Patients with pelvic bone fractures with gastrointestinal perforations are reported in 4.4% of the cases and in very rare cases jejunum (0.15) is involved. However, intestinal perforations are often undiagnosed on the first examination before peritonitis is evident. We are presenting a report where a patient with anteroposterior compression injury, who was expected to undergo an internal fixation procedure, did not show any jejunum perforations on abdominal CT or other physical exams but was found on abdominal CT 1 week after right before surgery, therefore excision and anastomosis surgery, pelvic open reduction and internal fixation was simultaneously done with favorable results. In our case, we present a 61 year old male patient with liver trauma, adhesion at the abdominal cavity, with a past history of gallbladder excision, but without abdominal pain, fever, or infection symptoms. Therefore, this was a case that was difficult to initially diagnose the patient with jejunum perforation and peritonitis. The diagnosis was further supported during laparotomy when peritonitis around the area of intestinal perforation was observed. Generally, it is understood that pelvic bone fracture surgery is not immediately done on patients with peritonitis. However, this kind of patient who had peritonitis with intestinal adhesion and other complications could undergo surgery immediately as infection or other related symptoms did not coexist and the patient was rather stable, and as a result the treatment was successful.
Ha, Jong-Kyoung;Yoo, Jae-Doo;Park, Sung-Pil;Shin, Sang-Jin
Clinics in Shoulder and Elbow
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v.9
no.1
/
pp.42-49
/
2006
Purpose: This study evaluated clinical results, and recommended treatment protocol of traumatic anterior shoulder dislocation in the patients older than 60 years of age. Materials and Methods: Thirty-eight patients with first traumatic anterior shoulder dislocation aged over 60 years were included. The average age was 69.4 (range, 60 to 87 years). There were 8 men (average age of 71.6) and 30 women (average age of 69). Most common cause of injuries was a fall on the outstretched hand. The additional injuries were evaluated using MRI or CT arthrogram in the patients with significant pain and weakness while movements after 2 weeks sling immobilization. Results: Fifteen patients (39%) had rotator cuff tears and 5 patients (14%) had greater tuberosity fractures. The sizes of rotator cuff tears were diverse; 2 partial tears, 1 small tear, 4 medium tears, 3 large tears and 5 massive tears. Among 5 massive cuff tears, 3 patients revealed cuff arthropathy after reduction. 4 patients (11%) had recurrent dislocation more than one time during 1 month after the first dislocation. Bankart lesions revealed in 5 patients and three of them had associated rotator cuff tears. 3 out of 5 patients with Bankart lesions, 13 out of 15 patients with rotator cuff tears and 3 patients with displaced greater tuberosity fracture had operations. Conclusion: The injury mechanism of shoulder dislocation in patients older than 60 years of age seems to have either anterior or posterior mechanism. The diagnosis and treatment should be approached 2 weeks after dislocation.
Purpose: The purpose of this study was to describe the intervention model development of health promotion for women workers working in the traditional marketplace, using community capacity building framework. Methods: Need assessment of the target population, work-related environment investigation, social network group building, and setting health management in the marketplace were performed. Then the interventions including cardiovascular health, musculoskeletal health, and psychological health were conducted. The results were evaluated using NCEP-ATP III(National Cholesterol Education Program's Adult Treatment Panel III), OWAS, and CES-D. Results: It was found that the intervention program for the vulnerable group in marketplace was appropriate, promoting the improvement of metabolic syndrome and the reduction of pain complaints. Therefore, the intervention framework for health promotion of women workers in the marketplace was developed. Work-related environment assessment also was included in the framework development. Several community capacity building strategies, including developing community resources and promoting partnership, making small social network group, and promoting program participation. Conclusion: It is suggested that occupational health nurses and professionals consider the appropriateness of intervention framework development after identifying the needs of women workers' work-related environmental problems.
