• Journal of Korean Foot and Ankle Society
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• v.25 no.4
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• pp.149-156
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• 2021

Purpose: Given the lack of definite evidence-based guidelines in clinical practice, there may be a wide variation in treatment protocols for osteochondral lesions of the talus (OLT). Based on the Korean Foot and Ankle Society (KFAS) member survey, this study aimed to report the current trends in the management of OLT. Materials and Methods: A web-based questionnaire containing 30 questions was sent to all KFAS members in September 2021. The questions were mainly related to clinical experience and preferences in diagnosis, conservative, and surgical treatments for patients with OLT. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: Sixty-two (11.3%) of the 550 surgeons queried responded to the survey. The responses to 9 (30.0%) of the total of 30 questions established a tendency. Answers exhibiting a tendency were as follows; additional diagnostic tools except for plain radiograph (magnetic resonance imaging), most common conservative treatment method (oral medication, rest), most important radiological factor in decision making for surgical treatment and method (size of the lesion, ankle instability, loose bodies), most important patient factors in decision making for surgical treatment and method (age, activity or occupation), infrequently requiring posterior arthroscopy (less than 3%), most common revision surgery for failed bone marrow stimulation procedure (osteochondral autograft transplantation [OAT]), not requiring additional procedure for donor site in OAT, the main reason for unsatisfactory result after OAT (persistent pain without radiological abnormality), no generalization of autologous chondrocyte implantation or chondrogenesis using stem cells. Conclusion: This study presents updated information on current trends in the management of OLT in Korea. Both consensus and variations in the approach to patients with OLT were revealed through this survey. Since recent biologic efforts to regenerate cartilage have been unsuccessful, further studies to identify clinical evidence would be needed.

• Journal of Korean Foot and Ankle Society
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• v.25 no.4
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• pp.157-164
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• 2021

Purpose: This study aimed to report the current trends in the management of the hallux valgus (HV) deformity over the last few decades through a survey of the Korean Foot and Ankle Society (KFAS) members. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experience in correction in patients with an HV deformity. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: One hundred and nine (19.8%) of the 550 members responded to the survey. The most common symptom for determining surgical treatment was bunion pain (68.8%), and different surgical techniques were selected according to the following radiological parameters: HV angle 30 to 40 degrees and intermetatarsal angle 15 to 20 degrees. The two procedures most preferred by the respondents were distal chevron osteotomy (55.0%), and proximal chevron osteotomy (21.1%). In an average of 71.6% of respondents, Arkin osteotomy was performed simultaneously during HV surgery. HV accompanied by an overriding deformity of the second toe was most often addressed with a combination of second metatarsal osteotomy and soft tissue rebalancing procedure (35.8%). After HV surgery, the recurrence rate of HV deformity was found to be 12.2% on average and the surgeons who had performed minimally invasive surgery (MIS) for HV comprised 34.9% of the total respondents. Conclusion: This study provides updated information on the current trends in the management of the HV deformity in Korea. Both consensus and variation in the approach to patients with HV were identified by this survey study. Although MIS for HV has increased, it appears the consensus for selecting this method has not yet been established.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.1
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• pp.19-28
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• 2023

Background: Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings. Methods: A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps. The charts were completed at two oral surgeons and one general dentist's office over 6 months. Hypoxia, hypotension, bradycardia, and over-sedation were considered adverse events and were collected using Tracking and Reporting Outcomes of Procedural Sedation (TROOPS). Furthermore, patient recovery time, sedation length, drug dose, and patient satisfaction questionnaires were used to measure sedation effectiveness. Results: Of the 101 reviewed sedation charts, 54 were of men, and 47 were of women. The mean age of the patients was 40.5 ±18.7 years, and their mean BMI was 25.6 ± 4.4. The patients did not experience hypoxia, bradycardia, and hypotension during the 4694 min of sedation. The average minimum Mean Arterial Pressure (MAP) and heartbeats were 75.1 mmHg and 60.4 bpm, respectively. 98% of patients agreed that the sedation technique met their needs in reducing their anxiety, and 99% agreed that they were satisfied with the sedation 24 hours later. The average sedation time was 46.9 ± 55.6 min, and the average recovery time was 12.4 ± 4.4 min. Remifentanil and propofol had mean initial effect-site concentration doses of 0.96 µ/.ml and 1.0 ng/ml respectively. The overall total amount of drug administered was significantly higher in longer sedation procedures compared to shorter ones, while the infusion rate decreased as the procedural stimulus decreased. Conclusion: According to the results of this study, no patients experienced adverse events during sedation, and all patients were kept at a moderate sedation level for a wide range of sedation times and differing procedures. The results showed that TCI pumps are safe and effective for administering propofol and remifentanil for moderate sedation in dentistry.

