We present a series of 97 patients with spinal cord injury. Those patients were treated at Soonchunhyan University Chonan Hospital during six-year-period(January 1986-December 1992), and followed up for at least 3 months. They were divide into four groups ; complete-surgical, complete-conservative, partial-surgical, and partial-conservative. Male to female ratio was 3.6:1, and the peak age was the fifth decade. Passenger's traffic accident(46%) was the most common cause of injury and fall/slip(39%) followed next. Level of spinal injury was cervical in 51%, thoracic in 29%, lumbar in 13%, and others in 7%. Type of injury was fracture-dislocation in 31%, dislocation in 19%, compression fracture in 19%, burst fracture in 18%, cord injury without bony lesion in 7%, and others in 7%. Cord injury was complete in 36 patients(37%) and partial in 61 patients(63%). Surgery was performed in 20 patients with complete cord injury and 34 patients with partial injury. Majority of operations were performed for spinal stability, and posterior instrumentation was the most commonly used operative method. The mean neurotrauma motor index on admission was 44.1 in the complete-surgical group, 39.5 in complete-conservative group, 70.1 in partial-surgical group, and 63.2 in partial-conservative group. It improved to 52.5, 50.3, 90.4, 80.3 at 3 months, and 53.4, 51.7, 91.8, 82.0 at final examination(mean follow-up period was 182.2 days), respectively. The mean values of the final index were higher in the surgically treated groups than the conservatively treated groups, but these differences were not statistically significant(student t-test p>0.1) The mean recovery rate was 14.2% in the complete-surgical group, 17.7% in complete-conservative group, 66.1% in partial-surgical group, and 46.1% in partial-conservative group at 3 months. It improved to 16.6%, 19.3%, 70.0%, and 48.7% at final examination, respectively. The mean recovery rates were higher in the partially injured groups than the completely injured groups(student t-test, p<0.01), regardless the methods of treatment. The final neurotrauma motor index was significantly(regression analysis, p<0.01) related to the initial index except the partial-surgical group. Neurotrauma motor index was a useful method for assessing the injury severity, comparing the recovery rate and predicting prognosis.
Chungcheongnam-do ; Dislocations ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Male ; Prognosis* ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries

OBJECTIVES: This study aimed to identify the group with high risk of suicide in general hospital inpatient by comparing the depression, anxiety, and distress and their clinical characteristics. METHODS: The study included all patients admitted to a general hospital between January 2016 and December 2017, and the final 41,249 patients were analyzed. Distress thermometer (DT) and hospital anxiety-depression scale (HADS) were used for emotional state evaluation. Group with high risk of suicide was defined as showing more than 4 in the DT and more than 8 in one of the two subscales (anxiety and depression) of the HADS. RESULTS: Among the subjects, 3,603 patients (8.7%) met the high-risk criteria for suicide. The group with high risk of suicide experienced more severe pain than the control patient group, and it was found that there was more underlying disease. Patients who reported pain showed higher scores than those who reported no pain on the DT and HADS subscales. CONCLUSIONS: Group with high risk of suicide showed more severe pain and more underlying disease. Therefore, suicide prevention program specifically targeted for the group with high risk of suicide should be developed according to the risk of the patient evaluated at the time of the admission.
Anxiety ; Depression ; Hospitals, General ; Humans ; Inpatients ; Suicide ; Thermometers

Background: Chondroblastomas, which account for approximately 1% of all bone tumors, typically occur in long bones, such as the femur, humerus, and tibia. However, in extremely rare cases, they may also occur in the craniofacial region where the tumor is often found in the squamous portion of the temporomandibular joint (TMJ) and in the temporal bone.Case presentation: This case report describes a large chondroblastoma (diameter, approximately 37 mm) that occurred in the TMJ. The tumor was sufficiently aggressive to destroy the TMJ, mandibular condyle neck, external auditory canal (EAC), mandibular fossa of the temporal bone, and facial nerve. The tumor was completely excised using a pre-auricular approach. The EAC and surgical defect were successfully reconstructed using a temporoparietal fascia flap (TPFF) and an inguinal free fat graft. There was no local tumor recurrence at the 18-month follow-up visits. However, the patient developed sensory neural hearing loss, and his eyebrow paralysis worsened, eventually requiring plastic surgery. Conclusion Large, invasive chondroblastomas of the TMJ can be completely removed through a pre-auricular approach, and the resulting surgical defect can be reconstructed using TPFF and free fat grafts. However, preoperative evaluation of the facial nerve and auditory function is necessary. Therefore, a multidisciplinary approach is essential.

