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An avulsion fracture occurs when a muscle-tendon unit attached to a bone produces sufficient force to tear a fragment of the bone. If not treated properly, this injury can lead to deformity, nonunion, malunion, pain, and disability. Although avulsion fractures around the foot and ankle can occur anywhere there are tendon and ligament attachments, they are common in the anterior talofibular ligament, anterior-inferior tibiotalar ligament, calcaneal tuberosity, the base of the fifth metatarsal, and navicular bone. The optimal treatment for each fracture depends on the location and severity of the fracture.Conservative treatment involves limiting weight bearing for a period, splint immobilization, and using various orthoses. Surgical treatment is usually reserved for cases of severe displacement or when nonsurgical treatment has failed. The goals of surgery include reduction of the fracture fragment, prevention of nonunion or malunion and soft tissue injury, and early return to function. The decision for each treatment modality may depend on the patient demographics or preferences and the surgeon experience. This review summarizes previous and current views on the pathogenesis, diagnosis, and treatment of common avulsion fractures to guide the treatment and diagnosis.
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Objective@#This study aimed to identify the factors affecting posttraumatic stress disorder (PTSD) symptom remission prospectively through a 1-year follow-up of sexual assault (SA) victims. @*Methods@#A total 65 female SA victims who visited the crisis intervention center were included. Self-administered questionnaires regarding PTSD symptoms and PTSD related prognostic factors were conducted at both recruitment (T1) and 1 year after recruitment (T2). The multivariate analyses were used to determine the significant predictors of PTSD remissionon-remission state 1 year after SA. @*Results@#In logistic regression analysis, both anxiety and secondary victimization were identified as significant factors explaining the results on PTSD remissionon-remission state at T2 (Beck’s Anxiety Inventory [BAI], p=0.003; Secondary Victimization Questionnaire, p=0.024). In a linear mixed analysis, both depression and anxiety were found to be significant variables leading to changes in Posttraumatic Diagnostic Scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition from T1 to T2 (BAI, p<0.001; Center for Epidemiological Studies Depression Scale, p<0.001). @*Conclusion@#Depression, anxiety symptoms, and secondary victimization after SA were associated with PTSD symptom non-remission 1 year after SA.
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In this review, we provide information about the etiology, risk factors, and clinical presentations of maltreatment to help clinicians better understand child abuse and neglect. Child maltreatment is a major global health challenge that can result in severe consequences. Abused and neglected children are likely to develop psychiatric disorders, such as major depressive disorder, anxiety disorder, and posttraumatic stress disorder. Understanding child maltreatment is expected to prevent and reduce victimization in children, adolescents, and their families.
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The purpose of this study was to explore the variables of foot pressure according to glycated hemoglobin level during walking in diabetic patients with pes rectus. The subjects of this study were 39 people (78 feet) in their 40s and 60s, and they were divided into 11 pre-diabetic patients (22 feet) and 14 diabetic patients (28 feet) based on glycated hemoglobin; 14 patients without diabetes (28 feet) was used as a control. Foot pressure was measured using the EMED-LE Measurement system. The sole of the foot was divided into 12 parts, each of which was analyzed for pressure, force, contact area, and grounding time. For statistics, nonparametric Kruskal–Wallis and Wilcoxon signed rank test were used. Prediabetic and diabetic patients had lower hindfoot and second and third metatarsal foot pressure but higher first and third toe pressure compared to those without diabetes. In addition, the maximum and minimum force were high in all parts of the sole, and the contact time was long, signifying strong downward force for a long duration. Measurement of foot pressure by parts allowed detailed analysis of abnormal foot pressure and is valuable as basic data for diagnosis, prediction, and treatment of diabetic foot. Based on these data, maximum and minimum pressure better explain the problem of plantar pressure distribution rather than mean maximum pressure.
