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Perioperative complications of the modified Stoppa approach for the treatment of pelvic bone fractures: a single-institution review of 48 cases

  • Lee, Hyeonjoon;Jo, Suenghwan;Lee, Gwangchul;Cho, Yongjin
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.19-24
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    • 2022
  • Purpose: The current study aimed to report the perioperative complications of the modified Stoppa approach for the treatment of pelvic bone fractures. Methods: We analyzed 48 consecutive operations in 45 patients who were treated with internal fixation using the modified Stoppa approach between March 2016 and July 2018. This included three revision operations. The mean age of the patients was 54.5 years, and the patients included 35 male patients and 10 female patients. All fractures occurred as a consequence of high-energy trauma and 70.3% had associated injuries at the time of the fracture. The mean Injury Severity Score was 9.03±5.60. The perioperative complications found during and immediately after surgery were recorded and were classified into three categories: vascular injuries, nerve injuries, and other complications. Results: Overall, 14 perioperative complications (29.2%) in 14 cases were identified. The most common complications were nerve injuries, which occurred in seven cases, all involving the obturator nerve. Uncontrollable vascular injuries occurred in six cases, which required additional incisions and support of vascular surgeons or postoperative interventions. Additionally, one case of peritoneal tearing occurred, which required help from an abdominal surgeon. Conclusions: While the modified Stoppa approach seems to be a viable method to treat pelvic fractures, significant perioperative complications may occur, suggesting that surgeons should pay careful attention to minimize the damage to other structures and that appropriate support from other surgical departments is paramount.

Secondary nipple reconstruction using two surgical techniques

  • Chung, Jae-Ho;Kim, Da-Som;Yeo, Hyun-Dong;Jung, Seung-Pil;Park, Seung-Ha;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.590-598
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    • 2021
  • Background Although the initial projection after primary nipple reconstruction is excellent, nipple projection gradually flattens in most cases due to multiple causes. Although various methods have been reported to rebuild the nipple after nipple flattening, the most effective method of secondary nipple reconstruction remains unknown. The aim of this study was to review our institution's experiences with secondary nipple reconstruction. Methods We conducted a retrospective review from March 2012 to January 2019. We performed secondary nipple reconstruction if the primary reconstructed nipple height differed by more than 6 mm from the normal nipple height. We chose the method of nipple revision according to the degree of tissue scarring and the remaining nipple projection. Results We performed secondary nipple reconstruction on a total of 27 nipples, using purse-string sutures for 19 nipples and star flaps in eight nipples. The median follow-up period was 8 months (range, 6-19 months) after the final nipple reconstruction. Among the 19 nipples reconstructed using purse-string sutures, 10 (53%) demonstrated acceptable projection of more than 5 mm. Among the eight nipples reconstructed using star flaps, six (75%) showed acceptable projection of more than 5 mm. Most of the patients (73%) were satisfied (scores of 4 or 5) with the nipple reconstruction overall. Conclusions Few studies have presented favorable outcomes of secondary nipple reconstruction. When the star flap and purse-string suture methods were used depending on the remaining nipple height and scarring, appropriate projection could be achieved.

Reinforcement Plan of safety and health technical support project for small-sized businesses by experts' survey (전문가 설문조사에 근거한 소규모 사업장 안전보건 기술지원사업 내실화 방안)

  • Yoon, Younggeun;Ahn, Yongro;Oh, Taekeun
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.5
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    • pp.631-639
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    • 2022
  • Recently, the government is trying to change the paradigm of occupational safety by enforcing the entire revision of the Industrial Safety and Health Act and the Punishment of Serious Accidents Act with the goal of reducing the occupational accident and death rate by half. In particular, small-scale workplaces with less than 50 employees or less than 100 million won have difficulties in establishing a safety and health management system due to lack of safety and health management competency and lack of will of business owners. Therefore, this study attempted to identify problems and suggest improvement measures through an expert survey on the overall business area of the small business safety and health technology support project, which is one of the government's policies.

