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

No abstract available.
DNA* ; Herpesvirus 3, Human*

No abstract available.
Muscle, Smooth* ; Smooth Muscle Tumor* ; Stomach*

No abstract available.
Hemodynamics* ; Hypertension, Pulmonary*

The 213 first ribs Koreans were measured and morphologically studied. The results were as follows. 1. On average, the internal straight length of the first rib was 53.7mm (male), 49.9mm (female) ; the external straight length was 79.7mm (male), 75.4mm (female), the maximum straight length was 87.4mm (male), 81.2mm (female) ; the breadth was 15.2mm (male), 14.4mm (female) ; and the thickness was 5.5mm (male), 5.4mm (female). 2. The proportion of the scalene tubercle to the costal breadth was 0% to 90% (average 37%). 3. The incidence of the presence of the groove for the first thoracic nerve was 7.5%. 4. The common shapes of the articular surface of the head were ball-shape(41%), cylinder-shape (25%) and plane-shape (25%) ; and those of the tubercle were cylinder-shape (44%), saddle-shape (31%) and socket-shape (14%).
Head ; Incidence ; Ribs* ; Thoracic Nerves

Epidural clonidine is reported to produce analgesia in humans. To investigate the analgesic effect and prolongation of epidural and spinal anesthesia, we mixed 0.2mg epinephrine, 150 mcg clonidine, or 1 cc normal saline with 0.5% bupivacaine and compared the hemodynamie and analgesic effects of each drug. Heart rate and blood pressure were checked before, during and after anesthesia. Sensory level was checked by pin-prick method. The results were as follows; 1) The analgesia onset time and the time to highest level of sensory loss was most rapid in the epinephrine group. 2) The two segment regression time was significantly prolonged in the epinephrine group. 3) The analgesia duration was significantly prolonged in the clonidine and epinephrine group. 4) Although the heart rate gradually decreased over 60 min. After injection of each drug, there was no significant change between the groups. 5) Blood pressure decreased over 20-30 min. After injection of each drug, but there was no significant change between the groups.
Analgesia ; Anesthesia ; Anesthesia, Epidural* ; Anesthesia, Spinal ; Blood Pressure ; Bupivacaine* ; Clonidine* ; Epinephrine* ; Heart Rate ; Humans

Forty patients with preeclampsia, undergoing general anesthesia for Cesarean section were studied. They were allocated randomly to receive either propofol 2.5 mg/kg and laryngeal mask insertion or thiopental sodium 4 mg/kg and endotracheal intubation for induction of anesthesia. All patients receiving thiopental sodium and tracheal intubation showed potentially dangerous reflex cardiovascular instability. There was a average 48.7 mmHg increase in systolic blood pressure after intubation. The patients receiving propofol and laryngeal mask insertion showed only 10.7 mmHg increase in systolic blood pressure. It is concluded that thiopental sodium induction and traeheal intubation of patients with preecalmpsia produces an increase in blood pressure which can lead to a risk of significant complication. Thus propofol induction and laryngeal mask seems to be a suitable anesthetic method in preeclampsia.
Anesthesia ; Anesthesia, General ; Blood Pressure ; Cesarean Section* ; Female ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngeal Masks* ; Pre-Eclampsia* ; Pregnancy ; Propofol* ; Reflex ; Thiopental

A 36 years old man was scheduled for carinal resction, left pneumonectomy, and tracheobronchial anastomosis under the diagncais of malignant tumor in the carina and left main bronchus. During the procedure of carinal resection, anesthesia had been maintained with a right bronchial tube which was intubated through operating thoracic cavity. The E.K.G. was monitored continuously and a radial artery canula was inserted for disect arterial pressure monitoring and blood gas analysis sampling. Anesthetic course was uneventful with nitrous oxide, ahlothane and pancuronium under controlled respiration. Postoperative course had minor problem with right upper lobe atelectasis which disappeared soon after tracheal suction.
Adult ; Anesthesia ; Arterial Pressure ; Blood Gas Analysis ; Bronchi ; Humans ; Nitrous Oxide ; Pancuronium ; Pneumonectomy ; Pulmonary Atelectasis ; Radial Artery ; Respiration ; Suction ; Thoracic Cavity