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Objective@#Extant studies indicate that just one characteristic of sexual assault cannot properly represent the whole experience of sexual assault and, especially, the severity of sexual assault. This study aimed to understand the totality of sexual assault experiences and elucidate subtypes of sexual assault victims based on the detailed characteristics of their sexual assault experiences and those relationships with mental health. @*Methods@#A total of 255 adult sexual violence victims who used intervention services and a comparison group were included. Information on their sexual assault experiences was gleaned from case records data. @*Results@#The following four distinctive profile groups were identified: “Sexual Touching” (19.6%), “Rape/Social Relation” (30.4%), “Intimate Partner Violence (IPV)” (18.8%), and “Rape/Stranger” (31.3%). The subgroups differed in terms of secondary victimization and adverse childhood experiences. The Rape/Social Relation and IPV subgroups most frequently experienced secondary victimization and childhood adversity. The four profile subgroups demonstrated different relationships with mental health outcomes, with a complicated pattern. The Rap/Social Relation and IPV subgroups scored higher on mental health problem screening measures compared to other groups. However, a considerable proportion of victims in the Sexual Touching subgroup also reported suicidal behaviors and self-injury. @*Conclusion@#Based on the results, theoretical and clinical implications were discussed.
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Objective@#Extant studies indicate that just one characteristic of sexual assault cannot properly represent the whole experience of sexual assault and, especially, the severity of sexual assault. This study aimed to understand the totality of sexual assault experiences and elucidate subtypes of sexual assault victims based on the detailed characteristics of their sexual assault experiences and those relationships with mental health. @*Methods@#A total of 255 adult sexual violence victims who used intervention services and a comparison group were included. Information on their sexual assault experiences was gleaned from case records data. @*Results@#The following four distinctive profile groups were identified: “Sexual Touching” (19.6%), “Rape/Social Relation” (30.4%), “Intimate Partner Violence (IPV)” (18.8%), and “Rape/Stranger” (31.3%). The subgroups differed in terms of secondary victimization and adverse childhood experiences. The Rape/Social Relation and IPV subgroups most frequently experienced secondary victimization and childhood adversity. The four profile subgroups demonstrated different relationships with mental health outcomes, with a complicated pattern. The Rap/Social Relation and IPV subgroups scored higher on mental health problem screening measures compared to other groups. However, a considerable proportion of victims in the Sexual Touching subgroup also reported suicidal behaviors and self-injury. @*Conclusion@#Based on the results, theoretical and clinical implications were discussed.
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Objective@#This study aimed to develop a brief self-report measure of depressive and anxiety symptoms in victims of sexual violence. @*Methods@#The sample, which consisted of 215 victims and 255 healthy controls, was recruited between December 2016 and November 2018 from eight Sunflower Centers. Eligible items were selected from existing scales of depression (CES-DC and CES-D) and anxiety (SAI-C and BAI) symptoms by item-total correlation coefficients and item response theory (IRT) analysis. Internal consistency coefficients were computed and the receiver operating characteristics curve was inspected to assess the validity of the brief scale and determine optimal cutoff scores. @*Results@#The brief scales showed high internal consistency across all age groups. The optimal cutoff score of brief depression scale was 1.5 for children, 2.5 for adolescents, and 2.5 for the adults. That of brief anxiety scale was 8.5, 6.5, and 3.5, respectively. @*Conclusion@#The results underscore the need for age-appropriate screening measures of depressive and anxiety symptoms in victims of sexual violence.
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PURPOSE: Pain management in burn treatment is important in improving wound healing and quality of life. Ibuprofen is a proven pain relieving agent in patients with partial thickness burn by intraveous injection. The purpose of this study is to evaluate the efficacy of Biatain Ibu® (polyurethane foam containing ibuprofen) in pain control for outpatients with partial thickness burns. METHODS: A prospective randomized clinical trial was performed in outpatients with partial thickness burn from August 1, 2017 to July 31, 2018. Acute pain, chronic pain, complications, days for re-epithelialization and patient's satisfaction were compared between Biatain Ibu® and Biatain® groups. RESULTS: A total of 20 patients (Biatain Ibu®, n=10; Biatain®, n=10) were assessed in the trial. On Burn days 3, 5, 7, 11, 13, and 15, the acute pain levels were significantly lower in the Biatain Ibu® group than in the Biatain® group. Complications, chronic pain levels and days for re-epithelialization were not significantly different between the two groups. Patient's satisfaction was not statistically significant but was higher in the Biatain Ibu® group. CONCLUSION: Biatain Ibu® is effective in relieving pain in outpatients with partial thickness burn without decreasing patient satisfaction, wound healing ability or developing any complications.
