In this study noise source in a ward at four general hospitals in Seoul area has investigated and analysed. The degree of reaction against noise by 171 randomly has also been examined. The results of the study have shown that the source of noise is the speakers of wired broadcasting or from visiting guests in two hospitals located in residential area. The patients at the two other hospitals located at commercial site have been suffered more from traffic noise, However, because of their separated living at hospital from their ordinary houselife, sixty on percent of the inpatients have wished a music sound of around 60 dB (A). After having considered the results of the investigation and wishes of the inpatients, following suggestions have been made: 1. Reduce the number of guests or their length of stay. 2. Wired bodadcasting system should be substitued by sireless one, or if it's unavoidable, it should be used in office rooms only. 3. Since the stops and starts of vehicles induce much noise, Seoul City Government be requested to prepare an appropriate administrative measure for the vehicles around hospital area and ti should prevent the establishment of new hospitals along high way site. 4. By using earphone, inpatients can choose a wireless channel according to each individual's taste. This through the masking effect, would cover up the noise source. 5. Rooms along the streets should be utilized as offices, otherwise double windows should be set up for inpatient's wards.
Hospitals, General ; Humans ; Inpatients ; Length of Stay ; Local Government ; Masks ; Music ; Noise* ; Seoul

No abstract available.
Hirschsprung Disease*

A retrospective analysis was conducted on ski injury collected in past 12 years, from 1982 to 1995, exception of 1986 and 1987 at the Young Pyeong Ski Resort in Korea. A total of 3,093,667 skiers during the 12 years period are cohort of this investigation. Of 3,093,667 skiers, 7,172 injuries were indexed by anatomic region and severity according to diagnosis on initial evaluation. The frequency of injury changes from 3.4 to 1.5 per 1,000 skier-days during the 12 years. The rate of upper extremity to lower extremity injury increased from 1:1.33 to 1:0.89 during the study period(P<0.005). The most common upper extremity injury pattern was simple injury including laceration and contusion(74.2%). The ulnar collateral ligament injury of thumb make up of 6.5% of all injuries. In conclusion, upper extremity skiing injury was related to 1) Skiers activity level, 2) Skiers skill, 3) Degree of fatigue, 4) Slope condition, 5) Improvement of ski equipment, and 6) Increased skiing population density.
Cohort Studies ; Collateral Ligaments ; Diagnosis ; Fatigue ; Health Resorts ; Korea* ; Lacerations ; Lower Extremity ; Population Density ; Retrospective Studies ; Skiing ; Snow* ; Thumb ; Upper Extremity*

No abstract available.
Solvents*

The aim in arthrodesis of ankle is to gain a painless, normal walking gait of destroyed ankle joint caused by various origins. Despite more than 30 different fusion techniques have been described in the literature, but the results were not always satisfactory. Blair introduced tibial sliding graft, rectangular hone block donated at distal tibia, to the neck of talus. His method has advantages of a normal apperance of the foot, no shortening, and the weight bearing thrust on normal tissue. The purpose of this study was to compare the ankle arthrodesis according to surgical procedures & introduce the method which could produce excellent results for ankle arthrodesis. We reviewed 23 patients(24 cases) undergone ankle arthrodesis from Jan. 1989 to Dec. 1996 in Kyung Hee Medical Center. Male were twelve(13 cases) and female were eleven. Mean age was 42.6(l8-75)years. The Blair fusion method was used in ten cases. Iliac bone graft followed by internal fixation using Steinmann pin in 4 cases, using cancellous screw in I case, and using both Steinmann pin and staple in 1 case, while tibiotalar coaptation without bone graft followed by internal fixation using Steinmann pin in 3 cases, using staple in 1 case, and using cancellous screw in 1 case. In 3 cases, arthroscopic abrasion and cancellous screw was used. The mean duration of follow-up was 46(6-99) inonths. Time to union was average l4.6(8-23) weeks in Blair fusion and 17.5(8-40) weeks in other methods. Delayed union was observed in three cases, but no case was found in Blair fusion. Pain was ohserved in 5 cases, 3 in Blair fusion and 2 in other methods. Nonunion or pseudoarthrosis was not ohserved. On the clinical criteria for Boston Childrens Hospital ankle-scoring system, we ohserved nineteen excellent and five good cases. The difference in results according to fusion method was not ohserved. The results in tibiopedal motion using cineroentgenography were seven good and three fair cases in Blair, while two good, ten fair and two poor in other methods. By using Blair fusion, we expect early bony union and better clinical results.
Ankle Joint ; Ankle* ; Arthrodesis* ; Child ; Female ; Follow-Up Studies ; Foot ; Gait ; Humans ; Male ; Neck ; Pseudarthrosis ; Talus ; Tibia ; Transplants ; Walking ; Weight-Bearing

