Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm2 and the mean size of the donor sites was 51.9 cm2. The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

Purpose: A diaphyseal simple transverse fracture (DSTF) of the upper extremity (UE) requires direct anatomical reduction and absolute stability. No standard efficient method exists for reducing and maintaining a DSTF, despite its importance. Here, we introduce our transosseous wiring (TOW) method for UE-DSTFs. Methods: To maintain reduction, the UE-DSTF was first fixed with TOW before definitive fixation with a locking plate across the fracture. We retrospectively reviewed 15 patients with at least 1 year of postoperative follow-up treatment from 2019 to 2021. Results: All patients had achieved anatomical reduction and bone union at the final follow-up. Three patients had hardware removed because of irritation caused by the plate and screws. However, none of those three patients complained of irritation from the wire. One patient experienced refracture at the same site after hardware removal after a fall. The same technique was used in this case, and the bone union was observed 6 months after surgery. Conclusion TOW is a simple straightforward method that can be applied without special instruments. It could be an efficient method for interfragmentary compression and attachment of a locking plate without the burden of maintaining the reduction of UE-DSTFs.

Purpose: A diaphyseal simple transverse fracture (DSTF) of the upper extremity (UE) requires direct anatomical reduction and absolute stability. No standard efficient method exists for reducing and maintaining a DSTF, despite its importance. Here, we introduce our transosseous wiring (TOW) method for UE-DSTFs. Methods: To maintain reduction, the UE-DSTF was first fixed with TOW before definitive fixation with a locking plate across the fracture. We retrospectively reviewed 15 patients with at least 1 year of postoperative follow-up treatment from 2019 to 2021. Results: All patients had achieved anatomical reduction and bone union at the final follow-up. Three patients had hardware removed because of irritation caused by the plate and screws. However, none of those three patients complained of irritation from the wire. One patient experienced refracture at the same site after hardware removal after a fall. The same technique was used in this case, and the bone union was observed 6 months after surgery. Conclusion TOW is a simple straightforward method that can be applied without special instruments. It could be an efficient method for interfragmentary compression and attachment of a locking plate without the burden of maintaining the reduction of UE-DSTFs.

Purpose: A diaphyseal simple transverse fracture (DSTF) of the upper extremity (UE) requires direct anatomical reduction and absolute stability. No standard efficient method exists for reducing and maintaining a DSTF, despite its importance. Here, we introduce our transosseous wiring (TOW) method for UE-DSTFs. Methods: To maintain reduction, the UE-DSTF was first fixed with TOW before definitive fixation with a locking plate across the fracture. We retrospectively reviewed 15 patients with at least 1 year of postoperative follow-up treatment from 2019 to 2021. Results: All patients had achieved anatomical reduction and bone union at the final follow-up. Three patients had hardware removed because of irritation caused by the plate and screws. However, none of those three patients complained of irritation from the wire. One patient experienced refracture at the same site after hardware removal after a fall. The same technique was used in this case, and the bone union was observed 6 months after surgery. Conclusion TOW is a simple straightforward method that can be applied without special instruments. It could be an efficient method for interfragmentary compression and attachment of a locking plate without the burden of maintaining the reduction of UE-DSTFs.

Purpose: A diaphyseal simple transverse fracture (DSTF) of the upper extremity (UE) requires direct anatomical reduction and absolute stability. No standard efficient method exists for reducing and maintaining a DSTF, despite its importance. Here, we introduce our transosseous wiring (TOW) method for UE-DSTFs. Methods: To maintain reduction, the UE-DSTF was first fixed with TOW before definitive fixation with a locking plate across the fracture. We retrospectively reviewed 15 patients with at least 1 year of postoperative follow-up treatment from 2019 to 2021. Results: All patients had achieved anatomical reduction and bone union at the final follow-up. Three patients had hardware removed because of irritation caused by the plate and screws. However, none of those three patients complained of irritation from the wire. One patient experienced refracture at the same site after hardware removal after a fall. The same technique was used in this case, and the bone union was observed 6 months after surgery. Conclusion TOW is a simple straightforward method that can be applied without special instruments. It could be an efficient method for interfragmentary compression and attachment of a locking plate without the burden of maintaining the reduction of UE-DSTFs.

