For the nonunion of humeral shaft, there have been many methods of treatment. We are aimed to analyse the causes of nonunion of humeral shaft fracture and present the direction of treatment. We reviewed total 21 cases which were diagnosed as delayed or nonunion of humeral shaft and analysed the causes. l. Initial method of treatment was surgical in 19 out of 21 cases. Among these 19 cases, 14 cases were operated with internal fixation with plate and screw. 2. The most common cause of nonunion was inadequate internal fixation in 26 cases(81%) in which were unstable fixation in 13 cases, choice of inadequate internal fixator in 11 cases, and failure of operative technique in 2 cases. Other causes were distraction between fracture fragments in 4 cases(13%) and open comminuted fracture in 2 cases. 3. Eighteen cases of established nonunion due to inadequate internal fixation were treated by rigid fixation with longer and broader plate and bone graft, and 1 case interlocking IM nailing, 1 case Ender nailing and 1 case bone graft only. 4. Union was obtained in all cases at least in 5 months. And there were no specific complications. In conclusion, surgeons should contemplate the operative indication and principles in primary treatment. In treatment of nonunion, surgeons should treat by more longer and broder internal fixator and additional bone graft.
Fractures, Comminuted ; Humerus ; Internal Fixators ; Methods ; Surgeons ; Transplants

PURPOSE: The aim of this study was to determine the role of renal ultrasonography in neonates with isolated preauricular tags. METHODS: We performed a retrospective study of 10,997 newborn infants delivered from January 1995 to June 2003 in Wonkwang University Hospital. Nineteen newborns born with isolated preauricular tags were assessed for renal anomalies by performing renal ultrasonography within one week after birth. The study group was compared with a control group of 25 healthy neonates without preauricular tags during the same period, also using renal ultrasonography. RESULTS: Preauricular tags were detected in 19 of 10,997(0.17%) neonates; 57.9% were found on the right side. Renal anomalies in neonates with isolated preauricular tags were detected in four infants (21.1%); this incidence was higher, but was not significant, compared with the control group. Types of anomalies were mild hydronephrosis of grade 1(3 cases) and 2(1 case) which were normalized within one year. CONCLUSION: Routine renal ultrasonography is not recommended for newborn infant with isolated preauricular tags.
Humans ; Hydronephrosis ; Incidence ; Infant ; Infant, Newborn* ; Parturition ; Retrospective Studies ; Ultrasonography

The authors interviewed with 21 North Korean defectors who detected from North Korea in 1990-1995 and investigated their adjustment to South Korean society. The main categories of their problems in adjustment were a poor social network, financial difficulties, problems in social competency, problems resulting from their indoctrinated way of thinking, some psychological problems such as excessive self-consciousness and guilty feelings, and some social-structural problems such as poor education system in the government shelter. But, generally speaking, inspite of their problems, they have adjusted to South Korea society rather successfully In the view of short term adjustment, the reasons for their success were thought to be the characteristics and merits of a capitalistic economy ; their compliant personalities resulting from an educational system that emphasized obedience to authority and Kim Il Sung, and the dualism of North Korean lifts. Four points were discussed to assist a successful adjustment in the long term ; Fostering of the ability to make individual choices with internal principles, overcoming a judgemental, moralizing attitude, overcoming of overfull thought centered attitude and rebounding thought-lacking attitude, overcoming the effect of negative collectivism. Three things have been suggested to foster their healthy adjustment ; development and running of resocialization program for the each period of settlement ; building up a network of accessible support organizations who work for the adjustment of defectors ; systemic studies of North Korean people and defecters for the successful adjustment to unified Korean society. It is said that the division of Korean people has been the most tragic thing happen to Korea. But there can be a greater tragedy and that would be the unification of land but not the unification of people. failure to understand the real problems of the North Korean population can potentially produce conflicts and confusion which can only lead to funker re-division and greater tragedy. It is very important to study the adjustment to problems of North Korean defectors to help prepare far the unification of the Korean people.
Democratic People's Republic of Korea ; Education ; Foster Home Care ; Korea* ; Running ; Thinking

