Congenital hand anomalies encompass a very broad spectrum of deformity, and precise classification of these deformities has always posed a major problem. We reviewed 50 cases of congenital hand deformities in 47 patients, managed at Department of,Orthopedic Surgery, Severance Hospital from Jan. 1980. to Jun. 1984 and the following results were obtained. 1. There were 26 males and 21 females in 47 patients and the ratio between male and female was 1.2: 1. Right hands were involved in 16 patients and both hands were in 14 patients. 2. The most commomn type of anomalies were polydactylysm(48%), next were syndactylysm (24%) and the follwing anomalies were found: camptodactyly, congenital constriction band syndrome, congenital ulnar deficiency, congenital clasped thumb, clinodactyly, congenital finger deficiency, symphalangism. 3. 9 associated congenital anomalias were found in 5 patients, in which, anomalies of the foot were most common. 4. Prenatal history such as drug ingestion, preeclampsia, breech delivery, prematurity, low birth weight were found and 2 cases of family history were found. 5. Treatment was stressed upon the function of hand and the improvement of the deformity.
Classification ; Clinical Study ; Congenital Abnormalities ; Constriction ; Eating ; Female ; Fingers ; Foot ; Hand Deformities, Congenital ; Hand ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Pre-Eclampsia ; Thumb

The complications of herpes zoster ophthalmicus vary greatly among different patients. The major portion of the complications fall under four types; (1) keratitis, (2) iridocyclitis, (3) muscular palsies, and (4) optic neuritis. We have experienced a case of herpes zoster ophthalmicus complicated by abducens palsy, sectorial paralysis of iris sphincter, iritis, and transient increase of intraocular pressure. The case was reviewed and the pathogenesis of the complications were discus sed.
Herpes Zoster Ophthalmicus* ; Herpes Zoster* ; Humans ; Intraocular Pressure ; Iridocyclitis ; Iris ; Iritis ; Keratitis ; Optic Neuritis ; Paralysis*

PURPOSE: This study is designed to evaluate the current situation of interhospital transports of critical ill patients requiring emergency care. METHODS: Using a clinical prospective 162 interhospital transports of ill patients by ambulance were evaluated in 2 hospitals. Patients were divided into severe & mild to moderate group by modified-ESI. We evaluated the state of patients, vital sign, monitoring of patient's state, hospitalization or transportation. Data were collected by mean of comprehensive form filled by a physician at the receiving hospital. RESULTS: The receiving hospital were notified prior to the transport in 57.4%. Pretransport information about the patients were adequate in 75% and no data in 9.9%. In 10.4% of the transports, the patients arrived at the receiving hospital in an agonized state. In 80.8% of the transports admitted and 7.4% of the patients were transfer to the other hospital. CONCLUSION: It appears that there are no established guidelines for the emergency transport of critical ill patients in Korea.
Ambulances ; Emergencies ; Emergency Medical Services ; Felodipine ; Hospitalization ; Humans ; Korea ; Patient Transfer ; Prospective Studies ; Transportation ; Vital Signs

Last year, we had experienced 2 cases of frontal mucocele from which exophthalmos was induced. In both cases, all were male and exophthalmos was unilateral at right eye. They revealed visual disturbances and ocular deviations to the temporal and inferior direction, a]so with the diplopia in one case. The duration of the exophthalmos was 5 months in one case, and 10 years long in another case. They were treated by means of external sinusotomy through the anterior orbitotomy with good results. In one case visual disturbance was also recovered to the normal.
Diplopia ; Exophthalmos* ; Humans ; Male ; Mucocele*

PURPOSE: To statistically analyze the advantages of distraction osteogenesis in combination with free flap in the treatment of tibial open fracture with bone and soft tissue defect. MATERIALS AND METHODS: Twenty patients with tibial open fracture with bone and soft tissue defect were treated by distraction osteogenesis with or without flap. Patients were followed up for a minimum of 12 months and retrospectively analyzed, for the admission period, the out patient follow-up period, and the intravenous antibiotic period, and distraction consolidation indices were determined. RESULTS: Those treated with free flap showed statistically significance shorter antibiotic period, admission period, and distraction consolidation indices. CONCLUSION: Free flap and distraction osteogenesis with an Ilizarov external fixator has many advantages for treating tibial open fracture with bone and soft tissue defect.
External Fixators ; Follow-Up Studies ; Fractures, Open ; Free Tissue Flaps* ; Humans ; Osteogenesis, Distraction ; Retrospective Studies ; Tibia

PURPOSE: To establish modality of diagnosis and treatment in pisiform injuries by analysis of its clinical experiences. Materials & Methods : Twelve fractures and one dislocation of the pisiform that were followed up for more than twelve months were reviewed retrospectively. RESULTS: Eight cases had associated injuries on the wrist or hand of ipsilateral side. Eight cases were diagnosed by routine radiography and three cases required additional special radiography such as the supinated oblique view or carpal tunnel view. One case was diagnosed by computed tomography. Cast immobilization was performed in nine cases and three cases underwent internal fixation. Pisiform was excised in one chronic dislocation case. The results were usually satisfactory but two cases showed pisotriquetral arthritis and one of them underwent excision of pisiform. CONCLUSION: The diagnosis of pisiform injury may accompany some difficulties due to associated carpal injuries. Routine radiography is sufficient for the screening of it if attention is paid and specific radiography such as supinated oblique view or carpal tunnel view may be very useful for confirmation. As conservative treatment alone shows good result, operative fixation is recommended for limited cases. The excision of pisiform is required in case of pisotriquetral arthritis or neglected chronic dislocation.
Arthritis ; Diagnosis* ; Dislocations ; Hand ; Immobilization ; Mass Screening ; Radiography ; Retrospective Studies ; Wrist

