Abdominal oblique muscle injuries are relatively common in professional baseball players and can result in substantial loss of playing time. It is usually caused by a sudden movement of the torso in sports involving repetitive activity requiring trunk rotation and it tend to occur on the contralateral side of the dominant arm. We report a unique case of sequentially occurred bilateral abdominal internal oblique muscle rupture in a right-handed professional baseball batter over two seasons. Each internal oblique rupture had a different mechanism of the injury, the non-dominant side occurred during bat swing and the dominant side during bent leg sliding. After rest and rehabilitation, each injury was recovered to play in about 1 month.

Traditional soft tissue Bankart repair has high failure rates in the setting of a critical glenoid bone defect in recurrent shoulder dislocation.Hence, coracoid transfer, particularly the Latarjet procedure, can be performed to reduce the recurrence. A commercialized guide can be used during the Latarjet procedure. On the other hand, it is difficult to handle the guide parallel to the glenoid articular surface because of the predetermined fixed direction of the guide, and the guide pin is so thin that it can be broken in the wrong direction of insertion. Screw holes can also be drilled using the free hand technique without a guide, but it is inaccurate in maintaining a parallel direction or constant spacing between the screw holes. This study devised an instrument by cutting a 3.5 mm locking compression plate used in fracture surgeries, and the Latarjet procedure was performed relatively easily.

OBJECTIVE: To study the clinical characteristics of pregnancy induced hypertension(PIH). METHODS: Five hundred seventy-five cases of PIH and 7,702 cases of normotensive pregnancies who were delivered their infants at Wonkwang University Hospital from January, 1994 to December, 1998 were selected for the study. The data were collected by review of the hospital record and the statistical analysis was performed using Chi-square tests, and statistical significance was defined as p<0.05. RESULTS: The incidence of PIH was 7.1% of total deliveries. Among the PIH, the incidence of mild preedampsia was found in 59%, severe preeclampsia in 36%, and edampsia in 5%. The most prevalent gestational period was 38-42wks gestation in mild PIH and 33-37wks gestation in severe PIH & eclampsia. The incidence of cesarean section was significantly higher in severe PIH & eclampsia(72.2%) than in mild PIH(48.7%) and normotensive pregnancies(39.7%). The incidence of hypoalbuminemia, preterm labor, placental abruption, disseminated intravascular coagulation, and pulmonary edema were significantly higher in severe PIH & edampsia than in mild PIH and normotensive pregnancies. Compared with normotensive pregnancies or mild PIH, severe PIH & eclampsia had significantly elevated risks for low birth weight, intrauterine growth retardation, fetal distress, low apgar score, meconium stained, and neonatal deaths. CONCLUSION: The incidence of PIH is not decreasing and it still an important role in the cause of maternal and perinatal mortality and morbidity in Korea. So, further studies are necessary to prepare a guide for the treatment of PIH.
Abruptio Placentae ; Apgar Score ; Cesarean Section ; Disseminated Intravascular Coagulation ; Eclampsia ; Female ; Fetal Distress ; Fetal Growth Retardation ; Hospital Records ; Humans ; Hypertension, Pregnancy-Induced* ; Hypoalbuminemia ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Korea ; Meconium ; Obstetric Labor, Premature ; Perinatal Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy* ; Pulmonary Edema

PURPOSE: The purpose of this study was to evaluate clinical and radiological results after osteosynthesis of distal phalangeal nonunion with bone defect by using matchstick-shaped bone graft. MATERIALS AND METHODS: Fifteen distal phalangeal nonunions were treated with osteosynthesis using matchstick-shaped bone graft from September, 2009 to October, 2010. The mean age of patients was 36.1 years (range: 15 to 56 years). This study included 4 women and 10 men. The mean duration of follow-up was 16.8 months (range: 12 to 20 months). We evaluated radiographs, and measured postoperative visual analogue scale (VAS) score and pinch power. RESULTS: Union was achieved in all cases at a mean of postoperative 5.5 weeks (range: 4 to 6 weeks). The mean VAS score improved from 7.25 (range: 5 to 9) to 1.0 (range: 0 to 2) postoperatively. The mean postoperative pinch power was 7.75 lbs (range: 4 to 13 lbs) compared to opposite pinch power of 9.63 lbs (range: 5 to 15 lbs). There was no scar problem, pinch pain and other complication. CONCLUSION: Steosynthesis of distal phalageal nonunion with bone defect by using matchstick-shaped bone graft is technically feasible and simple in that it does not need volar incision and debridement. It is considered as an effective treatment option in distal phalangeal nonunion with bone defect.
Bone Transplantation ; Cicatrix ; Debridement ; Female ; Follow-Up Studies ; Humans ; Male ; Transplants

