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

Apraclonidine is a potent alpha-adrenergic agonist that, like clonidine, is relatively selective for alpha-2 receptors. Apraclonidine has been shown to lower intraocular pressure by diminishing aqueous humor formation. The purpose of this study is to know the morphological changes in the ciliary epithelium by apraclonidine against aqueous formation. In group I, two drops of 1% apraclonidine hydrochloride were instilled on the right eye of the pigmented rabbits and the eyes were enucleated on 1,2.6 and 24 hours after instillation to find out the duration of action of the drug and the tissue response. In group II, one drop was instilled twice daily for seven days on the right eye and the eyes were enucleated on 1, 2 and 5 days after cessation of the instillation observing the cumulative effect of the drug and the tissue response. These eyes were studied with electron mIcroscopIc examiation. As a result, widening of cell membranes(basal infoldings) of the non-pigmented epithelium(NPE) were observed. This change was recovered with time, and seems to be the principal morphological changes of apraclonidine against aqueous formation in the ciliary body. In group II, the cellular changes were minimal except for well developed rough endoplasmic reticulum representing resumed secretary function of the cell.
Rabbits ; Animals

The elderly can experience a lot of stressful events and the stress acts as a various fluent that affects a well-being level, the self-contentment of lives. and the achievements by themselves. Also. the elderly are different from the young in many unexpressed stress and have diverse copings for perceived stress. Moreover. they mainly seem to use a problem-focused coping and an emotion-focused coping. To use whatever copings is to improve the quality of life in the old period and very important fact to achieve their ends. The purpose of this study was to investigate the relationship between Perceived Stress and the Ways of Coping in the Elderly and to gain the baseline data for development of nursing intervention program for improve to the quality of life in the elderly. The design of this study was a correlational study. The subjects of this study consisted of 230 of the elderly living in Pusan. The data was collected from 1st July, to 1st September. 2002. The instruments used for this study were 'Perceived Stress Scale(20items, 5point. scale)' developed by Kang In(990) and translated by Lee young-ja(1999). and its reliability is Cronbach's a= .89. Coping Scale(30items, 4point. scale. 14 items about a problem-focused coping, 16 items about an emotion-focused coping, 4 points scale) developed by Lazarus & Folkman (1984) and translated by Yang Young-hee(1998). The reliability of this study is Cronbach's a = .90. The data was analyzed by the SPSS WIN 10.0 program using frequency, percentage, mean, standard deviation, t-test, ANOVA & Scheffe test and Pearson's correlation coefficient. The results of this study were as follows: 1. The mean score of perceived stress was 31.75+/-0.23(Min 20, Max 100), which the item mean score was 1.59+/-.51(Min 1. Max 5). 2. The number of subjects in a problem-focused coping was 72(31.3%), the number of subjects in an emotion-focused coping was 158(68.7%) 3. There were statistically significant positive correlation between perceived stress and problem-focoused coping method and the more emotion-focoused coping method. (r = .180, r= .209, p< .05). It means the more stress, the more problem-focoused coping method and the more emotion-focoused coping method. 4. There was significant difference the score of perceived stress according to sex (F=-5.057, P=.000)marital status, (F=-2.909. P=.004) , economic level, (F=10.243, P=.000), paticipated meeting, (F=9.346, P=.000), perceived health status(F=5.1l7, P=.007). 5. There was significant difference the score of problem-focoused coping method according to age(F=14.200, P=.000), marital status (F=2.432, P=.0160), economic level (F=14.410, P=.000), monthly income, (F=8.300. P= .000), income resource (F=10.235, P=.000), educational level (F= 15.222, P= .000), occupation (F= 1.544, P=.04l), paticipated meeting (F=4.936, P= .008), perceived health status(F=5.655, P= .004). And there was significant difference the score of emotion-focoused coping method according to monthly income(F=4.781, P= .009), income resource (F=2.930, P= .035), educational level (F=6.101. P=.003), religion(F=2698, P= .032), paticipated meetings(F=7.285, P= .00l). As a result of the study, the elderly had a bit less stress and the two-thirds of the elderly used the emotion-focused coping. Thus, the more perceived stress, the more problem-focoused coping method and the more emotion-focoused coping method. Accordingly, to improve the quality of life of the elderly, there needs and applies a nursing intervention program that relieves the stress and use effective coping method.
Aged* ; Busan ; Humans ; Life Change Events ; Marital Status ; Nursing ; Occupations ; Quality of Life

Balloon-tipped, flow-directed (Swan-Ganz) catheters are used commonly for monitoring of cardiac function in patients undergoing cardiac surgical procedures. We report a case of pulmonary hypertension with hypoxemia which may be caused by incorrect positioning of pulmonary artery catheter (PAC) during CABG. Pulmonary arterial pressure (PAP) of 70/40 mmHg which was nearly high as systemic pressure was measured when we tried to wean patient from cardiopulmonary bypass. But, TEE (transesophageal echocardiography) showed nonspecific finding. PAP decreased soon and maintained about 33/16 mmHg for a few minutes. But, the PAP elevated high to 70/40 mmHg again and the arteral oxygen tension (PaO2) decreased to 61.2 mmHg. When we withdrew the PAC to the depth of 35 cm, the PAP and systolic pressure returned to normal range and PaO2 elevaed to 320 mmHg. End tidal CO2 was elevated from 30 mmHg to 35 mmHg.
Anoxia* ; Arterial Pressure ; Blood Pressure ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Catheters* ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Hypertension, Pulmonary* ; Oxygen ; Pulmonary Artery ; Reference Values

