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

No abstract available.
Adenocarcinoma* ; Adenoma* ; DNA*

OBJECTIVE: Many diffusion tensor imaging (DTI) studies of the corpus callosum (CC) have been performed with a relatively thick slice thickness in the axial plane, which may result in underestimating the fractional anisotropy (FA) of the CC due to a partial volume effect. We hypothesized that the FA of the CC can be more accurately measured by using mid-sagittal DTI. We compared the FA values of the CC between the axial and mid-sagittal DTI. MATERIALS AND METHODS: Fourteen healthy volunteers underwent MRI at 3.0 T. DTI was performed in both the mid-sagittal and axial planes. One 5-mm mid-sagittal image and twenty-five 2-mm axial images were obtained for the CC. The five regions of interest (ROIs) that included the prefrontal (I), premotor and supplementary motor (II), motor (III), sensory (IV) and parietal, temporal and occipital regions (V) were drawn along the border of the CC on each sagittal FA map. The FA values obtained from each region were compared between the two sagittal maps. RESULTS: The FA values of all the regions, except for region V, were significantly increased on the mid-sagittal imaging. The FA values in region IV were significantly underestimated on the mid-sagittal image from the axial imaging, compared with those in the regions I and V (p = 0.037 and p = 0.001, respectively). CONCLUSION: The FA values of the CC were significantly higher on the mid-sagittal DTI than those on the axial DTI in regions I-IV, and particularly in the region IV. Mid-sagittal DTI may provide more accurate FA values of the CC than can the axial DTI, and mid-sagittal DTI may be more desirable for studies that compare between patients and healthy subjects.
Adult ; Analysis of Variance ; Anisotropy ; Brain Mapping/*methods ; Corpus Callosum/*anatomy & histology ; Diffusion Magnetic Resonance Imaging/*methods ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Statistics, Nonparametric

Malaria is the world's most important parasitic infec tion. Although it has been eradicated from temperate zones including Korea , increasing numbers of travellers visit tropical malarious countries and imported malaria becomes important medical problem in the developed countries. In Korea with increasing travellers to malaria endemic area, the incidence of imported malaria shows rising tendency same as the developed countries. It beco mes important to provide general personal protective me asures and chemoprophylaxis to trevellers, when employed in appropriate manner, that can be highly effective in preventing malaria . We recently experienced a case of imported Plasmodium vivax malaria with delayed mani festations due to inadequate chemoprophylaxis. A 53- year-old woman with history of trevel to East Africa 4 months ago and chief complaint of fever was diagnosed as tertian malaria. She had irregularly taken prophylatic antimalarial during travel and had not taken it after return but should have taken it at least 4 weeks after return.
Africa, Eastern ; Chemoprevention* ; Developed Countries ; Female ; Fever ; Humans ; Incidence ; Korea ; Malaria ; Malaria, Vivax* ; Plasmodium vivax* ; Plasmodium*

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

OBJECTIVE: Staphylococcus aureus has persisted and is now resurging as an important hospital and community pathogen. Nosocomial infection caused by methicillin-resistant S.aureus(MRSA) is a major problem which may be connected with heavy or prolonged use of antibiotics S.aureus bacteremia caused acute complications, which occasionally resulted in death, and infectious/suppurative complications, which necessitated prolonged antibiotic therapy, sometimes in conjunction with surgery. Therefore, S.aureus bacteremia is a serious medical problem in association with high morbidity and mortality. METHODS: 130 patients with S.aureus bacteremia who were admitted in the Kyung Hee University Hospital from January, 1991 to December, 1994 were analyzed retrospectively. We compared the clinical and laboratory characteristics, and antibiotics resistances between MRSA and MSSA bacteremia and also we evaluated risk factors that contribute to fatal outcome in patients with S.aureus bacteremia. RESULTS: 1) of 130cases, 80 were male and 50 were female. The mean age was 44.5+/-25.1 years. 2) 84(65%) of S.aureus bacteremia were nosocomial and 46(35%) were community-acpuired. The percentage of MRSA stains studied was 55%(71/130) and The percentage of MRSA bacteremia in hospital-acpuired and community-accquired S. aureus bacteremia were 64% (54/84) and 36%(17/46), respectively. Sources of bacteremia were uncertain in 85(65%) with intravascular catheter(20%) and skin wound sites (8%) being the most common sources in remainder(35%) 3) 110(85%) of 130 patients had one or more underlying diseases. Common underlying dieases were cerebrovascular disease(33%), malignancy(17%), Diabetes mellitus(15%), chronic renal failure(8%) and liver cirrhosis(6%). 4) Acute complications occurred in 35 patients and were fatal in 21 5) The risk factors associated with MRSA bacteremia were various severe underlying diseases, vairous invasive procedures, IV catheter-associated infection, hypoalbuminemia, previous use of antibiotics, male sex and old age. 6) The Case fatality rate for patients with S. aureus bacteremia was 18% and those for patients with MRSA and MSSA bactermia were 20% and 12%, respectively. The risk factors that contribute to the increment of mortality rate in patients with S. aureus bacteremia were acute complication, low serum level of total protein, hypoalbuminemia, various invasive procedures and IV catheter-associated infection, 7) In the antibiotic sensitivity test S. aureus was resistant to penicillin in 98.5%, ofloxacin in 73%, cefotaxime in 67%, erythromycin in 58%, aztreonam in 56%, clindamycin in 52%, vancomycin in 0%. 8) In the multiple antibiotic resistance of S. aureus, 43(68%) of MRSA was resistant to more than 10 antibotics, revealing multiply resistant nature of strains, While all but one MSSA was resistant to 1 to 4 antibiotics, one revealing resistance to 8 antibiotics. CONCLUSION: S. aureus bacteremia is a cause of considerable morbidity and mortality in hospitalized patients who especially, exposed to various risk factors. MRSA revealed higher resistance rate to most antibiotics tested and more marked multiply resistant nature than MSSA. But there was no significant difference in case fatality rate between patients with MRSA and MSSA bacteremia.
Anti-Bacterial Agents ; Aztreonam ; Bacteremia* ; Catheter-Related Infections ; Cefotaxime ; Clindamycin ; Coloring Agents ; Cross Infection ; Drug Resistance, Microbial ; Erythromycin ; Fatal Outcome ; Female ; Humans ; Hypoalbuminemia ; Liver ; Male ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Ofloxacin ; Penicillins ; Retrospective Studies ; Risk Factors ; Skin ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin ; Wounds and Injuries

