Bartter's syndrome is a rare tubular disorder characterized by hypokalemic, hypochloremic metabolic alkalosis, hyperreninemic, hyperaldosteronism, hyporesponsiveness to pressor agents and juxtaglomerular apparatus heperplasia. We report a case of Bartter's syndrome of a 5 month-old male infant with subdural hematoma who was confirmed by characteristic clinical, laboratory findings and kidney biopsy.
Alkalosis ; Bartter Syndrome* ; Biopsy ; Epilepsy* ; Hematoma, Subdural* ; Humans ; Hyperaldosteronism ; Infant ; Juxtaglomerular Apparatus ; Kidney ; Male ; Seizures*

n-Hexane and benezene are organic compounds which have been widely used as industrial solvents. However, they are also increasingly recognized as important pollutants in working environment. The purpose of this study is to analyze neurotoxicity of benzene and n-Hexane. In this study, tibial nerve of Sprague-Dawley rats were observed after exposing them to two different concentrations of these compounds (6000 ppm of n-Hexane and 2000 ppm of benezene) which were known to be the levels to cause subacute toxicity for the three different periods; two weeks, four weeks, and sex weeks. The following results were obtained from the analysis of variance, Duncan's multiple comparison test, and regression analysis: 1) Myelin sheath thickness of nerve fiber for two n-Hexane exposed groups (four weeks and six weeks) were both reduced compared with the control group and the benezene exposed group. 2) There were positive relationships between nerve fiber diameter and myelin sheath thickness for both exposed and control groups. 3) There were significant difference in myelin sheath thickness from equal diameter nerve fibers between benzene exposed group and control group, but the greater number of thin myelin sheath were observed for n-Hexane exposed group compared with control group. Thus, it is concluded that n-Hexane tends to reduce the rate of growth of nerve fiber more than the benzene and control group. While these results shed light on understanding the effects of benzene and n-Hexane, the duration of exposure was not long enough to apply these results to real working environments. In addition, to further understand the mechanism of nerve degeneration caused by organic solvents, both epidemiological and biochemical studies should accompanied by this kind of study.
Animals ; Benzene* ; Myelin Sheath ; Nerve Degeneration ; Nerve Fibers ; Rats* ; Rats, Sprague-Dawley ; Solvents ; Tibial Nerve*

The objective of this study is to examine the correlation between the tolylene concentration in the work environment of organic solvents and the concentration of hippuric acid in urine of workers exposed toluene, and to acquire the fundamental materials of workers' health care and to assist the assessment of the biological permissible exposure limit. The control groups are 72 workers who had never been exposed to toluene and the case groups are 101 workers who had been exposed to toluene. This study was conducted to examine the correlation between the concentration of toluene in work environment and workers' hippuric acid concentration, to investigate the complaint difference of subjective symptoms by means of questionnaire, between the case groups and control groups. The results and conclusions are as follows: 1) The highest mean concentration of toluene in the air is 544.13+/-7.75 ppm in the Printing Department of mixing organic solvents. The concentrations of the others are 463.27+/-5.24 ppm in Department of mixture for organic solvents, and 393.56+/-45.69 ppm in the Printing Department(1), and 248.38+/-45.16 ppm in the Printing Department(2), and 159.38+/-18.51 ppm in the Printing Department(3). 2) The highest mean concentration of hippuric acid in urine is 6034.84+/-1298.35 mg/l in the Printing Department with mixing organic solvents. The concentrations of the others are 4798.44+/-784.53 mg/l in Department of mixture of organic solvents, and 2883.06+/-701.90 mg/l in the Printing Department(1), and 1449.98+/-905.19 mg/l in the Printing Department(2), and 598.52+/-299.43 mg/l in the Printing Department(3). 3) As the toluene concentration in the work environment becomes higher, the concentration of hippuric acid in urine also becomes higher. It is found that the coefficient of correlation between toluene concentration and the concentration of hippuric acid are positive (r=0.868, Y=7.18X+349.57). 4) It is found that the case groups complain of much more subjective symptoms than the control groups.
Delivery of Health Care ; Surveys and Questionnaires ; Solvents ; Toluene*

