• Journal of Trauma and Injury
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• v.26 no.3
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• pp.125-130
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• 2013

Purpose: This study was undertaken in order to identify the characteristics of patients diagnosed with occult an hip fracture after hip trauma. Methods: We retrospectively reviewed the medical records and radiology reports of all patients who underwent hip skeletal computed tomography (CT) for suspected hip fractures but had normal initial X-rays after hip trauma between August 2006 and January 2012. The variables evaluated included age, gender, body mass index (BMI), accident mechanism, previous fracture, independence, late presentation, ability to bear weight, pain on passive rotation, tenderness of the groin area, diagnosis and treatment. Patients were divided into two groups, with hip fracture (occult hip fracture group) and without hip fracture (no fracture group) to evaluate the characteristics associated with an occult hip fracture. Results: The patients, a total of 139, had a mean age of 58.3 years and included 72 male patients(51.8%). The occult hip fracture group included 43 patients(30.9%). Of those 43, 21 patients(48.8%) had intertrochanteric or trochanteric fractures, 8 patients(18.6%) had femur neck fractures and 14 patients(32.6%) had acetabular fractures. Of the 43, 15 patients(34.9%) needed operative treatment. Age was higher in the occult hip fracture group than it was in the no fracture group($64.4{\pm}19.1$ years vs. $55.5{\pm}23.6$ years, p=0.021). A previous fracture was associated with the presence of a new fracture (p=0.014; OR=3.971, 95% CI=1.314-11.997). Conclusion: Further evaluation of patients who are older or have history of fractures is prudent, even though the initial X-rays are normal.

• Journal of Korean Neurosurgical Society
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• v.55 no.4
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• pp.195-199
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• 2014

Objective : Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods : We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3--8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results : Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion : Ethical training and developing decision-making skills are necessary including shared decision making.

• Journal of Trauma and Injury
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• v.34 no.3
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• pp.147-154
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• 2021

Purpose: We analyzed the characteristics and outcomes of patients with bicycle-related injuries at a regional trauma center in northern Gyeonggi Province as a first step toward the development of improved prevention measures and treatments. Methods: The records of 239 patients who were injured in different types of bicycle-related accidents and transported to a single regional trauma center between January 2017 and December 2018 were examined. This retrospective single-center study used data from the Korea Trauma Database. Results: In total, 239 patients experienced bicycle-related accidents, most of whom were males (204, 85.4%), and 46.9% of the accidents were on roads for automobiles. Forty patients (16.7%) had an Injury Severity Score (ISS) of 16 or more. There were 125 patients (52.3%) with head/neck/face injuries, 97 patients (40.6%) with injuries to the extremities, 59 patients (24.7%) with chest injuries, and 21 patients (8.8%) with abdominal injuries. Patients who had head/neck/face injuries and an Abbreviated Injury Score (AIS) ≥3 were more likely to experience severe trauma (ISS ≥16). In addition, only 13 of 125 patients (10.4%) with head/neck/face injuries were wearing helmets, and patients with injuries in this region who were not wearing helmets had a 3.9-fold increased odds ratio of severe injury (AIS ≥2). Conclusions: We suggest that comprehensive accident prevention measures, including safety training and expansion of safety facilities, should be implemented at the governmental level, and that helmet wearing should be more strictly enforced to prevent injuries to the head, neck, and face.

• Journal of Trauma and Injury
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• v.32 no.2
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• pp.86-92
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• 2019

Purpose: There is increasing interest in intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) in critically ill patients. This study investigated the effects and outcomes of elevated IAP in a trauma intensive care unit (ICU) population. Methods: Eleven consecutive critically ill patients admitted to the trauma ICU at Pusan National University Hospital Regional Trauma Center were included in this study. IAP was measured every 8-12 hours (intermittently) for 72 hours. IAP was registered as mean and maximal values per day throughout the study period. IAH was defined as $IAP{\geq}12mmHg$. Abdominal compartment syndrome was defined as $IAP{\geq}20mmHg$ plus ${\geq}1$ new organ failure. The main outcome measure was in-hospital mortality. Results: According to maximal and mean IAP values, 10 (90.9%) of the patients developed IAH during the study period. The Sequential Organ Failure Assessment (SOFA) score was significantly higher in patients with $IAP{\geq}20mmHg$ than in those with IAP <20 mmHg (16 vs. 5, p=0.049). The hospital mortality rate was 27.3%. Patients with a maximum $IAP{\geq}20mmHg$ exhibited significantly higher hospital mortality rates (p=0.006). Non-survivors had higher maximum and mean IAP values. Conclusions: Our results suggest that an elevated IAP may be associated with a poor prognosis in critically ill trauma patients.

• Journal of Chest Surgery
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• v.46 no.6
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• pp.444-448
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• 2013

Background: We aimed to investigate the preoperative, operative, and postoperative factors affecting intra-aortic balloon pump (IABP) insertion in patients undergoing isolated on-pump coronary artery bypass grafting (CABG). We also investigated factors affecting morbidity, mortality, and survival in patients with IABP support. Methods: Between January 2002 and December 2009, 1,657 patients underwent isolated CABG in Izmir Katip Celebi University Ataturk Training and Research Hospital. The number of patients requiring support with IABP was 134 (8.1%). Results: In a multivariate logistic regression analysis, prolonged cardiopulmonary bypass time and prolonged operation time were independent predictive factors of IABP insertion. The postoperative mortality rate was 35.8% and 1% in patients with and without IABP support, respectively (p=0.000). Postoperative renal insufficiency, prolonged ventilatory support, and postoperative atrial fibrillation were independent predictive factors of postoperative mortality in patients with IABP support. The mean follow-up time was $38.55{\pm}22.70$ months and $48.78{\pm}25.20$ months in patients with and without IABP support, respectively. The follow-up mortality rate was 3% (n=4) and 5.3% (n=78) in patients with and without IABP support, respectively. Conclusion: The patients with IABP support had a higher postoperative mortality rate and a longer length of intensive care unit and hospital stay. The mid-term survival was good for patients surviving the early postoperative period.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3631-3635
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• 2016

