9 Cases of femoral head fractures treated in Seoul National University Hospital were reviewed. They were classified according to Pipkin, and assessed according to Ebstein's criteria. The longest follow-up was 3 years and the shortest 6 months, the average being 1 year and 6 months. l. 8 cases were injured due to auto accident and there was no one who had worn seatbelt. 2. 1 case of intestine rupture and 2 cases of homothorax were accompanied. 3. There were 1 excellent, 1 good, and 1 poor results in 3 cases of Pipkin type 1, 1 fair result in 1 case of Pipkin type 2, 1 good and 1 fair results in 2 cases of Pipkin type 3, 1 good and 2 fair results in 3 cases of Pipkin type 4. 4. The following complications were encountered, 2 cases of sciatic nerve palsy, 1 case of avascular necrosis of femoral head, 1 case of traumatic arthritis.
Arthritis ; Follow-Up Studies ; Head ; Intestines ; Necrosis ; Rupture ; Sciatic Neuropathy ; Seoul

The authors conducted an in-Vivo experimental study using sciatic nerve of 200-300 grammed rats to verify clinical applicability of Silicone cuffing method, by which scar adhesion of repaired nerve in crushed limb is assumed hopefully to be reduced. The following observations were obtainable. 1. Nerve conduction velocity was noted faster in Silicone cuff group than in control group significantly after 6 weeks postoperatively. 2. Adhesion of repaired nerve with surrounding scar tissue was far less present in Silicone cuff group than in control group when observed grossly. 3. The amount of scar formation and axonal degeneration were noted reduced remarkably in Silicone cuff group than in control group after 3 weeks postoperatively. 4. The intraneural vascularity was noted reduced either in Silicone cuff group and in control group, but definitely less reduced in the former than in the latter. Clinical relevance: Above results may be taken as an experimental basis supporting clinical applicability of Silicone cuff wrapping method for neurorraphy in crushed limb.
Animals ; Axons ; Cicatrix ; Extremities ; Methods ; Neural Conduction ; Peripheral Nerves ; Rats ; Sciatic Nerve ; Silicon ; Silicones

OBJECTIVE: This study was conducted to investigate the incidence rate of fatty liver and it's related factors based on a three year follow up of multiphasic health screening participants. METHODS: 671 male workers who had participated in both initial and second multiphasic health screening were selected. Initial screening was performed during the year of 1996 to 1997 and second screening was performed during the year of 1999 to 2000. Among them, four hundred and thirty workers who didn't initially have a fatty liver were selected as the final study subjects. They were classified into 2 categories according to the initial and second hepatic ultrasonographic findings; stationary normal(307, 71.4%), and fatty liver incident(123, 28.6%). The incidence rate was calculated using the incidence density method. RESULTS: The incidence rate of fatty liver among the male workers was 9.73 per 100 person-years. The white collar workers had a higher incidence rate(10.66) than the blue collar workers(8.14). The incidence density ratio of alcohol drinking to fatty liver incidence was 1.41, and the incidence density ratio of low vegetable diet was 1.63. The incidence density ratio of obesity was 1.78 for the 100-109% obesity index group, 2.83 for the 110-119% obesity index group, 4.25 for the >or=120% obesity index group over <100%. Smoking, regular exercise, salty food preference, and taking food supplement had no significant effect on the incidence of fatty liver. The fatty liver incident group had higher initial blood pressure, GPT, gamma GTP, fasting blood sugar, HbA1c, uric acid, total cholesterol and triglyceride levels than the stationary normal group. However, there were no differences in the GOT, HDL-cholesterol or LDL-cholesterol levels. In the multiple logistic regression analysis, obesity index and serum triglyceride were found to be major factors in the incidence of fatty liver after controlling age, alcohol drinking, vegetable diet, daily coffee intake, blood pressure, HbA1c, total cholesterol, and uric acid levels. CONCLUSION: The incidence rate of fatty liver among the male workers was 9.73 per 100 person-years. The lifestyles which gave rise to an increasing incidence of fatty liver were those involving excessive alcohol drinking, obesity, and low vegetable diet. Moreover, many cardiovascular disorder related health indices such as blood pressure, and the blood sugar, blood lipid and uric acid levels, were related to the incidence of fatty liver.
Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Cholesterol ; Coffee ; Diet ; Dietary Supplements ; Fasting ; Fatty Liver* ; Follow-Up Studies ; Food Preferences ; Guanosine Triphosphate ; Health Behavior ; Humans ; Incidence* ; Life Style ; Logistic Models ; Male* ; Mass Screening ; Obesity ; Smoke ; Smoking ; Triglycerides ; Uric Acid ; Vegetables

