Purpose: The purpose of this study was to evaluate the mortality of patients over eighty years old with femoral neck fractures that have been treated with bipolar endoprostheses. Materials and Methods: We retrospectively studied 37 patients out of a total of 83, who suffered from hip fractures and were treated with surgery from 2000 through December 2004. We attempted to distinguish the differences between the 8 patients who died (Group A) and the 29 patients who lived (Group B). The variables that we analyzed, were: age, sex, operative time, the time period from admission to surgery, the time period from admission to discharge, the ASA score, and any medical comorbidities. Results: In Group A, 2 patients died within 1 month, 2 died between 1 and 6 months, 1 died between 6 and 12 months, and 3 died after 1 year. There were statistical differences between Group A and Group B with respect to two variables: the time period from admission to, and medical comorbidities. Conclusion: There were significant correlations with an increase in the mortality rate among patients with lung disease, female patients in general, and delays in surgery. Therefore, particular care should be paid to patients with these variables.
Comorbidity ; Female ; Femoral Neck Fractures ; Hip Fractures ; Hip* ; Humans ; Lung Diseases ; Mortality* ; Operative Time ; Retrospective Studies

BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

PURPOSE: Republic of Korea is now progressing to an aging society. Ones of rural areas in Korea are already aged societies. Others are post-aged societies in some areas. The urban areas in Korea is westernized, industrialized, and so crowded but the rural areas are still traditional and agricultural. The geriatric trauma victims in rural area have been neglected in that the rural medical environment including emergency medical service is not well-equipped and wellorganized. The purpose of this study is to evaluate clinical comparison of geriatric trauma victims between urban and rural area to prevent geriatric trauma and improve geriatric trauma outcomes. METHODS: In urban area, there was 382 geriatric trauma victims. And In rural area, there was 230 geriatric trauma victims. They was enrolled in this study from 1 Jan 2007 to 31 Dec 2007. We analyzed the medical data by using SPSS 12.0 and compared between urban and rural geriatric trauma victims in RTS (Revised trauma score), NISS (New injury severity score), vital sign, mentality, access, transportation, trauma time, mechanism of injury, and disposition. RESULTS: The mean age was 73.33+/-6.71 vs 73.00+/-6.13 (urban area geriatric trauma victims vs rural area geriatric trauma victims). The mean NISS was 7.18+/-8.66 vs 11.10 +/-11.10 (p-value=0.000). The mean RTS was 7.73+/-0.59 vs 7.67+/-0.75 (p-value=0.272). The factor of access, transportation, mechanism of injury, and disposition between urban and rural geriatric trauma victims showed statistical difference by chi-square test. CONCLUSION: In conclusion, rural area geriatric trauma victims were visited the emergency medical center with different method and route compared with the urban area geriatric trauma victims, showed the difference in mechanism of injury and results of medical treatment and thus needs to be concerned about difference of geriatric trauma between urban and rural area for prevention and better medical outcome.
Aged ; Aging ; Emergencies ; Emergency Medical Services ; Geriatrics ; Humans ; Korea ; Republic of Korea ; Rural Population ; Transportation ; Urban Population ; Vital Signs

No abstract available.
Multiple Myeloma* ; Plasmacytoma*

PURPOSE: To analyze the clinical characteristics and factors affecting visual outcome after surgery in rhegmatogenous retinal detachment resulting from blunt trauma. METHODS: We retrospectively reviewed the medical records of 122 patients (122 eyes) who were diagnosed with rhegmatogenous retinal detachment after blunt trauma and who had been under regular observation for at least six months. RESULTS: The frequency of traumatic rhegmatogenous retinal detachment was 122 eyes out of 989 total eyes with rhegmatogenous retinal detachment (12.3%). The mean age was 36.3 years (7-66): 93 (76.2%) male, 29 (23.8%) female. The most common type of retinal break was a horseshoe-shaped retinal tear (31.1%), and the most common location was the superotemporal quadrant (32.8%) and on the retinal equator or anterior to the equator (90.2%). Patients older than 50 years had a shorter latent period from the traumatic event to the symptom presentation (p=0.028). Whether the retinal detachment involve the macula, the extent of detachment, the initial visual acuity and the time interval from symptom presentation to treatment influenced on the postoperative visual recovery. CONCLUSIONS: Traumatic rhegmatogenous retinal detachment had a favorable visual recovery in cases of early diagnosis. Therefore, detailed and frequent examinations of the retinal periphery after ocular trauma are important if vision is to be preserved. Older patients showed a tendency to advance into traumatic rhegmatogenous retinal detachment more rapidly after trauma than did younger patients. Therefore, elderly patients will require special intensive treatment following traumatic retinal detachment.
Aged ; Early Diagnosis ; Eye ; Female ; Humans ; Male ; Medical Records ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Vision, Ocular ; Visual Acuity

