The authors experienced a case of lid cloboma with congenital anomalies. Congenital colobomas of the lid are uncommon but, if extensive, they may be difficult problems in reconstruction. A case, 17 years old male, lid coloboma characterized by congenital anomalies with both upperlid coloboma, symblepharon of left eye. corneal opacity, nystagmus, microophthalmia, hypertelorism, abduction deficiency, proboscis, deformity of ears, macrostomia, high palate, receding chin, funnel chest, hypertrichosis on the back, flexion deformities of the fingers, spoon nails, and multiple warts on dorsum of both hands. The authors performed the Cutler-Beard procedure on the right upperlid and three suture technique on the left upperlid, followed by eyelash transplantation and lateral canthotomy on both eyes. A brief review of relating references is described.
Adolescent ; Chin ; Coloboma* ; Congenital Abnormalities ; Corneal Opacity ; Ear ; Fingers ; Funnel Chest ; Hand ; Humans ; Hypertelorism ; Hypertrichosis ; Macrostomia ; Male ; Palate ; Suture Techniques ; Warts

Purpose: The aim of this study was to show the association between the childbirth experience and life satisfaction among women with disabilities and estimate the moderating effect of family strengths and social support. Methods: The target sample included disabled married women aged 20-49 years. We used the Disability and Life Dynamics Panel 2018. The total number of participants was 220. Three groups were defined based on the childbirth experience: women who had never given birth (13.6%), those who gave birth before the onset of disability (73.2%), and those who gave birth after the onset of disability (13.2%). We identified differences in general characteristics, family strengths, social support, and life satisfaction across the 3 groups and examined the moderating effect of family strengths and social support for the childbirth experience and life satisfaction. Results: Women who gave birth after the onset of disability were in better health, exhibiting longer disability retention periods. The multiple regression analysis revealed that among women who gave birth after the onset of disability, life satisfaction was significantly higher than that of women without the childbirth experience because of the moderating effect of family strengths. However, social support had no significant effect on the childbirth experience and life satisfaction. Conclusion We empirically analyzed the status of childbirth before and after the onset of disability using representative survey data. The findings indicate a positive moderating effect of family strengths on the level of life satisfaction among women with disabilities.

BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). METHODS: We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. RESULTS: The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. CONCLUSIONS: In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
APACHE* ; Cardiovascular System ; Complement System Proteins ; Critical Care* ; Critical Illness ; Humans ; Injury Severity Score ; Intensive Care Units* ; Mortality ; Multiple Trauma ; Retrospective Studies ; Survival Rate ; Trauma Centers

PURPOSE: The present survey was conducted to investigate the perceptions among nurses of neonatal pain and the associated use of pharmacologic measures (PMs) and nonpharmacologic comfort measures (CMs) in neonatal intensive care units (NICUs). Pain perception, the necessity and actual use of PMs and CMs, and their relationships were investigated and compared according to nurses' positions, educational levels, the existence of guidelines, and prior education on neonatal pain management. METHODS: Participants were 141 nurses from five NICUs at university hospitals. A questionnaire was developed by researchers based on previous studies of neonatal pain management and current practices in surveyed NICUs. Five-point Likert scales were used to assess nurses' perceptions of pain, the necessity of PMs and CMs, and their actual use in 29 painful procedures. RESULTS: The mean scores of perceived pain and the necessity of PMs and CMs were 3.68, 2.96, and 3.79 points, respectively. The actual use of PMs and CMs was 1.67 and 2.63 points, respectively. The perceived necessity of PMs correlated with the actual use of PMs (r = .316, p < .001), and CMs were performed (r = .390, p < .001). Keeping or reading guidelines, or receiving education on pain management resulted in a higher perception of the necessity of PMs. CONCLUSION: Korean nurses in NICUs often underestimate the necessity of pain relief measures and use few PMs or CMs. Therefore, systematic approaches to implement guidelines, such as adaptation of guidelines for each NICU, dissemination of guideline content to all NICU staff, and regular measurements of compliance with the guidelines, are recommended.
Adult ; *Attitude of Health Personnel ; Cross-Sectional Studies ; Female ; Humans ; Infant, Newborn ; *Intensive Care Units, Neonatal ; Intensive Care, Neonatal/*methods ; Nursing Staff, Hospital/*psychology ; Pain/nursing ; Pain Management/*methods/psychology/*utilization ; Questionnaires ; Republic of Korea ; Young Adult

PURPOSE: We evaluated the results of allograft reconstruction following wide resection of malignant bone tumors in long bone, retrospectively. MATERIALS AND METHODS: Seven patients were included. The mean age was 44 years old. Male was 4 cases, and female was 3 cases. Mean follow-up period was 38 months. The mean Musculoskeletal Tumor Society (MSTS) score at final follow-up was evaluated. Postoperative complications were evaluated via periodic radiologic follow-up. Oncologic results were analyzed at final follow-up. RESULTS: The primary malignancies occurred at femur in 5 cases, humerus in 1 case and tibia in 1 case. Pathologic diagnoses were osteosarcoma in 4 cases, multiple myeloma in 2 cases and adamantinoma in 1 case. Mean length of allograft was 165 mm. Fixations of allograft were intramedullary nailing with additional plate in 4 cases, intramedullary nailing in 2 cases, and screw fixation in 1 case. Mean time to union was 14.5 weeks. Mean MSTS score at final follow-up was 20 (67%). Postoperative complications were nonunion in 3 cases, implant failure in 1 case, and infection in 1 case. Oncologic outcomes were continuous disease free in 5 cases and alive with disease in 2 cases at final follow-up. Autologous bone graft and hemi-cortical onlay graft were performed in 2 cases of nonunion. CONCLUSION: Allograft reconstruction following wide resection of malignant bone tumors in long bone was effective surgical option. However, the possibility of nonunion between host bone and allograft should be considered.
Adamantinoma ; Allografts* ; Diagnosis ; Female ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Humerus ; Inlays ; Male ; Multiple Myeloma ; Osteosarcoma ; Postoperative Complications ; Retrospective Studies ; Tibia ; Transplants