As trochanteric fractures frequently occur in the elderly patients and complications such as pneumonia, thrombo-embolic disease, decubitus ulcer, and urinary tract infection are common, early mobilization after open reduction and internal fixation with hip nail are the standard treatment. Since 1931 when Smith-Peterson first introduced a tri-flanged nail, further more, since 1941 when Jewett pioneered the one-piece nail by adding a solid plate to a Smith-Peterson nail, numorous implants including threaded pins, screws, nails, and plates have been modified and desiged for fractured hips till now to achieve early ambulation and to maintain stable reduction. In 1955 Pugh and Ken introduced a sliding nail-plate and Schumpelick described the use of sliding screw-plate, which was modified further by Callender and Holt pioneered the concept of heavy nail in 1963. Recently compression sliding screw-plate is popular. Also many surgeons such as Evans, Dimon and Hughston, Sarmiento, and Boyd and Anderson have attempted to provide stable fixation of fracture by altering the position of fracture fragments to improve the mechanical resistances of bone to disruptive forces of weight-bearing. The surgical procedures of open reduction and internal fixation were carried out and followed for more than 6 months on 45 intertrochanteric fractures at Department of Orthopedic Surgery, Seoul National University Hospital, from Jan. 1968 to June. 1975 and the results were observed as follows. 1. Of 45 cases of inter-trochanteric fractures 28 cases occurred in man, 17 cases in woman and each mean age was 54 years in man, 74 years in woman. 2. Of fixation devices, Smith-Peterson nail-plates were used in 19 cases, Jewett nails in 15 cases, compression sliding screw-plates in 9 cases, Smith-Peterson nail in 1 case, and Ken sliding nail-plate in 1 case. 3. Stable fractures occurred in 10 cases were fixed internaly after anatomical reduction. 4. Dimon-Hughston reductions and Jewett Nailing were achieved in 11 cases of 12 unstabIe fractures and had disadvantages such as some limitation of R.O.M. of the affected hip, shortening, and valgus deformity. 5. Of 9 unstable fractures treated by compression sliding screw-plate 7 cases were reduced as anatomicaly as possible and 2 cases were reduced non-anatomicaly because of impossible anatomical reduction but good results were obtained except one failed nailing. 6. Of 7 failures, 6 cases resuIted from failures of nailing during operation and only 1 failure resulted in varus defermity after Dimen-Hughston reduction with Jewett nail.
Aged ; Congenital Abnormalities ; Early Ambulation ; Female ; Hip ; Hip Fractures ; Humans ; Orthopedics ; Pneumonia ; Pressure Ulcer ; Seoul ; Surgeons ; Urinary Tract Infections ; Weight-Bearing

Great strides has been made in the past 20 years in the treatment of scoliosis. Treatment before scoliosis becomes severe eliminates the need for extensive surgery. Early detection of scoliosis by school screening has proven to be valuable for early diagnosis and prevention of severe deformities. Authors screened 5,256 middle and high school students in Seoul, who were chosen arbitrarily, to determine the incidence rates of scoliosis, and following results were obtained. 1. Scoliosis was diagnosed on a combination of at least one positive physical sign and a lateral curvature more than 5 degrees on an antero-posterior standing X-ray. 2. The overall incidence of scoliosis was 4.68% (Male 0.74%, Female 6.43%). 3. Idiopathic scoliosis was found in 238 students, congenital scoliosis in 5, and paralytic scoliosis in 3. 4. The most common pattern of curvature was thoracic curve. 5. In the single curve right to left ratio was 2.1, but 8.4 in the upper curve of double curve. 6. Close observations were required for all the 246 students and treatment was required in 14 students who had more than 20 degrees, 9 students for Milwaukee brace, and 5 students for surgical correction.
Braces ; Congenital Abnormalities ; Early Diagnosis ; Female ; Humans ; Incidence ; Korea ; Mass Screening ; Scoliosis ; Seoul

