BACKGROUND: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. METHODS: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. RESULTS: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. CONCLUSIONS: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.
California ; Follow-Up Studies ; Humans ; Humerus ; Shoulder ; Shoulder Fractures*

BACKGROUND: Using c-fos expression one of the immediate early gene, as a marker of altered neuronal response, we investigated the effect of superior cervical ganglion block (SCGB) exhibiting the same effect of SGB of human on the activity of several brain regions which are considered as located on autonomic neural pathway and neuroendocrine axis in rat. METHOD: The 48 Sprague-Dawley strain rats were divided into 4 groups, as saline/stress (control) group, SCGB/stress (tested) group, saline group, SCGB group. Superior cervical ganglion block was conducted in the SCGB/stress group and SCGB group while saline/stress and saline group were sham operated. After then restraint stress was imposed on the animals of SCGB/stress group and saline/stress group. And 2 hour after injection (saline, SCGB group) or restraint stress (saline/stress, SCGB/stress group), c-fos protein (Fos) was localized by immunocytochemistry. RESULTS: Much stronger Fos immunoreactivity was induced in the several brain region of control group rats compared to other three groups and the numbers of Fos positive cell count of tested group were significantly decreased in paraventricular hypothalamic nucleus (p<0.01), A5 (p<0.01), raphe pallidus (p<0.05), nucleus tractus solitaius (p<0.01) compared to control group. CONCLUSION: This study demonstrate that superior cervical ganglion block attenuates stress induced neuronal activities of paraventricular hypothalamic nucleus, A5, raphe pallidus, nucleus tractus solitarius.
Animals ; Axis, Cervical Vertebra ; Brain* ; Cell Count ; Genes, vif ; Humans ; Immunohistochemistry ; Neural Pathways ; Neurons ; Paraventricular Hypothalamic Nucleus ; Rats* ; Rats, Sprague-Dawley ; Solitary Nucleus ; Superior Cervical Ganglion*

No abstract available.
Cesarean Section* ; Female ; Pregnancy

We investigated HBV markers in serum and cerebrospinal fluid of 50 subjects with neurologic disorders or other disorders, who visited Dept. of neurology, college of medicine, Yeungnam University, from April-1 to August-31 1994 and were performed cerebrospinal fluid analysis to investigate the detection rate of HBV markers in cerebrospinal fluid and the possibility of neurologic disorders associated with HBV infection. The results were as follows. The positivity of HBsAg and. HBV prevalence rate in serum were 6(12.04) and 37(74.0%). Thf, number of patient with HBsAg, only anti-HBV and no markers were 6(12.0%), 31(62.0%) and 13(26.0%), respectively. The positivity of HBsAg and HBV prevalence rate in cerebrospinal fluid were 3(6%) and 18(36.0%). The number of patient with HBsAg, only anti-HBV and no markers were 6(100.0%), 12(38.7%) and 0(0.0%) respectively. The number of patient with virus associated diseases(VAD) and non virus associated diseases(NVAD) were 26(52%) and 24(48%). The HBV prevalence rate in serum of VAD and NVAD groups were 88.5% and 58.3% (p<0.05). The HBV prevalence rate in CSF of VAD and NVAD groups were 53.8% and 16.7%(p<0.05). The HBV prevalence rate in serum and CSF of VAD and NVAD groups were 60.9% and 28.6%
Cerebrospinal Fluid* ; Hepatitis B Surface Antigens ; Herpesvirus 1, Cercopithecine* ; Humans ; Nervous System Diseases ; Neurology ; Prevalence

