No abstract available.
Adrenogenital Syndrome* ; Congenital Hypothyroidism*

The purpose of this study is to compare the effects of the femoral attachment points of the graft and knee flexion angles at the time of graft fixation on stability of posterior cruciate ligament reconstruction. We analyzed the posterior stability of the knee on 23 patients(24 knees) with posterior cruciate ligament injury whose posterior cruciate ligament had been reconstructed arthroscopically and followed for minimum 1 year period at Asan Medical Center from May 1992 to June 1994. The patients were divided into the two groups according to femoral attachment points of the graft and knee flexion angles at the time of graft fixation. The distance from the junction of the intercondylar notch with trochlear groove of the femoral attachment points and knee flexion angles were 11mm and 0°-30° in group A and 7mm and 70°-90° in group B, respectively. 11 knees were included in group A and 13 knees in group B. Posterior stability was determined by difference in posterior tibial translation between the injured and the opposite knee with Telos device. In group A, 5 cases were at the range of 0-2mm, 3 cases 3-5 mm, 3 cases 6-10mm. In group B, 10 cases were at the range of 0-2mm and 3 cases 3-5mm, respectively. Differences in posterior tibial translation on average were 3.6mm and 1.7mm in group A and B, respectively. Conclusively, arthroscopic postrior cruciate ligament reconstruction with femoral attachment point at 7mm from the junction of interconlylar notch with trochlear groove and 70°
Chungcheongnam-do ; Humans ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Transplants

BACKGROUND AND OBJECTIVES: The transradial approach for coronary intervention has a lower incidence of access site complications and can increase patient comfort after percutaneus tansluminal coronary angioplasty(PTCA). The purpose of this study is to compare procedural success and complication rates of percutaneous transradial coronary stenting which was performed by four operators in two hospitals with those using transfemoral approach. MATERIALS AND METHOD: From September 1998 to July 1999, one hundred seventy five consecutive patients(201 lesions) treated with coronary stent implantation were enrolled for this study : 84 patients underwent transradial coronary stenting(Radial Group), and 91 patients transfemoral coronary stenting(Femoral Group). RESULTS: Seven patients who failed coronary cannulation via radial artery were crossed over to the Femoral Group. The measurements of the radial artery were not done. Patient demographics were similar in both groups. Procedural success was similar in both group(95.2% in Radial Group vs. 97.8% in Femoral Group, p=S). All transradial coronary stenting were possible using conventional guiding catheters which are used in transfemoral intervention. Local vascular complication rates showed a trend toward a reduction in the Radial Group(2.4% vs. 8.8%, p=.06). CONCLUSION: This study showed the similarity in the safety and efficacy of transradial coronary stenting compared to those of transfemoral approach.
Catheterization ; Catheters ; Demography ; Humans ; Incidence ; Radial Artery ; Stents*

A child who had iron deficiency anemia(IDA) resulted from the prolonged breast feeding presented with left side hemiparesis following mild head injury. The serial computed tomography and magnetic resonance imaging showed right internal carotid artery territory infarction. It has been generally accepted that prolonged breast feeding causes IDA. A few cases of infarction caused by IDA have been reported. A few cases of cerebral infarction caused by mild head injury have been also reported. However, few have been reported nonhemorrhagic cerebral infarction caused by mild head injury associated with IDA from prolonged breast feeding. We reviewed the literature that prolonged breast feeding causes IDA and in this case, mild head injury could cause the cerebral infarction. We think that it is important to have clinical suspicion of cerebral infarction in a child with IDA from prolonged breast feeding who has mild head injury because early diagnosis is difficult.
Anemia, Iron-Deficiency* ; Breast Feeding* ; Breast* ; Carotid Artery, Internal ; Cerebral Infarction* ; Child* ; Craniocerebral Trauma* ; Early Diagnosis ; Head* ; Humans ; Infarction ; Iron* ; Magnetic Resonance Imaging ; Paresis ; Thrombosis