Subject(s)
Humans , Acute Pain , Bandages , Burns , Chronic Pain , Ibuprofen , Outpatients , Pain Management , Patient Satisfaction , Prospective Studies , Quality of Life , Re-Epithelialization , Wound Healing , Wounds and InjuriesABSTRACT
The purpose of this study was to develop a brief rating scale of post-traumatic stress disorder (PTSD) symptoms among sexual violence victims. We analyzed the data from 195 victims and 220 non-victims to select meaningful items from the original PTSD rating scales. We also examined the validity of the brief scale by assessing internal consistency and ROC curves. The optimal cutoff scores for each brief scales were obtained. The results showed that a different approach may be required for early intervention in different age groups.
Subject(s)
Humans , Early Intervention, Educational , ROC Curve , Sex Offenses , Stress Disorders, Post-Traumatic , Weights and MeasuresABSTRACT
BACKGROUND: Dexmedetomidine, an α2-adrenergic agonist, can be used for sedation and as an adjuvant to anesthetics. This study aimed to evaluate the effects of preanesthetic administration of dexmedetomidine on the propofol and remifentanil requirement during general anesthesia and postoperative pain in patients undergoing laparoscopic cholecystectomy. METHODS: Sixty patients were randomly assigned to group D or S (n = 30 each). Dexmedetomidine (0.5 µg/kg) and a comparable volume of saline were administered in groups D and S, respectively, over a 10 minutes period before induction. General anesthesia was induced and maintained with propofol and remifentanil; the bispectral index was maintained at 40–60. The intraoperative remifentanil and propofol dosages were recorded, and postoperative pain was assessed using a visual analog scale (VAS). RESULTS: In groups S and D, propofol dosage was 8.52 ± 1.64 and 6.83 ± 1.55 mg/kg/h, respectively (P < 0.001), while remifentanil dosage was 7.18 ± 2.42 and 4.84 ± 1.44 µg/ kg/h, respectively (P < 0.001). VAS scores for postoperative pain were 6.50 (6–7) and 6.0 (6–7), respectively, at 30 minutes (P = 0.569), 5 (4–5) and 4 (3–5), respectively, at 12 hours (P = 0.039), and 2 (2–3) and 2 (1.25–2), respectively, at 24 hours (P = 0.044). The Friedman test revealed that VAS scores changed over time in both groups (P < 0.001). CONCLUSIONS: Preanesthetic single administration of a low dose of dexmedetomidine (0.5 µg/kg) can significantly decrease the remifentanil and propofol requirement during short surgeries and alleviate postoperative pain.
Subject(s)
Humans , Anesthesia, General , Anesthetics , Cholecystectomy, Laparoscopic , Dexmedetomidine , Pain, Postoperative , Propofol , Visual Analog ScaleABSTRACT
No abstract available.
Subject(s)
Carcinoma, Squamous Cell , Epidermal Cyst , Epithelial Cells , UlcerABSTRACT
OBJECTIVE: According to the 3rd Korean National Dementia Plan, the dementia-friendly community initiative was launched. The aim of this study was to evaluate the effects of a rural dementia-friendly village project on the participants. METHODS: Jeollabukdo Provincial Dementia Center designated Sosu-maeul, located in Buan-gun Jeollabuk-do, as a rural dementia-friendly village. We conducted dementia partnership education, youth-elder matching activity, and cognitive enhancing program. The efficacy of this project was evaluated by the changes in dementia awareness, cognitive function, and depressive symptoms. We used dementia awareness questionnaire, Mini-Mental Status Examination for Dementia Screening (MMSE-DS), and Korean version of Short form of Geriatric Depression Scale (SGDS-K). RESULTS: This study was carried out with 24 residents in this community. There was no significant change in dementia awareness score between pre- and post-intervention (p=0.25). MMSE-DS score was significantly increased from 24.5 to 25.5 (p < 0.001) and SGDS-K score was statistically improved from 3.5 to 2.5 (p=0.04) after interventions. CONCLUSION: We Jeollabukdo Provincial Dementia Center carried out a pilot study of a rural dementia-friendly village project. This project led to improvements on cognitive functions and depressive symptoms in the participants. But the improvement of dementia awareness was not achieved. More direct and experiencing interventions for people with dementia are necessary to improve dementia awareness.