Objective: This study examined the association between social support and postpartum depression (PPD) according to the time after childbirth within 12 months in South Korea. Methods: Data were collected from 1,481 women in Chungnam Province, South Korea from September 21 to 30, 2022. Multivariate logistic regression models were used to examine the association between social support and PPD. Subgroup analysis of the associations of support from family, friends, and significant others with PPD according to the time after childbirth was undertaken using crude and adjusted models. Results: Of the participants, 39.91% had PPD. The prevalence of PPD was 36.05% at <3 months, 37.50% at 3≤ to <6 months, and 44.41% at 6≤ to <12 months. A 1-point increase in the social support score was associated with an increase in the adjusted odds ratio of PPD of 0.91 (95% confidence interval=0.90–0.93). Social support from family was significantly associated with PPD regardless of the time after childbirth. Support from significant others was significantly associated with PPD after 6≤ to <12 months. Conclusion Family support should be provided consistently to women after birth; social connections with significant others can prevent PPD.

PURPOSE: Voice change after thyroidectomy has generally been the result of damage to the recurrent or superior laryngeal nerve. But many patients complain voice alteration without laryngeal nerve injury after thyroidectomy. The purpose of this study is to investigate whether strap muscle division results in any subjective or objective functional sequelae in voice, through long-term follow-up prospectively. METHODS: Twenty-two female patients who had undergone thyroid surgery between July 1998 and December 1999, were studied. The patients who were planned for neck dissection, who had benign laryngeal disease or vocal cord paresis, and whose vocal cord paresis were developed after thyroid surgery, were excluded from this study. Twelve patients had undergone thyroidectomy via retraction of strap muscle and ten patients had undergone thyroidectomy via cutting of strap muscle. For evaluation of voice, questionnaires for changes of voice, acoustics (fundamental frequency, jitter, shimmer, signal to noise ratio, noise to harmonic ratio, voice range), and aerodynamic (maximal phonation time) analyses were done. RESULTS: The subjective voice symptoms after thyroidectomy were disturbances of high pitch, singing, loud voice, and easy fatigue at phonation. There were no significant differences in voice parameters on acoustic and aerodynamic analyses between the strap muscle retraction group and the cutting group through long-term follow-up. CONCLUSION: We conclude that strap muscle division does not result in any subjective or objective functional problems in voice. We suggest that surgical division and reconstruction of these muscles should be employed routinely when operating on large, toxic or neoplastic glands.
Acoustics ; Fatigue ; Female ; Follow-Up Studies ; Humans ; Laryngeal Diseases ; Laryngeal Nerve Injuries ; Laryngeal Nerves ; Muscles ; Neck Dissection ; Noise ; Phonation ; Prospective Studies ; Signal-To-Noise Ratio ; Singing ; Thyroid Gland ; Thyroidectomy* ; Vocal Cord Paralysis ; Voice*

