• Title/Summary/Keyword: Non-operative management

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Impacts of Financial Inclusion on Sustainable Development in India

  • SINGH, Saumya;GAUTAM, Rahul Singh;AGARWAL, Bhakti;PUSHP, Aman;BARGE, Prashant;RASTOGI, Shailesh
    • The Journal of Asian Finance, Economics and Business
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    • v.9 no.10
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    • pp.235-242
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    • 2022
  • The ultimate motive of the paper is to establish whether financial inclusion (FI) has a consequential impact on the Sustainable Development (SD) of India. This study uses one model for the assessment of the influence of FI through the Co-Operative bank network on SD. This is purposely done to analyze the absolute impact of the role of the Co-Operative bank network in the said context. The sample encompasses data taken from 28 states and 3 Union Territories for two years (FY2018-FY2020). Assessment of data for the remaining Union Territories is not undertaken for the reason of the non-availability of data for other Union Territories. This study uses Panel Data Analysis (PDA) to establish the nexus of the relation between the said variables. Results of this study reveal elevated levels of SD resultant of increased FI thereby indicating a positive and significant relationship between the said variables. Unlike previous studies, this study gives India-specific significant findings, which suggests policy formulation for increasing the numbers and improving the governance of Co-Operative bank networks for SD. Co-Operative bank network as a proxy despite having high weighted significance in FI has not been incorporated in any recent study as per the last updated knowledge of authors.

Non-Operative Management of Traumatic Gallbladder Bleeding with Cystic Artery Injury: A Case Report

  • Kim, Tae Hoon
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.208-211
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    • 2021
  • Gallbladder injuries are rare in cases of blunt abdominal trauma and are usually associated with damage to other internal organs. If the physician does not suspect gallbladder injury and check imaging studies carefully, it may be difficult to distinguish a gallbladder injury from gallbladder stone, hematoma, or bleeding. Therefore, in order not to miss the diagnosis, the clinical findings and correlation should be confirmed. In the present case, a 60-year-old male presented to a local trauma center complaining of pain in the upper right quadrant and chest wall following a motor vehicle collision. Abdominal computed tomography (CT) showed a hepatic laceration and hematoma in the parenchyma in segments 4, 5, and 6 and active bleeding in the lumen of the gallbladder. Traumatic gallbladder injuries generally require surgery, but in this case, non-operative management was possible with cautious follow-up consisting of abdominal CT and angiography with repeated physical examinations and hemodynamic monitoring in the intensive care unit.

Non-Operative Management with Angioembolization of Grade IV and V Renal Injuries in a Hybrid Emergency Room System

  • Ahn, So Ra;Seo, Sang Hyun;Lee, Joo Hyun;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.191-197
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    • 2021
  • Renal injuries occur in more than 10% of patients who sustain blunt abdominal injuries. Non-operative management (NOM) is the established treatment strategy for lowgrade (I-III) renal injuries. However, despite some evidence that NOM can be successfully applied to high-grade (IV, V) renal injuries, it remains unclear whether NOM is appropriate in such cases. The authors report two cases of high-grade renal injuries that underwent NOM after embolization in a hybrid emergency room (ER) system with a 24/7 in-house interventional radiology (IR) team. A 29-year-old male visited Wonkwang University Hospital Regional Trauma Center complaining of right abdominal pain after being hit by a rope. Computed tomography (CT) was performed 16 minutes after arrival, and the CT scan indicated a grade V right renal injury. Arterial embolization was initiated within 31 minutes of presentation. A 56-year-old male was transferred to Wonkwang University Hospital Regional Trauma Center with a complaint of right flank pain. He had initially presented to a nearby hospital after falling from a 3-m height. Thanks to the key CT images sent from the previous hospital prior to the patient's arrival, angiography was performed within 8 minutes of the patient's arrival and arterial embolization was completed within 25 minutes. Both patients were treated successfully through NOM with angioembolization and preserved kidneys. Hematoma in the first patient and urinoma in the second patient resolved with percutaneous catheter drainage. The authors believe that the hybrid ER system with an in-house IR team could contribute to NOM and kidney preservation even in high-grade renal injuries.

Traumatic Liver Injury in Pediatric Patients (소아 환자에서의 외상성 간 손상)

  • Koo, Byung Han;Park, Joon Beom;Bae, Keum Seok;Kang, Sung Joon
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.242-247
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    • 2009
  • Purpose: Trauma is an important cause of death in children. In particular, the liver is the second most commonly organ injured by blunt abdominal trauma. Treatment of patients with liver injury is has changed, and non-operative treatment is the major treatment method at present. In this study, we reviewed traumatic liver injury in pediatric patients. Methods: Seventy-seven patients younger than 16 years of age with traumatic liver injury were assessed for 10 years from July 1999 to June 2009 at Wonju Christian hospital. Records of the patients were reviewed retrospectively. Demographic and clinical data were analyzed. Results: The median age was 6 years, and the male-to-female ratio was 1.2 : 1. The most common injury grade was grade I. The majority of injuries were caused by was traffic accidents, and the second most common cause of injuries was falls. Twenty-four patients had liver injuries alone, and the most common accopaning injury was a lung injury. The average hospital stay was 20.7 days, and the average ICU stay was 4.8 days. Four patients died (5.2%). There were 6 patients with under 10 points on the Glasgow coma scale (GCS). Among these patients, three died. All mortality cases had over 16 points on the Injury Severity Score (ISS). Two patients were treated surgically, one of whom died. Of the 75 patients with non-operative management, three died due to associated injuries. Conclusion: Most pediatric patients with liver injury have good results with non-operative management. Associated injuries and hemodynamic instability are predictive of patient outcome, and those with isolated liver injuries can be successfully managed non-operatively.

