We report herein our surgical experience of Hartmann's procedure reversal using laparoscopic technique in a 72-year-old woman who underwent Hartmann's procedure for an obstructing sigmoid colon cancer 6 month earlier. The purposes of this report are to describe our technique of laparoscopic reversal of Hartmann's procedure, to introduce several technical tips in avoiding pitfalls, and to review its safty and efficacy. In brief, the colostomy was freed from the abdominal wall using a conventional technique, then a center rod and an anvil of a circular stapler were inserted into the colon. CO2 insufflation was performed through this insertion. Using a five-cannula technique, rectal stump was mobilized, then colorectal anastomosis was performed laparoscopically via a transanal stapled approach. The operating time was 130 minutes and blood loss was 50 ml. There were no intra- and postoperative complications. Up to now, with a 4-month follow-up period, the patient has been well without having any problems associated with this operation
Abdominal Wall ; Aged ; Colon ; Colostomy ; Female ; Follow-Up Studies ; Humans ; Insufflation ; Laparoscopy ; Postoperative Complications ; Sigmoid Neoplasms

PURPOSE: The purpose of this study was to provide a critical assessment of evidence-based Korean pediatric research that can inform clinical practicability of, and future research on distraction interventions for pediatric procedural pain management. METHODS: A critical review of evidence-based Korean pediatric research was conducted. Databases were searched to identify research that included an evaluation of a distraction intervention as an intervention for pediatric procedural pain management. The search yielded 68 studies. RESULTS: From these studies, 14 were included for this review and all were recently published (2003-2014). Quasi experimental designs were most frequently used (n=12) and for 71.4% the focus was preschoolers. Audiovisual techniques were the most common form of distraction. In most studies clinical utility of the distraction intervention was not examined. Fairly consistent reductions in behavioral measures of pain in association with the distraction intervention were found but less consistent results were found for physiological measures. CONCLUSION: Lack of methodological rigor limits the evidence for distraction interventions to reduce pain and fear experienced by children during painful procedures. Further research to analyze the cost and time-effectiveness and to identify consumer and provider satisfaction with distraction interventions is needed to determine whether distraction interventions are clinically relevant.
Child* ; Humans ; Pain Management ; Research Design

Nerve Conduction studies are used not only in diagnosis of compression neuropathy, but also as a prognostic evaluation after is treatment. Authors analyzed the changes of nerve conduction studies in the 21 hands of 19 patients of carpal tunnel syndrome which was confirmed by clinical and electrodiagnostic methods, and treated by surgical release of transverse carpal ligament. The changes of nerve conduction and clinical studies were completed just before surgery, and at 2-week, 1-month, 3-month and 6-month of postoperative periods, and summarized as follows; 1. The distal sensory and motor latencies were significantly(P < 0.05) improved at the 3-month of postoperative periods, respectively. 2. The sensory conduction velocities across the carpal tunnel was significantly(P < 0.05) improved at the 6-month of postoperative periods. 3. The distal motor amplitude was significantly(P < 0.05) improved at the 6-month of postoperative periods. 4. The changes in sensory conduction studies were more sensitive value for evaluation of patients with carpal tunnel syndrome. 5. The distal latencies reflected the progress of clinical improvement, accurately. These conduction studies are considerable value in the evaluation of the post-carpal tunnel release patient.
Carpal Tunnel Syndrome ; Diagnosis ; Hand ; Humans ; Ligaments ; Neural Conduction ; Postoperative Period

Purpose: This study aimed to apply a health partnership program using commercially available mobile health apps to improve cardiovascular risk factors in male employees and verify its effectiveness. Methods: Using a randomized control group pretest-posttest design, male employees with cardiovascular risk factors from five small and medium-sized workplaces were randomly assigned to an experimental group (n = 32) and a control group (n = 31). The experimental group was encouraged to use three mobile health apps for 12 weeks to acquire the necessary cardiovascular disease-related information and practice strengthening training, walking, and diet management appropriate to their level. They also received feedback on their weekly activities and motivational text messages from health partners. Hypotheses were tested using the SPSS WIN 22.0. Results: The experimental group showed a significant difference compared to the control group in terms of their perception of mobile health app (p < .05), self-efficacy for exercise and diet, self-management partnership, and cardiovascular disease prevention health behavior (p < .001). In particular, there were significant decreases in the body mass index, ratio, serum fasting blood sugar, total cholesterol, and triglyceride in the experimental group (p < .001); however, there was no significant difference in high-density lipoprotein-cholesterol. Conclusion Intervention using mobile apps based on partnership with health managers is effective in improving the objective cardiovascular risk index in male employees; therefore, such intervention should be continuously used as a useful lifestyle modification strategy in the workplace.

This article has been retracted.