Subject(s)
Cognition , Dementia , Depression , Education , Mass Screening , Pilot ProjectsABSTRACT
BACKGROUND: Previously, surveys have been used to investigate breast reconstruction statistics. Since 2015, breast reconstruction surgery after mastectomy has been covered by the National Health Insurance Service in Korea, and data from breast reconstruction patients are now available from the Health Insurance Review and Assessment Service (HIRA). We investigated statistics in breast reconstruction in Korea through statistics provided by the HIRA Big Data Hub. METHODS: We investigated the number of cases in mastectomy and breast reconstruction methods from April 1, 2015 to December 31, 2016. Data were furnished by the HIRA Big Data Hub and accessed remotely online. Results were tabulated using SAS Enterprise version 6.1. RESULTS: The 31,155 mastectomy cases included 7,088 breast reconstruction cases. Implant-based methods were used in 4,702 cases, and autologous methods in 2,386. The Implant-based reconstructions included 1,896 direct-to-implant and 2,806 tissue-expander (2-stage) breast reconstructions. The 2-stage tissue-expander reconstructions included 1,624 expander insertions (first stage) and 1,182 expander-to-permanent-implant exchanges (second stage). Of the autologous breast reconstructions, 705 involved latissimus dorsi muscle flaps, 498 involved pedicled transverse rectus abdominis myocutaneous (TRAM) flaps, and 1,183 involved free-tissue transfer TRAM flaps, including deep inferior epigastric perforator free-tissue transfer flaps. There were 1,707 nipple-areolar complex reconstructions, including 1,565 nipple reconstructions and 142 areola reconstructions. The 1-year mean number of breast reconstructions was 4,050. CONCLUSIONS: This was the first attempt to evaluate the total number of breast reconstruction procedures using accurate, comprehensive data, and our findings may prove valuable as a foundation for future statistical studies of breast reconstruction procedures in Korea.
Subject(s)
Female , Humans , Breast , Insurance, Health , Korea , Mammaplasty , Mastectomy , National Health Programs , Nipples , Rectus Abdominis , Statistics as Topic , Superficial Back MusclesABSTRACT
OBJECTIVE: To determine whether fragment removal on in vitro fertilization (IVF) day 2 improved the subsequent development and pregnancy outcomes of fragmented embryos compared to similar-grade embryos without fragment removal. METHODS: This study was a retrospective analysis involving 191 IVF cycles in which all embryos had over 10% fragmentation (grade 3 or 4) on day 2 of the IVF-embryo transfer cycle from March 2015 to December 2017. IVF cycles were divided into the fragment removal group (n=87) and the no fragment removal group (n=104) as a control cohort. Before fragment removal, embryos with fragmentation on day 2 were incubated in Ca2+- and Mg2+-free biopsy medium under paraffin oil for 30 minutes. Microsurgical fragment removal was performed with later-assisted hatching and a handmade suction micropipette that had an outer diameter of 30 µm. RESULTS: There were no significant differences in the characteristics of the patients between the control and the fragment removal groups. After fragment removal and subsequent in vitro culture for 24 hours, the number of blastomeres (7.1±1.7 vs. 6.9±1.6) was comparable between the transferred embryos in the two groups, but the morphological grade of the embryos in the fragment removal group (1.9±0.7) was significantly higher than that of the control group (3.1±0.5, p < 0.01). The clinical pregnancy (43.7%) and implantation rates (25.8%) in the fragment removal group were significantly higher than those in the control group (28.8% and 14.0%, respectively; p < 0.05). CONCLUSION: Early fragment removal on day 2 significantly improved the subsequent development and pregnancy outcomes of fragmented embryos.
Subject(s)
Female , Humans , Pregnancy , Biopsy , Blastomeres , Cohort Studies , Embryonic Structures , Fertilization in Vitro , In Vitro Techniques , Paraffin , Pregnancy Outcome , Retrospective Studies , SuctionABSTRACT
BACKGROUND: Acellular dermal matrix (ADM) helps wound healing by stimulating angiogenesis, acting as a chemoattractant for endothelial cells, providing growth factors, and permitting a substrate for fibroblasts to attach. The current standard for using paste-type ADM (CG Paste) in wound healing is direct application over the wounds. The major concerns regarding this method are unpredictable separation from the wounds and absorption into negative-pressure wound therapy devices. This study aimed to investigate the effects of subcutaneous injection of paste-type ADM on wound healing in rats. METHODS: Full-thickness skin defects were created on the dorsal skin of rats. Eighteen rats were randomly divided into three groups and treated using different wound coverage methods: group A, with a saline dressing; group B, standard application of CG Paste; and group C, injection of CG Paste. On postoperative days 3, 5, 7, 10, and 14, the wound areas were analyzed morphologically. Histological and immunohistochemical tissue analyses were performed on postoperative days 3 and 7. RESULTS: Groups B and C had significantly less raw surface than group A on postoperative days 10 and 14. Collagen fiber deposition and microvessel density were significantly higher in group C than in groups A and B on postoperative days 3 and 7. CONCLUSIONS: This study showed comparable effectiveness between subcutaneous injection and the conventional dressing method of paste-type ADM. Moreover, the injection of CG Paste led to improved wound healing quality through the accumulation of collagen fibers and an increase in microvessel density.
