Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.
Acromioclavicular Joint ; Acromion* ; Clavicle* ; Dislocations ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Rotator Cuff ; Tears

PURPOSE: The purpose of this study is to systematically review and analyze disasters involving South Korean hospitals from 1990 and to introduce a newly developed implement to manage patients' evacuation. MATERIALS AND METHODS: We searched for studies reporting disaster preparedness and hospital injuries in South Korean hospitals from 1990 to 2008, by using the Korean Studies Information Service System (KISS, copyright Korean Studies Information Co, Ltd, Seoul, Korea) and, simultaneously, hospital injuries which were reported and regarded as a disaster. Then, each study and injury were analyzed. RESULTS: Five studies (3 on prevention and structure, 1 on implement of new device, and 1 on basic supplement to current methods) and 8 injuries were found within this period. During the evacuations, the mean gait speed of walking patients was 0.82 m/s and the mean time of evacuation of individual patients was 38.39 seconds. Regarding structure evaluation, almost all hospitals had no balconies in patient rooms; hospital elevators were placed peripherally and were insufficient in number. As a new device, Savingsun (evacuation elevator) was introduced and had some merits as a fast and easy tool, regardless of patient status or the height of hospital. CONCLUSION: In South Korea, preparation for hospital disasters was noted to be insufficient but has involved various departments such as architectural, clinical, and building operations. In addition, Savignsun has been shown to effectively evacuate and save patients in a hospital disaster.
Disaster Planning/*methods ; *Disasters ; Emergency Service, Hospital ; Equipment Design ; Hospital Administration ; *Hospitals ; Humans ; Japan ; Patient Transfer ; Republic of Korea ; Transportation of Patients ; United States

Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.
Acromioclavicular Joint ; Acromion ; Clavicle ; Dislocations ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Rotator Cuff ; Tears

The aim of this study was to develop a method for measuring the slumping resistance of flowable resin composites and to evaluate the efficacy using rheological methodology. Five commercial flowable composites (Aelitefil flow:AF, Filtek flow:FF, DenFil flow:DF, Tetric flow:TF and Revolution:RV) were used. Same volume of composites in a syringe was extruded on a glass slide using a custom-made loading device. The resin composites were allowed to slump for 10 seconds at 25degrees C and light cured. The aspect ratio (height/diameter) of cone or dome shaped specimen was measured for estimating the slumping tendency of composites. The complex viscosity of each composite was measured by a dynamic oscillatory shear test as a function of angular frequency using a rheometer. To compare the slumping tendency of composites, one way-ANOVA and Turkey's post hoc test was performed for the aspect ratio at 95% confidence level. Regression analysis was performed to investigate the relationship between the complex viscosity and the aspect ratio. The results were as follows. 1. Slumping tendency based on the aspect ratio varied among the five materials (AF < FF < DF < TF < RV). 2. Flowable composites exhibited pseudoplasticity in which the complex viscosity decreased with increasing frequency (shear rate). AF was the most significant, RV the least. 3. The slumping tendency was strongly related with the complex viscosity. Slumping resistance increased with increasing the complex viscosity. The slumping tendency could be quantified by measuring the aspect ratio of slumped flowable composites. This method may be applicable to evaluate the clinical handling characteristics of flowable composites.
Composite Resins ; Glass ; Handling (Psychology) ; Light ; Syringes ; Viscosity

BACKGROUND: Limited information about the effects of stroke on sexual functioning is available. The purpose of this study was to assess the influences of ischemic stroke on sexual functioning and to evaluate the clinical and psychological factors related to poststroke sexual dysfunctions. METHODS:Sixty-six male post-ischemic stroke patients and fifty-one age-matched healthy controls completed a self-administered questionnaire on sexual functioning. The localization of ischemic stroke was determined by neuroimaging findings as well as focal neurological signs. The degree of disability and the degree of depression were also assessed. RESULTS: All domains of sexual functioning, including erectile functions, orgas-mic functions, sexual desire, intercourse satisfaction, and overall satisfaction were decreased in poststroke patients. Patients with occipital lesions had a lesser degree of sexual dysfunctions than those with lesions affecting other areas (p<0.05). Also, sexual dysfunctions in stroke patients were related to the degree of physical disability and the presence of depression (p<0.05). CONCLUSIONS Sexual dysfunctions are common in stroke patients. The reasons for sexual dysfunc-tions after stroke are multifaceted, which include stroke lesion site, physiological factors, and psychosocial factors. (J Korean Neurol Assoc 19(4):342~348, 2001)
Depression ; Humans ; Male ; Neuroimaging ; Psychology ; Surveys and Questionnaires ; Stroke*