No abstract available.
Female ; Obstetric Labor, Premature* ; Pregnancy ; Ritodrine*

PURPOSE: To evaluate the clinical characteristics of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures and assess the surgical outcomes of a novel, closed intramedullary nailing surgical approach designed to minimize fixation failure. MATERIALS AND METHODS: Between May 2013 and April 2017, 31 patients with intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures treated with closed intramedullary nailing or long proximal femoral nail antirotation (PFNA) were enrolled in this study. Preoperative data included age, sex, injury severity score, body mass index, location of shaft fracture, injury mechanism, accompanying traumatic injury, walking ability before injury, and surgical timing. Perioperative outcomes, including follow-up period, types of intramedullary nails, number of blocking screws used, operation time, and blood loss were assessed. Radiologic outcomes, including union rate, time from surgery to union, and femoral shortening, and clinical outcomes, including hip flexion, walking ability, and Harris hip score were also evaluated. RESULTS: A total of 29 unions (93.5%) were achieved. The time to union was 16.8 months (range, 11–25 months) for hip fractures (15.7 weeks for intertrochanteric fractures and 21.7 weeks for subtrochanteric fractures) and 22.8 months for femoral shaft fractures. There were no significant differences in surgical outcomes between the two groups except for type of intramedullary nail. CONCLUSION: Closed intramedullary nailing in the treatment of intertrochanteric or subtrochanteric fractures associated with ipsilateral femoral shaft fractures may be a good surgical option. However, fixation of femoral shaft fractures might not be sufficient depending on the implant design.
Body Mass Index ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip ; Hip Fractures ; Humans ; Injury Severity Score ; Walking

PURPOSE: Iliosacral screw fixation is an effective and less invasive method that is used widely for the definitive treatment of unstable pelvic ring injuries. On the other hand, fixation failures after iliosacral screw fixation have been reported in vertically unstable pelvic ring injuries. This study examined the surgical outcomes of posterior pelvic fixation using S1 and S2 screws in vertically unstable pelvic ring injuries. MATERIALS AND METHODS: Between January 2011 and April 2016, 17 patients with vertically unstable pelvic ring injuries who met the minimum 1 year follow-up criteria were treated with internal fixation using posterior pelvic S1 and S2 screws. Their mean age was 43.9 years. According to the AO/OTA classification, 10 patients had C1, 6 had C2, and 1 had C3 injuries. Surgical treatments of single or multiple steps, where necessary, were performed by two surgeons. The clinical and radiologic outcomes were assessed retrospectively using radiographs and medical records. RESULTS: Overall, 16 patients had bone healing without screw loosening; however, one patient could not maintain anterior pelvic fixation because of an open fracture and deep infection in the anterior pelvic ring. Of five patients who complained of neurological symptoms after injury, three had partially recovered from their neurological deficit. At the last follow-up, the clinical outcomes according to the Majeed score were excellent in 5, good in 6, fair in 4, and poor in 2 patients. The postoperative radiologic outcomes by Matta and Tornetta's method were excellent in 5, good in 8, and fair in 4 patients. Malposition of the S2 screw was identified in one case. The mean time to union was 14.6 weeks after surgery. CONCLUSION: S1 and S2 screw fixation can be an effective treatment option for posterior pelvic stabilization in vertically unstable pelvic ring injuries when considering the surgical outcomes, such as screw loosening and loss of reduction.
Classification ; Follow-Up Studies ; Fractures, Open ; Hand ; Humans ; Medical Records ; Methods ; Retrospective Studies ; Surgeons