A nationwide survey was performed to know the distribution and prevalence of human Gymnophalloides seoi infection on western and southern coastal islands in the Republic of Korea. A total of 4,178 fecal specimens were collected from residents on 45 (24 western and 21 southern) islands, and examined by Kato-Katz and formalin-ether sedimentation techniques. Eggs of G. seoi were detected from 160 (3.8%) people living on 22 (13 western and 9 southern) islands. The prevalence varied by the location of islands; higher on western islands than on southern islands. The highest prevalence was found on Amtaedo (25.3%), followed by Cheungdo (25.0%), and Anchwado (20.9%) (Shinan-gun). A little lower prevalence was observed on Munyodo (13.3%), Shinshido (12.9%), and Sonyudo (10.3%) (Kunsan-shi). Of the remaining islands, the regions showing the prevalence greater than 5% included Kohado, Dallido (Mokpo-shi), Pyeongildo, Kogumdo (Wando-gun), and Keogumdo (Kohung-gun). A strong age predilection was noted (P < 0.05); 95% of the infected people were over 40 years old. Females showed a little higher prevalence than males. The results indicate that human G. seoi infection is more widely distributed than previously considered. Nine of 11 islands (excluding the 2 known areas Munyodo and Sunyudo) that showed greater prevalence than 5% are regarded as new endemic foci of G. seoi.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Animals ; Child ; Child, Preschool ; Female ; Human ; Infant ; Intestinal Diseases, Parasitic/*epidemiology ; Korea/epidemiology ; Male ; Middle Aged ; Prevalence ; Sex Factors ; Support, Non-U.S. Gov't ; Trematode Infections/*epidemiology

BACKGROUND: In Korea before the enforcement of the medical reform in July 2000, it was generally difficult to analyze the conditions of prescriptions in hospitals and clinics. It was true that the circulation process of prescribed medicine was unclear and that there was no support between medical and pharmaceutical industries with the government. Also with the reality of high rate of pharmaceutical expenses among medical costs in Korea, it was necessary to enforce reform of medical and pharmaceutical industries and for our citizens to follow the new reform as well in order to prevent drug abuse and reduce medical costs. This research was to provide basis for future studies on prescription conditions and related factors through compared analysis of before and after the medical reform by analyzing university hospital prescriptions. METHODS: A comparison and analysis of patients, who visited a university hospital for medical treatment, was dpme. There were 23,974 patients in March 2000, and 22,550 patients in March 2001. During these periods 16,870, 12,919 prescriptions were each issued, respectively. RESULTS: There was a total of 46,524 outpatients with 29,789 prescription issued. There were 23,974 outpatients in March 2000 and 22,550 in March 2001 with 16,870 and 12,919 prescriptions, respectively. Among the outpatients, there were 20,769 men (44.6%) and 24,471 women (52.6%) with 13,527 and 16,209 prescriptions, respectively. In comparing the outpatients and prescription issued patients in March 2000 and in March 2001, both men and women showed decrease in the number of prescriptions (P <.001). Also in the ages between 0-15, 16-40 and 41-65, there was a clear evidence of decrease in the number of both outpatients and prescription issued patients (P<0.001). However in the age group of 65 and over there was an increase of 4,453 patients from 3,956 outpatients. The patient analysis in March 2000 and March 2001 excluding the outpatients in emergency, urology, dentistry and radiology shows a decrease in the number of patients in medical departments in general. Also except for the increase of prescription authorized patients in dentistry, urology and family health, it showed a decrease. In general, there was a decrease in the number of cases in the issuance of prescriptions excluding few item changes in the upper 1st to 10th medicine categories in prescribed frequencies. For prescribed medicine categories no vast difference existed. In total medicine categories, there was a decrease in injections from 24.5% to 12.3% and increase of oral medications from 64.5% to 73.8%. Also there was a significant decrease of prescriptions in injections for antibiotics and significant increase of prescription for anti-hypertensive agents such as Angiotensin Converting Enzyme inhibitors. CONCLUSION: This study involved before and after the reform of prescription conditions and obtained related factor information. The results may differ depending on the type of a hospital, patient distribution and local area, but has provided valuable basic research information which did not exist in previous university hospital unit. Hence in relation to the before and after the medical reform, future studies on diseases and on significant changes in elderly patient care, antibiotic usage and in categories of anti-hypertensive agents may be necessary.
Aged ; Angiotensin-Converting Enzyme Inhibitors ; Anti-Bacterial Agents ; Antihypertensive Agents ; Dentistry ; Drug Industry ; Emergencies ; Family Health ; Female ; Hospital Units ; Humans ; Korea ; Male ; Outpatients* ; Patient Care ; Prescriptions* ; Substance-Related Disorders ; Urology

