Hypertension is a risk factor for developing fatal aortic dissection. Aortic dissection occurs 2~3 times as often in men than in women between ages of 50~70 years old. Among other risk factors, aortic dissection occurs especially in women below the age of 40 years old in pregnancy-related cases. In pregnancy-related cases, aortic dissection occurs in the third trimester and in puerperium, as well as in multiparous women. The writers experienced an aortic dissection related pregnancy. The patient was 32 years old, diagnosis of dissection occurred in the postpartum period. Although, aortic dissection is a rare complication of pregnancy, the knowledge of this may assist the emergency physician save the lives of patients.
Adult ; Diagnosis ; Emergencies ; Female ; Humans ; Hypertension ; Male ; Postpartum Period ; Pregnancy ; Pregnancy Trimester, Third ; Risk Factors

In our series with old electrical burn around the the wrist, there are several characteristics: for example, bad scarring in palm and volar aspect of wrist and distal forearm, large multiple defects of the flexor tendons, low median and ulnar nerve palsy, and occasionally insufficient blood supply. Between 1992 and 1995, we treated 8 cases of 7 patients with staged reconstruction. 4 patients with bilateral involvements had below-elbow amputee of contralateral upper extremity. The common approachs in each were soft tissue coverage, staged tendon reconstructiuon, and opponensplasty. The length of time between the injury and tendon reconstruction was 9 months on an average. Soft tissue coverage consisted of: 1. free tissue transfer (n=3), 2. abdominal (n=3) or groin (n=2). Total numbers of flexor tendon reconstruction were 26. Among them, staged reconstruction using silicone prosthesis were done in 18 tendons and primary tendon graft following tenolysis were done in 8 tendons. The time between first and second stage tendon reconstruction was 4.13 months. In all cases, opponen-splasty using extensor indicis proprius (n=4), extensor pollicis longus (n=2), and extensor digiti mini- mi (n=l), were performed. Good functional improvement of the hand were obtained in all cases. Patient s satisfaction were much better than the degree of functional improvement of the hand.
Amputees ; Burns* ; Cicatrix ; Forearm ; Groin ; Hand ; Humans ; Prostheses and Implants ; Silicones ; Tendons ; Transplants ; Ulnar Neuropathies ; Upper Extremity ; Wrist*

The femoral neck fracture in children are extremely rare and occur secondary to severe trauma. Many authors recommend early anatomical reduction and firm internal fixation because of many complications after treatment. Eleven displaced femoral neck fractures in children who were treated at the Keimyung University Dong San Medical Center from February, 1989 to February, 1993. Following results were obtained, after clinical and radiological evaluations. 1. Fractures of the femoral neck in children occurred from five to sixteen years, the highest inci dence was between ten and thirteen years of age. 2. The main causes of the fracture were traffic accident in 9 cases. 3. 10 cases were treated by arthrotomy, open reduction and internal fixation and one by closed reduction and internal fixation. 4. Operation were performed within 24 hrs after trauma in 5 cases, within 5 days in 4 cases, and 2 cases were performed within 10 days after trauma. 5. According to the classification of Delbet and Colonna(12), cervicotrochanteric fracture(type III) was the most common type(7 cases). 6. The degrees of displacement were 4 cases totally displaced, one case more than two third dis placed, 4 cases 1/3 to 2/3 displaced, and 2 cases less than one third displaced. 7. Complications were transient AVN confirmed by bone scan(1 case) and coxa vara due to nonunion(1 case). 8. According to the Ratliffs assessment(22) the results were good in 9 cases, fair in one, and poor in one.
Accidents, Traffic ; Child ; Classification ; Coxa Vara ; Decompression ; Femoral Neck Fractures ; Femur Neck ; Humans

Total hip replacement for adults with severe acetabular dysplasia presents a difficult problem because deficient bone stock and soft tissue contractures usually prevent sitting at the normal anatomic level. The rationales of high hip center are due to high failure rate of bulk structural weight bearing graft, good short-term result of hemispherical cementless acetabular component in revision surgery, high hip center but not lateral which does not adversely affect the biomechanics of the hip, and intimate apposition with viable host bone. We represented the short-term results of 21 total hip replacements with proximal placement of the acetabular cup than the anatomical position that is normally used. The mean duration of follow up was 18 months(range, 12-58 months) and the mean age of the patient was fifty-one years(range, thirty to sixty-seven years). Most of these hips had a major deficiency or defect of the acetabular bone stock. They had an aver- age Harris hip score of 47 points preoperatively and 90 points postoperatively. Roentgenographic measurements showed that the mean change in the height of the center of the hip postoperatively was only +6.6 millimeters and the mean change of horizontal location of them was 10 millimeters medial to the preoperative position. Postoperative complications included calcar fracture(1 case), trochanteric bursitis(1 case), postop- erative dislocation(1 case) and one case of radiological loosening of the acetabular component. The center of the hip in THR is not a crucial parameter with regard to the long-term stability of acetabular component, so our recommendation is to place the acetabular component at a more proximal but not lateral position if strong bone stock is available. But future studies of high hip center need to address femoral component longevity.
Acetabulum ; Adult ; Arthroplasty, Replacement, Hip ; Contracture ; Femur ; Follow-Up Studies ; Hip Joint ; Hip ; Humans ; Longevity ; Osteoarthritis ; Postoperative Complications ; Transplants ; Weight-Bearing

