No abstract available.
Arteriovenous Fistula* ; Telangiectasia, Hereditary Hemorrhagic*

BACKGROUND: The goal of this study was to evaluate whether a modified fluoroscopic technique for positioning a hook plate affected the clinical results of treating Neer type II distal clavicle fractures and Rockwood type V acromioclavicular (AC) joint separations with this device. METHODS: The study was a retrospective consecutive case series with data analysis. Sixty-four patients with a Neer type II distal clavicle fracture or a Rockwood type V AC joint injury treated between March 2009 and June 2013 were divided into 2 groups: traditional fluoroscopic technique (traditional view, 31 patients) or modified fluoroscopic technique ('hook' view, 33 patients). A visual analogue scale (VAS) score, the modified University of California-Los Angeles (UCLA) shoulder scale score, and radiographic osteolysis were the main outcome measures. RESULTS: The traditional group included a significantly larger number of patients with acromial osteolysis than the hook view group: 23 patients (74.2%) vs. 11 patients (33.3%), respectively (p=0.01). Before plate removal, the hook group reported less pain and higher UCLA shoulder scale scores than the traditional group: average VAS score, 1.55 vs. 2.26, respectively; average UCLA score, 30.88 vs. 27.06, respectively. However, there was no significant difference after plate removal. CONCLUSIONS: The hook view allows more accurate bending of the hook plate around the contour of the acromion, resulting in decreased osteolysis, decreased pain, and better function with the plate in situ.
Acromioclavicular Joint ; Acromion ; Clavicle* ; Dislocations ; Humans ; Joints ; Osteolysis ; Outcome Assessment (Health Care) ; Retrospective Studies ; Shoulder ; Statistics as Topic

Parkinson’s disease (PD) is the second most common neurodegenerative disorder. Although dopaminergic drugs are the mainstay for improving PD symptoms, there are still few effective disease-modifying therapies. With the increasing prevalence of PD and the rapid transition to an aging society, more emphasis needs to be placed on rehabilitation that could slow the disease progression combined with pharmacological therapy. In this review, we present an update on evidence related to rehabilitation programs for motor function, swallowing difficulty, and speech disorders in PD. Aerobic exercise, music therapy, dance, virtual reality, and non-invasive brain stimulation have been shown to improve motor function, and telerehabilitation could also be feasibly applied in PD. Recent studies have shown the effectiveness of expiratory muscle strengthening exercises and Lee Silverman Voice Treatment for swallowing difficulty and speech disorders, respectively. Although many rehabilitation programs have been tried, the evidence is still limited. Well-designed future randomized controlled trials with large numbers of participants are needed to establish evidence for rehabilitation in PD.

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

BACKGROUND: Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae are main pathogens of bloodstream infection. We compared the epidemiology of ESBL-producing E. coli and K. pneumoniae. METHODS: From January 2003 through March 2007, we retrospectively investigated the clinical characteristics and comorbidities of patients with bloodstream infection by ESBL-producing E. coli and K. pneumoniae. RESULTS: During the study period, 79 patients (54 with E. coli and 25 with K. pneumoniae) with blood cultures positive for ESBL-producing E. coli or K. pneumoniae were studied. When comparing the source of bloodstream infections, urinary tract infections (UTIs) were more commonly caused by E. coli (24% vs. 0; P=0.007), and respiratory tract and soft tissue infection (36% vs. 15%; P=0.04, 12% vs. 0; P=0.03, respectively) were more commonly associated with K. pneumoniae. Among hospital-acquired bloodstream infection, third-generation cephalosporin was more commonly used in patients with E. coli than patients with K. pneumoniae (81% vs. 24%, P<0.001). Medical devices (central venous catheter and urinary catheter) were more commonly used in patients with K. pneumoniae. CONCLUSION: ESBL-producing E. coli bloodstream infection is more common in urinary tract infections. ESBL-producing K. pneumoniae is more common in respiratory tract infections and in skin and soft tissue infections. In hospital-acquired infections, ESBL-producing E. coli bloodstream infection is more common in biliary tract infection. ESBL-producing E. coli was more commonly associated with prior frequent antibiotics use and K. pneumoniae was more commonly associated with use of medical devices.
Anti-Bacterial Agents ; beta-Lactamases ; Biliary Tract ; Catheters ; Comorbidity ; Epidemiology* ; Escherichia coli* ; Humans ; Klebsiella pneumoniae* ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Retrospective Studies ; Skin ; Soft Tissue Infections ; Urinary Tract Infections

Dystonia is a movement disorder characterized by involuntary contraction of muscles resulting in repetitive or twisting movements. Dystonia is generally caused by basal ganglia dysfunction.Recent studies have reported an association between dystonia and brainstem disorders. However, the pathological mechanism is uncertain, and detailed management strategies are limited. Here, we report a case of hemidystonia with abnormal posture and impaired proprioception after pontine hemorrhage that was effectively treated with pharmacotherapy combined with early intensive comprehensive rehabilitation. A 45-year-old man presented with abnormal posture and dystonic movement in the right hand and foot after a pontine hemorrhagic stroke. Pharmacotherapy with clonazepam and benztropine was administered, and comprehensive rehabilitation programs were implemented intensively from the early stages of symptom onset. After 3 months, the patient was able to walk independently, go up and down a few stairs without the use of a handrail, and was able to perform activities of daily living with minimal assistance.

