The Incidence and Impact of Abdominal Surgery on Delirium in Abdominal Trauma Patients

Purpose@#The occurrence of trauma-related delirium following postoperative abdominal surgery is associated with a poor prognosis. The purpose of this study was to identify predictive risk factors for trauma-related delirium. @*Methods@#Trauma patient data from a regional trauma center were retrospectively collected from August 2015 to December 2016. The primary inclusion criteria were patients diagnosed with traumarelated delirium following abdominal trauma surgery. Head trauma patients and those under 18 years of age were excluded from this study. A multivariate logistic regression analysis was performed to identify the risk factors associated with trauma-related delirium. @*Results@#Of the 255 trauma patients who met the inclusion criteria, 32 (12.5%) were diagnosed with delirium. The mean values for the age of the patients, Injury Severity Score, Glasgow Coma Scale score, and length of intensive care unit stay were 52.1 ± 17.8 years, 16.9, 14, and 7.1 days, respectively. Among the measured parameters, age [odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01-1.06; p = 0.022)], sex (OR, 0.125; 0.03-0.55; p = 0.006), hemoglobin level (OR, 0.875; CI, 0.68-0.98; p = 0.03), length of stay in the intensive care unit (OR, 1.12; CI, 1.03-1.22; p = 0.01), and having an abdominal operation (OR, 2.92; CI, 1.10-7.23; p = 0.011) showed strong correlations with trauma-related delirium. @*Conclusion@#This study showed that abdominal surgery was strongly associated with delirium in patients with traumatic abdominal injury. Thus, changes in consciousness should be carefully monitored following surgery.

The Incidence and Impact of Abdominal Surgery on Delirium in Abdominal Trauma Patients

Purpose@#The occurrence of trauma-related delirium following postoperative abdominal surgery is associated with a poor prognosis. The purpose of this study was to identify predictive risk factors for trauma-related delirium. @*Methods@#Trauma patient data from a regional trauma center were retrospectively collected from August 2015 to December 2016. The primary inclusion criteria were patients diagnosed with traumarelated delirium following abdominal trauma surgery. Head trauma patients and those under 18 years of age were excluded from this study. A multivariate logistic regression analysis was performed to identify the risk factors associated with trauma-related delirium. @*Results@#Of the 255 trauma patients who met the inclusion criteria, 32 (12.5%) were diagnosed with delirium. The mean values for the age of the patients, Injury Severity Score, Glasgow Coma Scale score, and length of intensive care unit stay were 52.1 ± 17.8 years, 16.9, 14, and 7.1 days, respectively. Among the measured parameters, age [odds ratio (OR), 1.03; 95% confidence interval (CI), 1.01-1.06; p = 0.022)], sex (OR, 0.125; 0.03-0.55; p = 0.006), hemoglobin level (OR, 0.875; CI, 0.68-0.98; p = 0.03), length of stay in the intensive care unit (OR, 1.12; CI, 1.03-1.22; p = 0.01), and having an abdominal operation (OR, 2.92; CI, 1.10-7.23; p = 0.011) showed strong correlations with trauma-related delirium. @*Conclusion@#This study showed that abdominal surgery was strongly associated with delirium in patients with traumatic abdominal injury. Thus, changes in consciousness should be carefully monitored following surgery.

Comparison of Clinical Manifestations between Patients with Ocular Myasthenia Gravis and Generalized Myasthenia Gravis

PURPOSE: To compare the clinical manifestations between patients with ocular myasthenia gravis and those with generalized myasthenia gravis (MG). METHODS: The medical records of 71 patients diagnosed with MG between January 1995 and December 2007 were reviewed. Demographics, sensitivities of diagnostic methods, the presence of systemic autoimmune diseases, ophthalmic complications caused by MG, and treatments were evaluated and compared. RESULTS: Fourteen patients (20%) were diagnosed with ocular MG and 57 patients (80%) with generalized MG. Sensitivities of anti-acetylcholine receptor antibody and repetitive nerve stimulation tests were significantly higher in the generalized MG group (84%, 89%) compared to those in the ocular MG group (50%, 54%) (p = 0.011, p = 0.008). The sensitivity of the neostigmine test was the highest in both groups (98% of generalized MG, 79% of ocular MG), and the difference between the two groups was borderline significant (p = 0.058). The most common symptoms were ptosis and diplopia, and both groups presented with pain, blurred vision, and tearing. Systemic autoimmune disease was more prominent in the generalized MG group (21%) than in the ocular MG group (14%), and steroid therapy was used more frequently in the generalized MG group (82%) than in the ocular MG group (57%). Ophthalmic complications associated with long-term steroid treatment were more profound in the generalized MG (30%) compared to those of the ocular MG (21%). CONCLUSIONS: The generalized MG group was associated with higher sensitivities to diagnostic tests, more systemic steroid use, higher ophthalmic complications caused by systemic autoimmune disease, and long-term steroid treatment compared to those of the ocular MG group.

Assessment of Quality of Life and Depression in Korean Patients with Graves' Ophthalmopathy

PURPOSE: To assess quality of life and depressive status in Korean patients with Graves' ophthalmopathy. METHODS: A cross-sectional study of 49 patients (mean age, 41 years; sex ratio, M:F=11:38) with Graves' ophthalmopathy (referred to as the Graves' group) and 48 age-matched and sex-matched controls (mean age, 40.2 years; sex ratio, M:F=11:37) was performed using the Korean version of the 36-item Short-Form General Health Survey (SF-36) questionnaire and the Beck Depression Inventory (BDI). Survey data was compared among patients with mild, moderately severe, and sight-threatening Graves' ophthalmopathy and between patients with low (0 or 1) or high (2 or 3) Gorman scores. RESULTS: Those in the Graves' group scored significantly lower on all categories of the SF-36, as compared to the control group (p or =16 had significantly lower scores on the SF-36 and higher clinical activity scores, as compared to the 33 patients with BDI scores <16 (p<0.05). CONCLUSIONS: Patients with Graves' ophthalmopathy had reduced health-related quality of life and were more likely to be depressed, especially those with a sight threatening condition or significant diplopia. It is important to identify these patients to provide the necessary psychological support.

A case of myxoid malignant fibrous histiocytoma in the pelvic cavity / 부인종양

Malignant fibrous histiocytoma (MFH) is the most frequent malignant soft tissue tumor in adults. A primary MFH occurs most commonly in the extremities and the trunk, but rarely in the pelvic cavity. We report a case of malignant fibrous histiocytoma of the unknown origin in the pelvic cavity with a review of the literature. The neoplasm occurred in the pelvic cavity of 53-year-old female who complained of enlarging nontender mass in the lower abdomen. The final diagnosis was based on the pathological report of the surgical specimen.