Is an Anatomical Suprapectineal Quadrilateral Surface Plate Superior to Previous Fixation Methods for Anterior Column-Posterior Hemitransverse Acetabular Fractures Typical in the Elderly?: A Biomechanical Study

Background@#This study aimed to compare the mechanical characteristics of four fixation methods including an anatomical suprapectineal quadrilateral surface (QLS) plate in hemipelvic models of anterior column–posterior hemitransverse acetabular fractures typical in elderly patients. @*Methods@#In total, 24 composite hemipelvic models were used and allocated to four groups: group 1, pre-contoured anatomical suprapectineal QLS plate; group 2, suprapectineal reconstruction plate with two periarticular long screws; group 3, suprapectineal reconstruction plate with a buttress reconstruction plate; group 4, suprapectineal reconstruction plate with a buttress T-plate. Axial structural stiffness and displacement of each column fragment in four different fixation constructs were compared. @*Results@#Multiple group comparisons of axial structural stiffness demonstrated significant difference (p = 0.001). Although there was no significant difference between groups 1 and 2 (p = 0.699), group 1 showed greater stiffness than groups 3 and 4 (p = 0.002 and 0.002, respectively). Group 1 showed less displacement in the anterior region of the anterior fragment than group 4 (p = 0.009) and in the posterior region than groups 3 and 4 (p = 0.015 and p = 0.015, respectively). However, group 1 demonstrated greater displacement than group 2 in the posterior region of the posterior fragment (p = 0.004), while showing similar displacement to groups 3 and 4. @*Conclusions@#The anatomical suprapectineal QLS plate provided the mechanical stability comparable or superior to other existing fixations in osteoporotic models of anterior column–posterior hemitransverse acetabular fractures typical in the elderly. However, additional plate modification would be needed for better stability and outcomes.

Therapeutic effects of sialendoscopy for diagnosis and treatment of hyposalivation patients: a retrospective study / 대한악안면성형재건외과학회지

Background@#Hyposalivation is disease with multiple symptoms. This disease is hard to be diagnosed and to be treated, and there are not enough clinical protocols to cure the disease. In this study, we propose our own treatment protocols which aim not only to cure the disease but also to care for the disease-related symptoms. @*Methods@#At the 1st visit, we collect patient-related information. This procedure includes an intraoral exam, patient history taking, VAS value and unstimulated whole saliva (UWS) measurement, and salivary buffer test. Following the interview and oral examination, objective results are obtained by radiological image, CT, and sialoscintigraphy. At the 2nd visit, we analyze radiographic images including neck CT and salivary scintigraphy. These images can allow accurate diagnosis and help the patients to better understand the current condition. Depending on the severity of symptoms and patient’s discomfort, we try a surgical approach at the 3rd visit, sialendoscopy. @*Results@#With treatment, we can manage the discomfort of patients in daily life. The VAS value of hyposalivation patients dropped gradually with the trial of sialendoscopy. In the case of Sjogren’s syndrome patients, the treatment efficacy has been decreased with low reactivity of treatment. The true meaning of this treatment is in not only curing the disease, but also caring for the disrupted patients. Overall, the amount of UWS increased with the progress after the procedure. Especially in the lower UWS at the 1st visit, there was a more significant increase after the procedure. @*Conclusion@#Although many factors that cause hyposalivation have not been identified, the efficacy of sialendoscopy to relieve discomfort in hyposalivation patients has been observed. However, treatment was more difficult and complicated in the group of patients with systemic disease. This study will not only present a treatment protocol for hyposalivation patients, but also consider methods for diagnosing more precisely and improving treatment efficacy. Hyposalivation is a curable and manageable disease in some cases, so interpretation between the clinician and the patient is important.

