Aortic rupture caused by migration of a clavicular pin is a rare complication sometimes seen after clavicular fracture. There are many reviews of the complications of pin migration following surgery on the shoulder girdle. It is uncommon, though, for clavicular pin migration to result in aortic rupture and a subsequent cardiac tamponade. This unusual injury can be presented as acute shock symptoms after the previous pinning operation of a clavicle fracture, and it manifests characteristics that can be detected through computed tomography (CT) and focused by abdominal sonography for trauma (FAST). We report a case in which a patient suffered an aortic rupture induced cardiac tamponade caused by clavicular pin migration following surgery for a clavicular midshaft fracture.
Aortic Rupture ; Bone Wires ; Cardiac Tamponade* ; Clavicle* ; Emergencies* ; Emergency Service, Hospital* ; Fracture Fixation ; Humans ; Shock ; Shoulder

Adult ; Angiomyoma ; Diagnostic Errors ; Humans ; Nasal Obstruction ; Recurrence

BACKGROUND: Peritoneal solute transport rate, assessed by PET, varies widely among patients and has been shown to differ significantly among different ethnic groups. The aim of the present study is to investigate the peritoneal transport characteristics in Korean peritoneal dialysis (PD) patients and factors that predict peritoneal transport status. METHODS: Between May 2001 and February 2006, 141 patients on PD performed a standard 4-hour PET within the first 6 months after initiation of PD therapy. RESULTS: Of these 141 patients, there were 71males and 70 females. The mean age of the patients was 51.2+/-12.5 years and the etiology of renal failure was diabetes in 67 patients (47.5%). The mean 4-hour D/P creatinine ratio was 0.68+/-0.11. Compared with a mean of 0.65+/-0.15 as determined by Twardowski et al, our patients have significantly higher mean solute transport rate (p<0.05). Numbers of low (L), low-average (LA), high-average (HA), and high (H) transporters were 15 (10.6%). 68 (48.2 %), 53 (37.6%) and 5 (3.5%), respectively. However, according to our own data, the number of L, LA, HA and H were 18 (12.8%), 42 (29.8%), 64 (45.4%) and 17 (12.1%), respectively, significantly different from those classified by Twardowski et al. In univariate analysis, older age, hypoalbuminemia and lower BMI were predictive of high transport status. Using multiple linear regression, only hypoalbuminemia was independently predictive of higher 4-hour D/Pcr (p=0.000). CONCLUSION: Korean PD patients have a higher mean solute transport rate than Twardowskis data, and serum albumin is an independent predictor of high transport status. Further prospective studies with a large number of patients are needed for evaluating the diversity of peritoneal transport characteristics in different ethnic populations.
Female ; Male ; Humans

BACKGROUND: Peritoneal solute transport rate, assessed by PET, varies widely among patients and has been shown to differ significantly among different ethnic groups. The aim of the present study is to investigate the peritoneal transport characteristics in Korean peritoneal dialysis (PD) patients and factors that predict peritoneal transport status. METHODS: Between May 2001 and February 2006, 141 patients on PD performed a standard 4-hour PET within the first 6 months after initiation of PD therapy. RESULTS: Of these 141 patients, there were 71males and 70 females. The mean age of the patients was 51.2+/-12.5 years and the etiology of renal failure was diabetes in 67 patients (47.5%). The mean 4-hour D/P creatinine ratio was 0.68+/-0.11. Compared with a mean of 0.65+/-0.15 as determined by Twardowski et al, our patients have significantly higher mean solute transport rate (p<0.05). Numbers of low (L), low-average (LA), high-average (HA), and high (H) transporters were 15 (10.6%). 68 (48.2 %), 53 (37.6%) and 5 (3.5%), respectively. However, according to our own data, the number of L, LA, HA and H were 18 (12.8%), 42 (29.8%), 64 (45.4%) and 17 (12.1%), respectively, significantly different from those classified by Twardowski et al. In univariate analysis, older age, hypoalbuminemia and lower BMI were predictive of high transport status. Using multiple linear regression, only hypoalbuminemia was independently predictive of higher 4-hour D/Pcr (p=0.000). CONCLUSION: Korean PD patients have a higher mean solute transport rate than Twardowskis data, and serum albumin is an independent predictor of high transport status. Further prospective studies with a large number of patients are needed for evaluating the diversity of peritoneal transport characteristics in different ethnic populations.
Female ; Male ; Humans

