1.Surgical Fixation of a Comminuted Inter-Trochanteric Fracture in a Patient with Bilateral Below Knee Amputation
Malaysian Orthopaedic Journal 2018;12(1):54-56
Surgical fixation of hip fractures in patients with below kneeamputation is challenging due to the difficulty in obtainingoptimal traction for reduction of the fracture. Surgeons mayface difficulty in positioning such patients on the tractiontable due to the absence of the foot and distal lower limb.There are several techniques described to overcome thistechnical difficulty. In this case report, we present a case ofa 64-year old gentleman with bilateral below kneeamputation presenting with a comminuted rightintertrochanteric fracture. We highlight a simple andeffective method of applying skin traction to obtain adequatereduction for hip fracture fixation.
2.Stress and Burnout among Physicians: Prevalence and Risk Factors in a Singaporean Internal Medicine Programme.
Kay Choong SEE ; Tow Keang LIM ; Ee Heok KUA ; Jason PHUA ; Gerald Sw CHUA ; Khek Yu HO
Annals of the Academy of Medicine, Singapore 2016;45(10):471-474
Adult
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Age Factors
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Burnout, Professional
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epidemiology
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psychology
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Cross-Sectional Studies
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Exercise
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Female
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Humans
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Internal Medicine
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education
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Internship and Residency
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Interprofessional Relations
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Male
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Physicians
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psychology
;
statistics & numerical data
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Prevalence
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Risk Factors
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Singapore
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epidemiology
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Stress, Psychological
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epidemiology
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psychology
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Surveys and Questionnaires
3.An Impacted Clamshell in the Duodenum Mistaken for a Gall Stone.
Han Jin CHO ; Jong Yeol KIM ; Ho Chul LEE ; Young Oh KWEON ; Chang Min CHO ; Won Young TAK ; Seong Woo JEON
The Korean Journal of Internal Medicine 2007;22(4):292-295
Although most ingested foreign bodies pass through the gastrointestinal tract spontaneously, those that are sharp, pointed, or large require removal to avoid serious complications. Here we report an interesting case of a 60-year-old man who swallowed a clamshell that passed through the pylorus and was caught in the duodenum. Radiologic findings made it look like a biliary stone. Endoscopic retrieval of the clamshell with a Dormia Basket was performed safely and the patient was discharged uneventfully on the day of the procedure.
Diagnostic Errors
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Duodenum/*pathology
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Endoscopy
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Endoscopy, Gastrointestinal
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Foreign Bodies/*diagnosis/surgery
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Foreign-Body Migration/*diagnosis/surgery
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Gallstones/*diagnosis/pathology
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Humans
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Male
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Middle Aged
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Seafood/*adverse effects
4.Predictive Factors for Lymph Node Metastasis in Signet Ring Cell Gastric Cancer and the Feasibility of Endoscopic Submucosal Dissection.
Ji Yeon KIM ; Yi Young KIM ; Se Jin KIM ; Jung Chul PARK ; Yong Hwan KWON ; Min Kyu JUNG ; Oh Kyoung KWON ; Ho Young CHUNG ; Wansik YU ; Ji Young PARK ; Yong Kook LEE ; Sung Sik PARK ; Seong Woo JEON
Journal of Gastric Cancer 2013;13(2):93-97
PURPOSE: Endoscopic submucosal dissection has recently been practiced on a differentiated type of early gastric cancer. However, there is no clear evidence for endoscopic treatments of signet ring cell carcinoma. The aim of this study is to identify the predictive clinicopathological factors for lymph node metastasis in signet ring cell carcinoma for assisting endoscopic submucosal dissection trials. MATERIALS AND METHODS: A total of 186 patients with early signet ring cell carcinoma who underwent radical curative gastrectomy between January 2001 and September 2009 were enrolled in this study. Retrospective reviews of their medical records are being conducted. Several clinicopathologic factors were being investigated in order to identify predictive factors for lymph nodes metastasis: age, gender, tumor size, type of operation, tumor location, gross type, ulceration, Lauren's classification, depth of invasion, and lymphatic invasion. RESULTS: The lymph node metastasis rate for signet ring cell carcinoma was 4.3% (n=8). Of the 186 lesions with early signet ring cell carcinoma, 91 (48.9%) tumors were larger than 15 mm in size and 40 (21.5%) showed submucosal invasions in the resection specimens. In multivariate analysis, only the lymphatic invasion (P<0.0001) showed an association with lymph node metastasis. To evaluate cutoff values for tumor sizes in the presence of lymph node metastasis, early signet ring cell carcinomas with lymphatic invasions were excluded. In the absence of lymphatic invasion, mucosal cancer with tumor sizes <15 mm had no lymph node metastasis. CONCLUSIONS: Endoscopic submucosal dissection can be performed on patients with early signet ring cell carcinoma limited to the mucosa and less than 15 mm.
Carcinoma, Signet Ring Cell
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Gastrectomy
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Humans
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Lymph Nodes
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Medical Records
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Mucous Membrane
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Multivariate Analysis
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Neoplasm Metastasis
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Retrospective Studies
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Stomach Neoplasms
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Ulcer