PURPOSE: To analyze the clinical characteristics and factors affecting visual outcome after surgery in rhegmatogenous retinal detachment resulting from blunt trauma. METHODS: We retrospectively reviewed the medical records of 122 patients (122 eyes) who were diagnosed with rhegmatogenous retinal detachment after blunt trauma and who had been under regular observation for at least six months. RESULTS: The frequency of traumatic rhegmatogenous retinal detachment was 122 eyes out of 989 total eyes with rhegmatogenous retinal detachment (12.3%). The mean age was 36.3 years (7-66): 93 (76.2%) male, 29 (23.8%) female. The most common type of retinal break was a horseshoe-shaped retinal tear (31.1%), and the most common location was the superotemporal quadrant (32.8%) and on the retinal equator or anterior to the equator (90.2%). Patients older than 50 years had a shorter latent period from the traumatic event to the symptom presentation (p=0.028). Whether the retinal detachment involve the macula, the extent of detachment, the initial visual acuity and the time interval from symptom presentation to treatment influenced on the postoperative visual recovery. CONCLUSIONS: Traumatic rhegmatogenous retinal detachment had a favorable visual recovery in cases of early diagnosis. Therefore, detailed and frequent examinations of the retinal periphery after ocular trauma are important if vision is to be preserved. Older patients showed a tendency to advance into traumatic rhegmatogenous retinal detachment more rapidly after trauma than did younger patients. Therefore, elderly patients will require special intensive treatment following traumatic retinal detachment.
Aged ; Early Diagnosis ; Eye ; Female ; Humans ; Male ; Medical Records ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Vision, Ocular ; Visual Acuity

Zenker diverticulum is rare and symptoms of diverticulum are atypical. This is most commonly seen at the Killian's triangle. This is caused by altered motility, which results in abnormal intraluminal pressure and the pushing of the mucosa through weakness of the wall. Treatment is surgical via an endoscopic or external approach. Previous external approaches are associated with high com-plication rates and morbidity. We report a new external surgical approach using the gastrointestinal autostapler (GIA) instrument.
Diverticulum ; Mucous Membrane ; Zenker Diverticulum

We present a case of recurrent left atrial myxoma which occurred 7 years and 10 months after initial operation despite resection of originaltumor and adjacent atrial septum. This is the first case report of recurrence in Korea. Among the possible causes of recurrence, regrowth from pretumorous focus seems to be the most suggesting one in this case. Histopathologic findings of recurrent myxoma showed increased cellularity with active proliferation and nuclear hyperchromasia. These findings, together with the rapidity of regrowth, suggest that recurrent myxoma may have 'wilder' behavior. Prolonged postoperative observation is important, even if ample resection was done at the initial operation including atrial septum.
Atrial Septum ; Korea ; Myxoma* ; Recurrence*

Leber's hereditary optic neuropathy(LHON) is an optic nerve disease that causes blindness and is associated with maternally inherited mitochondrial DNA(mt DNA) mutations. The most common mitochondrial DNA mutation among LHON patients is a point mutation at the nucleotide 11778 in the subunit 4 of complex I. In one 45-year old male LHON patient with bilateral optic neuropathy, we investigated the presence of a point mutation of mitochondrial DNA and identified a single guanine to adenine transition mutation in the mitochondrial DNA at nucleotide point 11778.
Adenine ; Blindness ; DNA, Mitochondrial* ; Guanine ; Humans ; Male ; Middle Aged ; Optic Atrophy, Hereditary, Leber ; Optic Nerve Diseases ; Point Mutation*

Spontaneous epidural hematoma (SEH) is an uncommon cause of spinal cord compression. It tends to occur in patients at high risk for hemorrhage. Various medications are associated with SEH, including antiplatelet agents, anticoagulants, and thrombolytics. Because patients usually present with neurologic deficits, early diagnosis and proper management are required to achieve full recovery. The principal management is surgical evacuation of the SEH via laminectomy. We present a case of a 51-year-old woman on both oral aspirin and intravenous heparin who subsequently developed a SEH.
Anticoagulants ; Aspirin ; Early Diagnosis ; Female ; Hematoma ; Hematoma, Epidural, Spinal ; Hemorrhage ; Heparin ; Humans ; Laminectomy ; Middle Aged ; Neurologic Manifestations ; Platelet Aggregation Inhibitors ; Spinal Cord Compression