Purpose: The rate of interval colorectal cancer (iCRC) is now accepted as a key performance indicator of organized colorectal cancer (CRC) screening programs. We aimed to examine the association between endoscopist volumes and the rate of iCRC among individuals with a positive fecal immunochemical test (FIT) within a nationwide population-based CRC screening program. Materials and Methods: Individuals aged ≥ 50 years who underwent colonoscopy after a positive FIT from January 1, 2019 until December 31, 2020 in the Korean National Cancer Screening Program (KNCSP) were enrolled. We converted the data into per-endoscopist screening results, calculated the iCRC rates per endoscopist, and compared them to the previous year’s annual volume that was divided into five groups (V1, 1-9; V2, 10-29; V3, 30-59; V4, 60-119; V5, ≥ 120). Results: A total of 10,412 endoscopists performed 216,907 colonoscopies. Overall, the average rate of iCRC per endoscopist was 8.46 per 1,000 examinations. Compared with the group with the highest volume (V5 group), the rate of iCRC was 2.21 times higher in the V1 group. Similar trends were observed in the other groups (V2: relative risks [RR], 2.15; 95% confidence interval [CI], 1.57 to 2.94; V3: RR, 1.56; 95% CI, 1.15 to 2.13; V4: RR, 1.18; 95% CI, 0.83 to 1.67). Conclusion The findings emphasize that endoscopists with lower procedure volumes have higher risks of interval cancer being missed or undetected. To maximize the preventative impact of colonoscopy for CRC, this issue should be addressed by monitoring endoscopist volumes and variations in performances.

Purpose: The rate of interval colorectal cancer (iCRC) is now accepted as a key performance indicator of organized colorectal cancer (CRC) screening programs. We aimed to examine the association between endoscopist volumes and the rate of iCRC among individuals with a positive fecal immunochemical test (FIT) within a nationwide population-based CRC screening program. Materials and Methods: Individuals aged ≥ 50 years who underwent colonoscopy after a positive FIT from January 1, 2019 until December 31, 2020 in the Korean National Cancer Screening Program (KNCSP) were enrolled. We converted the data into per-endoscopist screening results, calculated the iCRC rates per endoscopist, and compared them to the previous year’s annual volume that was divided into five groups (V1, 1-9; V2, 10-29; V3, 30-59; V4, 60-119; V5, ≥ 120). Results: A total of 10,412 endoscopists performed 216,907 colonoscopies. Overall, the average rate of iCRC per endoscopist was 8.46 per 1,000 examinations. Compared with the group with the highest volume (V5 group), the rate of iCRC was 2.21 times higher in the V1 group. Similar trends were observed in the other groups (V2: relative risks [RR], 2.15; 95% confidence interval [CI], 1.57 to 2.94; V3: RR, 1.56; 95% CI, 1.15 to 2.13; V4: RR, 1.18; 95% CI, 0.83 to 1.67). Conclusion The findings emphasize that endoscopists with lower procedure volumes have higher risks of interval cancer being missed or undetected. To maximize the preventative impact of colonoscopy for CRC, this issue should be addressed by monitoring endoscopist volumes and variations in performances.

Purpose: The rate of interval colorectal cancer (iCRC) is now accepted as a key performance indicator of organized colorectal cancer (CRC) screening programs. We aimed to examine the association between endoscopist volumes and the rate of iCRC among individuals with a positive fecal immunochemical test (FIT) within a nationwide population-based CRC screening program. Materials and Methods: Individuals aged ≥ 50 years who underwent colonoscopy after a positive FIT from January 1, 2019 until December 31, 2020 in the Korean National Cancer Screening Program (KNCSP) were enrolled. We converted the data into per-endoscopist screening results, calculated the iCRC rates per endoscopist, and compared them to the previous year’s annual volume that was divided into five groups (V1, 1-9; V2, 10-29; V3, 30-59; V4, 60-119; V5, ≥ 120). Results: A total of 10,412 endoscopists performed 216,907 colonoscopies. Overall, the average rate of iCRC per endoscopist was 8.46 per 1,000 examinations. Compared with the group with the highest volume (V5 group), the rate of iCRC was 2.21 times higher in the V1 group. Similar trends were observed in the other groups (V2: relative risks [RR], 2.15; 95% confidence interval [CI], 1.57 to 2.94; V3: RR, 1.56; 95% CI, 1.15 to 2.13; V4: RR, 1.18; 95% CI, 0.83 to 1.67). Conclusion The findings emphasize that endoscopists with lower procedure volumes have higher risks of interval cancer being missed or undetected. To maximize the preventative impact of colonoscopy for CRC, this issue should be addressed by monitoring endoscopist volumes and variations in performances.