Yonsei medical journal
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Yonsei medical journal · Sep 2014
The efficacy of endoscopic palliation of obstructive jaundice in hepatocellular carcinoma.
Obstructive jaundice in patients with hepatocellular carcinoma (HCC) is uncommon (0.5-13%). Unlike other causes of obstructive jaundice, the role of endoscopic intervention in obstructive jaundice complicated by HCC has not been clearly defined. The aim of this study was to evaluate the clinical characteristics of obstructive jaundice caused by HCC and predictive factors for successful endoscopic intervention. ⋯ Before endoscopic intervention, liver function, especially total bilirubin level, should be checked to achieve the best clinical outcome. Endoscopic intervention can be helpful to relieve jaundice in well selected patients with HCC.
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Yonsei medical journal · Sep 2014
Risk factors associated with amputation-free survival in patient with diabetic foot ulcers.
To determine the 1-year survival rate, 1-year amputation-free survival rate and the risk factors of amputation for patients with diabetic foot ulcers. ⋯ In assessing the prognosis of diabetic foot ulcers, clinicians should consider the severity of ulcer and presence of peripheral artery disease. Our study provides important insights into clinical practice and supplementary information for both physicians and patients.
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Yonsei medical journal · Sep 2014
Incidence and risk factors of postoperative nausea and vomiting in patients with fentanyl-based intravenous patient-controlled analgesia and single antiemetic prophylaxis.
We evaluated the incidence and risk factors of postoperative nausea and vomiting (PONV) in patients with fentanyl-based intravenous patient-controlled analgesia (IV-PCA) and single antiemetic prophylaxis of 5-hydroxytryptamine type 3 (5 HT₃)-receptor antagonist after the general anesthesia. ⋯ Despite antiemetic prophylaxis with 5 HT₃-receptor antagonist, 23% of patients with fentanyl-based IV-PCA after general anesthesia showed PONV. Long duration of anesthesia and use of desflurane were identified as risk factors, in addition to risk factors of Apfel's score (female, non-smoker, history of motion sickness or PONV). Also, intraoperative remifentanil infusion was risk factor independent of postoperative opioid use. As the incidence of PONV was up to 50% according to the number of risk factors, risk-adapted, multimodal or combination therapy should be applied.
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Yonsei medical journal · Sep 2014
Child-Pugh score is an independent risk factor for immediate bleeding after colonoscopic polypectomy in liver cirrhosis.
Post-polypectomy bleeding is the most common colonoscopic polypectomy complication. However, the risk of post-polypectomy bleeding in liver cirrhosis is unknown. We aimed to evaluate the risk of post-polypectomy bleeding in patients with liver cirrhosis. ⋯ Cirrhotic patients with Child-Pugh class B or C have a high risk of immediate post-polypectomy bleeding. Thus, endoscopists should be cautious about performing colonoscopic polypectomy in patients with Child-Pugh class B or C.
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Yonsei medical journal · Sep 2014
Presence of a nail in the medullary canal; is it enough to prevent femoral neck shortening in trochanteric fracture?
Presence of a cephalomedullary nail (CMN) in the medullary canal has been thought as advantageous in the control of femoral neck shortening (FNS) and lag screw sliding in trochanteric fracture compared to extramedullary fixation system. However, researches on the factors that influence the degree of FNS after cephalomedullary nailing are lacking. ⋯ Presence of a CMN in the medullary canal could not effectively prevent FNS in patients with low COR and in A3 type fracture.