We have employed the external akeletal fixation devices, that is Hoffmann apparatus and Pin and Resin fixation method, for the treatment of 44 cases of long bone fractures from Dec. 1978 to Dec. 1981. The following are our impressins. 1. Hoffmann apparatus and Pin and Resin fixation method proved to be effective and useful measure for the management of fractures of long bones, particulary in cases of the open tibial fractures. 2. Employing the Hoffmann apparatus to the tibial model, the possible limit of correction of the fracture alignment was calculated. It was found that the average angle of correction of deformity can be managed up to 20 degrees in varus and valgus deformity, 70 degrees in anterior angulation, 40 degrees in posterior angulation and 70 degrees in rotation. 3. Pin and Resin fixation method is one of effective means in immobilization of long bones. It is simple to apply, easy to manipulate and inexpensive while offering fair fixation without much complications and therefore we recommend the method as the best alternative to expensive Hoffmann apparatus. 4. The complications of Hoffmann apparatus and Pin and Resin fixation method were pin tract infections and ankle stiffness which were generally minor and prevented by more careful aseptic technique and encouraging early joint motion.
Ankle ; Congenital Abnormalities ; Fracture Fixation ; Fractures, Bone ; Immobilization ; Joints ; Methods ; Tibial Fractures

Cytomegalovirus (CMV) reactivation in immune compromised patients such as those undergoing hematopoietic progenitor cell transplantation (HPCT) and those with HIV infections can cause severe morbidity and mortality despite treatment with appropriate antiviral agents. The recovery of Cytomegalovirus (CMV) specific cytotoxic T lymphocytes (CTL) plays an important role in the reconstitution of CMV specific immunity in immunocompromised patients. Recent studies have reported that CMV reactivation can be successfully treated by adoptive transfer of CMV-specific T cell clones from CMV seropositive donors expanded in vitro with CMV infected fibroblasts or lysates of CMV infected cells. Other studies have used immune dominant CMV proteins or peptides to expand CMV-specific cytotoxic T lymphocytes. This review describes the clinical manifestations of CMV disease in immunocompromised patients, recent advances of antiviral therapy for CMV disease, the principals of the induction of cellular immune response to CMV, and the clinical application of CMV immunotherapy.
Cytomegalovirus Infections/*immunology/*therapy ; Humans ; *Immunocompromised Host ; *Immunotherapy, Adoptive

PURPOSE: Early identification of causative agents in lower respiratory infection of pediatric patients can reduce morbidity and prevent an overuse of antimicrobials. Two kinds of multiplex polymerase chain reaction (PCR) and a commercial shell vial viral culture were performed to identify causative agents in pediatric patients. MATERIALS AND METHODS: Nasopharyngeal aspirates of 220 children diagnosed with viral pneumonia were obtained. Two kinds of multiplex PCR (Seeplextrade mark RV detection kit, and Labopasstrade mark RV detection kit), and a shell vial culture by R-Mix were performed. RESULTS: Positive samples from 220 total samples by two multiplex PCRs were 52.7% and 46.4%, respectively. We also cultured 103 samples that showed positive results of the adenovirus, influenza virus, parainfluenza virus, and respiratory syncytial virus (RSV) by two multiplex PCR. The RSV was most frequently detected in 53.0% (Seeplex) and 51.7% (Labopass) of patients. The detection rate of adenovirus (AdV) was 10.3% and 12.1%, influenza virus (IFV) A and B was 12.5% and 3.4%, and parainfluenza virus (PIFV) 1, 2, and 3 were 2.9% and 2.6%. Shell vial cultures showed concordant results with each multiplex PCR by 96.1% and 77.7%, respectively. Sequencing results were 90% consistent with multiplex PCR. CONCLUSION: Multiplex PCR showed more positivity than the shell vial culture and it can be an effective primary test. Other complementary efforts such as viral cultures and sequencing analysis could be considered, according to clinical and laboratory conditions.
Adenoviridae/genetics/*isolation & purification ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Orthomyxoviridae/genetics/*isolation & purification ; Pneumonia, Viral/*virology ; Polymerase Chain Reaction/*methods ; Respiratory Syncytial Viruses/genetics/*isolation & purification ; Respirovirus/genetics/*isolation & purification

