No abstract available.
Tibial Fractures*

PURPOSE: The purpose of this study was to analyze any effectiveness, advantages, and the procedure of an ultrasound-guided suprascapular nerve block via the proximal approach in patients suffering from shoulder pain. MATERIALS AND METHODS: A total of 51 patients treated with nerve block between November 2015 and November 2016 were analyzed. We identified the suprascapular nerve that branches off the superior trunk of the brachial plexus, and found the suprascapular nerve, which is located in the fascial layer between the inferior belly of the omohyoid muscle and the serratus anterior muscle. We then performed a nerve block. We evaluated the visual analogue scale (VAS) of pre- and post-nerve block, and the visualization of the nerve, depth from the skin to the nerve, angle of needle entry, as well as complications. Moreover, we measured the visualization of the nerve, depth from the skin to the nerve in a classic approach, and compared it with the proximal approach. RESULTS: There was significant improvement (p < 0.05) in the mean VAS, from 7.1 to 3.4, without any major complications. Compared with the classic approach, we were able to identify the suprascapular nerve much better (classic 25.5%/proximal 96.1%), and the mean distance from the skin to the nerve (classic 38 mm/proximal 12 mm) was significantly short (p < 0.05), and the mean angle of needle entry was 19 degrees in the proximal approach. CONCLUSION: In an ultrasound-guided suprascapular nerve block by proximal approach, the nerve and needle tip can be more easily identified, which increases accuracy; with a small amount of local anesthetic, more effective pain control can be achieved. Hence, this approach is an effective alternative pain control method for patients suffering from shoulder pain.
Brachial Plexus ; Humans ; Methods ; Needles ; Nerve Block* ; Shoulder ; Shoulder Pain ; Skin ; Ultrasonography

Recently, Prosthetic replacement of hip was recognized as a reliable technique for the treatment of avascular necrosis of femoral head in adult. There were many reports about post-operative evaluation of functional difference between hemiarthroplasty and total hip arthroplasty and which revealed that the revision rate for the total hip arthroplasty was less compared with the femoral endoprosthesis. Also, controversy was existed between the porous coating system and bone cement fixation. In order to evaluate the functional difference among each prosthetic replacement, authors reviewed the result of 10 cases of cementless unipolar endoprosthesis (abbreviated as UE), 10 cases of cementless bipolar endoprosthesis (abbreviated as BE), and 25 cases of cementless total hip replacement arthroplasy (abbreviated as THRA), performed at Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital, during the period from September, 1985 to August, 1988. The following results were obtained: 1. The incidence was higher in 6th decade in UE, THRA groups, 4th decade in BE group. 2. The average follow up of UE, BE, and THRA groups were 30.7, 15.2, and 16.9 months, respectively. 3. By radiological classification of Marcus et al., the average stages of UE, BE, and THRA were 4.9, 4.0, and 5.3respectively. 4. According to Harris hip rating system, post-op. Harris scores were increased as much as 33.1, 37.2, and 43.4 in UE, BE, and THRA groups respectivelycompared with pre-op. score. 5. In this study, the last follow up results of hip function in BE, and THRA groups were better than that evaluated at 6 months after surgery in most cases. 6. External rotation, which was one of needed motion in cross leg sitting position, was significantly influenced by the degree of excision of joint capsule, the type of replacement prosthesis, the regimen of post-op. starting exercise, and a history of previous surgical treatment. 7. Because serious complications were not developed at recent follow up, the UE, BE, and THRA groups showed insignificant difference in functional difference in prosthetic replacement.
Adult ; Arthroplasty, Replacement ; Arthroplasty, Replacement, Hip ; Classification ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Incidence ; Joint Capsule ; Leg ; Necrosis ; Prostheses and Implants

The coronary arteries are also subject to congenital anomalies of both minor and major consequence. Hemodynamically significant primary anomalies of the coronary arteries are those which alter myocardial perfusion. There are four major types : coronary artery fistula, origin of the left voronary artery from the pulmonary artery, congenital coronary stenosis or atresia and origin of the left or right coronary artery from the opposite sinus of Valsalva with subsequent passage of the vessel between the aorta and right ventricular infundibulum. Minor anomlies are the variation of the origin of the coronary arteries from the aorta with normal distal circulation. We can see more coronary anomalies associated with congenital cardiac anomalies, probably representing a circulatory response to the primary intracardiac defect. We present a total of 76 cases of congenital coronary anomalies, reviewing 3946 cases of angiocardiography or selective coronary arteriography, performed during last 8 years at Sejong General Hospital.
Angiocardiography ; Angiography ; Aorta ; Arteries ; Coronary Stenosis ; Coronary Vessels* ; Fistula ; Hospitals, General ; Perfusion ; Pulmonary Artery ; Sinus of Valsalva

