PURPOSE: To evaluate the incidence of disc extrusion and neurologic deficit, the relation between disc extrusion and neurologic deficit and the treatment results according to our basic treatment principles in lower cervical facet joint fracture and dislocations MATERIALS AND METHODS: Twelve patients were evaluated, 8 male and 4 female with an average age of 41 years comprised the group. Six injuries were attributable to automobile accidents, 5 to fall from building, bed, floor and hill, and one to stand on her head. One case was distractive-flexion stage (DFS) 1, 9 cases with DFS 2 and 2 cases with DFS 3. Plain X-ray, CT, Myelo CT and MRI were used as a diagnostic tools. As a treatment criteria, feasibility of closed reduction, status of neuroglogic injury, and stability of injured spine were considered. Anterior cervical discectomy and fusion in accompanied disc extrusion, posterior reduction and fusion with triple wiring in unreduced dislocation, and anterior decompression and fusion in incomplete cord and root injury were selected as a basic treatment principles. RESULTS: Ten out of 12 cases (83%) showed neurologic deficits, 2 complete cord injury, 1 incomplete cord injury, and 7 radiculopathy. Nine out of 12 (75%) demonstrated disc extrusion and all disc extruded patients had neurologic deficits. Anterior cervical discectomy and fusion (ACDF) were performed in 5 cases, ACDF and posterior reduction with triple wiring (PRTW) in 4 cases, PRTW in 1 case, and skull traction and philadelphia brace in 2 cases. Seven radiculpathy patients were completely recovered and one incomplete cord injury patient can ambulate with spastic gait after surgery. There were 2 bed sore and 1 pneumonia in complications. CONCLUSION: Soft disc extrusion should be evaluated carefully with MRI and CT in lower cervical spine injury with the facet joint fracture-dislocations before the decision of treatment. As disc extrusion always accompanies neurologic deficit, it must be surgically treated by anterior cervical discectomy and fusion.
Automobiles ; Braces ; Decompression ; Diskectomy ; Dislocations* ; Female ; Gait Disorders, Neurologic ; Head ; Humans ; Incidence ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Pneumonia ; Pressure Ulcer ; Radiculopathy ; Skull ; Spine ; Traction ; Zygapophyseal Joint*

PURPOSE: This descriptive study was to investigate the quality of life in patients with hematopoietic stem cell transplantation (HSCT) from June 1 to October 13, 2007. METHOD: The survey was conducted in 6 different university hospitals which located in Seoul and Jellanamdo province using the Functional Assessment of Cancer Therapy-BMT Scale (FACT-BMT) version 4. We collected a total of 155 questionnaires and analyzed 149 among them. RESULTS: The average score of quality of life was 2.53 out of 5. Physical well being score was highest among sub-domains, followed by emotional well-being, additional concerns, social/family well-being, and functional well-being. Study subjects worried that their conditions would get worse. However study subjects didn't regret having been received HSCT. Age, duration from HSCT, age at diagnosis, income, readmission, HSCT type, educational background, marital status, and the level of activities of daily living were related to quality of life. CONCLUSIONS: The findings of this study indicates that the HSCT survivor's quality of life issue is still important and have to be investigated repeatedly in the future. That is necessary for generalizing QOL outcomes for clinical use. We also suggest to develop interventions to improve QOL.
Activities of Daily Living ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Hospitals, University ; Humans ; Marital Status ; Quality of Life ; Surveys and Questionnaires ; Transplants

We performed a retrospective analysis of the results of surgical treatment of sixteen patient with comminuted fracture of the distal femur from September 1993 to August 1995 and evaluated the efficacy of the angled blade plate as one of the fixation devices used. The fractures were limited to C2 and C3 fracture classifed according to the AO classification. After an average follow-up of 13 months (range, 9 to 24 months), all of the fractures had healed. Postoperatively, the arc of flexion was limited between 90degrees and 125degrees in eight, normal arc in five, and severely restricted arc of joint motion was present unexceptionally in three patients with deep infection. In angular deformity, average 5.8degrees of valgus and 2.4degrees posterior angulation were showed. The functional results by Sanders-Swiontkowski-Rosen-Helfet rating system were showed excellent in 3, good in 7, fair in 3, and poor in 3 cases. The overall results were seen to be excellent to good in ten cases (62.5%) but in twelve patients using the angled blade plate, excellent to good results were showed 10 patients (83.3%). We attribute the favorable results in our series to restoration of the articular surface through the modified extensile approach, sufficient stable fixation using the angled blade plate with conforming to the concept of bridge plate, routinely performing the bone graft for medial buttress and bone healing, and early mobilization of the extremity.
Classification ; Congenital Abnormalities ; Early Ambulation ; Extremities ; Femur* ; Follow-Up Studies ; Fractures, Comminuted ; Humans ; Joints ; Retrospective Studies ; Transplants