The Effects of Peat-Pack Poultice and Salt Groundwater Foot Bath in Taean-gun on Depression and Pain in Single Parent Family

Purpose@#Studies have reported on treating various diseases with marine healing, but not the effects of marine healing on depression, anxiety, and pain in single-parent families. This study aimed to evaluate the scientific efficacy of treatment using peat-pack poultice and salt groundwater and evaluate its effects on depression, anxiety, and pain in single-parent families. @*Methods@#For 26 women of single-parent families, peat-pack thermal therapy and salt-water foot baths were performed daily for 4 days. Of the 26 subjects, three dropped out and 23 were enrolled in the study. The depression and pain results were compared before versus after the peat-pack poultice and salt groundwater treatments. The Edinburgh Postnatal Depression Scale, Hospital Anxiety and Depression Scale (HADS), and visual analog scale (VAS) pain score were evaluated. @*Results@#In Taean-gun, a peat-pack poultice and salt groundwater foot bath program were administered along with a questionnaire for depression, anxiety, and pain. Mean Edinburgh score was significantly improved after the program (11.78±7.6 vs. 9.7±7.6, p=0.005), mean HADS anxiety score (7±9.7 vs. 5.3± 2.7, p=0.002) and mean VAS pain score also improved (5.39±2.8 vs. 3.96±2.7, p=0.003). @*Conclusion@#Peat-pack thermal therapy and salt groundwater foot bath improved chronic pain, depression, and anxiety in single-parent families.

Short Term Intake of Undaria pinnatifida Does Not Affect Bone Biomarkers in Young Korean Women with Low Calcium Intake

Calcium intake is essential for bone health, but young Korean women have low calcium intakes. Seaweeds have high calcium content, which may affect calcium metabolism. Twenty nine females aged 18–39 years with low calcium intake (< 400 mg/day) participated in a 19-day open-label randomized controlled trial. During the first five days, participants adhered to a controlled-feeding protocol followed by a two-week supplementation period in free-living conditions. The treatment group (n = 14) received an additional 200 mg Ca/day through Undaria pinnatifida and Porphyra in meals during the controlled-feeding period, and as U. pinnatifida noodles during days 6–19. Mineral intake (Ca, P, Mg, Na, and K) was assessed from diet composites and three 24-hour recalls during the controlled-feeding and free-living periods, respectively. Fasting serum levels of calcium, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D (1,25[OH]D), phosphorus, parathyroid hormone (PTH), and alkaline phosphatase (ALP) were assessed at baseline, day 6, and day 19. Statistical analyses were performed by Student's t-test and mixed ANOVA. Mean intakes of all minerals during days 1–5 and mean Ca and Mg intakes during days 6–19 were greater in the treatment group compared to the control group. No group effect or group and time interaction was observed in serum biomarkers. Serum 1,25(OH)D increased while PTH and ALP tended to decrease on day 6 but returned to baseline values on day 20. Short-term intake of U. pinnatifida and Porphyra does not affect calcium metabolism in young Korean women with low calcium intakes.

Marine Healing, but Not Additional Intake of Undaria pinnatifida, Benefits Physical and Emotional Exhaustion Symptoms of Menopause

Effects of Meaning-Centered and Mindfulness-Based Stress Management Program with Using Marine Resources on the Improvement of Emotion, Sleep Quality, Quality of Life and Cognitive Function in Family Caregiver of Patients with Severe Physical Disability : Preliminary Study / 정신신체의학

OBJECTIVES@#The purpose of this study was to investigate the effects of meaning centered and mindfulnessbased stress management program with using marine resources on positive changes in mood, sleep, quality of life and cognitive function.@*METHODS@#Nine family caregivers of patients with severe disability experienced meaning centered and mindfulness-based stress management program for four-days in marine areas near Uljin-gun, Gyeongsangbuk-do in South Korea. Subjective questionnaires and objective assessments were conducted and statistically analyzed to examine changes in mood, sleep, quality of life, and cognitive function before, after, and after 6 weeks of participation.@*RESULTS@#After participating in the program, moods including depression improved significantly. This effect lasted until 6 weeks. Participants' sleep quality, quality of life and cognitive function improved significantly after 6 weeks of program participation.@*CONCLUSIONS@#This new specialized stress management program using marine resources for family caregivers of patients with severe disability is expected to be used effectively in terms of improving their overall quality of life, mental health status and cognitive efficiency.

