The treatment of calcaneal fracture has been controvertial because of its difficulty for many years, and now it tended to be concluded with ultimate result of earIy weight bearing. Authors tried a serial treatment of calcaneal fracture with enforcing early weight bearing after a week of elevation, eold compression, and other 3 weeks of cast immobilization. Materials are compised of 21 feet of 18 patients. Of which 12 cases treated by this method have restored normal range of walking ability. Another group of materials treated by open reduction showed delayed recovery.
Clinical Study ; Foot ; Humans ; Immobilization ; Methods ; Reference Values ; Walking ; Weight-Bearing

No abstract available.
Oropharynx* ; Tongue*

In 1961, Salter had devised the innominate osteotomy in treating C.D.H, which has been one of the most popular methods in these days. 14 hips with 12 patients who have been admitted and received Salters innominate osteotomy in the department of orthopaedic surgery, National Medical Center, from Feb. 1974 to Dec. 1976, were evaluated as for the results. Clinical analysis and follow-up study were carried out in 14 hips with C.D.H. and the following results were obtained. The mean age of the cases was 34 months, and sex preponderance of female to male was 11: 1. The ratio of left to right was not significantly different. 2 cases of complication out of 12 cases was found; redislocation and subluxaiton respectively. The age of first detection of C.D.H., was surprisingly late around 18 months old. In addition, approximately 12 months has elapsed between the first detection of C.D.H. and the first consultation to doctor. Assesment of the result was carried out by Severine and Macays method respectively; Radiological evaluation was as followings: (Severine) Excellent: 4, Good: 8, Fair: 1, Poor: 1. Clineal evaluation was as followings: (Macay) Excellent: 4, Good: 7, Fair: 1, Poor; 1, Failure: 1.
Equidae ; Female ; Follow-Up Studies ; Hip ; Humans ; Male ; Methods ; Osteotomy

OBJECTIVE: Study was designed preliminarily to observe the accordance of caregivers strain and depression with other factors such as sex of the patient, caregiver, lesion side, Mini Mental Status Examination (MMSE) score and Beck's Depression Index (BDI). METHOD: We composed a questionnaire with BDI, and the Sense of Competence Questionnaire (SCQ) in order to evaluate the amount of stress and depression of caregivers. Evaluation of the patient was done by interviewing them along with reviewing their medical records and obtaining scores such as the MMSE, Functional Inependence Index (FIM) and the Geriatric Depression Scale (GDS). RESULTS: BDI of the caregivers showed a negative correlation with the patients' age. Lesion side nor age, nor the prevalence of hemiplegia of patients did not show statistical relevance with the strain that the caregiver felt. The first subscale of SCQ showed a positive correlation with the caregiving time that the caregiver gave. In accordance to the sex of the caregiver, females showed to spend more time with the patient, showed to be more unsatisfied with the patient but showed a tendency of lesser SCQ score. CONCLUSION: Depression, strain and burden that the caregivers went through showed to have slight correlation with the patient and caregiver factors.
Caregivers* ; Depression* ; Female ; Hemiplegia ; Humans ; Medical Records ; Mental Competency ; Prevalence ; Surveys and Questionnaires

No abstract available.
Mastoid*

Many authors have been reported that the abdominal trauma, especially injury of the liver and spleen, is frequently found with lower rib fractures, below the ninth rib fractures and the incidence was about 20 to 30%. In cases of rib fractures, Intra- abdominal organs may be injured in the higher rib fractures than the ninth because the diaphragm is elevated at the level of filth intercostal space in expiration period and the intra-abdominal lesions are often delayed evaluated due to the pain of the fractures and masked by the other injuries of the head and the extremities. So above reasons, we were often questioned what the level of rib fracture we must evaluate the intra-abdominal injury was? So we investigated 452 patients with rib fractures who visited our emergency medical center from 1995, January to 1996, December and divided into two groups according to the prescience of intra-abdominal organ injuries by each the level of rib fractures. The number of patients with intra-abdominal organ injuries were 75(16.6%) and the most frequently damaged organ was the liver(25 cases, 33.3%). We calculated the statistical values of each level of rib fractures by the Chi-Square method and got a result that the level of rib fracture we must evaluate the intra-abdominal injuries was the sixth rib fracture. Therefore, if we will meet the patients with rib fracture below the sixth, we must have attentions to the intra-abdominal injuries and evaluate the abdomen closely with various diagnostic methods.
Abdomen ; Attention ; Diaphragm ; Emergencies ; Extremities ; Head ; Humans ; Incidence ; Liver ; Masks ; Rib Fractures* ; Ribs* ; Spleen

