No abstract available.
Dislocations* ; Tendons*

Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a syndrome with complex genetics and diverse manifestations. Diffuse alveolar hemorrhage is caused by alveolar microcirculation injury associated with lung illness or systemic disorders. To date, the relationship between diffuse alveolar hemorrhage and MELAS has not been reported. We report a MELAS patient who presented complications with diffuse alveolar hemorrhage.

High tibial osteotomy is a useful procedure in the treatment of early stage osteoarthritis of the knee which is confined to the medial compartment. But long term follow-up study of high tibial osteotomy has not been provided yet and its prerequisite for a successful result still remains unrevealed. Since the osteoarthritis can progress after the osteotomy, it may result in the loss of correction and recurrence of pain and require conversion to total knee replacement arthroplasty. We studied clinically and radiologically the long term result of high tibial osteotomy in 11 patients(16 knees) who had been treated at the Department of Orthopaedic surgery of Seoul Paik Hospital during the period from January, 1978 to May, 1989, and follow-up for longer than 4 years. Preoperative mean varus angle was 6.4 degrees and immediate postoperative mean valgus angle was 8.6 degrees and final mean valgus angle was 4.7 degrees. The average loss of correction angle was 3.9 degrees. At 2-year follow-up, the results of 16 knees were as follows; excellent in six knees, good in seven knees. The final results at average 7.2-year follow-up were excellent in four knees, good in six knees and one knee was converted to total knee replacement arthroplasty. The results showed deterioration of clinical results and loss of correction with time after osteotomy. However, in more than half of the cases the results were good or excellent at the final follow-up, We, therefore, conclude that high tibial osteotomy is still a useful procedure in osteoarthritis of the knee if performed with a precise surgical technique and an adequate overcorrection more than 10 degrees.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Knee ; Osteoarthritis ; Osteotomy ; Recurrence ; Seoul

The location of the sigmoid colon varies within the abdominal cavity, but its mesocolon is fixed to the left side. Right side fixation of the sigmoid colon is a very rare congenital positional anomaly. In addition, it has been reported that hepatocolic fistula is also a very rare disease that may present lower gastrointestinal bleeding. Here, the authors describe a case of a 71-year-old man who underwent surgery for hepato-sigmoidocolic fistula complicated by hepatocellular carcinoma and the right side fixation of the sigmoid colon.
Abdominal Cavity ; Carcinoma, Hepatocellular ; Colon, Sigmoid ; Fistula ; Hemorrhage ; Humans ; Mesocolon ; Rare Diseases

BACKGROUND: In the Republic of Korea, Plasmodium vivax malaria, which had disappeared since 1984, re-emerged in 1993. Currently, malaria is becoming a serious public health problem in the Republic of Korea. The diagnosis of malaria has relied on microscopic examination such as thin and thick blood smears. However, even for expert microscopists, this test is a laborious and time-consuming procedure. Therefore, the development of a reliable, easy, and convenient diagnostic test is crucial. Recently, the LG malaria anti-PvTM enzyme-linked immunosorbent assay (ELISA) kit for the detection of a specific antibody against the merozoite surface protein (MSP) of P. vivax was developed. The aim of this study was to evaluate the diagnostic kit for P. vivax malaria in the Republic of Korea. METHODS: To determine the usefulness of the LG malaria anti-PvTM as a diagnostic kit for vivax malaria, a total of 59 serum samples from patients with P. vivax malaria were tested. The patients were diagnosed microscopically and the parasitemia index of their blood was calculated. Sera from 203 uninfected healthy blood donors, which were microscopically negative for Plasmodium vivax, were used as negative controls. RESULTS: The sensitivity and specificity of the LG malaria anti-PvTM were 98.31% (58/59) and 98.03% (199/203), respectively. The false-positive and false-negative rates were 1.97% (4/203) and 1.69% (1/59), respectively. CONCLUSIONS: The diagnostic kit, LG malaria anti-PvTM, might be a useful tool for diagnosis and screening of P. vivax malaria in Korea.
Blood Donors ; Diagnosis* ; Diagnostic Tests, Routine ; Enzyme-Linked Immunosorbent Assay ; Humans ; Korea ; Malaria* ; Malaria, Vivax* ; Mass Screening ; Merozoites ; Parasitemia ; Plasmodium vivax* ; Plasmodium* ; Public Health ; Republic of Korea* ; Sensitivity and Specificity

