One of the commonest and most serious problems of the injured hand is flexion contractures of the fingers. Such deformities not only functionally impair the digit, but also reduce or restrict the functional capability of the entire hand. We reviewed 150 digits of 73 patients with flexion contractures of the fingers which had been treated at National Medical Center from Jan. 1976 to Dec. 1985. The results were as follows: 1. The duration of flexion contractures which were scattered from 4 months to 17 years and average duration of contracture was 20.6 months. 2. The methods of treatment were Z-plasty, adhesiolysis, capsulotomy, excision of both collateral ligaments, stripping of extensor mechanism and volar plate and release of flexor tendon sheath according to injury mechanism and duration of contracture. 3. The postoperative results showed up 32 (21.3%) excellent, 78 (52%) good, 24 (16%) fair and 16 (10.7%) poor. 4. The postoperative results of burned injury which showed up-8 excellent, 11 good out of 20 cases they are supposed to have satisfactory results. 5. Crushing injury which had intraarticular fracture or comminution show up unsatisfactory results. 6. It seems obvious that the early active motion of interphalangeal joint is important to improve joint function. 7. The arc of motion was retained in a more functional position postoperatively than preoperatively.
Burns ; Clinical Study ; Collateral Ligaments ; Congenital Abnormalities ; Contracture ; Fingers ; Hand ; Humans ; Intra-Articular Fractures ; Joints ; Tendons

PURPOSE: The purpose of this study was to identify cultural competence and factors influencing cultural competence of nursing students in South Korea. METHODS: Participants in this study were 248 nursing students who agreed to participate in the study. Data were collected during November and December, 2012 using structured questionnaires. Data were analyzed using PASW/WIN 20.0 program and included t-test, one-way ANOVA, Scheffe test, and multiple regression. RESULTS: The mean score for cultural competence in nursing students was 3.0 points out of a possible 5. Factors influencing cultural competence in nursing students were identified as being female (beta=-.23), third year (beta=.30), having foreign friends (beta=.29) and fluency (beta=.12). These factors explained 18% of cultural competence reported by nursing students (F=10.13, p<.001). CONCLUSION: The results of this study show the major factors influencing cultural competence in nursing students. Therefore, it is recommended that further cultural competence promotion programs for nursing students be considered directly along with ongoing transcultural experiences.
Cultural Competency* ; Female ; Friends ; Humans ; Surveys and Questionnaires ; Students, Nursing*

No abstract available.
Child* ; Humans ; Pneumonia, Staphylococcal* ; Thorax*

When blow-out fracture repair is performed, many implants including Silastic, Supramid, Porous polyethylene and others have been used to pervent reherniation of orbital tissue. Complications associated with implants include implant extrusion, orbital infection, fistula formation, implant migration, extraocular muscle entrapment, globe elevation, protosis and orbital cyst formation. The latter was known as a rare late complication of blow-out fracture repair. We report two cases of orbital cyst which developed after blow-out fracture repair with alloplastic implants. These patients developed diplopia and unliateral proptosis 7 and 10 years after repair of blow-out fracture, respectively. In these cases, orbital CT scan revealed retrobulbar cyst-like structures surrounding the orbital implant. At sufgery, a fibrous capsule surrounded the previously inserted orbital implants and was filled with dark brown mucoid material in both cases. These cysts were lined by squamous epithelium with cholesterol cleft and hemosiderin laden macrophage collection. Proptosis and diplopia were resolved after surgical removal of the cyst. These cases illustrate that it is important for us to be aware of the complication of late cyst formation around alloplastic implants after repair of blow-out fracture.
Cholesterol ; Diplopia ; Epithelium ; Exophthalmos ; Fistula ; Hemosiderin ; Humans ; Macrophages ; Nylons ; Orbit* ; Orbital Fractures* ; Orbital Implants ; Polyethylene ; Tomography, X-Ray Computed

PURPOSE: To evaluate the surgical results of tarsal fracture and anterior lamellar reposition in patients with cicatricial entropion. METHODS: The authors retrospectively analyzed the medical records of 9 patients (11 eyes) who had undergone tarsal fracture and anterior lamellar reposition for cicatricial entropion from October 2003 to September 2008. RESULTS: 6 eyes of 5 patients were male and 5 eyes of 4 patients were female. The patients' mean age was 63.4 (43.5~75.9) years. The mean follow-up period was 29.9 (7~67.6) months. After surgery, the ocular irritation disappeared in all patients. There were no recurrences or complications. CONCLUSIONS: Tarsal fracture and anterior lamellar reposition in patients with cicatricial entropion is a simple and cosmetically effective procedure without complications.
Entropion ; Eye ; Eyelids ; Female ; Follow-Up Studies ; Humans ; Male ; Medical Records ; Recurrence ; Retrospective Studies