Effect of arthrocentesis on the clinical outcome of various treatment methods for temporomandibular joint disorders / 대한악안면성형재건외과학회지

BACKGROUND@#We evaluated the improvement of pain and the increase in mouth opening after temporomandibular joint arthrocentesis and the possible association with various factors such as previous splint treatment, medication, and diagnosis.@*RESULTS@#We studied 57 temporomandibular joint disorder patients who underwent arthrocentesis at Korea University Anam Hospital. These patients (24 males and 33 females, aged between 15 and 76 years) underwent arthrocentesis that was performed by one surgeon. The degree of mouth opening (assessed using the maximum mouth opening: MMO) and pain (assessed using the visual analog scale: VAS) were assessed pre- and post-arthrocentesis. The study also investigated whether treatment modalities other than arthrocentesis (medication and appliance therapy) were performed. Statistical analysis revealed that there was a significant difference in mouth opening and pain after temporomandibular joint arthrocentesis. Preoperative appliance therapy affected the results of arthrocentesis, but it was not statistically significant. With regard to pain relief, preoperative diagnosis did not show a significant difference. However, with regard to maximum mouth opening, patients with disc displacement without reduction with limited mouth opening (closed lock) showed the highest recovery (11.13 mm).@*CONCLUSION@#The average of MMO increase after arthrocentesis was 9.10 mm, and patients with disc displacement without reduction with locking (closed lock) showed most recovery in maximum mouth opening and it was statistically significant. The average pain relief of patients after arthrocentesis was 3.03 in the VAS scale, and patients using anterior repositioning splint (ARS) preoperatively showed the most pain relief.

Effects of a Mindfulness-Based Mind-Body Intervention Program using Marine Resources on the Improvement of Sleep Quality and Mood Symptoms in Korean Female Emotional Labor Workers : A Pilot Study / 수면정신생리

OBJECTIVES: The purpose of this pilot study was to examine the effects of a mindfulness-based Body-Mind Intervention Program using marine resources on the improvement of quality of sleep, mood symptoms, and cognitive function in Korean female emotional labor workers. METHODS: Twelve female workers who experienced excess emotional labor participated at the training camp program for five days in Danghangpo-ocean park, Goseung-gun, Gyeongnam Province in South Korea. Participant sleep quality, mood symptoms, and cognitive functioning before, after, and 1.5 months later were evaluated and analyzed. RESULTS: After participating in the marine resource program, participants reported significantly decreased sleep latency. Global sleep quality, cognitive functions (attention, flexibility, and inhibition control), and mood states, including depression, tension, anger, fatigue, were also improved. These effects were generally maintained after 1. 5 months (PSQI t = 2.63, p = 0.02 ; HAM-D t = 5.92, p < 0.001). CONCLUSION: A Body-Mind Intervention Program using marine resources was effective in relaxing emotion-related tension and improving cognitive function. To advance this pilot study, it is necessary to carry out further research to investigate the use of marine resources in mental health interventions.

The Formation of Extragraft Bone Bridging after Anterior Cervical Discectomy and Fusion: A Finite Element Analysis

OBJECTIVE: In addition to bone bridging inside a cage or graft (intragraft bone bridging, InGBB), extragraft bone bridging (ExGBB) is commonly observed after anterior cervical discectomy and fusion (ACDF) with a stand-alone cage. However, solid bony fusion without the formation of ExGBB might be a desirable condition. We hypothesized that an insufficient contact area for InGBB might be a causative factor for ExGBB. The objective was to determine the minimal area of InGBB by finite element analysis. METHODS: A validated 3-dimensional, nonlinear ligamentous cervical segment (C3–7) finite element model was used. This study simulated a single-level ACDF at C5–6 with a cylindroid interbody graft. The variables were the properties of the incorporated interbody graft (cancellous bone [Young’s modulus of 100 or 300 MPa] to cortical bone [10000 MPa]) and the contact area between the vertebra and interbody graft (Graft-area, from 10 to 200 mm²). Interspinous motion between the flexion and extension models of less than 2 mm was considered solid fusion. RESULTS: The minimal Graft-areas for solid fusion were 190 mm², 140 mm², and 100 mm² with graft properties of 100, 300, and 10000 MPa, respectively. The minimal Graft-areas were generally unobtainable with only the formation of InGBB after the use of a commercial stand-alone cage. CONCLUSION: ExGBB may be formed to compensate for insufficient InGBB. Although various factors may be involved, solid fusion with less formation of ExGBB may be achieved with refinements in biomaterials, such as the use of osteoinductive cage materials; changes in cage design, such as increasing the area of polyetheretherketone or the inside cage area for bone grafts; or surgical techniques, such as the use of plate/screw systems.

