One of the patellar function is to protect the femoral condyle from direct blowing to knee, so it is known that ligament injuries of the knee are rare in the presence of patellar fracture. We experienced four cases of posterior cruciate ligament injury associated with patellar fracture. Unfortunately, three cases were initially neglected, and one case was identified by visualization on avulsed posterior tibial spine in plain X-ray film. We reviewed these cases and obtained several results as follows; 1. Among four cases, three cases(75%) are fractured at the lower pole of patella without displacement and one case is a longitudinal fracture. 2. We consider possible two mechanisms of this injury; first, in flexed knee, posteriorly directed force on the proximal tibia produces posterior cruciate ligament injury followed by avulsed fracture at the lower pole of patella. Second, by fall on a flexed knee, the load is sustained on the inferior pole of the patella first and continuously drives the tibia backwards producing posterior cruciate ligament injury. We recommend that all surgeon should be aware of possibility of the ligament injury in the presence of patellar fracture, especially in lower pole fracture.
Knee ; Ligaments ; Patella ; Posterior Cruciate Ligament ; Spine ; Tibia ; X-Ray Film

Traditionally, the Rhododendron species has been used in gastrointestinal disorder or hypertension. Grayanotoxin exists in honey, flowers, pollen, and the nectar of the Rhododendron species. We experienced 3 cases of Grayanotoxin intoxication. The symptoms of intoxication were nausea, vomiting, hypotension, bradycardia, diplopia, dizziness, and chest discomfort. Generally, the treatment for Grayanotoxin intoxication is fluid resuscitation and injection of atropine sulfate. The patients who were intoxicated with Grayanotoxin were discharged without complication after supportive care.
Atropine ; Bradycardia ; Diplopia ; Dizziness ; Flowers ; Honey ; Humans ; Hypertension ; Hypotension ; Nausea ; Plant Nectar ; Pollen ; Resuscitation ; Rhododendron ; Thorax ; Vomiting

BACKGROUND: Recently, the trend pursuing slimness is significantly increasing in adolescents. Because of distorted body image, excessive body weight control can cause problems of health. The goal of this study is to investigate the factors of distorted body image and its problems. METHODS: The survey was performed in a high school of Jindo island on May, 2000. All of 258 students in 1st and 2nd grade participated in this study by questionnaires. Thirteen truthless questionnaires were excluded in this study. Therefore 245 student were selected. RESULTS: Only 20% of 245 repliers were satisfied with their body figure. In male, 24.1% wanted weight loss, and 39.8% wanted weight gain. In female, 73% wanted weight loss. In a populations(BMI<20), 70 males wanted weight loss, whereas 35(52.2%) among 67 females want weight loss. According to these result, female stuedents wanted strongly weight loss than male. The factors which most influenced body figure were sports star in males(36.1%), and movie stars in female.(43.8%) A group of 58.4% of repliers has experienced body weight control. A group of 37% in male and 39.6% in female suffered from side effects. 77% of total hoped to be educated about adequate body weight control method. CONCLUSION: Almost of adolescents dissatisfied with their body figure, Many adolescent who is not obese attempt weight loss, and are sufferd from side effects. Therefore, it is required for effective education about body weight control and social attitude permitting adequate body image.
Adolescent ; Body Image* ; Body Mass Index ; Body Weight ; Education ; Female ; Hope ; Humans ; Male ; Sports ; Weight Gain ; Weight Loss ; Surveys and Questionnaires

The vertebral artery is infrequently injured because it lies deep in the neck, surrounded for the most part by bony foramina. Vertebral artery injuries are caused by penetrating traumas, blunt traumas and iatrogenic injuries. Sequela of vertebral artery injury include arteriovenous (AV) fistulae, and pseudoaneurysms may appear months after injury. Angiography is currently the gold standard for evaluating vascular injuries, such as vertebral artery injuries, and can be therapeutic. A vertebral artery fistula can also be treated by operative ligation. We experienced a rare case of a vertebro-jugular AV fistula secondary to a cervical stab wound. In this case, the patient was successfully treated by coil embolization and glue injection during angiography, which was confirmed by a postangiograpy operation.
Adhesives ; Aneurysm, False ; Angiography ; Arteriovenous Fistula* ; Embolization, Therapeutic ; Fistula ; Humans ; Ligation ; Neck ; Vascular System Injuries ; Vertebral Artery ; Wounds, Stab