Syphilitic granulomatous pancreatitis is an extremely rare condition,and can occur in the generalized acquired syphilitic patient in tertiary or secondary phase. The most serious problem with granulomatous pancreatic lesion is clinical or radiological misdiagnosis as cancer. We experienced a case of syphilitic granulomatous pancreatitis arising in 54 year old female patient. She was treated for syphilis 20years ago. But she and her husband are still strong positive to VDRL and TPHA. On abdominal computed tomography and endoscopic pancreatico- duodenography, there was an obstructive mass of low density in the distal common bile duct or pancreatic head. Under the preoperative diagnosis of pancreatic head carcinoma, Whipple's operation was done. On gross examination, the pancreas was fibrotic, and the common bile duct was well preserved without tumor mass. Microscopically, numerous intralobular noncaseating epithelioid cell granulomas with multinucleated giant cells are identified. They surround thick-walled, small to medium sized arteries and involve vascular wall with luminal narrowing or obliteration, which are characteristic findings of the syphilitic granuloma. The remaining parenchyme shows fibrosis, acinar atrophy or destruction with dense infiltration of lymphohistiocytes, plasma cells with granuloma formation. Although the Warthin-Starry stain reveals no spirochetes, the serologic result and pathologic findings are compatible with syphilitic granulomatous pancreatitis.
Female ; Humans

We report of 3 cases of atypical coloboma of choroid. The two of these were one male and one female. A man aged 40 discovered atypical coloboma of choroid bilaterally with red-green color blindness. One of his son aged 6 discovered atypical coloboma of choroid bilaterally with nystagmus. One of his daughter aged 11 discovered of atypical coloboma of choroid bllaterally with alternating exotropia.
Choroid* ; Coloboma* ; Color Vision Defects ; Exotropia ; Female ; Humans ; Male ; Nuclear Family

The mesectodermal leiomyosarcoma of the orbit is extremely rare disease. An 81-year-old woman presented with progressive painless proptosis in her right eye of 1 month duration. Computed tomographic scan of the orbit demonstrated 5-cm size lobulating mass of the right orbit which displaces eyeball anteriorly and bulges out to temporalis portion with severe destruction of lateral orbital wall and intracranial extension. For diagnostic pur-pose, incisional biopsy was performed. Light microscopic examination showed the characteristics of neurogenic tumor. Electron microscopic examination disclosed the features of smooth muscle cells as well as neural differentiation of the tumor, leading to the diagnosis of mesectodermal leiomyosarcoma. To the best of our knowledge, this is the first case of mesectodermal leiomyosar-coma of the orbit in Korea
Aged, 80 and over ; Biopsy ; Diagnosis ; Exophthalmos ; Female ; Humans ; Korea ; Leiomyosarcoma* ; Myocytes, Smooth Muscle ; Orbit ; Rare Diseases

PURPOSE: To evaluate the efficacy and safety of the inferior conjunctival transposition flap for primary pterygium surgery. METHODS: This study reviewed 59 eyes in 59 patients with primary pterygium who were treated with pterygium excision and an inferior conjunctival transposition flap. The inferior conjunctival flap was obtained from lower bulbar conjunctiva and was secured with 8-0 vicryl. Patients were followed-up on the third day after surgery and then at 1, 2, 4 and 12 weeks postoperatively. RESULTS: The mean patient age was 55.6 (ranging from 34 to 74) years. The mean follow-up period was 24.9 (ranging from 12 to 46) months. During the follow-up period, the pterygium recurred in one (1.7%) of the 59 eyes. There were no severe complications except for mild congestion and hemorrhage of the conjunctival flap. CONCLUSIONS: Inferior conjunctival transposition flap technique may be considered as a safe and effective method that reduces complications and recurrences after primary pterygium excision.
Conjunctiva ; Estrogens, Conjugated (USP) ; Eye ; Follow-Up Studies ; Hemorrhage ; Humans ; Polyglactin 910 ; Pterygium ; Recurrence

Esophageal perforation is a rare disease, which require emergent diagnosis and therapeutic procedure. In this paper, we present one case of esophageal perforation by traction of toothbrush which was swallowed during pharyngeal irritation. After the toothbrush was inserted to stomach by gastroscope, gastrostomy was performed for removal of toothbrush and the esophageal perforation was repaired by operation.
Diagnosis ; Esophageal Perforation* ; Gastroscopes ; Gastrostomy ; Rare Diseases ; Stomach ; Traction