Endovascular aneurysm repair (EVAR) of combined abdominal and iliac aneurysm requires exclusion of the hypogastric artery for prevention of endoleak. However, exclusion of the hypogastric artery is often associated with significant ischemic complications such as hip or buttock claudication, gluteal necrosis and bowel ischemia. Several techniques have been introduced to preserve the flow of the hypogastric artery. We report a successful case of external iliac artery-to-hypogastric artery bypass with artificial graft combined with EVAR.
Aneurysm ; Aortic Aneurysm, Abdominal ; Arteries ; Buttocks ; Endoleak ; Hip ; Humans ; Iliac Aneurysm ; Ischemia ; Necrosis ; Transplants

Bone marrow edema syndrome (BMES) is a rare condition which mainly affects the hip area. The etiology and pathogenesis of BMES is still unclear. Pain near the affected area, regional osteoporosis, bone marrow edema (identified using magnetic resonance imaging) and spontaneous regression within 6-12 months are the main characteristics of BMES. In this case, a 52-year-old male was diagnosed with BMES of the right hip followed by spontaneous subsiding of symptoms. After 3 years, and under nearly the same social and physical conditions, he was admitted again with newly developed left hip pain and again diagnosed with BMES. We report this rare case since a similar one has not been previously reported in the domestic literature and may be considered valuable for basic research relating to the pathogenesis of BMES.
Bone Marrow* ; Edema* ; Femur Head ; Head* ; Hip ; Humans ; Male ; Middle Aged ; Osteoporosis

Purpose: The purpose of this study was to evaluate the validity and reliability of the Korean version of the Apathy Evaluation Scale Short Form (K AES-10) for people with dementia. Methods: Participants in this study were 198 patients with dementia resident in two hospitals in the Republic of Korea. The AES-10 was translated into Korean through the translation and adaptation of instruments process developed by the World Health Organization. This process was carried out by three bilingual nursing professionals. Validity and reliability, such as construct validity, convergent validity, Cronbach's ⍺, inter-rater reliability, and test-retest reliability, were evaluated. IBM SPSS Statistics 25.0 and AMOS 26.0 programs were used for the data analysis. Results: A uni-dimensional model was proposed in the explanatory factor analysis; a single factor accounted for 68.0% of total variances. The confirmatory factor analysis supported the validity of the Korean version of the AES-10. The scale had a Cronbach's ⍺ of .95, inter-rater reliability of .66 (p<.001), and a test-retest reliability of .81 (p<.001). Conclusion The findings show that the Korean version of the AES-10 is both valid and reliable for measuring apathy among people diagnosed with dementia in the Republic of Korea.

Poststroke depression is very common and has been reported in as many as 40~50% of poststroke patients. The fluoxetine is one of the most frequently prescribed drugs for the treatment of poststroke depression. This serotonin selective reuptake inhibitor, known as generally safe and well tolerated drug, has been recently reported to induce mania. We report a case of fluoxetine-induced mania. A 64 year-old male, who has taken 10 mg of fluoxetine daily due to poststroke depression, presented elevated mood, hyperactivity, regressed behavior, excessive planning, sleep deterioration, and talkativeness abruptly. We were suspicious of fluoxetine- induced manic state and discontinued immediately fluoxetine without prescription of mood stabilizer. His symptoms had been ceased over two weeks.
Bipolar Disorder ; Depression ; Fluoxetine ; Humans ; Male ; Prescriptions ; Serotonin

