We had a female patient with soft tissue tumor involving large portion of Achilles tendon. After resection of tumor, Achilles tendon was reconstructed using an allogenic human fascia lata manufactured by Pfrimmer-Viggo. EMG findings on postoperative 8 months show marked improvement of function of medial and lateral gastrocnemius muscles. Biopsy specimen of fascia lata allograft, which was acquired during TAL 8 months postoperatively, shows myxoid degeneration, a few lymphocytic infiltration and some foreign body giant cells. Functional, histologic and EMG findings suggest that human fascia lata allograft could be used to bridge defect of Achilles tendon being resected during tumor surgery.
Achilles Tendon ; Allografts ; Biopsy ; Fascia Lata ; Fascia ; Female ; Giant Cells, Foreign-Body ; Humans ; Muscles

Objectives: The purpose of this study was to identify the effectiveness of COVID-19 vaccinations on deaths of the COVID-19 cases in some elderly long-term care facilities (LTCF) in Gwangju Metropolitan City. Methods: The study subjects were 659 COVID-19 cases in residents of 7 elderly LTCF, Gwangju, from 21 Dec. 2021 to 28 Jan. 2022. The used variables were confirmed dates for COVID-19, demographic characteristics, co-morbidities, presentation of symptoms, death and vaccination related characteristics including type of vaccine, doses and dates. Vaccination status were classified as not vaccinated, partially and fully vaccinated. The associations of vaccination status and deaths of COVID-19 cases were tested by chi-square test and multiple logistic regression analysis. Results: The rates of not vaccinated, partially vaccinated and fully vaccinated were 19.4%, 10.2% and 70.4%, respectively. The mortality rate of the cases was 6.4%.The death rate by vaccination status was 16.4% in not vaccinated, 15.4% in partially vaccinated and 2.6% in fully vaccinated, showing a statistically significant difference. The adjusted odds ratios (ORs) (95% confidence intervals, CIs) of death compared to fully vaccinated were 7.64 (3.87-16.34) in non-vaccinated, and 6.97 (3.44-14.14) in partially vaccinated. Conclusions COVID-19 vaccination seems to work effectively in preventing deaths of COVID-19 cases of elderly LTCF residents. This finding support that fully vaccinations in high risk group such as elderly LTCF residents is very important for one of strategies of COVID-19 management.

No abstract available.
Intussusception* ; Peutz-Jeghers Syndrome*

PURPOSE: To determine impacts of symptom clusters, performance and emotional status on the quality of life of gynecologic cancer patients. METHODS: Subjects completed questionnaires consisting of four measurements: symptom cluster, performance and emotional status, and the quality of life. A total of 104 completed data sets were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and a multiple regression analysis using the SPSS 21.0 program. RESULTS: Fatigue was identified as the most prevalent symptom (77.9%) and sweating (2.08) as the most severe and uncomfortable symptom (1.80). Six symptom clusters, performance status, anxiety and depression were negatively correlated with quality of life. Four symptom clusters were positively correlated with performance status, and six symptom clusters were positively correlated with anxiety and depression. Factors affecting quality of life were abdominal discomfort cluster (β=−0.23, p=0.005), performance status (β=−0.20, p=0.020), and depression (β=−0.42, p < 0.001). The model was statistically significant explaining 42.5% of variance (F=26.369, p < 0.001). CONCLUSION: The findings supported that symptom clusters and depression negatively influence the quality of life and need to be addressed as we are caring for patients and promoting quality of life.
Anxiety ; Dataset ; Depression ; Fatigue ; Humans ; Quality of Life ; Sweat ; Sweating

