BACKGROUND: To report the radiological and clinical outcomes of internal fixation using distal clavicle hook plates for distal clavicle fractures. METHODS: From April 2008 to December 2012, 32 patients with distal clavicle fractures underwent surgery using an AO hook plate. The reduction was qualified and evaluated according to the radiological findings. The evaluation of the clinical outcomes was performed with the University of California at Los Angeles (UCLA) score, the Korean Shoulder score, and the visual analogue scale (VAS) pain score. RESULTS: By radiological evaluation, we found that 31 of 32 patients showed anatomical reduction and solid bone union. Although we obtained satisfactory UCLA scores, Korean Shoulder Scale scores, and VAS pain scores, 12 cases of complications were present. We found 4 cases of osteolysis of the acromion, 1 case of nonunion, 3 cases of periprosthetic fractures, 3 cases of subacromial pain, and 1 case of skin irritation. We performed re-operations in 2 patients. CONCLUSIONS: To avoid complications associated with clavicle hook plates, choosing the appropriate hook size and bending of the hook according to the slope of the acromion undersurface is critical. Also, we believe that early removal of clavicle plates may help reduce complications.
Acromion ; California ; Clavicle* ; Humans ; Osteolysis ; Periprosthetic Fractures ; Shoulder ; Skin

No abstract available.
Fracture Fixation, Intramedullary*

BACKGROUND: Hypertension and tachycardia usually accompany laryngoscopy and tracheal intubation. Topical and intravenous lidocaine are used in an attempt to blunt these potentially adverse hemodynamic responses, but these effects of lidocaine are controversial. The purpose of this study is to evaluate whether intratracheal nebulized lidocaine and/or intravenous lidocaine attenuate circulatory stimulating response to tracheal intubation. METHODS: Sixty patients, ASA physical status I, scheduled elective surgery, were randomly assigned to receive a preintubation dose of either 5 mL of normal saline intravenously, 4 mL of 4% lidocaine by intratracheal nebulizer, 1.5 mg/kg of 2% lidocaine intravenously, or 4 mL of 4% lidocaine intratracheal nebulizer and 2% lidocaine of 1.5 mg/kg intravenouly. Induction of anesthesia was accomplished with 5 mg/kg of thiopental IV, and 1 mg/kg of succinylcholine was given. Laryngoscopy and intubation was performed, and anesthesia maintained with 2% enflurane in 50% nitrous oxide in oxygen. Blood pressure and heart rate were recorded at preinduction, after induction, and every minute until 5 min after intubation. RESULTS: Intratracheal nebulized lidocaine and/or intravenous lidocaine were effective in attenuating increases in systolic pressure with no detectable difference between them, and failed to attenuate increases in diastolic pressure and heart rate. And significant decrease in systolic pressure 3 min after intubation was detected in intratracheal and intravenous lidocaine group. CONCLUSIONS: These data suggest that intratracheal nebulized lidocaine or intravenous lidocaine is effective in attenuating increase in systolic pressure to tracheal intubation, but intratracheal and intravenous lidocaine has not synergistic effect.
Anesthesia ; Blood Pressure ; Carbon Dioxide ; Enflurane ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Intubation* ; Laryngoscopy ; Lidocaine* ; Nebulizers and Vaporizers ; Nitrous Oxide ; Oxygen ; Succinylcholine ; Tachycardia ; Thiopental

OBJECTIVES: In Korea, pharmacists can dispense medicines without doctor's prescription. This causes the high proportion of pharmaceutical expenditures. The study shows the prescribing behaviors of practicing pharmacists with the simulated patient of arthritis. We select the arthritis as a subject of simulation, because the arthritis is one of the major health problems and the abuse of cortico-steroids is usual in treatment of arthritis patients. METHODS: Twenty drug stores among the 320 drug stores in a district, Seoul, Korea were randomly selected. One of the researchers visited the drug stores and received the medicines from the pharmacists after explaining standardized scenario of arthritis. The simulated patient recorded the practice behaviors of pharmacists. RESULTS: The mean number of prescribed drugs are four and half. Among the twenty pharmacists, the nineteen prescribed non-steroidal anti-inflammatory drugs and the seven(35%) prescribed the cortico-steroids. The antacids were prescribed by the fourteen(70%) pharmacists. The five(25%) pharmacists only recommended the simulated patients to visit the medical doctors, and the three(15%) performed physical examination to the simulated patients. The three pharmacists(15%) asked the past history of the drug adverse effects and no pharmacist explained the adverse effects of prescribed medicines. CONCLUSIONS: The research shows that the cortico-steroids are frequently prescribed and the pharmacists commonly do not give the explanations of the prescribed medicines to the arthritis patients.
Antacids ; Arthritis* ; Health Expenditures ; Humans ; Korea ; Patient Simulation ; Pharmacists* ; Physical Examination ; Prescriptions* ; Seoul

