BACKGROUND: Neer type II distal clavicle fractures have the drawback of coracoclavicular instability and insufficient distal bony fragment, thereby making it difficult to achieve adequate fixation. Although various surgical treatments have been described for Neer type II fracture, the optimal treatment remains controversial. This study reports the clinical results and usefulness of anatomical locking plate with additional K-wire fixation. METHODS: A totally of 21 patients with type II distal clavicle fracture were included in the study. The surgical procedure reduced the fracture temporarily; it included insertion of one or two K-wire from the lateral margin of the distal fragment to the proximal fragment through the fracture site, followed by application and fixation of the locking plate. The bony union and migration of K-wire was evaluated in the follow-up radiography. The coracoclavicular distance and acromioclavicular joint arthrosis were assessed at the final follow-up. The Constant Score (CS) and Korean Shoulder Score (KSS) were evaluated for clinical scoring. RESULTS: Bone union was achieved in all cases. At the final follow-up, coracoclavicular distance of the injured shoulder was increased, as compared to the intact shoulder (p=0.002), with no accompanying clinical symptoms. No K-wire migration was observed. At the final follow-up, K-wire irritation was observed in two cases and acromioclavicular arthrosis in one case, with no other adverse effects. Pain visual analogue scale, CS, and KSS were improved in all cases. CONCLUSIONS: The method of anatomical locking plate with additional K-wire fixation could be useful in achieving beneficial clinical results.
Acromioclavicular Joint ; Clavicle* ; Follow-Up Studies ; Humans ; Methods ; Radiography ; Shoulder

The rim sign in renovascular compromise may be defined as a thin nephrographic rim outlinning a kidney with another wise faint nephrogram. Renal infarction with gelform and blood clots was induced experimentally in 5 dogsand high dose IVP and CT were performed to evaluate renal cortical rim sign after renal infarction. One expireddue to anesthetic technical failure, and one was embolized partially. So we could be obtain the result on 3 dogs.The reults were as follows; 1. The high dose IVP films show cortical rim sign on 24 hrs and 72 hrs films in twodogs. The CT films show rim sign in 3 dogs. 2. The rim sign may be visualized, if the renal artery is occuludedenough to drop perfusion presssure below the authoregulatory range. 3. The high dose IVP and early nephrogramphase are necessary for the rim sign.
Animals ; Dogs ; Infarction ; Kidney ; Perfusion ; Renal Artery

BACKGROUND AND OBJECTIVES: The goal of this study was to examine the safety and feasibility of a primary (direct) stenting in acute myocardial infarction (AMI). In the treatment of AMI, Percutaneous transluminal coronary angioplasty (PTCA) has documented superior reperfusion rate and improved clinical outcomes than thrombolytic therapy. However, there are several limitations of PTCA, such as recurrent ischemia in 10 to 15%, reinfarction in 3 to 5% and restenosis in 30 to 50% of patients. There are several reports that, compared with PTCA, the implantation of coronary stent has been shown to reduce angiographic restenosis and improve late clinical outcomes. But in general, stenting has been contraindicated in thrombus containing lesion due to the risk of subacute thrombosis. With advance in technique and the recognition of the importance of adequate platelet inhibition, the incidence of subacute thrombosis has fallen in patients with acute coronary syndrome and thrombus laden lesion. Methods and Results: In our study, primary stenting was performed in 42 patients of AMI. There are 6 cases (22.5%) target lesion restenosis during the follow up coronary angiography (150+/-86day) and no in-hospital death. Three cases (7.1%) of them require revascularization including two re-PCTA and a coronary artery bypass graft for the recurrent ischemic symptoms. There were no reinfarction and death after discharge. Six-months event free survival reate was 85.7%. CONCLUSION: Primary stenting is safe and feasible in the majority of patients with AMI and results in excellent mid-term outcomes compared with PTCA.
Acute Coronary Syndrome ; Angioplasty, Balloon, Coronary ; Blood Platelets ; Coronary Angiography ; Coronary Artery Bypass ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Ischemia ; Myocardial Infarction* ; Reperfusion ; Stents* ; Thrombolytic Therapy ; Thrombosis ; Transplants

Abscess ; Age Distribution ; Cardiovascular Diseases ; Dental Caries ; Drainage ; Endocrine System Diseases ; Female ; Humans ; Jeollabuk-do ; Korea ; Liver ; Male ; Periodontal Diseases ; Prognosis ; Retrospective Studies ; Surgery, Oral ; Tooth Extraction

PURPOSE: To determine the clinical efficacy of SS-cream, the topical agent made from the extracts of natural products for treating premature ejaculation(PE), a double blind, randomized placebo controlled phase III study on the patients with primary PE was performed in three medical centers. MATERIALS AND METHODS: Mean age of patient with primary PE was 38.7+/-0.6 years and duration of suffer from PE was 15.8+/-0.4 years. We investigated the ejaculatory latency calculated by stop watch and sexual satisfaction rate after the treatment(1 placebo and 5 SS-cream 0.2gm). Patients were instructed to apply the cream on the glans penis 1 hour before sexual intercourse in double blind randomized fashion. Clinical efficacy was compared with the prolongation of ejaculatory latency and improvement of sexual satisfaction rate. RESULTS: 106 patients with primary premature ejaculation completed this study. Mean ejaculatory latency tested at screening period was 1.37+/-0.1 min and both of patient and partner were not satisfied with their sexual lives. The mean ejaculatory latency was significantly prolonged as 10.92+/-1.0 min with SS-cream, while 2.45+/-0.3 min with placebo. In 79.8%, there was prolongation of ejaculatory latency longer than 2 minutes with SS-cream, while in 15.1% with placebo. The sexual satisfaction rate was also significantly improved as 82.2% with SS-cream, while 12.6% with placebo. 103 (16.2%) out of 636 trials of SS-cream showed mild local irritation including 82 mild burning senses and 21 mild pain, which disappeared in less than 1 hour. No adverse effect on sexual function and partner and no systemic side effects were observed. CONCLUSIONS: With these results, SS-cream is effective and safe in the treatment PE with mild local side effect.
Biological Products ; Burns ; Coitus ; Humans ; Male ; Mass Screening ; Penis ; Premature Ejaculation*

