PURPOSE: This study was performed to examine if CT classification of renal blunt injury could aid in expectation of hemodynamic stability and clinical decision of whether to intervene surgically. MATERIALS AND METHODS: Over a 80-month period between July 1987 and March 1994, 41 patients were admitted to our hospital with the diagnosis of renal blunt injury. The renal blunt injuries were classified on Fedede's three-point scale CT classification methods :grade I, contusion, intrarenal hematoma, segmental infarction, and small subcapsular hematoma;grade II, complete or incomplete laceration, large subcapsular hematoma, and renal fracture;grade Ill, shattered kidney and renal pedicle injury. Hemodynamic stability, treatment method and clinical outcome of the patients with different CT grade were analyzed retrospectively. RESULTS: All 34 patients with grade I or II CT findings were hemodynamically stable and were successfully managed with conservative method. Among 7 patients with grade III CT findings, 6 patients were hemodynamically unstable. Out of the 6, One patient with grade IIIb or renal pedicle injury was expired before surgical intervention due to ischemic shock. Four patients were intervened surgically with one failure to thrive. The remaining one patient refused to be intervened surgically, and was discharged against medical advice. Only one out of 7 patients was hemodynamically stable and was managed conservatively. CONCLUSION: The patients with grade I or II CT findings are prone to be hemodynamically stable and to be managed with conservative method. But the patients with grade III CT findings are more likely to be hemodynamically unstable. Therefore patients with grade III CT findings should be closely monitored and be pre- pared for the possibility of immediate surgical intervention
Classification* ; Contusions ; Diagnosis ; Failure to Thrive ; Hematoma ; Hemodynamics ; Humans ; Infarction ; Kidney ; Lacerations ; Retrospective Studies ; Shock ; Wounds, Nonpenetrating

No abstract available.
Umbilical Cord*

OBJECTIVES: We compared the characteristics of the pain threshold and pain experience between demented group and non-demented group. METHODS: This study was part of Gangwon projects for early detection of dementia in 2010. We recruited 8302 local resident ages over 65 years old. Of theses, 1259 people who scored low MMSE were selected and 365 of them completed CERAD-K(Consortium to Establish a Registry for Alzheimer's disease). Finally, 90 in non-demented group and 57 in demented group(mild to moderate Alzheimer's disease) were analyzed. Pain threshold was experimentally measured by pressure algometer and we investigated the pain experience, by Brief pain inventory (BPI), a self-report test. RESULTS: In the demographic characteristics, there are more female, higher ages, lower education in the demented group. There was no significant difference between the two groups in the pain threshold. On the BPI results, 'shoulder pain', 'the number of pain' and 'interference of working' were significantly more prevalent in non-demented group. However, there are no significant differences between the groups in the 'pain severity', 'prevalence of pain' and 'pain treatment'. CONCLUSIONS: Demented group report less pain experience but, still perceived pain. It support previous studies that patient with dementia have increased pain tolerance but preserved pain threshold. Thus, active pain assessment and treatment for patients with dementia is needed.
Aged* ; Dementia* ; Education ; Female ; Gangwon-do ; Humans ; Pain Measurement ; Pain Threshold*

Purpose: The purpose of this study was to identify the effects of repeated audiovisual information on the reduction of uncertainty and anxiety in patients undergoing thyroidectomy. Methods: A non-equivalent control group pretest-posttest design was used. The study included 32 patients in the experimental group and 32 in the control group. Preoperative information using video-audio media was provided two times for 5 minutes and 45 seconds each in the experimental group, while the control group only received routine care. The data collection period was from November 1, 2017 to February 23, 2018. The data were analyzed using χ² test, t test, and independent t-test with SPSS/WIN 24.0. Results: Significant differences were observed between the two groups in pre- and post-uncertainty scores (t = -2.06, p= .044) and anxiety scores (t = -2.06, p= .044). Conclusion Repeated information provided by using videoaudio media is effective as a nursing intervention to reduce uncertainty and anxiety in patients undergoing thyroidectomy.

Purpose: This study sought to evaluate the clinical effectiveness of the shortening effect of the modified Weil osteotomy for the treatment of Freiberg’s disease. Materials and Methods: We reviewed 21 cases treated with the modified Weil osteotomy for Freiberg’s disease from November 2005 to June 2019. The average follow-up period was 32.5 months and the mean age of the patients was 38.3 years. The clinical results were analyzed using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal scale, the visual analogue scale (VAS), and the range of motion (ROM) of the metatarsophalangeal joint. In the radiologic evaluation, the length of preoperative and postoperative metatarsal shortening was compared. Results: The average AOFAS lesser metatarsophalangeal-interphalangeal scale showed an improvement from 60.5 preoperatively to 90.9 at the latest follow-up. VAS showed a decrease from 5.4 preoperatively to 0.9 at the latest follow-up. ROM of the affected metatarsophalangeal joint increased from 40.2 degrees preoperatively to 58.6 degrees at the latest follow-up. The mean length of metatarsal shortening was 6.7 mm. There was no transfer metatarsalgia, osteonecrosis, and definite joint space narrowing. Conclusion Modified Weil osteotomy with second layer cutting is an effective treatment option to restore the joint surface and painless joint motion for patients with Freiberg’s disease.