PURPOSE: The aim of the study was to identify the relationships among age, activities of daily living and health-related quality of life (HRQoL) for centenarians in Busan. METHODS: Forty-nine centenarians (2 males and 47 females) participated in the study, done from April to July, 2006. Pace-to-face interviews were used to collect data. Activities of daily living were measured using K-ADL, K-IADL and health-related quality of life, using the Short Form Health Survey (SF-36). RESULTS: Over 50% of the centenarians reported independence for six-items but not for bathing. With regard to type of dependency, 77.6% were independent in transferring, 71.4%, in using the toilet, 67.3%, in feeding and in continence and 57.1% in dressing but just 24.5% were independent in bathing. Age was significantly associated with K-IADL (r= -.303, p= .03). The centenarians were more impaired in physical health components compared to mental health components for health-related quality of life. CONCLUSION: These results may contribute to a better understanding of activities of daily living and health-related quality of life of centenarians. The findings are relevant to health professionals, in particular professionals who are developing wellness programs to optimize health-related quality of life and functional status for the extremely old age population.
Activities of Daily Living ; Aged, 80 and over ; Bandages ; Baths ; Dependency (Psychology) ; Health Occupations ; Health Promotion ; Health Surveys ; Humans ; Male ; Mental Health ; Quality of Life

Colonoscopy is a safe and standard procedure for diagnosis and therapy of colonic disorders. Iatrogenic colonic perforation during diagnostic colonoscopy, a rare abdominal emergency, has an 0.3~0.8% incidence rate. The choice of treatment for this complication remains controversial. Prompt operative intervention is preferred to minimize morbidity and mortality. However, operative intervention is invasive and needs a long-term recovery period. Conservative treatment is less invasive but can lead to more extensive surgery in case of treatment failure. Very important point on the treatment of iatrogenic perforation of the colon during diagnostic colonoscopy is to avoid the leaking of intestinal contents into the intraperitoneal cavity. We report here a case in which an iatrogenic perforation of the colon during diagnostic colonoscopy was successfully treated by endoscopic clip therapy.
Colon* ; Colonoscopy* ; Diagnosis ; Emergencies ; Gastrointestinal Contents ; Incidence ; Mortality ; Treatment Failure

BACKGROUND: Surgical hepatic inflow obstructions such as the Pringle Maneuver (PM) or hepatic vascular exclusion (HVE) can reduce bleeding during hepatic resection, but ischemia/reperfusion injury of the liver and systemic hemodynamic changes are also inevitable during and after PM or HVE. Nitric oxide plays a pivotal role in ischemia/reperfusion injury. We evaluated hemodynamic changes and changes of nitric oxide during liver ischemia/reperfusion injury excluding the effects of intestinal ischemia. METHODS: Liver ischemia was induced by clamping of the portal triad, infrahepatic and suprahepatic inferior vena cava for 90 minutes. To exclude the effects of intestinal ischemia during liver ischemia, portal and iliac venous blood was bypassed to the jugular vein using a pump. Hemodynamic parameters and nitric oxide were measured serially; before and during ischemia, and after reperfusion. RESULTS: Mean arterial blood pressure (MAP) was well-maintained during ischemia, but after reperfusion, MAP, cardiac output (CO) and stroke volume (SV) significantly decreased (35 - 40, 30 - 40 and 30%, respectively) postischemia. Compared to preischemia, systemic vascular resistance and heart rate did not change after reperfusion. Pulmonary vascular resistance and mean pulmonary arterial blood pressure significantly increased (220 - 250% and 60 - 70%) after reperfusion. Nitric oxide (NO) did not change until 20 minutes after reperfusion, but after 40 minutes reperfusion, NO significantly decreased (20%) compared to preischemia. CONCLUSIONS: After 90 minutes warm liver ischemia/reperfusion causes hypotension induced by decreased CO and SV. Increased PVR seems to be the cause of decreased CO and SV. NO-SVR interaction does not seem to be the cause of postreperfusion hypotension.
Arterial Pressure ; Cardiac Output ; Constriction ; Heart Rate ; Hemodynamics* ; Hemorrhage ; Hypotension ; Ischemia ; Jugular Veins ; Liver* ; Nitric Oxide* ; Reperfusion ; Stroke Volume ; Vascular Resistance ; Vena Cava, Inferior