The purpose of this study was to investigate the intakes and perceptions of convenient breakfast related to age and family type. The survey included 545 men and women living in Seoul from June to July. Questionnaire items covered their age, gender, family types, breakfast intakes and preference for convenient breakfast menu. As a result, there were significant differences in the number of breakfast intakes per week according to family types; large families recorded the highest frequency in "I have breakfast everyday" and the couple-only families and nuclear families scored relatively high numbers. In terms of the type of breakfast, the first choice was "rice and side dishes" across all the age groups (69.3%). There were differences in the preference of convenient breakfast in "bread", "cereal", "rice cake", "sunsik", and "rice gruel" by different age. The teens exhibited the highest preference of bread (5.63), and cereal (5.53) for breakfast; those who were in their fifties for rice cake (5.42). Both forties and fifties showed the higher preference of sunsik (4.58, 4.76) and rice gruel (5.89, 5.77) than other age groups. As for the preference for convenient breakfast according to family types, single person families displayed the highest preference of bread (5.42) and cereal (5.75). Couple families showed higher preference of rice gruel (5.82) than other family groups. The preference level for "rice cake" was similar among all the family types. As a result, it is suggested that the development of various breakfast menus considering age groups and family types is needed so that modern people can enjoy breakfast in terms of quality and quantity in their busy daily life.
Adolescent ; Bread ; Breakfast ; Edible Grain ; Female ; Humans ; Male ; Nuclear Family ; Surveys and Questionnaires ; Single Person

PURPOSE: To compare clinical results and radiologic changes after arthroscopic and microscopic discectomy of lumbar disc herniation in teenagers who have no degenerative change. MATERIALS AND METHODS: From Jan 1990 to Aug 2001. 70 lumbar disc herniations were performed in patients below 20 years old who were admitted to our department, among these 67 cases (49:male, 18:female) were evaluated for at least 1 year. Their aver-age age was 18.1 years (13 ~20 years). Forty-six received microscopic discectomy and 21 arthroscopic discectomy. Mean follow-up duration was 26.4 months (12 ~88 months). RESULTS: Clinical results and disc height change were compared between the arthroscopic and microscopic discectomy groups using the criteria of MacNab, and the relationship between disc height change and clinical results, excised disc volume, opera-tive technique, body mass index and symptom duration were investigated. Clinically there was no significant difference between the two groups (p=0.425), and their results were the same as those of adults. At the 1 year-follow up, disc height changes showed no correlation with the method of operation (p=0.996) or the volume of the excised disc. Postoperative disc height in teenagers of lumbar disc herniation who showed no degenerative change significantly decreased with time, but no significant relation was observed between disc height changes and clinical results, operative technique, excised disc volume, body mass index, involved disc site or symptom duration between the two groups. CONCLUSION: We believe that arthroscopic discectomy is an effective method, if the patients status permits, because it has the advantages of non-invasiveness, short hospitalization period and earlier return to normal life.
Adolescent* ; Adult ; Body Mass Index ; Diskectomy* ; Follow-Up Studies ; Hospitalization ; Humans ; Young Adult

STUDY DESIGN: A retrospective study OBJECTIVES: To demonstrate the early experience of operative treatment about adjacent segments degeneration after lumbar fusion. SUMMARY OF LITERATURE REVIEW: The treatment of degenerative changes at adjacent segment after lumbar spinal fusion have not been well described in literature. MATERIALS AND METHODS: A retrospective reviews of radiographs, medical records and follow up study were undertaken in eight patients who had been treated surgically due to degenerative changes at adjacent segment after lumbar fusion. Average follow up duration was 25 months. Causes of secondary operation were 3 cases of segmental instability, 2 cases of degenerative spondylolisthesis, 2 cases of degenerative spinal stenosis, 2 cases of cauda equina syndrome, 1 case of disc degeneration. Clinical results were evaluated by using of author's criteria. For the radiographic evaluation, plain roentgenogram(AP, Lat. flextion/extension Lat.), CT, MRI were checked. RESULTS: The mean time interval to secondary operation from first operation was seven years nine months. At the preoperative CT or MRI film review, there were initial adjacent segment degenerative changes in half of the cases preoperatively. The level developing degenerative changes were upper segment in 5 cases, lower segment in 2 cases and both segment in 1 case. Most common segment was L3,4 in 5 cases. The second operations were mainly PLIF in 7 cases and PL fusion in 1 case. All cases showed solid fusion. Clinical results were excellent in 3 cases, good in 4 cases, fair in 1 case and poor in no case. CONCLUSION: The early clinical and radiographic results of surgical treatment was satisfactory. If the degenerative changes of adjacent segments are detected preoperatively, there are some needs to consider the extension of surgery according to the severity of the lesions. We think that the results of secondary operation was better in case of PLIF than posterolateral fusion because PLIF provided more rigid stability which enabled early walking stability and better corrective power. But long term results of that should be followed up.
Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; Magnetic Resonance Imaging ; Medical Records ; Polyradiculopathy ; Retrospective Studies ; Spinal Fusion ; Spinal Stenosis ; Spondylolisthesis ; Walking