We retrospectively studied 53 cases of thymic tumors diagnosed after thymectomy to clearfied the pathologic difference of thymic tumor associated with myasthenia gravis and without myasthenia gravis. Among them, there are 23 cases with myasthenia gravis; 19 among 36 thymomas(52.8%), 3 of 4 thymolipoma (75%) and 1 squamous cell carcinoma. Lymphoma and teratoma are not associated with myasthenia gravis. There is no significant difference in the prevalence of myasthenia gravis between types of the old traditional classification of thymoma. But according to the new Muller-Hermelink classification, about two-thirds of myasthenia gravis have the thymoma with cortical cell origin. The prevalence of myasthenia gavis were relatively low in the patients with thymoma of medullary or mixed type. The frequent association of myasthenia gravis was suggesting that the thymolipoma might be a variant of thymoma, cortical type.
Carcinoma, Squamous Cell ; Classification ; Humans ; Lymphoma ; Myasthenia Gravis* ; Prevalence ; Retrospective Studies ; Teratoma ; Thymectomy ; Thymoma ; Thymus Gland* ; Thymus Neoplasms

Intraventricular hemorrhage (IVH) is common in the premature infants and occurs mainly in subependymal germinal matrix. In contrast, IVH in the term infants is rare and different in pathogenesis and bleeding sites from those of the premature infants. Most studies of IVH in term infants have been studied by computerized tomography and postmortem examination. Brain ultrasonography which has become a frequently used diagnostic tool of IVH in the premature infants is reported to be also effective in diagnosis in the term infants. The study population comprised 11 term neonates admitted to the Neonatal Intensive Care Unit of Seoul National University Children's Hospital between July 1989 and June 1991, in whom IVH was diagnosed by ultrasonography. We analysed severity of birth asphyxia. ultrasonographic findings and clinical manifestations to investigate severity, timing, risk factors, and pathogenesis of IVH in the term neonates. 1) Apgar scores were available in 7 cases with severe asphyxia (Apgar at 1 min: less than 3), 1 cases with mild asphyxia (Apgar at 1 min: between 5~7), and 2 cases without asphyxia. 2) Clinically, 4 cases had fetal distress, and 3 cases had meconium aspiration pneumonia. 3) Bleeding sites by ultrasonography were subependymal germinal matrix in all 11 cases. IVH of choroid plexus was combined in 2 cases. Severity of IVH were grade I in 9 cases, grade II in 2 cases by Papile's classification. 4) There were no correlations between the grade of IVH and severity of perinatal asphyxia. In conclusion, ultrasonography is very useful in diagnosis and follow-up of IVH in term neonates. Subependymal germinal matrix could be common site of IVH in term neonates because germinal matrix still remains in term neonates despite of its regression. Also this can explain why IVH in our cases is not severe.
Asphyxia ; Autopsy ; Brain ; Choroid Plexus ; Classification ; Diagnosis ; Fetal Distress ; Follow-Up Studies ; Hemorrhage* ; Humans ; Infant* ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Meconium Aspiration Syndrome ; Parturition ; Pneumonia ; Risk Factors ; Seoul ; Ultrasonography

To determine the effects of central nervous system (CNS) involvement in systemic Lupus erythematosus (SLE) on cerebrospinal fluid (CSF), CSF studies of 35 cases of SLE (22 cases with CNS involvement and 13 cases without CNS involvement) were analyzed and compared with 20 normal CSF studies. The mean values of several CSF parameters were significantly changed in the group of SLE with CNS involvement (increased protein, white blood cell (WBC) counts and pressure, and decreased glucose contents), but not in the group of SLE without CNS involvement. In 22 case of SLE with CNS involvement, 10 cases (45.5%) were more than 4 WBC's in CSF, 12 cases (54.6%) more than 40 mg/dl of CSF protein and 8 cases (36.4%) less than 40 mg/dl of CSF glucose. CSF pressure was increased more than 200 mm CSF in 41.2%. On the other hand, in 13 cases of SLE without CNS involvement, the CSF studies were almost normal except 4 cases (30.8%) of more than 40 mg/dl in CSF protein.
Central Nervous System ; Cerebrospinal Fluid* ; Glucose ; Hand ; Leukocytes ; Lupus Erythematosus, Systemic*