No abstract available.
Spondylolisthesis*

This study was performed to identify the level of stress recognized by the parents as a support system for their infant patients who were hospitalized in an emergency department, thus to provide the resulting data as the basic material of care intervention for the families of infant patients. This study subjected the parents with infant patients who were hospitalized in emergency department of C University Hospital in Daejeon, and the data was collected from questionnaires for them, dating from Mar. 20, to Jun. 24, 2001 This study used the tool(30 questions) which was originally developed by Ji, Dong-ok (1992) for measuring the stress of families of infant patients in emergency room, and then was modified and complemented by this researcher suitably for infant patients. Collected data was statistically analyzed with frequency, percentage, mean, standard deviation, t-test, ANOVA, by using SPSS WIN10.0 program, and the results were as follows: 1. The stress of parents with infant patients hospitalized in emergency department averaged 3.31 on the basis of 5-point measure, which means that they felt stress beyond means. 2. The factor with high average out of stress factors the parents of infant patients recognized included the followings: 'about the pain of infant patients due to examination(3.91 +/- 1.00)'; 'about rare opportunity to be in contact with physician(3.78 +/- 1.09)'; 'delay in emergent treatment required for infant patients(3.75 +/- 1.31)'; 'delay in the general treatment of infant patients(3.72 +/- 1.32)'. Factors of the stress level includes the followings: 'care and medical treatment'(3.46 +/- .72); 'body and diseases'(3.41 +/- .97)'; 'lack of information and supportable resources (3.25 +/- .77)'; and so on. 3. For the stress level according to general characteristics, there were statistically significant differences in the result of the condition of infant patients, medical treatment(P < .01), religion, the procedure of treatment(P < .05). With little preceding studies for infant patients hospitalized in emergency department, this study looked through the level of stress recognized by the parents of infant patients. Based on the comprehension on the parents with infant patients and the knowledge on stress factors recognized by the parents, it is expected that we can seek the methods of care intervention such as explanation of care and treatment procedures, unit policies, continuous interest and emotional supports as well as the provision of information to understand the responses of parents and reduce accompanied stresses.
Complement System Proteins ; Comprehension ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Infant ; Parents* ; Child Health ; Surveys and Questionnaires

The ankle, which at times bears up to five times the body weight, is the most congruous joint of the lower extremity. Recently, importance of early joint motion and weight bearing after anatomical reduction & rigid internal fixation of the displaced ankle fracture was emphasized. Therefore, we studied prospectively, fifty-two patients with displaced ankle fractures admitted to the Department of Orthopedic Surgery, Severance hospital during a period of 4 years from January 1985 to December 1988. In fifty-two patients, group I (24 cases)were treated with early joint motion and weight bearing without cast immobilization and group II (28 cases) were treated with cast immobilization for long duration after open reduction and rigid internal fixation. The result of an average 15 months follow up of these patients were as follows. l. In displaced ankle fracture, early recovry of joint motion was obtained in early joint motion and weight bearing group after accurate anatomical reduction and rigid internal fixation. 2. In clincal evaluation, 95.8% resulted to satisfactory in group I, whereas 85.8% in group II. 3. In radiologic evaluation, 95.8% resulted to satisfactory in group I, whereas 82.1% in group II. 4. In lateral malleolar fracture, accurate reduction and fixation with plate and screws was important. 5. Syndesmotic ligament should be repaired and weight bearing was allowed without removal of transfixing screw. 6. Reduction of lateral malleolus made reduction and fixation of medial malleolus easy, and thus maintaining talar tilt angle. 7. Anatomical repair of deltoid ligament was needed for stability of ankle joint and prevention of local degenerative change.
Ankle Fractures ; Ankle Joint ; Ankle ; Body Weight ; Follow-Up Studies ; Humans ; Immobilization ; Joints ; Ligaments ; Lower Extremity ; Orthopedics ; Prospective Studies ; Weight-Bearing

There have been rare reports of damage to the blood vessels surrounding the bile duct during the gallstone removal process, causing hemobilia. In cases of severe hemobilia with unstable vital signs, insertion of a fully covered self-expanding metallic stent (SEMS) may be considered as salvage therapy. This case reports a patient with common bile duct stones and acute cholangitis who developed massive hemobilia during attempts to resolve basket device incarceration by performing mechanical lithotripsy. Endoscopic hemostasis was successfully achieved by insertion of a SEMS. However, during follow-up, the stent distally dislocated, resulting in rebleeding with a pseudoaneurysm in the surrounding blood vessels. Ultimately, hemostasis failed despite vascular intervention and additional hemostatic procedures, leading to death. Even if a stent is inserted in an appropriate location, hemostasis may not be achieved well, and if the stent migrates, hemobilia may worsen, so close monitoring is required to determine whether bleeding occurs again.

There have been rare reports of damage to the blood vessels surrounding the bile duct during the gallstone removal process, causing hemobilia. In cases of severe hemobilia with unstable vital signs, insertion of a fully covered self-expanding metallic stent (SEMS) may be considered as salvage therapy. This case reports a patient with common bile duct stones and acute cholangitis who developed massive hemobilia during attempts to resolve basket device incarceration by performing mechanical lithotripsy. Endoscopic hemostasis was successfully achieved by insertion of a SEMS. However, during follow-up, the stent distally dislocated, resulting in rebleeding with a pseudoaneurysm in the surrounding blood vessels. Ultimately, hemostasis failed despite vascular intervention and additional hemostatic procedures, leading to death. Even if a stent is inserted in an appropriate location, hemostasis may not be achieved well, and if the stent migrates, hemobilia may worsen, so close monitoring is required to determine whether bleeding occurs again.

