Shoulder dislocation is the most common dislocation presenting to the emergency department. In old age, the attempt of closed reduction is made with caution in order to prevent iatrogenic fracture around the shoulder. We report two cases of iatrogenic fractures of humeral shaft and anatomical neck in female patients older than 70 years old, which occurred during the manual closed reduction. One patient was proved as first-time and the other was recurrent. In addition, the second case had a massive irreparable rotator cuff tear. Those patients were treated successfully with humeral nailing and reverse total shoulder arthroplasty, respectively.
Arthroplasty ; Dislocations ; Emergency Service, Hospital ; Female ; Fracture Fixation, Intramedullary ; Humans ; Humeral Fractures* ; Neck ; Rotator Cuff ; Shoulder Dislocation* ; Shoulder* ; Tears

PURPOSE: To establish a database of the anthropometric measurements of soft-tissue orbits in Korean newborns. METHODS: A total of 69 normal term newborns (39 males, 30 females) in the first 48 hours after delivery, were included in the present study. Anthropometric measurements of soft-tissue orbits were taken with vernier calipers by one of the authors. With eyes closed, horizontal eyelid fissure length (HFL), lower lid height (LLH), upper lid height (ULH), intercanthal distance (ICD), and inter-outercanthal distance (IOCD) were measured and with eyes opened with a speculum, the interpupillary distance (IPD) was measured. RESULTS: There was no significant difference between either sex or between the right and left eyes. HFL was 20.8 +/- 1.2 mm, LLH and ULH were 11.1 +/- 2.3 and 16.5 +/- 2.5 mm, respectively; ICD, IPD, and IOCD were 22.9 +/- 2.1 mm, 39.8 +/- 3.0 mm, and 65.3 +/- 5.8 mm, respectively. CONCLUSIONS: Anthropometric measurements of normal Korean newborns' soft-tissue orbits in the present study can be used as basic data for the proper evaluation and growth of soft-tissue orbits.
Eye ; Eyelids ; Humans ; Infant, Newborn ; Male ; Orbit ; Surgical Instruments

BACKGROUND : Truncal vagotomy produces a reduction in bile flow, an increased gallbladder volume, a delay in gallbladdr emptying, decrease in resting pressure, and decreased contraction following stimulation with cholecystokinin. Retrospective studies have suggested that vagotomy can be responsible for a 4 to 6 fold increase in the 4% to 5% control rate of cholelithiasis noted in the Framingham study. The measurement of the gallbladder ejection fraction by using Tc-99m DISIDA scintigraphy is suitable for the study of the motor functions of the gallbaldder. A gallbladder ejection fraction of less than 35% is highly predictive of the presence of gallbladder disease and is a good indicator of a favorable outcome following a cholecystectomy. METHODS : Between January 1995 and December 1996, 24 patients (truncal vagotomy + pyloroplasty, 5; truncal vagotomy partial + gastrectomy + Billroth I, 4; truncal vagotomy + partial gastrectomy + Billroth II, 12; total gastrectomy, 3) and 18 healthy volunteers were investigated prospectively by Tc-99m DISIDA scintigraphy for the measurement of the gallbladder ejection fraction. RESULTS : In normal subjects, the mean value of the gallbladder ejection fraction was 70.8%, and in patients after a gastric operations, it was 66.0% (p>0.05). Three (25.0%) of the 12 patients with a truncal vagotomy, partial gastrectomy, and Billroth II gastrojejunostomy had gallbladder ejection fractions of less than 35% (p<0.05). CONCLUSIONS : There was no difference in the gallbladder ejection fractions between the control group and the patients after gastric operations, including a truncal vagotomy. However there was a significant difference between the patients with a truncal vagotomy, partial gastrectomy, and Billroth II anastomosis and those receiving other gastric operations.
Bile ; Cholecystectomy ; Cholecystokinin ; Cholelithiasis ; Gallbladder Diseases ; Gallbladder* ; Gallstones ; Gastrectomy ; Gastric Bypass ; Gastroenterostomy ; Healthy Volunteers ; Humans ; Prospective Studies ; Radionuclide Imaging* ; Vagotomy ; Vagotomy, Truncal

PURPOSE: To report a case of hemorrhagic lymphangiectasia treated with surgical excision and confirmed by pathologic examination. CASE SUMMARY: A 21-year-old man presented with spontaneous hyperemia of his right eye of 1 week duration. The patient had a history of tuberculous retinal vasculitis and uveitis 1 year prior, but there was no active lesion during regular follow-up. There was no history of trauma, visual disturbance, diplopia, ocular pain, or any sign of systemic disease. Slit lamp examination showed tortuous dilatation of blood-filled lymphatic vessels on temporal conjunctiva of the right eye. The lesion did not change during the 4 weeks of follow-up and local excision biopsy was made for final diagnosis and treatment. Pathologic examinations revealed thin-walled lymphatic vessels with localized dilatation which contained blood in the lumen consistent with hemorrhagic lymphangiectasia. There was no sign of recurrence until 2 months after the operation. CONCLUSIONS: Hemorrhagic lymphangiectasia should be considered in patients with recurrent or longstanding localized tortuous subconjunctival hemorrhage.
Biopsy ; Conjunctiva ; Dilatation ; Diplopia ; Eye ; Follow-Up Studies ; Hemorrhage ; Humans ; Hyperemia ; Lymphatic Vessels ; Recurrence ; Retinal Vasculitis ; Uveitis ; Young Adult