BACKGROUND: Although the association of hyperuricemia with an increased risk of mortality has been demonstrated in the context of acute exacerbation of chronic obstructive pulmonary disease (COPD), the long-term outcomes of hyperuricemia have not been studied in the case of stable COPD. METHODS: We retrospectively analyzed baseline data of 240 men with stable COPD enrolled in the Korea Obstructive Lung Disease cohort. We evaluated associations between serum uric acid levels and clinical parameters, risk factors for all-cause mortality, and acute exacerbation of COPD. RESULTS: The mean age of subjects was 66.4 ± 7.7 years, and the median follow-up time was 5.9 years. We identified no significant difference in terms of lung function or laboratory findings between patients with hyperuricemia and those without. Serum uric acid level was negatively associated with systemic inflammation indicated by neutrophil–lymphocyte ratio (r = −0.211, P = 0.001). Univariate Cox regression analysis revealed hyperuricemia to not be associated with an increased risk of all-cause mortality in men with stable COPD (hazard ratio [HR], 0.580; 95% confidence interval [CI], 0.250–1.370; P = 0.213). In the multivariate Cox regression model, hyperuricemia was not an independent predictor of acute exacerbation (HR, 1.383; 95% CI, 0.977–1.959; P = 0.068). CONCLUSION Among men with stable COPD, hyperuricemia is not an independent predictor of all-cause mortality or future acute exacerbation of COPD. These results differ from those of previous studies on patients with acute exacerbation of COPD.

BACKGROUND: Although the association of hyperuricemia with an increased risk of mortality has been demonstrated in the context of acute exacerbation of chronic obstructive pulmonary disease (COPD), the long-term outcomes of hyperuricemia have not been studied in the case of stable COPD.METHODS: We retrospectively analyzed baseline data of 240 men with stable COPD enrolled in the Korea Obstructive Lung Disease cohort. We evaluated associations between serum uric acid levels and clinical parameters, risk factors for all-cause mortality, and acute exacerbation of COPD.RESULTS: The mean age of subjects was 66.4 ± 7.7 years, and the median follow-up time was 5.9 years. We identified no significant difference in terms of lung function or laboratory findings between patients with hyperuricemia and those without. Serum uric acid level was negatively associated with systemic inflammation indicated by neutrophil–lymphocyte ratio (r = −0.211, P = 0.001). Univariate Cox regression analysis revealed hyperuricemia to not be associated with an increased risk of all-cause mortality in men with stable COPD (hazard ratio [HR], 0.580; 95% confidence interval [CI], 0.250–1.370; P = 0.213). In the multivariate Cox regression model, hyperuricemia was not an independent predictor of acute exacerbation (HR, 1.383; 95% CI, 0.977–1.959; P = 0.068).CONCLUSION: Among men with stable COPD, hyperuricemia is not an independent predictor of all-cause mortality or future acute exacerbation of COPD. These results differ from those of previous studies on patients with acute exacerbation of COPD.
Cohort Studies ; Follow-Up Studies ; Humans ; Hyperuricemia ; Inflammation ; Korea ; Lung ; Lung Diseases, Obstructive ; Male ; Mortality ; Pulmonary Disease, Chronic Obstructive ; Retrospective Studies ; Risk Factors ; Uric Acid

BACKGROUND: Fibrous dysplasia (FD) is a benign bone lesion characterized by the progressive replacement of normal bone with fibro-osseous connective tissue. The maxilla is the most commonly affected area of facial bone, resulting in facial asymmetry and functional disorders. Surgery is an effective management option and involves removing the diseased bone via an intraoral approach: conservative bone shaving or radical excision and reconstruction. CASE PRESENTATION: This case report describes a monostotic fibrous dysplasia in which the patient’s right midface had a prominent appearance. The asymmetric maxillary area was surgically recontoured via the midfacial degloving approach under general anesthesia. Follow-up photography and radiographic imaging after surgery showed the structures were in a stable state without recurrence of the FD lesion. Furthermore, there were no visible scars or functional disability, and the patient reported no postoperative discomfort. CONCLUSIONS: In conclusion, the midfacial degloving approach for treatment of maxillary fibrous dysplasia is a reliable and successful treatment option. Without visible scars and virtually free of postoperative functional disability, this approach offers good exposure of the middle third of the face for treatment of maxillary fibrous dysplasia with excellent cosmetic outcomes.
Anesthesia, General ; Cicatrix ; Connective Tissue ; Facial Asymmetry ; Facial Bones ; Fibrous Dysplasia, Monostotic ; Follow-Up Studies ; Humans ; Maxilla ; Photography ; Recurrence