There have been rare reports of damage to the blood vessels surrounding the bile duct during the gallstone removal process, causing hemobilia. In cases of severe hemobilia with unstable vital signs, insertion of a fully covered self-expanding metallic stent (SEMS) may be considered as salvage therapy. This case reports a patient with common bile duct stones and acute cholangitis who developed massive hemobilia during attempts to resolve basket device incarceration by performing mechanical lithotripsy. Endoscopic hemostasis was successfully achieved by insertion of a SEMS. However, during follow-up, the stent distally dislocated, resulting in rebleeding with a pseudoaneurysm in the surrounding blood vessels. Ultimately, hemostasis failed despite vascular intervention and additional hemostatic procedures, leading to death. Even if a stent is inserted in an appropriate location, hemostasis may not be achieved well, and if the stent migrates, hemobilia may worsen, so close monitoring is required to determine whether bleeding occurs again.

There have been rare reports of damage to the blood vessels surrounding the bile duct during the gallstone removal process, causing hemobilia. In cases of severe hemobilia with unstable vital signs, insertion of a fully covered self-expanding metallic stent (SEMS) may be considered as salvage therapy. This case reports a patient with common bile duct stones and acute cholangitis who developed massive hemobilia during attempts to resolve basket device incarceration by performing mechanical lithotripsy. Endoscopic hemostasis was successfully achieved by insertion of a SEMS. However, during follow-up, the stent distally dislocated, resulting in rebleeding with a pseudoaneurysm in the surrounding blood vessels. Ultimately, hemostasis failed despite vascular intervention and additional hemostatic procedures, leading to death. Even if a stent is inserted in an appropriate location, hemostasis may not be achieved well, and if the stent migrates, hemobilia may worsen, so close monitoring is required to determine whether bleeding occurs again.

There have been rare reports of damage to the blood vessels surrounding the bile duct during the gallstone removal process, causing hemobilia. In cases of severe hemobilia with unstable vital signs, insertion of a fully covered self-expanding metallic stent (SEMS) may be considered as salvage therapy. This case reports a patient with common bile duct stones and acute cholangitis who developed massive hemobilia during attempts to resolve basket device incarceration by performing mechanical lithotripsy. Endoscopic hemostasis was successfully achieved by insertion of a SEMS. However, during follow-up, the stent distally dislocated, resulting in rebleeding with a pseudoaneurysm in the surrounding blood vessels. Ultimately, hemostasis failed despite vascular intervention and additional hemostatic procedures, leading to death. Even if a stent is inserted in an appropriate location, hemostasis may not be achieved well, and if the stent migrates, hemobilia may worsen, so close monitoring is required to determine whether bleeding occurs again.

The purpose of this study was to compare the marginal fit of all ceramic crowns prepared from alumina slip casting, which is consistent with the conventional In-ceram system, and those fabricated from alumina tapes which is currently under development in an effort to alleviate complexities involved in the forming procedure of the In-ceram crown core. All ceramic crowns, made of In-ceram(slip casting) and alumina tapes(Doctor blade casting), were prepared with 90degreeand 135degreeshoulder margins. The crowns were cemented with a glass ionomer cement and embeded in epoxy resin. The embedded crowns were sectioned faciolingually and mesiodistally and marginal discrepancies and marginal gaps were measured under the Measurescope MM II. The measurements were analyzed using Wilcoxon rank sum test and Kruskal-Wallis test and the results were as follows: 1. In the case of 90degreeshoulder margin, the combined marginal discrepancies and marginal gaps were 78.3 micrometerm and 44.4 micrometer respectively, for the all ceramic crowns fabricated using the alumina tapes. In comparison, the values were 65 micrometer and 25.5 micrometer for the In-ceram crowns. For the marginal gaps a statistical difference existed (p<0.05) but no significant difference was observed for the marginal discrepancy (p>0.05). 2. In the case of 135degreeshoulder margin, the combined marginal discrepancy and marginal gaps were 82.1 micrometer and 40.2 micrometer respectively, for the all ceramic crowns formed with the tapes. As compared with the marginal discrepancy and gaps of the 90degreeshoulder margin in the fabricated from the alumina tapes, no significant statistical differencies were discerned in both cases (p>0.05). 3. There was no statistically significant difference in the fits among four locations around the margins of the all ceramic crowns fabricated using the alumina tapes. The results obtained in this study showed that the marginal fits of the glass infiltrated alumina cores fabricated from the alumina tapes are slightly higher value than those prepared using the In-ceram but the difference is within a clinically acceptable range.
Aluminum Oxide* ; Ceramics ; Crowns ; Glass Ionomer Cements ; Glass*

Hepatic artery pseudoaneurysm is a rare but potentially life-threatening condition that usually occurs after trauma. Early recognition and prompt management are essential for preventing catastrophic consequences, such as hemoperitoneum. We report a rare case of liver abscess caused byKlebsiella oxytoca resulting in hepatic artery pseudoaneurysm without iatrogenic injury. The unique feature of the present case is that the abscess cavity itself became a pseudoaneurysm as a result of fistula formation with the hepatic artery. Vascular complications should be considered in patients with unfavorable clinical course even in the absence of iatrogenic injury. Endovascular treatment is safe and effective.