Biomechanical Analysis of a Novel Wedge Locking Plate in a Porcine Tibial Model

BACKGROUND: The purpose of this study was to analyze biomechanical properties of a novel wedge locking plate in medial open wedge high tibial osteotomy (OWHTO) in a porcine tibial model. METHODS: A uniform 8-mm OWHTO was performed in 12 porcine tibiae. Six of them were subsequently fixed with the plate without a wedge, whereas the other 6 were additionally reinforced with a metal wedge of 8 mm. Biomechanical properties (stiffness, displacement of the osteotomy gap, and failure load) were evaluated under axial load. The different modes of failure were also investigated. RESULTS: The plate showed an axial stiffness of 2,457 ± 450 N/mm with a wedge and 1,969 ± 874 N/mm without a wedge. The maximum failure load was 5,380 ± 952 N with a wedge and 4,354 ± 607 N without a wedge. The plate with a wedge had a significantly greater failure load and significantly less displacement of medial gap at failure than that without a wedge (p = 0.041 and p = 0.002, respectively). The axial stiffness was not different between the two types of fixation. Most failures were caused by lateral cortex breakage and there was no implant failure. CONCLUSIONS: The novel wedge locking plate showed excellent biomechanical properties and an additional wedge provided significant improvement. This plate can be a good fixation method for OWHTO.

Biomechanical Comparison Analysis of Cervical Plate Systems for Anterior Cervical Discectomy and Fusion: Constrained vs. Semi-constrained Systems / 대한골다공증학회지

The purpose of this study were to constructed multi-level cervical spine finite element (FE) model and to investigate changes in load distribution and range of motion (ROM) at index level and adjacent levels at immediately after anterior cervical discectomy and fusion (ACDF) and after full bony union using constrained and semi-constrained cervical plate systems(dynamic plate, variable screw). A FE model of intact cervical spine (C3-6) was created from computer tomography (CT) images of the healthy adult (male, 26 years, no pathologies). The post-op FE models (C5-6 with ACDF, cage with bone graft) were constructed by modifying a intact cervical FE model. Four different configurations of the model were considered: Type 1-Rigid plate+Fixed screw, Type II-Rigid plate + Variable screw, Type III-Dynamic plate + Fixed screw, Type IV-Dynamic plate + Variable screw. The bone-cage and bone screw interface behavior were accomplished via 'tie' contact condition and friction coefficient of 0.2 to assume fusion and non-fusion, respectively. The inferior endplate of C6 vertebral body was constrained in all directions. Loading condition used hybrid protocol with follower load of 73.6N at superior endplate of C3 vertebral body. In non-fusion cases, load at the bone graft increased from Type I to IV (2.3

Relief of Chronic Posterior Neck Pain Depending on the Type of Forest Therapy: Comparison of the Therapeutic Effect of Forest Bathing Alone Versus Forest Bathing With Exercise

OBJECTIVE: To compare the pain-reducing effect of forest bathing alone versus forest bathing in combination with stretching and strengthening exercises in patients with chronic posterior neck pain. METHODS: Sixty-four subjects with posterior neck pain that had lasted more than 3 months were enrolled. They were randomly divided into a forest bathing alone (FBA) group and a forest bathing with exercise (FBE) group; each group included 32 subjects. All subjects from both groups walked every morning in the forest for about 2 hours for 5 days. In the afternoon, the FBE group did a stretching and strengthening exercise for about 4 hours; the FBA group had free time in the woods. Visual analog scale (VAS) on one day, VAS over the previous week, neck disability index (NDI), EuroQol 5D-3L VAS (EQ VAS) and index (EQ index), McGill pain questionnaire (MPQ), the number of trigger points in the posterior neck region (TRPs), and the range of motion of the cervical spine were evaluated on the first and last day of the program and compared between the two groups. RESULTS: The number of TRPs were significantly reduced in the FBE group compared with the FBA group (p=0.013). However, the other scales showed no significant difference between the two groups. CONCLUSION: When patients with chronic posterior neck pain underwent a short-term forest bathing (less than 7 days) program, FBE was more effective in the reduction of the number of TRPs than FBA. However, all other pain measurement scales we evaluated showed no statistically significant difference between the two protocols.

