A recurrent shoulder joint dislocation was performed on fourteen cases who were treated by modified Bristow operation from June, 1978 to April, 1981. and following results were obtained. 1. The age of initial dislocation varied from 13 years to 23 years of age with the average of 18. 6 years. 2. The age at operation varied from 20 years to 28 years of age with the average of 23 years. 3. The duration of recurrent dislocaticn varied from 2 years to 8 years with the average of 4.4 years. 4. The times of dislocation varied from 6 to 50 times with the average of 17.1 times. 5. The roentgenograms showed the Hill-Sachs' Iesion in 10cases (71.4%), subluxation in 4 cases (28.6%), and glenoid rim abnormality in 2 cases. 6. The operative findings were Bankart's lesion in II cases(78.6%), glenoid rim erosion in 2 case, and subscapularis laxity in 2 case. 7. The complication and recurrence were not observed in this period. 8. The average limitation of abduction and external rotation were 5. 7 and 12. 2 degree respectively.
Dislocations ; Recurrence ; Shoulder Dislocation ; Shoulder Joint ; Shoulder

Although the incidence of avascular necrosis of the pmximal end of the femur has declined by early diagnosis and gentle dynamic reduction, it is still one of the major complication in treatment of congenital dislocation of the hip. From 65 cases, followed up at least one year after reduction at the Department of Orthopaedic Surgery, Busan National University Hospital from January, 1980 to June, 1984, the authom studied the factom causing avascular necrosis of the femoral head and its radiographic classification. The following results were obtained. 1. Based on Salter's criteria, avascular necrosis of the femoral head was considered in 16 of the 65 hips, a rate of 24.6%. 2. Based on the classification of Bucholz and Ogden, radiographic patterns of avascular necrosis were: type 1, 6(37.5%); type 2,3(18.8%); type 3, 5(31.3%); type 4, 2(12.5%). 3. Generally, the older the child when treatment was initiated, the more likely was avascular necrosis to develop, and the more severe was its damage. 4. The incidences of avascular necrosis in various treatments were: Pavlik harness, 10%; manipulative reduction, 17%; medial approach open reduction 40%; Salters innominate osteotomy only, 36%; femoral osteotomy with pelvic osteotomy, 20%. The high incidence in medial approach open reduction and Salters innominate osteotomy may be due to failure of previous manipulative reduction. 5. The preliminary traction of 14 days or more substantially reduced the incidence of avascular necrosis. 6. There was particularly high incidence of avascular necrosis in cast immobilization of Lorenz position. 7. The correlation between adductor tenotomy and avascular necrosis was not noticed. There was no avascular necrosis in the normal contralateral hip after cast immobilization.
Busan ; Child ; Classification ; Dislocations ; Early Diagnosis ; Femur ; Head ; Hip ; Humans ; Immobilization ; Incidence ; Necrosis ; Osteotomy ; Tenotomy ; Traction

Augmentation cystoplasty is effective in the rehabilitation of the contracted bladder of small capacity caused by tuberculosis or interstitial cystitis refractory to more conservative methods of management. Genitourinary tuberculosis is the most common cause of contracted bladder in Korea and it may lead to considerable vesicoureteral reflux and progressive deterioration of renal function. The use of hemi-Kock ileal pouch with an afferent intussuscepted nipple is a suitable solution in patient in whom the bladder outflow tract provides adequate resistance and supratrigonal cystectomy is to be performed with construction of an antireflux mechanism. Herein, we report 4 cases of hemi-Kock ileocystoplasty.
Cystectomy ; Cystitis, Interstitial ; Humans ; Korea ; Nipples ; Rehabilitation ; Tuberculosis ; Urinary Bladder ; Vesico-Ureteral Reflux

The purpose of this study was to compare the occupational health concerns and opinions among 4 groups: workers, employers and managers, government officials, and health & safety managers. It could help establishing occupational health plans efficiently and providing the way to solve health problems in workplaces in the Inchon area. The delphi technique which is used for deciding group opinion was adopted for this study. Questionnaires regarding health problems and their priorities in the workplaces were sent to four groups three times. All items were measured by five degree ordinal scales. The four groups agreed with questionnaire items, improvement of working environment, occupational health concerns of the employers, the health concerns of workers, and measurement and analysis of working environment, as the upper five priorities for solving the occupational health problems. Besides with the first five priorities, health examinations, health education, and occupational diseases were suggested as important health problems in workplace.
Delphi Technique ; Health Education ; Health Priorities ; Humans ; Incheon* ; Occupational Diseases ; Occupational Groups ; Occupational Health* ; Surveys and Questionnaires ; Weights and Measures

