The management of fractures of the intercondylar eminence of the tibia is uncomplicated when the fracture has minimal displacement(type I) or when only anterior one-third or half of the eminence is elevated(type II)(Meyers and Mckeever 1959, 1970). The treatment of complete separation(type III) has been controversial. Many authors however recommended conservative treatment even for the completely separated fracture if the fracture fragment is not rotated. Two cases of non-union of the tibial spine fracture we experienced were; one in type IIl, and the other type II. They were treated conservatively by cast immobilization. One patient had severe anterolateral rotatory.instability and had lateral meniscal tear, and the other had transverse ligament impingement at the fracture gap which interfered the reduction of the fragment and also bony union. Through the clinical experience and the two listed non-union cases, we drafted a therapeutic plan for the avulsed tibial spine fractures. The authors recommend open reduction and internal fixation of the avulsion fracture of the tibial spine in following circumstance; 1) all of the type K complete separation injuries 2) tibial spine fracture with positive Lachman test and soft end point 3) fracture with associated ligament injury. We applied the above surgical indications for 13 cases. The authors reviewed 25 cases of the anterior tibial spine fracture patients treated at the Department of Orthopaedic Surgery, Catholic Unviersity Medical College during the period from October 1982 to August 1986 and the following results were obtained. 1. The cases were classified into 3 different categories according to the Meyers and Mckeever classification; Type I(7 cases, 29%), Type II(10 cases, 40%), Type III(8 cases, 31%). 2. Associated ligament injuries on the same knee were rupture of LCL for 7 cases(28%) and MCL for 6 cases(24%). 3. Twelve out of thirteen open reduction and internal fixation cases had excellentresult in minimum 6 months follow-up period.
Classification ; Follow-Up Studies ; Humans ; Immobilization ; Knee ; Ligaments ; Rupture ; Spine ; Tears ; Tibia

With the increasing use of pedicular system to fix the spine, many complications are being reported. Recently many systems are available to fix the spine. However, each system has own advantages and disadvantages. The causes of metallic failure of Modular Segmental Spinal (MOSS) instrumentation on 42 consecutive patients undergone in Kang-Nam St. Mary's hospital since 1989 were reviewed. The specific aim of this investigation was to assess causes of metallic failure and loosening of this system on various spinal disorders. Of these, 8 cases had metallic failure and loosening. Breakage of screw and rod developed in 6 cases and dislodgement of rod from screw in 2 cases. In case of degenerative spondylolisthesis (unstable phase) with stenosis, however, the complications were closely correlated to expansile decompressive laminectomy to widen the narrowed spinal canal and the instrumental distraction to gain normal intervertebral disc space at the operation. Bony union and back pain were not correlated to metallic failure and loosening. Therefore, the main causes of metallic failure and loosening were (1) preoperative instability undergone expansile decompressive laminectomy including total bilateral facetectomy that aggravated preoperative instability, and (2) forceful instrumental dis traction. In cases needed these requirements, combined anterior interbody fusion or posterior interbody fusion should be added, heavier rods and screws larger than 3.5mm, 4.0mm in diameter, respectively, should be used. In addition to postoperatively sufficient bed rest and immobilization using rigid braces should be recommended to reduce these complications.
Back Pain ; Bed Rest ; Braces ; Constriction, Pathologic ; Humans ; Immobilization ; Intervertebral Disc ; Laminectomy ; Spinal Canal ; Spine ; Spondylolisthesis ; Traction

Purpose: The purpose of this study was to develop and verify the effectiveness of the home-based exercise program for prevention of sarcopenia in hemiplegic disorder patients. Methods: The participants consisted of 26 experimental group and 26 control group with hemiplegic disorders. The home-based exercise program to prevent sarcopenia was conducted twice a week and for six weeks from 11 January 2021 to 19 April 2021, measuring muscle mass, muscular strength, daily life movements, balance, dynamic posture control ability and quality of life. Results: The results showed the effectiveness of the home-based exercise program for hemiplegic patients.There were statistically significant differences between the control group and experimental group in patients’ muscle mass (F=8.26, p=.006), muscle strength (F=7.99,p=.007) and quality of life (F=12.19, p=.001). But, there were not statistically significant in patients’ daily life movements (F=0.33, p=.565), balance (F=0.04, p=.841) and dynamic posture control ability (F=3.48, p=.068). Conclusion In conclusion, the home-based exercise program was effective in improving muscle mass, muscle strength and quality of life in hemiplegic patients. Therefore, it is expected that the home-based exercise program developed in this study will be applied as an intervention for prevention of sarcopenia in hemiplegic patients and will be effective.