Although surgical techniques for treating acetabular fracture are evolving, the use of periacetabular screws is common, and their placement in acetabular surgery is still technically demanding. For instance, intraarticular screw perforation is a serious complication that may occur during surgical treatment of an acetabular fracture. Here, we describe the case of a 50-year-old female who experienced an intraarticular screw perforation after surgical treatment of a posterior acetabular wall fracture. Removal of the perforated screw was performed arthroscopically based on its ability to offer minimally invasive access to the hip joint. One year after removal of the screw, no radiological signs of osteoarthritic changes were observed. The patient regained normal ambulation without limitations to range of motion or hip pain. To our knowledge, this is the first report on the use of arthroscopy to treat intraarticular screw perforation after surgical treatment of an acetabular fracture.
Acetabulum ; Arthroscopy ; Female ; Hip ; Hip Joint ; Humans ; Middle Aged ; Range of Motion, Articular ; Walking

Metabolic syndrome is a cluster of diseases that include central obesity, hyperglycemia, dyslipidemia, and hypertension. Metabolic syndrome is a risk factor for type 2 diabetes and cardiovascular disease and the key pathophysiology is insulin resistance. Thyroid hormone has been known to play an important role in lipid and glucose metabolism and hypothyroidism causes atherosclerosis and insulin resistance. A number of clinical studies reported overt or subclinical hypothyroidism is associated with metabolic syndrome, and there has been the efforts elucidating a link between these two diseases. Recently, thyroid hormone analogue or thyromimetics has been developed to improve metabolic syndrome including dyslipidemia. I reviewed recently reported mechanisms explaining the association between hypothyroidism and metabolic syndrome, and current status of the development of thyromimetics was also reviewed.
Atherosclerosis ; Cardiovascular Diseases ; Dyslipidemias ; Glucose ; Hyperglycemia ; Hypertension ; Hypothyroidism* ; Insulin Resistance ; Metabolism ; Obesity, Abdominal ; Risk Factors ; Thyroid Gland

PURPOSE: To investigate long-term visual outcomes and prognostic factors to predict visual outcomes in patients with anatomic success after macular hole surgery. METHODS: Medical records of 36 eyes with successfully repaired stage 3 or 4 idiopathic macular hole and with at least 24 months of follow-up were reviewed. Hole height, stage of macular hole, base diameter, minimum diameter, hole form factor, macular hole index, and hole closure type were measured or calculated, and the correlations of visual outcomes with variables of preoperative optical coherence tomography (OCT) were analyzed. RESULTS: The patients were classified into 3 groups according to the time period necessary to achieve the best corrective visual acuity. The visual acuity of 16 eyes (44.4%) recovered in a mean of 6 months, 13 eyes (36.1%) improved slowly and continuously, and 7 eyes had no improvement despite successful anatomical closure. There were no statistical differences in hole height, base diameter, minimum diameter, hole form factor, macular hole index, or closure type among the 3 groups. CONCLUSIONS: The improvement in visual acuity after successful macular hole surgery persisted at the 24-month follow-up and after. There were no correlations between delayed visual acuity after macular hole surgery and minimum diameter, base diameter, hole height, hole form factor, macular hole index, or closure type.
Eye ; Follow-Up Studies ; Humans ; Medical Records ; Retinal Perforations ; Tomography, Optical Coherence ; Visual Acuity

Subjective symptoms, counts of blood cells and liver function test were conducted on 198 male workers who were exposed to toluene in Kyungin area from September to November, 1986. According to level of urinary hippuric acid concentration, the total sample was classified into the high exposure group (concentration > or = 3g/l) and the low exposure group(concentration < 3g/l). The following findings were obtained by comparing the two group: 1) Contrary to the previous findings, the urinary hippuric acid concentration of toluene exposed workers showed bimodal distribution. It meant that the toluene exposed workers were mixed with the non-exposed or minimal exposed workers. 2) The high exposure group showed a lower level of leucocccytes counts (6,630+/-1,860/microliter) than the low exposure group (6,340+/-1,960/microliter). 3) The high exposure group showed a higher level of SGOT, SGPT and r-GTP than the low exposure group(P<0.05). 4) The high exposure group complained much more subjective symptoms (e.g. skin rash, loss of appetite, palpitation) than the low exposure group.
Alanine Transaminase ; Appetite ; Aspartate Aminotransferases ; Blood Cells ; Exanthema ; Humans ; Liver Function Tests ; Male ; Toluene*