This study was aimed to develop an instrument for real-time measurement of fluid conductance and to investigate the hydrodynamics of dentinal fluid. The instrument consisted of three parts; (1) a glass capillary and a photo sensor for detection of fluid movement, (2) a servo-motor, a lead screw and a ball nut for tracking of fluid movement, (3) a rotary encoder and software for data processing. To observe the blocking effect of dentinal fluid movement, oxalate gel and self-etch adhesive agent were used. BisBlock (Bisco) and Clearfil SE Bond (Kuraray) were applied to the occlusal dentin surface of extracted human teeth. Using this new device, the fluid movement was measured and compared between before and after each agent was applied. The instrument was able to measure dentinal fluid movement with a high resolution (0.196 nL) and the flow occurred with a rate of 0.84 to 15.2 nL/s before treatment. After BisBlock or Clearfil SE Bond was used, the fluid movement was decreased by 39.8 to 89.6%.
Adhesives ; Capillaries ; Dentin ; Dentin Sensitivity ; Dentinal Fluid ; Glass ; Humans ; Hydrodynamics ; Nuts ; Oxalic Acid ; Resin Cements ; Tooth ; Track and Field

OBJECTIVE: We examined changes in general health status, the prevalence of depression and post-traumatic stress disorder (PTSD) symptoms, and the existence of pre-trauma contributing factors in an agricultural population following a massive flood. METHODS: Eighty-three of 160 residents of Garisan-ni, Inje-gun, Gangwon-do, were assessed using the Korean version of the 36-Item Short-Form Health Survey (SF-36-K) between April and June 2006, just prior to a massive flood. Among those initially assessed, 58 residents were available for follow-up 18 months after the flood. Participants completed the SF-36-K, Beck Depression Index (BDI), Minnesota Multiphasic Personality Inventory (MMPI)-PTSD, and the Korean version of the Impact of Event Scale-Revised (IES-R) to detect depression and PTSD. Trauma experiences were also assessed. Factors related to changes in health status were then analyzed. RESULTS: SF-36-K total scale scores decreased significantly, suggesting a significant reduction in health-related quality of life. The largest reductions were noted in physical and social functioning. Fifty-three percent of the subjects were at least mildly depressed, and 17% had severe depression. In addition, 22% had PTSD on both the IES-R and MMPI-PTSD. Factors that contributed to the deterioration of health status following the flood were the number of disaster events and existence of depression (as assessed by the BDI). CONCLUSION: The flood was found to lead to deterioration of health status and to provoke depression and PTSD among the agricultural population in the mountainous region. We suggest that the number of disaster event experiences and existence of depression contriuted to changes in health status after the flood.
Depression ; Disasters* ; Follow-Up Studies ; Gangwon-do ; Health Surveys ; MMPI ; Prevalence ; Prospective Studies* ; Quality of Life ; Stress Disorders, Post-Traumatic

