Twenty-six cases of Colles fracture were treated with closed reduction and percutaneous K-wire fixation under C-arm field and then wrist was immobilized by sugar tong splint and then short arm splint from Jan. 1982 to Dec. 1985 at the department of orthopaedic surgery of St. Benedict hospital. A prospective study was made and evaluated under the subjective and objective criteria of Gartland and Werley, and the objective criteria of Scheck. The result of this study were as follow: 1. The incidence of Colles fracture was highest in 3rd decade(26.9%) and 7th decade(23.1%) respectively. In the 3rd decade the reason for the highest incidence was the job-related accident during the productive age and they were male patients. 2. The main cause of the injury was falling accident comprising of 53.8% and the male to female ratio was about equal. 3. Among the 26 cases treated with the percutaneous K-wire fixation, the result was satisfactory in 92.2% but was unsatisfactory in one case with severe comminuted fracture. 4. The percutaneous K-wire fixation for Colles fracture had less complication and more advantages such as the early disappearance of edema by early exercies, the early returning of range of motion of joint to normal, and the comfortable cast immobilization in neutral position of wrist. 5. The percutaneous K-wire fixation for Colles fracture was applicable to the concept that the anatomical reduction and maintenance would lead to the improvement of the joint function. 6. The percutaneous K-wire fixation for Colles fracture was indicated when neurologic sign developed after reduction of fracture by classic methord and when the exercise of joint was required in the old age. 7. When the articular surface of the radius was severely comminuted and the distal radius became severely osteoporotic, the result from the use of percutaneous K-wire fixation was also poor. In this case we considered the use of an external fixator.
Accidental Falls ; Arm ; Clinical Study ; Colles' Fracture ; Edema ; External Fixators ; Female ; Fractures, Comminuted ; Humans ; Immobilization ; Incidence ; Joints ; Male ; Neurologic Manifestations ; Prospective Studies ; Radius ; Range of Motion, Articular ; Splints ; Wrist

Down syndrome is the most common autosomal syndrome in man. The incidence of trisomy 21 due to translocation is about 3.5-5%. Translocations are usually centric fusions between a 21 and a D group (54.2%) or a G group (40.9%) chromosome. Since the short arm of 21 carries no phenotypically active genes, even if the short arm of 21 is lost, usually there is no imbalance with clinical significance. Rare translocations in Down syndrome may also occur between a 21 and other chromosomes (4.9%). We experienced a case of unusual (1q;21q) translocation Down syndrome inherited from a t (1q;21q) balanced carrier mother. The segmental trisomy was confirmed by FISH analysis. This is the first case of a familial Down syndrome with t (1q;21q) in Korea.
Arm ; Down Syndrome* ; Humans ; Incidence ; Korea ; Mothers* ; Trisomy

OBJECTIVES: This study was conducted to evaluate the effectiveness of a suicide prevention advertising media campaign by the Korea Suicide Prevention Center in 2014 and to analyze the changes in the levels of suicide prevention related-knowledge, attitude, and behavior of the advertisement viewers. METHODS: Data of 703 participants who responded to both the pre and post telephone surveys out of 1100 adults aged 19 or over randomly selected nationwide were analyzed using a stratified proportional quota sampling method considering sex, age, and region by a survey agency. A propensity score matching (PSM) analysis was used to adjust for potential biases in estimated effects. RESULTS: Of 703 participants who completed pre and post survey interviews, 25.9% watched the media campaign. Comparing the knowledge, attitude, and behavior scores between the advertisement viewers (n=182) and non-viewers (n=521), of those who watched the media campaign, participants' knowledge score showed a statistically significantly increase in all methods of the PSM analysis while there were no statistically significant changes in attitude and behavior. CONCLUSION: The results supported the effectiveness of a suicide prevention media campaign in terms of knowledge, but not of attitude and behavior related to suicide prevention. Further long-term large evaluation studies are suggested.
Adult ; Bias (Epidemiology) ; Humans ; Korea ; Propensity Score* ; Suicide* ; Telephone

