Rotational ankle fractures are one of the most common injuries of lower limbs treated by orthopedic surgeons. Open reduction and internal fixation (ORIF) is considered a gold standard treatment for unstable ankle fractures, though adjunct ankle arthroscopy is being increasingly used in cases of ankle trauma. Although the role and use of ankle arthroscopy are expanding, the clinical outcomes and cost-effectiveness of arthroscopy remain undefined. Furthermore, despite the number of clinical research studies performed on arthroscopically assisted surgery for ankle fractures, no definite guidelines have been agreed, and no consensus has been reached regarding indications. This article reviews the role, indications, operative techniques, and complications of ankle arthroscopy and compares the clinical outcomes of conventional ORIF and arthroscopically assisted ORIF.

Premature infants with respiratory distress syndrome may have clinically significant shunting through a patent ductus arteriosus (PDA). Left-to-right shunting through the PDA may lead to left ventricular volume overload and pulmonary edema. We present a case of perioperative management for severe respiratory distress syndrome in a premature infant who underwent surgical closure of PDA. Under general anesthesia, the infant was successfully managed by inhaled nitric oxide, high frequency oscillation ventilation with intermittent mandatory ventilation despite intermittent hypoxia. The operation was performed safely in the neonatal intensive care unit.
Anesthesia, General ; Anoxia ; Ductus Arteriosus, Patent* ; High-Frequency Ventilation ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Nitric Oxide ; Pulmonary Edema ; Ventilation

BACKGROUND: The elastic properties of skin may be useful indicators of cutaneous diseases and skin aging. OBJECTIVE: The purpose of this study is to obtain the normal range of skin elastic properties according to anatomical sites in normal Korean individuals and to show the differences among them. METHODS: Eleven different anatomical sites were measured in 41 healthy volunteers (20 males and 21 females) with a measuring device, Dermaflex-A . Tensile distensibility(TD), elasticity(E), and hysteresis(H) were recorded. RESULTS: TD was decreased in the distal portions (e.g. 2.30 +/- 0.35 in the arm vs 1.62 +/- 0.30 in the palm in males) and in the sites where the subcutaneous tissue was thin (e.g. 3.08 +/- 0.60 in the abdomen vs 1.20 +/- 0.44 in the medial malleolus in males). E was also decreased in the distal portions (e.g. 82.3 +/- 8.5 in arm vs 51.2 +/- 11.1 in the palm in males) and in the sites where the subcutaneous tissue was thin (e.g. 89.3 +/- 8.3 in the abdomen vs 58.8 +/- 13.8 in the medial melleolus in males). In contrast, H had greater individual variations and it showed no definite tendency according to sites. TD and E were generally greater in males than in females, and there were some significant differences between sexes according to sites. CONCLUSION: Cutaneous elastic properties varied according to anatomical sites and sexes. This feature must be considered in future studies measuring elastic properties, such as aging experiments.
Abdomen ; Aging ; Arm ; Elasticity ; Female ; Healthy Volunteers ; Humans ; Male ; Reference Values ; Skin Aging ; Skin* ; Subcutaneous Tissue

BACKGROUND: Psoriatic lesions have reduced water-holding capacity and show increased transepidermal water loss (TEWL). The effect of D-PUVA therapy, which combines topical calcipotriol and PUVA therapy, on epidermal barrier function has not yet been evaluated. OBJECTIVE: The purpose of this study was to verify the change of TEWL in lesional and normal skin according to D-PUVA therapy in psoriasis patients. METHODS: TEWL was measured consecutively by TEWAMETER TM210®, in 13 psoriasis patients who received D-PUVA therapy. Clinical grading was done according to psoriasis severity index (PSI). RESULTS: TEWL of psoriatic lesion decreased as D-PUVA continued. TEWL of normal-looking skin gradually increased, although the increase was trivial. Clinical grading of scale and in-filtration followed the pattern of PSI in the decrease of TEWL, while that of erythema did not. CONCLUSION: In psoriatic plaques, TEWL was decreased according to the improvement. In normal-looking skin, D-PUVA therapy caused only a little effect on TEWL.
Erythema ; Humans ; Psoriasis ; PUVA Therapy ; Skin ; Water*