BACKGROUND: Catheter-related infection is one of the most important causes of technical failure in peritoneal dialysis patients. We have examined the incidence and etiology of exit-site infection (ESI) at Keimyung University Dongsan medical center. METHODS: Between January 2001 and December 2003, 292 new patients received peritoneal dialysis using double cuffed straight Tenckhoff catheter and were reviewed retrospectively. RESULTS: In 292 patients, 81 (27.7%) patients experienced ESI and a total of 97 episodes of ESI has occurred during study period. The overall incidence of peritonitis during peritoneal dialysis was 0.27 episodes/patient-year. According to Twardowski's classification, equivocal infection in 14.4%, acute infection in 68.1% and chronic infection in 17.5% were noted. Staphylococcus aureus was the most frequently isolated organism, followed by Staphylococcus epidermidis, and Pseudomonas aeruginosa. The duration of treatment was significantly longer in chronic infection group than acute infection group (44.6 days vs. 18.5 days, p<0.05). The rates of Pseudomonas infection (p<0.05) and catheter replacement (p<0.05) were significantly higher in the chronic infection group than in the acute infection group. There was one catheter loss due to refractory peritonitis and three deaths unassociated with ESI during mean follow-up of 20.3 months. CONCLUSIONS: Exit-stie infection is still a major causes of peritonitis and catheter failure. Because of suboptimal quality of practice guideline, additional studies on the definition, prevention and treatment of ESI are required.
Catheter-Related Infections ; Catheters ; Classification ; Focal Infection ; Follow-Up Studies ; Humans ; Incidence ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Pseudomonas aeruginosa ; Pseudomonas Infections ; Retrospective Studies ; Staphylococcus aureus ; Staphylococcus epidermidis

Background: Consistent uptake of colorectal cancer (CRC) screening is important to reduce the incidence and mortality from advanced-stage CRC and increase the survival rate of the patients. We conducted a longitudinal study to determine the factors affecting CRC screening compliance in Korean adults using individual-level linked data from the Korean National Health and Nutrition Examination Survey, Korean National Health Insurance Service, and Korean Health Insurance Review and Assessment Service. Methods: We selected 3,464 adults aged 50–79 years as the study population and followed them for 12 years (January 2007–December 2018). The outcome variable was the level of adherence to CRC screening, categorized as nonadherent, intermittently adherent, and consistently adherent. An ordinal logistic regression model was designed to determine the socioeconomic factors, family history of CRC, and medical conditions that could facilitate the consistent uptake of CRC screening. Results: The results showed a significant and positive association between consistent uptake of CRC screening and the 100–150% income category (odds ratio [OR], 1.710; 95% confidence interval [CI], 1.401–2.088); clerical, sales and service job category (OR, 1.962; 95% CI, 1.582–2.433); residency at medium-sized cities (OR, 1.295; 95% CI, 1.094–1.532); high-school graduation (OR, 1.440; 95% CI, 1.210–1.713); married status (OR, 2.281; 95% CI, 1.946–2.674); use of employment-based national health insurance (OR, 1.820; 95% CI, 1.261–2.626); use of private insurance (OR, 2.259; 95% CI, 1.970–2.589); no disability (OR, 1.428; 95% CI, 1.175–1.737); family history of CRC (OR, 2.027; 95% CI, 1.514–2.714); and history of colorectal neoplasm (OR, 1.216; 95% CI; 1.039–1.422). Conclusion The lack of regular participation in CRC screening programs in the Republic of Korea was found to be an issue that requires attention. Policies on CRC screening must place increased emphasis on strengthening educational and public relations initiatives.