• Journal of Korean Neurosurgical Society
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• v.59 no.2
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• pp.165-167
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• 2016

Langerhans cell histiocytosis (LCH) is a rare disorder histologically characterized by the proliferation of Langerhans cells. Here we present the case of a 13-year-old girl with LCH wherein CT and MRI results led us to an initially incorrect diagnosis of meningioma. The diagnosis was corrected to LCH based on pathology findings. An intracranial mass was found mainly in the dura mater, with thickening of the surrounding dura. It appeared to be growing downward from the calvaria, pressing on underlying brain tissue, and had infiltrated the inner skull, causing a bone defect. The lesion was calcified with the typical dural tail sign. The dural origin of the lesion was verified upon surgical dissection. There are no previous reports in the literature describing LCH of dural origin presenting in young patients with typical dural tail signs and meningioma-like imaging findings. The current case report underscores the need for thorough histological and immunocytochemical examinations in LCH differential diagnosis.

• Journal of Korean Neurosurgical Society
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• v.58 no.1
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• pp.30-35
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• 2015

Objective : The clinical and pathological characteristics of 10 cases of cerebral amyloid angiopathy (CAA)-related cerebral lobar hemorrhage (CLH) that was diagnosed at autopsy were investigated to facilitate the diagnosis of this condition. Methods : The clinical characteristics of 10 cases of CAA-related CLH were retrospectively reviewed, and a neuropathological examination was performed on autopsy samples. Results : The 10 cases included two with a single lobar hemorrhage and eight with multifocal lobar hemorrhages. In all of the cases, the hemorrhage bled into the subarachnoid space. Pathological examinations of the 10 cases revealed microaneurysms in two, double barrel-like changes in four, multifocal arteriolar clusters in five, obliterative onion skin-like intimal changes in four, fibrinoid necrosis of the vessels in seven, neurofibrillary tangles in eight, and senile plaques in five cases. Conclusion : CAA-related CLHs were located primarily in the parietal, temporal, and occipital lobes. These hemorrhages normally consisted of multiple repeated CLHs that frequently bled into the subarachnoid space. CAA-associated microvascular lesions may be the pathological factor underlying CLH.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.4
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• pp.191-197
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• 2018

Objectives: The objective of the study was to evaluate the results of nasolabial/extended nasolabial flaps as a modality for treatment of oral submucous fibrosis. Materials and Methods: Eleven patients of Stage III or IVa maximum interincisal opening were selected to be operated. Nasolabial/extended nasolabial flaps were done for both the sides. All of the flaps were done in a single stage and were inferiorly based. A similar flap harvest/surgical technique was utilized for all the cases. Results: The preoperative mouth opening ranged from 5 to 16 mm, with a mean of 10.09 mm. At 6 months the mouth opening ranged from 29 to 39 mm. Some of the complications encountered were poor scar, wisdom tooth traumatising the flap, decreased mouth opening due to non compliance and too much bulk. All of theses were managed satisfactorily. Conclusion: The nasolabial flap is a very reliable flap to restore the function of oral cavity. Important adjuvant measures are habit cessation, lifestyle changes, and aggressive physiotherapy.

• The Korean Journal of Emergency Medical Services
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• v.19 no.3
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• pp.33-49
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• 2015

Purpose: This study aimed to investigate the work and job satisfaction of military emergency medical technicians (EMTs). Methods: We selected 122 military EMTs who participated in the refresher education in 2012. This study was conducted from November 12 to December 21, 2012. Results: The most frequent duties of military EMTs were scene assessment, cardiopulmonary resuscitation, surgical treatment, prehospital first-aid, transfer to the hospital, education, and call response. The air force and navy EMTs had better performance than the army EMTs. As for job satisfaction, the work itself ranked highest, whereas payment ranked lowest. Conclusion: The scope of the work of the military EMTs varied in the 14 fields of work but should be considered for further evaluation. In order to increase the job satisfaction of EMTs, their work conditions should be improved such as through salary increase and extra pay for those with professional certificates.

• Journal of Korean Foot and Ankle Society
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• v.23 no.2
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• pp.52-57
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• 2019

Purpose: An ingrown nail is common in military trainees who are exposed to highly demanding activities. Although the matrixectomy procedure has been the main treatment modality, several drawbacks may follow after the procedure, such as infection, periostitis, and continued pain that causes a delayed return to duty. This study examined the outcomes of a simple partial nail extraction with the hypothesis that this procedure may bring an earlier return to duty, lower the perioperative complications, and produce a comparable recurrence rate. Materials and Methods: The medical records of patients who had surgical treatment for an ingrown nail in the authors' institution between April 2016 and December 2017 were reviewed retrospectively. Under the inclusion and exclusion criteria, 28 patients with a simple partial nail extraction (group A) and 29 patients with a partial nail extraction with matrixectomy (group B) were investigated. As the clinical outcome, the visual analogue scale (VAS) and satisfaction score, time to return to duty, complications, and recurrence rate were checked and compared between the groups. Results: The VAS scores of group B were significantly higher during the first (p<0.001) and second (p=0.026) follow-up week than group A. The time to return to duty was shorter in group A (7.8 days) than group B (10.1 days), and this difference was significant (p<0.001). Group B had five patients with complications, whereas group A had none (p=0.028). No differences in the recurrence rate (p=0.197) and patient satisfaction (p=0.764) were found between the groups. Conclusion: In this study, simple partial nail extraction in military trainees resulted in lower postoperative pain, lower complication rates, and earlier return to duty than the procedure with matrixectomy. Military trainees are temporarily exposed to highly demanding activities. Thus, a satisfactory outcome would be expected with simple partial nail extraction without performing a radical procedure, such as a matrixectomy.