PURPOSE: Anaphylaxis is a medical emergency requiring immediate recognition and treatment. Despite the serious nature of these reactions, there is no universal agreement on the definition and there have been few epidemiologic studies of anaphylaxis in children. The purpose of the study is to investigate the causative agents, presenting signs and symptoms and course of disease in children suitable for established diagnostic criteria for anaphylaxis in the middle area of South Korea. METHODS: We identified potential episodes of anaphylaxis occuring between March 1994 and October 2007 from the university hospitals in the middle area of South Korea. We reviewed all patients' medical records diagnosed with anaphylaxis and other related diagnoses. From chart review, we retrospectively collected demographic and epidemiologic data. RESULTS: We identified 40 patients with anaphylaxis. Patients' ages ranged from 2 months to 17 years, with a mean age of 6.6 years. A causative agent was recognized in 84.5%. The inciting agent included foods in 26 cases (65%), medication in 7 cases (17.5%) and bee sting in 1 case (2.5%). Mucocutaneous manifestations were the most common, respiratory symptoms were in 35 patients, cardiovascular symptoms were in 8 patients, and gastrointestinal symptoms were in 5 patients. CONCLUSION: We found some cases of anaphylaxis which had misdiagnosed as urticaria or angioedema using the established diagnostic criteria. Therefore, clinicians must accurately know the criteria of anaphylaxis and make an effort to identify cases of anaphylaxis with a high suspicion. Also, we found the epidemiology, causative agents, and symptoms and treatments of anaphylaxis in the middle area of South Korea. Our data will be the basis for anaphylactic studies in South Korea.
Anaphylaxis ; Angioedema ; Bees ; Bites and Stings ; Child ; Collodion ; Emergencies ; Epidemiologic Studies ; Hospitals, University ; Humans ; Medical Records ; Republic of Korea ; Retrospective Studies ; Urticaria

PURPOSE: CPR Anytime(R), a self-instructional video program, has gained popularity amongst CPR instructors for training non-healthcare providers. This instructional kit enables second-tier instruction. The purpose of this study is to determine the status of second-tier instruction CPR by CPR Anytime(R) trainees. METHODS: Questionnaires were sent to 606 CPR Anytime(R) trainees from 12 BLS training sites. The training period was from October 2006 to July 2007. Questionnaires included provider's basic information, post-course self exercise, amount of second-tier instruction, and multiplier status. RESULTS: The response rate of the questionnaire was 53.6%(325). The mean age was 20.4+/-10.3 years old. The professions of respondents were as follows: students (76.3%), office workers(13.2%), teachers(4.4%), and service providers(1.9%). The post-course self exercise rate was 49% with three fourths of those completing the exercises using both the DVD and MiniAnne(R). Second-tier instruction tools use rates(48%) were as follows: DVD and manikin(35%), manikin only(9%), verbal only(2%), and DVD only(1%). The total multiplier effect was 1.77(575/ 325) with the multiplier effect of teachers significantly higher than others. CONCLUSION: This study found that 48% of CPR Anytime(R) providers perform second-tier instruction to family and friends. Amongst them, the total multiplier effect was 1.77 (575/325).
Cardiopulmonary Resuscitation ; Surveys and Questionnaires ; Exercise ; Friends ; Humans ; Manikins

We report two cases of hemolytic uremic syndrome (HUS) associated with Escherichia coli O114. Two cases were similar and showed the same clinical courses. After prodrome of diarrhea and vomiting lasting 1-2 days, azotemia persisted for about 10 days, and during that period, the patients were on peritoneal dialysis. They recovered without any sequelae after about 15 days. Direct multiplex PCR of stool culture revealed eae and stx2 gene and the result of ELISA done on the colony positive of eae gene confirmed Escherichia coli O114. This is the first report of HUS associated with Escherichia coli O114. We recommend, Shiga toxin producing bacterial infection must be considered and efforts should be made to scrutinize the organism in all diarrhea-prodrome HUS patients.
Azotemia ; Bacterial Infections ; Diarrhea ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli* ; Escherichia* ; Hemolytic-Uremic Syndrome* ; Humans ; Multiplex Polymerase Chain Reaction ; Peritoneal Dialysis ; Shiga Toxin ; Vomiting

Chloride is the most abundant negative charge ion in extracellular fluid. In plasma it combines with sodium as sodium chloride and with potassium as potassium chloride. Chloride also is found with hydrogen as hydrochloric acid in the stomach. Although chloride was the first electrolyte to be easily measured, it has been considered often the least important of the major electrolytes because of its attachment to both sodium and potassium. There were lot of research and report about electrolyte imbalance, however it was difficult to find the clinical report about hypochloremia. We recently managed a patient with pyloric stenosis who was admitted to ICU with severe hypochloremic metabolic alkalosis. He was treated with hydration of normal saline and conservative management. Metabolic alkalosis and severe hypochloremia were improved and the patient was discharged on ICU 3 days.
Alkalosis* ; Electrolytes ; Extracellular Fluid ; Humans ; Hydrochloric Acid ; Hydrogen ; Plasma ; Potassium ; Potassium Chloride ; Pyloric Stenosis ; Sodium ; Sodium Chloride ; Stomach