The fractures of the both forearm bones are extremely common in children. Between the radius and ulna, there is normally through an arc of 180° rotation. To restore full rotation, rotational deformity and angulation after fracture must be corrected. The goal of treatment of the unstable forearm fracture is to increase the function of the forearm and hand as well as to get solid bone union. The general principle of treatment of forearm fracture in children is conservative due to remodeling and spontaneous correction ability. Thus, most fractures at any level need not and should not be treated by open reduction and internal fixation. But the operation will be perform frequently who shortly before maturity. We reviewed twenty-three children between 8-13 age, who had dsiplaced both forearm bones fracture, and who were treated with fixation using K-wire(14 cases) or plate(9 cases). Of the twenty-three fractures, sixteen were unsatisfactory reduction with more than 10° of angulation after initial closed reduction, two were loss of reduction in cast immobilization, and five were internally fixed primarily because of soft tissue interposition between fragment. The results were as follows. l. Operation time was 51.4 minutes in K-wire group and 86.7 minutes in plate group. 2. Bone union occured in all cases, at 7.3 weeks in K-wire fixation group and 8.9 weeks in plate fixation group. And immobilization period 7 weeks in K-wire fixation group and 4 weeks in plate fixation group. 3. Functional results were satisfactory all cases in both group. 4. The advantage of K-wire is a simple safe operation with minimal morbidity and small scar and compares with the extensive approach need for plate fixation which often giving a poor cosmetic result. Moreover, a second operation, with significant morbidity, is need to remove the plate after solid union. In Conclusion, this method is a favorable altenative to plate fixation of children forearm fractures. It allows rapid bone union with minimal morbidity, complication and scar.
Child ; Cicatrix ; Congenital Abnormalities ; Forearm ; Hand ; Humans ; Immobilization ; Methods ; Radius ; Ulna

Orbital varix is a relatively rare disease that causes exophthalmos due to increase of cerebral venous pressure. We experienced a forty-two-year-old male patient, who complained of intermittent exophthalmos and blurred vision. The diagnosis was based on clinical manifestation and various radiologic studies including computed tomography(CT), venography, and magnetic resonance imaging(MRI). MRI is a useful and safe diagnostic study through which we could observe the orbital varix and assess the relationship between the varix and the orbital structure. In this case, the varix is huge and attached to superior rectus muscle. There being many surgical risks, he has been followed up without surgical treatment and educated to modify the life pattern for prevention of increase of carotid venous presure.
Diagnosis ; Exophthalmos ; Follow-Up Studies* ; Humans ; Magnetic Resonance Imaging ; Male ; Orbit* ; Phlebography ; Rare Diseases ; Varicose Veins* ; Venous Pressure

No abstract available.
Antibodies, Antineutrophil Cytoplasmic* ; Wegener Granulomatosis*

PURPOSE: This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection.METHODS: This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann–Whitney U test, t-test, and generalized estimation equations (GEE).RESULTS: There were significant differences between the two groups regarding SEE (χ²=13.53, p=.009), PA (χ²=9.51, p=.049), functional status (χ²=10.55, p=.032), and 6MWD (χ²=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=−2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component.CONCLUSION: The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.
Dyspnea ; Exercise ; Humans ; Intention ; Lung Neoplasms ; Lung ; Motor Activity ; Non-Randomized Controlled Trials as Topic ; Nursing ; Patient Education as Topic ; Quality of Life ; Self Efficacy ; Walking