BACKGROUND: We compared the results of liver biopsy and the levels of serum type IV collagen of the hepatitis B carriers with normal liver function test (LFT) to evaluate the clinical usefulness of serum type IV collagen in predicting the progression of histopathological findings. METHODS : Thirty one chronic hepatitis B carriers with normal LFT and no significant clinical symptoms, who were Korean combat police, were classified into three groups according to their histologic results of the liver biopsies. The classification followed the standard proposed by Korean Society of Pathology. Blood samplings for serum type IVcollagen (reference : less than 5 ng/mL) were done in the morning of the same day of the liver biopsy. RESULTS: Of thirty one patients, thirteen patients showed normal histologic findings (41.9%, Group A), eleven patients revealed histologic abnormalities without fibrosis (35.5%, Group B) and seven patients were with fibrosis on liver biopsy (22.6%, Group C). Serum type IV collagen levels of Group A, B and C were 3.53 +/- .57 ng/mL, 3.56 +/- .17 ng/mL and 3.97 +/- .88 ng/mL, respectively. The average of serum type IV collagen levels of Group C was higher than of Group B and the average of Group B higher than that of Group A without any statistical significance (p > 0.05). The averages of serum type IV collagen of eighteen patients with histologic abnormalities (Group B and C) and twenty four patients without fibrosis (Group A and B) were 3.73 +/- 1.06 ng/mL and 3.55 +/- .88 ng/mL respectively. Upon comparison of these averages with the those of Group A and C, no statistical significance was established (p > 0.05). CONCLUSION : In chronic hepatitis B carriers with normal LFT findings, levels of serum type IV collagen were elevated along with histologic severities without statistical significance, therefore can not represent the changing degree of the histologic findings. Liver biopsy is considered to be one of the most accurate tool to assess the histologic status of the liver.
Biopsy* ; Classification ; Collagen Type IV* ; Collagen* ; Fibrosis ; Hepatitis B Surface Antigens ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Liver Function Tests* ; Liver* ; Needles ; Pathology ; Police

PURPOSE: Due to its rapidity and easy accessibility, the fingerstick blood glucometer has been used in almost all hospitals and private clinics, and even by patients themselves. We also have used it even in shock patient care, but shock shows global tissue hypoperfusion, especially in peripheral tissue. The changes of peripheral circulation have an influence on the results for fingerstick glucose. To evaluate the accuracy of the glucometer for patients with poor peripheral perfusion, we designed this study. METHODS: A prospective, nonrandomized comparison group study was done. A hypotensive group and a normotensive group were compared. We obtained three data from each patient: venous blood glucose level (clinicopathologic laboratory), venous blood glucose level (by glucometer) and fingerstick glucose level (by glucometer). RESULTS: We saw a significant difference between the fingerstick glucometer results and the laboratory glucose levels in hypotensive patients: 131.67+/-55.33 mg/dl vs. 1 4 7 . 2 3+/-62.06 mg/dl (paired t-test, p<0.05). There was no significant difference between fingerstick and laboratory glucose in normotensive patients: 101.75+/-20.14 mg/dl vs. 1 0 5 . 6 0+/-21.95 mg/dl (paired t-test, p>0.05). There was no significant difference between the results of venous glucometer and laboratory test in either group: 142.37+/-61.27 mg/dl vs. 147.23+/-62.06 mg/dl (paired t-test, p>0.05) and 102.98+/-17.02 mg/dl vs. 105.60+/-21.95 mg/dl (paired t-test, p>0.05). Although some statistical differences existed between the results, all of the error rates were in an acceptable range (within 15%, accepted by American Diabetes Association consensus). CONCLUSION: These results suggest that the blood glucose level of the glucometer with venous blood is more accurate than that with peripheral blood in patients with poor peripheral circulation.
Blood Glucose* ; Glucose ; Humans ; Patient Care ; Perfusion ; Prospective Studies ; Shock

