Distal radioulnar is a part which has a rotational movement through the function of distal radioulnar joint and extensor carpi ulnaris. The injury mechanism in this area is usually a trauma largely due to traffic accidents. In general these injuries to the distal radioulnar joint are treated by a closed reduction. However, the isolated distal ulnar fracture without radial fracture, which is often called the night stick fracture, is difficult to treat by a closed reduction and a cast immobilization alone, especially if there is a displacement or fracture segment impinging soft tissue or severe comminution. Nonunion has been the frequent outcome with this method of treatment and limitation of rotation of forearm and distal radioulnar joint have occurred due to long period of immobilization or malunion. Thus, a different treatment modality such as open reduction and internal fixation and early active joint motion has arisen as a better treatment modality. In this study, 8 cases of isolated distal ulnar fracture without radial fracture have recieved the operation and the early active joint movement, if a displacement was present either at the time of injury or after the initial closed reduction. As a result, this method has enabled the patients to reduce the rate of complication of nonunion and to recover limitation of joint motion in a shorter time period.
Accidents, Traffic ; Forearm ; Humans ; Immobilization ; Joints

Multiple Choice Question(MCQ) method of examination has long been used as the national medical licensing examination in Korea. If properly used, the MCQ method of examination has considerable value fo r evaluation, and in fact, it has become popular due to its economy of scale, ease of marking and consistency. Moreover, with this method of examination, a large number of candidates can be tested at once and the marking can even be read by automatic readers. However, MCQ does not lend itself so well to problem-solving, which is a far more real-life situation than having to choose between a number of pre-formed alternatives. This, again, however, can be much improved by increasing the proportion of question items associated with interpretation and problem solving level of cognitive domain, and adopting various types of MCQ. This study was planned to examine the proportions of question items by their levels of cognitive domains and the types MCQ together with the contents of medical knowledge of the Korean National Medical Licensing Examinations (NMLE) conducted in 1992 and 1993. All 880 question items (440 question items in each year) were reviewed one by one by three medical education specialists and the levels of cognitive domains, types of MCQ and contents of questions were judged by test subjects. Major findings obtained from the study are as follows: 1) In both years of 1992 and 1993, recall level question items formed 68.0% of all MCQ question items of NMLE. Problem-solving level question items were only 77.% in 1992 and 11.1% in 1993. 2) Major types of MCQ were 'best answer type' one correct answer type'. They were 40.7% and 30.9% of all respectively in 1992, and 35.0% and 32.0% respectively in 1993. Some subjects such as urology and internal medicine were adopting more 'combined response type' MCQ than other subjects. 3) Knowledge contents asked in the NMLE varied very much from subject to subject. However, the names of diseases were the most prevalent answers asked and they were 21.6% in 1992 and 18.2% in 1993. This study suggests that the Korean NMLE should increase the proportion of question items measuring the interpretation and/or problem-solving level of knowledge, and adopt several different types of MCQ.
Education, Medical ; Internal Medicine ; Korea ; Licensure* ; Problem Solving ; Specialization ; Urology

The question of infectivity and prevalence of Clonorchis sinensis in Cheju province (Quelpart Island) was arisen to authors since the several surveys on the endemic diseases were performed in this island. Therefore, authors decided to solute this question. Then the survey on the possible second intermediate host of Clonorchis sinensis was performed and reported already with negative finding. At present time, authors carried out the collection of all kinds of fresh-water snails through all areas of this island, to confirm the presence or not of Parafossarulus manchouricus, the only first intermediate host of Clonorchis sinensis in Korea . And the following results were obtained. The fresh-water snails collected in the survey were Semisulcospira libertina Gould and Lymnaea ollula Gould. Parafossarulus manchouricus Bourguigant was not collected in this island. It is confirmed that the Clonorchis sinensis can not be prevalent in this island.
parasitology-helminth-trematoda-Clonorchis sinensis ; life cycle ; epidemology ; Parafossarulus manchouricus ; Semisulcospira libertina Gould ; Lymnaea ollula Gould