PURPOSE: The presence of normal fingernail is important for the hand function and cosmetic appearance. We studied the results of the microsurgical reconstruction of the defected fingernail using composite toenail transfer. MATERIALS AND METHODS: From March of 2004 to May of 2009, eleven fingernails were reconstructed using microsurgical composite toenail transfer in 10 patients with a mean age of 27 years (range, 13 to 47 years). There were three thumbs, five index fingers, and three long fingers. Whole fingernail was destructed in three cases and remaining eight cases had partial nail defect. Toenail was grafted from great toe in eight cases and from second toe in three cases. Five cases were harvested as an osteoonychocutaneous flap, two as a endoosteoonychocutaneous flap and four as an onychocutaneous flap. RESULTS: All cases survived without any tissue necrosis. One arterial obstruction had occurred one day after surgery, which was resolved by repeated decompression and reanastomosis of the artery. All fingernails regenerated successfully. According to the rating system including assessment of shape, size and thickness of nail, nail pinch, pain, and patient's satisfaction, ten cases were rated as excellent and one as good. All patient's were satisfied with their hand function and appearance. CONCLUSION: Microsurgical composite toenail transfer can be an acceptable surgical reconstruction for the fingernail defect after trauma, providing satisfactory hand functions and cosmetic appearance.
Arteries ; Cosmetics ; Decompression ; Fingers ; Hand ; Humans ; Nails ; Necrosis ; Thumb ; Toes ; Transplants

BACKGROUND: Although epidural block has been widely used to control post operative pain, still there are many problems to be solved such as inadequate pain control and difficulty in its techniques. Subarachnoid morphine and clonidine injection also has been used to control postoperative pain and as adjuvant to spinal anesthesia. We compared subarachnoid morphine or morphine and clonidine injection with epidural morphine and bupivacaine injection for postoperative pain control. METHOD: The effect of the different types of postoperative pain control method in low abdominal surgery were investigated. 30 patients were randomly divided into one of three groups; single intrathecal morphine injection (group M), single intrathecal morphine and clonidine injection (group M/C) and continuous epidural morphine and bupivacaine injection (group M/B) prior to induction of general anesthesia. Visual analogue scale (VAS), Prince-Henry Hospital score (PHS), patient satisfaction score and the side effects were investigated at emergence, 1, 2, 4, 8, 12, 24 and 48 hours after emergence of anesthesia. The blood pressure and heart rate were monitored 0, 5, 10 and 30 min, 1, 2, 24 and 48 hours after block for monitor the hemodynamic changes. RESULT: In group M/C, the VAS showed statistically significant decrease till first 24 hours after block and in group M/B after then (p<0.05). PHS and patient satisfaction scores were similar in all groups. The side effects, pruritis and nausea, by the opioids were more frequent in subarachnoid groups versus epidural group but that were tolerable without medication in most cases. In spite that systolic and diastolic blood pressures and heart rate were significantly low (p<0.05) in group M/C, there were no severe hypotension or bradycardia that need treatment. CONCLUSION: From these results, it seems that intrathecal morphine and clonidine combination therapy can be used as an another choice for postoperative pain control in low abdominal surgery.
Analgesics, Opioid ; Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Blood Pressure ; Bradycardia ; Bupivacaine* ; Clonidine* ; Heart Rate ; Hemodynamics ; Humans ; Hydrogen-Ion Concentration ; Hypotension ; Morphine* ; Nausea ; Pain, Postoperative* ; Patient Satisfaction ; Pruritus