In order to evaluate the long-term effect of single lateral rectus muscle recession for the moderate angle exotropia(20-3-PD), we retrospectively studied 30 cases which were recessed by 8-9mm. The average follow-up period was 35.8 month. At 6 month postoperatively, the success rate was 75% in 8mm recession group and 84% in 8.5mm group, 88% in 9mm group. At the last follow-up, the success rate was 62%, 38%, 22% respectively. The recession of single lareral rectus muscle for the moderate angle exotropia was successful during the early postoperative period. But, its success rate was gradually decreased in the long-term follow-up especially for exotropia over 25PD. So, we should consider to recess lateral rectus muscle more than 8-9mm or choose the classic surgical method such as both lateral rectus recession or recession-resection for exotropia over 25PD.
Exotropia* ; Follow-Up Studies ; Postoperative Period ; Retrospective Studies

No abstract available.
Malignant Atrophic Papulosis*

BACKGROUND: The aim of this study is to evaluate the therapeutic effect of splenectomy in children with chronic idiopathic thrombocytopenic purpura(ITP) who do not respond to corticosteroids and intravenous immunoglobulin(IVIG). METHODS: Fifteen patients(7 boys and 8 girls) who were admitted to St. Mary's Hospital under the diagnosis of ITP from December 1990 to February 1997 were enrolled In this study. All had chronic forms(more than 6 months after diagnosis) and were refractory to corticosteroids(prednisolone 1~2mg/kg) and IVIG(400mg/kg for 5 days or 1 g/kg for 2 days). We you-finely employ pneumococcal vaccine in 13 patients before splenectomy slnce 1992. Antiplatelet antibody was examed in 10 patients. We measured platelet count at preoperative time, postoperative 1 day, 1 month, and 3 months or more. Hematologic results were analyzed according to Berchtold and McMillan's criteria (1) complete response(CR) >120 x 10(9)/l; (2) partial response(PR) >50 x 10(9)/l (3) no response(NR) < 50 x 10(9)/l. RESULTS: The median age at operation was 10 yr(6~16). The median time interval between diagnosis and splenectomy was 2 yr 2 mo(6 mo~5 yr 5 mo). Antiplatelet antibody was positive in 2 cases of 10 cases(20%). Of 15 cases, 12 cases were corticosteroid resistant and 3 cases were corticosteroid dependent. The postsplenectomy platelet count(median 407 x 10(9)/l of 1 day; 254 x 10(9)/l of 1 month; 227 x 10(9)/l of 3 months or more) was significantly higher than presplenectomy platelet count(median 9 x 10(9)/l)(P<0.05). All patients showed complete or parial response throughout the follow up period. Accessory spleen was found in 1 case and removed during operation. There were no serious complications following splenectomy except mild fever in 2 cases(14%). CONCLUSION: Splenectomy appears to be an effective and relatively safe treatment for patients with chronic ITP who have had inadequate response to conventional therapies.
Adrenal Cortex Hormones ; Blood Platelets ; Child ; Diagnosis ; Fever ; Follow-Up Studies ; Humans ; Platelet Count ; Purpura, Thrombocytopenic* ; Spleen ; Splenectomy*

No abstract available.
Blood Donors* ; HIV* ; Humans ; Mass Screening*

Purpose: The aim of this study was to evaluate the effect on sexual function after finasteride, tamsulosin, doxazosin single or combination therapy according the sexual function state before these therapies. Materials and Methods: This study included 192 men with benign prostatic hyperplasia (BPH) who had neither diabetes mellitus nor hypertension. All patients were classified into 2 groups according to their erectile dysfunction (ED) severity based on IIEF-5 before treatment; the above mild ED group (severe + moderate + mild to moderate) and mild or no ED group. The patients were assessed by IIEF inventory at the baseline and 1, 3 and 6 months after finasteride, tamsulosin, doxazosin single or combination therapies, respectively. Results: In the above mild erectile dysfunction group the mean IIEF score was significantly decreased at 3 and 6 months with finasteride single therapy, at 6 months with finasteride-tamsulosin combination therapy and at 3 and 6 months with finasteride-doxazosin combination therapy (p<0.05). In the mild or no erectile dysfunction group the mean IIEF score did not change significantly with any of the medications. Conclusions: Sexual function tended to decrease in the above mild ED group with finasteride single or combination therapy. Therefore, the patients in this group should be treated carefully at the beginning of these therapies.
Diabetes Mellitus ; Doxazosin* ; Erectile Dysfunction ; Finasteride* ; Humans ; Hypertension ; Male ; Prostatic Hyperplasia*