BACKGROUND: There are epidemiological clinical studies that describe the relationship of decreased serum cholesterol levels or their treatment with suicides, offensive actions and depression. METHODS: We studied 140 patients who were hospitalized at Asan Foundation Jeongup Hospital (in Korea) via emergency room after suicide attempts and whose serum cholesterol levels were acquired during 53 months (from Jan. 1. 1995 to May 31. 1999). They were evaluated with the use of t-test. The serum cholesterol levels were compared between the control group of 140 persons who underwent health check ups and 140 patients who were of similar age and sex ratios. RESULTS: Subjects showed significant decrease in serum cholesterol levels in comparison with the control group. Low serum cholesterol levels were related with the severity of suicidal attempts. 1) The subjects showed lower serum cholesterol levels than the control group(150.51+/-56.69mg/dl vs 185.61+/-31.94mg/dl; t= 6.382, df=278, P<0.001) (Table 3). 2) Those who killed themselves showed statistically significant decrease in serum cholesterol levels than those who survived after their suicidal attempts(169.13+/-49.29mg/dl vs 135.89+/-34.14; t=2.005, P<0.05) (Table 4). CONCLUSION: This study was carried out in farming and fishing villages of Korea. The result showed that the decrease in serum cholesterol levels increased the risk of suicide trials. This fact is similar to the results of the previous studies performed at other farming and fishing communities. In addition, those who killed themselves had lower serum cholesterol levels compared to those who survived suicide attempts. This relationship was associated with depression.
Cholesterol* ; Chungcheongnam-do ; Depression ; Emergency Service, Hospital ; Humans ; Korea ; Sex Ratio ; Suicide

Rupture of the colon caused by high pressure compressed air is a rare, unique and traumatic intra-abdominal injury. As the use of compressed air in industrial work has increased, so has the risk of associated pneumatic injuries from its improper use. Recently we experienced a case of pneumatic rupture of the sigmoid colon accompanied by tension pneumoperitoneum, which caused respiratory distress. The patient's respiration was very rapid with the rate of 44 breaths per minute. On arterial blood gas analysis, pH was 7.40, pO2 68 mmHg, pCO2 44 mmHg, and SaO2 90%. Chest X-ray film showed marked pneumoperitoneum and an elevated diaphragm. The respiratory distress was severe and required immediate relief by emergency decompression peritoneocentesis before surgical intervention consisting of the serosal tear repair, colonic rupture colostomy and abdominal cavity irrigation. A follow up operation 2 months later for colostomy repair completed the patient's recovery.
Adult ; Case Report ; Colonic Diseases/etiology* ; Human ; Male ; Pneumoperitoneum/complications* ; Pressure ; Rupture, Spontaneous

Subclavian artery(SCA) injuries are rare, accounting for only 1 to 2% of all acute vascular injuries. The majority of SCA injuries are occured by motor vehicle accident and by penetrating trauma, only 1 to 5% of all subclavian artery injuries occurred by blunt mechanisms. The incidence of brachial plexus injury is also rare and 60% of brachial plexus injuries induced by blunt injury is occurred by motor vehicle accident. Aggressive diagnostic work-up is recommended for the patients with high suspicious index and repair is essential for the successful management of these rare vascular injuries. We report the experience of one case of combined subclavian artery and brachial plexus injuries due to blunt trauma.
Brachial Plexus* ; Humans ; Incidence ; Motor Vehicles ; Subclavian Artery* ; Vascular System Injuries ; Wounds, Nonpenetrating

PURPOSE: Our study aimes to examine the outcome of open fractures with associated vascular injury and to assess the diagnostic value of angiography in patients who visit the emergency department (ED). METHODS: The records of 22 patients who were diagnosed as open fracture in the ED of Inha University Hospital between June 1996 and December 2001 were selected for review. Angiography was done on the suspicion of vascularinjury for patients with abnormal vascular examination results and an unclear level of injury that might require vascular repair. RESULTS: There were 21 men and one woman with a mean age of 37 years. The injury resulted from traffic accidents in 59.2% of the patients. The femur and tibia were most commonly involved and the popliteal artery was too. 18 patients were confirmed vascular injury by angiography (81.8%). 14 abnormal angiographic findings were found in 15 (93.3%) of the patients who were predicted the vascular injury by clinical findings. 4 abnormal angiographic findings were found in 7 (57.1%) of the patients who were not predicted the vascular injury. The group of patients who had demonstrated vascular injury and repair was performed within 6 hours of injury showed lesser incidence of complication than 6 hours after injury. The overall amputation rate was 22.7% (5 of 22). CONCLUSION: The most important factor in successful management is early recognition and early repair of vascular injury in open fracture. In conclusion, we suggest that emergency angiography is valuable diagnostic procedures for patients who visit the emergency department with the open fracture.
Accidents, Traffic ; Amputation ; Angiography* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Femur ; Fractures, Open* ; Humans ; Incidence ; Male ; Popliteal Artery ; Tibia ; Vascular System Injuries