PURPOSE:Despite the worldwide interests in the quality of life issues in children with epilepsy, only few studies have been conducted in Korea yet. This study is aimed to analyze clinical factors related with the issues of life in children with epilepsy. METHODS:A total of 158 children(79 patients/79 control) were involved in the study from the Department of Pediatrics at Asan Medical Center and 79 normal children who completed the Korean Child Behavior Checklist(K-CBCL). We used the Korean version of the Quality of Life in Childhood Epilepsy Questionnaire(K-QOLCE) to evaluate the quality of life. The differences of the quality of life between the patients and the controls were compared and the influencing factors were evaluated. RESULTS:The scores of physical functions, well-being, cognition, social functions, behaviors, general health, and quality of life were lower in the patients than in the controls. We found higher scores of quality of life in the patients with epilepsy who were younger when diagnosed, had shorter disease period, took fewer drugs, and took drugs for a shorter time(P<0.05). Higher scores of physical restriction(P=0.017), self-esteem(P=0.006), cognition(P=0.02), and behaviors(P=0.019) were noted for the patients with partial seizures, compared to those with generalized seizures. CONCLUSION:We found that the quality of life in the pediatric epilepsy patients was lower than that of normal children and various factors associated with the treatment of epilepsy influenced the quality of life. The information obtained from this study will help us offer better epilepsy management.
Child Behavior ; Child* ; Chungcheongnam-do ; Cognition ; Epilepsy* ; Humans ; Korea ; Pediatrics ; Quality of Life* ; Seizures

OBJECTIVE: To evaluate the impact on wound healing and long-term clinical outcomes of endovascular revascularization in patients with critical limb ischemia (CLI). MATERIALS AND METHODS: This is a retrospective study on 189 limbs with CLI treated with endovascular revascularization between 2008 and 2010 and followed for a mean 21 months. Angiographic outcome was graded to technical success (TS), partial failure (PF) and complete technical failure. The impact on wound healing of revascularization was assessed with univariate analysis and multivariate logistic regression models. Analysis of long-term event-free limb survival, and limb salvage rate (LSR) was performed by Kaplan-Meier method. RESULTS: TS was achieved in 89% of treated limbs, whereas PF and CF were achieved in 9% and 2% of the limbs, respectively. Major complications occurred in 6% of treated limbs. The 30-day mortality was 2%. Wound healing was successful in 85% and failed in 15%. Impact of angiographic outcome on wound healing was statistically significant. The event-free limb survival was 79.3% and 69.5% at 1- and 3-years, respectively. The LSR was 94.8% and 92.0% at 1- and 3-years, respectively. CONCLUSION: Endovascular revascularization improve wound healing rate and provide good long-term LSRs in CLI.
Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Endovascular Procedures/adverse effects/*methods ; Female ; Foot/*blood supply ; Humans ; Ischemia/physiopathology/*surgery ; Limb Salvage ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Outcome ; Wound Healing/*physiology

The possibility of a large quantity of information outflow has been growing since patients' private and medical information is being transmitted to inside and outside of the hospital because of the country's medical record computerization system. Accordingly, it has been threatening patient's privacy and the duty of confidentiality of medical people, and the introduction of security policy is needed which is required for patient information protection. We evaluated medical treatment facilities of diagnostic information security management by conducting questionnaire survey of medical documentation office about their standard of medical information security management, range of medical information access sanction to inside users, outside users' request for information and it's purpose. In the data of medical information user identification and authentication, about the grant of the ID and Password to official in charge, "All have it" has the most high percentaged as 60.0%, "Officer who's most needful have it" is the second as 15.7%, "one's post share it" is the third as 12.9%, but treatment facilities all show similar distribution. About the request for information by patients, All medical institution opened the information on occasion that patients themselves visited the institute and asked information, but in case of telephone inquiry, the only score 0.08 of the institutes accepted. This research, I hope, could be utilized for basic materials for medical recorder who control medical information to manage medical information security and to evaluate operation, and for individual hospital to manage the bound of opening to public and authority to access considering specificity of medical information, and supervisor. Also, the Goverment should set up a definite legal support about the political and technological plan to protect private information in the medical record.
Academies and Institutes ; Computer Security ; Confidentiality ; Financing, Organized ; Hope ; Humans ; Medical Records ; Privacy ; Surveys and Questionnaires ; Sensitivity and Specificity ; Telephone