PURPOSE: The purpose of this study was to determine the meaning of the adaptation experiences of new ICU nurses who were working in a newly established university hospital. The study was based on phenomenological research methodology. METHODS: Data were collected over 3 months through in depth interview with 6 new nurses who had worked less than 1 year in a newly established ICU of university hospital of less than 1 year located in Y city. The Colaizzi analysis method was used for data analysis. RESULTS: The themes were classified into 13 themes clusters. The 13 themes clusters were finally grouped into 6 categories, 'The endlessness of a new beginning', 'Pressure of work due to lack of senior nurses', 'Wanting to quit', 'Attachment for the complete hospital and ICU', 'Preciousness of colleagues', 'Pride in self-growth'. CONCLUSION: New ICU nurses have a difficult time due to pressures of work and lack of expert knowledge, and anxiety adds to these problems making the situation more difficult. The study results indicate that professional knowledge and skills learned through repetition of difficult work, pride through self growth, recognition from others and good-fellowship are driving forces to overcome obstacles and with stand difficult daily work.
Anxiety ; Intensive Care Units ; Qualitative Research

BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). METHODS: We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. RESULTS: The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. CONCLUSIONS: In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
APACHE ; Cardiovascular System ; Complement System Proteins ; Critical Care ; Critical Illness ; Humans ; Injury Severity Score ; Intensive Care Units ; Mortality ; Multiple Trauma ; Retrospective Studies ; Survival Rate ; Trauma Centers

OBJECTIVES: Firefighters and rescue workers are likely to be exposed to a variety of traumatic events; as such, they are vulnerable to the risk of post-traumatic stress disorder (PTSD). The psychometric properties of the Korean version of the PTSD Checklist (PCL), a widely used self-report screening tool for PTSD, were assessed in South Korean firefighters and rescue workers. METHODS: Data were collected via self-report questionnaires and semi-structured clinical interviews administered to 221 firefighters. Internal consistency, item-total correlation, one-week test-retest reliability, convergent validity, and divergent validity were examined. Content validity of the PCL was evaluated using factor analysis and receiver operating characteristic (ROC) analyses were used to estimate the optimal cutoff point and area under the curve. RESULTS: The PCL demonstrated excellent internal consistency (alpha = 0.97), item-total correlation (r = 0.72-0.88), test-retest reliability (r = 0.95), and convergent and divergent validity. The total score of PCL was positively correlated with the number of traumatic events experienced (p < 0.001). Factor analysis revealed two theoretically congruent factors: re-experience/avoidance and numbing/hyperarousal. The optimal cutoff was 45 and the area under the ROC curve was 0.97. CONCLUSIONS: The Korean version of the PCL may be a useful PTSD screening instrument for firefighters and rescue workers, further maximizing opportunities for accurate PTSD diagnosis and treatment.
Checklist* ; Diagnosis ; Firefighters* ; Humans ; Mass Screening ; Psychometrics ; Reproducibility of Results* ; Rescue Work* ; ROC Curve ; Stress Disorders, Post-Traumatic*

BACKGROUND: The possibility of developing pulmonary tuberculosis usually increases with increasing age. Therefore, the incidence of endobronchial tuberculosis in older people may increase. We evaluated the clinical characteristics in patients with endobronchial tuberculosis above the age of 70 years. METHODS: We enrolled 74 patients (12 males and 62 females; mean age 64.6+/-16.2 years) that were diagnosed with endobronchial tuberculosis from March 2003 to July 2006 at Gyeongsang University Hospital. We retrospectively evaluated the clinical characteristics of endobronchial tuberculosis for patients 70 years or older (older group) and for patients below the age of 70 years (younger group). RESULTS: The number of patients in the older group was 41 (55%). Cough was the most common symptom in the two groups of patients and dyspnea on exertion was more common in the older group of patients than in the younger group of patients (31.7% vs. 12.1%). The actively caesating type of disease was more common in the younger group of patients than in the older group of patients (66.7% vs. 39%). The edematous type of disease was more common in the older group of patients than in the younger group of patients (53.7% vs. 27.2%) (p<0.05). Tracheal and main bronchial involvement of lesions were more common for the younger group of patients than for the older group of patients (30.3% vs. 9.7%) (p<0.05). CONCLUSION: Endobronchial tuberculosis was commonly observed in patients older than 70 years and this group of patients had some clinical characteristics that were different from the younger group of patients.
Cough ; Dyspnea ; Female ; Humans ; Incidence ; Male ; Retrospective Studies ; Tuberculosis* ; Tuberculosis, Pulmonary

Mycobacterium avium complex (MAC) infection is a common opportunistic infection in patients with AIDS (acquired immune deficiency syndrome). Pulmonary involvement of MAC may range from asymptomatic colonization of the respiratory tract to invasive parenchymal or cavitary disease. However, endobronchial lesions with MAC infection are rare in immunocompetent and immunosuppressed hosts. Here, we report MAC infection presenting as an endobronchial mass in a patient with AIDS.
Acquired Immunodeficiency Syndrome/*complications ; Adult ; Antitubercular Agents/therapeutic use ; Bronchial Diseases/complications/diagnosis/drug therapy/*microbiology ; Bronchoscopy ; Humans ; Male ; Mycobacterium avium Complex ; Mycobacterium avium-intracellulare Infection/complications/*diagnosis/drug therapy ; Opportunistic Infections/*complications/diagnosis/drug therapy ; Tomography, X-Ray Computed