• Journal of Korean Medicine Rehabilitation
• /
• 제33권4호
• /
• pp.109-124
• /
• 2023

Objectives This study aims to find out effect of Korean medicine treatment on managing thoracolumbar compression fractures through retrospective observational study. Methods Among hospitalized patients at the Department of Korean Medicine Rehabilitation from January 1st, 2018 to February 28th, 2023, a total of 24 inpatients who were diagnosed with thoracolumbar compression fractures and received Korean medicine treatment were included in this study. Numeric rating scale (NRS) was used for pain assessment and clinical variables such as sex, symptoms, age, thoracolumbar injury classification and severity (TLICS) scores were collected. For subgroup analysis to analyze factors affecting treatment response, we divided patients into responders and non-responders according to NRS change. For statistical analysis, we compared before/after hospitalization and analyzed distinct features between two groups. Results Most of the patients were in their 70s and 83.33% were female. Average hospitalization period was 24.54±11.91 days. All patients had back pain as their chief complaint and only 2 patients received surgeries. In TLICS, only 1 patient got score 6, which represented surgery indication. After Korean medicine treatment, NRS of almost every patient got lower significantly at the time of discharge (3.02±1.93) than admission (5.52±1.95). Comparing two groups, responders had lower NRS at the time of discharge and TLICS score of them were lower than non-responders. Conclusions Our results show that Korean medicine treatment for thoracolumbar compression fractures was effective in reducing pain. There were distinct clinical features such as age, past history, surgeries between those with significant improvement in pain scores and those who did not.

• The Journal of the Korean bone and joint tumor society
• /
• 제18권2호
• /
• pp.51-58
• /
• 2012

Purpose: This study attempts to know functional results and gait analysis usefulness in patients with bone tumor around knee joint tumors who underwent prosthesis knee joint reconstruction. Materials and Methods: Retrospective study was conducted with 7 patients out of 30 patients who underwent prosthesis knee joint reconstruction after wide marginal excision for bone tumor around knee in orthopedics of this hospital from 2001 to 2010. Functional assessment and gait analysis were perforemed. Results: For the SF-36 score, while 'role physical' and 'role emotional' items showed 100% (100 points) high scores individually, general health, physical function, vitality, and social function showed low scores. The mean score of MSTS was 88.1% (23.8 points [17-27]), indicating a relatively high score. For the gait analysis, mean gait velocity was 97.2 m/s, mean cadence was 105.6 step/min, mean stride length was 111.3 m, mean step length was 61.5 cm, swing phase was 39.8%cycle, stance phase was 60.1%cycle, mean single limb support was 37.1%cycle, mean double limb support was 13.0%cycle, and mean push off was 60.7%cycle. Conclusion: It is expected that prosthesis reconstruction after wide marginal excision for bone tumor around knee has relatively good functional results. Gait analysis was considered one of method which showed gait phase and assessed functional ability objectively by quantitative assessment post operative patient condition. It might help treatment and post operative rehabilitation planning with the functional assessment.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권11호
• /
• pp.4705-4709
• /
• 2014

Objective: To determine the accuracy of magnetic resonance imaging (MRI) in detection of metastasis in pelvic and para-aortic lymph nodes from different gynecological malignancies. Materials and Methods: This retrospective cross sectional analytic study was conducted at the Department of Diagnostic Radiology, Aga Khan University Hospital Karachi Pakistan from January 2011 to December 2012. A sample of 48 women, age range between 20-79 years, fulfilling inclusion criteria were included. All patients had histopathologically proven gynecological malignancies in the cervix, endometrium or ovary and presented for a pretreatment MRI to our radiology department. Results: MRI was 100% sensitive and had a 100% positive predictive value to detect lymph node metastasis in lymph nodes with spiculated margins and 100% sensitive with a 75% positive predictive value to detect lymph node metastasis in a lymph node with lobulated margins. The sensitivity and positive predictive value of MRI to detect heterogeneous nodal enhancement were 100% and 75% respectively. Conclusions: Our study results reinforce that MRI should be used as a modality of choice in the pretreatment assessment of lymph nodes in proven gynaecological malignancies in order to determine the line of patientmanagement, distinguishing surgical from non-surgical cases.

• Archives of Plastic Surgery
• /
• 제42권4호
• /
• pp.469-474
• /
• 2015

Background Many methods have been proposed for the correction of sunken upper eyelids. These methods include surgical treatments, such as micro-fat, dermofat, or fascia-fat grafts, or the use of alloplastic materials. Here, we present our experience of sunken upper eyelid correction involving the simple addition of anchoring the central fat pad to the medial fat pad during upper blepharoplasty. Methods We performed 74 cases of upper blepharoplasty with sunken upper eyelid correction between October 2013 and September 2014. The lateral portion of the central fat pad was partially dissected to facilitate anchoring. The medial fat pad was gently exposed and then pulled out to facilitate anchoring. After the rotation of the dissected lateral portion of the central fat pad by $180^{\circ}$ to the medial side, it was anchored spreading to the medial fat pad. Photographs taken at 6 months postoperatively were presented to three physicians for objective assessment. Of the 74 patients, 54 patients followed at 6 months postoperatively were included in this retrospective, objective assessment. Results Sunken eyelids were effectively corrected in 51 of the 54 patients, but 3 had minimal effect because preaponeurotic fat pads had been removed during previous upper blepharoplasty. In addition to correcting sunken eyelids, lateral bulging was corrected and a better definition of the lateral portion of upper lid creases was obtained. Conclusions Anchoring the central fat pad to the medial fat pad provides an effective means of correcting sunken upper eyelids during upper blepharoplasty.