PURPOSE: Acute diverticulitis of the right colon is not rare in Korea and the clinical presentation is indistin guishable from acute appendicitis. Cecal diverticulitis has led to a controversy in the management of disease. METHODS: Thirty-one cases of acute cecal diverticulitis who underwent operation for suspected acute appendicitis were reviewed retrospectively from January 1995 to December 1998. RESULTS: There were 17 men & 14 women. Ages ranged from 9 to 69 (mean: 37.5) years. All patients presented with signs and symptoms as acute appendicitis. All patients were explored through a transverse incision in the right lower quadrant under the impression of acute appendicitis. An appendectomy and drainage was performed in 13 patients, and resection of the lesion was performed in 18 patients (12 ileocecal resection, one partial cecectomy including appendix, one partial cecectomy and an appendectomy, 4 diverticulectomy and appendectomy), depending on the location of diverticulitis, severity of inflammation, and surgeon. Staples (TA(R), GIA(R)) were used in all cecal resection cases except for diverticulectomy. Five complications were observed, 3 in cecal resection cases (one wound seroma, one wound infection and one bleeding), and 2 in appendectomy and drainage cases (two wound infections). There was no postoperative mortality. The average length of the postoperative stay was 10.2 days in the drainage group and 8.8 days in the cecal resection group. Two recurrences were observed. One was the patient who had diverticulectomy performed. The other was a patient who had had appendectomy and drainage. CONCLUSION: We concluded that the preferred surgical management of an acute cecal diverticulitis operated for a presumed acute appendicitis is cecectomy using staples depending on its location and severity of inflammation. It was safe, relatively easy to do through the same incision, and could be a definitive treatment.
Appendectomy* ; Appendicitis ; Appendix ; Colon ; Diverticulitis* ; Drainage ; Female ; Humans ; Inflammation ; Korea ; Male ; Mortality ; Recurrence ; Retrospective Studies ; Seroma ; Wound Infection ; Wounds and Injuries

OBJECTIVE:To evaluate the biodurability of the covering material in retrievable metallic stents covered with polycarbonate polyurethane. MATERIALS AND METHODS: Using a peristaltic pump at a constant rate of 1ml/min, bile was recirculated from a reservoir through a long tube containing four stents. Each of these was removed from the system every two weeks and a radial tensile strength test and scanning electron microscopy (SEM) were performed. Each stent, removed at 2, 4, 6 and 8 weeks, was compared with a control stent not exposed to bile juice. RESULTS: Gross examination showed that stents were intact at 2 weeks, but at 4, 6 and 8 weeks cracks were observed. The size of these increased gradually in accordance with the duration of exposure, and at 8 weeks several large holes in the polyurethane membrane were evident. With regard to radial tensile strength, extension and peak load at break were 84.47% and 10.030 N/mm, 54.90% and 6.769 N/mm, 16.55% and 2.452 N/mm, 11.21% and 1.373 N/mm at 0, 2, 4 and 6 weeks, respectively. Scanning electron microscopy at 2 weeks revealed intermittent pitting and cracking, and examination at 4, 6 and 8 weeks showed that the size of these defects was gradually increasing. CONCLUSION: When the polyurethane membrane was exposed to bile, biodegradation was first observed at week two and increased gradually according to the duration of exposure.
Bile Acids and Salts/physiology ; Biodegradation ; Hydrogen-Ion Concentration ; Microscopy, Electron, Scanning/*instrumentation ; Phantoms, Imaging ; *Polyurethanes ; *Stents ; Support, Non-U.S. Gov't ; Tensile Strength ; Time Factors

Eaton Lambert Syndrome (ELS) is a disorder of neuromuscular transmission. The defect of neuromuscular transmission is due to decrease in the release of acetylcholine quanta from nerve terminal. This syndrome is frequently associated with bronchogenic carcinoma. The diagnosis is established by electromyography, which characteristically shows 1) low amplitude of evoked compound muscle potential to a single supramaximal stimulus on nerve, 2) significant decremental response at low rates of stimulation 3) marked incremental response at high rates of stimulation. Our patient is 52year old man with dyspnea, coughing and muscle weakness of proximal lower limbs. He has small cell lung cancer and associated with ELS, Superior vena cava syndrome and has metastatic lesion on right supraclavicular lymph node confirmed by pathology. Metastatic mass and SVC syndrome are marked improved following chemotherapy and radiotherapy, however follow up EMG finding does not improved. We are here reporting one case which considered compatible for ELS, with a few elementary reviewed literatures.
Acetylcholine ; Carcinoma, Bronchogenic ; Cough ; Diagnosis ; Drug Therapy ; Dyspnea ; Electromyography ; Follow-Up Studies ; Humans ; Lambert-Eaton Myasthenic Syndrome* ; Lower Extremity ; Lymph Nodes ; Muscle Weakness ; Pathology ; Radiotherapy ; Small Cell Lung Carcinoma* ; Superior Vena Cava Syndrome