Preoperative Anxiety and Postoperative Pain Related to Donation Spontaneity in Living Donors Undergoing Liver Transplantation (간 공여자의 자발성 여부에 따른 수술 전 불안과 수술 후 통증 비교 연구)

  • Bea, Seng-Sim;Lee, Hyang-Yeon;Lee, Kook-Hyun
    • Journal of East-West Nursing Research
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    • v.15 no.2
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    • pp.82-90
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    • 2009
  • Purpose: The purpose of this study was to compare the degree of preoperative anxiety and postoperative pain among volunteer and non-volunteer donors in living liver transplantation. Methods: The 32 volunteer and 32 non-volunteer donors were recruited from a university hospital after obtaining research approval. The data were analyzed by $x^2$, t, ANOVA tests and Pearson's correlation coefficients using SPSS 12.0 program. Results: There were no significant differences in pre-operative anxiety between the two groups. However, the non-volunteer donors had significantly more severe pain for 3 post-operative days, measured by visual analogue scale (VAS) and non-verbal pain behavior scale (non-VPBS), compared to that of the volunteer donors. There was a significant correlation between preoperative state anxiety and postoperative non-VPBS score. Conclusions: These results showed that liver donors who belonged to the non-volunteer group needed much more active postoperative pain management and psychological support than the volunteer group.

Clinical Analysis of Adhesive Ileus in Children (소아의 유착성 장폐쇄증에 대한 임상적 고찰)

  • Lee, Jong-Jae;Youn, Hyun-Jo;Jeong, Yeoun-Jun;Kim, Jae-Chun
    • Advances in pediatric surgery
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    • v.7 no.2
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    • pp.118-125
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    • 2001
  • The effectiveness of operative and non-operative management for postoperative adhesive ileus in children has been discussed. This study reviews the clinical characteristics and the treatment consequences of adhesive ileus in our institution. Department of Surgery of Chunbuk National University Hospital, retrospectively. A total of 62 cases of post-operative small bowel obstruction treated between January 1975 and December 1998 under the 15 years of age are included in this study. The patients were divided into two groups, operative(n=26) and non-operative(n=36) groups. The prevalent age was between 11 and 15 years(28 cases; 45.2 %), and the most common previous operation was appendectomy(28 cases; 45.2 %). The most common operative procedures were adhesiolysis(17 cases; 65.4 %). The interval between admission and operation was 1 day in 11 cases(42.3 %). The most common site of adhesion was the ileum in 13 cases(50.0 %) and band constriction was the most frequent pattern(8 cases; 30.8 %). Intestinal resection was significantly high in delayed operations of more than four days, in the patients with three or more classical signs of strangulation(fever, tachycardia, leukocytosis, abdominal pain, rebound tenderness), and in the cases of complete obstruction on plain abdomen film(p < 0.05). In conclusion, operation should be considered in cases with three or more signs of strangulation, no clinical improvement for over four days of conservative treatment, and signs of complete obstruction on plain abdomen film during the observation periods.

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Abdominal Drainage in the Prevention and Management of Major Intra-Abdominal Complications after Total Gastrectomy for Gastric Carcinoma

  • Lim, Soo Young;Kang, Ji Hoon;Jung, Mi Ran;Ryu, Seong Yeob;Jeong, Oh
    • Journal of Gastric Cancer
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    • v.20 no.4
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    • pp.376-384
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    • 2020
  • Purpose: The role of prophylactic abdominal drainage in total gastrectomy is not well-established. This study aimed to evaluate the efficacy of abdominal drainage in the prevention and management of major intra-abdominal complications after total gastrectomy for gastric carcinoma. Materials and Methods: We retrospectively reviewed the data of 499 patients who underwent total gastrectomy for gastric carcinoma in a high-volume institution. The patients were divided into drainage and non-drainage groups and compared for the development and management of major intra-abdominal complications, including anastomotic leak, abdominal bleeding, abdominal infection, and pancreatic fistulas. Results: The drainage group included 388 patients and the non-drainage group included 111 patients. The 2 groups showed no significant differences in clinicopathological characteristics or operative procedures, except for more frequent D2 lymphadenectomies in the drainage group. After surgery, the overall morbidity (drainage group vs. non-drainage group: 24.7% vs. 28.8%, P=0.385) and incidence of major intra-abdominal complications (6.4% vs. 6.3%, P=0.959) did not significantly differ between the two groups. The non-drainage group showed no significant increase in the incidence rate of major intra-abdominal complications in the subgroups divided by age, sex, comorbidity, operative approach, body mass index, extent of lymphadenectomy, and pathological stage. Abdominal drainage had no significant impact on early diagnosis, secondary intervention or reoperation, or recovery from major intra-abdominal complications. Conclusions: Prophylactic abdominal drainage showed little demonstrable benefit in the prevention and management of major intra-abdominal complications of total gastrectomy for gastric carcinoma.