OBJECTIVES: This study was conducted in order to assess the experience of needle stick injury among interns and residents working in hospitals during the previous 4 months. METHODS: We conducted a questionnaire survey of 695 interns and residents working in two university hospitals and one general hospital in Tague city. Four hundred and forty three of those questioned(63.7 %) fully responded. RESULTS: Two hundred of the respondents(45.1 %) suffered at least one injury. Respondents suffered an average of 1.8 injuries. 96.5 % of interns, 40.6 % of surgical residents and 34.4 % of non-surgical residents suffered at least one injury. According to multiple logistic regression, Intern status and an increased amount of working time is associated with high risk of needle stick injury. CONCLUSIONS: This study demonstrates that interns and residents suffer a high rate of needle stick injury.
Data Collection ; Hospitals, General ; Hospitals, University ; Logistic Models ; Needles* ; Needlestick Injuries* ; Questionnaires

OBJECTIVES: The purpose of this study was firstly to introduce a Participatory Action-Oriented Training (PAOT) program for the prevention of work-related musculoskeletal diseases (WRMSDs) in Small and Medium sized Enterprises in the Gumi Industrial Zone, and secondly to assess its effect. METHODS: Two PAOT workshops to prevent WRMSDs were conducted with 39 volunteer participants from 10 companies selected (on a first-come, first-served basis) among 200 small- or medium-sized enterprises in Gumi. These companies had been provided with mandatory occupational health management agency services for Small and Medium sized Enterprises by an occupational medicine clinic. Each workshop consisted of 6 technical sessions and one closing ceremony. At the 1st session, the principles of each action checklist item were explained and an on-site checklist exercise was carried out. The 2nd to 5th sessions presented good example pictures on 4 subjects: material storage and handling, working environment, work organization and work-related welfare. Group discussions were carried out by the participants. In the final 6th session on the implementation of improvement, each participant was asked to present 6 action plans, 3 short-term and 3 long-term, for their own workplace improvement. RESULTS: Overall, the participants worked out 47 real action plans, 27 short-term and 20 long-term, for improvement of their own workplaces. Three to 6 months after the workshops, through in-person visits to each company, it was confirmed that more than half of these 47 plans had been completed; 25 plans (53.2%) had been completed as planned, 8 (17.0%) were in processing, and 14 (29.8%) had not yet been put into practice. CONCLUSIONS: The study findings confirmed that the PAOT program holds strong potential as an intervention method to prevent WRMSDs in Small and Medium sized Enterprises, although the final results have not been fully assessed yet.
Checklist ; Education ; Gyeongsangbuk-do ; Musculoskeletal Diseases ; Occupational Health ; Occupational Medicine ; Volunteers

OBJECTIVE: To evaluate the craniofacial asymmetry in adults with neglected congenital muscular torticollis (CMT) by quantitative assessment based on craniofacial three-dimensional computed tomography (3D-CT). METHODS: Preoperative craniofacial asymmetry was measured by 3D-CT for 31 CMT subjects > or =18 years of age who visited a tertiary medical center and underwent 3D-CT between January 2009 and December 2013. The relationship between the age and the severity of craniofacial asymmetry was analyzed in reference to anteroposterior length asymmetry of the frontal bone and zygomatic arch, vertical and lateral displacements of the facial landmarks, and mandibular axis rotation. RESULTS: The age at CT was 27.71+/-7.02 years (range, 18-44 years). All intra-class correlation coefficients were higher than 0.7, suggesting good inter-rater reliability (p<0.05) of all the measurements. The frontal and the zygomatic length ratio (i.e., the anteroposterior length asymmetry on the axial plane) was 1.06+/-0.03 and 1.07+/-0.03, respectively, which was increased significantly with age in the linear regression analysis (r2=0.176, p=0.019 and r2=0.188, p=0.015, respectively). The vertical or lateral displacement of the facial landmarks and rotation of the mandibular axis did not significantly correlate with age (p>0.05). CONCLUSION: Craniofacial asymmetry of neglected CMT became more severe with age in terms of anteroposterior length asymmetry of the ipsilateral frontal bone and zygomatic arch on the axial plane even after growth cessation. This finding may enhance the understanding of therapeutic strategies for craniofacial asymmetry in adults with neglected CMT.
Adult* ; Axis, Cervical Vertebra ; Craniofacial Abnormalities ; Facial Asymmetry ; Frontal Bone ; Humans ; Linear Models ; Torticollis* ; Zygoma