OBJECTIVES: This study compared attitudes toward antipsychotic treatment according to awareness of the name of their illness in patients with schizophrenia. METHODS: Information on sociodemographic and clinical characteristics, including awareness of the importance of antipsychotic treatment, was obtained through a self-report questionnaire. The Drug Attitude Inventory (DAI) was administered. The data were compared according to awareness of the name of their illness. RESULTS: The study analyzed data for 199 patients with schizophrenia. Of these, 115 patients (57.8%) were aware that their illness was called schizophrenia, while 84 patients (42.2%) knew it by their psychotic symptoms or as another mental illness, such as depression. The patients aware of the name of their illness had significantly longer durations of illness and higher scores on the DAI. They were significantly more likely to have stopped taking medication on their own accord and to agree with the importance of antipsychotic treatment. Statistical significance was sustained in a logistic regression analysis after adjusting for the duration of illness and study site, except for the DAI score, which had borderline significance (p=0.055). In subjects with duration of illness > or =5 years, patients aware of the name of their illness had significantly higher scores on the DAI. CONCLUSION: Awareness of the name of their illness was associated with awareness of the importance of, and a positive attitude toward, antipsychotic treatments in patients. Psycho-education, including telling the patient the correct name of his or her illness, might be needed for maintaining antipsychotic treatment in patients with chronic schizophrenia.
Antipsychotic Agents ; Depression ; Humans ; Logistic Models ; Surveys and Questionnaires ; Schizophrenia

Satisfactory results of unicondylar knee arthroplasty (UKA) have been reported since minimally invasive UKA had been introduced. However, several stress fractures of the tibial plateau, related to instrumentation design, have been reported. We report two cases of periprosthetic stress fractures of the tibial plateau after navigation-assisted unicondylar knee arthroplasties.
Arthroplasty* ; Fractures, Stress* ; Knee*

BACKGROUND: To assess the diagnostic value of 13C-UBT using capsulated 38 mg low dose for H. pylori infection, we investigated the sensitivity and specificity of 13C-UBT and to suggest the optimal positive cut-off value of DOB20 in 13C-UBT using ROC analysis. METHODS: The study subjects were 76 healthy individuals (males; 52, females; 24) who visited a health promotion center at a university hospital between July 2005 and June 2007. We tested for H. pylori infection by 38 mg low dose 13C-UBT and histology. We measured the expiratory 13C-urea concentration of basal and 20 minutes value after oral ingestion of 38 mg 13C- labelled urea with capsulated. The breath samples were analysed by gas chromatograph isotope ratio mass spectrometer and expressed as units of delta. RESULTS: Fifty subjects (65.8%) were H. pylori positive as judged from histology. ROC analysis showed an area under the curve (AUC) of 0.943 (95% confidence interval: 0.891~0.995), indicating an excellent classification performance of the model. The sensitivity of 96%, specificity of 85% were achieved at the optimal cut-off value of DOB20 which was 1.39. The 38 mg low dose 13C-UBT was a non-invasive, simple, short-time required and highly accurate method. CONCLUSION: The results suggested that capsulated 38 mg low dose 13C-UBT is considered more in term of accuracy, costeffectiveness and convenient method for the diagnosis of H. pylori infection. Further long-term research and meta analysis based on large-scale investigations is needed to establish a standardized testing method in creating protocol of 13C-UBT.
Breath Tests ; Eating ; Health Promotion ; Helicobacter ; Helicobacter pylori ; ROC Curve ; Sensitivity and Specificity ; Urea

PURPOSE: Fatigue, energy loss, feeling of helplessness, poor appetite, pain besides general weakness are major symptoms presented to terminally ill cancer patients. These symptoms are similar to those that appeared with adrenal insufficiency. Also, for terminally ill cancer patients who are hospitalized for palliative care, opioid agents are prescribed to control moderate to severe pain. We studied the relationship of opioid agents and adrenal insufficiency. METHODS: From November 2013 through June 2014, we monitored the serum level of cortisol and dehydroepiandrosterone sulfate (DHEAS, serum) in 55 cancer patients who were over 18 years old and were treated at a hospice center. We also checked the treatment period and dosage of opioid agents. RESULTS: The DHEAS level, treatment period and dosage of opioid agents did not have significant correlation. Correlation between the serum cortisol level and the opioid agent treatment period was not significant either, but the serum cortisol level was positively correlated with the dosage of opioid agents (P value 0.0322). CONCLUSION: This study did not identify a novel link between treatment period, dosage of opioid agents and adrenal insufficiency. But, the DHEAS level was mostly below the normal level in patients who were treated with opioid agents.
Adrenal Insufficiency ; Analgesics, Opioid* ; Appetite ; Dehydroepiandrosterone Sulfate ; Dehydroepiandrosterone* ; Fatigue ; Hospices ; Humans ; Hydrocortisone* ; Palliative Care ; Terminally Ill

No abstract available.
Parenteral Nutrition, Total