Treatment of Rockwood Type III Acromioclavicular Joint Dislocation

  • Kim, Seong-Hun;Koh, Kyoung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.21 no.1
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    • pp.48-55
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    • 2018
  • While non-operative treatment with structured rehabilitation tends to be the strategy of choice in the management of Rockwood type III acromioclavicular joint injury, some advocate surgical treatment to prevent persistent pain, disability, and prominence of the distal clavicle. There is no clear consensus regarding when the surgical treatment should be indicated, and successful clinical outcomes have been reported for non-operative treatment in more than 80% of type III acromioclavicular joint injuries. Furthermore, there is no gold standard procedure for operative treatment of type III acromioclavicular joint injury, and more than 60 different procedures have been used for this purpose in clinical practice. Among these surgical techniques, recently introduced arthroscopic-assisted procedures involving a coracoclavicular suspension device are minimally invasive and have been shown to achieve successful coracoclavicular reconstruction in 80% of patients with failed conservative treatment. Taken together, currently available data indicate that successful treatment can be expected with initial conservative treatment in more than 96% of type III acromioclavicular injuries, whereas minimally invasive surgical treatments can be considered for unstable type IIIB injuries, especially in young and active patients. Further studies are needed to clarify the optimal treatment approach in patients with higher functional needs, especially in high-level athletes.

Game Theory and a Study on Fishery Co-operation System in the Seas Surrounding Korea (게임이론과 한반도를 둘러싼 수산자원의 협력적 관리체계에 관한 연구)

  • Kang, Joon-Suk
    • The Journal of Fisheries Business Administration
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    • v.49 no.3
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    • pp.49-65
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    • 2018
  • The main purpose of this study is to explain fishery relation in the seas surrounding Korea and how the Prisoner's Dilemma (PD), within game theory is applied to the region and suggest possible co-operative approaches in the region. The seas surrounding Korea are very productive fishing grounds with abundant fisheries resources because of the favourable marine environment, including its geographical features and physical oceanography. Nevertheless, Fishery relations among the coastal states in the region have been historically characterized by conflict rather than co-operation. Based on the PD game where there is always an incentive to do better by not co-operating, in order to ensure a share of the short-run benefits, fishing countries in the region have so far pursued the non-co-operative strategy of 'don't fish responsibly' rather than the co-operative strategy of 'fish responsibly'. Considering rapidly deteriorating situations in terms of fishery resources, regional co-operation among coastal states is urgently required to eliminate overfishing and increase fish stocks to sustainable levels. The West Sea/East China Sea and the East Sea, semi-enclosed seas, have unitary ecosystems, and many migratory fish species are shared between coastal states. Therefore, one countries' efforts alone cannot effectively manage and conserve the fishery resources and close co-operation among coastal states is required. The 1982 UN Convention and other international instruments emphasize the role of RFOs in managing and conserving capture fisheries and encourage states to establish Regional Fishery organizations (RFOs) or strengthen existing RFOs to facilitate conservation and management for fish stocks. Therefore, an international regime is worthy of serious consideration in that it provides fundamental advantages for the conservation of fish stocks for the fishery characteristic of the region.

Problem on the Governing Body of National Federation of Fisheries Cooperatives (NFFC) - from the perspective of the Honorary Office of NFFC President - (수산업협동조합중앙회장의 명예직화에서 본 지배구조의 문제점)

  • Jeon, Hyeong-Soo
    • The Journal of Fisheries Business Administration
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    • v.40 no.1
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    • pp.97-112
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    • 2009
  • The amendment of regulation affecting the Governing Body of NFFC (National Federation of Fisheries Cooperatives) has been known to the public in May 2008. Its essential points are as follow: 1) the President of NFFC shall be a non-standing officer. 2) the Full-Time Directors shall have the authority to deal with all subjects except for those especially reserved for the General Meeting or Board of Directors, while minimizing the authority of NFFC President. By providing this amendment, the government seeks to make the Governing body becomes professionalized and the management functions carried out by full-time professional board members. However, the amendment seems to pay no attention to the co-operative's identity and principles. In this context, five issues will be discussed: 1) Strengthening the separation between ownership and control of NFFC. 2) Weakening the authority of General Meeting. 3) The bounds of Audit Committee. 4) Consolidating the management control of the Full-Time Directors. 5) The loss of NFFC's Identity, followed by a summary and conclusion.

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