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

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*

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

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

PURPOSE: To assess the diagnostic value of Mn-DPDP for the detection of focal hepatic tumors on MR images and to determine the optimal pulse sequence to maximize its effect. MATERIALS AND METHODS: Twenty-three patients with 32 focal hepatic tumors were examined by means of 1.5-T MRI. Before and after the intravenous administration of Mn-DPDP, five pulse sequences were used to obtain T1-weighted images: two-dimensional fast low-angle shot (2D FLASH) with/without fat saturation (FS), spinecho (SE), and three-dimensional fast low angle shot reconstruction (3D FLASH) with/without FS. Quantitative assessment involved determination of the signal-to-noise ratio (SNR) of the liver and the tumor, the percentage signal enhancement ratio (PSER) of the liver, and tumor-to-liver contrast to noise ratio (CNR). Pulse sequences were also evaluated subjectively for tumor conspicuity, delineation, and image artifact. In addition, two experienced radiologists compared tumor detection rates between precontrast and postcontrast images. RESULTS: Mn-DPDP had a marked effect on liver SNR and absolute CNR at all pulse sequences (p<0.05). On postcontrast images, PSER and absolute CNR of the liver were highest at 3D FLASH and 2D FLASH FS, respectively, and significantly higher at GRE than at SE (p<0.05). On postcontrast images, the CNR of focal nodular hyperplasia and hepatocellular carcinoma was positive, while that of hemangioma, metastasis and cholangiocarcinoma was negative. The postcontrast CNR of all tumors except hepatocellular carcinoma increased more than 100%. Qualitative studies showed that tumor conspicuity increased significantly at all sequences except SE, and delineation increased significantly except at SE and postcontrast 2D GRE FS. After Mn-DPDP, GRE more effectively demonstrated tumor conspicuity and image artifact than did SE, and GRE other than 2D FLASH FS was also better than SE for tumor dilineation (p<0.05). The sensitivity of all postcontrast images increased and the tumor detection rate at GRE was significantly higher than at SE. CONCLUSION: Mn-DPDP favorably affects tumor-to-liver contrast, and may be useful in the imaging of focal hepatic tumors, more so with 2D or 3D FLASH pulse sequences than with SE.
Administration, Intravenous ; Artifacts ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Dyphylline ; Focal Nodular Hyperplasia ; Hemangioma ; Humans ; Liver ; Magnetic Resonance Imaging* ; Manganese ; Neoplasm Metastasis ; Noise ; Signal-To-Noise Ratio

PURPOSE: Occult intertrochanteric fractures are misdiagnosed as isolated greater trochanteric fractures in some cases. We investigated the utility of three-dimensional computed tomography (3D-CT) and magnetic resonance imaging (MRI) in the diagnosis and outcome management of occult intertrochanteric fractures. MATERIALS AND METHODS: This study involved 23 cases of greater trochanteric fractures as diagnosed using plain radiographs from January 2004 to July 2013. Until January 2008, 9 cases were examined with 3D-CT only, while 14 cases were screened with both 3D-CT and MRI scans. We analyzed diagnostic accuracy and treatment results following 3D-CT and MRI scanning. RESULTS: Nine cases that underwent 3D-CT only were diagnosed with isolated greater trochanteric fractures without occult intertrochanteric fractures. Of these, a patient with displacement received surgical treatment. Of the 14 patients screened using both CT and MRI, 13 were diagnosed with occult intertrochanteric fractures. Of these, 11 were treated with surgical intervention and 2 with conservative management. CONCLUSION: Three-dimensional CT has very low diagnostic accuracy in diagnosing occult intertrochanteric fractures. For this reason, MRI is recommended to confirm a suspected occult intertrochanteric fracture and to determine the most appropriate mode of treatment.
Diagnosis ; Femur* ; Fractures, Closed ; Hip Fractures ; Humans ; Magnetic Resonance Imaging

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