Neoplastic polyps of colon are one of the most risky factors for colorectal cancer. Particularly villous adenomas have more malignant potential than other neoplastic polyps. The preoperative detection of malignant change in villous adenoma is very important to determine treatment modality of patients. We conducted that total twenty-four cases of villous adenoma who were diagnosed and treated at our institution between January 1990 and December 1995 were reviewed retrospectively. The peak incidence of age was 7th decades. And male to female ratio was 2 : 1. Size of the adenoma ranged from 1.2 to 10.7 cm with a mean diameter of 3.9 cm. Five cases(20.8%) were between 1 and 2 cm, 10(41.7%) between 2 and 4 cm, and 9(31.5%) greater than or equal to 4 cm. Location of the adenoma were 10 cases(41.7%) in upper rectum, 8(33.3%) in rectosigmoid, and 6(25.0%) in lower rectum respectively. Pathologic examination of the resected specimen were diagnosed 9(37.5%) as benign villous adenomas, 10(41.7%) as in situ carcinoma, and 5(20.8%) as invasive carcinoma. The diagnostic accuracy to detect in situ carcinoma or invasive carcinoma was endoscopic examination in 66.7 percent and digital examination in 86.7 percent. The grade of in situ carcinoma had not significantly relationship with the size of the adenoma on our study. However, invasive carcinoma was significantly related to adenoma size(P<0.05) as following results zero percent between 1 and 2 cm, 20 percent between 2 and 4 cm, and 33.3 percent greater than or equal to 4 cm. In conclusion, the larger villous adenoma has higher malignant potential, especially greater than or equal to 4 cm in size. Added, the clinical impression of the malignancy on digital examination can be more accurate than preoperative endoscopic examination on our study.
Adenoma ; Adenoma, Villous* ; Colon ; Colorectal Neoplasms ; Female ; Humans ; Incidence ; Male ; Polyps ; Rectum ; Retrospective Studies

PURPOSE: This study aims to examine the effects of nursing interventions based on the Extended Theory of Planned Behavior (ETPB) regarding self-efficacy for exercise (SEE), physical activity (PA), physical function (PF), and quality of life (QOL) in patients with lung cancer who have undergone pulmonary resection. METHODS: This quasi-experimental study was conducted between July 2015 and June 2018 in two university-affiliated hospitals. The intervention included pre-operative patient education, goal setting (action and coping planning), and feedback (behavior intention and perceived behavioral control). The intervention group (IG) (n=51) received nursing interventions from the day before surgery to 12 months after lung resection, while the comparison group (CG) (n=36) received usual care. SEE, PA, PF (dyspnea, functional status, and 6-minute walking distance [6MWD]), and QOL were measured before surgery and at one, three, six, and 12 months after surgery. Data were analyzed using the χ² test, Fisher's exact test, Mann–Whitney U test, t-test, and generalized estimation equations (GEE). RESULTS: There were significant differences between the two groups regarding SEE (χ²=13.53, p=.009), PA (χ²=9.51, p=.049), functional status (χ²=10.55, p=.032), and 6MWD (χ²=15.62, p=.004). Although there were no time or group effects, the QOL mental component (Z=−2.78, p=.005) of the IG was higher than that of the CG one month after surgery. Interventions did not affect dyspnea or the QOL physical component. CONCLUSION The intervention of this study was effective in improving SEE, PA, functional status, and 6MWD of lung cancer patients after lung resection. Further extended investigations that utilize ETPB are warranted to confirm these results.

Background: As a restorative material used to treat dental caries, the light-curing type resin is widely used, but it has the disadvantage of polymerization shrinkage. The Bulk-Fill composite resin was developed to solve these shortcomings, but the existing research mainly focused on comparing the physical properties of a composite resin and a Bulk-Fill resin. A study on the light curing time and distance of the Bulk-Fill resin itself tend to be lacking. Methods: This study compares the surface microhardness of specimens prepared by varying the light curing time and distance of smart dentin replacement (SDR) as a flowable Bulk-Fill resin and Tetric N-ceram as a packable Bulk-Fill resin, and confirms the polymerization time and distance that becomes the optimum hardness. To determine the hardness of the specimen, it was measured using the Vickers Hardness Number (Matsuzawa MMT-X, Japan). Results: In SDR, the surface microhardness decreased as the distance increased in all time groups in the change distance from the curing tip. In the change of light curing time with respect to the distance from curing tip, the surface microhardness increased as the time increased. In Tetric N-ceram, the surface microharness showed no significant difference in the change of the distance of curing tip in the group of 20 and 60 second. But in the group of 10 and 40 seconds, decreased as the distance increased. The surface microharness increased as the light curing time increased in all distance groups. Conclusion When using SDR and Tetric N-ceram in clinical practice, it is considered that as the distance from the polymerization reactor tip increases, a longer light curing time than the polymerization time recommended by the manufacturer is required.