OBJECTIVES: We aimed to assess the relationship between long-term exposure to air pollution and lung cancer in the Republic of Korea. METHODS: Using the Annual Report of Ambient Air Quality in Korea, Annual Report of National Cancer Registration, and Annual Report on the Cause of Death Statistics, we calculated the standardized mortality ratio (SMR) and standardized incidence ratio (SIR) of lung cancer for both sexes in 74 areas from 7 Korean metropolitan cities. We performed random intercept, Poisson regression using empirical Bayes method. RESULTS: Both SMRs and SIRs in the 7 metropolitan cities were higher in women than in men. Mean SIRs were 99.0 for males and 107.0 for females. The association between PM(10) and lung cancer risk differed according to gender. PM(10) was not associated with the risk of lung cancer in males, but both incidence and mortality of lung cancer were positively associated with PM(10) in females. The estimated percentage increases in the rate of female lung cancer mortality and incidence were 27% and 65% at the highest PM(10) category (> or = 70 microgram/m(3)), compared to the referent category (<50 microgram/m(3)). CONCLUSIONS: Long-term exposure to PM(10) was significantly associated with female lung cancer incidence in 7 Korean metropolitan cities. Further study is undergoing to estimate the relative risk of PM(10) using multi-level analysis for controlling individual and regional confounders such as smoking and socioeconomic position.
Air Pollution/*adverse effects ; Environmental Exposure/*adverse effects ; Female ; Humans ; Korea/epidemiology ; Lung Neoplasms/*epidemiology/mortality ; Male ; Sex Distribution ; Urban Health

BACKGROUND: Depolarizing muscle relaxant, frequently used for rapid sequence endotracheal intubation in clinical field, has serious complication that occur intermittently, such as, hyperkalemia, increased intraoccular pressure and sudden cardiac arrest, especially in infants and adolescents. So the priming principle, i.e., the administration of a subparalyzing dose of a nondepolarizing muscle relaxant (priming dose) prior to the intubating dose, was developed for rapid sequence endotracheal intubation with nondepolarizing muscle relaxant. However, the priming dose sometimes causes complications, such as, swallowing difficulty or pulmonary aspiration, and this can cause patient discomfort or fatal complications. In this study we examined proper atracurium priming dose and evaluated possible complications of priming doses. METHODS: One hundred patients, scheduled for elective surgery were randomly allocated into five groups according to the priming dose used (group 1; 0, group 2; 0.03, group 3; 0.06, group 4; 0.09, group 5; 0.12 mg/kg). Patients received a midazolam and fentanyl injection, the base line TOF ratio was measured, and an intubating dose was given. We also examined changes in vital sign for 20 minutes after injection and noted the time when the twitch height became zero (onset time). RESULTS: In group 1, the onset time was 107 +/- 22.9 sec, and in groups 4 and 5, the onset times were 85.0 +/- 15.6 and 69.9 +/- 19.3 sec, respectively. But, in group 5, some patients showed tachycardia and swallowing difficulty. CONCLUSIONS: The optimal priming dose of atracurium was determined as 0.09 mg/kg, in most cases, however patients sensitivity to the atracurium should be considered.
Adolescent ; Atracurium* ; Death, Sudden, Cardiac ; Deglutition ; Fentanyl ; Humans ; Hyperkalemia ; Infant ; Intubation* ; Intubation, Intratracheal ; Midazolam ; Tachycardia ; Vital Signs