Background: The flexion-relaxation phenomenon (FRP) refers to a sudden onset of activity in the erector spinae muscles that recedes or fades during full forward flexion of the trunk. Lumbar spine and hip flexion are associated with many daily physical activities that also impact trunk flexion. Shorter hamstring muscles result in a reduction of pelvic mobility that eventually culminates in low back pain (LBP). Many studies have explored the FRP in relation to LBP. However, few studies have investigated the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Objects: This study aimed to investigate the influence of hamstring muscle length on the FRP in relation to the erector spinae muscles during trunk flexion. Methods: Thirty subjects were divided into three groups according to hamstring length measured through an active knee extension test. The 30 participants consisted of 10 subjects who had a popliteal angle of 20° or less (Group 1), 10 subjects who had a popliteal angle of 21°-39° (Group 2), and 10 subjects who had a popliteal angle of 40° or more (Group 3). A one-way analysis of variance was used to compare the difference in muscle activity of the erector spinae muscles during trunk flexion. Results: The subjects with a shorter hamstring length had significantly higher muscle activity in their erector spinae muscles during trunk flexion and full trunk flexion (p < 0.05). The subjects with a shorter hamstring length also had a significantly higher flexion-relaxation ratio (p < 0.05). Conclusion: The results of this study demonstrate that differences in hamstring muscle length can influence the FRP in relation to the erector spinae muscles. This finding suggests that the shortening of the hamstring might be associated with LBP.
A 5-year-old, 2.7 kg female maltese dog was presented a local veterinary clinic with one week history of hindlimb lameness associated with patellar luxation. Reduction of bilateral medial patellar luxation was operated using trochlear resection and lateral reinforcement technique. Three weeks after the surgery, the dog showed bending spine with pain in thoracic and lumbar region, continuous ataxia and intermittent convulsion. Magnetic resonance imaging scanning revealed a hyperintense mass in right frontal lobe of brain and abnormal cavitation from cervical cord to third lumbar cord. Histopathologically, neoplasm in brain composed of meningothelial cells showed loosely reticular or lace-like morphology with numerous extracellular cystic spaces of variable size and shape. Neoplastic cells were positive for vimentin and negative for neuron specific enolase and glial fibrillary acidic protein. Irregular shaped enlarge central canal-like cavity was existed in cervical and lumbar cords. In our best knowledge, this report described the clinical findings, imaging and histopathologic characteristics of unusual intracranial microcystic meningioma with secondary syringomyelia in a dog.
Many arthritis patients experience weakness of muscles in extremities mainly due to disuse atrophy and weight gain because of the limited activities and exercises. This study examines the effects of the 6-week aquatic-exercise program on the body fat and the muscle of the rheumatoid arthritis patients. Seventeen patients in the experimental group and 18 in the control group were assigned depending on their preference and physical condition. These patients had more than 3 points of pain out of 10, deformities in knee, wrist and ankle joints. The amount of aquatic exercise increases from 35 minutes in the first week to 60 minutes in the 6th week. In the resting period they discussed their own experiences about exercise, personal and family affairs, and performed some recreation programs in order to increase the self-efficacy and promote the relationship with other patients by the group activities. Skinfold thickness and circumferences of both extremities were measured before and after experiment to compare the difference. For testing the body fat Saham Model was used. Prior to the experiment two group's body weight, skinfold thickness and skin circumferences were not significantly different which indicates the homogeneity of two groups. Body weight and most parts of skinfold thickness of the experimental group were significantly lower than the control group after 6-week aquatic exercise program. Circumference was not significantly lower than the control after the program. These findings indicate the in-crease of muscle sizes and the reduction of the body fat. Therefore a more active application of aquatic exercise into a variety of clients is strongly suggested.
Background: The objective of the present study was to examine the status of patients who had received dental treatment under intravenous (IV) sedation at Chungnam Dental Clinic for the Disabled in Korea from its inception to the present time, and to review the analysis results. Methods: Retrospective analysis was performed on 305 cases of patients who had received dental treatments under IV sedation between January 2011 and May 2016. The analysis examined the patient's sex, age, primary reason for IV sedation, duration of anesthesia and dental treatment, type of dental treatment performed, number of clinical departments involved in the dental treatment and level of multidisciplinary cooperation, and annual trends. Results: Most dental treatments using intravenous sedation were performed on medically disabled patients or dentally disabled patients with an extreme gag reflex or dental phobia. The mean duration of IV sedation was 72.5 min, while the mean duration of treatment was 58.0 min. The types of dental treatments included surgical treatment (n = 209), periodontal treatment (n = 28), prosthodontic treatment (n = 28), restorative treatment (n = 23), implant surgery (n = 22), endodontic treatment (n = 9), reduction of temporomandibular joint dislocation (n = 1), and treatment of traumatic injuries (n = 1), with treatments mostly performed on adult patients. Conclusions: With increasing demand for minimally painful treatment, cases using IV sedation are on an upward trend and are expected to continue to increase.