Background: Breast lymphomas constitute a rare disease entity. To date, limited relevant data have been reported. We therefore here present a review of breast lymphoma patients treated at a single center over a 20 year period, focusing on histological types, treatment modalities and outcomes. Materials and Methods: We identified patients who were diagnosed and treated for breast lymphoma at a single center from January 1995 to January 2014 and extracted data regarding patients' demographics and clinical data. Results: Twenty-seven patients with breast lymphoma were identified, of which 3 were males. The median age at diagnosis was 37 years (range: 22-76 years). Chemotherapy was the main stay of treatment and 55.6% patients also received radiation to the affected breast. At our institute, only 3 patients, all with progressive disease, had surgery performed to achieve local palliation. Complete response after chemotherapy was seen in 63% patients and partial response in 7.4%, while 26% patients demonstrated disease progression. The mean follow up was 46.8 months. Seven patients (33.3%) who were alive at last follow up, as well as 1 patient who died, survived more than 5 years after diagnosis. Conclusions: Patients with breast lymphoma should receive aggressive treatment, with combination of chemotherapy and radiation therapy. Surgery should be limited for diagnosis and palliation of local symptoms in cases of progressive disease.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.3993-3996
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• 2014

Background: Diabetes is a chronic disease characterized by impaired fasting blood glucose that leads to disturbances in various organs. In this study, we evaluated relationships between tumor size and grade in a population of diabetic and non-diabetic patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, in our clinic radical nephrectomy performed to 310 patients for renal tumors and pathology reported renal cell carcinoma cases were enrolled in the study. Patients with and without a history of diabetes regarding fasting glucose and HgA1c levels were evaluated during surgery for tumor size and Fuhrman grade. Results: Diabetes was found in 95 patients. The mean age of the patients with and without diabetes mellitus was 64.3 (40-79) and 58.4 (31-87) years, respectively. In the diabetes group 51% of patients had a tumor size over 7 cm and 54% a tumor grade over Fuhrman 3. The respective figures in the non-diabetes group were 35% and 30% (p<0.05 in both cases). Conclusions: Renal cancer appears more aggressive in patients with diabetes. In this study lifestyle and risk factors with diabetes regulation were observed to be important for renal cancer patients. Multicenter studies are needed in larger series for more accurate results.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.3 no.2
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• pp.19-27
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• 2008

Objective : The purpose of this study is to investigate the results of korean traditional conservative therapy for thoraco-lumbar compression fracture and it's recovery rate and different result in accordance with sex, age, medical history. Method : We studied about 35 cases who were admitted to Jaseng Hospital of Oriental Medicine with diagnosis of 'Thoraco lumbar compression fracture' with X-ray examination. Result : Out of 35 patients 31 patients discharged with satisfying results. Most of the compression fracture occurred in age of $60{\sim}70$. And the single fractured patients recovered more easily than the multi-level fractured patients. It didn't affect the results whether the patient had another vertebral disease(such as Herniated intervertebral disc or osteoporosis) or not. And most of the patients who had vertebral compression fracture visited the western medicine hospital first. Conclusions : We analyzed the tendency of the patients who had vertebral compression fracture, and concluded that the conservative Korean traditional therapy is an effective means of treatment for the patients who have thoraco-lumbar compression fracture.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7351-7354
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• 2013

Background: Metabolic syndrome (MetS) is a multifactorial disease characterized by impaired glucose tolerance/diabetes, obesity, high triglyceride levels, low HDL levels, and hypertension. In this study we evaluate the relationship between tumor size and grade, and presence of the metabolic syndrome in patients with renal cell carcinoma. Materials and Methods: Between 2007-2013, radical nephrectomy was performed for 310 patients with renal tumors in our clinic and those with pathology reported renal cell carcinoma were enrolled and divided into two groups, with and without metabolic syndrome diagnosed on the basis of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria. The relationship between tumor size and grade of the two groups (Fuhrman nuclear degree) was evaluated statistically. Results: The metabolic syndrome was found in 70 patients, with a mean age of 65.5 (40-87), as compared to 58.8 (31-84) years in the non-metabolic syndrome group. Tumor size over 7 cm was found in 54% and 33%, respectively, and tumor grade over Fuhrman 3 in 56% and 32% of patients. Patients with metabolic syndrome had significantly higher tumor size and grade (p<0.05). In the presence of hypertension, diabetes and high triglyceride levels, significant assocations were again observed (p<0.05). Tumor size and degree also increased with increasing body mass index but this was not statistically significant (p>0.05). Conclusions: Renal cancer is more aggressive in patients with metabolic syndrome. Lifestyle and risk factors were revealed to be significant influences in renal cancer patients.

• Health Policy and Management
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• v.32 no.3
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• pp.323-329
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• 2022

Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the "referral and return of patients to clinics" program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as "failure to transport," among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the "failure to transport" patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion: The success rate of the "referral and return of patient to clinics" program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.