Objectives : To review surgical results of post-fusion lumbar flatback treated with pedicle subtraction osteotomy (PSO) or Smith-Petersen osteotomies (SPOs). Methods : Twenty-eight patients underwent osteotomies. Radiological outcomes by sagittal vertical axis (SVA), and pelvic tilt (PT), T1 pelvic angle (T1PA), and pelvic incidence (PI)-lumbar lordosis (LL) at preoperative, postoperative 1 month, and final were evaluated. Oswestry Disability Index (ODI), visual analog scale (VAS) score of back pain/leg pain, and Scoliosis Research Society-22 score (SRS-22r) were analyzed and compared. Patients were divided into 2 groups (SVA ${\leq}5cm$ : normal, SVA >5 cm : positive) at final and compared outcomes. Results : Nineteen patients (68%) had PSO and the other 9 patients had SPOs with anterior lumbar interbody fusions (ALIFs) (Mean age : 65 years, follow-up : 31 months). The PT, PI-LL, SVA, T1PA were significantly improved at 1 month and at final (p<0.01). VAS score, ODI, and SRS-22r were also significantly improved at the final (p<0.01). 23 patients were restored with normal SVA and the rest 5 patients demonstrated to positive SVA. SVA and T1PA at 1 month and SVA, PI-LL, and T1PA at final were significantly different (p<0.05) while the ODI, VAS, and SRS-22r did not differ significantly between the groups (p>0.05). Common reoperations were early 4 proximal junctional failures (14%) and late four rod fractures. Conclusion : Our results demonstrate that PSO and SPOs with ALIFs at the lower lumbar are significantly improves sagittal balance. For maintenance of normal SVA, PI-LL might be made negative value and T1PA might be less than $11^{\circ}$ even though positive SVA group was also significantly improved clinical outcomes.
Purpose: To determine the clinical and radiographic results of arthroereisis using the $Kalix^{(R)}$ implant (Newdeal, Lyon, France) for the treatment of flexible flatfoot deformity. Materials and Methods: From February 2005 to February 2007, we performed the subtalar arthroereisis on 8 patients (9 feet) of symptomatic flexible flat feet after more than 6 months of conservative treatment. Average age was 14.5 years ($11{\sim}29$ years) old. We checked the functional status with AOFAS functional score pre-operatively and at final follow-up. Radiologically, we took weight bearing anterior to posterior and lateral view of the feet, and measured the talo-first metatarsal angle, calcaneal pitch angle in pre-operatively and at final follow-up. Results: Mean follow up period was 34.4 months. Average AOFAS score improved from preoperatively 65.6 to postoperatively 94.8. Average lateral talo-first metatarsal angle reduced from $12.8^{\circ}$ preoperatively to $1.6^{\circ}$ at final follow-up. Average anterior to posterior talo-first metatarsal angle was reduced from $15.1^{\circ}$ preoperatively to $8.3^{\circ}$ at final follow-up. Average calcaneal pitch angle was increased from $9.5^{\circ}$ preoperatively to $12.0^{\circ}$ at final follow-up. Conclusions: Subtalar arthroereisis with Kalix$K^{(R)}$ implant can be considered to be one of treatment options symptomatic flatfoot deformity patients.
Purpose: We evaluate the results of subtalar arthroereisis with $Kalix^{(R)}$ implant (Newdeal, Lyon, France) that were performed in painful flatfoot deformity. Materials and Methods: We performed the subtalar arthroereisis on 16 feet of children symptomatic flexible flat feet after more than 6 months of conservative treatment. Average age was 11 years (8-14 years) old. We checked the functional status with AOFAS functional score in pre-operatively and at final follow-up. Radiologically, we took weight bearing anterior to posterior and lateral view of the feet, and measured the talo-$1^{st}$ metatarsal angle, calcaneal pitch angle, cuboid-surface height. Finally, we asked to patient's parents for satisfaction of the surgery. Results: Mean follow up period was 34.1 months. Average AOFAS score improved from preoperatively 71.9 to postoperatively 91.3. Only one patient has subtalar pain. Average lateral $1^{st}$ metatarsal angle reduced from $-18.2^{\circ}$ preoperatively to $-4.6^{\circ}$ at final follow-up. Average anterior to posterior $1^{st}$ metatarsal angle was reduced from $18.9^{\circ}$ preoperatively to $6.5^{\circ}$ at final follow-up. Average calcaneal pitch angle was increased from $8.6^{\circ}$ preoperatively to $12.6^{\circ}$ at final follow-up. Average cuoboid-surface height was improved from 12.1 mm preoperatively to 16.0 mm at final follow-up. All patients had excellent or good satisfaction. Conclusions: Subtalar arthroereisis with $Kalix^{(R)}$ implant is a viable surgical alternative for painful flatfoot deformity of children.
