1. Ten cases of fracture of the carpal navicular were observed and analyzed, which were treated by thumb-including short arm cast in the Department of Orthopedic Surgery, Han Kang Sacred Heart Hospital during the period from November 1, 1977 to May 31, 1978. 2. Of the total ten cases eight cases were between the age of twenty and forty. 3. The sites of fracture were confined to the middle one third in ten cases. The fracture lines were-transverse in six cases. 4. There was little difficulty in confirming the diagnosis initially with clinical symptoms and signs and roentgenologic studies available. But, in one case the frature line was not detected by usual roentgenologic studies including the carpal navicular view. 5. Union was obtained from two cases after ten weeks of cast immobilization, from four cases after twelve weeks and from three cases after twenty weeks. In the remaining one case, however, pain was persistent after twenty-four weeks of immobilization. 6. The results of treatment were excellent in four cases and good in five cases so that nine patients could return to their work.
Arm ; Diagnosis ; Heart ; Humans ; Immobilization ; Orthopedics

PURPOSE: For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. METHODS: The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. RESULTS: The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastro intestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum(21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. CONCLUSION: The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.
Abdomen, Acute ; Abdominal Pain* ; Diagnosis ; Duodenitis ; Duodenum ; Early Diagnosis ; Endoscopy ; Exanthema* ; Gastrointestinal Hemorrhage ; Hemorrhage ; Nephritis ; Purpura* ; Recurrence ; Sigmoidoscopy ; Skin* ; Ulcer ; Ultrasonography

No abstract available.
Colitis, Ulcerative* ; Ulcer*

No abstract available.
Hemorrhagic Fever with Renal Syndrome* ; Pregnancy*

No abstract available.
Humans ; Pericardial Effusion* ; Rheumatic Fever*

Extracorporeal shock wave lithotripsy monotherapy was performed in 72 renoureteral units from 66 patients with the Northgate SD-3 lithotriptor using ultrasound stone localization between June 21, and August 25, 1989. Of 72 cases renal stones were 46 cases( 63.9% ) and ureteral stones 26 cases ( 36.1% ). No regional or general anesthesia were necessary but sedatives or analgesics were required in most patients. Among 67 cases who completed extracorporeal shock wave lithotripsy, the success rate of treatment(rate free of calculi plus that of clinically insignificant residual stone fragments) was achieved 100% below 20mm, 87.5% in 21-30mm and 100% over 31mm and the total mean success rate was 97%. 23 cases( 31.9% ) were required auxiliary procedures such as Double-J stent in 14 cases, push up procedures 6 cases and stone basket 3 cases. Poet-lithotripsy complications were transient macroscopic hematuria in 90%, renal colic 20.8%, steinstrasse 13.9%, fever 6.9% and subcapsular hematoma 2.8% and these complications were controlled with conservative management. We suggest that extracorporeal shock wave lithotripsy monotherapy with the Northgate SD-3 lithotriptor was considered to be effective and safe procedure for the initial treatment of urinary stone.
Analgesics ; Anesthesia, General ; Calculi ; Fever ; Hematoma ; Hematuria ; Humans ; Hypnotics and Sedatives ; Lithotripsy* ; Renal Colic ; Shock* ; Stents ; Ultrasonography ; Ureter ; Urinary Calculi

No abstract available.

Osteoporosis is a common adverse event among patients on glucocorticoid therapy. Glucocorticoids reduce bone formation and increase cortical porosity in proportion to the dose and duration of glucocorticoid use. While the epidemiology of glucocorticoid-induced osteoporosis has been well characterized, its pathophysiology and effective management remain unclear. Several recommendations for glucocorticoid-induced osteoporosis are used to determine which patients on long-term glucocorticoid treatment to treat and when. The fracture risk can be assessed using dual-energy X-ray absorptiometry and the Fracture Risk Assessment Tool algorithm, along with other clinical factors. The management of glucocorticoid-induced osteoporosis includes anti-osteoporotic therapy and measures to prevent bone loss. Bisphosphonates are currently the first choice treatment, with teriparatide and denosumab being alternatives.
Absorptiometry, Photon ; Bone Density ; Denosumab ; Diphosphonates ; Epidemiology ; Glucocorticoids ; Humans ; Osteogenesis ; Osteoporosis* ; Porosity ; Risk Assessment ; Teriparatide

BACKGROUNDS: This study was performed to determine the onset time and dose of intranasal midazolam used for preanesthetic sedation in children. METHODS: The children were randomly allocated to recieve one of three medications via the nasal route in a double blind manner. Group I: patients were given normal saline 0.2 ml/5kg, Group II: patients were given midazolam 0.2 mg/kg, Group III: patients were given midazolam 0.3 mg/kg. RESULTS: The cardiovascular and SpO2 changes were not significantly different among the patients of the three groups. The sedation score was greater in group II compared with group I from 5 minute after administration (1.9 vs 2.7, p<0.05). postanesthetic recovery score (PARS) was not significantly different among the three groups. CONCLUSIONS: It is suggested that intranasal midazolam (0.2 mg/kg) produces anxiolysis and sedation in children with rapid onset.
Child* ; Humans ; Midazolam*

PURPOSE: To evaluate the clinical features, courses, and prognosis of refractive accommodative esotropia associated with mild hyperopia. METHODS: We reviewed the records of 14 patients who were diagnosed with refractive accommodative esotropia associated with hyperopia of +2.00 diopters (D) or less. Age at onset and wearing glasses, refractive errors, angle of deviation before and after wearing glasses, binocular sensory status and the presence of amblyopia were evaluated for each patient. RESULTS: The average onset of esotropia was 25.2+/-22.0 months of age, and the average first use of glasses occurred at 65.9+/-12.9 months. The average angle of deviation at distance and near without correction were 21.7+/-8.7 prism diopters (PD) and 24.6+/-6.4PD, respectively. The average refractive error was +1.28+/-0.52D in the right eye and +1.41+/-0.55D in the left eye. The average angles of deviation at distance and near with correction were 3.0+/-2.7PD and 6.0+/-3.0PD, respectively. Among 14 patients, 9 showed esophoria or esotropia of 10PD or less within 14 weeks after wearing glasses. Decompensation developed in 1 patient who underwent recession of medial rectus. CONCLUSIONS: Hyperopia of +2.00D or less can cause refractive accommodative esotropia, so we should recommend the correction of hyperopia of +2.00D or less with esotropia.
Amblyopia ; Esotropia* ; Eyeglasses ; Glass ; Humans ; Hyperopia* ; Prognosis ; Refractive Errors ; Telescopes