PURPOSE: This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens. METHODS: Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed. RESULTS: Twenty-four patients (70.6%) were male. The mean age of the patients was 8.5±6.2 (range, 1.1–17.1) years. Six bacterial pathogens were isolated: Salmonella species (spp.) (32.4%), Campylobacter spp. (20.6%), verotoxin-producing Escherichia coli (14.7%), Staphylococcus aureus (11.8%), Clostridium difficile (8.8%), and Shigella spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with Salmonella were older than those infected with verotoxin-producing E. coli (p<0.05). C-reactive protein levels were higher in patients with Salmonella and Campylobacter infections than in those with verotoxin-producing E. coli infection (p<0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrated diverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen. CONCLUSION: Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detect the disease extent and severity.
Abdominal Pain ; Bacteria ; C-Reactive Protein ; Campylobacter ; Campylobacter Infections ; Child* ; Clostridium difficile ; Colon ; Diagnosis ; Enterocolitis* ; Humans ; Ileum ; Male ; Medical Records ; Multiplex Polymerase Chain Reaction ; Retrospective Studies ; Salmonella ; Shiga-Toxigenic Escherichia coli ; Shigella ; Staphylococcus aureus ; Ultrasonography

PURPOSE: Major drawbacks of conventional bone marrow stromal cells (BSCs) transplantation method are mainly caused by direct transplanted cell to host cell interactions. We hypothesized that separation of the transplanted cells by a microporous membrane might inhibit most of the potential adverse effects and induce superior effect. The purpose of the study is to determine the optimal condition of the microporous membrane. METHODS: First, BSCs were placed in polyethylene terephthalate (PET) transwell inserts with 3, 8, or 12 micrometer pore size, and cultured in 24 well culture plates. After 5 days, bottoms of the plates were observed for presence of attached BSCs in monolayer and cell numbers were evaluated. Second, BSCs were placed PET, polycarbonate (PCT), and mixed cellulose esters (MCE) transwell inserts with 3 and 8 micrometer pore size, and cultured in 24 well culture plates. After 3 days, the supernatants of the media left in culture plate were analyzed for collagen, vascular endothelial growth factor (VEGF), platelet derived growth factor BB (PDGF-BB), and basic fibroblast growth factor (bFGF). Third, BSCs were placed in 15% and 70% of the PET membrane with 3 micrometer pore size. All the experimental conditions and methods were same as the second study. RESULTS: The optimal pore sizes to prevent BSC leakage were 3 micrometer and 8 micrometer. The amounts of type I collagen and three growth factors tested did not show significant differences among PET, PCT, and MCE groups. However, the collagen, VEGF, and bFGF levels were much higher in the high (70%) density group than in the low (15%) density group. CONCLUSION: This study revealed that the optimal pore size of membrane to prevent direct BSC to recipient cell contact is in between 3 micrometer and 8 micrometer. Membrane materials and pore sizes do not influence the collagen and growth factor passage through the membrane. The most striking factor for collagen and growth factor transport is pore density of the membrane.
Bone Marrow ; Cell Communication ; Cell Count ; Cellulose ; Collagen ; Collagen Type I ; Esters ; Fibroblast Growth Factor 2 ; Intercellular Signaling Peptides and Proteins ; Membranes ; Mesenchymal Stromal Cells ; Phthalic Acids ; Platelet-Derived Growth Factor ; Polycarboxylate Cement ; Polyethylene Terephthalates ; Strikes, Employee ; Transplants ; Vascular Endothelial Growth Factor A ; Wound Healing

OBJECTIVES: The aim of this study was to examine the change in attitudes and satisfaction level of North Korean defectors in South Korea over a 3 year period (2001-2004). METHODS: In our first study in 2001, a total of 200 defectors were interviewed. In the follow up study after 3 years, 151 defectors were re-interviewed by an in-person interview. RESULTS: The level of satisfaction to the governmental support policy to defectors decreased significantly. However, the general level of satisfaction increased slightly (from 3.52 to 3.56 ; 5-score scale). This shows that North Korean defectors are stably adapting to South Korean society. The level of satisfaction significantly correlated with the defectors' confusion of the different value systems, the defectors' understanding of the South Korean people, satisfaction with their physical and mental health, and the prejudice of South Korean people to defectors. In terms of the attitudes, the type of schooling, the military service and the communist party membership in North Korea were not related to the change in attitude. However, there was a significant correlation with gender and age. Women showed a greater change in attitude compared to men. Older people had difficulty in understanding the South Korean people, but they showed little psychological affiliation to North Korea. Moreover, they showed a high level of satisfaction with the economic situation in South Korea and had an optimistic viewpoint for their future than younger people. Even though many defectors attended churches, religion was not associated with the level of satisfaction or their change in attitude. CONCLUSION: The factors that influence the level of satisfaction and attitudes of North Korean defectors have changed over 3 years. Therefore, the government, nongovernmental organizations (NGOs) associated with defectors and the churches need to be more sensitive to these changes and make plans to support the adaptation of defectors to South Korean society.
Democratic People's Republic of Korea ; Female ; Follow-Up Studies* ; Humans ; Korea* ; Male ; Mental Health ; Military Personnel ; Prejudice ; Refugees ; Thinking*

