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

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

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

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: To assess gastric pH and its relationship with urease-test positivity and histological findings in children with Helicobacter pylori infection. METHODS: Fasting gastric juices and endoscopic antral biopsy specimens were collected from 562 children and subjected to the urease test and histopathological examination. The subjects were divided into 3 age groups: 0-4, 5-9, and 10-15 years. The histopathological grade was assessed using the Updated Sydney System, while the gastric juice pH was determined using a pH meter. RESULTS: The median gastric juice pH did not differ significantly among the age groups (p=0.655). The proportion of individuals with gastric pH >4.0 was 1.3% in the 0-4 years group, 6.1% in the 5-9 years group, and 8.2% in 10-15 years (p=0.101). The proportions of moderate and severe chronic gastritis, active gastritis, and H. pylori infiltration increased with age (p<0.005). Urease-test positivity was higher in children with hypochlorhydria (77.8%) than in those with normal gastric pH (31.7%) (p<0.001). Chronic and active gastritis were more severe in the former than the latter (p<0.001), but the degree of H. pylori infiltration did not differ (20.9% vs. 38.9%; p=0.186). CONCLUSION: Gastric pH while fasting is normal in most children regardless of age. Urease-test positivity may be related to hypochlorhydria in children, and hypochlorhydria is in turn related to H. pylori infection.
Achlorhydria ; Biopsy ; Child* ; Fasting ; Gastric Juice ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hydrogen-Ion Concentration* ; Urease

This study describes the purification and characterization of type II restriction endonuclease of Helicobacter pylori in order to understand the DNA restriction and modification of H. pylori. H. pylori cell extract was subjected to polyethyleneimine treatment, salt precipitation, heparine-sepharose column chromatography, and fast protein liquid chromatography (FPLC) using Resource Q column and Mono Q column to purify the type II restriction endonuclease. Hpy51-I was characterized to recognize the sequneces 5`-GT(G/C)AC-3`, yielding 5-base 5` protruding ends. The restriction sequence was identical to that of Tsp 45 I. The enzyme exhibited its maximal activity in the presence of 10-20 mM LaCl, but was inhibited completely in the presence of more than 80 mM NaCl. The enzyme showed its maximal activity in the presence of 1-10 mM MgC1(2). The optimal pH and temperature for enzyme activity was pH 9.0 and 37 degrees C, respectively. MnC1(2) could not substitute for MgC1(2) in reaction mixture. And addition of j3-mercaptoethanol and bovine serum albumin in reaction mixture led to loss of enzyme activity of Hpy51-I. The whole cell extract of H. pylori strain 51 was confirmed to carry the enzyme activity for methylation of Hpy51-I-recognised sequence. Hpy51-I digested genomic DNAs of enteric bacteria to less than I kb while it could not cut the genomic DNAs of H. pylori isolates. In this study, the type II restriction enzyme (Hpy51-I) of H. pylori was identified and characterized its biochemical properties, demonstrating that Hpy51-I might be one of the barriers for preventing the introduction of foreign DNAs into H. pylori.
Chromatography ; Chromatography, Liquid ; DNA ; DNA Restriction Enzymes* ; Enterobacteriaceae ; Helicobacter pylori* ; Helicobacter* ; Hydrogen-Ion Concentration ; Methylation ; Polyethyleneimine ; Serum Albumin, Bovine