Associations between Smartphone Addiction Proneness and Psychopathology

OBJECTIVES: This study aims to investigate possible associations between proneness toward smartphone addiction and certain psychopathological variables to evaluate the psychopathological meaning of smartphone addiction. METHODS: Questionnaires were assigned to 755 adults between September and November 2012. We used the Korean Smartphone Addiction Proneness Scale (SAPS), the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Barratt Impulsivity Scale-11 (BIS-11). Subjects were classified into two groups according to the scores of the SAPS ; the addiction proneness group and the normal-user group. RESULTS: The addiction proneness group had significantly higher scores than the normal-user group in the BDI, BAI, OCI-R, and BIS-11. The scores of the SAPS were positively correlated with the scores of the BDI, BAI, OCI-R, and BIS-11. Using logistic regression analysis, smartphone addiction proneness showed a significant association with BIS-11. CONCLUSIONS: The results of this study suggest that smartphone addiction proneness may be associated with depression, anxiety, obsessive-compulsive symptoms, and impulsivity. Furthermore, impulsivity could be a vulnerability marker for smartphone addiction proneness.

Biomechanical Properties of a New Anatomical Locking Metal Block Plate for Opening Wedge High Tibial Osteotomy: Uniplane Osteotomy

PURPOSE: The purpose of this study was to evaluate the biomechanical properties of a new anatomical locking metal block plate by comparing the initial biomechanical stability of three different fixation constructs for open wedge high tibial osteotomy (HTO). MATERIALS AND METHODS: Sawbones composite tibiae were used to make a 10-mm opening osteotomy model with uniplane technique. The osteotomy was secured with three different types of plates: Group I, new osteotomy plate without a metal block (n=5); Group II, new osteotomy plate with a 10-mm metal block (n=5); and Group III, two short metal block plates (n=5). Single load to failure test and staircase load-controlled cyclical failure test were performed. In the single load to failure test, the yield load, maximum failure load, and the displacement of the osteotomy gap were measured. In the staircase cyclical load to failure test, the total number of cycles to failure was recorded. Failure modes were observed during both single and cyclic load tests. RESULTS: Group II showed the highest yield and ultimate loads (1829+/-319 N, 3493+/-1250 N) compared to Group I (1512+/-157 N, 2422+/-769 N) and Group III (1369+/-378 N, 2157+/-210 N, p<0.05). The displacement of the opening gap in Group II (0.34+/-0.35 mm) was significantly lesser than the other groups (p<0.05). In the staircase cyclical load to failure test, the total number of cycles to failure was 12,860 at 950 N in Group III, 20,280 at 1,140 N in Group I, and 42,816 at 1,330 N in Group II (p<0.05). All the specimens showed complete fracture of the intact lateral sawbones area and slight displacement of the distal fragment of the specimens in the single load to test. None of the specimens showed deformed or broken screws and plates during the single load to test. During the fatigue test with staircase cyclic loading, no fracture of the lateral sawbones area was observed. CONCLUSIONS: This study demonstrated that the new anatomical locking metal block plate could provide sufficient primary stability for open wedge HTO. The addition of a metal block to this new plate can increase the stability of the osteotomy compared to the one without a metal block.