Electromyogpraphic endotracheal tube (EMG tube) is a new device used to monitor recurrent laryngeal nerve integrity during thyroid surgery. The EMG tube has 2 pairs of electrodes on the surface of silicon-based tube reached to inner space of tube cuff. We experienced an unusual endotracheal tube-related problem from the distinct structural feature of the EMG tube. In this case, we intubated a patient who had difficult airway with the EMG tube using a lightwand. After successful endotracheal intubation, we could not expand the pilot balloon and ventilate the patient effectively. We removed the EMG tube and found that one of electrodes of the EMG tube is bended and made a right angle with the long axis of the tube, and perforated the tube cuff. So we report this case to make anesthesia providers aware that much more attention is needed to use EMG tube during endotracheal intubation.
Anesthesia ; Axis, Cervical Vertebra ; Electrodes ; Humans ; Intubation ; Intubation, Intratracheal ; Organothiophosphorus Compounds ; Recurrent Laryngeal Nerve ; Thyroid Gland

Lymphoproliferative disorders are among the most serious and potentially fatal complications of chronic immunosuppression in organ transplant recipients. Post-transplant lymphoproliferative disorder (PTLD) is the second common malignancy occurring in patients with kidney transplantation and has a high mortality rate. The pathogenesis of PTLD in most cases appears to be related to B cell proliferation induced by infection with Epstein-Barr virus (EBV) in the setting of chronic immunosuppression. The PTLD may present a solitary tumor around the hilum of transplant kidney, but it may not by easily considered as the cause of hydronephrosis in transplant kidney because the prevalence of PTLD is low and surgical complications such as lymphocele, stricture and hematoma that obstruct the transplant ureter are much more common. Early detection is important because reduction of immunosuppressive agents may reverse progression of the disease. Furthermore, several effective treatment options were recently introduced. Here we report a case of PTLD presenting with hydronephrosis, which was completely resolved by a multimodality therapeutic approach.
Cell Proliferation ; Constriction, Pathologic ; Hematoma ; Herpesvirus 4, Human ; Humans ; Hydronephrosis* ; Immunosuppression ; Immunosuppressive Agents ; Kidney Transplantation* ; Kidney* ; Lymphocele ; Lymphoproliferative Disorders* ; Mortality ; Prevalence ; Transplants ; Ureter

Emphysematous cystitis is an uncommon condition which is characterized by gas collection within the bladder wall and lumen due to gas forming organisms. Persons with diabetes, neurogenic bladder and chronic urinary infection are predisposed to the disease. We report a case of emphysematous cystitis owing to E. coli in a diabetic woman.
Cystitis* ; Female ; Humans ; Urinary Bladder ; Urinary Bladder, Neurogenic

PURPOSE: This study aimed to compare the clinical outcome of acute poststreptocaccal glomerulonephritis (APSGN) between patients who had presented with gross hematuria and those with microscopic hematuria. METHODS: Thirty-nine patients with acute poststreptococcal glomerulonephritis, who were diagnosed from January 2000 to April 2003 were enrolled. RESULTS: The mean age was 8.85 years and the male to female ratio was 1.1:1. Seventeen patients presented with gross hematuria at diagnosis(group A) and twenty-two patients had microscopic hematuria only(group B). There were no significant differences between the two groups in the incidence of edema, fever or history of respiratory infection and oliguria. But hypertension was more frequent in group B. Laboratory data showed decreased C3 and C4 level in group B. Spot urine protein/creatinine ratio and 24hr urine protein showed higher levels in group A. CONCLUSION: Patients with gross hematuria at diagnosis had lower incidence of hypertension and a higher rate of nephrotic range of proteinuria than patients with microscopic hematuria. However, no difference in the duration of admission or complication rate was observed. All patients had clinical improvement during follow-up. We conclude that gross hematuria is not a significant prognostic factor for poststreptococcal glomerulonephritis.
Diagnosis ; Edema ; Female ; Fever ; Follow-Up Studies ; Glomerulonephritis* ; Hematuria* ; Humans ; Hypertension ; Incidence ; Male ; Oliguria ; Proteinuria ; Streptococcal Infections