No abstract available.
Goldenhar Syndrome*

OBJECTIVES: It has been known that the contents of dreams change according to neuro-developmental differences in sex, progression of age and various environments, unlike the established psychoanalytic theory. To investigate the changes, we collected "most recent dream report" and analyzed the contents of dreams by using Hall/Van de Castle System. METHOD: Most recent dream reports were gathered from age 12-14 years old, 2,673 middle school students (1,544 male 1,129 female) and analyzed those reports using Hall/Van de Castle System. The data were sorted in SAS and dream SAT. RESULT: There were prominent differences between male and female middle school students in Male/Female Percentage (male/female; 56%/35%), Familiarity Percentage (57%/69%), Aggression/Friendliness Percentage (79%/65%), Befriender Percentage (50%/33%), Physical Aggression Percentage (90%/70%), Indoor Setting Percentage (40%/55%), Negative Emotion Percentage (56%/68%) and Torso/Anatomy Percentage (51%/36%). There were significant differences in Male/Female Percentage (65%/44%), Friendliness, Physical Aggression and Self Negativity Percentage in male and there were significant differences in Friendliness, Familiarity and Friends Percent in female between 1st and 2nd grade. But, it showed much similar dream patterns between 2nd and 3rd grade in both gender. In male, Aggression/Character Index with male character is significantly increased by 2nd grade (1st/ 2nd/ 3rd; 0.48/1.04/0.98), In female, Friendliness/Character Index with male character had significantly decreased by 2nd grade (0.38/0.19/0.20). CONCLUSION: There were apparent differences between age 12-14 years old male and female. Male adolescents have differences mostly in categories related with aggression, but female adolescents have differences in categories related with environment or character. It shows that developmental level of male are slower than female as of yet and male needs more active interpersonal relationship to find identity. Otherwise, the influences of passive attitude and actual circumferential environment are reflected in female's dream. There are no prominent differences among ages, but age 12-13 years old adolescents shows significant differences in interacting with the other gender. It means that circumferential environment and interpersonal relationship affect the contents of dreams and also the cognitive development related to age and sex. Afterwards, the development of dreams could be better understood through the neurocognitive study and dream analysis between other ages and nations.
Adolescent* ; Aggression ; Dreams* ; Female ; Friends ; Humans ; Male ; Psychoanalytic Theory ; Recognition (Psychology)

PURPOSE: There are no reports on amusement-park-related injuries in Korea. Thus, the objective of this study was to describe traumatic injury patterns that occurring in an amusement park. METHODS: The medical records of an infirmary were retrospectively reviewed. From January 1, 2008, to December 31 2008, patients who were transferred to the nearest emergency departments of hospitals for the purpose of further test and treatment were enrolled. Demographics, injury types and involved parts of the body were analyzed. RESULTS: A total of 3,608 patients visited an infirmary for traumatic injury and about two-thirds had soft tissue injuries. Of those, 191 patients (5.3%) were transferred to the emergency department of a hospital. Of the patients who were transferred to a hospital, laceration and contusion were the responsible injuries for about half. Laceration was the most common injury in pediatric patients, and a sprain or a strain was the most common in adult patients. The most commonly injured parts of the body were the extremities in adult patients. However, in pediatric patients, injuries of the head, face and neck were similar to injuries of the extremities. CONCLUSION: Soft tissue injury was the most common amusement-park-related injury. Laceration was the most common reason to transfer a patient to a hospital. There were differences in injury type and injured part of the body between adult and pediatric patients.
Adult ; Contusions ; Demography ; Emergencies ; Extremities ; Head ; Humans ; Korea ; Lacerations ; Medical Records ; Neck ; Retrospective Studies ; Soft Tissue Injuries ; Sprains and Strains

BACKGROUND: We analyzed the changes in QT dispersion (QTd) in children with Kawasaki disease (KD), and determined the presence of repolarization abnormality in these children even in the absence of coronary artery abnormalities. METHODS: Ninety-one children with KD and 20 healthy controls were enrolled in this retrospective study. Serial echocardiographic and electrocardiographic (ECG) measurements in the beginning of treatment, 2nd month and 6th month after the diagnosis were compared. Fifty-one of 91 children had at least 2 serial ECG data. The number of patients who had 3 consecutive ECG data was 23. RESULTS: Among the 67 KD patients with no coronary artery changes, the consecutive mean QTd values were 41.86 ms, 37.84 ms, and 25.47 ms, respectively (26 ms for controls). In the analysis of changes among KD patients without coronary artery abnormalities, QTd showed a significant decrease with time (p=0.01). Especially, the 1st month and the 6th month QTd values were significantly different (p=0.028). The mean QTd values in KD patients with coronary artery changes were significantly higher than those in KD patients with no coronary artery changes at each time (1st, 2nd, and 6th month exam). CONCLUSION: QTd is significantly increased in children during the early stage of KD. Repolarization abnormality may exist during the acute stage of KD, regardless of the echocardiographic changes.
Child* ; Coronary Vessels ; Diagnosis ; Echocardiography ; Electrocardiography ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies

No abstract available.
Child* ; Humans ; Humerus*

False aneurysm has been recognized for many years. Incomplete severance of an artery as the result of trauma is thought to be the precipitating factors in the formation of false aneurysm. False aneurysm of the peripheral artery is presented with pulsating mass and may show extrinsic indentations of the adjacent bone with or without neurovascular symptoms, mimicking a malignant tumor. But careful history taking can reveal a proceeding deep penetrating injury variable period prior to development of symptoms. We are reporting two cases of false aneurysm of the superior gluteal artery and superficial femoral artery in each after trauma.
Aneurysm, False ; Arteries ; Femoral Artery ; Precipitating Factors