep quality can be performed fast and easily in clinical practice. It is important to assess early cognitive function in the elderly with poor sleep quality, and further studies could suggest that these tests may be useful screening tests for early dementia in elderly with poor sleep quality.

Coronary sinus ostial atresia (CSOA) with persistent left superior vena cava (LSVC) in the absence of an unroofed coronary sinus is a benign and rare anomaly that may be taken lightly in most instances. However, if overlooked in patients undergoing univentricular heart repair such as bidirectional Glenn or Fontan-type surgery, fatal surgical outcomes may occur due to coronary venous drainage failure. We report a case of CSOA with a persistent LSVC that was managed through coronary sinus rerouting during a total cavopulmonary connection, and provide a review of the literature regarding this rare anomaly.
Coronary Sinus* ; Drainage ; Fontan Procedure ; Heart ; Heart Bypass, Right ; Humans ; Vena Cava, Superior

No abstract available.
Aneurysm, False ; Heart Ventricles ; Myocardial Infarction

Acute rupture of flexor tendons following distal radius fracture is very rare. We experienced four cases of acute rupture of flexor tendons that were treated surgically. Injured tendons included flexor pollicis longus, flexor carpi radialis, palmaris longus and third flexor digitorum profundus. A severely displaced fracture with a volar spike of the distal radius was detected on plain radiographs in all cases. Ruptures of flexor pollicis longus and third flexor digitorum profundus were diagnosed on preoperative examination but ruptures of other tendons were identified during the operation. Repairs of fractures and ruptured tendons were performed simultaneously and good functional outcomes were achieved.
Radius ; Radius Fractures* ; Rupture* ; Tendons*

BACKGROUND: The aim of this study is to evaluate the clinical and rhythm outcomes of atrial fibrillation (AF) ablation through a port access approach compared with sternotomy in patients with AF associated with mitral valve diseases. MATERIALS AND METHODS: From February 2006 through December 2009, 135 patients underwent biatrial AF ablation with a mitral operation via either a port-access approach (n=78, minimally invasive cardiac surgery [MICS] group) or a conventional sternotomy (n=57, sternotomy group). To adjust for the differences in the two groups' baseline characteristics, a propensity score analysis was performed. RESULTS: After adjustment, there were no significant differences in the two groups' baseline profiles. The cardiopulmonary bypass time was significantly longer (p=0.045) in the MICS group (176.0+/-49.5 minutes) than the sternotomy group (150.0+/-51.9 minutes). There were no significant differences (p=0.31) in the two groups' rate of reoperation for bleeding (MICS=6 vs. sternotomy= 2, p=0.47) or the requirement for permanent pacing (MICS=1 vs. sternotomy=3). The major event-free survival rates at two years were 87.4+/-8.1% in the MICS group and 89.6+/-5.8% in the sternotomy group (p=0.92). Freedom from late AF at 2 years was 86.8+/-6.2% in the MICS group and 85.0+/-6.9% in the sternotomy group (p=0.86). CONCLUSION: Both the port-access approach and sternotomy showed tolerable clinical outcomes following biatrial AF ablation with mitral valve surgery.
Atrial Fibrillation ; Cardiopulmonary Bypass ; Disease-Free Survival ; Freedom ; Hemorrhage ; Humans ; Mitral Valve ; Propensity Score ; Reoperation ; Sternotomy ; Thoracic Surgery

We detected two cases of right atrial angiosarcoma that had a similar appearance on imaging studies. Although the surgical findings were similar for the two patients, one had a clear resection margin, while the other had tumor cells in the resection margin on frozen biopsy. We suggest that preoperative data on magnetic resonance imaging and computed tomography in patients with angiosarcomas may not predict the exact extent of surgical resection or prognostic outcomes.
Biopsy ; Heart Neoplasms ; Hemangiosarcoma ; Humans ; Magnetic Resonance Imaging

A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.
Chest Pain ; Constriction, Pathologic ; Coronary Vessels ; Dyspnea ; Echocardiography ; Follow-Up Studies ; Heart Failure ; Humans ; Infarction ; Middle Aged ; Mitral Valve ; Mitral Valve Insufficiency ; Myocardial Infarction ; Outpatients ; Papillary Muscles ; Stents

A 53-year-old man presenting with dyspnea and chest pain was diagnosed with acute myocardial infarction secondary to occlusion of the left circumflex coronary artery. Urgent revascularization by percutaneous stenting was successfully performed. However, the post-echocardiography revealed a ruptured papillary muscle that was causing severe mitral regurgitation and aggravation of congestive heart failure. The patient subsequently underwent mitral valve repair with papillary muscle re-implantation. Postoperative echocardiography showed a competent mitral valve without residual stenosis or regurgitation. The patient was discharged from the hospital with an uneventful recovery and has been doing well on outpatient follow up.
Chest Pain ; Constriction, Pathologic ; Coronary Vessels ; Dyspnea ; Echocardiography ; Follow-Up Studies ; Heart Failure ; Humans ; Infarction ; Middle Aged ; Mitral Valve ; Mitral Valve Insufficiency ; Myocardial Infarction ; Outpatients ; Papillary Muscles ; Stents

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization