The complications of Salter's innominate osteotomy in the treatment of congenital dislocation of the hip were avascular necrosis of the femoral head, hematoma, rotation of distal pelvic fragment, infection, fracture of femoral shaft and redislocation. Among them the causes of redislocation were technical failure, immobilization failure and absorption the bone graft, etc. We experienced a case of redislocation after open reduction and Salter s innominate osteotomy in congenital dislocation of the hip which was induced by a foreign body reaction to the suture material.
Absorption ; Dislocations* ; Foreign-Body Reaction ; Head ; Hematoma ; Hip* ; Immobilization ; Necrosis ; Osteotomy* ; Sutures ; Transplants

The present study was undertaken to investigate the effect of acute administration of ethanol on production of cytokines such as IL-1j3, IL-2, IL-6, IL-10 and TNF-a, induction of penicillin V-induced active fatal anaphylaxis, and resistence to Salmonel/a typhimurium infection in mice. Ethanol administration into mice was performed by intraperitoneal injection of 0.5 ml of 20 % ethanol for 3 consecutive days before induction of cytokines with lipopolysaccharide (LPS), Con A or Salmone/la injection. Serum levels of cytokines were measured by ELISA. It was found that ethanol administration significantly inhibited both the serum levels of all cytokines examined and the resistance of mice to S. typhimurium. However, ethanol administration failed to prevent penicillin-induced fatal anaphylaxis. Taken together, the present results may need new insights in the diagnosis and treatment of various immunologically-mediated diseases.
Anaphylaxis* ; Animals ; Cytokines* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Ethanol ; Injections, Intraperitoneal ; Interleukin-10 ; Interleukin-2 ; Interleukin-6 ; Interleukins ; Mice* ; Penicillin V* ; Penicillins* ; Salmonella Infections* ; Salmonella*

PURPOSE: The aims of this cross-sectional study were to explore and evaluate the impact of adjuvant chemotherapy on quality of life in breast cancer patients according to the survival time from surgery. METHODS: Completed questionnaires were collected from 534 women with breast cancer. Clinical and sociodemographic characteristics were reviewed and Functional Assessment of Cancer Therapy-Breast cancer instrument, global quality of life, Beck Depression Inventory, and unmet sexuality needs were administered. Descriptive statistics, t-tests, chi-square tests and multiple analysis of covariance were performed while controlling for confounding variables. RESULTS: Statistically significant differences were found between chemotherapy and no chemotherapy group on depression (p=0.026), unmet sexuality needs (p=0.010), breast cancer specific concerns (p=0.010), physical well-being (p=0.001), and emotional well-being (p=0.028). Chemotherapy effects also varied according to survival time since surgery such as for group 1 (<1 year since surgery), significant differences were found on Beck Depression Inventory (p=0.042), unmet sexuality needs (p=0.016), breast cancer subscale (p=0.004), and physical well-being (p=0.016) and for group 3 (>3 years since surgery) on depression (p=0.019) and physical well-being (p=0.028) respectively; however, there were no significant differences between chemotherapy and no chemotherapy group for group 2 (1-3 years since surgery). CONCLUSION: As expected, breast cancer patients who underwent adjuvant chemotherapy experienced significantly worse quality of life than those who did not receive chemotherapy. Furthermore, the adverse chemotherapy effects on the quality of life appear to vary according to the time since surgery. These results suggest that health care professionals may need to address long-term as well as short-term chemotherapy side-effects and intervene accordingly to enhance quality of life of breast cancer patients.
Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Cross-Sectional Studies ; Delivery of Health Care ; Depression ; Female ; Humans ; Quality of Life ; Sexuality ; Survivors ; Surveys and Questionnaires

Purpose: The purpose of this study was to investigate the mental health of physical therapy students in clinical practice during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted during the pandemic and was completed by 100 physical therapy students in two universities in Gwangju and Jeollanam-do, South Korea. The Generalized Anxiety Disorder-7 (GAD-7) scale and the Patient Health Questionnaire-9 (PHQ-9) were used to evaluate their anxiety and depression status. A Chi-square test was conducted to evaluate the association of participant characteristics with the risk of having anxiety and depression. Logistic regression models were used to identify the general characteristic factors related to anxiety or depression. Results: Anxiety was found in 28 (28%) of the participants, and depression in 24 (24%). The risk of anxiety and depression in male physical therapy students was 0.189 and 0.211 times lower, respectively, than those female students (p<0.05). The risk of anxiety and depression in physical therapy students with a history of disease was 11.721 and 7.056 times higher, respectively, than those with a history of disease (p<0.05). The risk of anxiety in physical therapy students in clinical practice was 11.721 times higher than that in students who were not in clinical practice (p<0.05). Conclusion The COVID-19 pandemic has led to a high risk of anxiety and depression among many physical therapy students. More attention and improvements are needed so that physical therapy students can study in a safe environment.

