No abstract available.
Cisterna Magna*

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

OBJECTIVES: The purpose of this study was to determine whether pH and time has any influence on the degradation behavior of composite restoration by analyzing the leached monomers of dental composites qualitatively and quantitatively after storage in acetate buffer solution as a function of time using high performance liquid chromatography (HPLC) / mass spectrometer. MATERIALS AND METHODS: Three commercial composite restorative resin materials (Z-250, Heliomolar and Aeliteflo) with different matrix structure and filler composition were studied. Thirty specimens (7mm diameterx2mm thick) of each material were prepared. The cured materials were stored in acetate buffer solution at different pH (4, 7) for 1, 7 and 45days. As a reference, samples of unpolymerized composite materials of each product were treated with methanol (10 mg/ml). Identification of the various compounds was achieved by comparison of their mass spectra with those of reference compound, with literature data, and by their fragmentation patterns. Data were analysed statistically using ANOVA and Duncan's test. RESULTS: 1. Amounts of leached TEGDMA in Aeliteflo were significantly larger than those of UDMA in Z-250 and Heliomolar at experimental conditions of different storage time and pH variation (p < 0.001). 2. As to comparison of the amounts of leached monomers per sorage time, amounts of leached TEGDMA in Aeliteflo and UDMA in Z-250 and Heliomolar were increased in the pH 4 solution more significantly than in the pH 7 solution after 1day, 7days and 45days, respectively (p < 0.001). 3. In total amounts of all the leached monomers with storage times, the overall amounts of pH 4 extracts were larger than those of pH 7 extracts for all resin groups, but there was no significant difference (p > 0.05).
Chromatography, Liquid ; Composite Resins* ; Hydrogen-Ion Concentration* ; Methanol ; Polymers*

PURPOSE: To evaluate the risk factors related to the development of new fractures in adjacent vertebrae after vertebroplasty. MATERIALS AND METHODS: The study was conducted on 46 patients in whom 296 patients were performed during last 9 years. We were especially concerned with the restoration rate of vertebral height and kyphotic angle and estimated them on simple X-ray films. RESULTS: In patients experienced subsequent vertebral fractures and no subsequent vertebral fractures after vertebroplasty, the mean height restoration rate of treated vertebra were 16.7% and 7.07%, and the kyphotic angle difference were 2.53 degree and 4.2 degree. The greater degree of height restoration of the vertebral body, especially in middle vertebral height and the lesser degree of kyphotic angle difference increased the risk of adjacent vertebral fracture risk. This results were available statistically (all p<0.05, Logistic regression test, SPSS 13.0). CONCLUSION: It may be thought that the vertebral body height restoration rate will become risk factor of adjacent vertebral fractures.
Body Height ; Fractures, Compression* ; Humans ; Logistic Models ; Risk Factors* ; Spine* ; Vertebroplasty* ; X-Ray Film

PURPOSE: The purpose of this study is to evaluate the clinical and radiological results of the trochanteric flip osteotomy in cases of femoral head fractures. MATERIALS AND METHODS: Between May 2000 and January 2012, we evaluated 14 cases of femoral head fractures treated by trochanteric flip osteotomy in combination with the Kocher-Langenbeck approach after a minimum follow-up of one year. There were 13 men and one woman and the average follow-up period was 36.4 months. The clinical results were evaluated according to Merle d'Aubigne-Postel scores and the Thompson-Epstein scoring scale and the radiological results were evaluated according to time to union of fractures and osteotomy site. We also evaluated the incidence of complications. RESULTS: At the last follow-up, mean Merle d'Aubigne-Postel score was 16.4 and 11 cases out of 14 patients presented with good to excellent, two cases presented with fair, and one case presented with a poor clinical result according to the Thompson-Epstein scoring scale. Radiologically all cases achieved union of fractures and osteotomy site and the mean time to union of the osteotomy site was 7.9 weeks. Complications included one case of heterotopic ossification which did not disturb hip function, two cases of avascular necrosis of the femoral head, and one case of post-traumatic osteoarthritis. CONCLUSION: The trochanteric flip osteotomy in the case of a femoral head fracture showed good clinical and radiological results through good visualization and accurate reduction of the fracture site. However, conduct of further studies including larger number of patients is needed in order to evaluate the incidence of complications such as avascular necrosis of the femoral head.
Female ; Femur ; Femur Head ; Follow-Up Studies ; Head ; Hip ; Humans ; Incidence ; Male ; Necrosis ; Ossification, Heterotopic ; Osteotomy