Diagnostic peritoneal lavage is a accurate and safe method confirming the intraabdominal injury with head trauma, unstable multiple injuried patients. But the development of imaging technique and the trend in noninvasive diagnostic value is decreasing now. In the emergency room, the emergency physicians are required the rapidity and accuracy' in intial assessment and the decisions for the operation or not. So emergency physicians have been investigating the diagnostic method for intraabdomial injury that is more rapid, safe and accurate. Many diagnostic tools are developed and now accepted and used widely, among them the diagnostic peritoneal lavage is still the best method for unsatble or head injuries patients. But the positive diagnostic criterias are variable by many authors and still remain imperfectly. So our study was reviewed by medical record of patients who were undertaken the diagnostic peritoneal lavage for the diagnosis intraabdominal injury and statistical analyasis was done compared with many criteria of red blood cell and white blood cell for the more actuate way. A retrospective study of diagnostic peritoneal lavage was done of 90 patients with blunt abdominal trauma during 2 years from January, 1996 to December, 1997 and summerized our experience. The results were as follows; 1) There are 73 males and 17 females in sex. The most common type of injury was the traffic accident. 2) With many variable criteria of RBC and WBC, the accuracy and the false positive and false negative were not different in statistical results. The average accuracy was 80.1%. 3) The operations were done in 30(33.3%) cases, and the most frequent injuried organ was the small bowel, 20 cases(66.7%).
Accidents, Traffic ; Craniocerebral Trauma ; Diagnosis ; Emergencies ; Emergency Service, Hospital ; Erythrocytes ; Female ; Humans ; Leukocytes ; Male ; Medical Records ; Peritoneal Lavage* ; Retrospective Studies

No abstract available.
Atrial Fibrillation* ; Heart* ; Thoracic Surgery*

OBJECTIVE: This study was designed to investigate the effect of steroid injection on the blood sugar level in shoulder pain patients with diabetes mellitus. METHOD: Fifteen patients with shoulder pain and diagnosed diabetes mellitus were included. The blood sugar, insulin, cortisol and HbA1c level were measured before and twice (at 24 hours and 1 week) following a intraarticular, intratendinous or intrabursal injection containing triamcinolone. Statistical significance was determined by the paired t-test. RESULTS: The blood sugar, insulin and HbA1c levels had no significant difference between before and after steoid injection (p>0.05). But, the cortisol level significantly fell at 24 hours after steroid injection compared with preinjection level and returned to preinjection level by 1 week after steroid injection (p<0.05). CONCLUSION: One time triamcinolone injection resulted in significant suppression of cortisol level, but it returned to preinjection level after a week. The blood level of sugar, insulin and HbA1c showed no significant change after one time steroid injection.
Blood Glucose* ; Diabetes Mellitus* ; Humans ; Hydrocortisone ; Insulin ; Shoulder Pain* ; Shoulder* ; Triamcinolone

The purpose of this study was to evaluate the efficacy of an electric toothbrush, with a specially designed orthodontic brush head, compared to a manual toothbrush on the periodontal health of patients with fixed orthodontic appliances. Forty patients were randomly divided into two groups, the electric and the manual toothbrush groups, 1 month after attachment of fixed orthodontic appliances. Periodontal status was measured using a plaque index, a gingival index, a bleeding index, a pocket depth and a relative attachment loss, at baseline and after 3 months, 6 months, 9 months, and 12 months. The Braun Oral-B Plak Control with Ortho OD 15-1 brush head was used as the electric toothbrush while the Butler G.U.M 124 was given as the manual toothbrush. In the manual toothbrush group, the gingival and bleeding indices showed no statistically significant differences, but the plaque index was significantly decreased (p < 0.001) and pocket depth as well as relative attachment loss were significantly increased (p < 0.01). In the electric toothbrush group, the bleeding index, pocket depth and relative attachment loss showed no statistically significant differences, but the plaque and gingival indices were significantly decreased (p < 0.001). In the case of the plaque, gingival and bleeding indices, there were no statistically significant differences between the electric and the manual toothbrush groups. On the contrary, in the case of pocket depth and relative attachment loss, there were statistically significant differences between the electric and the manual toothbrush groups: an increase in the manual toothbrush groups unlike the electric toothbrush group which kept the same state (p < 0.05). These findings suggest that an electric toothbrush is useful for orthodontic patients with fixed appliances.
Head ; Hemorrhage ; Humans ; Oral Hygiene ; Orthodontic Appliances ; Periodontal Index