Purpose: The purpose of this study was to investigate the mental health of physical therapy students in clinical practice during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted during the pandemic and was completed by 100 physical therapy students in two universities in Gwangju and Jeollanam-do, South Korea. The Generalized Anxiety Disorder-7 (GAD-7) scale and the Patient Health Questionnaire-9 (PHQ-9) were used to evaluate their anxiety and depression status. A Chi-square test was conducted to evaluate the association of participant characteristics with the risk of having anxiety and depression. Logistic regression models were used to identify the general characteristic factors related to anxiety or depression. Results: Anxiety was found in 28 (28%) of the participants, and depression in 24 (24%). The risk of anxiety and depression in male physical therapy students was 0.189 and 0.211 times lower, respectively, than those female students (p<0.05). The risk of anxiety and depression in physical therapy students with a history of disease was 11.721 and 7.056 times higher, respectively, than those with a history of disease (p<0.05). The risk of anxiety in physical therapy students in clinical practice was 11.721 times higher than that in students who were not in clinical practice (p<0.05). Conclusion The COVID-19 pandemic has led to a high risk of anxiety and depression among many physical therapy students. More attention and improvements are needed so that physical therapy students can study in a safe environment.

Purpose: Errors in pediatric death certificates (DCs) have been rarely reported. We analyzed the errors in writing the DCs issued in an emergency department (ED). Methods: The DCs issued at the ED to patients aged 18 years or younger were retrospectively analyzed. Their medical records were reviewed by 4 emergency physicians. Major and minor errors in the DCs were defined based on the International Statistical Classification of Diseases and Related Health Problems 10th revision guidelines. The DCs were classified into the disease group and the external group by the manner of death, and the errors were compared. Results: Among a total of 87 DCs issued in the ED, 97.5% and 100% were confirmed to contain at least 1 error in the disease (n = 40) and external (n = 47) groups, respectively. The median numbers of errors in the analyzed DCs were 2.0 and 3.0 in the disease and external groups, respectively (P = 0.004). In the disease group, the most frequent major error was reporting only a secondary condition as the underlying cause of death without antecedent causes (6 cases [15.0%]). In the external group, the most frequent major error was writing 2 or more causes in a single line for the cause of death (17 cases [36.2%]). In both groups, the most common minor error was omission of a time interval record for the cause of death (disease, 37 cases [92.5%]; external, 42 cases [89.4%]). Conclusion Any errors were identified in 98.9% of pediatric DCs issued in the ED, and the total number of errors was larger in the external group.

Background: This study aimed to evaluate the relationship between clinical experience and death certificate (DC) errors by analyzing DCs written by experienced emergency physicians (EPs). Methods: DCs issued by four experienced EPs over a 10-year period were retrospectively reviewed. DC errors were divided into major and minor errors based on whether they affected the cause of death (COD) determination. The errors were judged through first and second evaluations. Basic information regarding DCs and 10-year changes in DC errors were analyzed. Results: A total of 505 DCs were analyzed, with an average of 34 to 70 for each study year.The number of CODs written in the DCs tended to decrease over time. The presentation of major DC errors did not show a tendency to change over time. However, the sum of the major and minor errors tended to increase over time. Secondary conditions as the underlying COD tended to increase, and the incompatible causal relationships between CODs tended to decrease over time in the detailed analysis of major errors. The increasing tendency for incorrect other significant conditions, incorrect type of accident, incorrect intention of the external cause, no record of the trauma mechanism, and record of the trauma mechanism without another COD were found in the detailed analysis of minor errors. Conclusion DC errors did not decrease as clinical experience increased. Education to reduce DC errors and a feedback process for written DCs are necessary, regardless of clinical experience.