Congenital myotonic dystrophy is an autosomal dominantly inherited myotonic dystrophy, rare form, with an incidence estimated to be 13/100,000 liveborns. Affected newborns can present with intrauterine growth retardation, prematurity, birth asphyxia, respiratory distress, and always exhibit generalized muscular hypotonia. Feeding problems are common and an association with protein losing enteropathy, hydrops fetalis, and persistent pulmonary hypertension of the newborn has been described. Twenty-five percent of the affected infants die within the first 18 months of life. The molecular basis is an unstable DNA fragment consisting of a variable expansion of a CTG triplet, Dystrophia myotonica-protein kinase (DMPK) which is localized on chromosome 19q 13.3. The severity of the disease is directly correlated to the length of the CTG sequence. Women with idiopathic polyhydroamnios, decreased fetal movement, prematurity, hypotonia, should be counselled family, and mother, father and baby should be evaluated congenital myotonic dystrophy, as PCR (polymerase chain reaction). It is possible to diagnose congenital myotonic dystrophy, by PCR, antenatal test, such as CVS, amniocentensis. We experienced a case of recurrent congenital myotonic dystrophy, with neonatal death, twice, and report with a review of related literatures.
Asphyxia ; DNA ; Fathers ; Female ; Fetal Growth Retardation ; Fetal Movement ; Humans ; Hydrops Fetalis ; Hypertension, Pulmonary ; Incidence ; Infant ; Infant, Newborn ; Mothers ; Muscle Hypotonia ; Myotonic Dystrophy* ; Parturition ; Phosphotransferases ; Polymerase Chain Reaction ; Protein-Losing Enteropathies ; Triplets

PURPOSE: This study compared the clinical results between compression hip screw (CHS) and proximal femoral nail (PFN) after the treatment of AO/OTA A2.2 intertrochanteric (ITC) fractures. MATERIALS AND METHODS: We retrospectively reviewed 125 cases of AO/OTA A2.2 ITC fracture, treated with either CHS (group I, 34 cases) or PFN (group II, 91 cases) between March 1994 and December 2014. We evaluated the mean operation time, estimated blood loss and transfusion, hospitalization stay, sliding length of lag screw, tip-apex distance, change of neck shaft angle, mean union time, weight bearing time, mechanical failure, and ambulatory ability by the Parker and Palmer mobility scores. RESULTS: Operative time, estimated blood loss, transfusion, hospitalization stay, tip-apex distance, change of neck-shaft angle, and Parker and Palmer mobility scores were not significantly different between the two groups (p>0.05). However, the mean sliding length of lag screw was 8.15 mm and 3.94 mm for group I and II, respectively, the mean union time was 16.85 weeks and 15.57 weeks, respectively, and the mean full weight bearing time was 4.54 weeks and 2.31 weeks, respectively. The mean sliding length of lag screw, union time, and full weight bearing time all had statistical significance (p<0.05). There were a total of 3 cases of postoperative complications in group I and 4 cases in group II. CONCLUSION: We conclude that PFN is more reliable than CHS as a treatment method for AO/OTA A2.2 intertrochanteric fracture.
Femoral Fractures* ; Femur ; Hip Fractures ; Hip* ; Hospitalization ; Methods ; Neck ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Weight-Bearing

Purpose: Splenectomy for patients with remnant gastric cancer has been controversial. The purpose of this study is to identify the impact of splenectomy in the treatment of remnant gastric cancer. Methods: We retrospectively analyzed 285 patients with remnant gastric cancer who underwent completion total gastrectomy with or without splenectomy in Samsung Medical Center, between September 1996 and December 2017. We used a 1:1 propensity score matching method for the analysis. The matching factors were age, sex, and pathologic stage. After the matching process, we compared the 5-year overall survival (OS) and the disease-free survival (DFS) between patients with and without splenectomy during completion total gastrectomy. Results: The median duration of follow-up was 58.0 months (range, 0–132 months). After propensity score matching, there were no statistically significant differences between the splenectomy group (n = 77) and no splenectomy group (n = 77) in terms of clinicopathological features. The 5-year OS rate between the no splenectomy and splenectomy group were not significantly different. There was no significant difference between 5-year DFS of the matched groups. Multivariate analysis revealed that splenectomy is not a significant prognostic factor in terms of 5-year OS (no splenectomy vs. splenectomy; 61.5% vs. 60.2%, P = 0.884) or DFS (74.9% vs. 69.8%, P = 0.880). Conclusion Splenectomy has no impact on the OS and DFS in patients with remnant gastric cancer. Splenectomy during completion total gastrectomy may not be necessary.