The written examination that is being used as the only tool to assess the learning ability of the students in Korea tests the degree to which each student has mastered the learning objectives. Idealy, the examination should test the students' in three major categories of objectives ; cognitive, motor-skills and affective area, and include various types of question items. In reality, however, the tests are very much simplified both in objective categories and types of question items simply because of the carelessness and conveniences of teachers. This study analyzes the pattern of objective categories, types of question items, and the number of question items of a mid-term examination of one medical school in Seoul. Fifty junior faculties from 50 departments and teaching units were asked to assess the question items of their own departmental examination after a guideline had been given by the authors. Major findings as obtained from the study are as follows ; 1. More than half (56.4%) of the test items were related to the cognitive area and only 10.8% of all the test items were related to motor-skills. Test items of pre-med courses were much more ideal than those of other medical and nursing courses in distribution of objective categories. Only 4.7% of the items of clinical medical courses were for evaluation of motor-skills. 2. In types of question items, 57.1% were essay type and the rest 43.9% were selection type. Test items of clinical medical courses were adopting the most ideal pattern in types of test items by having more than 4 different types of question items. 3. Average number of question items per teaching subject was 27.3 (range : 6-71). Some departments and teaching units were giving students too many test items in a given time period (50 minutes). In conclusion, written examination in a medical college varies in testing students' learning objectives, and types and number of test items by departments and teaching units. It is supported that before making test items, consideration on learning objective categories, types of question items and the number of question items in very much needed.
Humans ; Korea ; Learning* ; Nursing ; Schools, Medical ; Seoul*

No abstract available.
Thorax* ; Ventilators, Mechanical*

Rotor syndrome is a rare disease of hereditary hyperbilirubinemia transmitted with autosomal recessive trait. In general, Rotor syndrome shows direct hyperbilirubinemia and there has been several reports since Sons's report in 1966, in Korea. A 34-year-old female was admitted with the chief complaint of intermittent icteric sclera for 24 years. There was no family history of jaundice. Rotor syndrome was diagnosed by oral cholecystogram, BSP retention test, 99mTc-DISIDA scan, liver biopsy and electron microscopy study of liver biopsy specimen. We report this case with brief review of the literature.
Adult ; Biopsy ; Female ; Humans ; Hyperbilirubinemia ; Hyperbilirubinemia, Hereditary* ; Jaundice ; Korea ; Liver ; Microscopy, Electron ; Rare Diseases ; Sclera ; Technetium Tc 99m Disofenin

The effects and interactions of pancuronium and vecuronium with diltiazem on the electri- cally-evoked twitch response, train-of-four and tetanic stimulation were studied in the isolated rat hemi-diaphragm preparation. Pancuronium(3 X 10(-7) -10(-5) M) and vecuronium(3 X 10(-6)-15 X 10(-6) M) decreased the electrically evoked(nerve stimulation, 0.1Hz, 0.5ms, 10V) twitch response, train-of-four and tetanus ratio in a dose-related fashion and pancuronium was more potent than vecuronium. The inhibitory effects of pancuronium and vecuronium were potentiated by pretreatment with 5 & 10 uM diltiazem, a Ca++-channel blocker, in which the concentration of diltiazem has no obvious effects on the twitch response itself. Furthermore, it is noteworth that the inhibitory effects of pancuronium and vecuronium were markedly potentiated by 150 uM hemicholinium pretreatment. In cases of the direct(muscle, 0.1 Hz, 5 ms, 10 V) stimulation, pancuronium and vecuronium decreased the electrically evoked twitch response dose dependently, but the amplitudes of inhibition were less than those in indirect(nerve) stimulation. The inhibitory effects were not affected by diltiazem pretreatment except low doses of vecuronium. On the basis of these findings, the result of the present study suggests that the muscle relaxation by pancuronium and vecuronium is mediated by pre- and post-junctional receptor blockade, and that diltiazem intensifies neuromuscular blockade produced by muscle relaxants. The potentiating effect of diltiazem may be due to blocking influx of calcium and/or release of acetylcholine from presynaptic nerve terminals.
Acetylcholine ; Animals ; Calcium ; Diltiazem* ; Hemicholinium 3 ; Muscle Relaxation ; Neuromuscular Blockade* ; Pancuronium* ; Rats ; Tetanus ; Vecuronium Bromide*