• Korean Journal of Culture and Social Issue
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• v.23 no.4
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• pp.451-473
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• 2017

This study explores the aftermath of state violence and the meaning of its healing by analyzing testimony therapy designed to deal with trauma of the victims of May 18 democratization movement("May 18"). In order to have a point of view that May 18 had catastrophic impacts on many individuals and communities and to observe the after-effects of such event to individuals' lives, this study analyzed the contents of testimony therapy sessions of four people who were tortured, arrested and detained after their participating in May 18 in 1980. The experiences of those participants with their testimony therapy and the interactions they had with the audience during the sessions made sure what are the key factors to healing the trauma from state violence. Nineteen topics were drawn from analyzing the statements made in the therapy process, and out of them, seven subjects below were chosen as the most significant; 'repetitive pain', 'social and economic damage', 'isolation and disconnection', 'transition of suffering to other generations', and 'Safety', 'healing through connections', 'obligation as a survivor'. Based on its findings, this study also examined the characteristics of trauma caused by state violence and made suggestions for healing such trauma.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.3
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• pp.99-114
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• 2023

Purpose : The purpose of this study was to determine factors that affect the quality of life (QoL) of people with diabetes. We hope to provide a basis for intervention strategies for health promotion and related research among patients with diabetes in the field of physical therapy. Methods : We selected individuals diagnosed with diabetes who were aged 19 years or higher by using data from the 2019 Korean Health Panel survey and analyzed the results of 1,527 people. The influencing factors were sex, age, household income, marital status, age, education level, subjective health status, body mass index (BMI), smoking, drinking, regular exercise, experience of depression and anxiety, suicidal thoughts, stress, and frequency of walking (days/week). Frequency analysis, descriptive statistics, independent sample t-test, one-way analysis of variance, and multiple regression analysis were performed. Results : The EQ-5D score for QoL was .87 ± .12, with pain and discomfort being the most detrimental to the QoL of people with diabetes. In terms of patients characteristics, the QoL was lower among participants who were female, older, and separated/widowed/divorced; had an education level below middle school; had a poor subjective health status; were non-smokers and drinkers; and did not walk and exercise regularly, experienced a lot of stress, and experienced depression and anxiety; and had suicidal thoughts (p<.001). Being separated/bereaved/divorced; experiencing a lot of stress, depression, and anxiety; and having suicidal thoughts were negatively associated with QoL in people with diabetes (p<.01). On the other hand, age of 65 years or younger; graduation from high school, fair or better subjective health, regular exercise and alcohol consumption, and walking (days/week) were positively associated with QoL (p<.05). Conclusion : Regarding the QoL of patients with diabetes, intervention strategies should be formulated by considering general characteristics and disease-related characteristics. Among the various factors affecting QoL, the number of walking and regular exercise were found to be the factors that improved the QoL of patients with diabetes. These results can be used as a basis for the education and management of patients with diabetes in the field of physical therapy.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.22-29
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• 2022

Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.

• 한국노년학
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• v.39 no.1
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• pp.21-35
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• 2019

The purpose of this study was to empirically verify the effects of spousal bereavement and complicated grief level on death anxiety of the elderly. The sample consisted of 1,998 adults who were aged 65 or older. Dependent variable was measured with the Death Anxiety Scale-Korean version (DAS-K). Independent variable was measured with both spousal bereavement and the Inventory of Complicated Grief-Korean version (ICG-K). Multiple regression analysis was performed using SPSS 23.0, adjusting for demographics, psycho-social and health variables. The results indicated that death anxiety level was lower among the bereaved with normal grief (p<.01) than non-bereaved. In contrast, death anxiety level was higher among the bereaved with complicated grief than non-bereaved (p<.01). The study result suggests that the most risky factor for death anxiety is complicated grief rather than the bereavement. Although the bereavement can be a universal experience, the severity and duration of symptoms after the bereavement may not be general. The unhealed emotional and physical pain after the bereavement stimulates death anxiety, and senior citizens who suffer from complicated grief often fail to integrate the bereavement and loss into reality, therefore, may not accept the death phenomenon itself. Anxiety and fear of death can emerge when they cannot acknowledge the bereavement. To manage complex sorrows and mitigate death anxiety, intervention programs should be provided to increase adaptability to the bereavement.