BACKGROUND: The purpose of this study was to find out the effect of hypnotics and analgesics on oxygen saturation by pulse oximetry in surgery patients under spinal anesthesia. METHODS: Sixty-five patients classified ASA physical status 1 or 2 scheduled for surgery under spinal anesthesia were studied. These patients were divided into three groups. The 22 subjects of the first group did not receive either midazolam or fentanyl. The 22 subjects of the second group received midazolam. The 21 subjects of the third group received midazolam (0.03 mg/kg) and fentanyl (1.0 microgram/ kg). Oxygen saturation was measured with a pulse oximetry. Measurements were made before spinal anesthesia, 5 minutes, and 10 minutes after starting of spinal anesthesia, 5 minutes, 10 minutes, 30 minutes, and 60 minutes after the start of the operation or intravenous injection of drugs. In addition, measurements were made on arrival in the recovery room, and 5 minutes, 10 minutes, 20 minutes, and 30 minutes after arrival in the recovery room. RESULTS: There were statistically significant differences in oxygen saturation at 5 minutes after the start of the operation or intravenous injection of drugs. The mean oxygen saturation for the first group was 98.2 +/- 1.8%, for the second group 97.9 +/- 2.6%, and for the third group 92.4 +/- 2.8%. Hypoxia cases at 5 minutes after the start of the operation or intravenous injection of a drug occurred in 4.5% of the first group, 9.1% of the second group, and 57.1% of the third group CONCLUSIONS: We concluded that oxygen saturation monitoring should be done routinely in patients receiving hypnotics and analgesics during spinal anesthesia, and oxygen should be administered to patients who develope hypoxia during spinal anesthesia.
Analgesics* ; Anesthesia, Spinal* ; Anoxia* ; Fentanyl ; Humans ; Hypnotics and Sedatives* ; Incidence* ; Injections, Intravenous ; Midazolam ; Oximetry ; Oxygen ; Recovery Room

BACKGROUND: Healthy cities of Korea have engaged in various activities regarding the Korea Healthy Cities Partnership, and research activities on healthy cities is one of the important area. In the present context, due to the current policy to pursue Sustainable Development Goals locally and globally, it is essential to emphasize the importance of healthy city. Therefore, it is important to identify the research trend related to healthy city. The aim of this study was to find out research trend of healthy city studies from 1990 to 2014 by reviewing published papers and studies systematically. Based on the finding of the study, the necessary implications on future research directions of the healthy city are obtained. METHODS: The area of this study is domestic journal (Korea), international journal, thesis, and research report focusing on healthy city from 1990 to 2014. The selection of data was performed using keyword is based on domestic and international database. The analysis criteria were divided into year of publication, type of study, subjects, study methods, and study area. RESULTS: One hundred twenty papers were selected for the analysis. Papers related to the healthy city issue were published 4.8 times in an average in a year during that the period. However, the number of papers published increased dramatically in the recent 4 years. Of total, 28 papers (44.4%) focused on the healthy city policy and urban environmental improvement, 18 papers (28.6%) focused on health promotion, and the remaining were program centered. Most papers (71 out of 120) used quantitative study methods. Of total studies, studies have conducted in Jinju city (9), Wonju city (8), Changwon city (6) and Gangnam-gu (5), respectively, as a study area of healthy city. CONCLUSION: First, domestic healthy city researches has been gradually increasing every year, over the past 10 years which has heightened interest in healthy cities. Second, the expansion of the various areas of research is required in order to contribute to future sustainable healthy city. Third, in recent years, by taking advantage of a variety of research methods, conducting the qualitative and mixed method research is considered to be a desirable change.
Gangwon-do ; Gyeongsangnam-do ; Health Promotion ; Korea* ; Natural Resources ; Publications ; Research Report

The number of latex-induced allergic reactions, including anaphylaxis, has been increasing since latex induced contact urticaria was first reported in surgical patients by Nutter in 1979. Latex allergy is frequently seen in the healthcare industry, and is associated with systemic symptoms, hand eczema, and allergic contact dermatitis. Reactions range from contact urticaria, rhinitis and conjunctivitis, angioderma or bronchospasm to the recently recognized severe anaphylactic shock with cardiovascular collapse. We encountered a 55-year-old female patient who developed a severe anaphylactic reaction after manual vetilatory support using a facemask that contained latex. A subsequent allergy workup revealed a delayed-type hypersensitivity to latex. This case highlights the need for anesthesiologists to be able to diagnose the signs and symptoms of allergic reactions in patients during the peri-anesthetic period. Two types of allergic reactions to natural rubber latex (NRL) and rubber products are now known to exist: type I (immediate-type) and type IV (delayed-type hypersensitivity [DTH]). Patients with NRL allergy should be provided with information on non-latex devices and latex avoidance in medical, dental, and occupational settings. In addition, we should pay more attention to the management of allergic reactions to latex in high risk groups.
Anaphylaxis ; Bronchial Spasm ; Conjunctivitis ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Eczema ; Female ; Hand ; Health Care Sector ; Humans ; Hypersensitivity ; Latex ; Latex Hypersensitivity ; Masks ; Middle Aged ; Rhinitis ; Rubber ; Urticaria