OBJECTIVE: To compare the short-term effect and advantage of transforaminal epidural steroid injection (TFESI) performed using the Kambin's triangle and subpedicular approaches. METHOD: Forty-two patients with radicular pain from lumbar spinal stenosis were enrolled. Subjects were randomly assigned to one of two groups. All procedures were performed using C-arm KMC 950. The frequency of complications during the procedure and the effect of TFESI at 2 and 4 weeks after the procedure between the two groups were compared. Short-term outcomes were measured using a visual numeric scale (VNS) and a five-grade scale. Multiple logistic regression analyses were performed to evaluate the relationship between possible outcome predictors (Kambin's triangle or subpedicular approach, age, duration of symptoms and sex) and the therapeutic effect. RESULTS: VNS was improved 2 weeks after the injection and continued to improve until 4 weeks in both groups. There were no statistical differences in changes of VNS, effectiveness and contrast spread pattern between these two groups. No correlation was found between the other variables tested and therapeutic effect. Spinal nerve pricking occurred in five cases of the subpedicular and in none of the cases of the Kambin's triangle approach (p<0.05). CONCLUSION: The Kambin's triangle approach is as efficacious as the subpedicular approach for short-term effect and offers considerable advantages (i.e., less spinal nerve pricking during procedure). The Kambin's triangle approach maybe an alternative method for transforaminal epidural steroid injection in cases where needle tip positioning in the anterior epidural space is difficult.
Constriction, Pathologic ; Epidural Space ; Humans ; Imidazoles ; Injections, Epidural ; Logistic Models ; Needles ; Nitro Compounds ; Spinal Nerves ; Spinal Stenosis

BACKGROUND: The abnormal barrier function in atopic dermatitis(AD) is caused by a reduction in the amounts of ceramides in the intercellular lipids in the stratum corneum(SC). Replenishing the SC via the topical application of ceramides and pseudoceramides leads to effective recovery of the barrier function of skin. OBJECTIVES: An open clinical crossover evaluation was conducted to investigate the effects in AD of a multi-lamellar emulsion(MLE) that contained pseudoceramide(PC-9s). METHODS: The study group included 30 AD patiendaverage age: 4.4 yr, range: 1-8 yr), who applied MLE or a commercial moisturizing cream(CMC, 5% urea) alternately for four weeks each. We divided the subjects into two subgroups and started with different treatments in each subgroup. Treatment efficacy was evaluated using the average subjective satisfaction scores for each symptom and the global clinical response. In addition, the SCORAD(Scoring AD) index was adopted to evaluate the severity of AD as objectively as possible. The patients were evaluated using this index every other week. RESULTS: Although the SCORAD improved in both subgroups, the patients had better results (p<0.05) when applying MLE(31-35% decrease) than CMC(13% increase to 14% decrease). The subjective satisfaction scores of the symptoms and signs of patients, including itching, erythema, and dry skin, were higher in the MLE group than in the CMC group, and the global response to treatment was also better in the MLE group. During the follow-up period, AD improved in all patients. MLE was more effective than CMC in our patients. CONCLUSIONS: The topical application of a multi-lamellar emulsion containing pseudoceramide is an effective regimen for improving symptoms of AD.
Ceramides ; Cross-Over Studies* ; Dermatitis, Atopic* ; Erythema ; Follow-Up Studies ; Humans ; Pruritus ; Skin ; Treatment Outcome

PURPOSE: In the present study, we aimed to determine the risk factors for the development of cystic periventricular leukomalacia (CPVL) in very low birth weight (VLBW) infants. METHODS: We reviewed the medical records of 309 infants weighing less than 1,500 g who were admitted to the neonatal intensive care unit at Hanyang University Medical Center, Seoul from April 2007 to December 2012. Thirty-nine infants died within 28 days of birth. Of the remaining 270 infants, 21 with CPVL established by cranial ultrasonography, and 63 without CPVL, who were matched for gestational age, were enrolled in this study. Univariate and multivariate analyses of maternal, perinatal, and neonatal risk factors for CPVL were performed through retrospective assessment of data collected from the medical records. RESULTS: Necrotizing enterocolitis (NEC > or =stage II: 42.9% vs. 9.5%, P=0.002), culture-proven sepsis (66.7% vs. 34.9%, P=0.021), hypotension with sepsis (33.3% vs. 6.3%, P=0.004), and severe intraventricular hemorrhage (> or =grade III: 61.9% vs. 22.2%, P=0.002) were associated with the development of CPVL on univariate analysis. Using multivariate logistic regression analysis, two variables were found to be statistically significant independent risk factors: NEC (> or =stage II: adjusted OR, 5.12; 95% CI, 1.219-21.514; P=0.026) and hypotension with sepsis (adjusted OR, 8.23; 95% CI, 1.194-56.713; P=0.032). CONCLUSION: NEC (> or =stage II) and hypotension with sepsis were associated with an increased risk of developing CPVL in VLBW infants.
Academic Medical Centers ; Enterocolitis, Necrotizing ; Gestational Age ; Hemorrhage ; Humans ; Hypotension ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Leukomalacia, Periventricular* ; Logistic Models ; Medical Records ; Multivariate Analysis ; Parturition ; Retrospective Studies ; Risk Factors* ; Seoul ; Sepsis ; Ultrasonography