Neuroleptic malignant syndrome(NMS) is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics, characterized by muscular rigidity, fever, autonomic dysfunction, and altered consciousness. The major theories to explain NMS is central dopaminergic blockade, but it is unclear. Risperidone is a new antipsychotic drug, a benzisoxazole derivative that blocks dopamine D2 receptor and serotonin type 2 receptor. The comparatively greater serotonin-blocking activity is believed to give risperidone the specific property of not causing any more extrapyramidal side effects than conventional antipsychotics at the optimal dose of 4-8mg/day. It is postulated that risperidone is unlikely to cause NMS. Here, we report a case of risperidone induced neuroleptic malignant syndrome.
Antipsychotic Agents ; Consciousness ; Fever ; Muscle Rigidity ; Neuroleptic Malignant Syndrome* ; Receptors, Dopamine D2 ; Risperidone ; Serotonin

No abstract available.
Cutaneous Fistula ; Glomerulonephritis, Membranous* ; Humans ; Sarcoma, Kaposi*

BACKGROUND: Two types of word fluency tasks, namely, word generation by semantic or phonemic cues, are part of the neuropsychological evaluation of neurological patients. Cognitive mechanisms, such as strategies of memory retrieval, may differ for these two tasks. We therefore used functional magnetic resonance image (fMRI) to examine whether brain areas activated by the phonemic word fluency task may differ from those activated by the semantic word fluency task. METHODS: Semantic and phonemic word fluency tasks were administered to 112 normal subjects with two categories for each (animal and fruit names for semantic word fluency, and 'ah' and 'd' sounds for phonemic word fluency). The number and the degree of scattering of generated words were examined for the analysis of cortical activation. With another seven normal subjects, fMRI experiments were conducted while they generated words with the two types of cues (five categories for each). RESULTS: Performance in terms of number of words generated was better with semantic cues than with phonemic cues (14.15 words for semantic cues and 10.36 words for phonemic cues on the average). The same words were more commonly generated across subjects in semantic fluency tasks than in phonemic fluency. In a fMRI experiment, higher signals were observed during phonemic than in semantic word fluency tasks at the bilateral posterior-inferior temporal gyri, left premotor area, right cerebellum, and bilateral superior parietal lobules. The opposite was observed at the bilateral posterior cingulate gyri. CONCLUSIONS: The fluency tasks showed differential performance and several cortical areas showed differential activation, depending on the type of cues given for word generation. This result is consistent with the hypothesis that an automated visual imagery is adopted as word-finding strategy for semantic fluency, whereas controlled articulatory evaluation is used as a strategy for phonemic fluency.
Brain* ; Cerebellum ; Cues ; Fruit ; Humans ; Magnetic Resonance Imaging ; Memory ; Rabeprazole ; Semantics

No abstract available.
Chorion* ; Chorionic Villi Sampling* ; Chorionic Villi* ; Female ; Pregnancy

BACKGROUND/AIMS: Lamivudine, an oral nucleoside analogue, effectively inhibits hepatitis B virus replication and reduces hepatic necroinflammation in patients with chronic hepatitis B. This study investigated the effect and safety of 12 week lamivudine therapy in Korean patients with chronic hepatitis B (CHB). METHODS: In an open clinical trial, 113 patients with CHB were enrolled. They received 100 mg of lamivudine orally once daily for 12 weeks, and they were followed until 2 weeks after cessation of lamivudine. HBV DNA (by bDNA assay), liver enzymes, creatine phosphokinase, creatinine and CBC were checked at 0, 2, 4, 8, 12 and 14 weeks. Compliance and side effects were evaluated at the same time. RESULTS: After receiving lamivudine 100 mg, serum HBV DNA levels fell rapidly, remaining in 94.3% below baseline values at 2 weeks and 99.8% below baseline values at 12 weeks. Serum HBV DNA was cleared in 75.2% and alanine aminotransferase level (ALT) was normalized in 64.8% at 12 weeks. Cumulative percentage of HBeAg clearance (defined by clearance of serum HBV DNA and HBeAg) was 14.4%. Clearance of HBV DNA was more frequent in patients with lower pretreatment serum HBV DNA and higher ALT. During the treatment periods, adverse effects were negligible and transient. Two weeks after cessation of lamivudine, serum HBV DNA reappeared in 70.6% of responders. CONCLUSION: It is suggested that lamivudine is effective and safe in the treatment of CHB in Korean patients, but further study for adequate duration of treatment is needed because of high recurrence after 12 weeks therapy.
Alanine Transaminase ; Compliance ; Creatine Kinase ; Creatinine ; DNA ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Lamivudine* ; Liver ; Recurrence

We report a case of exogastric schwannoma of the stomach in 41-years-old male patient with papable mass in left upper abdomen. Upper GI series revealed extrinsic compression on the greater curvature of the stomach. CT scan showed a low density mass attached to greater curvature of the stomach with inhomogeneous contrast nhancement in the mass lesion. The mass was removed by surgery, and confirmed pathologically as schwannoma arising from the stomach.
Abdomen ; Humans ; Male ; Neurilemmoma* ; Stomach* ; Tomography, X-Ray Computed