• Journal of Korean Foot and Ankle Society
• /
• v.17 no.1
• /
• pp.23-27
• /
• 2013

Purpose: The optimal management for ankle fracture in elderly patients remains controversial. This study was undertaken to review the results of surgical treatment of ankle fracture in the elderly and to compare with other studies. Materials and Methods: The participants in this study were 33 patients over the age of 65(average 71.5 years) who underwent surgical treatment of ankle fracture from January 2004 to December 2011. The study was a retrospective review of outcomes after open reduction and internal fixation (ORIF) of ankle fractures. To measure the clinical outcomes, we assessed postoperative complications, the pre- and post-operative mobility status, fracture union status, the time of fracture union and the AOFAS (American Orthopaedic Foot and Ankle Society) Ankle-Hindfoot scale. The level of patient satisfaction was also identified. Results: Delayed wound healing occurred in three patients(9.1%) but their wounds healed with repeated dressings without additional surgical treatment. Malunion occurred in one patient(3%). One patient(3%) had postoperative infection but healed with antibiotic treatment. 24 patients(96%) returned to preoperative mobility status. VAS score was lower than 2 in all patients. Bone union occurred with the 3.8 months (average months) after the surgery in all patients. Average AOFAS score was 87.4 and these were similar results as other studies of young patients. All patients were satisfied with surgical outcomes according to interviews. Conclusion: Surgical treatment of ankle fractures in the elderly can carry a significant risk of delayed wound healing and infection but incidence is relatively low. Internal fixation of ankle fractures in the elderly can be undertaken safely and the majority of patients can expect good outcome.

• The Journal of the Korean bone and joint tumor society
• /
• v.16 no.2
• /
• pp.80-86
• /
• 2010

Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

• Korean Journal of Acupuncture
• /
• v.22 no.1
• /
• pp.55-66
• /
• 2005

Objectives : This study is a random-controlled post-design for confirmation of headache degree, quality of life, and satisfaction to therapeutical effect on chronic headache adults after management of non-medicinal treatment (acupuncture therapy and stellate ganglion block therapy). Methods : 51 clinical experiment participants were gathered and through a questioutaire patients who experienced headache for more than 4 hours a day and more than 15 days per month were qualified as chronic headache patients. The qualified patients were classified in to two groups, acupuncture group (AT group, n=28) and stellate ganglion block group (SGB group, n=23). Treatment was applied 2 times a weeks for 4 weeks. The effects of both groups were analyzed using VAS scores, BPI (Brief Pain Inventory) and the satisfaction degree to the therapy. Results : 1. The recognized score of the headache of AT group and SGB group was reduced indicating the degree of the headache was released. 2. The recognition at damage to the quality of life was reduced post therapy of AT group and SGB group, in which general activity, mood, enjoyment of life, personal relationship, and sleeping showed significant improvement of life quality, 3. The satisfaction degree to the therapy showed lower score than expectation to it in AT group and SGB group, however, it was not significant. Conclusions : The results showed that the four-week non-medicinal treatment (AT and SGB) in chronic headache patients was effective for reducing headache and releasing its damage in daily life, however, no difference in superiority was found. Therefore, non-medicinal treatment (AT therapy and SGB) could be utilized in chronic headache patients.

• Sleep Medicine and Psychophysiology
• /
• v.21 no.2
• /
• pp.69-73
• /
• 2014

Objectives: This study was designed to assess the change of heart rate variability (HRV) at resting, upright, and psychological stress in anxiety disorder patients. Methods: HRV was measured at resting, upright, and psychological stress states in 60 anxiety disorder patients. We used visual analogue scale (VAS) score to assess tension and stress severity. Beck depression inventory (BDI) and state trait anxiety inventories I and II (STAI-I and II) were used to assess depression and anxiety severity. Differences between HRV indices were evaluated using paired t-tests. Gender difference analysis was accomplished with ANCOVA. Results: SDNN (Standard deviation of normal RR intervals) and low frequency/high frequency (LF/HF) were significantly increased, while NN50, pNN50, and normalized HF (nHF) were significantly decreased in the upright position compared to resting state (p < 0.01). SDNN, root mean square of the differences of successive normal to normal intervals, and LF/HF were significantly increased, while nHF was significantly decreased in the psychological stress state compared to resting state (p < 0.01). SDNN, NN50, pNN50 were significantly lower in upright position compared to psychological stress and nVLF, nLF, nHF, and LF/HF showed no significant differences between them. Conclusion: The LF/HF ratio was significantly increased after both physical and psychological stress in anxiety disorder, but did not show a significant difference between these two stresses. Significant differences of SDNN, NN50, and pNN50 without any differences of nVLF, nLF, nHF, and LF/HF between two stresses might suggest that frequency domain analysis is more specific than time domain analysis.