No abstract available.
Eosinophils* ; Gyeongsangbuk-do* ; Humans ; Immunoglobulin E* ; Skin*

Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality. Twin pregnancy and cesarean delivery are well-known risk factors for PPH. However, few studies have investigated PPH risk factors in mothers who have undergone cesarean delivery for twin pregnancies. Therefore, this study investigated the risk factors associated with severe PPH after cesarean delivery for twin pregnancies. Methods: We searched and reviewed the Korean Health Insurance Review and Assessment Service’s claims data from July 2008 to June 2021 using the code corresponding to cesarean delivery for twin pregnancy. Severe PPH was defined as hemorrhage requiring red blood cell (RBC) transfusion during the peripartum period. The risk factors associated with severe PPH were identified among the procedure and diagnosis code variables and analyzed using univariate and multivariate logistic regressions. Results: We analyzed 31,074 cesarean deliveries for twin pregnancies, and 4,892 patients who underwent cesarean deliveries for twin pregnancies and received RBC transfusions for severe PPH were included. According to the multivariate analysis, placental disorders (odds ratio, 4.50; 95% confidence interval, 4.09– 4.95; P < 0.001), general anesthesia (2.33, 2.18–2.49; P < 0.001), preeclampsia (2.20, 1.99–2.43; P < 0.001), hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome (2.12, 1.22–3.68; P = 0.008), induction failure (1.37, 1.07–1.76; P = 0.014), and hypertension (1.31, 1.18–1.44; P < 0.001) predicted severe PPH. Conclusions: Placental disorders, hypertensive disorders such as preeclampsia and HELLP syndrome, and induction failure increased the risk of severe PPH after cesarean delivery for twin pregnancy

The modified Phemister technique, which fixes the acromioclavicular joint with a k-wire and fixes the coronoid process and clavicle with a sling, has often been used as surgical treatment for dislocation of the acromioclavicular joint. This technique has the advantage of allowing early rehabilitation exercises with accurate anatomical reduction and firm fixation. On the other hand, some complications have been reported, such as infection, deformation recurrence, fixation complications, erosion of the distal clavicle or fracture of the sling, and secondary arthritis. This study presents a patient who experienced shoulder pain and functional impairment after conservative treatment for a sling area insufficiency fracture that arose from using the modified Phemister technique. Locking screw plate fixation with tricortical iliac bone grafting and matchstick-shaped cancellous bone grafting were used, and successful outcomes were achieved. This paper reports this case with a review of the relevant literature.

The following is a retrospective study on the results of anterior spinal surgery with Kaneda II instrumentation and surgical Titanium MESH after thoracolumbar unstable spinal injuries. From July 1994 to June 1995, we operated on 14 patients at the Chosun University Kwang Yang hospital. Fourteen patients were followed for at least three months. Anterior spinal surgery was performed on the patients who had thoracolumbar unstable spine injuries. The procedure consisted of anterior decompression through corpectomy and stabilization with Kaneda II instrumentation and surgical Titanium MESH which was impacked with resected bone chip. Most of patients had demonstrated showed neurological improvement, relief of pain, immediate stabilization and early return to normal activities. Radiologic evaluation showed the correction of the fracture deformity with satisfactory outcome postoperatively.
Congenital Abnormalities ; Decompression* ; Humans ; Retrospective Studies ; Spinal Injuries ; Spine* ; Titanium*

A 36-year-old man presented with a hard mass on the right forearm. He had no specific symptom, but wanted surgical excision for cosmetic purpose. On the physical examination, the mass was located on the ulnar side of forearm, presented mild tenderness. Ultrasound examination showed a hypoechoic mass, 1.3 x 1 cm mass in the subcutaneous tissues. Under the local anesthesia, the patient underwent an excisional biopsy of the lesion. The histopathology and the immunohistochemical analysis confirmed the tumor to be a glomus tumor. The extradigital glomus tumors are sparsely reported apart from pain. The patients can present with subcutaneous nodule, or with discoloration of the skin. These atypical symptoms make difficult to diagnose extradigital glomus tumors. In the current study, we report the case of a patient with asymptomatic glomus tumor in a extradigital lesion of forearm.
Adult ; Anesthesia, Local ; Biopsy ; Forearm* ; Glomus Tumor* ; Humans ; Physical Examination ; Skin ; Subcutaneous Tissue ; Ultrasonography