A case of acquired Brown syndrome caused by surgical repair of medial orbital wall fracture is reported in the present paper. A 23-year-old man presented at the hospital with right periorbital trauma. Although the patient did not complain of any diplopia, the imaging study revealed a blow-out fracture of the medial orbital wall. Surgical repair with a calvarial bone autograft was performed at the department of plastic surgery. The patient was referred to the ophthalmologic department due to diplopia that newly developed after surgery. The prism cover test at distant fixation showed hypotropia of the right eye, which was 4 prism diopters (PD) in primary gaze, 20 PD in left gaze, while orthophoric in right gaze. Eye movement of the right eye was markedly limited on elevation in adduction with normal elevation in abduction with intorsion in the right eye present. Forced duction test of the right eye showed restricted elevation in adduction. Computerized tomography scan of the orbits showed the right superior oblique muscle was entrapped between the autografted bone fragment and posterior margin of the fracture. When repairing medial orbital wall fracture that causes Brown syndrome, surgeons should always be careful of entrapment of the superior oblique muscle if the implant is inserted without identifying the superior and posterior margin of the orbital fracture site.
Bone Transplantation/*adverse effects ; Diplopia/etiology ; Humans ; Male ; Ocular Motility Disorders/*etiology/radiography ; Ophthalmologic Surgical Procedures/*adverse effects ; Orbital Fractures/*surgery ; Tomography, X-Ray Computed ; Transplantation, Autologous ; Young Adult

Histoplasmosis is particularly virulent in infants, the elderly and immunocompromised individuals. Recently the authors experienced a case of histoplasmosis diagnosed on peripheral blood smear in a newborn. So the authors report a case with brief review of literature.
Aged ; Histoplasmosis* ; Humans ; Infant ; Infant, Newborn

BACKGROUND AND OBJECTIVES: Platelet activation and aggregation, with resultant arterial thrombus formation, play pivotal roles in the pathophysiology of acute coronary syndrome (ACS). The efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin, or low molecular heparin (LMWH), in the management of ACS were evaluated. SUBJECTS AND MEHTODS: One hundred seventeen patients (60.8+/-10.9 years, 76 male), with unstable angina or non-ST elevation myocardial infarction, who had ST-T changes and elevated troponin, were divided into 4 groups : Group I (n=30 : heparin alone), Group II (n=28 : LMWH, dalteparin alone), Group III (n=29 : tirofiban combined with heparin) and Group IV (n=30 : tirofiban with LMWH). The major adverse cardiac events (MACE) among the 4 groups, during 6-month clinical follow-ups, were compared. RESULTS: Percutaneous coronary intervention, or a coronary artery bypass graft, was performed in 23, 19, 19 and 22 patients from Groups I, II, III and IV, respectively (p=0.87). A minor bleeding complication developed in 2 (6.7%), 1 (3.6%), 1 (3.4%) and 2 patients (6.7%) in groups I, II, III and IV, respectively (p=0.79). During the six-month follow-up MACE occurred in 7 (30.4%), 6 (31.6%), 3 (15.8%) and 4 patients (18.2%) in groups I, II, III and IV, respectively (p=0.02 : Group I and II vs. Group III and IV). CONCLUSION: Tirofiban combined with LMWH is safe and may improve the long-term prognosis of patients with ACS.
Acute Coronary Syndrome* ; Angina, Unstable ; Angioplasty ; Blood Platelets* ; Coronary Artery Bypass ; Dalteparin ; Follow-Up Studies ; Glycoproteins* ; Hemorrhage ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Platelet Activation ; Prognosis ; Thrombosis ; Transplants ; Troponin

Thrombi in the right atrium (RA) are infrequent, and are rarely diagnosed before death. In addition, right heart thrombi are frequently associated with major pulmonary thromboembolism, and carry a very high risk of mortality, and therefore, require accurate diagnosis and prompt treatment. RA thrombi are generally associated with dilatation of the atrium, a low cardiac output state, intracardiac catheters, such as endocardial pacemakers and central venous hyperalimentation catheters, recent cardiac surgery, involving the atrium, and peripheral deep vein thrombosis. In addition, some systemic diseases, such as malignant tumors, amyloidosis and nephrotic syndrome, have been shown to contribute to the formation of an intracardiac thrombus. Echocardiography is valuable in the diagnosis of RA thrombi. There are some options in the treatment of RA thrombi, such as anticoagulant therapy using heparin, thrombolytic therapy and surgical removal. However, there is still adverse criticism as to the selection of the correct treatment method. A patient with RA thrombi, who presented with sudden cardiogenic shock, was diagnosed by two-dimensional echocardiography. He had been in a prolonged bed-ridden state because of quadriparesis caused by an injury to the cervical spine. The RA thrombi were successfully treated with anticoagulant and thrombolytic agents.
Amyloidosis ; Cardiac Catheters ; Cardiac Output, Low ; Catheters ; Diagnosis ; Dilatation ; Echocardiography ; Fibrinolytic Agents ; Heart ; Heart Atria ; Heparin ; Humans ; Mortality ; Nephrotic Syndrome ; Pulmonary Embolism ; Quadriplegia ; Shock, Cardiogenic ; Spine ; Thoracic Surgery ; Thrombolytic Therapy ; Thrombosis ; Venous Thrombosis