Extensive laceration of the lung itself has relatively little attention as a threat to life compared with other intrathoracic organ injuries. The incidence of pulmonary laceration extensive enough to require thoracotomy is rare, but is higher than expected. The diagnosis of extensive pulmonary laceration may be difficult, but this injury should be suspected with attention and early thoracotomy can be carried out in indicated cases. Recently, thoracoscopy has assumed a major role in the management of a variety of surgical diseases of the chest. We experienced a case of extensive pulmonary laceration caused by nonpenetrating trauma, which underwent lobectomy by thoracoscopic surgery. A 21-year-old man who was injured in a motocycle accident was brought to Emergency Room from the scene by an ambulance, and complained of chest pain and dyspnea. A chest roentgenogram showed a hemothorax and fractures of the posterior ends of the right seventh, eighth, and ninth ribs. A chest tube was inserted. Thirteen hundred ml of blood was drained through the chest tube during the next one hour. Emergency right mini-thoracotomy revealed extensive laceration of the lower lobe extending to the pulmonary hilum. The lower lobe was the most badly torn. A lower lobectomy was done by video-assisted thoracic surgery (VATS). He complained less postoperative pain and the postoperative course was uneventful.
Ambulances ; Chest Pain ; Chest Tubes ; Diagnosis ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Hemothorax ; Humans ; Incidence ; Lacerations* ; Lung ; Pain, Postoperative ; Ribs ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracotomy ; Thorax ; Young Adult

BACKGROUND: Discrepancies exist in the existing researches regarding the association between social capital and self-efficacy, and most of these researches have been done in developed countries. The aims of this study were to assess the independent association between individual social capital and self-efficacy and to assess the associations between individual social capital, self-efficacy and self-rated health. METHODS: Data were obtained from the Gyeongnam health survey (6,500 persons) conducted in 2008. A self-administered questionnaire was additionally administered to gather information on demographic variables, health behaviors, chronic diseases, self-efficacy, social capital, and self-rated health status. Total study population was 3,843 as those with chronic diseases were excluded. RESULTS: In males, trust was positively associated with confidence and preference to task difficulty, and participation was negatively associated with confidence and positively associated with regulation and preference to task difficulty. In females, trust was positively associated with confidence and preference to task difficulty and negatively associated with regulation. Participation was positively associated with preference to task difficulty. In males, the odds for self-rated health status was better for persons with confidence (95% confidence interval, CI 1.088-1.705), trust (95% CI 1.172-1.821) and participation (95% CI 1.268-2.117). In females, the odds for self-rated health status was better for those with confidence (95% CI 1.250-1.803), preference of task difficulty (95% CI 1.019-1.683) and participation (95% CI 1.024-1.555). CONCLUSIONS: High social capital measured at an individual level may promote self-efficacy and health status.
Chronic Disease ; Developed Countries ; Female ; Health Behavior ; Health Surveys ; Humans ; Male ; Self Efficacy ; Surveys and Questionnaires

STUDY DESIGN: This is a retrospective study analyzing 73 patients treated by decompression, pedicular screw instrumentation and posterior lumbar interbody fusion (PLIF) for lumbosacral spondylolithesis and symptomatic spinal stenosis. we used laminected laminar and spinous process instead of iliac bone. OBJECTIVES: This is to evaluate fusion rate and clinical results of PLIF with laminected laminar and spinous process. MATERIALS AND METHODS: PLIF in 73 patients with lumbosacral disorders who carried out at Pohang St. Mary's Hospital from March 1994 to January 1996. Fusion rate was evaluated by simple X-ray and dynamic view. Clinical effect was evaluated by Kirkaldy-Willis criteria. RESULTS: The solid fusion was achieved at 67 cases(91.8%) and the average period of fusion was 6.4 months. Complications were 2 cases of superficial skin infection and 3 cases of root irritation. The functional results by Kirkaldy-Willis were as follows ; excellent 40 cases, good 23 cases, fair 9 cases and poor 1 case. CONCLUSIONS: This PLIF procedure combined with transpedicular instrumentation showed sufficient fusion rate and excellent clinical results and improvement in vertebral alignment.
Decompression ; Gyeongsangbuk-do ; Humans ; Retrospective Studies ; Skin ; Spinal Stenosis