PURPOSE: The need for continuing Growth Hormone(GH) replacement after adolescence in patients with childhood-onset GH deficiency has been recognized. The purpose of this study was to evaluate the abnormalities of lipid profiles in young adults with childhood-onset hypopituitarism who discontinued GH therapy after the completion of height growth. METHODS: Nine male patients(mean age:22.4+/-3.3 years) with childhood-onset hypopituiatarism in whom GH treatment had been discontinued after final height was achieved were included. Their body mass index(BMI) and serum levels of total cholesterol, triglyceride(TG), high-density lipoprotein(HDL) cholesterol, and low-density lipoprotein(LDL) cholesterol were measured. The relationships of duration after GH discontinuation, age, and BMI to lipid profiles were anaylzed. RESULTS: BMI increased significantly from 21.8+/-1.9 kg/m2 before GH discontinuation to 23.0+/-3.0 kg/m2 after GH discontinuation(P<0.05). Serum levels of total cholesterol, TG, HDL cholesterol, and LDL cholesterol were 217.3+/-33.4, 237.8+/-128.2, 42.1+/-7.1, and 127.4+/-27.2 mg/dL, respectively, 3.1+/-2.0 years after GH discontinuation. Percentage of patients who had total cholesterol > or = 200 mg/dL, TG > or = 150 mg/ dL, LDL cholesterol > or = 140 mg/dL, and HDL cholesterol < or = 40 mg/dL were 77.8%, 88.9%, 44.4%, and 33.3%, respectively. All subjects had some abnormalities of lipid profiles. A significant positive correlation was found between duration after GH discontinuation and serum levels of total cholesterol and TG(r=0.84, P<0.01; r=0.83, P<0.01). A significant positive correlation was also found between age and serum levels of total cholesterol and TG(r=0.86, P<0.01; r=0.81, P<0.01). There were no correlations between BMI and serum lipid levels. CONCLUSION: Most of young adult patients with childhood-onset hypopituitarism had abnormal lipid profiles by 1-5 years after discontinuation of GH treatment. These data suggest that continuous GH treatment after completion of height growth is necessary.
Adolescent ; Adult* ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Growth Hormone* ; Humans ; Hypopituitarism* ; Male ; Young Adult

BACKGROUND: Methods to detect and quanitify Mycobacterium leprae(M. leprae)are needed for studies involving the epidemiology, pathogenesis, and chemotherapy of leprosy. Serological assays and skin tests lack the sensitivity and specificity to serve as diagnostic tool for M. leprae infection. The polymerase chain reaction(PCR) based on the selective amplification of an 530-bp frangment of the gene encoding the proline-rich antigen of M. leprae was performed with sections of fixed or frozen biopsy samples from leprosy patients. OBJECTIVE: This study was done to investigate the applicability of PCR for the detection of low numbers of M. leprae in tissues and peripheral blood. METHODS: The PCR was used to amplify a 530-base-pair M. leprae DNA with the thermoxtable Taq DNA polymerase. RESULTS: The In frozen skin tissues and peripheral blood of leprosy patients. relatively high detection rates of PCR products was achieved by using direct gel analysis as well as Southern blot hybridization. CONCLUSION: These results suggest that PCR amplification for the detection of M. leprae may be useful for the epidemiologic study of large papulations as well as coinical astudies on the individual patients.
Biopsy ; Blotting, Southern ; DNA ; Drug Therapy ; Epidemiologic Studies ; Epidemiology ; Humans ; Leprosy ; Mycobacterium leprae* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Skin ; Skin Tests ; Taq Polymerase