As a adjuvant, 99m Tc-IDA complex cholescintigraphy has been used to differentiate the causes of jaundice,hepatocellular jaundice from the obstructive jaundice. So we conducted the retrospective study from the 41 casesof cholescintigraphy from the Mar, 83 to Sept. 84 at the Dept. of radiology in the Sonnchyunhyang university todetermine the etiology and differential points in the diagnosing the Jaundice. The following results wereobtainend; 1. As a 1st-ordered parameter, the leading edge hepatic parenchymal transit time was very significant in differentiating the causes of jaundice, among the hepatocellular jaundice, obstructive jaundice due to tumor,and obstructive jaundice due to cholelithiasis. (P<0.01 by X2-test) 2. As a 2nd-ordered parameter, hepaticclearance was very significant in differentiating the hepatocellular jaundice from the jaundice due to partialbiliary obstruction. (P>0.01 by t-test) 3. The difference in hepatic clearance between the biliary obstruction dueto tumor and that of the cholelithiasis, was not significant. (P>0.05 by X2-test) 4. The difference in bile ductdilatation among the hepatocellular jaundice obstructive jaundice due to tumor, and obstructive jaundice due tocholelithiasis, was singnificant in differentiating the causes of jaundice. (P<0.05 by X2-test) 5. Intrahepaticstone showed scintigraphic pooling with partial stasis. 6. Cholescintigraphy was useful to differentiated the Rotor's syndrome from the Dubin-Johnson syndrome, supplying the additional criteria.
Bile ; Cholelithiasis ; Jaundice ; Jaundice, Chronic Idiopathic ; Jaundice, Obstructive ; Retrospective Studies

Background and Objectives: Recurrent epistaxis requiring emergency department (ED) visits results in increased morbidity in the elderly and associated with high health care costs. This study is to analyze the frequency and characteristics of epistaxis patients in the elderly and to find out the risk factors and effective treatment for recurrent epistaxis. Subjects and Method We studied retrospectively the clinical cases of 977 emergency patients and 155 patients, aged over 65, for the treatment of epistaxis during the last 10 years from January 2008 to January 2018. The group A, comprised of 95 patients (68.29%), was treated with an initial treatment. The group B, which comprised of 60 patients (38.71%), visited for re-bleeding following an initial treatment. Results: Patients made 2 to 10 ED visits due to re-bleeding and 32 of the 60 patients (53.5%) visited twice. The electrocauterization was the most common (61.7%) for treatment method during rebleeding, followed by posterior packing (18.3%). The factors that increases the risk of recurrent epistaxis are anticoagulants, posterior epistaxis, anterior packing, inefficient ED packing. There was no correlation between comorbidities and rebleeding. Conclusion Accurate medical history taking of anticoagulants may enable personnel to provide more effective management of these patients. The most important factors in the failure of primary care were not being able to find the precise area of bleeding and ineffective packing during the initial treatment. Therefore, it is important that we must carefully check the areas using the endoscope to decrease the failure of initial treatment of epistaxis.

OBJECTIVE: To evaluate of the perinatal outcome of twin gestations complicated by a single anomalous fetus. METHODS: The study included all patients with twin gestations diagnosed with a major fetal anomaly in one fetus in the second trimester during 1997-2000. Twins with anomalies in both fetuses and minor anomalies were excluded. From a total of 717 twin deliveries, there were 24 twin pregnancies with single anomalous fetus observed in Department of Obstetrics and Gynecology, CHA Hospital. Outcomes assessed included gestational age at diagnosis and delivery, antenatal complications, type of anomalies and perinatal mortality rate. RESULTS: The incidence of single anomalous fetus with twin pregnancies was 3.3% in the study population. There were 24 twin pregnancies with one anomalous fetus, and their median gestational age at delivery was 35+3 weeks (range 27-39). The incidence of preterm delivery was 54.2% (13/24) and growth restriction and respiratory distress syndrome of the normal sibling were 12.5% (8/24) and 8.3% (2/24), respectively. Eight cases (33.3%) of preterm deliveries, 3 cases (12.5%) of severe preeclampsia were noted and 2 cases (8.3%) of the pregnancies were complicated with both conditions. Regarding the type of anomalies, chromosomal anomalies and central nervous system (CNS) anomalies were the most common with 5 cases (20.8%) each. Perinatal outcomes of the normal twin and the anomalous twin were compared. There were 2 cases (8.3%) of neonatal death in the normal twin compared with 9 cases (37.5%) of intrauterine death, 9 cases (37.5%) of neonatal death in the abnormal twin. CONCLUSION: Our study shows that the presence of a major anomaly in one fetus in a twin gestation significantly increased the risk of preterm delivery and risk of intrauterine fetal death and neonatal death rate in anomalous fetus. This information may provide useful information for counseling patients about their options when faced in dilemma.
Central Nervous System ; Counseling ; Diagnosis ; Female ; Fetal Death ; Fetus* ; Gestational Age ; Gynecology ; Humans ; Incidence ; Mortality ; Obstetrics ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy, Twin ; Siblings