Aspirin(ASA) and NSAIDs can induce bronchoconstriction in 10~20% of adult asthmatics patients. Inhalation of lysine-ASA(L-ASA) has been described as an alternative method for diagnosis of ASA-sensitive asthma. To further understand the characterlstics of ASA-sensitive asthmas. we studied 38 asthmatic patients with ASA -sensitivity (36 intrinsic and 2 extrinsic asthma) proven by L-ASA bronchoprovocation test (BPT). Most were female (male to female ratio was 27:73). Twenty (53%) of them had no previous history of adverse reactions when exposed to ASA. Twenty nine (79%) had rhino-sinusitis symptoms. Early asthmatic response was observed in 16 (42%) patients, late only response in 16(42%), and dual response in 6(16%) patients. The threshold of L-ASA to provoke a positive response ranged from 11.2 to 180 mg/ml and most (68.3%) had a positive response after the inhalation of 180 mg/ml. Concurrent sensitivity to sulfite was noted in 14 (36%) patients, followed by sensitivity to tartrazine in one (3%) patient. None showed a positive response to sodium benzoate. After the avoidance from ASA/ NSAIDs with administration of anti-asthmatic medications, symptom and medication scores reduced in 26(87%) patients among 30 followed patients. They were classified into the improved group: four (13%) patients belonged to the not-improved group. There were no significant differences in clinical characteristics between the improved and not- improved group (p>0.05). In conclusion, L-ASA BPT could be considered as a useful method to diagnose ASA -sensitive asthma and be used to screen the causative agent for asthmatic patients with intrinsic type, especially in female patients with rhino-sinusitis and/or nasal polyp, even though they do not have arty history of adverse reactions. Cessation of exposure and proper treatment may allow to reduce symptom and medication scores.
Adult ; Anti-Inflammatory Agents, Non-Steroidal ; Asthma* ; Bronchoconstriction ; Diagnosis ; Female ; Humans ; Inhalation ; Nasal Polyps ; Sodium Benzoate ; Tartrazine

PURPOSE: The aim of this study was to explore the relationship among subjective health status, mental health, and cancer stigma of long-term cancer survivors after gastric surgery. METHODS: In this cross-sectional study, 135 cancer survivors visiting the family medicine clinic of a tertiary hospital were surveyed. Data were collected from March 1 to May 31, 2017. Using the questionnaire, subjective health status, mental health, and cancer stigma were measured and analyzed. RESULTS: The mean scores for subjective health status, stress, and cancer stigma were 80.16, 2.97 and 1.59 respectively. Anxiety and depression rates were 37.1% and 28.9% respectively. Cancer stigma was negatively correlated with subjective health status (r=−.18, p=.036) and positive association with anxiety (r=.23, p=.009), depression (r=.20, p=.023), and stress (r=.21, p=.017). CONCLUSION: In this study, long-term cancer survivors' subjective health status, mental health, and cancer stigma were low and these variables were significantly associated. In order to improve the quality of life of long-term gastric cancer survivors, it is necessary to actively evaluate anxiety, depression, stress, and cancer stigma. The appropriate psychosocial care interventions developed through repeated research of survivors of long-term cancer should be continued.
Anxiety ; Cross-Sectional Studies ; Depression ; Diagnostic Self Evaluation* ; Humans ; Mental Health* ; Quality of Life ; Stomach Neoplasms ; Survivors* ; Tertiary Care Centers