PURPOSE: Observational results on seasonal variation of interdialytic weight gain in patients with end-stage renal disease treated with hemodialysis are controversial till now. There has been no report about it for Korean patients. The relation of interdialytic weight gain and climatic factors was studied in one region of Korea. METHODS: From Jan. 2002 to Dec. 2002, fifty patients receiving conventional and regular hemodialysis three times a week in Hanyang University Hospital, Seoul, Korea, where there is distinct seasonal variation in monthly temperature, relatively humidity, and duration of sunshine, were analyzed. For each patient, body weight and blood pressure were measured before and after each dialysis treatment three times per week for one year. The monthly mean values for interdialytic weight gain and blood pressure in relation to the monthly values for climatic factors were then analyzed. RESULTS: The seasonal pattern of interdialytic weight gain was evident throughout the one-year period. The monthly mean temperature was highest in July and lowest in January and mean monthly interdialytic weight gain was lowest in July and highest in December. The difference of mean interdialytic weight gain between July and January was significant (p< 0.05). Interdialytic weight was inversely correlated with monthly mean temperature, mean maximal temperature, and mean minimal temperature(r= -0.721 with p=0.008, r=-0.714 with p=0.009, and r= -0.717 with p=0.009, respectively) but not with mean relatively humidity and duration of sunshine. Mean predialysis systolic and diastolic blood pressure were not related to changes in temperature, relative humidity, and duration of sunshine. CONCLUSION: Interdialytic weight gain in patients with end-stage renal disease treated on hemodialysis was correlated with seasonal variation in temperature, with higher values in the winter and lower values in the summer. It would be better to consider this finding to treat hemodialysis patients.
Blood Pressure ; Body Weight ; Dialysis ; Humans ; Humidity ; Kidney Failure, Chronic ; Korea ; Renal Dialysis* ; Seasons* ; Seoul ; Sunlight ; Weight Gain*

OBJECTIVE: Staphylococcus aureus has persisted and is now resurging as an important hospital and community pathogen. Nosocomial infection caused by methicillin-resistant S.aureus(MRSA) is a major problem which may be connected with heavy or prolonged use of antibiotics S.aureus bacteremia caused acute complications, which occasionally resulted in death, and infectious/suppurative complications, which necessitated prolonged antibiotic therapy, sometimes in conjunction with surgery. Therefore, S.aureus bacteremia is a serious medical problem in association with high morbidity and mortality. METHODS: 130 patients with S.aureus bacteremia who were admitted in the Kyung Hee University Hospital from January, 1991 to December, 1994 were analyzed retrospectively. We compared the clinical and laboratory characteristics, and antibiotics resistances between MRSA and MSSA bacteremia and also we evaluated risk factors that contribute to fatal outcome in patients with S.aureus bacteremia. RESULTS: 1) of 130cases, 80 were male and 50 were female. The mean age was 44.5+/-25.1 years. 2) 84(65%) of S.aureus bacteremia were nosocomial and 46(35%) were community-acpuired. The percentage of MRSA stains studied was 55%(71/130) and The percentage of MRSA bacteremia in hospital-acpuired and community-accquired S. aureus bacteremia were 64% (54/84) and 36%(17/46), respectively. Sources of bacteremia were uncertain in 85(65%) with intravascular catheter(20%) and skin wound sites (8%) being the most common sources in remainder(35%) 3) 110(85%) of 130 patients had one or more underlying diseases. Common underlying dieases were cerebrovascular disease(33%), malignancy(17%), Diabetes mellitus(15%), chronic renal failure(8%) and liver cirrhosis(6%). 4) Acute complications occurred in 35 patients and were fatal in 21 5) The risk factors associated with MRSA bacteremia were various severe underlying diseases, vairous invasive procedures, IV catheter-associated infection, hypoalbuminemia, previous use of antibiotics, male sex and old age. 6) The Case fatality rate for patients with S. aureus bacteremia was 18% and those for patients with MRSA and MSSA bactermia were 20% and 12%, respectively. The risk factors that contribute to the increment of mortality rate in patients with S. aureus bacteremia were acute complication, low serum level of total protein, hypoalbuminemia, various invasive procedures and IV catheter-associated infection, 7) In the antibiotic sensitivity test S. aureus was resistant to penicillin in 98.5%, ofloxacin in 73%, cefotaxime in 67%, erythromycin in 58%, aztreonam in 56%, clindamycin in 52%, vancomycin in 0%. 8) In the multiple antibiotic resistance of S. aureus, 43(68%) of MRSA was resistant to more than 10 antibotics, revealing multiply resistant nature of strains, While all but one MSSA was resistant to 1 to 4 antibiotics, one revealing resistance to 8 antibiotics. CONCLUSION: S. aureus bacteremia is a cause of considerable morbidity and mortality in hospitalized patients who especially, exposed to various risk factors. MRSA revealed higher resistance rate to most antibiotics tested and more marked multiply resistant nature than MSSA. But there was no significant difference in case fatality rate between patients with MRSA and MSSA bacteremia.
Anti-Bacterial Agents ; Aztreonam ; Bacteremia* ; Catheter-Related Infections ; Cefotaxime ; Clindamycin ; Coloring Agents ; Cross Infection ; Drug Resistance, Microbial ; Erythromycin ; Fatal Outcome ; Female ; Humans ; Hypoalbuminemia ; Liver ; Male ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Ofloxacin ; Penicillins ; Retrospective Studies ; Risk Factors ; Skin ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin ; Wounds and Injuries