Avian metapneumovirus (AMPV) is an emerging pathogen causing respiratory and reproductive illness in poultry worldwide. To demonstrate the presence of AMPV in domestic chickens in Korea, we attempted to isolate AMPV from affected chickens. A cytopathic agent was isolated using chicken tracheal ring culture from dead chickens from a broiler breeder farm with reduced egg production in Korea. This agent, termed SC1509 strain, subsequently passed in Vero cells with distinct cytopathic effects. The SC1509 strain was confirmed as avian metapneumovirus (AMPV) using both RT-PCR test and monoclonal antibody-based immunofluorescence assay. Sequence analysis based on the G glycoprotein revealed that the SC1509 strain had 22.5 to 96.0% nucleotide sequence identity and 11.1 to 92.7% predicted amino acid sequence identity with previously published AMPV strains, particularly with the highest sequence homology (95.8 to 96% for nucleotides and 92.2 to 92.7% for amino acids) to European strains belonging to genotype B. The SC1509 strain was phylogenetically clustered with genotype B viruses, confirming that the SC1509 strain belongs to genotype B. This is the first report of genotype B avian metapneumovirus from chickens in Korea.
Amino Acid Sequence ; Base Sequence ; Chickens ; Fluorescent Antibody Technique ; Genotype ; Glycoproteins ; GTP-Binding Proteins ; Herpesvirus 1, Cercopithecine ; Korea ; Metapneumovirus ; Nucleotides ; Ovum ; Poultry ; Sequence Analysis ; Sequence Homology ; Sprains and Strains ; Vero Cells

BACKGROUND: The indocyanine green (ICG) finger monitoring method is a newly developed noninvasive method for the ICG clearance test. This study was performed to determine its clinical usefulness compared with the conventional blood sampling method. METHODS: The ICG clearance test was performed on 270 patients using both the conventional blood sampling method and the finger monitoring method simultaneously. The plasma disappearance rate of the ICG and the 15-minute retention ratio (ICG R15) were analyzed and compared with the conventional blood sampling method. RESULTS: The plasma disappearance rate using the finger monitoring method was slightly lower than that of the conventional blood sampling method with good correlation (r=0.840, P<0.001). ICG R15 using finger monitoring method was slightly higher than that of the conventional blood sampling method with good correlation (r=0.839, P<0.001). CONCLUSIONS: As there was a good correlation between the conventional blood sampling method and the finger monitoring method, the latter method seemed to be clinically useful due to its convenience and accuracy.
Fingers* ; Humans ; Indocyanine Green* ; Plasma

Cerebrovascular disease and coronary heart disease are the first and the fourth common causes of death among adults in Korea. Reported risk factors of one of these diseases may prevent other diseases. Therefore, we tried to compare and discriminate the risk factors of these diseases. We recruited four case groups and four control groups among the inpatients who were admitted to Wonju Christian Hospital from March, 1994 to November, 1995. Four control groups were matched with each of four case groups by age and sex. The number of patients in each of four case and control groups were 106 and 168 for acute myocardial infarction(AMI), 84 and 133 for subarachnoid hemorrhage(SAH), 102 and 148 for intracerebral hemorrhage(ICH), and 91 and 182 for ischemic stroke(IS) respectively. Factors whose levels were significantly higher in AMI and IS than in responding control group(RCG) were education, economic status, and triglyceride. Factors whose levels were significantly lower in hemorrhagic stroke than in RCG were age of menarch, and prothrombin time. The factor whose level was higher in AMI than in RCG was uric acid. The factor whose level was higher in AMI, ICH, and SAH than in RCG was blood sugar. Factors whose levels were significantly higher in all the case groups than in RCG were earlobe crease, Quetelet index, white blood cell count, hemoglobin, hematocrit, and total cholesterol. The list of risk factors were somewhat different among the four diseases, though none of the risk factors to the one disease except prothrombin time acted as a preventive factor to the other diseases. The percent of grouped cases correctly classified was higher in the discrimination of ischemic diseases(AMI and IS) from hemorrhagic diseases(SAH and ICH) than in the discrimination of cerebrovascular disease from AMI. The factors concerned in the discrimination of ischemic diseases from hemorrhagic diseases were prothrombin time, earlobe crease, gender, age uric aci, education, albumin, hemoglobin, the history of taking steroid, total cholesterol, and hematocrit according to the selection order through forward selection.
Adult ; Blood Glucose ; Body Mass Index ; Case-Control Studies* ; Cause of Death ; Cholesterol ; Coronary Disease* ; Discrimination (Psychology) ; Education ; Gangwon-do ; Hematocrit ; Humans ; Inpatients ; Korea ; Leukocyte Count ; Prothrombin Time ; Risk Factors* ; Stroke ; Triglycerides ; Uric Acid