OBJECTIVE: In the pediatric population the skull has not yet undergone ossification and it is assumed that the diagnostic rate of skull fractures by simple X-rays are lower than that of adults. It has been recently proposed that the diagnostic rates of skull fractures by 3-dimensional computer tomography (3D-CT) are higher than simple X-rays. The authors therefore attempted to compare the diagnostic rates of pediatric skull fractures by simple X-rays and 3D-CTs with respect to the type of fracture. METHODS: One-hundred patients aged less than 12 years who visited the Emergency Center for cranial injury were subject to simple X-rays and 3D-CTs. The type and location of the fractures were compared and Kappa statistical analysis and the t-test were conducted. RESULTS: Among the 100 pediatric patients, 65 were male and 35 were female. The mean age was 50+/-45 months. 63 patients had simple skull fractures and 22 had complex fractures, and the types of fractures were linear fractures in 74, diastatic fractures 15, depressed fractures in 10, penetrating fracture in 1, and greenstick fractures in 3 patients. Statistical difference was observed for the predictive value of simple skull fractures' diagnostic rate depending on the method for diagnosis. A significant difference of the Kappa value was noted in the diagnosis of depressed skull fractures and diastatic skull fractures. CONCLUSION: In the majority of pediatric skull fractures, 3D-CT showed superior diagnosis rates compared to simple skull X-rays and therefore 3D-CT is recommended whenever skull fractures are suspected. This is especially true for depressed skull fractures and diastatic skull fractures.
Adult ; Aged ; Child ; Emergencies ; Female ; Humans ; Male ; Skull ; Skull Fracture, Depressed ; Skull Fractures

The effects of hind-limb immobilization by skeletal fixation of bilateral ankle and knee joints. for sither one or five weeks on glycogen concentrations, glycogen resynthetic activities and insulin responses to glucose uptake of hind-limb muscles were studied on male Splague-Dawley rats. There were significant drops in muscle wet weight to body weight ratio of immobilized soleus and plataris. In the group immobilized for one week, the ratios of sleous and plantaris were decreased by 11% and 38% respectively; and in the group immobilized for five weeks, the ratios were decreased by 42% in both muscles equally. The glycogen concentration and glycogen resynthetic activities of soleus and plantaris muscles in immobilized rats were decreased significantly in the one week group. However, in the five week group, these values were increased significantly compared to the values of those muscles of the one week group. The increased values of the five week group did not exceed those of the control group. The glucose uptake rate of the soleus muscle of the hind-limbs immobilized for one week and for five weeks were studied in vitro. The basal glucose uptake rate of the muscle of the control group was 8.4 ± 0.77Mol/gm/20min. The values of basal rate and insulin responses to the glucose uptake rates in the doses of physiological and supramaximal on the soleus muscles immobilized for one week was significantly decreased, but after immobilization for five weeks, these values were not significantly different statistically those from of the control group statistically.
Animals ; Ankle ; Body Weight ; Extremities ; Fracture Fixation ; Glucose ; Glycogen ; Humans ; Immobilization ; In Vitro Techniques ; Insulin ; Knee Joint ; Male ; Metabolism ; Muscle, Skeletal ; Muscles ; Rats

From the prudent use of quinolone in clinical practice, quinolone-resistant E. coli strains are being isolated with increasing frequency in the community as well as in the hospital. To analyze the risk factors, clinical features and prognosis of QREC, we reviewed the microbiologic records of E. coli bacteremia patients, estimated the quinolone consumption and performed the PFGE to compare genetic diversity. From 1994 to 1998, 40 episodes of QREC bacteremia were observed, 15 cases (37.5%) were hospital acquired. Overall, there is significant correlation between the increased incidence of QREC bacteremia and the upward trend in quinolone use in the hospital as out-and in-patients medication (P=0.003, r=0.98). When we compare the 40 case patients with 80 simultaneous control patients who had quinolone-susceptible E. coli bacteremia, the case patients more frequently had chronic underlying illness, prior use of quinolones and other antibiotics. Quinolone resistance was not significantly associated with higher mortality. A logistic regression analysis identified prior quinolone (P=0.001) use and prior use of other antibiotics (P=0.04) as the only independent risk factors for QREC bacteremia. 10-or 8-different PFGE patterns were observed in QREC isolates from community and hospital. They revealed little evidence of clonal spread, and may have emerged in direct response to the selective pressure exerted by antibiotic use.
Anti-Bacterial Agents ; Bacteremia* ; Genetic Variation ; Humans ; Incidence ; Logistic Models ; Mortality ; Prognosis ; Quinolones ; Risk Factors