Transient synovitis of the hip is non-specific inflammation and self limited condition, which is most common cause of painful limping in children under 10 years of age. Ultrasonography presents some merits, simple, rapid, non-invasive, low cost, repetitive to assess soft structures in and around the hip joint compared to other diagnostic methods. We prospectively studied 32 cases of unilateral transient synovitis at OPD from Jan. 1988 to Oct. 1989 using 5-7.5 MH, probe ultrasonography. 2-times serial check up in symptomatic and asymptomatic stage about capsule thickness and bone-capsule distance in 3 different positions of the both hips were performed for comparision. The following results were obtained; 1. Boys were 25 cases (78%) and 26 cases (83%) were between 3 and 7 years old of age. 2. Bone-capsule distance in ultrasonography revealed abnormal increase in 72%. 3. External rotation position showed wider bone-capsule distance than other position. 4. Capsule thickness was 3.3mm in diseased and 3.0mm in sound, 0.3mm decrease after treatment. 5. Bone-capsule distance was 4.5mm in symptomatic stage, 2.7mm in asymptomatic stage, 1.8mm decrease after treatment in averge.
Child ; Hip Joint ; Hip ; Humans ; Inflammation ; Prospective Studies ; Synovitis ; Ultrasonography

No abstract available.
Leukemia*

The corpus callosum is the main interhemispheric connection in human brain. Agenesis of corpus callosum may partial or complete, and it may have not functional abnormalities. Its prenatal sonographic diagnosis is difficult because of fetal head position, especially in a cephalic presentation. We experienced a case of complete agenesis of corpus callosum. The prenatal sonographic findings was disproportionate dilatation of lateral ventricle, which were suggestive finding of agenesis of corpus callosum or hydrocephalus. We could confirm the diagnosis of complete agenesis of corpus callosum by postnatal MRI.
Agenesis of Corpus Callosum* ; Brain ; Corpus Callosum ; Diagnosis ; Dilatation ; Head ; Humans ; Hydrocephalus ; Lateral Ventricles ; Magnetic Resonance Imaging ; Ultrasonography

BACKGROUND/AIMS: The individual course of Crohn's disease is diverse, and some patients may require bowel resection. The aims of this study were to determine the early surgery rate of Crohn's disease and to identify risk factors associated with early surgery in Korea. METHODS: Ninety six patients with Crohn's disease (68 men; median age at the time of diagnosis: 25 years), who had been followed up more than a year, were retrospectively analyzed. Early surgery was defined as a bowel operation for Crohn's disease or its complications occurring within 3 years from diagnosis. Early surgery rate and risk factors for early surgery were identified. RESULTS: Fifteen patients (15.6%) underwent early surgery. The cumulative surgery rate was 8.6% after 6 months, 11.9% after 12 months, 14.1% after 18 months, and 16.7% after 24 to 36 months. Multivariate analysis revealed penetrating or stricturing behavior to be an independent risk factor for early surgery (p<0.001, Exp (B)=2.97 CI 1.39-6.37). CONCLUSIONS: The cumulative early surgery rate in Korean patients seems to be lower than Western patients. Penetrating or stricturing behavior is significantly associated with early surgery, requiring early aggressive medical treatments.
Adolescent ; Adult ; Aged ; Constriction, Pathologic ; Crohn Disease/*surgery ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Sex Factors ; Time Factors

No abstract available.
Hospitals, General* ; Humans ; Tuberculosis, Pulmonary*

BACKGROUND: Surgical correction of the full spectrum of esophageal atresia with tracheoesophageal fistula has improved over the years, but the mortality and morbidity assoiated with repair of these anomalies still remains high. MATERIAL AND METHOD: We retrospectively analyzes 27 surgically treated patients with esophageal atresia and tracheoesophageal fistula at Dong-A University Hospital between January 1992 and March 1997. RESULT: There were 21 male and 6 female patients. Mean birth weight was 2.62+/-.385 kg(2.0~3.4 kg). Twenty- four(88.9%) had esophageal atresia with distal tracheoesophageal fistula, and 3(11.1%) had pure esophageal atresia. Four(14.8%) infants were allocated to Waterston risk group A, 18(66.7%) to group B, and 5(18.5%) to group C. In eighteen(66.7%) infants with associated anomalies, cardiovascular anomalies were the most common. Three had a gap length of 3.5 cm or greater(ultra-long gap) between esophageal segments, 7 had 2.0 to 3.5 cm(long gap), 8 had 1.0 to 2.0 cm(medium gap), and 9 had 1 cm or less(short gap) gap length. Among 27 neonates, 3 cases underwent staged operation, late colon interposition was done in 2, and all other 24 cases underwent primary esophageal anastomosis. Oerative mortality was 2/27(7.4%). Causes of death included acute renal failure(n=1), empyema from anastomotic leak(n=1), necrotizing enterocolitis(n=1), sepsis(n=1), insulin-dependent diabetus mellitus(n=1 . There were 4 anastomosis- related complications including stricture in 3, leakage in 1. Mortality was related to the gap length(p<.05). CONCLUSION: Although the complication rate associated with surgical repair of these anomalies is high, this does not always implicate the operative mortality. The overall survival can be improved by effective treatment for combined anomalies and intensive postoperatve care.
Birth Weight ; Cause of Death ; Colon ; Constriction, Pathologic ; Empyema ; Esophageal Atresia* ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mortality ; Retrospective Studies ; Tracheoesophageal Fistula