Lee, Young Ah;Yun, Kyong-Ah;Shin, Choong Ho;Yang, Sei Won
Clinical and Experimental Pediatrics
/
v.50
no.2
/
pp.190-197
/
2007
Purpose : Reduced growth and microvascular complications have been recognized as consequences of type 1 diabetes mellitus (T1DM). We assessed the effect of T1DM on growth and factors associated with the development of microvascular complications. Methods : We conducted a retrospective longitudinal evaluation of 154 patients above 16 years of age. We analyzed factors which affect final height standard deviation scores (SDS) and development of microvascular complications. Results : Final height SDS was $-0.11{\pm}1.15$ ($-0.26{\pm}1.33$ in females, $0.04{\pm}0.91$ in males). Final height SDS was significantly lower than midparental height SDS and height SDS at diagnosis. There was no difference in final height SDS according to age at onset, existence or nonexistence of complications, or average $HbA_{1C}$. Height SDS at onset of puberty, midparental height SDS and pubertal growth gain affected final height SDS. The number of patients with complications was 37 (24 percent). Microvascular complications developed at a younger age and after longer duration of diabetes in patients with a prepubertal onset of T1DM compared to patients with pubertal onset. Patients with complications had a higher level of average $HbA_{1C}$ than patients without complications. Patients whose microalbuminuria regressed had lower levels of average $HbA_{1C}$, systolic BP, second 24h urine microalbumin than patients with persistant or progressed microalbuminuria. Conclusion : The results suggest that degrees of glycemic control don't affect final height, but various factors associated with T1DM can impair growth potential. Additionally, the degrees of glycemic control and puberty affect the development of microvascular complications.
Purpose : The purpose of this study is to investigate an occurrence of valgus deformity of ankle joint after vascularized fibular graft in children. Materials and Methods : Four children under 15 years who were surgically treated with vascularized fibular graft were studied. The age of the patients was from 4 years to 13 years, the follow-up period was from 24 months to 108 months. The causes of vascularized fibular graft were open fracture (1 case), congenital psuedarthrosis (2 cases), hypoplastic ulna (1 case). The tibiofibular synostosis was done in 3 cases and not in 1 case. We measured the tibiotalar angle and bimalleolar angle at immediately postoperative and final radiography, and checked ankle motion, pain, and instability of ankle joint. Results : The A-P mortise angle was not different between initial and final radiography in all cases. The intermalleolar angle increased in all cases at the final radiography. There were no pain, instability and limitation of ankle motion. Conclusion: We consider the tibiofibular synostosis can prevent from ankle valgus deformity after vascularized fibular graft in children.
The purpose of this study was to investigate the syllable and phoneme frequencies in the spontaneous speech of some Korean children. Sixty four normally developing children aged from 2 to 5 were involved (male: female=1 : 1, 16 children in each age group). Fifty connected utterances were analyzed using the KCLA (Korean Computerized Language Analysis) 2.0 and Exel. The findings were as follows: 1) /i/ was the most frequently used syllable and was followed by /yo/, /k/, /s'/, /nen/ and so on. 2) The most frequently used Korean phonemes were syllable-initial consonant /k/, syllable- medial vowel /a/ and syllable-final consonant /n/. 3) All seven syllable final consonants (/p,t,k,m,n,n,l/) were used more frequently in the word-medial position than in the word-final position. Three syllable initial consonants(/k, I, s'/) were used more frequently in the word-medial position than in the word-initial position. The syllable and phoneme frequencies in the Korean children's spontaneous speech will provide valuable information in interpreting the severity of phonological disorder and in developing tools for the Korean phonological assessment and intervention.