• Clinics in Shoulder and Elbow
• /
• v.11 no.2
• /
• pp.104-111
• /
• 2008

Purpose: The aim of this study is to analyze the clinical results of using the technique of rotator cuff repair without parting the biceps long head from the glenoid for large or massive tear of the rotator cuff. Material and Methods: Form January 2005 to January 2007, we performed the arthroscopic biceps repair with incorporating suture to the rotator cuff for 21 patients with large or massive rotator cuff tear. The mean follow up period was 23 months (range: 6-48months). The number of males and females was 9 and 13, respectively. The age distribution ranged from 47 to 73 years with a mean age of 60.3 years. We compared the preoperative score with the postoperative scores using the University of California Los Angeles (UCLA) score, the shoulder index of the American Shoulder and Elbow Surgeons (ASES) and a simple shoulder test (SST). Results: The improvement in the VAS, ASES and the UCLA and SST scores was statistically significant at the final follow up (average follow-up 23 months) (p>0.05). Two of nine cases were found to have partial tear with continuity but seven cases were found to have complete tear according to the ultrasonography and MRI. Conclusion: The technique of rotator cuff repair without parting the biceps long head from the glenoid for large or massive tear of the rotator cuff is considered to be recommendable.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.5 no.2
• /
• pp.61-65
• /
• 2012

Purpose: The aim of this study was to evaluate the effectiveness of ultrasound-guide steroid injection according to Morton's neuroma size. Materials and Methods: From October 2008 to September 2011, 17 patients (23 cases) diagnosed with Morton's neuroma were investigated. All cases were female and mean age was 52.6 years old. Neuroma were measured by the horizontal and longitudinal length of the mass and underwent ultrasound-guided steroid (5 mg dexamethasone) injection. The efficacy of the injection was determined by Visual Analogue Scale pain score and patient satisfaction(subdivided 4 group-much improved, improved, not improved, aggrevation) Results: 7 of 23(30.4%) cases showed much improved and improved satisfaction and mean longitudinal and horizontal length were $0.71{\pm}0.39cm$ and $0.47{\pm}0.24cm$, respectively. 16 of 23(69.6%) cases showed not improved and aggrevation satisfaction and mean longitudinal and horizontal length were $0.83{\pm}0.42cm$ and $0.54{\pm}0.14cm$, repectively. There was a significant difference in VAS and patient satisfaction in case longitudinal and horizontal length were smaller than 0.5 cm and 0.4 cm. (p<0.05) Conclusion: The ultrasonography is a important modality in diagnosis and treatment of morton's neuroma. Ultrasound-guide steroid injection is effective in case longitudinal and horizontal length were smaller than 0.5 cm and 0.4 cm, respectively.

