PURPOSE: Congenital limb anomalies are manifested in various degree of severity and complexity bearing confusion for description and nomenclature of each anomaly. We retrospectively analyzed the roentgenograms of congenital limb anomalies for the purpose of further understanding of radiologic manifestations based on the embryonal defect and also to find the incidence of each anomaly. MATERIALS AND METHODS: Total number of the patients was 89 with 137 anomalies. Recently the uniform system of classification for congenital anomalies of the upper limb was adopted by International Federation of Societies for Surgery of the Hand (IFSSH), which were categorized as 7 classifications. We used the IFSSH classification with some modification as 5 classifications;failure of formation of parts, failure of differentiation of parts, duplications, overgrowth, and undergrowth. RESULTS: The patients with upper limb anomalies were 65 out of 89(73%), lower limb were 21(24%), and both upper and lower limb anomalies were 3(4%). Failure of formation was seen in 18%, failure of differentiation 39%, duplications 39%, overgrowth 8%, and undergrowth in 12%. Thirty-five patients had more than one anomaly, and 14 patients had intergroup anomalies. CONCLUSION: The upper limb anomalies were more common than lower limb. Among the anomalies, failure of differentiation and duplications were the most common types of congenital limb anomalies. Patients with failure of formation, failure of differentiation, and undergrowth had intergroup association of anomalies, but duplication and overgrowth tended to be isolated anomalies.
Classification ; Extremities* ; Hand ; Humans ; Incidence ; Lower Extremity ; Retrospective Studies ; Upper Extremity

Although many reports have been published about Legg-Calve-Perthes disease, developmental dysplasia of hip, it is difficult to gain a satisfactory results in treatment. We experienced 9 year-old girl with ipsilateral neglected DDH combined with contralateral LCPD, and treated with Klisic operation for DDH and femoral valgus osteotomy for hinged abduction of LCPD. We gained satisfactory results and report this rare case.
Child ; Female ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Osteotomy

In the case of brachial plexus block, mixtures of local anesthetics can combine better features of both components, rapid onset and long duration. Combining effects may influence the onset and duration of neural blockade. Our study was undertaken in order to compare the onset time (time of injection to time of loss of pain on pin prick) and duration of analgesia (time of return of sense of pain on pin prick minus time required for onset of analgesia) of a lidocaine and bupivacaine mixture with 5 minutes interval injection of lidocaine and bupivacaine. The patients admitted to our hospital for hand or forearm operations were divided into three groups. In Group 1, 9 patients were injected with 0.5% bupivacaine 150 mg only, in Group 2, 11 patients were injected with a mixture of 29: lidocaine 200 mg and 0.5% bupivacaine 100 mg, in Group 3, 10 patients were injected with 2% lidocaine 200 mg and 5 minutes later, 0.5% bupivacaine 100 mg was injected through the same needle. Group 3 had the shortest onset time (7.2+/-0.2 minutes) with moderately long duration (9.4+/-2.4hours). Group 2 had a moderately rapid onset time (9.4+/-2.3 mintes) with the shortest duration (8.6+/-1.6 hours). Group 1 had the slowest onset time (14.8+/-4.3 minutes) with the longest duration (11.3+/-2. 4 hours). The time for analgesia to reach the C7 dermatome was the slowest in group 1 and Group 2, but in Group 3, there was no difference in the time needed to achieve analgesia in all dermatomes.
Analgesia ; Anesthetics, Local* ; Brachial Plexus ; Bupivacaine ; Forearm ; Hand ; Humans ; Lidocaine ; Needles

Insulinoma is a functional endocrine tumor arising from the beta cells of islets of Langerhans of pancreas. The only effective treatment of insulinoma was surgical removal of the tumor. Recently, laparoscopic surgery for islet cell tumors of the pancreas is introduced. Laparoscopic enucleation or resection of benign islet tumors results in a shorter hospital recovery and is a good alternative to open surgery We report a case of insulinoma that was treated sucessfully by laparoscopic enucleation.
Adenoma, Islet Cell ; Insulinoma* ; Islets of Langerhans ; Laparoscopy ; Pancreas