This study was carried to determine the possibility of finding motile spermatozoa and fertilization, pregnancy rate after testicular sperm extraction(TESE) with ICSI in obstructive and non-obstructive azoospermic patients. In 154 cases(132 patients), obstructive azoospermia was 77 cases and non-obstructive azoospermia was 77 cases. In obstructive azoospermia, patients generally showed normal spermatogenesis and included vas agenesis(n=8), multiple vas obstruction(n=7), epididymal obstruction (n=54). Total of 982 retrieved oocytes were obtained and 84.4% were injected. The fertilization rates with 2 PN and cleavage rate were 72.5% and 62.3%, .respectively. 30 pregnancies(38.9%) were achieved and the ongoing pregnancies were 22 cases (28.6%). In non-obstructive azoospermia, patients showed hypospermatogenesis(n=49), maturation arrest(n=4), Sertoli cell only syndrome (n=24). The various stages of spermatogenic cell could be retrieved by TESE and could be reached normal fertilization and embryo development with ICSI. Total of 1072 retrieved oocytes obtained and 80.2% were injected. The fertilization rates with 2 PN and cleavage rate were 52.8% and 68.9%, respectively. 22 pregnancies(30.1%) were achieved and the ongoing pregnancies were 19 cases(26.0%). Conclusively, the combination of TESE with ICSI using testicular spermatozoa can achieve normal fertilization and pregnancy rate and effective method in obstructive and non-obstructive azoospermic patients.
Azoospermia ; Embryonic Development ; Female ; Fertilization* ; Humans ; Oocytes ; Pregnancy Rate* ; Pregnancy* ; Sertoli Cell-Only Syndrome ; Sperm Injections, Intracytoplasmic ; Spermatogenesis ; Spermatozoa*

Pneumomediastinum, pneumothorax and subcutaneous emphysema are uncommon in pediatric practice, but they may be rarely ocured in association with respiratory distress and excessive ressusciation in the neonatal period, and as a complication of bronchial asthma, measles in childhood. And also, there was a report of a few cases that developed to pneumomediastinum and subcutaneous emphysema caused by vomiting in patient of diabetic coma. It is rare so far in this country that above events are complicated by miliary tuberculosis, but they may lead the patient to fatal and lifethreatening conditions, even though we perform a considerable medical treatment for that. We presnted 3 cases of 6 month 20 days old female infant, and each 10 year and 11 year old boys, developed to pneumomediastinu, pneumothorax and subcutaneous emphysema, and suddenly expired during hospital treatment of miliary tuberculosis. And, we reviewed the literatures, too.
Asthma ; Child ; Diabetic Coma ; Female ; Humans ; Infant ; Measles ; Mediastinal Emphysema* ; Pneumothorax* ; Subcutaneous Emphysema* ; Tuberculosis, Miliary* ; Vomiting

We experienced a case of cryptococcosis in a 13-year-old female who had been admitted to our hospital because of intermittent high fever and generalized lymphadenopathy accompanied by multiple nodular eruptions with erosions on the face, scalp, neck and back. The patient was treated under the impression of tuberculous lymphadenitis without any improvement. A surgical biopsy of the lymph node and the subcutaneous nodule, which was performed 14 days later, revealed chronic granulomatous tissue and Langhan's type giant cells which contained numerous cryptococci. A brief review of the literature was done.
Adolescent ; Amphotericin B ; Biopsy ; Cryptococcosis* ; Female ; Fever ; Flucytosine ; Giant Cells ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Neck ; Scalp ; Tuberculosis, Lymph Node