BACKGROUND: Measles is an acute highly contagious infection caused by measles virus. Since the introduction of measles vaccines in 1963, measles has been dramatically decreased in Korea. However, measles outbreaks have occurred periodically every 4 to 6 years during the 1990s. During 2000, measles outbreak of large scale occurred throughout the country and the total of 32,088 cases were reported. The majority of affected population was infants and school-aged children, but measles was reported also among adolescent and adult population. There was no report about the epidemiology of adult measles cases during the last decade. In this study, we retrospectively analyzed the epidemiologic and clinical features of adult measles patients in Korea. METHODS: From July of 2000 to January of 2001, 50 adult cases of measles had been admitted to Korea University Hospital. Medical records of these 50 patients, who were clinically diagnosed as measles, were reviewed. Demographic data, clinical features, history of measles vaccination and laboratory findings were evaluated. RESULTS: The median age of patients was 23 years : 28 (56%) were male. Most cases (49/50, 98%) occurred between November of 2000 to January of 2001 and 8 (16%) patients were associated with outbreaks. The occupation of patients was diverse but, students (28%) and office workers (20%) were the most common. 44 (88%) of 50 patients had no underlying diseases. Adult measles patients demonstrated similar clinical symptoms, which were shown in children with measles. In laboratory findings, mean WBC count was 4,933/micro L and 18 (36%) patients had thrombocytopenia. 21 (42 %) patients had complication of measles, and hepatitis was the most common episodes among them. Measles vaccination history revealed that 5 (10%) had two-dose and 7 (14%) had one-dose measled vaccine. In 35 patients, measles IgM antibody test was done. It appears that IgM positive rate among one-dose measle vaccination group, two-dose measle vaccination group, and group with unknown vaccination history were 86% (6/ 7), 40% (2/5), and 78% (18/23), respectively. Most (94%) of patients were hospitalized and more than two-third of patients were isolated. All the patients were recovered without sequelae. CONCLUSION: In 2000 measles outbreak, adult measles had the typical clinical features similar to those in the children and the severe complication was rare. Adult measles patients demonstrated low measles vaccination rate and occurred mainly among the students and office workers.
Adolescent ; Adult* ; Child ; Disease Outbreaks ; Epidemiology ; Hepatitis ; Humans ; Immunoglobulin M ; Infant ; Korea ; Male ; Measles virus ; Measles* ; Medical Records ; Occupations ; Retrospective Studies ; Thrombocytopenia ; Vaccination ; Vaccines

No abstract available.
Dexamethasone* ; Humans ; Membranes* ; Rupture*

Inhaled nitric oxide (NO) is occasionally used to treat hypoxemia for patients with acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU). However, it is controversial whether or not to maintain inhalation of NO during general anesthesia because of complications, such as nitrogen dioxide (NO2) production, methemoglobinemia, and inhibition of platelet aggregation. In this case, a 67-year-old male fell from a roof and was brought to an emergency care center. During management, he vomited gastric contents and aspirated. In spite of tracheal intubation and mechanical ventilation with high oxygen therapy, the hypoxia did not improve. NO inhalation with mechanical ventilation was performed to treat hypoxemia due to ARDS in the ICU. We maintained the NO inhalation during the surgery for a hemoperitonium. The surgery was completed without intra-operative hemodynamic instability or any complications.
Aged ; Anesthesia, General ; Anoxia ; Emergency Medical Services ; Hemodynamics ; Humans ; Inhalation ; Intensive Care Units ; Intubation ; Male ; Methemoglobinemia ; Nitric Oxide ; Nitrogen Dioxide ; Oxygen ; Platelet Aggregation ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult