To achieve full pronation and supination after fracture, many authors have pointed out the importance of the length of the bones, the absence of the angulatory deformity and rotational deformity, maintenance of the interosseous space and the curves of the radius, especially the lateral bowing of the radius. Over the years many methods of open reduction and internal fixation or the closed method have been advocated and comparisons have been made between the groups treated by the conservative method and open reduction and internal fixation. The authors have reviewed 108 cases of the fracture of the shaft af the forearm bones from 1 January 1971 to 31 March 1979 which were treated in Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine. The following results were obtalned from analysis of the cases studies. 1. There was no difference between the conservative treatment group and the open reduction and internal fixation group for fractures of the radius or ulna alone in fracture heallng time, but there was delay in fracture healing time in the open reduction and internal fixation group compared to the conservative treatment group for fractures of both forearm bones. 2. Satisfactory functional results were shown in the open reduction and internal fixation group rather than in the conservative treatment group. 3. Angulatory deformities were shown in 47.2% of the conservative treatment group and 14.8% of the open reduction and internal fixatlon group. 4. In selected cases, an Evan's tuberosity view was taken and rotational deformities were shown in 30.0% of the conservative treatment group and in 8.8% of the open reduction and internal fixation group. 5. There was no difference between the conservative treatment group and the open reduction and internal fixatlon group in non-union rate and delayed union rate.
Clinical Study ; Congenital Abnormalities ; Forearm ; Fracture Healing ; Methods ; Orthopedics ; Pronation ; Radius ; Supination ; Ulna

We report a case of eccrine adenocarcinoma in 65-year-old man who showed tender, painful, dark-brown colored, and verrucous surfaced tumor on the left neck for 18 months. Hisopathologic examination revealed large atypical cell masses with a tubular cystic, or adenoid pattern in the demis and it was difficult to differentiate from metastatic adenocarcinoma. Materials in the lumina revealed PAS positive, diastase resistant, alcian blue positive at pH 2.5 but negative at pH 0,4 Electron microscopy revealed that tumor cells contained secretory vacuoloes and microvilli projected into intercellular space. Around the cells, myoepithelial cell was seen. After radiotherapy and chemotherapy, tumor size was reduced transiently but 2 months later, tumor was more spread.
Adenocarcinoma* ; Adenoids ; Aged ; Alcian Blue ; Amylases ; Drug Therapy ; Extracellular Space ; Humans ; Hydrogen-Ion Concentration ; Microscopy, Electron ; Microvilli ; Neck ; Radiotherapy

No abstract available.

PURPOSE: To examine the effects, complications, and safeties of sclera allograft and amniotic membrane transplantation with fibrin glue as surgical treatment methods for scleromalacia. METHODS: The study included 14 eyes of 14 scleromalacia patients who needed surgical treatment. Among them, seven eyes of seven patients whose scleral defect was small (<6 mm) were operated on using only fibrin glue and no suturing, while seven eyes of seven patients whose defect was large (>6 mm) were operated on using fibrin glue and minimum suturing. Amniotic membrane transplantation was performed at the site of the conjunctival defect. RESULTS: In all of the cases, the results of grafting were successful throughout the follow-up period, which was 14.6+/-4.4 months, on average (ranging from 12 to 27 months). No particular complication was observed during the follow-up period after using fibrin glue. CONCLUSIONS: For scleromalacia patients, sclera allograft and amniotic membrane transplantation were performed using fibrin glue. The grafted sclera survived successfully, allowing this treatment modality to be considered an effective and safe option without complications.
Amnion ; Eye ; Fibrin ; Fibrin Tissue Adhesive ; Follow-Up Studies ; Humans ; Safety ; Sclera ; Transplantation, Homologous ; Transplants

PURPOSE: The purpose of the study was done to identify the nursing care needs of patients in the recovery room. METHOD: The subjects in this study were 127 patients in a recovery room between 6/9/2001 and 24/9/2001. The instrument used for this study was the descriptive questionnaire developed by Shin Hyun-Jin (1999). The data was analysed by frequency, percentage, mean, standard deviation, t-test, ANOVA, and factor analysis using the SPSS program. RESULT: 1) Kaiser-Meyer-Olkin sample appropriateness was 0.799 and Bartlett's test of sphericity significant probability was 0.000. 2) The mean score for nursing care need of patients in the recovery room was 4.17+/-.51 of a total possible score of 5. The score of nursing need for different parameters was as follows: Educational need (4.31+/-.49), physical need (4.27+/-.47), emotional need (4.11+/-.52), environmental need (3.99+/-.56). 3) Differences in the needs for nursing care according to the demographics were significant for gender, marital status, operation experience, and departments consulted. General characteristic variables significantly related to nursing need were as follows: Physical need significantly related to the departments consulted (F=2.23, p=.036). Educational need significantly related to the marital status (F=2.55, P=.012), departments consulted (F=2.30, p=.031). Emotional need significantly related to the marital status (F=2.22, p=.028). Environmental need significantly related to the gender (t=-2.44, p=.016), marital status (F=2.01, p=.046), operation experience (t=-1.99, p=.048). CONCLUSION: Nursing care needs of patients in the recovery room are significantly related to educational need, physical need, emotional need and environmental need. Intervention plans and program need to be developed to improve strategies to meet nursing needs of patients in the recovery room.
Demography ; Humans ; Marital Status ; Nursing Care ; Nursing* ; Surveys and Questionnaires ; Recovery Room*

BACKGROUND: Recently, there have been several case reports and retrospective studies about the incidence of intradiscal (ID) injection during transforaminal epidural steroid injection (TFESI). Inadvertent ID injection is not a rare complication, and it carries the risk of developing diskitis, although there has been no report of diskitis after TFESI. We prospectively evaluated the incidence of inadvertent ID injection during lumbar TFESI and analyzed the contributing factors. METHODS: Ten patients received 2-level TFESI, and the remaining 229 patients received 1-level TFESI. When successful TFESI was performed, 2 ml of contrast dye was injected under real-time fluoroscopy to check for any inadvertent ID spread. A musculoskeletal radiologist analyzed all magnetic resonance images (MRIs) of patients who demonstrated inadvertent ID injection. When reviewing MRIs, the intervertebral foramen level where ID injection occurred was carefully examined, and any anatomical structure which narrowing the foramen was identified. RESULTS: Among the 249 TFESI, we identified 6 ID injections; thus, there was an incidence of 2.4%. Four patients had isthmic spondylolisthesis, and the level of spondylolisthesis coincided with the level of ID injection. We further examined the right or left foramen of the spondylolisthesis level and identified the upward migrated disc material that was narrowing the foramen. CONCLUSIONS: Inadvertent ID injection during TFESI is not infrequent, and pain physicians must pay close attention to the type and location of disc herniation.
Discitis ; Fluoroscopy ; Humans ; Incidence ; Injections, Epidural* ; Magnetic Resonance Imaging ; Prospective Studies ; Spondylolisthesis

Systemic erythematous lupus is a systemic inflammatory autoimmune disease that develops from drug, viral, or chemical irritants. We report a case of lupus-like syndrome after kidney transplantation with an unknown cause. A 55-year-old woman was admitted with severe myalgia, fever, and arthralgia 2 days previously. She had received a kidney transplantation 8 years ago, because an acute kidney injury had progressed to chronic kidney disease. After transplantation, she had no problems. We performed blood, urine, and sputum cultures but could found no microorganisms. We suspected a connective tissue disease, such as adult Still's disease, and performed autoantibody testing. As a result, antinuclear antibody was positive, and we diagnosed her with lupus-like syndrome due to an unknown cause. We increased the prednisolone dose and her symptoms improved.
Acute Kidney Injury ; Adult ; Antibodies, Antinuclear ; Arthralgia ; Autoimmune Diseases ; Connective Tissue Diseases ; Female ; Fever ; Humans ; Irritants ; Kidney ; Kidney Transplantation ; Lupus Erythematosus, Systemic ; Middle Aged ; Prednisolone ; Renal Insufficiency, Chronic ; Sputum ; Transplants

Mycobacterium chelonae is a rapidly growing organism that has been found in water, soil, and dust. Although it can colonize healthy persons without sequelae, it can also cause skin and soft tissue infections, pulmonary infections and other sequelaes and rarely, disseminated disease in immunocompromised patients. But, infections due to rapidly growing mycobacteria are probably markedly underdiagnosed and these organisms are capable of causing a wide spectrum of clinical disease. We experienced a case of wound infection with M. chelonae after percutaneous endoscopic gastrostomy and report with review of literatures.
Colon ; Dust ; Gastrostomy* ; Humans ; Immunocompromised Host ; Mycobacterium chelonae* ; Mycobacterium* ; Skin ; Soft Tissue Infections ; Soil ; Wound Infection* ; Wounds and Injuries*

BACKGROUND: Micrognathia is the prime, constant bony finding that signals trouble for access to the airway. Anatomical factors of difficult tracheal intubation in micrognathia have been evaluated. METHOD: Forty one patients with micrognathia were divided into 3 groups based on modified Mallampati classification. Lateral cephalometric view taken preoperatively was used to measure 13 anatomical factors. Kruskal-Wallis test and discriminant analysis were used to select the most predictable factors for distinguishing between the difficult and easy groups. RESULTS: The most discriminating factors are mandibulo-hyoid distance(V12), atlanto-occipital distance(V10) and mentum-hyoid distance(V11). The discriminant analysis using above 3 factors gives the following discriminant functions(Y1= 0.7924(V12) - 0.2154(V10) - 0.3531(V11) (discriminant function 1), Y2= -0.2177(V12) + 0.8221(V10) -0.6304(V11) (discriminent fuction 2)) and the discriminating power of difficult intubation is 72.9%. CONCLUSIONS: Modified Mallampati classification and lateral cephalometric assessment of 3 anatomical factors can predict the difficult intubation.
Classification ; Humans ; Intubation*

In order to observe the changes in left ventricular function during coronary artery occlusion and reperfusion, left anterior descending (LAD) coronary arteries in the anesthetized dogs were occluded for 1 hour and then reperfused for 4 hours. Hemodynamic indexes of global systolic and diastolic function and regional wall thickness changes as a regional contractile index were measured during occlusion and reperfusion. The results were as follows; 1) Indexes of global systolic function (left ventricular peak systolic pressure, peak positive dP/dt) and global diastolic function (peak negative dP/dt, time constant, left ventricular end-diastolic pressure) showed deterioration in early occlusion period (10-30 minutes) but gradually improved even if coronary occlusion persisted. Reperfusion did not induce significant changes except that peak positive dP/dt transiently deteriorated 30 minutes after reperfusion and left ventricular end-diastolic pressure decreased 1.5-2 hours after reperfusion. 2) Indexed of regional function (i.e, end-diastolic thickness and % systolic thickening of anterior left ventricular wall) deteriorated by 10 minutes' occlusion which persisted during the entire occlusion period. Reperfusion induced no significant improvement in regional contractile function compared with occlusion 60 minutes' data, which suggested reperfusion for 4 hours after 1 hour's LAD occlusion may be insufficient for the ischemic region to recover its contractility. 3) Reperfusion arrhythmia (ventricular tachycardia) was noted in most (6/9) of the dogs, one of which deteriorated into ventricular fibrillation and the others spontaneously converted to normal sinus rhythm.
Animals ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Hemodynamics ; Reperfusion* ; Ventricular Fibrillation ; Ventricular Function, Left*