Analysis of Clinical Outcome and Effectiveness of Steroid and Antiviral Treatment in Patients with Bell's Palsy in the Emergency Department

PURPOSE: This study was conducted for investigation of the recovery rate and prognostic factors of Bell's palsy treated with steroid and antiviral agents in the emergency department (ED). METHODS: A retrospective review of electronic medical records of patients with acute, unilateral Bell's palsy within 72 hrs of onset who were admitted from the ED between March 2008 and February 2010 was conducted. All patients were treated uniformly with high-dose steroid and valaciclovir. The House-Brackmann (HB) grading system was used for evaluation of the severity of facial palsy. Satisfactory recovery was defined as facial palsy that recovered to Grade I on the HB grading scale. RESULTS: During the three-year period, 231 patients (age, 51+/-15) with confirmed Bell's palsy were included in this study. Initial grade of paralysis was as follows: 43 patients (18.6%) were HB grade II, 107 patients (46.3%) were grade III, 72 patients (31.2%) were grade IV, and nine patients (3.9%) were grade V. The satisfactory recovery rate was 77.9% at three months, and 88.3% at 12 months from diagnosis. Satisfactory recovery rate was significantly lower in patients with initial HB grade III/IV (85.2% vs. 92.7%, p<0.01), and age over 40 years (85.72% vs. 95.2%, p=0.04). CONCLUSION: The satisfactory recovery rate of patients with Bell's palsy treated with steroid and antiviral agents was 77.9% at three months, and 88.3% at 12 months, and initial severity was found to be an important factor in predicting the long term prognosis of Bell's palsy.

What does integrative medicine mean to the physician and the ministry of health and welfare?

Our aging society, rapid growth of diseases resulting from unhealty habits, frequent occurrences of sickness, and variations in the awareness of health by patients, the worldwide need for integrative medicine, which means the incorporation and integration of complementary and alternative medicine (CAM) into conventional medical systems, is growing rapidly. The most widely available forms of CAM in the treatment of diseases in the U.S. and Europe are acupuncture, chiropractic, phytomedicine (western herbal medicine), mind-body therapies, and nutrition therapy. The well-known hospitals in the U.S. and in Europe (e.g., Harvard, Memorial Sloan-Kettering Cancer Center, Duke, Maryland, Essen, and Humboldt) are offering integrative medicine. The clinical practices as well as the education on CAM of medical schools is becoming more widespread in Korea. It is critical for us as physicians to be aware that the role of CAM is to support and complement conventional medicine, not to substitute for it. To manage chronic diseases effectively, it is imperative for physicians to incorporate and integrate Korean oriental medicine as well as CAM into the conventional medical systems. It is the duty of the medical universities and hospitals to integrate care delivery proven by CAM therapies into the conventional medicine and to develop the standard curriculum for integrative medicine at the undergraduate and graduate levels. To globalize Korean oriental medicine and to scientifically prove the efficiency of CAM, the role of integrative medicine is critical. One of the most important roles of the Ministry of Health and Welfare is to support the hospitals in which integrative medicine is systematically practiced and financially supported. In order to successfully accomplish integrative medicine in Korea, it is important to not only establish an integrative medicine center, but to also develop the contents and clinical pathway along with legal systems regarding integrative medicine with the support of the specialists in the field of integrative medicine.

Effects of Mindfulness Based Stress Reduction Program on Depression, Anxiety and Stress in Patients with Aneurysmal Subarachnoid Hemorrhage

OBJECTIVE: In this study, the Mindfulness Based Stress Reduction (MBSR) program was applied to patients presenting with depression and anxiety after surgery from spontaneous subarachnoid hemorrhage (SAH) and the effects were assessed. METHODS: The subjects were patients admitted for cerebral aneurysm rupture and treated by means of surgery from March to December, 2007. More than 6 months had passed after surgery, without any special lesions showing up on computed tomography (CT), and the Glasgow outcome scale (GOS) was 5 points. Among patients with anxiety and depression symptoms, 11 patients completed the program. The MBSR program was conducted once a week, 2.5 hours each, for 8 weeks. The evaluation criteria were : 1) the Beck Depression Inventory (BDI): it measures the type and level of depression, 2) the State-Trait Anxiety Inventory : the anxiety state of normal adults without mental disorder, and 3) Heart Rate Variability (HRV) : the influence of the autonomous nervous system on the sinoarterial node varies continuously in response to the change of the internal/external environment. RESULTS: The BDI value was decreased from 18.5 +/- 10.9 to 9.5 +/- 7.1 (p = 0.013) : it was statistically significant, and the depression level of patients was lowered. The state anxiety was decreased from 51.3 +/- 13.9 to 42.3 +/- 15.2; the trait anxiety was reduced from 50.9 +/- 12.3 to 41.3 +/- 12.8, and a borderline significant difference was shown (p = 0.091, p = 0.056). In other words, after the treatment, although it was not statistically significant, a decreased tendency in anxiety was shown. In the HRV measurement, standard deviation normal to normal (SDNN), square root of the square root of the mean sum of squared differences between adjacent normal to normal intervals (RMSSD), and total power (TP) showed significant increase, Physical Stress Index (PSI) showed a significant reduction, and thus an improvement in the homeostatic control mechanism of the autonomic nervous system was ween. CONCLUSION: The MBSR program was applied to the patients showing anxiety and depression reaction after SAH treatment, and a reduction in depression symptoms and physiological reactions were observed. The application of the MBSR program may be considered as a new tool in improving the quality of life for patients after surgery.

