Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.

We present a study on the systemic insults in the early death(within one week) after head injury. The patient population consisted of 192 patients who were admitted to the Soonchunhyang University Chonan Hospital from August 1986 to May 1990 after head injury. We collected clinical features and systemic insults including blood pressure, arterial pH, PaO2, PaCO2, hematocrit, and serum concentration of Na, retrospectively. The most common cause of injury was road traffic accident(77.6%). More than half(57.8%) were under the age of 40 years. The interval from injury to admission was within one hour in 63.2%, and within four hours in 91.4%. The mean interval was 1.8 hours. However, in 154(80.2%) patients, we found the evidence of systemic insults on admission. We found hypotension(ststolic less than 90mmHg) in 22.9%, acidemia(pH<7.35) in 71.3%, arterial hypoxemia(PaO2<60mmHg) in 42.7%, hypercarbia(PaCO2>45mmHg) in 28.7%, anemia(hematocrit<30%) in 13.0%, hyponatremia(Na<135mEq/L) in 10.7%, and hypernatremia(Na>145mEq/L) in 11.2%. These results imply that the prehospital emergency care system useful at the scene of accident and during the transportation is more important than the simple quick-transport-system.
Arterial Pressure ; Chungcheongnam-do ; Craniocerebral Trauma* ; Emergency Medical Services ; Head* ; Hematocrit ; Humans ; Hydrogen-Ion Concentration ; Retrospective Studies ; Transportation

For the evaluation of the 51Cr labelled in-vivo crossmatching test as a transfusion safety test, We examined the viability of the thransfused autologous and heterologous 51Cr labelled red cell at 1 hour and 24 hour in 6 normal volunteers and 4 patients whose RBC had been stored in CPDA-1 media from 1 day to 30 day. In both autologous transfusion control group(n=3) and allogeneic transfusion control group(n=3), the in-vivo RBC survival rate were more than 70% at 1 hour and 24 hour compared to that of basal 3 minute result(percent counted as 100%), and the eluted free radioisotope activity was less than 5% compared to that of whole blood. The crossmatch incompatible patient group also satisfied the safe transfusion criteria. The mean labelling efficiency which was tested in three patients was more than 95% and also satisfactory to reliable test. We concluded that in-vivo crossmatching test using 51Cr radioisotope would give us valuable informations about transfusion safety, especially in serologically incompatible patients.
Healthy Volunteers ; Humans ; Survival Rate

No abstract available.
Funnel Chest*

This study was carried out to evaluate high-school students' nutrient intakes according to the status of depressive trends, and to analyse the in physical and mental health status. The volunteers were 560 high school students selected from 8 provinces, but 511 students were analyzed. A was used for evaluation, The questions were composed in consideration of socio-demographic characteristics, physical health condition by CMI, mental condition assessed by a modified Zung's self-rating depression scale (SDS), and the evaluation of food consumption by a 24 hours recall method. The family situations of the subjects were mostly nuclear family(73%), agricultural work(53%), and having religion(53%). Only 3% of the students suffered depression where as 19% showed depression trendencies. The individual factors that affected their mental condition were family farming and consciousness of academic accomplishment. The health status counted with CMI was 6.2/20 scores. The non-depressed trend group of students had a lower score of CMI than others. The overall nutrient intakes of students were low compared with the Korean RDA for adolescents. The Mean Adequacy Ratio(MAR) of nutrient intakes was only 0.45 +/- 0.23. Iron, vitamin A, and riboflavin intakes were significantly low and correlated with depressive trend score. The result from the regression analysis showed that CMI, study accomplishment, and vitamin A were the most significant factors influencing mental condition. We concluded that Korean rural high-school students were healthy in mental condition and showed lower rates of depression academic. For there more we could say that the intakes of iron and vitamin A also influenced mental health. Findings confirmed the need of becoming hopeful job of farming and better nutritional status. These situations would be necessary for students to ameliorate the quality of rural living.
Adolescent ; Consciousness ; Depression ; Hope ; Humans ; Iron ; Mental Health ; Nutritional Status ; Riboflavin ; Vitamin A ; Volunteers

Osteoporosis is the most common generalized skeletal disease, which lays a significant socioeconomic burden to Korea. The early diagnosis and treatment of osteoporosis are of the great interest to minimize the economic co nsequence. We have studied vertebral BMD and bone scan of 30 patients with osteoporotic compression fractures. The purpose of this study was to investigate the effect of osteoporotic compression fracture on bone mineral density(BMD). We have measured the vertebral heights, vertebral bone mineral density, and bone scan counts of vertebral bodies on osteoporotic patients. Vertebral BMD was measured from T12 to L4 using dual photon absorptiometry. Anterior(Ha), middle(Hm), and posterior(Hp) height of vertebrae were measured from T12 to L4, and the spinal deformity indices(Ha/Hp, Hm/Hp, and Hp/Hi ratios) were calculated. The bone scan counts were measured from T12 to L4, and bone scan ratios were calculated. The BMD of fractured vertebrae was significantly higher than that of non-fractured vertebrae The spinal deformity indices were not correlated to the BMD of fractured vertebrae. The bone scan ratio was correlated to the BMD of fractured vertebrae. This study suggests that the increased BMD observed in fractured vertebrae is related to metabolic effect of compression fractures rather than mechanical effect.
Absorptiometry, Photon ; Bone Density* ; Congenital Abnormalities ; Early Diagnosis ; Fractures, Compression* ; Humans ; Korea ; Osteoporosis ; Spine