A Study on the Analysis of Curriculum for Information Literacy Instruction in Pennsylvania, USA (정보활용교육을 위한 미국 펜실베니아 주의 교육과정 분석에 관한 연구)

  • Byeong-Kee, Lee
    • Journal of the Korean Society for Library and Information Science
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    • v.57 no.3
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    • pp.5-26
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    • 2023
  • Curriculum is essential for primary and secondary education. The development of the 2022 revised curriculum, which is Korea's national level curriculum has been completed. Nevertheless, the library and information life, which are curriculums for information literacy instruction remain in the structure of the 2009 curriculum. In this study, I analyze the structure and contents of the curriculum for information utilization education in Pennsylvania, USA, identify trends in information literacy instruction, and present the direction of revision of library and information life. The Pennsylvania curriculum for information literacy instruction has an overall structure consisting of long-term transfer goals, big ideas(inquire, include, collaborate, curate, explore, engage), concepts, competencies, and essential questions. In addition, there is a detailed structure consisting of stage l(desired results), stage 2(assessment evidence of learning) and stage (learning plan).

An Analysis for the improvement strategies of the Education Welfare Priority Support Project (교육복지우선지원사업 정책 개선을 위한 실태조사 연구)

  • Song, Ji-hoon;Jeong, Yeong-mo
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.7 no.11
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    • pp.305-314
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    • 2017
  • The purpose of this study is examining the status of Education Welfare Priority Support Project and providing constructive strategies for future direction. In order to collect data, we have used on-line survey, in-depth interview personnels in charge of 17 school districts and open forum with municipal board members of education along with related literature review. As results, since 2003, the effectiveness of the Education Welfare Priority Support Project has been proved and the areas have been expanded. Furthermore, institutional stability has been confirmed along with the supports of enforcement ordinance of the Elementary and Secondary Education Acts and Ministry of Education Ordinances. However, since the management authority of the project has transferred to 17 provincial offices of education, it shows the tendency of that the overall programs were not fully activated and gradually stagnated. According to these issues, we proposed various implemental policy suggestions though the revision of Article 28 of elementary and secondary education-related law.

Major Medical Issues and Interests in the Joseon Dynasty - Focusing on Enforcement Laws (조선시대 주요 의료 관련 쟁점과 관심사 - 시행법령을 중심으로)

  • PARK Hun-pyeong
    • The Journal of Korean Medical History
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    • v.36 no.1
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    • pp.31-50
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    • 2023
  • Through this paper, all the provisions of the enforcement statutes stipulated in the Joseon's law code were investigated and major medical issues and interests in the Joseon Dynasty were analyzed. The characteristics of each period reviewed in the text are as follows. The early Joseon Dynasty is divided into three periods. First of all, Joseon filled the gap in the law with the active acceptance of the Ming Dynasty's law code, Daemyeongrul, which conformed to Confucian virtue. Next, the completion of Gyeonggukdaejeon was an opportunity to prepare the basis for Joseon's medical laws. Lastly, from the late 15th century to the 16th century, the existing medicine promotion measures and emphasis on hyangyak(domestic herb) continued. it can be said that Joseon's politicians needed a medical policy based on Confucian virtues and maintained state-led promotion policies, but on the other hand, there was no other alternative to try newly by reflecting the limitations and failures of the policy. The late Joseon Dynasty is also divided into three periods. First of all, the period from the late 16th century to the early 18th century was marked by the growth of families in technical positions. The era of King Yeongjo can be said to be the period of reorganization of medical related laws. Finally, the period after the late 18th century is a period of passive regulation and supplementation. Lastly, the revision of the actual medical law was not made or reflected in era of King Jeongjo. In the case of the early Joseon Dynasty, the policy shifted from state-led to families in technical positions. However, in the 19th century, the weakening of the royal authority led to the weakening of the overall administrative system of the country, and the pharmaceutical policy had to be limited.

Treatment Outcome and Prognostic Factors of Cushing's Disease in Adults (성인 쿠싱병의 치료성적과 예후인자)