Idiopathic restrictive cardiomyopathy is characterized by clinical and hemodynamic findings of restrictive cardiomyopathy in the absence of morphologic cause. The differential diagnosis between idiopathic restrictive cardiomyopathy and noncalcified constrictive pericarditis is difficult but the distinction is crucial because of the therapeutic implication. The diagnosis of idiopathic restrictive cardiomyopathy is aided by echocardiography and cardiac catheterization, cardiac magnetic resonance imaging. The patients should be approached systemically to differentiate from noncalcified constritive pericarditis.
Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Restrictive* ; Diagnosis ; Diagnosis, Differential ; Echocardiography ; Hemodynamics ; Humans ; Magnetic Resonance Imaging ; Pericarditis ; Pericarditis, Constrictive

Animal ; Ascorbic Acid/metabolism ; Helicobacter Infections/*prevention & control ; Helicobacter pylori/*physiology ; Human ; Nitroso Compounds/metabolism ; Stomach Neoplasms/*microbiology ; Support, Non-U.S. Gov't

We experienced one case of anesthesia for liver transplantation in a 14 year old girl with Wilson's disease. The liver was donated from a patient with a brain tumor who was diagnosed as brain death. We monitored blood pressure, heart rate, cardiac output, pulmonary capillary wedge pressure, systemic vascular resistance, arterial pH, arterial PCO2, serum potassium, ionized calcium, glucose, and blood coagulation states including platelet count, prothrombin time, activated partial thromboplastin time and coagulation factor assay. We used isoflurane and nitrous oxide as the main inhalation anesthetics. The operation was performed without serious problem. The patient became conscious three hours after the operation.
Adolescent ; Anesthesia* ; Anesthetics, Inhalation ; Blood Coagulation ; Blood Coagulation Factors ; Blood Pressure ; Brain Death ; Brain Neoplasms ; Calcium ; Cardiac Output ; Female ; Glucose ; Heart Rate ; Hepatolenticular Degeneration ; Humans ; Hydrogen-Ion Concentration ; Isoflurane ; Liver Transplantation* ; Liver* ; Nitrous Oxide ; Partial Thromboplastin Time ; Platelet Count ; Potassium ; Prothrombin Time ; Pulmonary Wedge Pressure ; Vascular Resistance

PURPOSE: Living related donor liver transplantation (LRLT) was introduced into our pediatric liver transplantation program as a response to the shortage of donors. This study was performed to evaluate the indication, complication and outcome of LRLT in children. METHODS: From December, 1994 to May, 1997, a total of 20 LRLTs had been performed at Asan Medical Center for end-stage liver disease. The patients ranged in age from 6 months to 14 years (median : 1 year 4 months) and in body weight from 5.8 to 50.5kg (median : 9.8kg). The indications for transplantation were biliary atresia (11), Wilson disease (3), nonsyndromic intrahepatic bile duct paucity (2), Byler syndrome (1), cirrhosis (1), fulminant hepatitis (1) and posthepatectomy bile duct stricture (1). Among them 3 ABO blood group incompatibilities were included. The lateral segment or the left lobe of the liver was used for the graft. As for immunosuppression, cyclosporin A based immunosuppression was used for the initial 11 cases which later changed into FK506 based for the last 9 cases. RESULTS: The actuarial survival rate of recipients was 90% for our cases. Two deaths occurred, one of whom died of acute respiratory distress syndrome due to respiratory syncytial virus infection on 51st postoperative day and the other died of gastrointestinal bleeding from Epstein- Barr virus infection and posttransplant lymphoproliferative disease on 11th postoperative month. No patient died of surgical complications. Acute rejection episodes were observed in 6 (5 among 11 cyclosporin A based immunosuppression and 1 among FK506 group) which were managed successfully. All donors (6 fathers and 14 mothers) are alive and well with normal activity. CONCLUSION: We concluded that LRLT is a promising option for alleviating the shortage of livers for pediatric transplantation.
Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Atresia ; Blood Group Incompatibility ; Body Weight ; Child* ; Chungcheongnam-do ; Constriction, Pathologic ; Cyclosporine ; Fathers ; Fibrosis ; Hemorrhage ; Hepatitis ; Hepatolenticular Degeneration ; Humans ; Immunosuppression ; Liver Diseases ; Liver Transplantation* ; Liver* ; Living Donors ; Respiratory Distress Syndrome, Adult ; Respiratory Syncytial Viruses ; Survival Rate ; Tacrolimus ; Tissue Donors* ; Transplants

