원위 경비 인대 결합 손상은 외측 족관절 염좌보다 복귀하기 위해 두 배 이상의 시간이 들 정도로 치료가 어려우며, 종종 간과되며 놓치기 쉬운 손상이다. 늦은 진단으로 인한 만성 손상은 완치가 힘들 뿐더러 돌이킬 수 없는 결과를 나타내기 때문에, 원위 경비 인대 결합손상에 대한 치료의 핵심은 정확한 조기 진단과 초기치료를 통해 적절한 안정성을 획득하여 부작용이나 만성으로 변화 과정을 최소화는 것이다. 모든 급성 불안정 원위 경비 인대 결합 손상(2, 3단계)은 수술적 처치를 요하며 급성 손상에서의 적절한 치료는 만성 손상에 의한 부작용을 피할 수 있는 최고의 방법이다.

Esophagojejunostomy after total gastrectomy shows high mortality and morbidity. Complication after esophagojejunostomy was caused by constant tension on esophagojejunostomy in erect-position, resulting in disturbance of blood flow in the anastomotic site. The purpose is to evaluate efficacy of anchoring sutures. Medical charts of patients diagnosed with gastric cancer who underwent total gastrectomy from 1998 to 2008 were analyzed retrospectively. Anchoring suture between jejunum and diaphragm after esphagojejunostomy was performed in all patients. A total of 155 patients were enrolled. Esophagojejunostomy leakage 3, revision operation 2, and conservation 1. Esophagojejunostomy stenosis 1, which was improved by balloon. This procedure could protect the esophagojejunostomy site from traction force.

The purpose of this study was to develop guidelines to improve the health of an elderly population classified into unilateral and bilateral hip fracture groups based on the mortality and risk factors affecting survival time. In the bilateral fracture group, the incidence of fracture was 3.1%, whereas mortality was 35%, average age was 83.9, and the male to female ratio was 3:17. In patients older than 75 years of age with a unilateral fracture, close ambulatory follow up is needed to avoid bilateral fracture and protect against secondary fracture within 3 years.

This study was conducted in order to determine the relationship between thinking styles and stress of clinical practice among nursing students. Data were collected from 151 nursing students through self-report questionnaires, and analyzed by descriptive statistics, t-test, ANOVA, Scheffe’s Test, and Pearson's correlation using SPSS18.0. The thinking styles were relatively high in ‘hierarchic’ style and ‘clinical practice environment’ was the highest in stress of clinical practice. Relationship between thinking styles and stress of clinical practice showed correlation in the sub-scales. ‘External’ style differed significantly according to ‘undesirable role model’, ‘interpersonal conflict’, and ‘conflict with patient’. ‘Internal’ style was negative significantly different according to ‘interpersonal conflict’. In conclusion, development of nursing intervention for stress of clinical practice which considers thinking styles is needed.

We evaluated the surgical results of vitrectomy for macular hole, according to the type of gas. Retrospective analysis was performed on the clinical data of 45 patients who underwent macular hole surgery without any complication influencing visual acuity who were included in this study. They were divided into two groups according to the type of gas: Group 1 - SF6, Group 2 - C3F8. We compared the anatomical results of these groups. This study shows that the type of gas does not significantly influence surgical results. However, large sized macular holes lead to poor post-operative visual acuity.

We report on the case of a 59-year-old man who presented with continuous chest discomfort. The patient's initial electrocardiogram (ECG) showed normal sinus rhythm. Coronary angiography showed significant stenosis in the proximal left anterior descending coronary artery (LAD), the distal left circumflex coronary artery (LCX). Therefore, we deployed a stent in the proximal LAD and the distal LCX. Two days after percutaneous coronary intervention (PCI), he complained of atypical chest pain. His ECG showed ST segment elevation in leads V1 to V3. In emergent coronary angiography, there was no stent thrombosis. ECG findings showed that the ST segment has a "saddle back" ST-T wave configuration in which the elevated ST segment descends toward the baseline, then rises again to an upright T wave, like the Brugada ECG pattern. This case report shows how dynamic ST segment elevations may look similar in cases of stent thrombosis after PCI.