Purpose: The purpose of this study was to identify factors influencing the Radiation Protection(RP) behaviors of endoscopy nurses during endoscopic interventional radiology. Methods: A total of 188 endoscopy nurses working at 30 tertiary or general hospitals participated in this questionnaire-based study. The questionnaire included items on general and job related characteristics, RP knowledge, RP attitude, RP behavior, self-efficacy, and safety climate. Data were collected through online surveys from March 22 to April 10, 2019. Results: Multivariate analysis revealed that RP attitude (β=.65, p<.001), safety climate (β=.12, p=.035), self-efficacy (β=.14,p=.009), and existence of RP protocols (β=.11,p=.038) were significant predictors of better RP behavior. Conclusion The findings showed that the RP behavior of endoscopy nurses was at high levels and the continuing education for endoscopy nurses and development of a radiation safety management education program were important to improve RP behavior.

PURPOSE: The subareolar area is often difficult to evaluate ultrasonographically due to tissue shadowing, which obscures visualization of ducts and parenchymal tissue. The purpose of this study is to determine if real-time compound imaging improves evaluation of normal subareolar tissue and solid nodules in subareolar area compared to conventional ultrasonography. METHODS: 190 images of the subareolar area were obtained from 135 patients from March 2001 to July 2002. Thirty-three of 190 images showed solid nodules, extraductal nodules in 30 and intraductal nodules in three. We scanned both conventional and compound imaging with a stationary probe, to maintain an identical projection and tissue pressure. We used two compound techniques; survey mode (S) is made by 3 coplanar images and target mode (T) by 9 coplanar images. The evaluating points were 1) reduction in the density of shadowing, 2) resolution of duct wall, 3) resolution of duct lumen, 4) margin of nodule, and 5) internal echoes of nodule. In a blinded fashion, three radiologists graded the quality of images on a 5-point scale. RESULTS: For reviewer 1/2/3, S showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.1 0.6/0.5+/-0.5), 2) resolution of duct wall (0.9+/-0.2/1.5+/-0.6/1.0+/-0.5), 3) resolution of duct lumen (0.9+/-0.2/1.6 +/-0.6/0.7+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.5/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/- 0.5/1.2+/-0.4) and T showed grade improvements in 1) reduction in the density of shadowing (0.4+/-0.6/1.2+/-0.6/0.7+/-0.7), 2) resolution of duct wall (1.0+/-0.3/1.5+/-0.6/1.1+/-0.5), 3) resolution of duct lumen (0.9+/-0.3/1.6+/-0.6/0.8+/-0.6), 4) margin of nodule (1.0+/-0.3/1.5+/-0.6/1.2+/-0.5), and 5) internal echoes of nodule (1.1+/-0.3/1.5+/-0.6/1.3+/-0.4). In all evaluating points, two modes of real-time compound imaging were superior to conventional imaging (P<0.05). There was no significant difference between two modes of compound imaging. CONCLUSION: Real-time compound imaging improves evaluation of normal subareolar tissue and subareolar solid nodules compared to conventional ultrasonography by reducing shadowing and increasing anatomic resolution of ducts.
Breast ; Humans ; Shadowing (Histology) ; Ultrasonography*

Angiogenesis is a fundamental biological process including endothelial cell adhesion, migration, invasion and tube formation. Integrin receptors of endothelial cells play important roles in angiogenesis. They mediate cell-cell contact and cell adhesion to extracellular matrix. Roles of integrins have been described for a number of cell types. ECV304 endothelial cells were known to overexpress alpha3beta1 integrin and to form tube like structure in 3-D Matrigel culture. However the function of alpha3beta1 integrin in endothelial cells remains to be determined. Therefore, we have investigated morphological characteristics of ECV304 cells and roles of alpha3beta1 integrin in angiogenesis. To elucidate several characteristics, ECV304 endothelial cells were compared with HUVEC in the aspect of morphology, localization of integrins, angiogenesis pattern. In addition, role of alpha3beta1 integrin were analyzed in the aspect of endothelial cell binding, migration, invasion and tube formation on Matrigel. The result showed that alpha3beta1 integrin overexpressed ECV304 endothelial cells showed strong adhesiveness to extracellular matrix proteins, and high migration and invasion activities. Furthermore, expression of alpha3beta1 integrin was increased according to time course during in vitro culture and was continuously strong in ECV304 cells on 3-D Matrigel culture. These results indicate that alpha3beta1 integrin is able to be a critical component in control of angiogenesis by regulation of cell adhesion, migration, invasion and tube formation of ECV304 endothelial cells.
Adhesiveness ; Biological Processes ; Cell Adhesion ; Endothelial Cells* ; Extracellular Matrix ; Extracellular Matrix Proteins ; Integrin alpha3beta1* ; Integrins