• Journal of Trauma and Injury
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• v.34 no.1
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• pp.50-56
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• 2021

Purpose: Fractures are common in the military population, but limited studies have investigated the incidence of fractures among Korean military personnel. Hence, this study aimed to clarify this issue. Methods: Eligible subjects were patients who had sustained a fracture and were registered in the N-DEMIS (the medical records system of participating hospitals) from June 2017 to May 2019. Fractures were categorized according to the fracture site, patients' age, sex, and type of duty. Results: In total, 23,687 patients with 23,981 fractures were included. There were 216 patients with multiple fractures, of whom 156 had fractures at two sites, 42 had fractures at three sites, and 18 had fractures at four sites. Of the 23,687 patients, 23,340 were men and 347 were women. The incidence of fractures in men and women was 12.96 per 1,000 person-years and 0.19 per 1,000 person-years, respectively. In terms of the broad location of fractures, the percentage of fractures was the highest in the hand, followed by the foot and lower leg. When the location of fractures was analyzed more specifically, the percentage of fractures was the highest in the phalanx (thumb and fingers), followed by the ankle and metacarpal bones. Conclusions: Hand, foot, ankle, and wrist fractures were the most commonly encountered fractures in the Korean military population. To prevent the loss of combat power due to non-battle-related injuries, thorough preparation is necessary, including protective equipment and preliminary training for areas with a high frequency of fracture occurrence.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.32 no.2
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• pp.195-207
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• 2022

Objectives: The purpose of this study was to identify the factors affecting rehabilitation motivation in hospitalized orthopedic patients. Methods: Data were collected from June 1th to July 31th, 2019 and structured questionnaires were used. Study subjects were 97 orthopedic patients who received fixed treatment more than two weeks and started rehabilitation exercise in a military hospital. The data were summarized using descriptive statistics and analyzed by t-test or one way ANOVA, Pearson's correlation analysis and multiple regression analysis were run in SPSS 20.0 program. Results: The results of this study may be summarized as follows. (1) The demographic characteristics that showed differences in rehabilitation motivation were marital status, age and the ranks of the armed forces. The rehabilitation motivation of married, older than 31, officer ranked soldiers turned out to be higher than those of singles, younger than 30, non-officers, respectively. (2) The results of Pearson's correlation analysis showed that independent variables were all correlated significantly each other. (3) The results of stepwise multiple regression analysis showed that the factors influencing rehabilitation motivation were family social support, medical personnel's social support and the level of military life adaption. Conclusions: The rehabilitation motivation of hospitalized soldiers may be improved by receiving supports from family members and medical personnels and by adapting to military life. Military medical workers need to explore nursing strategies that help hospitalized orthopedic patients increase their own rehabilitation motivation.

• Anxiety and mood
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• v.16 no.1
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• pp.32-40
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• 2020

Objective : The purpose of this study was to investigate the cognitive performance of major depressive disorder (MDD) in military service/conscription personnel who visited the psychiatric clinic for a medical certificate to consider the situation from the perspective of Korea's unique compulsory military system. We used the Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV) as the test for verifying the suitable level of cognitive functioning for military service and as the embedded measure with reflecting suboptimal effort. Methods : The study was conducted on 56 (28 males, age 19-34) in/out-patients admitted to the psychiatry department and diagnosed with MDD (DSM-IV). All participants completed a structured clinical interview (MINI-Plus), as well as self-report questionnaires related to demographics and severity of clinical symptoms. K-WAIS-IV was administered to each subject to assess cognitive characteristics. Results : Military group showed significantly lower processing speed index (PSI) score including subtests of symbol search (SS) and coding (CD) score, compared to the control group. There was no other significant differences in the Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) scores including sub-tests comprised of the above indices, and Reliable Digit Span (RDS), Enhanced-RDS-Revised (E-RDS-R) between the study and control groups. Conclusion : This study was the first effort to verify the characteristics of Korea's military group with MDD and suggest the applicability of PSI and processing speed of K-WAIS-IV as an embedded performance index to test sub-optimal effort or low motivation beyond the purpose of testing cognitive deficits.

• Parasites, Hosts and Diseases
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• v.55 no.4
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• pp.391-398
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• 2017

Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.

• Journal of Trauma and Injury
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• v.36 no.4
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• pp.376-384
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• 2023

Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.