No abstract available.
Hepacivirus* ; Hepatitis C* ; Hepatitis*

BACKGROUND: The purpose of this study is to compare the radiological and clinical outcomes after open reduction and plate fixation of midshaft clavicle fractures between patients who achieved successful anatomical reduction and those who had a remaining fracture gap even after open reduction and plate fixation, and were thus treated with additional demineralized bone matrix (DBM). METHODS: This retrospective analysis was conducted on 56 consecutive patients who underwent open reduction and internal fixation using a locking compression plate for acute displaced midshaft clavicle fractures, and who underwent radiographic and clinical outcome evaluations at least 6 months postoperatively. The outcomes between those who achieved perfect anatomical reduction without remnant gap (n=32) and those who had a remaining fracture gap even after open reduction and plate fixation treated with additional DBM (n=24) were evaluated. RESULTS: There were no differences in the use of lag screws or wiring and operation time (all p>0.05) between those with and without remnant gap. No difference in the average radiological union time and clinical outcomes (satisfaction and Constant score) was observed between the two groups (all p>0.05). However, significantly faster union time was observed for AO type A fracture compared with other types (p=0.012), and traffic accident showed association with worse clinical outcomes compared with other causes of injury. CONCLUSIONS: Surgical outcome of midshaft clavicle fracture was more affected by initial fracture type and event, and re-reduction and re-fixation of the fracture to obtain a perfect anatomical reduction spending time appears to be unnecessary if rigid fixation is achieved.
Accidents, Traffic ; Bone Matrix ; Clavicle* ; Fracture Fixation ; Fracture Healing ; Humans ; Retrospective Studies

No abstract available.
Humans ; Moral Development* ; Students, Medical*

No abstract available.
Aged* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Hypercholesterolemia*

BACKGROUND: Because of wide individual variations in response to sedative and the level of sedation desired by different patients, inadequate sedation is frequent during surgery. Patient-controlled sedation is a logical extension of patient-controlled analgesia to find and maintain their own steady-state of sedation by self-administration of sedatives during surgery. The purpose of this study was to evaluate the feasibility of patient-controlled sedation compared with anesthesiologist-controlled sedation during surgical spinal anesthesia. METHODS: Unpremedicated forty adult patients who received spinal anesthesia for lower extremity surgery were randomly allocated into two groups (n=20 for each group). After selection of target state of sedation according to sedation scale, patient-controlled sedation (PCS) group self-administered 0.5 mg (1 ml) intravenous midazolam in increments using a Walkmed PCA infusor and anesthesiologist- controlled sedation (ACS) group administered by the anesthesiologist as the same manner to achieve previously selected sedation state. Sedation score, vital signs, SpO2 were checked 5, 10, 20, 30, 40min after start of drug injection. RESULTS: The sedation scores patient desired were 4.4 +/- 0.8 in PCS group and 4.3 +/- 0.7 in ACS group. These scores were achieved 20min after start of injection in PCS group and 40 min in ACS grou p (p<0.05). Degree of satisfaction was higher in PCS group compared with ACS group (1.5 +/- 0.6 vs 2.1 +/- 0.8, p<0.05). No complications were detected in two groups. CONCLUSIONS: PCS using midazolam was better than ACS in terms of early achievement of sedation state patient desired and degree of satisfaction.
Adult ; Analgesia, Patient-Controlled ; Anesthesia, Spinal ; Humans ; Hypnotics and Sedatives ; Infusion Pumps ; Logic ; Lower Extremity ; Midazolam* ; Passive Cutaneous Anaphylaxis ; Vital Signs

Iris neovascularization was produced in rabbits by hypotony following repeated aspiration of the vitreous. The hypotony was produced after 0.3 ml of vitreous fluid was aspirated using a 25-gauge needle through the pars plana of 10 rabbits. For the histochemical study, horseradish peroxidase(HRP) was injected through the ear lobe vein. After fixation of the iris tissue, the tissue was treated with diaminobenzidine and examined with both light microscopy and transmission electron microscopy. The newly-formed vessel was abundant, particularly on the upper stroma of the iris. The new vessel formation was evident due to the proliferation of endothelial cells, which may have been derived from preexisting iris vessels. The endothelial cells of the newly-formed vessels revealed prominent villous processes into the vascular lumen, formation of the marginal flap, numerous fenestrations in the endothelial junction, and reaction product onto extravascular space by the cytochemical electron microscopy. These results suggest that hypotony in the rabbit produces the disruption of the blood-iris barrier and the balance between angiogenesis-antiangiogenesis modulation.
Animals ; Biological Transport, Active ; Disease Models, Animal ; Horseradish Peroxidase/diagnostic use ; Iris/*blood supply/*ultrastructure ; Iritis/*pathology ; Neovascularization, Pathologic/*pathology ; Rabbits ; Vitreous Body/surgery