PURPOSE: The purpose of this study was to compare the clinical results between the subacromial injection of the ketorolac and that of the corticosteroid in patients with subacromial shoulder impingement syndrome. MATERIALS AND METHODS: Twenty patients with shoulder impingement syndrome received an injection of 60 mg ketorolac and were evaluated in terms of visual analogue scale (VAS), range of motion (ROM) and Constant-Murley score. The outcomes are compared with the data of patients treated by 40 mg triamcinolone injection, retrospectively. RESULTS: There was no significant difference in the demographics, VAS, ROM, and Constan-Murley score between the two groups before the injection. At the 4 weeks follow-up, pain improvement was significantly greater in the corticosteroid group (2.7±1.53) than in the ketorolac group (4.9±2.08; p=0.001). However 12 weeks after the injection, there was no significant difference in pain improvement between the two groups (ketorolac: 2.9±2.32, corticosteroid: 2.6±1.82; p=0.707). The Constant-Murley score at the final follow-up improved from 33.5 to 52.1 in the corticosteroid group, and from 39.0 to 56.6 in the ketorolac group (p=0.677). ROM was increased in both groups, and external rotation was significantly greater in the ketorolac group than in the corticosteroid group at the final follow-up (ketorolac: 29.3°±9.90°, corticosteroid: 20.8°±7.99°; p=0.005). CONCLUSION: In this study, ketolorac provided an effect equivalent to triamcinolone in the treatment of subacromial shoulder impingement syndrome at 12 weeks after the injection. This result could offer better opportunities to manage patients with diabetes or local and systemic side effects of repetitive use of corticosteroids.
Adrenal Cortex Hormones ; Anti-Inflammatory Agents, Non-Steroidal ; Demography ; Follow-Up Studies ; Glucocorticoids ; Humans ; Ketorolac* ; Range of Motion, Articular ; Retrospective Studies ; Shoulder Impingement Syndrome* ; Shoulder* ; Triamcinolone

Objective: This study was conducted to investigate the awareness of work-related disease prevention of farmers.Method: As a research method, a qualitative focus group interview was conducted in 18 participants. Results: Prevention and management services for work-related diseases of farmers mostly are based on research from other fields and so are not highly effective because their content is not relevant to agricultural work. It has been suggested that such program designers be required to have some appropriate related knowledge, and that incentives and a certification system for participation in such education be established. To analyze work-related diseases of farmers, fields of prevention, diagnosis, treatment, and rehabilitation should be created. They demanded the designation of hospitals and the actualization of compensation for farmers' safety insurance. The work-related diseases to address were include musculoskeletal diseases, pesticide poisoning-related diseases (cardiovascular disease, respiratory disease), psychiatric diseases such as depression, and allergic diseases. However, this must have been the result of the harmful factors they felt during agricultural work. And for farmer patients diagnosed with work-related diseases, it was said to strengthen farmer safety insurance. Conclusion In order to increase the safely and health effects of agricultural work, it is necessary to prevent and manage work-related diseases of farmers. Projects should be developed in consideration of cultural and economic barriers of farmers and the characteristics of the work.

BACKGROUND: Few studies have investigated the effects of sarcopenia on postoperative outcomes including mortality rates following surgery for osteoporotic hip fractures. The purpose of the present study was to determine the prevalence of sarcopenia and the relationship between sarcopenia and 1- and 5-year mortality rates in a consecutive series of patients with osteoporotic hip fractures. METHODS: Among patients who underwent hip surgery for osteoporotic hip fractures, this study included 91 patients subjected to abdominal computed tomography within 1 year of hip surgery. We defined sarcopenia using sex-specific cut-off points for the skeletal muscle index at the level of the third lumbar vertebra. All patients were divided into 2 groups according to the presence or absence of sarcopenia and the 1- and 5-year mortality rates were compared. To confirm factors affecting mortality in addition to sarcopenia, we examined patient age, sex, American Society of Anesthesiologists grade, location of fracture, type of surgery, and bone mineral density. RESULTS: The 1- and 5-year mortality rates were 20.9% and 67.2%, respectively. Among the 45 patients with sarcopenia, the 1- and 5-year mortality rates were 22.2% and 82.7%, respectively. Of the 46 patients without sarcopenia, the 1- and 5-year mortality rates were 19.6% and 52.7%, respectively. Results of the Kaplan-Meier analysis showed that sarcopenia did not affect the 1-year mortality rate (P=0.793), but had a significant effect on the 5-year mortality rate (P=0.028). Both perioperative sarcopenia (P=0.018) and osteoporosis (P=0.000) affected the 5-year mortality rate. CONCLUSIONS: Sarcopenia increases the risk of 5-year mortality in patients with osteoporotic hip fractures.
Bone Density ; Hip Fractures ; Hip* ; Humans ; Kaplan-Meier Estimate ; Mortality* ; Muscle, Skeletal ; Osteoporosis ; Osteoporotic Fractures ; Prevalence ; Sarcopenia* ; Spine