Superior vena cava syndrome (SVCS) is usually caused by extrinsic compression or invasion of the superior vena cava (SVC) by malignant tumors involving mediastinal structures. Although thymomas are well-known causes of SVCS, cases of SVCS caused by malignant thymomas protruding into adjacent vessels draining the SVC with thrombosis have been very rarely reported worldwide. We experienced a 39-year-old female patient with SVCS that developed after the direct invasion of the left brachiocephalic vein (LBCV) and SVC by an anterior mediastinal mass with a high maximum standardized uptake value on the chest computed tomography (CT) and positron emission tomography-CT. Based on these results, she underwent en bloc resection of the tumor, including removal of the involved vessels, and was eventually diagnosed as having a type B2 thymoma permeating into the LBCV and SVC. We present this case as a very rare form of SVCS caused by an invasive thymoma.
Adult ; Brachiocephalic Veins ; Electrons ; Female ; Humans ; Positron-Emission Tomography ; Superior Vena Cava Syndrome* ; Thorax ; Thrombosis ; Thymoma* ; Vena Cava, Superior*

The 2010 Emergency Physician (EP) Survey of the Korean Society of Emergency Medicine (KSEM) was the first comprehensive survey of its members on their working conditions, working environment, and compensation. The survey was conducted using a questionnaire on the web interface and e-mail from March to December of 2010. The subjects were currently active EPs working in an emergency department (ED). Additional e-mails, telephone calls, and visits were necessary in order to encourage the participation of members. Out of 841 members, 394 members completed the questionnaire. Excluding members who are currently not working in an ED, retired, opened a private practice as a primary physician, or unknown status, 635 (75.5%) EPs were working in 203 EDs out of a total of 465 EDs in Korea. There was a wide range of variations in ED employing EP. EP employing practices by the hospitals depended on the size and level of ED and the region of the country. ED employed 4.52+/-2.97 Eps, and 4.80+/-5.69 emergency residents, 4.21+/-3.05 interns, and 26.02+/-16.99 nurses. On average, EPs worked 17.51+/-5.84 days, and 7.87+/-3.17 night shifts in a month, 228.11+/-57.46 hours in a month. The average pay for the hour was 33,300 KRW. Satisfaction of the EPs with their compensation was below average. Important factors in selection of a workplace depended on night-shifts, time for the family, pay, and the relationship with other specialties. On a 10 point scale, satisfaction with their training was 6.38; the answer to selection of the same specialty was 5.53; satisfaction with the current emergency medical services (EMS) system was 3.85; emergency medicine in 10 years was 5.75. The adult APGAR score was 5.05. As in the survey, members of KSEM as a whole are working a large number of heavy duty hours, with insufficient pay. Most of them feel over burdened and unsatisfied with their current state. They also share a dim outlook on the future. In order to increase job satisfaction of EPs, there must be an improvement in the welfare and working conditions. This survey was conducted in order to obtain a clear view of the current status of EPs in Korea, and in hopes of contributing to improvement of the EP status. This survey will lay a cornerstone for development of an EMS system in Korea.
Adult ; Apgar Score ; Compensation and Redress ; Electronic Mail ; Emergencies* ; Emergency Medical Services ; Emergency Medicine ; Emergency Service, Hospital ; Hope ; Humans ; Job Satisfaction ; Korea ; Private Practice ; Surveys and Questionnaires ; Telephone

Urethral reconstruction is a problematic issue, thus its management can be challenging. Different methods using various materials were introduced for urethral reconstruction. The authors have made some changes in the groin flap surgery, affording more successful urethral reconstruction for defects of long urethra and penile soft tissue. A 45-year-old male requested both functional and cosmetic reconstruction of his defected penis, caused by an iatrogenic urethral injury and chronic infection following removal of paraffin self-injected on the penile shaft. The defect affected the full length of the penile urethra, corpus spongiosum, and prepuce. A groin flap was designed, measuring 28×10 cm. The most distal flap was utilized for the construction of the luminal surface of the neourethra; relaxed length measuring 8 cm, and the lumen wide enough. Competent external meatus and neourethra was confirmed by retrograde cystogram and the patient voided with sufficient urine caliber up to 2 years follow-up. This operative technique has advantages. Donor sites have non-hair bearing skin for the neourethra and minimal or almost not-recognizable donor site morbidity. After surgery, the patient was relieved from voiding difficulties combined with psychological stress. The author would like to introduce a unique approach for the urethral and ventral phalloplasty using the groin flap.
Follow-Up Studies ; Genitalia ; Groin* ; Humans ; Male ; Middle Aged ; Paraffin ; Penis ; Phenobarbital ; Skin ; Stress, Psychological ; Tissue Donors ; Urethra