Purpose: This study aimed to determine the factors influencing the turnover intention of nurses in coronavirus disease (COVID-19) and general wards. Methods: Data were collected through a survey of 340 nurses at seven public hospitals in Gyeonggi Province from October 12 to October 30 in 2020. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation coefficient and multiple regression. Results: The job demand stress of nurses in COVID-19 wards was 63.99±8.05 points, which was lower than 65.77±7.35 points of nurses in general wards. The turnover intention of nurses in COVID-19 wards was 3.24±0.74 points, which was higher than the 3.06±0.67 points of those in general wards. The multiple regression analysis indicates that the factors affecting the turnover intention of the two groups (COVID-19 and general wards) were type of wards (β=-.15, p<.001), age (COVID-19 wards: β=-.37, p<.001, General wards: β=-.40, p<.001), job resource stress (COVID-19 wards: β=.52, p<.001, general indicates: β=.60, p<.001), and clinical experience in present wards (COVID-19: β=.13, p=.021). Conclusion The results indicate that nurses who care for COVID-19 patients have higher turnover intentions than general nurses and suggests that a decrease in the job resource stress is vital for reducing nurse turnover intentions.

Purpose: This study aimed to determine the factors influencing the turnover intention of nurses in coronavirus disease (COVID-19) and general wards. Methods: Data were collected through a survey of 340 nurses at seven public hospitals in Gyeonggi Province from October 12 to October 30 in 2020. The data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation coefficient and multiple regression. Results: The job demand stress of nurses in COVID-19 wards was 63.99±8.05 points, which was lower than 65.77±7.35 points of nurses in general wards. The turnover intention of nurses in COVID-19 wards was 3.24±0.74 points, which was higher than the 3.06±0.67 points of those in general wards. The multiple regression analysis indicates that the factors affecting the turnover intention of the two groups (COVID-19 and general wards) were type of wards (β=-.15, p<.001), age (COVID-19 wards: β=-.37, p<.001, General wards: β=-.40, p<.001), job resource stress (COVID-19 wards: β=.52, p<.001, general indicates: β=.60, p<.001), and clinical experience in present wards (COVID-19: β=.13, p=.021). Conclusion The results indicate that nurses who care for COVID-19 patients have higher turnover intentions than general nurses and suggests that a decrease in the job resource stress is vital for reducing nurse turnover intentions.

PURPOSE: This study was intended to investigate the migrating motor complex (MMC) changes after ileal bypass in ex-vivo mouse models. METHODS: Partial (side-to-side) and total bypass (occlusion of proximal part of bypassed loop) were performed on ileums of female Institute of Cancer Research mice. After 2 and 4 weeks, the bypassed segments were harvested and MMCs were recorded at 4 different sites ex-vivo. Amplitude, duration, interval, direction of propagation, and the area under the curve (AUC) of MMCs were measured and compared to those of the controls. RESULTS: In control mice (n = 7), most MMCs propagated aborally (91.1%). After 2 weeks of partial bypass (n = 4), there was a significant decrease in both amplitude and AUC, and orally-propagating MMCs increased significantly (45%, P = 0.002). Bidirectional MMCs (originating in the bypassed loop and propagating in both directions) were also observed (10%). The amplitude of the MMCs remained decreased at 4 weeks after partial bypass (n = 4), and neither the AUC nor the direction of propagation showed significant changes compared to 2 weeks. Similarly, in the total bypass model, both the amplitude and AUC of the MMCs decreased significantly compared to controls. In contrast to partial bypass, 95% of the MMCs within the bypassed loop propagated aborally after 2 weeks (n = 6), which was similar to the control state. After 4 weeks (n = 5), however, MMCs either lost their temporal relationship or completely disappeared. CONCLUSION: The changes in propagation direction of the MMCs in the partially bypassed loop may contribute to stagnation of bowel contents and the development of blind loop syndrome.
Animals ; Area Under Curve ; Blind Loop Syndrome ; Female ; Humans ; Ileum ; Jejunoileal Bypass ; Mice ; Myoelectric Complex, Migrating