This is the study of Jaedong Jejoongwon the first westernized hospital in Korea founded in 1885. To build the groundwork for study of Jejoongwon its size location building structure and medical functions were studied. At the same time the history of jejoongwon particularly that of the time when there arose a need for its moving and expansion was studied Jaedong Jejoongwon was founded in a renovated building. The building was formerly owned by Hong Young-sik who was killed while leading the Gapsinjungbyun. According to the existing block plan of Jaedong Jejoongwon when it was opened in 1885 it was located in the place which later became a park Nowadays this park is to northwest of the Constitutional Court At that time its size was about 600 p'yung As the medical school was built from end of 1885 to early 1886 Jejoongwon was expanded to north and its size was enlarged to 862 16 p'yung Jaedong Jejoongwon reflected the characteristics of western medical system When it was opened in 1885 Jejoongwon consisted of a servants' room an assistants' room the outpatient clinic the operation room (which was also used as the pharmacy) surgical wards women's wards and general wards In 1886 as the number of patients was increased and medical school was opened the function and the structure of hospital changed The most significant change was that a new medical school building was built as the nearby buildings were bought The medical school consisted of the students' dormitory a chemistry laboratory and classrooms Moreover new functions were added to already- existed hospital building a contagious ward a waiting room for outpatients an eye ward a darkroom a room for special diagnosis and treatment and a vaccination room Also from the time when it was first opened Jejoongwon needed the expansion as too many patients came in and the medical education was started Therefore in the summer of 1886 Allen positively explored ways toward the hospital's moving. At last in early 1887 Jaedong Jejoongwon moved to Kurigae on along with the development of medical education and medical treatment shows how the modern medical system was formed and developed in Korea.
English Abstract ; History of Medicine, 19th Cent. ; Hospitals/*history ; Korea ; Medicine ; *Western World/*history

Objective: Despite a high prevalence of dementia in older adults hospitalized with severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2), or so called COVID-19, research investigating association between preexisting diagnoses of dementia and prognosis of COVID-19 is scarce. We aimed to investigate treatment outcome of patients with dementia after COVID-19. Methods: We explored a nationwide cohort with a total of 2,800 subjects older than 50 years who were diagnosed with COVID-19 between January and April 2020. Among them, 223 patients had underlying dementia (dementia group). We matched 1:1 for each dementia- non-dementia group pair yielding 223 patients without dementia (no dementia group) using propensity score matching. Results: Mortality rate after COVID-19 was higher in dementia group than in no dementia group (33.6% vs. 20.2%, p=0.002). Dementia group had higher proportion of patients requiring invasive ventilatory support than no dementia group (34.1% vs. 22.0%, p=0.006). Multivariable analysis showed that dementia group had a higher risk of mortality than no dementia group (odds ratio=3.05, p<0.001). We also found that patients in dementia group had a higher risk of needing invasive ventilatory support than those in no dementia group. Conclusion Our results suggest that system including strengthen quarantines are required for patients with dementia during the COVID- 19 pandemic.

Objective: Despite a high prevalence of dementia in older adults hospitalized with severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2), or so called COVID-19, research investigating association between preexisting diagnoses of dementia and prognosis of COVID-19 is scarce. We aimed to investigate treatment outcome of patients with dementia after COVID-19. Methods: We explored a nationwide cohort with a total of 2,800 subjects older than 50 years who were diagnosed with COVID-19 between January and April 2020. Among them, 223 patients had underlying dementia (dementia group). We matched 1:1 for each dementia- non-dementia group pair yielding 223 patients without dementia (no dementia group) using propensity score matching. Results: Mortality rate after COVID-19 was higher in dementia group than in no dementia group (33.6% vs. 20.2%, p=0.002). Dementia group had higher proportion of patients requiring invasive ventilatory support than no dementia group (34.1% vs. 22.0%, p=0.006). Multivariable analysis showed that dementia group had a higher risk of mortality than no dementia group (odds ratio=3.05, p<0.001). We also found that patients in dementia group had a higher risk of needing invasive ventilatory support than those in no dementia group. Conclusion Our results suggest that system including strengthen quarantines are required for patients with dementia during the COVID- 19 pandemic.