PURPOSE: The extraction of nucleic acid is initially a limiting step for successful molecular-based diagnostic workup. This study aims to compare the effectiveness of three automated DNA extraction systems for clinical laboratory use. MATERIALS AND METHODS: Venous blood samples from 22 healthy volunteers were analyzed using QIAamp(R) Blood Mini Kit (Qiagen), MagNA Pure LC Nucleic Acid Isolation Kit I (Roche), and Magtration-Magnazorb DNA common kit-200N (PSS). The concentration of extracted DNAs was measured by NanoDrop ND-1000 (PeqLab). Also, extracted DNAs were confirmed by applying in direct agarose gel electrophoresis and were amplified by polymerase chain reaction (PCR) for human beta-globin gene. RESULTS: The corrected concentrations of extracted DNAs were 25.42 +/- 8.82 ng/microLiter (13.49-52.85 ng/microLiter) by QIAamp(R) Blood Mini Kit (Qiagen), and 22.65 +/- 14.49 ng/microLiter (19.18-93.39 ng/microLiter) by MagNA Pure LC Nucleic Acid Isolation Kit I, and 22.35 +/- 6.47 ng/microLiter (12.57-35.08 ng/microLiter) by Magtration-Magnazorb DNA common kit-200N (PSS). No statistically significant difference was noticed among the three commercial kits (p > 0.05). Only the mean value of DNA purity through PSS was slightly lower than others. All the extracted DNAs were successfully identified in direct agarose gel electrophoresis. And all the product of beta-globin gene PCR showed a reproducible pattern of bands. CONCLUSION: The effectiveness of the three automated extraction systems is of an equivalent level and good enough to produce reasonable results. Each laboratory could select the automated system according to its clinical and laboratory conditions.
Automation/methods ; DNA/blood/*isolation & purification ; Humans ; Polymerase Chain Reaction ; *Reagent Kits, Diagnostic ; Reproducibility of Results

PURPOSE: To evaluate characteristic MR findings of craniocerebral anomaly and its relationship with neurologic manifestations. MATERIALS AND METHODS: We retrospectively reviewed MR images of 36 patients with craniocerebral anomaly diagnosed by MRI and clinical courses. We correlated the characteristic MR findings in 41 lesions with neurologic manifestastions focusing on seizures and developmental delay. RESULTS: Twenty-three patients with seizures consisted of 14 patients(60%) with neuronal migration disorders and seven(30%) with phakomatosis, among which 18 patients(78%) had generalized type of seizures. Locations of the lesions were the parietal lobes in 11 patients(52%) and the subependymal or periventricular regions in seven(33%). Two patients with tuberous sclerosis had the lesions in both parietal and subependymal areas. Nine patients had the signs of developmental delay that were seen in the four(44%) with schizencephaly, two (22%) with tuberous sclerosis, two(22%) with heterotopia, and one(ll %) with pachygyria. CONCLUSION: Neuronal migration anomaly was relatively common lesion that presented neurologic manifestations such as seizures and developmental delay. Generalized type of seizures was common. We were able to diagnose these anomalies using the MRI that helped establish therapeutic plans.
Humans ; Lissencephaly ; Magnetic Resonance Imaging ; Malformations of Cortical Development ; Neurocutaneous Syndromes ; Neurologic Manifestations ; Neuronal Migration Disorders ; Neurons ; Parietal Lobe ; Rabeprazole ; Retrospective Studies ; Seizures* ; Tuberous Sclerosis

PURPOSE: To investigate the epidemiology of contact lens (CL)-related complications in Korea. METHODS: A questionnaire regarding CL-related complications including patient's gender, age, causative factors, and signs and symptoms was distributed to members of the Korean Ophthalmological Society by The Korean Contact Lens Study Society and the results of the questionnaire analyzed. RESULTS: Responses to the questionnaire written by ophthalmologists from 22 institutes and clinics were collected from 499 subjects over a 20-month period starting in October 2008 and analyzed. The mean age of respondents was 22.9 years and the male-to-female ratio was 1:8.1. The soft CL and cosmetic colored lens comprised the majority (46.6% and 42.1%, respectively) of the reported cases, followed by the rigid gas permeable lens (RGP lens; 10.6%) and orthokeratology lens (0.8%). In subjects using a cosmetic colored lens, 62.2% showed emmetropia and 89.1% of the lenses were prescribed by opticians. The main complications included corneal erosion, sterile corneal infiltrate, allergic disease, conjunctival injection, corneal ulcer, and dry eye syndrome. The most common causative factor of complications was excessive lens wear. Comparing main causative factors according to the RGP lens prescriber, the most common factor was poor lens fit. CONCLUSIONS: The number of cosmetic colored lens-related complications in the emmetropic eyes of young patients is increasing rapidly. Considering opticians are the main CL prescribers in CL-related complications, Korean ophthalmologists need to pay more attention to CL fitting and constant education of patients regarding proper CL wear and care.
Academies and Institutes ; Conjunctival Diseases ; Corneal Ulcer ; Surveys and Questionnaires ; Dry Eye Syndromes ; Emmetropia ; Epidemiology ; Humans ; Korea* ; Patient Education as Topic

Nesidioblastosis, persistent hyperinsulinemic hypoglycemia of infancy (PHHI) is a disorder characterized by diffuse pancreatic islet cell hyperplasia arising from the ductal epithelium. Patients usually present during the neonatal or infantile period with apnea, hypotonia, poor feeding, lethargy, or seizure. Despite of greater awareness, one in three has some degree of mental retardation by the time the diagnosis is made. The diagnosis is established by demonstrating high plasma insulin concentration during an episode of hypoglycemia. This hypoglycemia is initially managed medically, but these medical treatment modalities are failed in more than half of nesidioblastosis. Patient who failed to respond to optimal medical treatment should be referred for surgery early, if permanent neurologic damage is to be avoided. The surgical procedure of choice is near total pancreatectomy (95~98% resection). We herein discuss the anesthetic management of a patient with nesidioblastosis who presented for near total pancreatectomy.
Apnea ; Congenital Hyperinsulinism ; Diagnosis ; Epithelium ; Humans ; Hyperinsulinism ; Hyperplasia ; Hypoglycemia ; Infant* ; Insulin ; Intellectual Disability ; Islets of Langerhans ; Lethargy ; Metabolism ; Muscle Hypotonia ; Nesidioblastosis* ; Pancreatectomy ; Plasma ; Seizures