OBJECTIVES: Salmonellosis is one of the most common bacterial infections in the Korea. The incidence of salmonellosis has changed dramatically. The incidence of typhoid fever tends to decrease as environmental & personal sanitations improve, whereas that of nontyphoid salmonellae have markedly increased. Antimicrobial resistance is increasing in Salmonella strains. Increasing emergence in multiple-drug resistant Sallmonella strains has important clinical & public implications for populations at risk and the treatment of invasive salmonellosis is complicated by the increasing resistance among Salmonella strains to commonly used antimicrobial agents. This study is performed to fine out the pattern and the antimicrobial susceptibility of isolated Salmonella strains and the clinical charateristics of Salmonella infection. METHODS: We reviewed medical records of all patients with culture-confirmed Salmonella infection in Kyung Hee University Hospital for the period January 1987 through December 1995. RESULTS: 1) The mean age of the patients was 31.0 years and the ratio of male to female was 1.03:1. 2) The frequency of isolation of specific serogroups is ordered as followings : serogroup B(47.9%), serogroup D(23.3%), S. typhi(16.2%), serogroup C(9.6%), serogroup E(1.8%), serogroup A(1.2%). 3) The sites of isolation were as follows : stool(68.6%), blood(24.0%), pus(3.5%), urine(2.2%), bone marrow(2.2%), bile juice(0.4%), ascites(0.4%), CSF(0.2%), sputum(0.2%). 4) The isolation rate of resistant strains of specific serogroups was as follows in order : serogroup B(52.4%), serogroup C(33.3%), serogroup E(25%), serogroup D(9.8%), S. typhi(4.2%), serogroup A(0%). 5) The frequency of animicrobial resistance in Salmonella strains to tested 8 antimicrobial agents was as follows : ampicillin(28.8%), carbenicillin(28.1%), chloramphenicol(16.4%), kanamycin(5.9%), trimethoprim-sulfamethoxazole(5.3%), cephalothin(2.3%), gentamicin(0.9%), amikacin(0.5%). 6) The most of antimicrobial-resistant Salmonella(95.0% of resistant strains) has multiple drug resiatance. 7) The frequency of clinical manifestations of nontyphoid salmonellosis was as follows : enterocolitis(80.1%), bacteremia without focal infection(13.1%), focal infection(6.8%). 8) The clinical variables statistically significant between resistant and sensitive Salmonella infection are frequency of bacteremia and duration of admission. CONCLUSION: Different serogroups of Salmonella isolates reveal the different frequency & pattern in antimicrobial resistance. The frequency of antimicrobial resistance for Salmonella isolates is markely increased during recent 9 years. In preparation for the future outbreaks of multiresistant sallmonellosis, nationwide studies should be carried out periodically to monitor effectively trends in the antimicrobial resistance of Salmonella and the development of effective and practical alternative therapy for resistant salmonellosis is clearly needed.
Anti-Infective Agents ; Bacteremia ; Bacterial Infections ; Bile ; Disease Outbreaks ; Female ; Humans ; Incidence ; Korea ; Male ; Medical Records ; Population Characteristics ; Salmonella Infections* ; Salmonella* ; Typhoid Fever

Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studifford criteria. The clinical characteristics of abdominal pregnancy is extremely variable, so early diagnosis is very difficult. Because of it's high maternal morbidity and mortality, the prompt surgical intervention is required. We experienced a primary abdominal pregnancy with intraperitoneal hemorrhage. So we present our case with a brief review of literature.
Early Diagnosis ; Female ; Hemorrhage* ; Mortality ; Pregnancy ; Pregnancy, Abdominal*

Bell's palsy is acute idiopathic peripheral facial nerve palsy which is diagnosed after all the possible causes are ruled out. Several symptoms and signs of polyneuropathy, such as hypesthesia of cranial nerve IX or V, vagal motor weakness, retroauricular pain, and hearing impairment were frequently accompanied with Bell's palsy. However, association of vertigo has been rarely reported, and moreover, associated vestibulopathy was not characterized in detail in those cases. We report a 35 year-old male patient with Bell's palsy accompanying acute peripheral vestibular loss, which eventually evolved to benign paroxysmal positional vertigo.
Adult ; Bell Palsy* ; Facial Nerve ; Glossopharyngeal Nerve ; Hearing Loss ; Humans ; Hypesthesia ; Male ; Paralysis ; Polyneuropathies ; Vertigo

Although intracranial dural metastasis of Ewing's sarcoma is a very rare finding, its imaging characteristics are similar to those of its primary form in the central nervous system. Thus, this tumor must be considered in the differential diagnosis of extra-axial dural masses.
Adult ; Dura Mater/*pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Sarcoma, Ewing's/diagnosis/*pathology/surgery ; Skull Neoplasms/diagnosis/*secondary/surgery ; Spinal Neoplasms/diagnosis/pathology/surgery ; Tomography, X-Ray Computed