BACKGROUND: This randomized, double-blinded clinical study was designed to evaluate the efficiency and safety of remifentanil with ketorolac for IV PCA after laparoscopic-assisted vaginal hysterectomy. METHODS: Eighty patients were randomly allocated into four groups. Group R received IV PCA using only remifentanil at a basal rate of 0.025 microg/kg/min and a bolus of 0.375 microg/kg. Group RK1 received IV PCA using remifentanil at a basal rate of 0.015 microg/kg/min and a bolus of 0.225 microg/kg. Group RK2 received IV PCA using remifentanil at a basal rate of 0.0075 microg/kg/min and a bolus of 0.1125 microg/kg. Group F received IV PCA using fentanyl at a basal rate of 0.3 microg/kg/h and a bolus of 0.075 microg/kg. In addition, ketorolac at a basal rate of 0.04 mg/kg/h and a bolus of 0.01 mg/kg was added to Group RK1, RK2, and F. All PCA conditions had a lock out period of 15 minutes. Pulse rate, systolic and diastolic BP, sedation score, visual analogue scale (VAS), and PONV score were recorded at 1, 3, 6, 12, and 24 hours after the operation. Total opioid use and the patients' number for rescue analgesic drug were also collected. RESULTS: The groups did not differ in PONV score and hemodynamic changes. The VAS in Group RK2 was high compared with the other groups. In addition, the sedation score was high in Group R. CONCLUSIONS: The additional ketorolac administration in remifentanil IV PCA had remifentanil sparing effects and reduced sedation among the side effects. Further studies will be needed to evaluate the precise and adequate dosage of ketorolac.
Analgesia, Patient-Controlled ; Female ; Fentanyl ; Heart Rate ; Hemodynamics ; Humans ; Hysterectomy, Vaginal ; Ketorolac ; Passive Cutaneous Anaphylaxis ; Piperidines ; Postoperative Nausea and Vomiting

Refractory status epilepticus is defined as seizure activity that continues after treatment with conventional anticonvulsants. An 8-month-old male had an operation for repair of small bowel perforation, and he suffered a febrile seizure that developed into refractory status epilepticus. Febrile seizure is the most common etiology for children with status epilepticus. We report here on a case of a patient with refractory status epilepticus, and he was managed with sevoflurane, an inhalational anesthetic. The patient was given an inspired concentration of 0.6-2 vol% sevoflurane for 15 days. After stopping of sevoflurane inhalation, he continued to experience intermittent convulsive status epilepticus that was successfully managed with using conventional anticonvulsants.
Anticonvulsants ; Child ; Humans ; Infant ; Inhalation ; Male ; Seizures ; Seizures, Febrile ; Status Epilepticus*

A cross-sectional study was conducted to assess the association between perceived occu-pational psychosocial stress at work and the work-related musculoskeletal disorders (WRMSD) among employees using video display terminals. The study included 111 female telecommunication employees from three companies at ChungBuk province. Cases of WRMSD were defined using symptom questionnaire and physical examination conducted by rehabilitation specialist. Information on demographics, individual factors, and perceived psychosocial stress, were obtained by self-administered questionnaire. For assessing perceived psychosocial stress, we used variables from 'job strain model' proposed by Karasek. Associations between perceived psychosocial stress and WRMSD were assessed by multiple logistic regression models. Forty nine (44% to the total) subjects met our operational definition for WRMSD. Age, seniority, housing load were not associated with WRMSD. Perceived psychosocial stress was associated with WRMSD [odds ratio=3.28, 95% confidence interval: 1.05-10.19]. This study suggests that perceived occupational psychosocial stress is related to the prevalence of WRMSD.
Chungcheongbuk-do ; Computer Terminals* ; Cross-Sectional Studies ; Demography ; Female ; Housing ; Humans ; Logistic Models ; Physical Examination ; Prevalence ; Questionnaires ; Rehabilitation ; Specialization ; Telecommunications