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Background@#Operative management with intramedullary nail fixation remains the definitive treatment of choice for osteoporotic subtrochanteric (ST) fractures; however, there remains no consensus regarding the proper nail length. We aimed to use 3-dimensional finite element (FE) analysis to determine the optimal nail length for the safe fixation of osteoporotic ST fractures. @*Methods@#Nine modes of FE models were constructed using 9 different lengths of cephalomedullary nails (short nails: 170, 180, and 200 mm; long nails: 280, 300, 320, 340, 360, and 380 mm) from the same company. The interfragmentary motion was analyzed. Additionally, the peak von Mises stress (PVMS) in the cortical bone, cancellous bone of the femoral head, and the nail were measured, and the yielding risk for each subject was investigated. @*Results@#Long nails were associated with less interfragmentary motion. In the cortical bone, the PVMS of short nails was observed at the distal locking screw holes of the femoral medial cortex; however, in long nails, the PVMS was observed at the lag screw holes on the lateral cortex. The mean yielding risk of long nails was 40.1% lower than that of short nails. For the cancellous bone of the femoral head, the PVMS in all 9 FE models was in the same area: at the apex of the femoral head. There was no difference in the yielding risk between short and long nails. For implants, the PVMS was at the distal locking screw hole of the nail body in the short nails and the nail body at the fracture level in the long nails. The mean yielding risk was 74.9% lower for long nails than that for short nails. @*Conclusions@#Compared to short nails, long nails with a length of 320 mm or more showed less interfragmentary motion and lower yielding risk in low-level osteoporotic ST fractures. The FE analysis supports long nails as a safer option than short nails, especially for treating transverse-type low-level osteoporotic ST fractures.
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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.
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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.
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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.
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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.
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Femenino , Humanos , Dieta , Servicios de Información , Menopausia , Planta de la Mostaza , Calidad de Vida , Algas Marinas , UndariaRESUMEN
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.
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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.
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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.
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Femenino , Humanos , Ira , Cognición , Depresión , Fatiga , Corea (Geográfico) , Salud Mental , Proyectos Piloto , DocilidadRESUMEN
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.