The malar bones are major determinants of mid-facial shape. In an oriental population, malar prominences are considered an unpleasing and undesirable feature because they give the face a triangular shape and may produce an emaciated and sunken appearance. There are two main operative approaches to malarplasty. One is a coronal approach and the other is a intraoral approach. The former possess advantages of symmetricity, accuracy and superiorly, medially and posteriorly aesthetical transposition of the malar bone. However, it has drawbacks such as a long visible scar on the scalp and extensive operation. Though the latter is a simple method avoiding a visible scar, it has some problems of asymmetricity, cheekdrooping, partial transposition of the malar complex and difficulty of aesthetic transposition. The authors intended to perform intraoral malarplasty for symmetrically aesthetic transposition of the whole malar bone without cheekdrooping. From February 1996 to January 1999, 9 female patients with prominent malar complex, in whom the coronal incision was objectionable, had intraoral malarplasty performed with 2-point fixation after L-shaped osteotomy involving the zygomatic process of maxilla, resulting in symmetric and aesthetically desirable three dimensional transposition of the malar bone.
Cicatrix ; Female ; Humans ; Maxilla* ; Osteotomy ; Scalp ; Zygoma

The retinal and choroidal blood vessels respond independently to the abruptly increased arterial pressure due to their differences in the anatomic and physiologic properties, which induce hypertensive retinopathy and hypertensive choroidopathy respectively. The authors reviewed the fluorescein angiogram retrospectively to observe the ischemic changes of the choroid in 15 cases of hypertensive choroidopathy. The ischemic changes of the choroid in hypertensive choroidopathy were characterized by generalized or sectorial filling delay which was followed by staining or leakage of dye. These findings suggest that the choroidal circulation may lead to the sectorial and generalized ischemic conditions following the abruptly increased arterial pressure due to their differences in the anatomic structures. The fluorescein angiographic findings in the hypertensive choroidopathy depend on both the degree of the circulatory disturbance and the levels of the affected choroidal vessels.
Arterial Pressure ; Blood Vessels ; Choroid ; Fluorescein Angiography* ; Fluorescein* ; Hypertensive Retinopathy ; Retinaldehyde ; Retrospective Studies

Serpiginous choroiditis is a chronic. progressive, recurrent, and usually bilateral disease involving the choriocapillaris, retinal pigment epithelium, and retina. This disease classically involves the juxtapapillary retina and extends outward in a pseudopodial fashion. We report a case of serpiginous choroiditis beginning in the posterior pole without initial peripapillary lesion, and extending toward the optic disc. The fluorescein angiogram of the lesion showed hypofluorescence in the early phase and hyperfluorescence in the late phase, and the progression of the lesion with time.
Choroid* ; Choroiditis* ; Fluorescein ; Retina ; Retinal Pigment Epithelium

The most important basic requirements for successful skin grafting are the accurate approximation of the edge of the skin graft to that of the wound and the application of even pressure to the graft by a carefully designed dressing. Pressure dressing is indicated for the protection of the graft and the prevention of shearing between the graft and its bed. One of the most widely used methods of pressure dressing is tie-over dressing. The traditional technique is based on the application of long silk sutures along the margin of the graft that are tied over bolus of antibiotics oint-impregnated nonadherent fluffed gauze. With the traditional tie-over dressing, it is impossible to inspect the graft bed for possible hematoma and seroma during the application of dressing. So we adopted another modification of the previously described tie-over dressing methods. From January 1997 to July 1997, we had performed 27 skin graft surgeries and 8 subdermal shavings in 35 patients with our new method of tie-over dressing. We can apply even pressure to the grafts by twisting the long silk sutures instead of typing.In comparison with the plethora of devices and techniques described previously in tie-over dressing construction, our technique offers simplicity and reliable fixation of the graft to the bed and allows further adjustment of the dressing by individual tightening of the threads. Other particularly attractive features are the ability to inspect the graft at any time with little difficulty and the reapplicability of tie-over dressing with the remaining long threads if needed.
Anti-Bacterial Agents ; Bandages* ; Hematoma ; Humans ; Seroma ; Silk ; Skin ; Skin Transplantation ; Sutures ; Transplants ; Wounds and Injuries