OBJECTIVE: We examined the difference between IQ(Intelligence Quotient) estimated from computerized Standard Progressive Matrices(SPM) score(SPM IQ) and Korean-Wechsler Adult Intelligence Scale(KWAIS) IQ(KWAIS IQ) in Korean patients with mental disorders in order to test the validity of SPM as a brief nonverbal intelligence test, and to find the groups that need standardization. And, we studied the method to predict KWAIS IQ more precisely from SPM test. METHODS: SPM test in Vienna test system was administered to 166 Korean patients with mental disorders. The degree of consistency and Pearson's correlation coefficient between SPM IQ and KWAIS IQ in total subjects and groups by sex, age, education, and clinical diagnosis were investigated. And, we obtained a regression equation to predict KWAIS IQ from SPM score. RESULTS: In total subjects, Pearson's correlation coefficient between SPM IQ and KWAIS IQ was as high as 0.704, and the percent of patients whose absolute value of difference between SPM IQ and KWAIS IQ is equal to or less than 10 was 54.8%. The degree of consistency between SPM IQ and KWAIS IQ was influenced by age and educational level. SPM IQ were higher than KWAIS IQ in younger age and lower education group. SPM IQ were lower than KWAIS IQ in older age and higher education group. The regression equation from SPM score, age, and education years predicted KWAIS IQ more correctly. CONCLUSION: The Computerized Standard Progressive Matrices test is validated and can be used usefully as a brief nonverbal intelligence test in patients with mental disorders. In order to provide more precise evaluation, standardized data should be prepared for age group 16 to 25 and age group 26 to 35 with lower educational level.
Adult ; Diagnosis ; Education ; Humans ; Intelligence ; Intelligence Tests ; Mental Disorders*

PURPOSE: Islet cell transplantation, as an alternative approach to endocrine cell replacement to treat the diabetes mellitus, has received significant attention because it holds several advantages over whole gland transplantation. However cell damage from islet isolation and immunologic rejection after transplantation prevent from successful clinical application for diabetic patients. Culture of cells at low temperature has known to stabilize the cell viability, and to decrease the immunologic antigenicity. Aim of this study is to investigate the effect of culture at 24oC on cell viability, cellular function, immunogenicity and cytokine profiles in rat pancreas islet. METHODS: Pancreas islets were isolated from Lewis rat and cultured at 24oC or 37oC during 14 days. Islet recovery after culture period was counted as islet equivalent number, and islet viability was examined with fluorescent vital staining (FDA/PI). Islet function was measured with glucose stimulation test. Annexin V expression and MHC class I and II expression were measured with flow cytometric assay for apoptosis and immunogenicity respectively. Lymphocyte cell proliferation through mixed lymphocyte islet culture was examined with WST-1 proliferation assay. Cytokine profiles were analyzed with quantitative real time RT-PCR. All these parameters were measured on 1, 3, 5, 7, 14 culture days after islet isolation. RESULTS: Islet recovery was higher in islet cultured at 24oC than in islet cultured at 37oC without change of viability. Insulin secretion after glucose stimulation was more effective in 24oC culture condition. Decrease of apoptotic cell death was demonstrated in 24oC cultured islet. MHC class I and II expression on islets and lymphocyte proliferation when cocultured with islets were less prominent in 24oC cultured islet. TNF-alpha and IL-4 cytokine expression was higher in islet cultured at 24oC than in islet cultured at 37oC. IL-1beta and IL-10 cytokine expression were similar in both culture condition. CONCLUSION: This study demonstrated that cell recovery and function are increased in islet cultured at 24oC than in islet cultured at 37oC while antigenicity and proinflammatory cytokine expression are decreased. Low temperature culture can be a good approach to prevent the loss of islet mass, and to reduce the immunologic rejection of transplanted islet for successful clinical islet transplantation.
Animals ; Annexin A5 ; Apoptosis ; Cell Death ; Cell Proliferation ; Cell Survival ; Diabetes Mellitus ; Endocrine Cells ; Glucose ; Humans ; Insulin ; Interleukin-10 ; Interleukin-4 ; Islets of Langerhans Transplantation ; Islets of Langerhans* ; Lymphocytes ; Pancreas* ; Rats* ; Tumor Necrosis Factor-alpha

Background: To examine the incidence of traumatic spinal cord injury (TSCI) from all etiologies, we measured and compared the incidence of TSCI from three national or quasinational databases in South Korea, namely, the National Health Insurance Service (NHIS), automobile insurance (AUI), and Industrial Accident Compensation Insurance (IACI). Methods: We reviewed patients with TSCI reported in the NHIS database between 2009 and 2018, and in the AUI and IACI databases between 2014 and 2018. TSCI patients were defined as those first admitted to the hospital with a diagnosis of TSCI according to the International Classification of Diseases (10th revision) criteria. Age-adjusted incidence was calculated using direct standardization using the 2005 South Korean population or the 2000 US population as the standard population. The annual percentage changes (APC) of TSCI incidence were calculated. The Cochrane–Armitage trend test was performed according to the injured body region. Results: In the NHIS database, age-adjusted TSCI incidence using the Korean standard population increased significantly from 2009 to 2018 (from 33.73 per million in 2009 to 38.14 per million in 2018, APC = 1.2%, P = 0.014). Contrarily, age-adjusted incidence in the AUI database significantly decreased from 13.88 per million in 2014 to 11.57 per million in 2018 (APC = – 5.1%, P = 0.009). In the IACI database, the age-adjusted incidence showed no significant difference, while crude incidence showed a significant increase (from 22.02 per million in 2014 to 28.92 per million in 2018, APC = 6.1%, P = 0.038). According to the age group, all the three databases showed high incidences of TSCI in those in their 60s and 70s or older. Among those in their 70s or older, the incidence of TSCI increased dramatically in the NHIS and IACI databases, while no significant trend was found in AUI database. In 2018, the number of TSCI patients was the highest among those over 70 years of age in the NHIS, whereas among those in their 50s were the highest in both AUI and IACI. The proportion of patients with cervical spinal cord injury was the most common in all these databases. Conclusions The differences in trends in the incidence of TSCI may be due to the different etiologies and different characteristics of subjects depending on insurance type. These results imply the need for tailored medical strategies for the different injury mechanisms represented by three national insurance services in South Korea.

PURPOSE: We evaluated the usefulness of intracranial stent implantation for treating patients with atherosclerotic stenosis and with recurrent, ischemic, neurological symptoms despite having undergone medical therapy. MATERIALS AND METHODS: Between March 2004 and April 2010, we attempted intracranial, stent-assisted angioplasty in 77 patients with 85 lesions (anterior circulation 73 cases, posterior circulation 12 cases) and who had ischemic neurological symptoms with more than 50% major cerebral artery stenosis. We analyzed the results regarding the technical success rate, complication rate, and restenosis rate during the mean 29.4 month follow-up period. RESULTS: Intracranial stent implantation was successfully performed in 74 cases (87.1%). In nine cases among the 11, failed cases, stent implantation failure was due to the tortuosity of the target vessel. One patient experienced middle cerebral artery rupture during the procedure, and we embolized the vessel using a microcoil. Five patients developed cerebral infarction in three weeks after the procedure, three of whom improved using conservative management, although the other, two patients expired. The mean number of residual stenoses decreased from 72.3% to 14.7%. Three patients demonstrated significant in-stent restenosis, i.e. more than 50%, during the follow-up period. CONCLUSION: As stent-assisted angioplasty in intracranial, atherosclerotic stenosis is effective and relatively safe, it can be considered as an alternative treatment for patients with recurrent, ischemic, neurologic symptoms despite having undergone medical therapy.
Angioplasty ; Cerebral Arteries ; Cerebral Infarction ; Constriction, Pathologic ; Follow-Up Studies ; Glycosaminoglycans ; Humans ; Intracranial Arteriosclerosis ; Middle Cerebral Artery ; Neurologic Manifestations ; Rupture ; Stents