Background: To evaluate the antimicrobial activity of lidocaine (LD) topical anesthetic spray against oral microflora. Methods: Antimicrobial effects of 10% LD spray were assessed against six bacterial cultures obtained from volunteers: Escherichia coli, Enterococcus faecalis, Staphylococcus aureus, Streptococcus salivarius, Streptococcus pyogenes, and Streptococcus sanguinis. The filter papers contained $50-{\mu}l$ LD, brain heart infusion (BHI) broth, or 0.2% chlorhexidine. Papers were placed on the cultured blood plates for 1-3 min. After the papers were removed, plates were incubated for 24 h. Bacterial growth on the contact areas was recorded as the antimicrobial score. The split mouth technique was use in for sample collection in clinical study. Filter papers soaked with either BHI broth or LD were placed on the right or left buccal mucosa for 1 min, and replaced with other papers to imprint biofilms onto the contact areas. Papers were placed on blood plates, incubated for 24 h, and antimicrobial scores were determined. Experiments were conducted for 2- and 3-min exposure times with a 1-day washout period. Results: LD exhibited bactericidal effects against E. coli, S. sanguinis, and S. salivarius within 1 min but displayed no effect against S. aureus, E. faecalis, and S. pyogenes. The antimicrobial effect of LD on oral microflora depended upon exposure time, similar to the results obtained from the clinical study (P < 0.05). LD showed 60-95% biofilm reduction on buccal mucosa. Conclusions: Antimicrobial activity of 10% LD topical anesthetic spray was increased by exposure time. The 3 min application reduced oral microflora in the buccal mucosa.
Kim, Da-Arm;Oh, Sang-Ha;Seo, Young Joon;Yang, Ho Jik;Jung, Sung Won
Archives of Craniofacial Surgery
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v.13
no.1
/
pp.46-49
/
2012
Purpose: The forehead flap is the workhorse in nasal reconstruction, which provides a similar skin color, texture, structure, and reliability. There are some disadvantages, including donor site morbidities, 2- or 3-stage operations, and postoperative management after initial flap transfer. Furthermore, there has been little attention to the exposed raw surface wound, after the first stage of an operation. This article describes the authors' modification to overcome this problem, using artificial collagen membrane. Methods: An Artificial collagen membrane is composed of an outer silicone membrane and an inner collagen layer. After a forehead flap elevation, the expected raw surface was covered by an artificial collagen membrane with 5-0 nylon suture. A simple dressing, which had been applied to the site, was changed every 2 or 3 days in an outpatient unit. At 3 weeks postprocedure, a second stage operation was performed. Results: With biosynthetic protection of the raw surface, there were no wound problems, such as infection or flap loss. Thus, the patient was satisfied due to an effortless management of the wound and a reduction in pain. Conclusion: The application of an artificial collagen membrane to the raw under-surface of the flap could be a comfortable and a protective choice for this procedure.
Purpose: This Study aims to explore the Wormwood smoke(Ssukjahun) experiences of women and to provide the data to develop Korean traditional nursing intervention for women. Methods: A sample of 15 women aged between 20 to 60 years with Ssukjahun experiences was interviewed and content analysis was used to analyze the data. Results: Six categories and Thirty attributes were derived for Ssukjahun experiences in women. The reason of Ssukjahun is related to illness included vaginitis, insomnia, mental depression, circulation down of hand and feet, repeat abortion, dysmenorrhea, hemorrhoids, disc, rheumatism, and asthma. The place of Ssukjahun was home, oriental hospital and Ssukjahun room. Also method of Ssukjahun included steam methods and burn the wormwood. The time-consuming of Ssukjahun was about 30 minutes. The response and effect in Ssukjahunincluded relax, decreasing rhinitis, weight reduction, feel better, increasing circulation, sleep well, reducing constipation, insomnia, hemorrhoid, back pain, asthma, and dysmenorrhea. The negative effect of Ssukjahun included vesicle, headache, itching sense, generalache, acne, and edema. However, women who did Ssukjahun believed that is the belligerent reaction because it is gone after several times. The preference of Ssukjahun than hospital treatment is related to side effect of medication, temporary method for reducing symptom. Recommends: It is recommended for nurses to understand experience of Ssukjahun in women. If Ssukjahun is to be own nursing intervention, it has to find solutions to encourage positive experiences and overcome negative experiences. Also it recommended research for experience of men.
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