  • Park, Chul-Kee;Hwang, Sung Kyun;Gwak, Ho-Shin;Yoo, Heon;Chung, Young Seob;Paek, Sun Ha;Kim, Dong Gyu;Jung, Hee-Won;Kim, Seong Yeon;Hong, Seung Kuan
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1316-1321
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    • 2000
  • Objectives : The authors analyzed the surgical series of Cushing's disease to evaluate the proper treatment policy and to verify the possible prognostic factors. Material and Methods : Of 50 patients diagnosed as Cushing's disease and operated at Department of Neurosurgery of our institute between 1988 and 1999, 48 patients with available medical records were analyzed retrospectively. Mean follow-up period was 48 months(3 to 109 months). Preoperative diagnosis was made after evaluating the patients with multiple-stage endocrinological studies and 31 selective patients were evaluated with inferior petrosal sinus sampling(IPSS). Magnetic resonance imaging(MRI) and/or high resolution computerized tomography(CT) was done in all patients. A total of 51 transsphenoidal adenomectomy(TSA) were performed including 3 revision for initial surgical failure cases. Remission was decided on the basis of both endocrinological criteria and clinical status. Radiation and/or ketoconazole therapy were applied to failed cases. For the verification of prognostic factors, the authors evaluated the statistical significance of multiple variables over remission rate by chi-square test. Result : Sensitivity of IPSS for central localization was 93.5% which was better than that of MRI(87.5%). But for lateralization, it was 72.4% for IPSS versus MRI 90.5%. Success rate of TSA was 82%(42/51) and recurrence rate was 9%(4/48). When including adjuvant treatments for surgically failed cases, overall success rate was 89.6% and all of 3 reoperated cases(TSA) due to recurrence were successful. Significant complication occurred in 7.8%(4/51) after TSA including hypopituitarism, diabetes insipidus, and visual loss. Non-existence of tumor in MRI and prolonged symptom duration(>3 years) were significant prognostic factors. Conclusion : TSA can be considered as initial treatment for Cushing's disease. In surgically failed cases, multiple treatment modality may improve the overall outcome and repeated TSA for recurrent cases seem to provide similar success.

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A Study on the Preventive Education for Adolescents′s Problems in Home Economic Education (II) - Adolescents′Culture Analyzed with Newspaper Articles Concerning Adolescents - (가정과 교육에서의 청소년문제 예방교육을 위한 기초 연구 (II) -청소년관련 신문기사분석을 통해 본 청소년 문화 -)

  • 배영미
    • Journal of Korean Home Economics Education Association
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    • v.10 no.2
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    • pp.131-144
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    • 1998
  • The lack of characteristical understanding of the Home Economics Education will have difficulty in achieving the goal of the Home Economics Education. To allow the Home Economics Education class in school contribute toward the enhancement of the quality of life, it is inevitable to reinforce the recognition of the importance and necessity of the Home Economics Education and to newly propose a directional guidance forward the coming 21st century. The purpose of this study was to provide basic data for planners of the future Home Economics Education by surveying research administrators in charge of programming the overall school curriculum. This study was conducted under the following procedure to have the outcome as follows ; 1. Answers from respondents of age over 50 or careers over 16 years tended to grasp the goal of Home Economics Education in relation to the enhancement of quality of life rather than to the accumulation of knowledge, skill or capacity. 2. Of all the surveyed, 9.64% regarded Home Economics Education as an essential part of school education and the positive ratio was higher with younger respondents. 3. To the question asking if the high school Home Economics Education could have influence on one's capacity, 97.2% of the answerers said yes. The respondents with career under 15 year showed 100% of positive agreement in this matter and of age under 40 marked much higher ratio of 98.84% than the elders. 4. The overall recognition of the necessity for separate sections in Home Economics Education programmed in accordance with the 6th Revision of High School Curriculum displayed a considerably high ratio, with a little differences among age and job groups. The purpose of this study is to analyze and understand adolescents'culture, thereby to provide fundamental information for Preventive Education for Adolescents'Problems in Home Economic Education. 745 articles collected in computer communication service were used for the analysis. The data were analyzed by frequency and percentage using the SPSS/PC+computer program. The most important results of this study were as follows ; 1) Concerning 'Adolescent's Problems's, problems such as violence, homicide and robbery were treated with the greatest frequency. It was also analyzed that the older generations are highly inclined to understand adolescents'culture as a negative one, for example, 'delinquency'or 'immaturity'. 2) Although the area of 'Adolescents'Education'was treated most frequently reflecting the high educational concern in our society, the significant part of those articles were on wrongful educational administration. As much as 70.6% of the articles analyzed were on 'Education'and 'Problems'. Thereby it may be concluded that the other areas such as health, activities, worries, values and harmful environments ere treated respectively as only a 'subculture'or'fragmentary culture'. The articles containing correlations and interactions among them and certain alternative proposals were very rare. 3) The areas such as 'Worries and Counselling'and 'Health'were occupying only a small portion of the articles. The articles which were treating the practical worries and their resolutions were even rarer. 4) 'Values'of the adolescents tended to be viewed by the older generations very negatively. It was also found that the older generations gave the tendency to see the 'consumption culture'of the adolescents as a kind of 'counter culture'or'subculture'.