We noticed a group of thoracolumbar and lumbar spine fractures showing a unique fracture pattern that consisted of 1) superior disc injury, 2) crush fracture of the upper half of the vertebral body, 3) sagittal fracture of the lower half of the vertebral body, 4) bone fragments in the spinal canal, and 5) lamina fracture. Some of these fracture patterns were present in type B burst fracture of Denis classification. The purpose of this study was to compare the difference between crush-cleavage fracture and type B burst fracture in the viewpoint of neural canal involvement and neurologic status, and functional outcome with surgical treatment. Ten cases were identified as crush-cleavage fractures in 22 type B burst fractures during a 5 year period from Mar. 1989 to Jun. 1993 at the Department of Orthopedic Surgery of Chonbuk National University Hospital. Four out of 10 crush-cleavage fractures and 4 out of 12 type B burst fractures were paraparetic. Crush-cleavage fracture must be an unstable thoracolumbar comminuted fracture, but there were no significant differences in the neural canal involvement, incidence of neurologic deficit, and in the functional outcome, compared with type B burst fracture (P>0.05). It could be classified as a progressed form of type B burst fracture in Denis classification, or as a burst-split fracture in Magerl classification in the anatomical viewpoint. In conclusion, crush-cleavage fracture must be a variant of burst fracture.
Classification ; Fractures, Comminuted ; Incidence ; Jeollabuk-do ; Neural Tube ; Neurologic Manifestations ; Orthopedics ; Spinal Canal ; Spine

As the newly reconstructed nipple tends to be flattened, especially if submitted to pressure, prudent dressings using various protective devices as a physical support against pressure on a new nipple is important. We used a breathing bag connecting tube as a protective device in nipple reconstruction. A breathing bag connecting tube recycled was cut and trimmed at 1cm above the height of the reconstructed nipple. Before stitch out, the newly reconstructed nipple with a local flap was dressed and protected in this way for 10 days after surgery. After stitch out, patients learnt how to manage the new nipple at home. The sole means of nipple dressing was affixing the breathing bag connecting tube with adhesive tape. Two patients had worn the tube for two months with the best compliance. Owing to the soft composition of the tube material, it is possible for a surgeon to have an easy cutting and trimming of the tube at appropriate heights as well as for a patient to show better compliance yielding better results. The cost factor is another advantage.
Adhesives ; Bandages ; Compliance ; Fibrinogen ; Humans ; Nipples* ; Protective Devices ; Respiration*

Background: Femoral neck stress fractures (FNSFs) are rare but potentially disabling injuries if the diagnosis is missed or delayed and proper treatment is not provided. The aim of this study was to investigate and describe the characteristics and clinical course of FNSFs in South Korean male military recruits. Methods: Between May 2015 and October 2019, 16 fractures in 12 young male military recruits were reviewed. The characteristics of the fractures were ascertained by detailed analysis of the history and clinical course, as well as radiographs, bone scintigrams, and magnetic resonance images. Results: The median duration between endurance training and the development of hip pain was 5 weeks, while the median duration of pain before the patient sought medical attention was 3 weeks. Four patients (33.3%) exhibited bilateral fractures, and concomitant lesions involving the proximal tibia were found in 3 patients (25%). Fourteen of the 16 fractures (87.5%) were compression-type fractures, and surgery was performed for 7 hips. Complete union without malunion or osteonecrosis was achieved in all cases, and all cadets returned to their full activity levels in an average of 10 weeks. Conclusions We observed excellent prognosis of FNSFs. Our report highlights the importance of early reporting, detection, and treatment regarding the challenging management of FNSFs. When a military recruit reports hip pain, a FNSF should be considered; furthermore, the bilaterality of the fracture and the presence of concomitant lesions should also be investigated.

Purpose: This study was to identify nurses’ intentions for COVID-19 vaccination in 2022. Methods: A questionnaire survey was conducted among 222 nurses in Korea. The collected data were analyzed using the independent t-test, one-way analysis of variance, the Wilcoxon rank sum test, Pearson’s correlation coefficients, and multiple regression analysis. Results: The score for intention to be vaccinated against COVID-19 in 2022 was 2.70 points on a 5-point scale, significantly lower than in 2020 (3.02 points on a 5-point scale). The average score for knowledge related to COVID-19 was 7.22 out of 10 points. Positive correlations were found between the intention for COVID-19 vaccination in 2022 and preventive health behavior, as well as between nurses’ intentions for COVID-19 vaccination in 2022 and 2020. The factors affecting nurses’ intentions for COVID-19 vaccination in 2022 were preventive health behavior (β=.11, p=.045) and nurses’ intentions for COVID-19 vaccination in 2020 (β=.65, p<.001). This model showed a significant explanatory power of approximately 45% (F=36.88, p<.001) for the COVID-19 vaccination intention in 2022. Conclusion This result points to the importance of managing nurses’ preventive health behaviors to promote COVID-19 vaccination uptake. Nurses’ vaccination intentions are an important issue for the safety of both nurses and patients. A safe vaccination environment and national policy should be prepared to reduce nurses' hesitations about COVID-19 vaccination.