The Roll of Complementary and Alternative Medicine in Integrative Medicine / 한양의대학술지

Complementary and alternative medicine (CAM) is a diagnosis, treatment and prevention which complements mainstream medicine by contributing to a common whole, satisfying a demand met by orthodox medicine. One of the most widely used classification structures, developed by National Center for Complementary and Alternative Medicine, divides CAM modalities into five categories: 1) Alternative medical systems, 2) Biologically based treatments, 3) Mind-body interventions, 4) Manipulative and body-based methods, 5) Energy therapies. But the effectiveness of the most CAM is not proven scientifically. The Federation of State Medical Boards developed model guidelines for the use of CAM in medical practice. The guidelines focus on encouraging the medical community to adopt consistent standards, ensuring the public health and safety by facilitating the proper and effective use of both conventional and CAM treatments. The integration of scientifically proven CAM into orthodox medicine is growing up and important in medicine. This kind of medicine is called "integrative medicine", which is a new paradigm in medicine.

Effect of Fracture Gap on Biomechanical Stability of Compression Bone-Plate Fixation System after Bone Fracture Augmentation

PURPOSE: The goal of this study using the biomechanical test was to evaluate the mechanical stability of the bone-plate fixation system according to changes of the fracture gap sizes and widths. MATERIALS AND METHODS: For mechanical test, four types with different fracture models simulating the clinical situations were constructed depending on the gap size (FGS, mm) and the gap width (FGW, %) at the fracture site: 0 mm/0%, 1 mm/100%, 4 mm/100%, 4 mm/50%. For analyzing the effects of fracture gap on the biomechanical stability of the bone-plate fixation system, 4-point bending test was performed under all same conditions. RESULTS: It was found that the fracture gap sizes of 1 and 4 mm decreased mechanical stiffness by about 50~60% or more. Furthermore, even without fracture gap size, 50% or more fracture gap width considerably decreased mechanical stiffness and suggested the possibility of plate damage through strain results. CONCLUSION: Our findings suggested that at least 50% contact of the fracture faces in a fracture surgery would be maintained to increase the mechanical stability of the bone-plate fixation system.

The Use of Complementary and Alternative Medicine in a General Population in South Korea: Results from a National Survey in 2006

The purpose of this survey was to obtain information on the prevalence, costs, and patterns of use of complementary and alternative medicine (CAM) in a general population in the Republic of Korea. In 2006, we conducted nationwide and population- weighted personal interviews with 6,021 adults ranging from 30 to 69 yr of age; the final sample consisted of 3,000 people with a 49.8% response rate. In addition to their general socio-demographics, the respondents were asked about their use of CAM during the previous 12-month period, costs, sources of information, and reasons for use. The prevalence of use overall was 74.8%, while biologically based CAM therapies were the most likely type of use (65.4%). The median annual out-of-pocket expenditures for CAM therapies was about US$203. The primary reason for using CAM was for disease prevention and health promotion (78.8%). The main source of advice about CAM therapies use was most likely to be from family and friends (66.9%). Our study suggests that CAM use has been and continues to be very popular in South Korea. Conventional western medical doctors and governments should obtain more evidence and become more interested in CAM therapies.