Newcastle disease (ND) caused by virulent Newcastle disease virus (NDV) is a highly contagious viral disease of poultry. Virulent NDVs characteristically have a multibasic amino acid sequence (virulence motif) such as (112)RRQKRF(117) at the cleavage site of the precusor fusion (F0) protein. The antigenic and immunogenic characteristics of the virulence motif (112)RRQKRF(117) in the F0 protein of virulent NDVs were investigated. Epitope mapping analysis revealed that a RRQKRF-specific monoclonal antibody 4G2 recognized the KRF section of the motif. A synthetic peptide bearing the RRQKRF motif reacted strongly with sera from virulent NDV (with RRQKRF motif)-infected chickens. These sera also showed reactivity to peptides bearing other virulence motifs ((112)KRQKRF(117), (112)RRQRRF(117) and (112)RRRKRF(117)) but not an avirulence motif ((112)GRQGRL(117)) by ELISA. The synthetic bearing RRQKRF motif reacted with 60% to 91% of sera taken from surviving chickens on ND outbreak farms but not with sera from vaccinated birds, even though most of the sera had antibody to NDV due to vaccination. This indicates that the virulence motif has the potential to differentiate virulent NDV infected birds from vaccinated birds.
Amino Acid Motifs/*immunology ; Amino Acid Sequence ; Animals ; Chickens ; Enzyme-Linked Immunosorbent Assay/veterinary ; Epitope Mapping/veterinary ; Newcastle Disease/*immunology ; Newcastle disease virus/*genetics/pathogenicity ; Poultry Diseases/*immunology/*virology ; Serologic Tests/veterinary ; Viral Fusion Proteins/*genetics/immunology ; Virulence/genetics

This study was aimed to furnish the data of facial bone fracture which was related regional and social environment and to aid diagnosis and treatment of the fracture. This is the retrospective and clinicostatical study on 625 patients with facial bone fracture. The patients were treated in the Dept. of Oral and Maxillofacial Surgery of Wonkwang University Hospital from Jan. 1, 1993 to Dec. 31, 1997. The result were as follows : The facial bone fractures occured most frequently in the twenties(32.3%) and male were predominent(77.4%) than female. The most frequent etiologic factor of facial bone fracture was fall down(42.8%) and midface fracture was traffic accident(63.4%). The most common site of fracture was symphysis(51.1%) and angle(29.7%), condyle(27.5%), ZMC(13.4%) were next in order of frequency. Of the 626 patients, 590 patients(89.5%) were treated with open reduction and only 36 patients(10.5%) were treated with closed reduction. In the blow, the ratio of angle fracture(50%) is especially high(the overall ratio 29.7%) and in the Out car TA, the ratio of ZMC fracture(34.6%) is especially high(the overall ratio 13.4%). In the fall-down, the ratio of symphysis(58.4%) and condyle fracture(33.6%) is especially high(the overall ratio 51.1%, 27.5%). Postoperatives complication were found in 35(5.6%) of 626 patients, in which mouth opening limitation(3%) was the most common. Above results suggest that early diagnosis and treatment of fracture site, systemic condition and associated injuries are nessary, and cooperative treatment with medical department should be performed.
Diagnosis ; Early Diagnosis ; Facial Bones* ; Female ; Humans ; Male ; Mouth ; Retrospective Studies ; Social Environment ; Surgery, Oral

No abstract available.
Humans ; Laparoscopy* ; Pleural Effusion*