Subject(s)
Animals , Rats , Absorption , Acellular Dermis , Bandages , Collagen , Endothelial Cells , Fibroblasts , Injections, Subcutaneous , Intercellular Signaling Peptides and Proteins , Methods , Microvessels , Negative-Pressure Wound Therapy , Ointments , Skin , Wound Healing , Wounds and InjuriesABSTRACT
PURPOSE: Schizophrenia is a devastating mental disorder and is known to be affected by genetic factors. The chromogranin B (CHGB), a member of the chromogranin gene family, has been proposed as a candidate gene associated with the risk of schizophrenia. The secretory pathway for peptide hormones and neuropeptides in the brain is regulated by chromogranin proteins. The aim of this study was to investigate the potential associations between genetic variants of CHGB and schizophrenia susceptibility. MATERIALS AND METHODS: In the current study, 15 single nucleotide polymorphisms of CHGB were genotyped in 310 schizophrenia patients and 604 healthy controls. RESULTS: Statistical analysis revealed that two genetic variants (non-synonymous rs910122; rs2821 in 3′-untranslated region) were associated with schizophrenia [minimum p=0.002; odds ratio (OR)=0.72], even after correction for multiple testing (p(corr)=0.02). Since schizophrenia is known to be differentially expressed between sexes, additional analysis for sex was performed. As a result, these two genetic variants (rs910122 and rs2821) and a haplotype (ht3) showed significant associations with schizophrenia in male subjects (p(corr)=0.02; OR=0.64), whereas the significance disappeared in female subjects (p>0.05). CONCLUSION: Although this study has limitations including a small number of samples and lack of functional study, our results suggest that genetic variants of CHGB may have sex-specific effects on the risk of schizophrenia and provide useful preliminary information for further study.
Subject(s)
Female , Humans , Male , Brain , Chromogranin B , Haplotypes , Mental Disorders , Neuropeptides , Odds Ratio , Peptide Hormones , Polymorphism, Single Nucleotide , Schizophrenia , Secretory PathwayABSTRACT
The task force of the Korean Society for Reproductive Immunology recommends intravenous immunoglobulin G treatment in women with reproductive failure, including recurrent pregnancy loss and/or repeated implantation failure, who show cellular immune factors such as abnormal natural killer cell levels, natural killer cell cytotoxicity, and/or type 1 T helper immunity.
Subject(s)
Female , Humans , Pregnancy , Abortion, Habitual , Advisory Committees , Allergy and Immunology , Immunoglobulin G , Immunoglobulins , Immunologic Factors , Infertility , Killer Cells, NaturalABSTRACT
The identification of circulating tumor cells (CTCs) is clinically important for diagnosing cancer. We have previously developed a size-based filtration platform followed by epithelial cell adhesion molecule immunofluorescence staining for detecting CTCs. To characterize CTCs independently of cell surface protein expression, we incorporated a chromosomal fluorescence in situ hybridization (FISH) assay to detect abnormal copy numbers of chromosomes in cells collected from peripheral blood samples by the size-based filtration platform. Aneuploid cells were detected in the peripheral blood of patients with lung cancer. Unexpectedly, aneuploid cells were also detected in the control group, which consisted of peripheral blood samples from patients with benign lung diseases, such as empyema necessitatis and non-tuberculous mycobacterial lung disease. These findings suggest that chromosomal abnormalities are observed not only in tumor cells, but also in benign infectious diseases. Thus, our findings present new considerations and bring into light the possibility of false positives when using FISH for cancer diagnosis.