Interlocking medullary nails have been widely used in the treatment of long bone fractures especially in tibia and femur. But with increasing use of nails, many preoperative, intra-operative and post-operative complications have been reported. We have experienced 3 cases of very rare complication, fracture of tibia shaft which occurred during removal of interlocking medullary nail after complete healing of original tibial fracture. We report these rare complications with literature review.
Femur ; Fractures, Bone ; Tibia* ; Tibial Fractures

In orthopedic practice, patients sometimes ask certain kinds of medical documents certifying their disability grading. But many orthopedic surgeons are not accustomed to issue such medical certificates. So we want to review the way of evaluation and grading of disabilities for such different kinds of medical certificates(for examples: disability grading certificate for use in traffic accident, industrial accident, liability of national compensation, private insurance, the handicapped, military service and others) and compare the differences between them.
Accidents, Occupational ; Accidents, Traffic ; Compensation and Redress ; Disability Evaluation ; Disabled Persons ; Humans ; Insurance ; Military Personnel ; Orthopedics*

PURPOSE: In the last three decades liver transplantation (LT) has been established as a standard procedure for end-stage liver disease. However, the shortage of donor livers is the most significant factor inhibiting further application of clinical liver transplantation. In Korea, where B-hepatitis is endemic, most patients waiting for LT are adult with B-hepatitis associated end stage liver disease. Safe, in situ splitting of a cadaver donor liver for two separate adult recipients would be an attractive way to decrease the deaths of adult patients while waiting for organs. Split grafts weighing more than 1% of the recipient's body weight (Graft to Recipient Weight Ratio, GRWR>1%) should be transplanted in order to adequately meet postoperative metabolic needs. We investigated whether one cadaver liver can be split into two so that each graft has a GRWR>1%. METHODS: Between January 1999 and December 1999 at Guro medical center, we selected 47 patients diagnosed as early gastric cancer (EGC) or early stage colon cancer and reviewed their pre-operative abdominal CT films for use in our study. Pictures of CT films were taken with a digital camera and converted to TIF files in order to calculate the standard liver volumes which were then divided by the plane that represented two operative methods proposed in this study. First, we performed a Rt. lobectomy along the right side of the middle hepatic vein to increase the function of segment IV by preventing venous congestion. Second, we performed a Lt. lobectomy with hepatic IVC to save the volume of the caudate lobe (segment I). RESULTS: The body index of the 47 cases was distributed from -10% to 20%. The standard whole liver volume was 1266+/-299 ml (Mean+/-SD). Rt. lobe volume was 751+/-188 ml, and Lt. lobe volume was 515+/-154 ml. Each result was no less than 1% of 75 kg and 50 kg adult's body weight. CONCLUSION: On average, the GRWR of the Rt. lobe is more than 1% in a 75 kg adult by itself and that of the Lt. lobe can also be above 1% in a 50 kg adult by maximizing the function of segments I and IV using the surgical techniques mentioned above. Therefore, we would be able to successfully spilt a cadaver donor liver to a 75 kg and a 50 kg adult recipient, respectively.
Adult* ; Body Weight ; Cadaver ; Colonic Neoplasms ; End Stage Liver Disease ; Hepatic Veins ; Humans ; Hyperemia ; Korea ; Liver Diseases ; Liver Transplantation* ; Liver* ; Stomach Neoplasms ; Tissue Donors ; Tomography, X-Ray Computed ; Transplants

PURPOSE: The purpose of this study is to examine the clinical nurses' resilience, occupational stress, and occupational satisfaction and to identify the correlations among them. METHODS: Structured questionnaires were administered with total 75 questions for 433 nurses working at a university hospital in Jin-ju from July 19 to 30, 2010. Data from the completed questionnaires were analyzed with the SPSS/WIN program. RESULTS: The resilience had a significant difference according to the age, marital status, religion, education level, annual income, motive of choosing the nursing science, clinical career, position, and workplace. Resilience had a negative correlation with occupational stress (r=-.405), and had a positive correlation with occupational satisfaction (r=.380). Occupational stress had a negative correlation with occupational satisfaction (r=-.637). CONCLUSION: The higher their resilience was, the lower their occupational stress and the higher the occupational satisfaction. It is recommended that intervention program be developed that can enhance personal resilience in nurse.
Humans ; Marital Status ; Surveys and Questionnaires

Objectives: : This study aimed to characteristic the systolic blood pressure (SBP), diastolic pressure, pulse pressure, glucose, creatine, and lipid profile. This study also aimed to investigate the prevalence of hypertension and the relationship between hypertension and the lipid profile in Uzbekistan. Methods: The subjects consisted of 58 Uzbekistan subjects recruited from Ewha Medical Care patients. Blood samples were collected from the patients for the lipid profile and random glucose and creatinine levels. Paired t tests were used for the group means and a chi-square or Fisher’s exact test for categorical variables. A multiple logistic regression analysis was performed. Results: Among the 58 patients constituting the baseline population, hypertension developed in 42 patients. Among them, the triglyceride (TG) level was significantly higher in the hypertension group than normal group (173.19 vs. 127.06 mg/dL, P=0.014). The SBP had a positive correlation with the TG (r=0.979, P<0.01) and creatinine (r=0.002, P<0.05) levels and also, the pulse pressure had a positive correlation with the cholesterol level (r=0.539, P<0.05). A multivariate analysis (adjusted for age and sex) indicated that there was a positive correlation between the SBP and TG level (r=0.941, P<0.05). Conclusion There was a positive correlation between the SBP and TG level in the Uzbekistan population according to this study.