OBJECTIVE:Optimized voxel based morphometry (VBM) has been increasingly applied to investigate differences in brain morphology between a group of Alzheimer's Disease (AD) patients and control subjects. Optimized VBM permits comparison of gray matter (GM) volume at voxel-level from the entire brain. The purpose of this study was to assess the regional GM volume loss measured by optimized VBM in AD compared to controls METHODS:Twenty-three AD patients and 20 cognitively normal elderly control subjects included in this study. To improve the VBM performance, the study specific template and the probability maps were generated from the control subjects. RESULTS:Optimized VBM analysis revealed GM loss, including hippocampus, amygdala, anterior cingulate, posterior cingulate, insula, frontal lobe and middle temporal complex in the AD group as compared to normal control group CONCLUSION:The VBM results confirmed previous findings of temporal lobe and limbic lobe atrophic changes in AD, and suggest that these abnormalities may be confined to specific sites within that lobe, rather than showing a widespread distribution.
Aged ; Alzheimer Disease ; Amygdala ; Brain ; Frontal Lobe ; Hippocampus ; Humans ; Temporal Lobe

STUDY DESIGN: This is a retrospective study. OBJECTIVE: We analyzed the clinical and radiographic results of surgical treatment for patients with tuberculous spondylitis. MATERIAL AND METHODS: Our study included 18 active tuberculous spondylitis patients (12 males and 6 females) who underwent anterior curettage, strut bone grafting and posterior instrumentation. Their average age was 50.1 years (age range: 24-76 years). The mean follow-up was 43 months. Vertebral bodies from T5 to L5 were involved. The anterior column support was iliac autograft in 10 patients and titanium mesh in 4. All the patients had transpedicular instrumentation with an additional hook in 3 and anterior instrumentation in 1. Except for one paraplegic patient, all the others were able to ambulate wearing TLSO. The mean duration of Anti-Tbc medication was 13.3 months (range: 12 to 18 months). The clinical and radiographic results were analyzed, and they included the segmental kyphotic angle and the complications of instrumentation on the involved vertebrae. RESULT: The subjective satisfaction was greater than good except for 2 patients. These 2 patients' satisfaction was fair due to incomplete neurologic recovery and persistent BG-donor site pain. The three paraplegic patients fully recovered postoperatively. The mean correction of the segmental kyphosis was 13 degrees. The mean correction loss was 0.7 degrees at the final follow-up. Pedicle screws were inserted in the involved vertebrae for 10 patients (n = 30). There was no loosening of instrumentation nor spread or recurrence of infection. One case was complicated by pneumonia. CONCLUSION: For the surgical treatment of active tuberculous spondylitis, anterior column support with strut grafting and posterior instrumentation is mandatory in the destabilized spine after anterior debridement or the correction of kyphosis.
Autografts ; Bone Transplantation ; Curettage ; Debridement* ; Follow-Up Studies ; Humans ; Kyphosis ; Male ; Pneumonia ; Recurrence ; Retrospective Studies ; Spine ; Spondylitis* ; Titanium ; Transplants*

STUDY DESIGN: A retrospective study. SUMMARY OF THE LITERATURE REVIEW: The reports comparing short- and long-segment instrumentation are insufficient. OBJECTIVES: To determine the postoperative results and to analyze relative factors affecting results between short- and long-segment instrumentation in thoracolumbar fractures. MATERIALS AND METHODS: From March 2006 to March 2012, 97 patients with thoracolumbar fracture were treated with posterior instrumentation. They were divided into 2 groups, the short- (Group I) and long-segment groups (Group II). To analyze factors affecting results, several factors including age, anterior column height (ACH), and the kyphotic angle were reviewed. For radiologic evaluation, postoperative and follow-up radiographs were evaluated by measuring the kyphotic angle and ACH. Additionally, the presence of complications was reviewed. RESULTS: Groups I and II consisted of 45, 52 cases and had mean ages of 50.3, 55.8 years, respectively. In Group I, the ACH increased from 44.2% to 75.3% postoperatively, and remained 72.8% at follow-up. The kyphotic angle decreased from 19.4degrees to 10.6degrees postoperatively, and remained at 12.8degrees at follow-up. In Group II, the ACH recovered from 41.6% to 76.4% postoperatively, and was 74.8% at follow-up. The kyphotic angle decreased from 21.6degrees to 12.6degrees postoperatively, and was 13.9degrees at follow-up. The canal compromise, age, and comminution were not directly related with results. However, the mean age of the 7 cases showing complications was 72 years, and the 7 cases had severe comminuted fractures. CONCLUSIONS: The short- and long-segment instrumentations of thoracolumbar fractures are not significantly different with respect to the results attained. However, in order to decrease complications, we should pay attention to age and fracture comminution.
Follow-Up Studies ; Fractures, Comminuted ; Humans ; Retrospective Studies