PURPOSE: This study aims to investigate the most appropriate effect-site concentration of remifentanil to minimize cardiovascular changes during inhalation of high concentration desflurane. MATERIALS AND METHODS: Sixty-nine American Society of Anesthesiologists physical status class I patients aged 20-65 years were randomly allocated into one of three groups. Anesthesia was induced with etomidate and rocuronium. Remifentanil was infused at effect-site concentrations of 2, 4 and 6 ng/mL in groups R2, R4 and R6, respectively. After target concentrations of remifentanil were reached, desflurane was inhaled to maintain the end-tidal concentration of 1.7 minimum alveolar concentrations for 5 minutes (over-pressure paradigm). The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and end-tidal concentration of desflurane were measured for 5 minutes. RESULTS: The end-tidal concentration of desflurane increased similarly in all groups. The SBP, DBP, MAP and HR within group R4 were not significantly different as compared with baseline values. However, measured parameters within group R2 increased significantly 1-3 minutes after desflurane inhalation. The MAP within group R6 decreased significantly at 1, 2, 4, and 5 minutes (p<0.05). There were significant differences in SBP, DBP, MAP and HR among the three groups 1-3 minutes after inhalation (p<0.05). The incidence of side effects such as hyper- or hypo-tension, and tachy- or brady-cardia in group R4 was 4.8% compared with 21.8% in group R2 and 15.0% in group R6. CONCLUSION: The most appropriate effect-site concentration of remifentanil for blunting hemodynamic responses by inhalation of high concentration desflurane is 4 ng/mL.
Adult ; Aged ; Androstanols/adverse effects/pharmacology ; Anesthetics/adverse effects/pharmacology ; Anesthetics, Inhalation/adverse effects/*pharmacology ; Blood Pressure/drug effects ; Etomidate/adverse effects/pharmacology ; Female ; Heart/*drug effects ; Heart Rate/drug effects ; Humans ; Isoflurane/adverse effects/*analogs & derivatives/pharmacology ; Male ; Middle Aged ; Piperidines/adverse effects/*therapeutic use ; Protective Agents/adverse effects/*therapeutic use

PURPOSE: The Infertility Self-Efficacy scale (ISE) is an instrument used to identify infertility-related self-efficacy. The purpose of this study was to assess the reliability and validity of the Korean version of the ISE developed by Cousineau et al. in 2006. METHODS: The translated instrument was pilot-tested and administered to 314 women and men with a diagnosis of infertility. For estimating reliability, testeretest and the internal consistency reliability coefficients were calculated. Validity was evaluated through content validity, concurrent validity, and construct validity with exploratory and confirmatory factor analyses. RESULTS: The internal consistency reliability was satisfactory (Cronbach's alpha = .92, item-total correlations = .44–.80), and the intra-class correlation coefficient was .84 (p < .001). The overall content validity index was 98.1%, and the concurrent validity coefficient (correlations between the ISE scale and general self-efficacy scale) was .31 (p < .001). The final model's fit indexes were acceptable (CFI = .96, NFI = .93, RMSEA = .07, GFI = .94, and SRMR = .03), indicating good construct validity. CONCLUSION: The Korean version of the ISE has high reliability (stability and homogeneity), and good content, concurrent, and construct validity (EFA and CFA). Validated Korean version of the ISE may help nurses identify infertility-related self-efficacy.
Diagnosis ; Female ; Humans ; Infertility* ; Male ; Psychometrics* ; Reproducibility of Results

PURPOSE: To investigate the neuroprotective effect of Ginexin (Ginkgo biloba extract) on rat retinal ganglion cell in the optic nerve crush injury model. METHODS: From 1 week before the optic nerve injury, Ginexin 100 mg/kg/day (100 mg group), 200 mg/kg/day (200 mg group) or carboxymethylcellulose as a control group (CMC group) was administrated orally 4 weeks in Spraque-Dawley rats. At 3 weeks after the optic nerve injury, the RGCs were counted and the concentration of intravitreal glutamate was measured. RESULTS: The RGC density of CMC group (103+/-22 cells/mm2) was significantly lower than that of 100 mg group (182+/-39 cells/mm2) and 200 mg group (201+/-63 cells/mm2). There was no difference between the 100 mg group and 200 mg group. The concentration of invtravitreal glutamate did not significantly differ among normal, CMC group, 100 mg group and 200 mg group. CONCLUSIONS: Ginexin increased the survival of the retinal ganglion cell in rat optic nerve crush injury model, but, did not influence on the concentration of intravitreal glutamate.
Animals ; Carboxymethylcellulose Sodium ; Glutamic Acid ; Neuroprotective Agents* ; Optic Nerve Injuries ; Optic Nerve* ; Rats* ; Retinal Ganglion Cells* ; Retinaldehyde*