PURPOSE: To evaluate the differences between IOLMaster(R) and A-scans in changes in axial length after vitrectomy in patients with macular disease. METHODS: Using IOLMaster(R) and A-scans, we measured preoperative and postoperative axial length in 12 eyes with epiretinal membranes (ERM) and in 8 eyes with macular holes (MH). The relationship between the absolute error in axial length after vitrectomy and both methods was assessed using Mann-Whitney U test. The correlation to central macular thickness was evaluated by Spearman's correlation coefficient. RESULTS: In eyes with ERM and MH, preoperative and postoperative axial lengths obtained with both methods had no significant difference (p>0.05). The absolute error in axial length after vitrectomy was not significant using IOLMaster(R) (ERM: 0.07+/-0.05 mm, MH: 0.04+/-0.02 mm, p>0.05) but was significant using A-scan (ERM: 0.20+/-0.11 mm, MH: 0.30+/-0.07 mm, p<0.05). The correlation between the change of axial length after vitrectomy and the central macular thickness was poor (IOLMaster(R): ERM; correlation coefficient = -0.182, p>0.05, MH; correlation coefficient = -0.054, p>0.05, A-scan: ERM; correlation coefficient = -0.210, p>0.05, MH; correlation coefficient = -0.156, p>0.05). CONCLUSIONS: The IOLMaster(R) is more useful than the A-scan when measuring axial length without refractive errors after vitrectomy in eyes with macular disease.
Epiretinal Membrane ; Eye ; Humans ; Refractive Errors ; Retinal Perforations ; Vitrectomy

PURPOSE: To evaluate the differences between IOLMaster(R) and A-scans in changes in axial length after vitrectomy in patients with macular disease. METHODS: Using IOLMaster(R) and A-scans, we measured preoperative and postoperative axial length in 12 eyes with epiretinal membranes (ERM) and in 8 eyes with macular holes (MH). The relationship between the absolute error in axial length after vitrectomy and both methods was assessed using Mann-Whitney U test. The correlation to central macular thickness was evaluated by Spearman's correlation coefficient. RESULTS: In eyes with ERM and MH, preoperative and postoperative axial lengths obtained with both methods had no significant difference (p>0.05). The absolute error in axial length after vitrectomy was not significant using IOLMaster(R) (ERM: 0.07+/-0.05 mm, MH: 0.04+/-0.02 mm, p>0.05) but was significant using A-scan (ERM: 0.20+/-0.11 mm, MH: 0.30+/-0.07 mm, p<0.05). The correlation between the change of axial length after vitrectomy and the central macular thickness was poor (IOLMaster(R): ERM; correlation coefficient = -0.182, p>0.05, MH; correlation coefficient = -0.054, p>0.05, A-scan: ERM; correlation coefficient = -0.210, p>0.05, MH; correlation coefficient = -0.156, p>0.05). CONCLUSIONS: The IOLMaster(R) is more useful than the A-scan when measuring axial length without refractive errors after vitrectomy in eyes with macular disease.
Epiretinal Membrane ; Eye ; Humans ; Refractive Errors ; Retinal Perforations ; Vitrectomy

BACKGROUND: Information on the long-term fate of patients with prosthetic valve is limited. Cerebral embolism is a major cause of late morbidity and mortality in patients with prosthetic valves even though recent prostheses are less thrombogenic and anticoagulants are administered. We investigated the long-term risk of the first ischemic and hemorrhagic stroke and effect of presumed risk factors on the development of stroke in patients with prosthetic valves. METHODS: In a retrospective study, 554 patients who survived the 30-days after cardiac valve replacement between June, 1985 and May, 1995 were included. End points were attacks of ischemic and hemorrhagic stroke. Risk of stroke at end points was calculated according to Kaplan-Meier method. The influence of several clinical variables on these stroke events was analyzed by univariate and mutivariate analyses. RESULTS: Thirty seven of 554 patients had 42 stroke events(34 ischemic stroke, 8 hemorrhagic stroke) during follow-up periods(mean: 52.9months). Six of these patients died from stroke. The cumulative stroke-free probability was 92.4% at 5years and 87.7% at 10years. The cumulative ischemic stroke-free probability was 93.7% at 5years and 89.4% at 10years. No or irregular use of anticoagulants was the only significant independent predictor(RR:4.99, 95%CI:2.01-12.41, p<0.01) of ischemic stroke. The cumulative hemorrhagic stroke-free probability was 98.7% at 5years and 98.1% at 10years. CONCLUSION: Regardless of the type of prostheses, patients with prosthetic valves, notably those without anticoagulants, are at high risk for ischemic stroke.
Anticoagulants ; Follow-Up Studies ; Heart Valves ; Humans ; Intracranial Embolism ; Mortality ; Prostheses and Implants ; Retrospective Studies ; Risk Factors ; Stroke* ; Thromboembolism

In this paper, we propose a brain detection algorithm of cross-sectional images through a 3D volume. The proposed brain detection algorithm uses several steps. They are as follows; In the first step, the standard value and downward from input image data are removed. in the second step, the pixels with maximum intensity are removed but undesirable many small areas were appeared as by-products. In order to detect brain, these small areas need to be removed. In the third step, many small areas are removed by masking but some small areas still remained. In the fourth step, they are removed using three-dimensional connectivity. The proposed algorithm was applied to real human MRI data and the brain area was successfully detected.
Brain* ; Humans ; Magnetic Resonance Imaging ; Masks