BACKGROUND: Through change in the climate and living environment, bacterial pathogens that cause diarrhea also change. This study sought to determine the characteristics of pathogens according to species, isolated region, and patient age/sex using National Surveillance Data for diarrhea, and to provide basic data for the prevention of diarrheal disease. METHODS: From January to December 2012, stool specimens were collected from 21,180 diarrheal patients in Korea to identify the pathogenic bacteria involved. Pathogenic bacteria were analyzed according to isolated region and patient age/sex. Identification and analysis of the pathogens were conducted based on the Guidelines of the National Institute of Health Diagnostic Laboratory: Disease-specific protocol (2005). RESULTS: Among the 21,180 stool specimens, pathogenic bacteria known to cause diarrhea were isolated from 2,444 stool specimens (11.5%). The isolation rate was highest in the summer (from June to September) for most pathogenic bacteria, except Escherichia coli, Staphylococcus aureus, and Clostridium perfringens. The isolation rate of pathogenic bacteria based on patient age was highest in children under the age of 10. CONCLUSION: Hygiene education should be addressed in diarrheal disease-susceptible groups, such as children under 10, people in their 50s, and those greater than 70 years old, and ongoing monitoring for pathogens is needed. In addition, an efficient information system and surveillance program should be continued for infection prevention.

BACKGROUND: The laryngeal tube is a variant of the esophageal obturator airway. We compared laryngeal tube (LT), laryngeal mask airway classicTM (LMA) and laryngeal mask airway ProsealTM (PLMA) as a airway management device during general anesthesia. METHODS: Forty-five fasted healthy adult patients were enrolled in this study into one of three groups in a randomized, single-blinded protocol. Group 1 was to receive LT for airway management, LMA for Group 2, and PLMA for Group 3. General anesthesia was induced identically in three groups with thiopental sodium 5 mg/kg followed rocuronium 0.6 mg/kg. 90 seconds later, LT, LMA or PLMA was placed for airway management. Blood pressure and heart rate were measured immediately pre-induction control value, post-insertion of device 0 min, 1 min, 3 min and 5 min. We also compared times of insertion, the amounts of secretion, blood stain, and postoperative sore throat. RESULTS: There was no significant change of SBP, DBP and HR within three groups. All the groups showed stable hemodynamic results. The success rate on the first attempt was 93.6% (14/15, Group 1), 93.6% (14/15, Group 2) and 86.6% (13/15, Group 3). Minimum cuff volume to prevent gas leakage was 69.9+/-0.5 ml (Group 1), 11.1+/-4.3 ml (Group 2) and 11.9+/-3.2 ml (Group 3). The corresponding cuff pressure was 61.6+/-22.0 cmH2O (Group 1), 4.8+/-0.9 cmH2O (Group 2) and 4.6+/-1.5 cmH2O (Group 3). Moderate, severe sore throat was 20% (3/15, Group 1), 6.6% (1/15, Group 2) and 6.6% (1/15, Group 3). Moderate, profuse secretion was 40% (6/15, Group 1), 20% (3/15, Group 2) and 13.3% (2/15, Group 3). There was a 20% (3/15, Group 1) and 13.3% (2/15, Group 3) blood stain. But there was no blood stain for the Group 2. There was a 20% (3/15) gas leakage in Group 1, so we had to insert gas intermittently, but there were no gastric distension, regurgitation, aspiration, hypoxia, airway obstruction and laryngospasm in all three groups. CONCLUSIONS: All the groups revealed stable hemodynamics, no serious complications such as regurgitation, aspiration, hypoxia and airway obstruction during general anesthesia. But we did not find any evidence that LMA and PLMA have the remarkable advantages than laryngeal tube. So we suggested that laryngeal tube could be an alternative airway management device, even though further study will be needed.
Adult ; Airway Management ; Airway Obstruction ; Anesthesia, General* ; Anoxia ; Blood Pressure ; Blood Stains ; Heart Rate ; Hemodynamics ; Humans ; Laryngeal Masks* ; Laryngismus ; Pharyngitis ; Thiopental

The laryngeal mask as an new form of airway has recently been described. This mask is introduced blindly into the hypopharynx to form a seal around the larynx, so permitting spontaneous or positive pressure ventilation without passing the larynx, therefore associated with much reduced incidence of laryngeal damage. But endotracheal intubation is associated with a significant rate of layngeal damage and subsequent vocal cord pathology. This study was designed to investigate the effects of postoperative sore throat related to insertion of laryngeal mask airway and to compare with these effects after endotracheal intubation. One hundred randomly selected female patients who had gynecological procedures under general anesthesia were surveyed to ascertain the incidence of sore throats. The results were as follows; l) The incidence of sore throat after endotracheal intubation with the Portex tube was 48% but 12% after insertion of laryngeal mask. 2) The average volume of air required to inflate the cuff of laryngeal mask sufficiently to form air-tight seal around larynx was 11.4+/-2.8ml and cuff pressure was 25.6+/-13.2cmH2O when the laryngeal mask 3 was used for Korean adult female.
Adult ; Anesthesia, General ; Female ; Humans ; Hypopharynx ; Incidence* ; Intubation, Intratracheal ; Laryngeal Masks* ; Larynx ; Masks ; Pathology ; Pharyngitis* ; Positive-Pressure Respiration ; Vocal Cords