PURPOSE: To find the factors influencing bone union in segmental tibial shaft fractures treated with interlocking intramedullary nailing, and to find the special attentions during operation based on this factors. MATERIALS AND METHODS: This retrospective study made to investigate the medical records and plain radiograms of 32 patients who treated with interlocking intramedullary nailing. We statistically analyzed the correlation between bone union time and factors influencing bone union, including fracture site, fracture pattern, Melis type, open fracture, nail diameter, reaming, postoperative gap, postoperative angulation. RESULTS: The factors that showed the significant difference statistically were fracture site, Melis type, open fracture, postoperative gap, postoperative angulation. The factors that showed no significant difference statistically were fracture pattern, nail diameter, reaming. CONCLUSION: We recommend that surgeons should be considered the site and type, open fracure in preoperative stage. During operation, try to reduce it accurately without angulation and gap if possible. And so, the careful planing of treament can be expected with a high rate of union and a low rate of complication.
Attention ; Fracture Fixation, Intramedullary* ; Fractures, Open ; Humans ; Medical Records ; Retrospective Studies ; Tibia

BACKGROUND: Jeju Island is geographically and socioeconomically distinct from the mainland of South Korea. Thus, the presentation and management of non-melanocytic skin cancers (NMSC) of the head and neck may differ from those in other regions of the country. We compared the clinical characteristics and treatment modalities of NMSC on Jeju Island with the findings of similar regional studies. METHODS: Patient data, including age, sex, diagnosis, tumor site, treatment, and recurrence, were obtained from the medical and pathology records of patients diagnosed with NMSC between January 2010 and June 2015. RESULTS: In total, 190 patients (57 men) with a mean age of 75 years (range, 42–97) were assessed. Overall, 203 NMSCs were diagnosed, including 123 basal cell carcinomas and 80 squamous cell carcinomas. The tumor sites included the nose, cheeks, periorbital area, and lips (n=55, 54, 25, and 20, respectively). We identified 92 T1-stage and 60 T2-stage tumors, and 120 cases were treated with wide surgical resection and 17 cases were treated with radiation therapy at the medical center. Of the 120 cases treated surgically, 69 required reconstructive surgery using a local skin flap, 22 required full-thickness skin grafting, and 12 underwent primary closure. Basal and squamous cell carcinomas recurred in 2 and 1 cases, respectively. CONCLUSIONS: Compared to the reports from other regions, the average patient age was 10 years higher, with a marked female preponderance. While the proportion of squamous cell carcinoma was higher than in other regions, the tumor distribution and surgical management profiles were similar.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Cheek ; Clinical Study* ; Diagnosis ; Female ; Head* ; Humans ; Korea ; Lip ; Neck* ; Nose ; Pathology ; Recurrence ; Skin Neoplasms* ; Skin Transplantation ; Skin*

PURPOSE: To reconstruct the midface, local flaps such as nasolabial flaps have been frequently used. These local flaps, however, have the shortcomings of requiring a secondary operation or limitations in the movement of the flap. Thus, new methods have been developed. This paper reports a case wherein the basal cell carcinoma on the cheek was resected and the skin and soft tissue defect was successfully treated using a facial artery perforator flap. METHODS: A 68-year-old female consulted the authors on the basal cell carcinoma that developed on her cheek. The mass was fully resected and revealed a 2.3 x 2.3 cm defective region. Using a Doppler ultrasonography, the facial artery path was traced, and using a loupe magnification, the facial artery perforator flap was elevated and the defective region was covered with the flap. RESULTS: The flap developed early venous congestion, but it disappeared without any treatment. Six months after the surgery, the patient was satisfied with the postoperative result. CONCLUSION: The facial artery perforator flap has a thin pedicle. It offers a big arc of the rotation that allows free movement and one-stage operation. These strengths make the method useful for the reconstruction of the midface among other procedures.
Aged ; Arteries ; Carcinoma, Basal Cell ; Cheek ; Female ; Humans ; Hyperemia ; Perforator Flap ; Skin ; Ultrasonography, Doppler