The 45 neonates with bronchopulmonary dysplasia among 355 neonates who were managed with mechanical ventilation and oxygen therapy in NICU of Seoul National University Chhildren's Hospital from January 1, 1968 to December 31, 1991, were analyzed for risk factors and outcome. The results were as follows: 1) The incidence of bronchopulmonary dysplasia was 12.7% 2) Respiratory Distress Syndrome was most common underlying problem. 3) The common radiologic findings of BPD were peripheral streaky density, emphysematous change, reticular or granular perihilar density, pulmonary interstitial emphysema, bubbly or small cystic change, and pneumothorax. 4) The survival rate of BPD showed 80% in the follow-up study. 5) Retinopathy of prematurity and intraventricular hemorrhage were more frequent significantly in the BPD group (p<0.05). 6) The risk factors of BPD were lower birth weight, shorter gestational age, longer duration of oxygen therapy an mechanical ventilation, and the presence of PDA.
Birth Weight ; Bronchopulmonary Dysplasia* ; Emphysema ; Follow-Up Studies ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Infant, Newborn ; Oxygen ; Pneumothorax ; Respiration, Artificial ; Retinopathy of Prematurity ; Risk Factors* ; Seoul ; Survival Rate

OBJECTIVE: to determine the frequency of the multiple consecutive rib fracture after blunt chest trauma. DESIGN, MATERIALS, AND METHODS: We retrospectively reviewed all the radiographs and medical charts of 87 patients with rib fractures after blunt chest trauma. Rib fractures were divided into single aud multiple. The multiple rib fractures were subclassified as consecutive, interrupted continuous, or random. RESULTS: Thirteen cases of single and 83 cases of multiple rib fractures were present. Among the 83 cases of multiple fractures, there were 73 cases (88%) of consecutive fractures, 5 cases (6%) of interrupted continuous fractures and 5 cases (6%) of random fractures. CONCLUSION: Among the multiple rib fractures consecutive rib fractrues are much more common than noncontiguous rib fractures. We recommend that if one find an apparently nonfractured rib between contiguously fractured upper and lower ribs, one should meticulously search for possible fracture of an apparently normal rib with high-index of suspicion.
Humans ; Retrospective Studies ; Rib Fractures* ; Ribs* ; Thorax*

PURPOSE: To present our operative experiences with carpometacarpal (CMC) injuries, excluding thumb. MATERIALS AND METHODS: Thirty four fracture and dislocations of CMC joint excluding thumb were reviewed retrospectively. Emphases were placed on injury mechanisms, anatomical location, times between diagnosis and surgery, treatment and complications. RESULTS: The average age of patients was 31.5 years. 19 cases of axial loading by blow as an injury mechanism. The 5th CMC joint was found to be the most frequently involved single joint (18 cases of 34 cases). Dorsal dislocation of CMC joints was present in 12 cases. Comminution of the carpal or metacarpal bone was present in 18 cases. The average time to surgery was 6 days. Twenty-seven cases were operated upon by closed reduction and percutaneous pinning. Seven cases were treated by open reduction and internal fixation. In the last follow up period, a clinically full hand function was restored in 31 cases. Intermittent pain was present in 6 cases in which there was grip weakness in 4 cases and limitation of motion in 3 cases. However, all cases were able to activities of daily living. CONCLUSION: We obtained good outcomes in CMC joint injuries through the accurate diagnosis and proper operative treatment.
Activities of Daily Living ; Carpometacarpal Joints* ; Diagnosis ; Dislocations ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Joints ; Retrospective Studies ; Thumb

PURPOSE: To analyze the results between PFN (Proximal Femoral Nail) and DHS (Dynamic Hip Screw) on the operative treatment of unstable intertrochanteric fractures retrospectively. MATERIALS AND METHODS: 35 cases of unstable intertrochanteric fractures (grouped 24 patients with DHS and 11 patients with PFN) who were taken the operations from Jan. 2001 to Mar. 2002 were analysed regarding to union state, union time, operation time, sliding length of lag screws, blood loss, postoperative complications and functional recovery scores by Sk?vron with ANOVA and multivariate linear regression. RESULTS: The means of union time were 17.9 weeks (DHS) and 17.0 weeks (PFN), sliding length of lag screws were 3.9 mm (DHS) and 2.1 mm (PFN), perioperative blood losses were 743 cc (DHS) and 736 cc (PFN), operation time were 93.4 minutes (DHS) and 102 minutes (PFN), and the functional recovery scores by Sk?vron were 71.8% (DHS) and 76.8% (PFN), respectively. The results of our study indicate that there were not statistically significant differences between PFN and DHS groups in treatment of unstable intertrochanteric fractures (p>0.05). But, there was less sliding of lag screws in PFN group in statistical significance (p<0.05). CONCLUSION: Authors think that PFN is one of the useful implants in treating unstable intertrochanteric fractures of the femur in regarding to sliding.
Femur* ; Hip Fractures ; Hip* ; Humans ; Linear Models ; Postoperative Hemorrhage ; Retrospective Studies