• Korean Journal of Social Welfare Studies
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• v.42 no.2
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• pp.419-441
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• 2011

Cancer is a disease that threatens the individual's life. This is why the cancer patient goes through psychosocial pain in the form of a trauma. Thus, the previous researches have only focused on the cancer patient's psychosocial distress. However, the cancer patients who have grown more mature and brought upon positive changes in their lives have been clinically observed. Because of this, researches regarding the ways that social welfare can intervene in order to examine the cancer patients' positive changes and growth which breaks away from the previous pathological point of view of the cancer patients are being actively conducted in other countries. But it turns out that there aren't enough basic researches related to this topic and thereby the need to lay out the basis for social welfare intervention. Therefore, this research examines positive changes and growth that may result from the traumatic experience of having a cancer. The predictable factors regarding this are analyzed in order to provide the basic information that may promote clinical intervention for cancer patient's posttraumatic growth. For this, the information from 206 cancer patients who have agreed to participate in the research have been used to predict and evaluate the predictable factors for the cancer patient's post-traumatic growth and hierarchy multiple regression haven been analyzed. As the result of the research, main factor of the post-traumatic growth is found to be social support and coping. The positive reconstruction of coping has been discovered to be the strongest predictable factor for cancer patient's posttraumatic growth. Based on this result, the advice for further research and implications for social welfare have been given.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.362-368
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• 2023

Purpose: Clinical reports on treatment outcomes of sternal fractures are lacking. This study details the clinical features, treatment approaches, and outcomes related to traumatic sternal fractures over a 10-year period at a single institution. Methods: A retrospective cohort study was conducted of patients admitted to a regional trauma center between January 2012 and December 2021. Among 7,918 patients with chest injuries, 266 were diagnosed with traumatic sternal fractures. Patient data were collected, including demographics, injury mechanisms, severity, associated injuries, sternal fracture characteristics, hospital stay duration, mortality, respiratory complications, and surgical details. Surgical indications encompassed emergency cases involving intrathoracic injuries, unstable fractures, severe dislocations, flail chest, malunion, and persistent high-grade pain. Results: Of 266 patients with traumatic sternal fractures, 260 were included; 98 underwent surgical treatment for sternal fractures, while 162 were managed conservatively. Surgical indications ranged from intrathoracic organ or blood vessel injuries necessitating thoracotomy to unstable fractures with severe dislocations. Factors influencing surgical treatment included flail motion and rib fracture. The median length of intensive care unit stay was 5.4 days (interquartile range [IQR], 1.5-18.0 days) for the nonsurgery group and 8.6 days (IQR, 3.3-23.6 days) for the surgery group. The median length of hospital stay was 20.9 days (IQR, 9.3-48.3 days) for the nonsurgery group and 27.5 days (IQR, 17.0 to 58.0 days) for the surgery group. The between-group differences were not statistically significant. Surgical interventions were successful, with stable bone union and minimal complications. Flail motion in the presence of rib fracture was a crucial consideration for surgical intervention. Conclusions: Surgical treatment recommendations for sternal fractures vary based on flail chest presence, displacement degree, and rib fracture. Surgery is recommended for patients with offset-type sternal fractures with rib and segmental sternal fractures. Surgical intervention led to stable bone union and minimal complications.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.3
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• pp.258-263
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• 2023

Backgrounds/Aims: Hemangiomas are the most common benign liver lesions; however, they are usually asymptomatic and seldom require surgery. Enucleation and resection are the most commonly performed surgical procedures for symptomatic lesions. This study aims to compare the outcomes of these two surgical techniques. Methods: A retrospective analysis of symptomatic hepatic hemangiomas (HH) operated upon between 2000 and 2021. Patients were categorized into the enucleation and resection groups. Demographic profile, intraoperative bleeding, and morbidity (Clavien-Dindo Grade) were compared. Independent t-test and chi-square tests were used for continuous and categorical variables respectively. p-value of < 0.05 was considered significant. Results: Sixteen symptomatic HH patients aged 30 to 66 years underwent surgery (enucleation = 8, resection = 8) and majority were females (n = 10 [62.5%]). Fifteen patients presented with abdominal pain, and one patient had an interval increase in the size of the lesion from 9 to 12 cm. The size of hemangiomas varied from 6 to 23 cm. The median blood loss (enucleation: 350 vs. resection: 600 mL), operative time (enucleation: 5.8 vs. resection: 7.5 hours), and postoperative hospital stay (enucleation: 6.5 vs. resection: 11 days) were greater in the resection group (statistically insignificant). In the resection group, morbidity was significantly higher (62.6% vs. 12.5%, p = 0.05), including one mortality. All patients remained asymptomatic during the follow-up. Conclusions: Enucleation was simpler with less morbidity as compared to resection in our series. However, considering the small number of patients, further studies are needed with comparable groups to confirm the superiority of enucleation over resection.