May-Thurner syndrome is associated with deep vein thrombosis resulting from chronic compression of the iliac vein against the lumbar vertebrae caused by the overlying common iliac artery. Stent insertion into the compressed lesion is used in treatment of May-Thurner syndrome. Various complications can occur during angioplasty while using a stent. Among these complications, shrinkage of the vein below the stent, a rare complication, was observed in our hospital during treatment of a patient with May-Thurner syndrome. Different complications can occur when venous angioplasty is performed, unlike that when arterial angioplasty is performed.

Prevalence of the coronary artery anomaly is approximately 1% of the population who undergo coronary angiography. The anomalous origin of the right coronary artery (RCA) as a branch of the left anterior descending artery (LAD) is a very rare variation of single coronary artery. The anatomic variation has no clinical significance. However, some patterns of congenital coronary artery anomalies can cause clinical manifestations of myocardial ischemia, reducing myocardial perfusion. We report on a case of a 78-year-old man who had anomalous RCA arising from the proximal part of the LAD, which probably caused chest pain.

Spontaneous intracranial hypotension (SIH) causes headache in the absence of tissue injury such as trauma, spinal cord injury, surgery, or epidural anesthesia. Epidural blood patch in the epidural space where CSF leakage occurs is effective for treatment of SIH. However, when the leakage site is unknown, administration of autologous blood into the lumbar epidural space could be effective. Here we report on patients who suffered from headache by SIH and could not confirm the leakage site, however, treatment by lumbar epidural blood patch was administered successfully.

Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third leading cause of cancer-related deaths worldwide. The radiologic findings of liver abscess, HCC, and metastatic tumor to the liver may be quite similar, and a specific diagnosis cannot be made using procedures such as serum tumor marker assay, computerized tomography, and ultrasonography of the liver. We report on a case of HCC successfully diagnosed and treated by surgery which was misconceived as a liver abscess.

Gastrointestinal tuberculosis is a commonly presenting ileocecal disease. Appendiceal tuberculosis results from secondary to either ileocecal tuberculosis, or tuberculosis at other sites of the abdomen. "Isolated" form of tuberculosis affecting appendix only, without evidence of disease elsewhere, is very rare. We report on two cases of isolated appendiceal tuberculosis initially presenting as acute appendicitis. Each case was proven as tuberculosis by acid fast bacilli or caseous necrosis in pathology. Colonoscopy and abdominal computed tomography showed neither intestinal nor intra-abdominal disease.

May-Thurner syndrome is caused by blockade of local venous flow due to local vascular intimal proliferation, caused by repeated pulsatile compression of the iliac or iliofemoral vein between the iliac artery and the lumbar spine. In this case, we confirmed May-Thurner syndrome using lower extremity computed tomographic angiography and venography. However, on venography, it was impossible to distinguish the left iliac vein from the collateral vein; a thrombus was also seen, although some of the thrombus was not seen clearly. These problems were overcome with use of intravascular ultrasound. We report on intravascular ultrasound guided treatment of May-Thurner syndrome.

Lymphangioma is a malformation of the lymphatic system, which can involve any part of the body. However, lymphangioma in the gastrointestinal tract is uncommon. Large intestine is the least commonly involved site. The authors encountered a case of lymphangioma mimicking neoplastic polyp located in the rectum of a 65-year-old woman on screening colonoscopy. The surface mucosa showed dark red. The vascular pattern was difficult to define on narrow-band imaging. This polyp was reckoned as a neoplastic polyp and endoscopic mucosal resection was performed. Histologic examination revealed lymphangioma accompanying pressure induced necrosis. This case indicates the possibility of misdiagnosis due to pressure necrosis of mucosa.