PURPOSE: Recently, percutaneous aspiration with sclerotherapy has become widely used as a treatment of the symptomatic, large, and simple renal cysts, due to its minimal invasiveness and high effectiveness. However, the reported recurrence rates of simple aspiration are high, in the range 30 to 70%. Therefore, the effect of percutaneous aspiration with sclerotherapy of simple renal cysts was analyzed. MATERIALS AND METHODS: The results of the treatment in 35 simple renal cysts, between June 1994 and July 2003, were evaluated. The symptoms associated with simple renal cysts were; none (40%), flank pain (31.4%), indigestion (17.1%), hematuria (8.6%) and a palpable mass (2.9%). The simple renal cysts were treated with percutaneous aspiration in only 7 cases (group I), single percutaneous aspiration with sclerotherapy, using 99% ethanol, in 18 (group II) and a repeated percutaneous aspiration with sclerotherapy, using 99% ethanol, in 10 (group III). All patient were followed up by ultrasound or CT scan for 12 to 80 months (mean 28.1 months). RESULTS: Complete and partial collapses and recurrences of the renal cysts occurred in 1 (14.2%), 3 (42.9%) and 3 (42.9%) in group I, 7 (39%), 10 (55.5%) and 1 (5.5%) in group II, and 6 (60%), 3 (30%) and 1 (10%) in group III. The overall efficacies were 92% in all 3 groups. Furthermore, all recurrences occurred within the first year of the follow up period in all groups. CONCLUSIONS: For a simple renal cyst, percutaneous aspiration with sclerotherapy, using 99% ethanol, either singly or repeatedly, appears to be effective in the prevention of re-accumulation of cystic fluid; it also proved to have a positive long term result in terms of a relapse of a simple renal cyst.
Dyspepsia ; Ethanol ; Flank Pain ; Follow-Up Studies ; Hematuria ; Humans ; Recurrence ; Sclerotherapy* ; Tomography, X-Ray Computed ; Ultrasonography

Traumatic rupture of the major airways may be caused by blunt or penetrating injury. The incidence of blunt trauma has risen dramatically in this century with the increase in modern high-velocity transportation. Clinical presentation of bronchial injuries in blunt trauma is varied, and the initial diagnostic evaluation is often misleading. The emphasis in management of these injuries is on early diagnosis and intervention. We experienced a case of bronchial rupture caused by blunt trauma. A 5-year-old male visited Emergency Room complaining of severe dyspnea and chest pain after traffic accident. Chest X-ray showed left tension pneumothorax. After emergent closed-thoracostomy, persistent air leakage and collapse of the left lung were noted. Chest CT revealed cut-off of left main bronchus and "dropped lung". Bronchoscopic examination confirmed the rupture of left main bronchus including proximal part of upper lobe bronchus. The patient underwent left upper lobectomy and bronchoplasty by using interrupted 4-0 Vicryl sutures. The postoperative course was uneventful.
Accidents, Traffic ; Bronchi ; Chest Pain ; Child, Preschool ; Dyspnea ; Early Diagnosis ; Emergency Service, Hospital ; Humans ; Incidence ; Lung ; Male ; Pneumothorax ; Polyglactin 910 ; Rupture* ; Sutures ; Thorax ; Tomography, X-Ray Computed ; Transportation