Covariance components and genetic parameters of weekly live body weight from hatching to six weeks of age and age of sexual maturation were estimated in a laying type Japanese quail line. The univariate and bivariate animal model analysis included hatching group and sex as fixed effects. Each trait was analysed with animal as random effect to fit the additive direct effect. Additional random effects incorporated in the models were changed according to the trait examined. The best model for a trait was chosen based on a likelihood ratio test, comparing the models with and without maternal additive genetic and maternal permanent environmental effects. Heritability estimates of live-weight at hatch and one to six weeks of age with their standard errors were 0.22${\pm}$0.088, 0.39${\pm}$0.099, 0.31${\pm}$0.086, 0.38${\pm}$0.056, 0.46${\pm}$0.055, 0.50${\pm}$0.059, and 0.56${\pm}$0.062, respectively. Direct heritability value of age of sexual maturation was moderate (0.24${\pm}$0.055). The variances due to permanent environmental effect of dam after one week of age and maternal genetic effect after two weeks of age were not important sources of variation. The correlations between direct and maternal genetic effects were negative and ranged from high to moderate values (-0.21 to -0.83). Among the weekly live weights, genetic correlations were generally high between not only successive but also early and late weightings. It suggests that selection for final weight may be based on early weight records. Genetic correlations between age of sexual maturation and live weights were low, favourable but had high standard errors. These results indicate that selection for high weight will potentially result in lower age of sexual maturation only with accurate determination of breeding values.
The purpose of this study was to investigate the natural menopause age of middle-aged women in Korea and to analyse various factors affecting them. For the collection of date, 1,140 women aged between 45-54 were selected through stratified sampling technics in Seoul and at a rual area in Kyong KiProvince. They were interviewed from Nov. 1 through Dec. 31,1987 by use of questionnaires made after pilot study had been performed twice. Among them the final subjects for analysis were restricted to only those who had experienced menopause or irregular menstruation during the past one year, the number of which was total 410:206 in urban and 204 in rural area. For the analysis, menopause age was used as dependent variables while fertility variables, socio-economic variables, bio-physical varibles, and insight of life variables were classified as independent variables. Dependent variables such as menopause was tested and analysed by descriptive statistical methods(e.g., frequency, percentage, mean, $X^2-test.$ t-test, ANOVA). The relation between menopause age and independent variables was analysed by use of Pearson's correlation coefficients. For the analysis of various factors affecting menopause age, multiple stepwise regression method was used. The obtained results are summarized as follows: 1. The natural menopause age of Korean women were 47.2 mean age: it was 47.7 and 46.7 mean age in urban and rural area respectively, which revealed that the former was later then the latter by one year. And the recollective error on menopause starting age between the menopause group and the group who had experienced irregular menstruation during the past one year was 0.4-0.7 year. 2. The main factors affecting the menopause age were (1) the duration of marital life, (2) the duration of oral pill use, (3) insight of life and economic status, (4) educational background. (5) menarche, (6) usual menstruation amount, (7) electic charge. and (8) area. These factors. altogether, could explain $18.4\%$ of factors related with menopause, and they took the high percentage in the order mentioned.
Objectives: The purpose of the study is to investigate the need for the preparation of old age of dental hygienists and happy life. Methods: This study is a descriptive study. A self-reported questionnaire in Likert 5 scale was completed by the dental hygienists in Korea through online report or written report from December, 2012 to June, 2013. Except incomplete answers, 200 data were analyzed. The questionnaire consisted of 10 questions of preparation for old age and awareness for old ages, 9 questions of physical preparation, and 9 questions of emotional preparation. Cronbach's alpha of old age preparation and awareness of old age was 0.634 in the study. Cronbach's alpha was 0.709 and 0.757 in physical preparation and emotional preparation, respectively. The final analyses of 200 copies were conducted using SPSS 11.5 software for Windows(SPSS Inc., Chicago, lllinois, USA). Results: Awareness toward preparation for old age of dental hygienists was 3.72 points, physical preparation was 2.94 points, and emotional preparation was 2.91 points. Awareness toward preparation for old age of dental hygienists showed the relationship between birth date, marital status, education level, and subjective health condition. Physical preparation was closely related to birth date, marital status, education level, and the workplace. Emotional preparation was closely related to birth date, marital status, education level, and the workplace. Conclusions: This study suggested that preparation for old age of dental hygienists was very important and the preparation must be connected with the social welfare policy.
Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.
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