PURPOSE: The objective of this study was to evaluate clinical results of dual miniplate fixation for comminuted or periarticular fractures of the hand. MATERIALS AND METHODS: Twenty cases in 18 patients who had comminuted or periarticular fractures of metacarpal or phalangeal bones were treated with dual miniplate fixation from April, 2007 to May, 2009. The mean followed up period was 14.7 months. Our study included comminuted or periarticular fractures which were difficult to keep the fixation by pining or single plating. We evaluated radiologic bony union, angular or rotational deformity, extensor tendon irritaion and total arc of motion. RESULTS: Bony union was achieved successfully after primary dual miniplate fixationin in 12 cases. In 7 cases with a nonunion following previous operative fixation, bony union was obtained by dual miniplate fixation and bone grafting. In one case who had received primary dual plate fixation, nonunion occurred due to massive bone defect. Bony union was obtained by secondary dual plate fixation and bone grafting. Postoperative rotational deformity, angular deformity and irritation symptom were not observed in all cases. Functionally acceptable range of active motion was restored by way of early active motion. CONCLUSION: The dual miniplate fixation is one of the useful method for comminuted metacarpal or phalangeal fractures which cannot obtain firm fixation by other methods.
Bone Transplantation ; Congenital Abnormalities ; Fractures, Comminuted ; Hand ; Humans ; Tendons

Cortical dysplasia is a rare developmental disorder developed from a defect of neuronal migration. It is characterized by disruption of the normal cortical lamination by abnormal large nerve cells and large astrocytes in the cerebral mantle, often causing intractable seizures. The advance of magnetic resonance imaging enables us to make an in-vivo diagnosis of cortical dysplasia. The authors present a case of 23-months-old girl, who underwent temporal lobectomy for medically intractable seizures.
Astrocytes ; Diagnosis ; Epilepsy* ; Female ; Humans ; Magnetic Resonance Imaging ; Malformations of Cortical Development* ; Neurons ; Seizures

BACKGREOUND: The endotracheal intubation for inhalational anesthesia induces hypertension and tachycardia and these hemodynamic changes cause many cardiovascular complications. Propofol has hemodynamic stability compared with thiopental sodium as an induction agent of general anesthesia. Clonidine, an 2-adrenergic receptor agonist, blunts hemodynamic changes when administered as premedicant. We evaluated the hemodynamic stability during endotracheal intubation after clonidine premedication and each induction with thiopental sodium or propofol. METHODS: The 40 male and 40 female patients who scheduled for elective surgery, were randomly assigned in 4 groups (Group I, II, III and IV). In Group II and IV, the patients were administered 150 microgram of oral clonidine 90 minutes before induction of general anesthesia. Thiopental sodium was used as induction agents in Group I and II, propofol in Group III and IV. We measured systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate at ward before administration of oral clonidine premedication (baseline value), before induction, after administration of induction agent, just after intubation, 1, 2, 3 and 5 minutes after endotracheal intubation. RESULTS: The systolic, diastolic and mean arterial pressure and heart rate were increased significantly in all 4 groups (P<0.05) when compared to baseline value of each group but lower in Group IV (P<0.05) compared to Group I, II, III. CONCLUSION: Clonidine 150 microgram premedication and induction of general anesthesia with propofol blunts hemodynamic changes induced by endotracheal intubation.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Blood Pressure* ; Clonidine* ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Hypertension ; Intubation ; Intubation, Intratracheal* ; Male ; Premedication* ; Propofol ; Tachycardia ; Thiopental

This study examined whether amifostine (WR-2721) could attenuate memory impairment and suppress hippocampal neurogenesis in adult mice with the relatively low-dose exposure of acute radiation syndrome (ARS). These were assessed using object recognition memory test, the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay, and immunohistochemical markers of neurogenesis [Ki-67 and doublecortin (DCX)]. Amifostine treatment (214 mg/kg, i.p.) prior to irradiation significantly attenuated the recognition memory defect in ARS, and markedly blocked the apoptotic death and decrease of Ki-67- and DCX-positive cells in ARS. Therefore, amifostine may attenuate recognition memory defect in a relatively low-dose exposure of ARS in adult mice, possibly by inhibiting a detrimental effect of irradiation on hippocampal neurogenesis.
Acute Radiation Syndrome/drug therapy/*immunology/psychology ; Amifostine/*pharmacology/therapeutic use ; Animals ; Apoptosis/immunology ; Gamma Rays/*adverse effects ; Hippocampus/immunology ; Immunohistochemistry ; In Situ Nick-End Labeling ; Male ; Memory/*radiation effects ; Mice ; Mice, Inbred ICR ; Neurogenesis/immunology ; Radiation-Protective Agents/*pharmacology/therapeutic use