Objectives: : This study aimed to characteristic the systolic blood pressure (SBP), diastolic pressure, pulse pressure, glucose, creatine, and lipid profile. This study also aimed to investigate the prevalence of hypertension and the relationship between hypertension and the lipid profile in Uzbekistan. Methods: The subjects consisted of 58 Uzbekistan subjects recruited from Ewha Medical Care patients. Blood samples were collected from the patients for the lipid profile and random glucose and creatinine levels. Paired t tests were used for the group means and a chi-square or Fisher’s exact test for categorical variables. A multiple logistic regression analysis was performed. Results: Among the 58 patients constituting the baseline population, hypertension developed in 42 patients. Among them, the triglyceride (TG) level was significantly higher in the hypertension group than normal group (173.19 vs. 127.06 mg/dL, P=0.014). The SBP had a positive correlation with the TG (r=0.979, P<0.01) and creatinine (r=0.002, P<0.05) levels and also, the pulse pressure had a positive correlation with the cholesterol level (r=0.539, P<0.05). A multivariate analysis (adjusted for age and sex) indicated that there was a positive correlation between the SBP and TG level (r=0.941, P<0.05). Conclusion There was a positive correlation between the SBP and TG level in the Uzbekistan population according to this study.

BACKGROUND: High blood pressure is prevalent in obesity and diabetes, especially noninsulin dependent diabetes mellitus, and both conditions are insulin resistant state. METHOD: To test whether resistance to insulin-stimulated glucose uptake and hyperinsulinemia are involved in the pochogenesis of hypertension, author measured glucose, insulin and C-Peptide reponse after oral glucose loading in 52 cases of essential hypertension and 62 cases of normal controls who had been admitted to the ward of internal medicine, Pusan National University Hospita. RESULTS: Basal plasma glucose, insulin and C-Peptide levels in control subjects were 92.1+/-36.8mg/dl, 8.7+/-5.5microu/ml and 2.2+/-1.8ng/ml and in hypertensive subjects were 95.7+/-32.6mg/dl, 12.2+/-5.3microu/ml and 2.9+/-1.6ng/ml. The basal insulin level was markedly higher than tat of control subjets (p<0.05). The basal glucose and C-Peptide levels in hypertensive patioents were higher than controls but statistically not significant. Plasma glucose levels in time course after glucose load in hypertensive patients showed significantly higher levels in 60,90minutes than controls. Plasma insulin levels in hypertensives in 90 minutes were significantly higher. The C-Peptide levels in hypertensives showed significantly higher in each times 30,60,90,120 minutes than controls. In hypertensive patients, body weight, blood pressure levels and duration of hypertension were not significantly correlated with responses of glucose, insalin and c-peptioce. Hypertensive patients aboce the age of 50 showed significantly higher glucose levels in 60,90,120 minutes than under age of 50. CONCLUSION: These results indicate some tendency of disturbed glucose turnover or insulin-resistant state in essential hypertension. This metabolic disturbance in essential hypertension should be considered in the management of hypertensive patients.
Blood Glucose* ; Blood Pressure ; Body Weight ; Busan ; C-Peptide* ; Diabetes Mellitus ; Glucose ; Humans ; Hyperinsulinism ; Hypertension* ; Insulin Resistance ; Insulin* ; Internal Medicine ; Obesity ; Plasma*

B13, a ceramide analogue, is a ceramidase inhibitor and induces apoptosis to give potent anticancer activity. A series of thiourea B13 analogues was evaluated for their in vitro cytotoxic activities against human renal cancer Caki-2 and leukemic cancer HL-60 in the MTT assay. Some compounds (12, 15, and 16) showed stronger cytotoxicity than B13 and C6-ceramide against both tumor cell lines, and compound (12) gave the most potent activity with IC50 values of 36 and 9 microM, respectively. Molecular modeling of thiourea B13 analogues was carried out by comparative molecular field analysis (CoMFA) and comparative molecular similarity indices analysis (CoMSIA). We obtained highly reliable and predictive CoMSIA models with cross-validated q2 values of 0.707 and 0.753 and CoMSIA contour maps to show the structural requirements for potent activity. These data suggest that the amide group of B13 could be replaced by thiourea, that the stereochemistry of 1,3-propandiol may not be essential for activity and that long alkyl chains increase cytotoxicity.
Apoptosis ; Cell Line, Tumor ; Ceramidases ; Ceramides ; HL-60 Cells ; Humans ; Inhibitory Concentration 50 ; Kidney Neoplasms ; Models, Molecular ; Structure-Activity Relationship ; Thiourea