No abstract available.
Blood Flow Velocity*

After the introduction of antibiotics, empyema is a rare complication of retropharyngeal abscess caused by acute epiglottitis. But once it occurs, it may be a fatal outcome. Retropharyngeal abscess may spread to mediastinum and pleural cavity along the deep cervical fascia, then it can induce pneumonia, mediastinitis, empyema, and sepsis. Because of its fatal complication, early diagnosis and intensive surgical treatment, such as incision and drainage, is necessary. Now we have a experience of empyema caused by retropharyngeal abscess in a 56-year old diabetic patient with nephropathy. He was admitted to our hospital because of hoarseness and sore throat due to acute epiglottitis. Several days after his admission, he complained of swelling of neck, which was diagnosed as retropharyngeal abscess by the computerized tomography. Retropharyngeal abscess was managed with antibiotics, incision and drainage and culture revealed Peptostreptococcus prevotii. Subsequently empyema developed in his right chest, which was managed with closed thoracotomy, though, he expired due to progression of sepsis.
Anti-Bacterial Agents ; Drainage ; Early Diagnosis ; Empyema* ; Epiglottitis* ; Fascia ; Fatal Outcome ; Hoarseness ; Humans ; Mediastinitis ; Mediastinum ; Middle Aged ; Neck ; Peptostreptococcus ; Pharyngitis ; Pleural Cavity ; Pneumonia ; Retropharyngeal Abscess* ; Sepsis ; Thoracotomy ; Thorax

Xiphoid elongation is a rare phenomenon where the xiphoid process elongates after stimuli such as surgery, physical therapy, or trauma. We report on a 47-year-old male involved in a traffic accident who went into cardiac arrest. He received ongoing cardiopulmonary resuscitation for nine minutes before recovery of cardiac rhythm, and transfer from a local hospital to the trauma center. He received management for hypotensive shock which was temporarily corrected using Resuscitative Endovascular Balloon Occlusion of the Aorta, and underwent trauma laparotomy in which ileocolic artery ligation and a splenectomy were performed. Six months later, the patient reported epigastric discomfort when he bent over. A hard, linear mass was palpated along the upper midline incision scar and a computed tomography scan showed an elongated xiphoid process (10 cm). The patient underwent surgical excision, and electrocauterization of the xiphoid process. This is a rare case of xiphoid elongation following multiple stimuli to the xiphoid process.

Villous adenomas of the stomach are rare, although they more frequently occur in the colon and rectum. Clinical symptoms are similar to gastric polyps, but acute or chronic bleeding with anemia occurs frequently. The size of tumors varies between 4 and 6 cm, and the malignant potential is greater when the tumor is larger. Complete resection with surgery or endoscopic resection is the treatment of choice. Endoscopic findings revealed a dome-like or pedunculated appearance. Microscopically, the tumor was composed of long fronds and papillations covered by columnar epithelia with a reduced number of goblet cells. We report a case of polyps with chronic intermittent and acute bleeding for 6 months, which was alleviated by endoscopic mucosal resection and was confirmed as a villous adenoma.
Adenoma ; Adenoma, Villous ; Anemia ; Colon ; Gastrointestinal Hemorrhage ; Goblet Cells ; Hemorrhage ; Polyps ; Rectum ; Stomach

Oseltamivir is a potent selective neuraminidase enzyme inhibitor and effective against nearly all strains of influenza A and B. The importance of treating influenza has been recognized, and oseltamivir has been prescribed frequently at the onset of the H1N1 influenza A pandemic this year. However, oseltamivir can cause hemorrhagic colitis as a rare adverse effect. Until now, only two cases of hemorrhagic colitis following the use of oseltamivir have been reported in Japan, and none have been reported in Korea. We report a case of acute hemorrhagic colitis in a 15-year-old boy after the oral administration of oseltamivir for swine originating influenza A.
Administration, Oral ; Adolescent ; Colitis ; Humans ; Influenza, Human ; Japan ; Korea ; Neuraminidase ; Oseltamivir ; Pandemics ; Swine