• Journal of Korean Foot and Ankle Society
• /
• 제8권1호
• /
• pp.86-91
• /
• 2004

Purpose: To evaluate the methods and results of the surgical treatment in the trimalleolar fracture of the ankle. Materials and Methods: We analysed the results of the ankle trimalleolar fracture which were treated with open reduction and internal fixation from January 1999 till September 2003. There were 45 patients who had at least six months follow up, 16 men, and 29 women. We have analysed the mechanism of injury, methods of operation and postoperative complications. Results: The results were assessed on ankle AP, lateral and mortise X-rays and retrospective chart review. There were 30 supination-external rotation, 13 pronation-external rotation, 2 pronation-abduction in the mechanism of injury by Lauge-Hansen classification. Cases of the posterior malleolar fracture which involved more than 25% of the weight bearing surface were 7 (15.6%). Medial malleolar mono-fixation was done in 5 cases, fibular mono-fixation in 2 cases, bimalleolar fixation in 32 cases, trimalleolar fixation in 6 cases. 38 cases (84.4%) were good or excellent in clincal assessment and 39 cases (86.7%) were good or excellent in radiological assessment according to the criteria of the Meyer. There was no difference of results among the surgical treatment methods. Conclusion: The results of our study indicate that the rigid fixation with early ankle motion and weight bearing is needed in ankle trimalleolar fracture. But minimal fixation is not bad in slight displaced fracture. Both anterior approach and posterior approach were useful methods to stabilization the posterior malleolar fracture. And pre-operative evaluation to detect the hidden soft tissue injuries and fracture mechanism is very important to avoid the failure.

• Clinical and Experimental Pediatrics
• /
• 제61권1호
• /
• pp.17-23
• /
• 2018

Purpose: To determine the relationship between vaginal reflux (VR) and urinary tract infection (UTI) in female children aged <36 months. Methods: A single center retrospective study was performed for 191 girls aged <36 months, with a diagnosis of febrile UTI, who underwent a voiding cystourethrography (VCUG) for assessment of vesicoureteral reflux (VUR) at Sanggye Paik Hospital. Fifty-one girls, who underwent VCUG for assessment of congenital hydronephrosis or renal pelvis dilatation, without a UTI, formed the control group. The correlation between the presence and grade of VR and UTI was evaluated. Results: The prevalence rate of VR was higher in the UTI (42.9%) than control (13.7%) group (P<0.05), with a higher VR severity grade in the UTI (mean, 0.64) than control (mean, 0.18) group (P<0.05). On subanalysis with age-matching (UTI group: n=126, age, $5.28{\pm}2.13months$; control group: n=22, age, $4.79{\pm}2.40months$; P=0.33), both VR prevalence (43.65% vs. 18.18%, P<0.05) and grade (0.65 vs. 0.22, P<0.05) remained higher in the UTI than control group. Presence and higher grade of VR were associated with UTI recurrence (P<0.05). VR was correlated to urosepsis (P<0.05). The renal defect rate of patients with VR (VR [+]/VUR [+]) was not different from that of patients without VR (74% vs. 52%, P=0.143) in the VUR group; however, it was higher than that of VR (+)/VUR (-) patients (74% vs. 32%, P=0.001). If a child with VR (+)/VUR (+) is exposed to a UTI, the risk of renal defect increases. Conclusion: Occurrence of VR is associated with UTI recurrence and urosepsis in pediatric female patients.

• Journal of Chest Surgery
• /
• 제52권6호
• /
• pp.400-408
• /
• 2019

Background: For decades, trauma has been recognized globally as a major cause of death. Reducing the mortality of patients with trauma is an extremely pressing issue, particularly for those with severe trauma. An early and accurate assessment of the risk of mortality among patients with severe trauma is important for improving patient outcomes. Methods: We performed a retrospective medical record review of 582 patients with severe trauma admitted to the emergency department between July 2011 and June 2016. We analyzed the associations of in-hospital mortality with the baseline characteristics and initial biochemical markers of patients with severe trauma on admission. Results: The overall in-hospital mortality rate was 14.9%. Multivariate logistic regression analysis showed that the patient's Rapid Emergency Medicine Score (REMS; odds ratio [OR], 1.186; 95% confidence interval [CI], 1.018-1.383; p=0.029), Emergency Trauma Score (EMTRAS; OR, 2.168; 95% CI, 1.570-2.994; p<0.001), serum lactate levels (SLL; OR, 1.298; 95% CI, 1.118-1.507; p<0.001), and Injury Severity Score (ISS; OR, 1.038; 95% CI, 1.010-1.130; p=0.021) were significantly associated with in-hospital mortality. Conclusion: The REMS, EMTRAS, and SLL can easily and rapidly be used as alternatives to the injury severity score to predict in-hospital mortality for patients who present to the emergency department with severe trauma.