PURPOSE: Report of the good results of breast reconstruction using Becker permanent tissue expander that showed a short operation time and a quick post- operation recovery time, little side effects and usually superb aesthetic results without the need for additional incisions or donor site morbidity. The authors, after carrying out breast reconstruction operations using Becker permanent tissue expander on patients with appropriate indications, attempted to analyze several factors such as complication rates and patient satisfaction measurements. METHODS: 11 cases of breast reconstruction using Becker expander implants were carried out on a total of 10 patients between March 2000 and February 2003. The patients were followed up at outpatient visit for an average of 6 months. RESULTS: The most common post-operation complication was pain resulting from saline injection into the expanders, complained by 5 patients(50%). rib fractures, skin necrosis, implant removal due to infection, and breast cancer recurrence each occurred in 1 patient (9.9%). There was no occurrence of skin contracture complications which occurs frequently in case of silicone implant insertion. Patient complacency was surveyed by patient interviews made right after the operations and during outpatient follow-up periods: 5(50%) patients out of 10 showed excellent, 3(30%) good, and 2(20%) showed fair, leaving no patients who were disappointed with operation results. On routine follow-up, 80% of patients expressed satisfaction with the cosmetic outcome of their post-mastectomy beast reconstruction. CONCLUSION: Breast reconstruction using the Becker expander is a reliable alternative to other reconstructive methods but good patient selection is essential for satisfactory results.
Breast Neoplasms ; Breast* ; Contracture ; Female ; Follow-Up Studies ; Humans ; Mammaplasty* ; Mastectomy, Modified Radical* ; Necrosis ; Outpatients ; Patient Satisfaction ; Patient Selection ; Recurrence ; Rib Fractures ; Silicones ; Skin ; Tissue Donors ; Tissue Expansion Devices*

BACKGROUND: With the rapid increase in elderly population arousing from development of medical technology and in standards of living, mental disorders as well as organic disorders according to aging constitute a serious social problem. This study aimed to find a factor related closely to cognitive impairment by analyzing the risk factors influencing cognitive impairment, which is one of the typical geriatric neuropsychiatric conditions. METHODS: This study was conducted using a questionnaire survey and history taking and physical examination was done in 200 elderly patients over sixty-five, who had visited either of the four universities hospitals in the Kyongin district from July 1997 to June 2002. A variety of factors being widely known to be related to cognitive impairment by was investigated using the existing comprehensive geriatric assessment. By using MMSE-K (Korea version of Mini- Mental State Examination), the relation between cognitive impairment and each variable was analyzed by using chi-square test and logistic regression analysis with SPSS 10.0k/PC statistical program. RESULTS: The number of males and females was 73 (36.5%) and 127 (63.5%), respectively, among the total number of 200 examinees. Males and females having symptoms of cognitive impairment was 25 (34.2%) and 49 (38.6%) among the total number of 74 (37%), respectively. Total mean point of MMSE-K was 24 5.4, 24 5.3 in males and 23.9 5.5 in females. According to the results of multi-variable quantities analysis, it was shown that the cognitive impairment had positive relation to age (P= 0.004), but negative relation to regular exercising (P= 0.016), instrumental activities of daily living (P=0.039) and social support (P=0.003). CONCLUSIONS: The factors having a close relation to cognitive impairment of elderly people were social support, age, regular exercising and instrumental activities of daily living.
Activities of Daily Living ; Aged* ; Aging ; Female ; Geriatric Assessment ; Humans ; Logistic Models ; Male ; Mental Disorders ; Physical Examination ; Risk Factors ; Social Problems ; Surveys and Questionnaires