OBJECTIVES: Aseptic meningitis is a major cause of Korean childhood morbidity late spring and early summer. However, the nationwide incidences of the disease have not been reported. This study was conducted to evaluate the availability of National Health Insurance data (NHID) for the study of an epidemiological trend in the surveillance of aseptic meningitis in children. METHODS: All the claims, under A87, A87.8, and A87.9 by ICD-10, among children below 15 years of age, to the National Health Insurance Corporation, between January and December 1998, were extracted. A survey of the medical record of 3, 874 cases from 136 general hospitals was performed. The availability of the NHID was evaluated by the three following methods: 1) The diagnostic accuracy (the positive predictive value = proportion of the confirmed aseptic meningitis among the subjects registered as above disease-codes in NHID) was evaluated through a chart review, and according to age, gender, month and region of disease-occurrence. 2) The distribution of confirmed cases was compared with the distribution of total subjects from the NHID, for subjects in General hospitals, or the subjects surveyed. 3) The proportion of confirmed CSF test was confirmed, and the relating factor, which was the difference in CSF-test rate, analyzed. RESULTS: Among 3, 874 cases, CSF examinations were performed on 1, 845 (47.6%), and the CSF-test rates were different according to the medical utility (admission vs. OPD visit) and the severity of the symptoms and signs. The diagnostic accuracy for aseptic meningitis, and during the epidemic (May-Aug) and sporadic (Sept-Apr) periods, were 85.0 (1, 568/1, 845), 86.0 (1, 239/1, 440) and 81.2% (329/405), respectively. The distributions by age, sex, month or period (epidemic/sporadic) and region, in the confirmed cases, were similar to those in the NHID, in both the subjects at General hospitals and in those surveyed, to within +/-7%. CONCLUSIONS: In this paper, the NHID for the subjects registered with an aseptic meningitis disease-code might be available for an epidemiological study on the incidence-estimation of childhood aseptic meningitis, as the NHID could include both the probable and definite cases. On the basis of this result, further studies of time-series and secular trend analyses, using the NHID, will be performed.
Child ; Enterovirus ; Epidemiologic Studies* ; Hospitals, General ; Humans ; Incidence ; Insurance, Health* ; International Classification of Diseases ; Medical Records ; Meningitis ; Meningitis, Aseptic* ; National Health Programs

PURPOSE: Peripheral arterial disease (PAD) is an increasing health problem, as we progress towards an aging society. The diseases known as risk factors of PAD are diabetes mellitus (DM), hypertension, and dyslipidemia, and PAD occurs consistently in patients with diabetes. The patients with PAD do not receive proper treatment at the proper moment, because PAD is almost asymptomatic, and most of the diagnosis is delayed. We aimed to determine the prevalence, risk factors and co-morbidities of PAD in patients who are managed for DM and hypertension in our referral center. METHODS: Patients with diabetes and hypertension were selected from the Gachon University Gil Hospital. Data of the patients, including demographics and presence of risk factors, were collected using an interviewer-administered questionnaire. For PAD of the low limbs, the ankle-brachial index (ABI) was used, and the PAD of low limbs was defined as <0.9 ABI. For carotid artery stenosis (CAS), carotid duplex ultrasound was analyzed, and CAS was defined as > or =50% internal CAS. RESULTS: Logistic regression analysis showed that old age (>70) and diabetes were independent risk factors of PAD. As the risk factor number increased, the prevalence of PAD became higher. CONCLUSION: The prevalence of PAD is continuously increasing. Old age and diabetes were independently associated with a high risk of all-cause PAD patients. For timely and proper management of PAD, large-scale research is needed. Based on research, we should make a detailed plan about early screening, and treatment of PAD.
Aging ; Ankle Brachial Index ; Carotid Stenosis ; Demography ; Diabetes Mellitus ; Dyslipidemias ; Extremities ; Humans ; Hypertension ; Logistic Models ; Mass Screening ; Peripheral Arterial Disease ; Prevalence ; Surveys and Questionnaires ; Referral and Consultation ; Risk Factors