• Korean Journal of Adult Nursing
• /
• 제24권4호
• /
• pp.348-357
• /
• 2012

Purpose: This retrospective chart review study was carried out in order to examine the frequency of delirium, and to identify the risk factors associated with the development of delirium in elderly patients with arthroplasty. Methods: Data were collected from medical records of patients who received arthroplasty during one and half year in a hospital. Three hundred sixty five patients were selected for the study. The onset of delirium was reviewed based on the result of psychological doctor's consultation or nurse's assessment with Confusion Assessment Method and delirium onset risk factors were examined. Data were analyzed with descriptive statistics, t-test, $x_2$-test, Fisher's exact test and logistic regression analysis. Results: Delirium occurred with 31 patients (8.5%) out of 365 patients who underwent arthroplasty. There were statistically significant differences between incidence of delirium and gender ($x_2$=6.11, p=.025), age ($x_2$=32.81, p<.001), hearing difficulty ($x_2$=8.08, p=.012), albumin level of preoperational day (t=-3.43, p<.001), albumin (t=-2.20, p=.028) and hemoglobin level (t=-2.83, p=.005) of operational day. Age and gender were the most significant predictive factors with regard to the incidence of delirium. Conclusion: Through understanding of these results, nurses will be able to identify those patients who may be at risk for developing delirium in early stages.

• Asian Pacific Journal of Cancer Prevention
• /
• 제13권8호
• /
• pp.4045-4050
• /
• 2012

Objective: The impact of ablative oral cancer surgery was studied, with particular reference to recurrence and nodal metastasis, to assess survival probability and prognostic indicators and to elucidate if ethnicity influences the survival of patients. Methods: Patients who underwent major ablative surgery of the head and neck region with neck dissection were identified and clinical records were assessed. Inclusion criteria were stage I-IV oral and oropharyngeal malignancies necessitating resection with or without radiotherapy from 2004 to 2009. All individuals had a pre-operative assessment prior to the surgery. The post operative assessment period ranged from 1 year to 5 years. Survival distributions were analyzed using Kaplan-Meier curves. Results: 87 patients (males:38%; females:62%) were included in this study, with an age range of 21-85 years. Some 78% underwent neck dissections while 63% had surgery and radiotherapy. Nodal recurrence was detected in 5.7% while 20.5% had primary site recurrence within the study period. Kaplan-Meier survival analysis revealed that the median survival time was 57 months. One year overall survival (OS) rate was 72.7% and three year overall survival rate dropped to 61.5%. On OS analysis, the log-rank test showed a significant difference of survival between Malay and Chinese patients (Bonferroni correction p=0.033). Recurrence-free survival (RFS) analysis revealed that 25% of the patients have reached the event of recurrence at 46 months. One year RFS rate was 85.2% and the three year survival rate was 76.1%. In the RFS analysis, the log-rank test showed a significant difference in the event of recurrence and nodal metastasis (p<0.001). Conclusion: Conservative neck is effective, in conjunction with postoperative radiotherapy, for control of neck metastases. Ethnicity appears to influence the survival of the patients, but a prospective trial is required to validate this.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권9호
• /
• pp.4463-4467
• /
• 2016

Purpose: To review the impact of using intra-operative ultrasound guided breast conserving surgery with frozen sections on final pathological margin outcome with the current guidelines set forth by the Society of Surgical Oncology (SSO) and the American Society of Surgical Oncology (ASTRO). Materials and Methods: A retrospective review including all cases of intra-operative ultrasound guided breast conserving surgery was performed at the National Cancer Institute Thailand between 2013 and 2016. Patient demographics, tumor variables, intraoperative frozen section and final pathological margin outcomes were collected. Factors for positive or close margins were analyzed. Results: A total of 86 patients aged between 27 and 75 years with intra-operative ultrasound guided breast conserving surgery were included. Three cases (3.5%) of positive margin were detected by intra-operative frozen section and 4 cases (4.7%) by final pathology reports. There were 18 cases (20.9%) with a close margin (<1 mm). Factors affecting this result comprised multi-foci, presence of invasive ductal carcinoma (IDC) combined with ductal carcinoma in situ (DCIS) and invasive lobular carcinoma (ILC). Conclusions: With the current SSO/ASTRO for adequate margin guidelines, using intra-operative ultrasound to locate the boundary for resection with breast conserving surgery provided a high success rate in obtaining final pathology free margin outcomes and minimizing re-operation risks especially when combined with intra-operative frozen section assessment. The chance of finding positive or close margins appears higher in cases of IDC combined with DCIS, ILC and with multi-foci cancers.