PURPOSE: This study was undertaken to evaluate the gastroduodenal pathology and Helicobacter pylori infection in children with upper gastrointestinal symptoms. METHODS: One hundred and seven pediatric patients with upper gastrointestinal symptoms were undergone endoscopy at the Gyeongsang National University Hospital from June 1990 to April 1991. Histopathologic examination was done by H & E staining of gastric antral biopsy specimen and gastritis was defined according to the Sydney System. Tissue H. pylori status was evaluated with the urease test using Christensen's urea broth and H & E or Warthin-Starry silver staining of gastric antral biopsy specimen. IgG Immunoblotting were also performed to detect specific anti-H. pylori antibody in these patients. RESULTS: The reasons for endoscopy were recurrent abdominal pain, acute abdominal pain, sallow face, hunger pain, and frequent nausea. Variable degrees of gastric mucosal hyperemia were found in most of the patients. Gastric hemorrhagic spots, gastric ulcer, duodenal ulcer, duodenal erosion, and hemorrhagic duodenitis were rare endoscopic findings. Histologic chronic gastritis was found in 88% of 107 patients. Histologic chronic duodenitis was observed in all 99 patients whose tissue were available. Gastric tissue H. pylori was positive in 57% of 107 patients by one of the ureasetest, H & E staining and Warthin-Starry silver staining. However, gastric tissue H. pylori detection rate was lower in the younger age groups. Anti-H. pylori IgG antibodies were detectable in 96% of 107 patients. CONCLUSION: Chronic gastroduodenitis and anti-H. pylori IgG antibody were ubiquitous in children with upper gastrointestinal symptoms.
Abdominal Pain ; Antibodies ; Biopsy ; Child* ; Duodenal Ulcer ; Duodenitis ; Endoscopy ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hunger ; Hyperemia ; Immunoblotting ; Immunoglobulin G ; Nausea ; Pathology* ; Silver Staining ; Stomach Ulcer ; Urea ; Urease

To identify the Helicobacter pylori antigens operating during early infection in sera from infected infants using proteomics and immunoblot analysis. Two-dimensional (2D) large and small gel electrophoresis was performed using H. pylori strain 51. We performed 2D immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM) antibody immunoblotting using small gels on sera collected at the Gyeongsang National University Hospital from 4–11-month-old infants confirmed with H. pylori infection by pre-embedding immunoelectron microscopy. Immunoblot spots appearing to represent early infection markers in infant sera were compared to those of the large 2D gel for H. pylori strain 51. Corresponding spots were analyzed by matrix-assisted laser desorption/ionization time of flight-mass spectrometry (MALDI-TOF-MS). The peptide fingerprints obtained were searched in the National Center for Biotechnology Information (NCBI) database. Eight infant patients were confirmed with H. pylori infection based on urease tests, histopathologic examinations, and pre-embedding immunoelectron microscopy. One infant showed a 2D IgM immunoblot pattern that seemed to represent early infection. Immunoblot spots were compared with those from whole-cell extracts of H. pylori strain 51 and 18 spots were excised, digested in gel, and analyzed by MALDI-TOF-MS. Of the 10 peptide fingerprints obtained, the H. pylori proteins flagellin A (FlaA), urease β subunit (UreB), pyruvate ferredoxin oxidoreductase (POR), and translation elongation factor Ts (EF-Ts) were identified and appeared to be active during the early infection periods. These results might aid identification of serological markers for the serodiagnosis of early H. pylori infection in infants.
Biotechnology ; Electrophoresis ; Flagellin ; Gels ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoblotting ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Infant* ; Microscopy, Immunoelectron ; Peptide Elongation Factors ; Peptide Mapping ; Proteomics ; Pyruvate Synthase ; Serologic Tests ; Spectrum Analysis ; Urease