Purpose: Patients who undergo radical surgery for rectal cancer often experience low anterior resection syndrome (LARS). Symptoms of this syndrome include frequent bowel movements, gas incontinence, fecal incontinence, fragmentation, and urgency. The aim of this study was to investigate the convergent validity, discriminative validity, and reliability of the Korean version of the LARS score questionnaire. Methods: The English LARS score questionnaire was translated into Korean using the forward-and-back translation method. A total of 146 patients who underwent radical surgery for rectal cancer answered the Korean version of the LARS score questionnaire including an anchor question assessing the impact of bowel function. Participants answered the questionnaire once more after 2 weeks. Results: The Korean LARS score questionnaire showed high convergent validity in terms of high correlation between the LARS score and quality of life (perfect fit 55.5% vs. moderate fit 37.6% vs. no fit 6.8%, respectively; P < 0.001). The LARS score also showed good discriminative validity between groups of patients differing by sex (29 for males vs. 25 for females; P = 0.014), tumor level (29 for ≤8 cm vs. 24 for >8 cm; P = 0.021), and radiotherapy (32 for yes vs. 24 for no; P = 0.001). The LARS score also demonstrated high reliability at test-retest with no difference between scores at the first and second tests (intraclass correlation coefficient: Q1 = 0.932; Q2 = 0.909, Q3 = 0.944, Q4 = 0.931, and Q5 = 0.942; P < 0.001, respectively). Conclusion The Korean version of the LARS score questionnaire has proven to be a valid and reliable tool for measuring LARS in Korean patients with rectal cancer.

Pulmonary lymphangiomatosis is a very rare pulmonary lesion with an aggressive potential that occurs mainly in newborns, infants and young children of both sexes. It is characterized by pulmonary abnormalities of lymphatic system, showing an increased number of complex anastomosing lymphatic channels in the pleura, in the subpleural interlobular septa, and along the bronchovascular lymphatic route and uniformly fatal. We report a case of lymphangiomatosis behaving like lymphangioleiomyomatosis in a 26-year-old woman.
Adult ; Child ; Female ; Humans ; Infant ; Infant, Newborn ; Lymphangioleiomyomatosis ; Lymphatic System ; Pleura

BACKGROUND: Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. MATERIAL AND METHOD: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. RESULT: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4:1 (male:female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. CONCLUSION: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.
Anti-Bacterial Agents ; Catheters ; Chest Tubes ; Debridement ; Diagnosis ; Drainage ; Empyema* ; Empyema, Pleural ; Fever ; Follow-Up Studies ; Humans ; Length of Stay ; Lung ; Middle Aged ; Operative Time ; Postoperative Complications ; Recurrence ; Thoracic Surgery, Video-Assisted* ; Thoracoscopy ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed

PURPOSE: To review the result of bony mallet finger treated with a closed reduction using extension block K-wire MATERIALS AND METHODS: Between January 2001 and November 2002, among the patients with bony mallet finger underwent closed reduction using extension block K-wire, we retrospectively reviewed 14 patients with 14 fractures who had a minimum follow-up of 12 months. RESULTS: There were 10 men and 4 women, with an average follow-up for all cases 15.7 months (range, 12 months~18 months). According to Crawford's evaluation criteria, we obtained 7 excellent, 5 good, 2 fair. We obtained bony union in all patients, with no remained pain. The average ROM was 67 degrees at postoperative 12 months. Postoperative complications occurred in two cases, which were nail deformity and mild osteoarthritis at the distal interphalangeal joint. There was no pin site infection. CONCLUSION: This technique is not only easier but also less invasive than other techniques for reduction of mallet finger. Also, it shows excellent result with lower complication rate. So, it seems a reliable treatment for bony mallet finger.
Congenital Abnormalities ; Female ; Fingers* ; Follow-Up Studies ; Humans ; Joints ; Male ; Osteoarthritis ; Postoperative Complications ; Retrospective Studies