Autonomic dysfunction is a common manifestation in Guillain-Barre syndrome (GBS), but it rarely persists. We report a case involving a 22-year-old man who presented with glove-and-stocking type sensory loss, symmetric weakness, urinary distension, orthostatic hypotension, decreased perspiration, and the syndrome of inappropriate secretion of antidiuretic hormone. He was subsequently diagnosed as having GBS with autonomic failure that persisted for more than six months, despite regaining muscle strength. Orthostatic hypotension progressively improved after rehabilitation and administration of midodrine and fludrocortisone. Extensive evaluation and management should be performed in patients with GBS because severe autonomic dysfunction is a major source of disability.
Fludrocortisone ; Guillain-Barre Syndrome ; Humans ; Hypotension, Orthostatic ; Midodrine ; Muscle Strength ; Young Adult

Purpose: Although ultrasonography is the gold standard of diagnosing intussusception, plain abdomen radiograph (AXR) is often used to make differential diagnosis for pediatric patients with abdominal pain. In intussusception patients, we aimed to analyze the AXR and clinical data to determine the characteristics of early AXR findings associated with diagnosis of intussusception and recurrence after reduction. Methods: Between January 2011 and June 2018, 446 patients diagnosed with intussusception based on International Classification of Diseases-10 code of K56.1 were admitted. We retrospectively reviewed medical records of 398 patients who received air reduction; 51 of them have recurred after initial reduction. We evaluated six AXR features including absent ascending colon gas, absent transverse colon gas, target sign, meniscus sign, mass, and ileus. Clinical data and AXR features were compared between single episode and recurrence groups. Results: Two groups did not show significant differences regarding clinical data. Mean time to recurrence from air reduction was 3.4±3.2 days. Absent ascending colon gas (63.9%) was the most common feature in intussusception, followed by mass (29.1%). All of six AXR features were observed more frequently in the recurrence group. Absent transverse colon gas was the most closely associated AXR finding for recurrence (odds ratio, 2.964; 95% confidence interval, 1.327–6.618; p=0.008). Conclusion In our study, absence of ascending colon gas was the most frequently seen AXR factor in intussusception patients. Extended and careful observation after reduction may be beneficial if such finding on AXR is found in intussusception patients.

Purpose: Although ultrasonography is the gold standard of diagnosing intussusception, plain abdomen radiograph (AXR) is often used to make differential diagnosis for pediatric patients with abdominal pain. In intussusception patients, we aimed to analyze the AXR and clinical data to determine the characteristics of early AXR findings associated with diagnosis of intussusception and recurrence after reduction. Methods: Between January 2011 and June 2018, 446 patients diagnosed with intussusception based on International Classification of Diseases-10 code of K56.1 were admitted. We retrospectively reviewed medical records of 398 patients who received air reduction; 51 of them have recurred after initial reduction. We evaluated six AXR features including absent ascending colon gas, absent transverse colon gas, target sign, meniscus sign, mass, and ileus. Clinical data and AXR features were compared between single episode and recurrence groups. Results: Two groups did not show significant differences regarding clinical data. Mean time to recurrence from air reduction was 3.4±3.2 days. Absent ascending colon gas (63.9%) was the most common feature in intussusception, followed by mass (29.1%). All of six AXR features were observed more frequently in the recurrence group. Absent transverse colon gas was the most closely associated AXR finding for recurrence (odds ratio, 2.964; 95% confidence interval, 1.327–6.618; p=0.008). Conclusion In our study, absence of ascending colon gas was the most frequently seen AXR factor in intussusception patients. Extended and careful observation after reduction may be beneficial if such finding on AXR is found in intussusception patients.