• Journal of Korean Academy of Nursing
• /
• v.22 no.1
• /
• pp.49-67
• /
• 1992

Most hospitalized children will experience physical pain as well as psychological distress. Preschool children's pain perception related to painful procedures can increase due to elevated anxiety and fear because they do not have understanding logical of their disease and hospitalization. In particular, they are distressed about needle - related procedures which are feared because they are seen to be a cause of bodily damage. This descriptive study attempted to identify pain perception levels in preschool children and their mothers. A self-reporting measurement and behavioral observation were used to collect the data. A total of 25 hospitalized preschool children and their mothers were investigated and data were collected about 60 painful procedures. Data collection was carried out by the researcher and two trained investigators from November first to December tenth. Three insruments were used to collect the data : Faces Pain Rating Scale(FPRS) developed by Beyer was used to measure the degree of preschool children's pain perception about painful procedures. The Visual Analogue Scale(VAS) devised by Huskisson was used to assess the degree of mothers' pain perception about their children's painful procedures. A Pain Behavioral Checklist based on the Procedure Behavior Check List by LeBaron and Zelter and modified by the researcher was used to observe behaviors of preschool children, their mothers, and nurses when the painful procedures took place. The data were analyzed by an SPSS program, and were tested using real numbers, percentages, Pearson correlation coefficient, t-test, and ANOVA. The results of this study are as follows : 1. Of all the painful procedures, the mean score for the FPRS for the preschool children's pain perception was 4.02 points, and the mean score for the VAS of mothers' pain perception was 10.92 points. 2. A Positive correlation which was statistically significant was found between the pain perception of preschool children and their mothers (r＝.53, p＜.01). that is, the higher the children's pain perception was, the higher their mothers' pain perception was. 3. The characteristics of the painful procedures related with children's pain perception as follows : The type of painful procedure was found to be statistically significant (F＝23.44, p＜.01), Among the three procedures Ⅳ starting was found to be perceived as the most painful procedures to the children. The greater the number of times that the procedure had been done, the higher the pain perception was (F＝4.44, p＜.01), and the longer the duration of the procedure, the higher the pain perception wa(r＝.30, p＜.05). Pain perception in the treatment room was higher than in the children's room(t＝6.30, ＜.01), pain perception in the mother's presence was the higher than when the mother was not present (t＝2.91, p＜.01). 4. The characteristics of the painful procedures related with the mothers' pain perception as follows : The type of painful procedure was found to be statistically significant(F＝6.01, p＜.01). Among the three procedures Ⅳ sampling was found to be perceived as the most painful procedures to the mothers. The greater the number of times that the procedure had been done, the higher the pain perception was (F＝5.95, p＜.01), and the longer the duration of the procedure, the higher the pain perception was (r＝.31, p＜.05). Pain perception in the treatment room was higher than in the children's room (t＝3.51, p＜.01), but pain perception in the mother's presence showed statistically significant no difference. 5. Of all of the 19 children's behaviors during the painful procedures, the most frequent behaviors observed Were as follows in order of frequency “crying”, “screamirig”, “facial grimacing”, “physical resistance”, Of all of the nine methers' behaviors, the most frequent by observed in “console children”, “hold children”, “applaud children”, Of all of the 11 nurses' behaviors during the painful procedures, the mast frequent in order were “smiling”, “physical restraint”, “console children”, “praise children”. 6. A positive correlation between children's and mothers' pain perception and children's behaviors was found to be statistically significant (r＝.65, p＜.01, r＝67, p＜.01). Also the relationship between children's and mothers' pain percertion, and mothers' behavior was found to be statistically significant (r＝.57, p＜. 01, 4＝.60, p＜.01). The relationship between children's pain perception and nurses' behaviors was also found to be statistically significant (r＝.46, p＜.01), but there was difference between mothers' pain perception and nurses' behaviors.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.33 no.1
• /
• pp.20-25
• /
• 2022

Background and Objectives Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst^®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst^® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI). Materials and Method We prospectively evaluated the efficacy of Mucomyst^® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst^® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst^® for 4 and 8 weeks. Results The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. Conclusion Inhaled Mucomyst^® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst^® treatment as a standard treatment for globus.

• Journal of the Korean Orthopaedic Association
• /
• v.56 no.6
• /
• pp.484-490
• /
• 2021

Purpose: A rheumatoid forefoot deformity includes severe hallux valgus and claw toe of the four lateral toes. The authors intended to analyze the mid-term results of the modified Hoffman procedure for a rheumatoid forefoot deformity. Materials and Methods: Twenty-two feet of eighteen patients were followed up for more than two years after the modified Hoffman procedure. The mean age was 54.7 years, and the mean follow-up period was three years and four months. Clinically visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) MP-IP score were analyzed preoperatively and postoperatively. The postoperative complications, the satisfaction of patients, and the presence of plantar callosity were also analyzed. Radiographically, the hallux valgus angle, the 1st intermetatarsal angle, the 1st interphalangeal angle, the 1st interphalangeal joint arthritic change after the operation, and the dorsiflexion angle and the time to union of the 1st metatarsophalangeal joint were analyzed. Results: Clinically, the VAS and AOFAS score were respectively improved from 7.1 points and 30.3 points preoperatively to 1.5 points and 83.1 points postoperatively (p<0.001). All patients were satisfied with the results. Plantar callosity disappeared in all cases. Radiographically, the mean hallux valgus angle, the 1st intermetatarsal angle, and the 1st interphalangeal angle changed from 52.8°, 13.3°, and 7.5° preoperatively to 16.2°, 8.7°, and 14.6° postoperatively (p<0.001). The mean dorsiflexion angle of the 1st metatarsophalangeal joint was 17.2° postoperatively. The mean time to radiographic union of the 1st metatarsophalangeal joint was 11.1 weeks. There were two cock-up deformities of the lesser toe, one wound problem, and two hallux interphalangeal joint arthritis as a complication. There were no cases of nonunion of the 1st metatarsophalangeal joint. Conclusion: The modified Hoffman procedure appears to be a safe and satisfactory procedure for a rheumatoid forefoot deformity.

• Journal of the Korean Orthopaedic Association
• /
• v.52 no.1
• /
• pp.1-6
• /
• 2017

Purpose: To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture. Materials and Methods: Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication. Results: The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B. Conclusion: Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.