The effects and interactions of pancuronium and vecuronium with diltiazem on the electri- cally-evoked twitch response, train-of-four and tetanic stimulation were studied in the isolated rat hemi-diaphragm preparation. Pancuronium(3 X 10(-7) -10(-5) M) and vecuronium(3 X 10(-6)-15 X 10(-6) M) decreased the electrically evoked(nerve stimulation, 0.1Hz, 0.5ms, 10V) twitch response, train-of-four and tetanus ratio in a dose-related fashion and pancuronium was more potent than vecuronium. The inhibitory effects of pancuronium and vecuronium were potentiated by pretreatment with 5 & 10 uM diltiazem, a Ca++-channel blocker, in which the concentration of diltiazem has no obvious effects on the twitch response itself. Furthermore, it is noteworth that the inhibitory effects of pancuronium and vecuronium were markedly potentiated by 150 uM hemicholinium pretreatment. In cases of the direct(muscle, 0.1 Hz, 5 ms, 10 V) stimulation, pancuronium and vecuronium decreased the electrically evoked twitch response dose dependently, but the amplitudes of inhibition were less than those in indirect(nerve) stimulation. The inhibitory effects were not affected by diltiazem pretreatment except low doses of vecuronium. On the basis of these findings, the result of the present study suggests that the muscle relaxation by pancuronium and vecuronium is mediated by pre- and post-junctional receptor blockade, and that diltiazem intensifies neuromuscular blockade produced by muscle relaxants. The potentiating effect of diltiazem may be due to blocking influx of calcium and/or release of acetylcholine from presynaptic nerve terminals.
Acetylcholine ; Animals ; Calcium ; Diltiazem* ; Hemicholinium 3 ; Muscle Relaxation ; Neuromuscular Blockade* ; Pancuronium* ; Rats ; Tetanus ; Vecuronium Bromide*

The effects and interactions of metabolic and respiratory acid-base changes on electrically-evoked twitch response, train-of-four and tetanic stimulation with pipecuronium (Pip), vecuronium (Vec) and atracurium (Tra) were studied in the isolated rat hemi-diaphragm preparation. pip (3X10(-7) - 4X10(-6) M), Vec (3X10(-6) - 15X10(-6) M) and Tra (10(-6) - 3X10(-5) M) decreased the electrically-evoked (phrenic nerve stimulation, 0.1 Hz, 0.2 ms, 10 V) twitch response in a dose related fashion and Pip was more potent than Vec and Tra. In the alkali state (pH 7.6 or high HCO3 ), the decrements of twitch response, train-of-four and tetanus ratio induced by Pip (1.5uM) were potentiated, but the effects of Vec or Tra were markedly intensified by acid midium (pH 7.2 or low HCO3 ). And also, decreasing pH by increasing PCO2 or by decreasing HCO3 intensified the effects of Vec and Tra, whereas it reversed by Pip. Conversely, increasing pH by decreasing PCO2 or by increasing HCO3 antagonized the effects of Vec and Tra, whereas it potentiated the Pip effect. On the basis of these finding, the result of the present study suggest that neither PCO2 nor HCO3 has a specific action, but that changes in pH may be responsible for the results. In addition, the differences of the above results by each drugs may not be due to the number of quaternary ammonium of the agents. And also, indicate that the effective site of the influence of the acid-base change upon the neuromuscular blocking effects might be prejunctional nerve terminal.
Alkalies ; Ammonium Compounds ; Animals ; Atracurium ; Hydrogen-Ion Concentration ; Neuromuscular Blockade ; Pipecuronium ; Rats* ; Tetanus ; Vecuronium Bromide

The effects of diltiazem and verapamil on the electrically-evoked twitch response, train-of- four and tetanic stimulation were studied in the isolated rat hemidiaphragm preparation. Diltiazem(3-150 pM) and verapamil(3-100 pM) increased the electrically-evoked(nerve stimulation, 0.1 Hz, 0.5 ms, 10 V) twitch responses in a dose-related fashion and diltiazem was more potent than verapamil. But, the large doses of diltiazem(150-300 uM) and verapamil(100-300 uM) decreased the twich responses. And the effects of diltiazem and verapamil were not effected by reducing the extracellular calcium from 2.5 to 1.25 mM. Diltiazem and verapamil decreased the train-of-four and tetanus ratio as well as the d-tubocurarine in a dose-related fashion. d-Tubocurarine, a specific nicotinic antagonist, decreased twitch response, and the potentiating twitch response of diltiazem was significantly inhibited by pretreatment of d-tubocura- rine. Furthermore, it is noteworth that the inhibitory effects of d-tubocurararine were markedly potentiated by diltiazem. In cases of the direct(muscle, 0.1 Hz, 5 ms, 10 V) stimulation, diltiazem and verapamil decreaaed the electrically-evoked twitch response with dose dependently. These results indicate that diltiazem and verapamil elicited two distinctive types of twitch response in the rat phrenic-hemidiaphragm preparation. The potentiating effect of twitch response is mediated by the acetylcholine release from the prejunctional nerve terminal and the inhibiting effect may be due to blcking influx of calcium and/or release of acetylcholine from presynaptic nerve terminals.
Acetylcholine ; Animals ; Calcium ; Diltiazem* ; Rats* ; Tetanus ; Tubocurarine ; Verapamil*