Medicine
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Mental illness has been increasing globally and its global burden of disease has reached a significant level, and urban dwellers have more chances of having worse mental health status due to high population density, isolated social networks. In Korea's medical security system, Medical Aid (MA) program and National Health Insurance (NHI), patients covered by MA pay much smaller out-of-pocket payments for outpatient services because of exempt from hospitalization fees. However, as a result of focusing on improving access to medical services for the urban poor due to lower out-of-pocket payment, their healthcare costs have greatly increased, while their health management has thus far been inadequate. ⋯ However, the rate of hospital emergency room visits by NHI enrollees was higher than that of MA beneficiaries. Overall, community-based interventions are required to prevent and treat mental health by providing primary medical care in the community, and linking with mental health centers. Such policies will ultimately improve the financial sustainability of medical security systems.
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Removal of impacted supernumerary teeth requires precision and accuracy to prevent iatrogenic injury to important anatomical structures during dental surgery and to improve postoperative healing. ⋯ Combining the digital guide plate with planting instruments offers a useful aid for the removal of impacted supernumerary teeth among the maxillary anterior region and is, thus, worth promoting.
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Endoscopic resection is increasingly used to treat patients with pathological T1 (pT1) esophageal squamous cell carcinoma (ESCC) because of its small surgical trauma. However, reports of the risk factors for lymph node metastasis (LNM) have been controversial. Therefore, we aim to build a nomogram to individually predict the risk of LNM in pT1 ESCC patients, to make an optimal balance between surgical trauma and surgical income. ⋯ The decision curve analysis provided the most significant clinical benefit for the entire included population, with scores falling just above the total score of 85 in the nomogram. Smoking, carcinoembryonic antigen, vascular tumor thromboembolus, and tumor differentiation degree may predict the risk of LNM in tumor 1 ESCC. The risk of LNM can be predicted by the nomogram.
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Thumb function is one of the most fundamental components of hand function, and a vast majority of hand functions are derived from thumb motion. Injury of the thumb interphalangeal joint has a tremendous impact on the function of the thumb, and damage to the thumb interphalangeal joint (IPJ) caused by trauma is usually accompanied by dislocation of the surrounding skin; therefore, it is particularly important to restore the thumb anatomy and skin coverage. ⋯ The innovative application of the second toe proximal IPJ flap combined with double-layer artificial dermis covering to reconstruct the thumb IPJ defect not only solves the problem of skin defects in the recipient area after transplantation in previous cases but also restores the beauty of the recipient area, making it easier for patients to accept this surgical program.
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Chondromas are benign tumors comprising cartilaginous tissue that commonly occur in the small bones of the hands and feet. Chondromas are extremely rare in extraskeletal soft tissues, and only six cases of bladder chondromas have been reported thus far. ⋯ Chondromas of the urinary bladder can present as urinary symptoms and abdominal pain in older patients. Transurethral resection is the treatment of choice.