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Long-Term Outcomes of Preoperative Atrial Fibrillation in Cardiac Surgery

  • Kim, Hyo-Hyun;Kim, Ji-Hong;Lee, Sak;Joo, Hyun-Chel;Youn, Young-Nam;Yoo, Kyung-Jong;Lee, Seung Hyun
    • Journal of Chest Surgery
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    • v.55 no.5
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    • pp.378-387
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    • 2022
  • Background: Atrial fibrillation (Afib) is a marker of increased cardiovascular morbidity and mortality. Owing to the increased prevalence of Afib in patients undergoing cardiac surgery, assessing the effect of Afib on postsurgical outcomes is important. We aimed to analyze the effect of preoperative Afib on clinical outcomes in patients undergoing cardiac surgery using a large surgical database. Methods: This retrospective cohort study was based on the national health claims database established by the National Health Insurance Service of the Republic of Korea from 2009 to 2015. Diagnosis and procedure codes were used to identify diseases according to the International Statistical Classification of Diseases, 10th revision. Results: We included 1,037 patients (0.1%) who had undergone cardiac surgery from a randomized 1,000,000-patient cohort, and 15 patients (1.5%) treated with isolated surgical Afib ablation were excluded. Of these 1,022 patients, 412 (39.7%), 303 (29.2%), and 92 (9.0%) underwent coronary artery bypass, heart valve surgery, and Cox-maze surgery, respectively. Preoperative Afib was associated with higher patient mortality (p=0.028), regardless of the surgical procedure. Patients with preoperative Afib (n=190, 18.6%) experienced a higher cumulative risk of overall mortality (hazard ratio [HR], 1.435; 95% confidence interval [CI], 1.263-2.107; p=0.034). Subgroup analysis revealed a reduced risk of overall mortality with Cox-maze surgery in Afib patients (HR, 0.500; 95% CI, 0.266-0.938; p=0.031). Postoperative cerebral ischemia or hemorrhage events were not related to Afib. Conclusion: Preoperative Afib was independently associated with worse long-term postoperative outcomes after cardiac surgery. Concomitant Cox-maze surgery may improve the survival rate.

Development of Music Psychotherapy Program Applying the Inner Family System(IFS) to Reduce Adult Depression and Improve Self-Esteem (성인의 우울 감소와 자아존중감 향상을 위한 내면가족체계(IFS)적용 음악심리치료 프로그램 개발)

  • Jeon, Soon-ae
    • Industry Promotion Research
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    • v.7 no.3
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    • pp.125-130
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    • 2022
  • The purpose of this study is to develop music psychotherapy program applying the Inner Family System(IFS) to reduce adult depression and improve self-esteem and to verify its effectiveness. For this, literature search and theoretical basis were prepared, and validity was secured through a demand survey and evaluation by experts. After going through the preliminary program, the final program consisting of 10 sessions was developed after revision and supplementation. To verify the effectiveness of the program, 25 people who met the selection criteria with a score of 20 or higher on the Depression Scale(CES-D) were selected. Of the 25 subjects, 10 subjects in the experimental group, 10 subjects in the control group, and 5 subjects in the preliminary group were randomly assigned and analyzed as final study subjects. The experimental group performed 10 sessions of music psychotherapy applying IFS twice a week for 90 minutes, and the control group did not receive any treatment. As a result of data analysis, first, it was confirmed that there was a difference between the experimental group and the control group in the change patterns according to the measurement period of overall depression and the sub-factors, depressive emotion, interpersonal emotion, and physical depression score. Second, the effects were statistically significant on overall self-esteem and sub-factors such as self-deprecation, relationship with others, leadership and popularity, assertion and anxiety. Third, it was confirmed that the pattern of change according to the measurement period of the IFS score differed between the experimental and control groups.