The laryngeal mask as an new form of airway has recently been described. This mask is introduced blindly into the hypopharynx to form a seal around the larynx, so permitting spontaneous or positive pressure ventilation without passing the larynx, therefore associated with much reduced incidence of laryngeal damage. But endotracheal intubation is associated with a significant rate of layngeal damage and subsequent vocal cord pathology. This study was designed to investigate the effects of postoperative sore throat related to insertion of laryngeal mask airway and to compare with these effects after endotracheal intubation. One hundred randomly selected female patients who had gynecological procedures under general anesthesia were surveyed to ascertain the incidence of sore throats. The results were as follows; l) The incidence of sore throat after endotracheal intubation with the Portex tube was 48% but 12% after insertion of laryngeal mask. 2) The average volume of air required to inflate the cuff of laryngeal mask sufficiently to form air-tight seal around larynx was 11.4+/-2.8ml and cuff pressure was 25.6+/-13.2cmH2O when the laryngeal mask 3 was used for Korean adult female.
Adult ; Anesthesia, General ; Female ; Humans ; Hypopharynx ; Incidence* ; Intubation, Intratracheal ; Laryngeal Masks* ; Larynx ; Masks ; Pathology ; Pharyngitis* ; Positive-Pressure Respiration ; Vocal Cords

PURPOSE: The purpose of this study was to analyze trends in complementary and alternative therapy in nursing research in Korea. METHOD: The researchers examined academic theses and dissertations published from 1990 to 2002, and 151 articles were used for the analysis. RESULT: Nursing research on CAT increased rapidly from 1995. Articles with quantitative research designs made up 93.9% of the total and there were more experimental studies than non-experimental studies. Patients who had surgery, mental disorders, renal failure, hypertension, arthritis, dementia & cancer were the most frequently participants in studies on CAT. The type of CAT used in nursing research were mind-body therapy (65.8%), manual healing therapy (28.7%), phamacologic & biological therapy (3.7%), bioelectromagnetics (0.9%) and herbal therapy (0.9%). In 44 articles both psychological and physiological parameters were used as dependent variables. In 34 articles only physiological parameters were used and in 13 only psychological parameters. The most frequently used physiological parameters in CAT were pain, physiological function and vital signs, while the most used psychological parameters were anxiety, depression and stress. CONCLUSION: More studies about CAT are needed to extend the role and fields for professional nursing. There is a need to conduct qualitative studies in nursing about the experiences of patients who receive CAT and nurses who use CAT.
Animals ; Anxiety ; Arthritis ; Biological Therapy ; Cats ; Dementia ; Depression ; Humans ; Hypertension ; Korea* ; Mental Disorders ; Mind-Body Therapies ; Nursing Research* ; Nursing* ; Phytotherapy ; Renal Insufficiency ; Research Design ; Vital Signs

BACKGROUND: Preemptive analgesia is an antinociceptive treatment that prevents the establishment of central sensitization, which amplifies the postoperative pain. In this study, we investigated the preemptive effect of local infiltration of bupivacaine on postoperative pain after inguinal herniorrhaphy. METHODS: Thirty adult patients scheduled for inguinal herniorrhaphy were randomly assigned to one of two groups. 0.25% bupivacaine 20 ml was infiltrated in the surgical wound site either 15 min before skin incision or immediately after skin closure. Postoperatively, visual analogue scale (VAS) at rest and movement were assessed. Also the time to the first request for postoperative analgesic and the total dose of postoperative analgesics were assessed. In addition, the number of patients who didn't require any analgesics during the postoperative period were assessed. RESULTS: The VAS at rest and movement was not significantly different between the two groups. The time to the first request for postoperative analgesic, the total dose of supplemental analgesics and the number of patients who didn't require any analgesics were not significantly different. CONCLUSIONS: In pain after inguinal herniorrhaphy, we could not demonstrate the pre-emptive analgesic effect of preincisional bupivacaine infiltration. Traction pain after inguinal herniorrhaphy was sustained during the study period and this kind of pain was not inhibited (or prevented) by local infiltration of bupivacaine.
Adult ; Analgesia ; Analgesics ; Bupivacaine* ; Central Nervous System Sensitization ; Herniorrhaphy* ; Humans ; Pain, Postoperative* ; Postoperative Period ; Skin ; Traction ; Wounds and Injuries