No abstract available.
Hemodynamics* ; Nitroprusside*

The use of external fixator is popular in the treatment of open tibial fracture, severe comminuted fracture and segmental fracture, which minimizes further soft tissue injury and provides rigie fixation. The purpose of this study was to determine the complications and effectiveness of external fixation for treating the fractures of tibia. 33 patients with tibial fracture had been treated with external fixator from April 1993 to April 1994 at the orthopaedic department of Kang Dong Catholic General Hospital. We analysed 23 cases(21 patients) which could be followed up more than 12 months. The results were as follows; 1. Average duration with external fixator was 15.1 weeks. 2. Average time of bone union was 22.9 weeks. 3. 6 cases of pin tract infection were developed and they were treated with curettage and drainage, local antibiotics therapy, pin translation, or removal of external fixator. 4. The delayed union were developed in 5 cases, angulation deformity in 1 case, chronic osteomyelitis in 2 cases and soft tissue defect in 1 case. 5. Secondary operations caused by delayed union, valgus deformity, skin defect and bone exposure, were performed in 6 cases. 6. The use of external fixator provided good result in open fracture, intraarticular comminuted fracture, segmental fracture, and multiple injury, but chronic osteomyelitis and articular stiffness were developed in some cases.
Anti-Bacterial Agents ; Congenital Abnormalities ; Curettage ; Drainage ; External Fixators ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Multiple Trauma ; Osteomyelitis ; Skin ; Soft Tissue Injuries ; Tibia ; Tibial Fractures

BACKGROUND & OBJECTIVES: There are few reports of affecting factors of the longterm prognosis after acute ischemic stroke. The aim of this prospective study was to determine which variables, of those easily measurable during the first 24 hours after stroke onset, would be predictors of longterm outcome. METHOD: Ninety-eight patients with an acute ischemic stroke were evaluated within 24 hours after symptom onset. The following potential affecting factors of outcome were prospectively collected : demographic datas, socioeconomic factors, risk factors of cerebrovascular accidents, clinical f indings as measured by the National Institute of Health (NIH) scale, laboratory findings and premorbid varibles rated according to modified Rankin score (mRS). We evaluated the outcome, assessed with mRS as good (mRS 3 or less) and poor (mRS 4, 5 or death) and follow up was undertaken at 6, 12, 18 and 24 months after onset. The statistical analysis was performed by means of SPSS/PC+package to determine the longterm prognostic factors. RESULTS: The multiple stepwise regression analysis revealed that the outcome depend on NIH scale(p<0.001), age (p<0.01), previous stroke(p<0.01), loss of consciousness (LOC) at onset (p Follow-Up Studies ; Humans ; Paresis ; Prognosis ; Prospective Studies ; Risk Factors ; Socioeconomic Factors ; Stroke ; Unconsciousness

PURPOSE: Our aim was to evaluate the effects of the centralized intensive education system (CIES) compared with an individualized ward education system (IWES) in the degree of acquisition of the proper clean intermittent catheterization (CIC) method as a treatment of patients with voiding dysfunction. MATERIALS AND METHODS: From March 2002 to March 2003, a prospective questionnaire study was performed on 122 patients (age 55.7+/-17.0 years; 52 males and 70 females). Patients were randomly divided into two groups (the CIES group versus the IWES group) at the time of the urologic consultation for voiding dysfunction. After the CIC education, the patients were asked to complete a self-administered questionnaire about the CIC education. Under the protocol of CIES or IWES for CIC, patients were instructed by doctors or nurses at their wards and performed self- catheterization under supervision. RESULTS: There were 122 patients with 72 patients in CIES, 50 patients in IWES, respectively. There were no differences between two groups in age, sex, education level, and socioeconomic status (p>0.05). CIES was superior to IWES in terms of the patient's understanding on the need for CIC, cause of their voiding dysfunction, help from pictures and the use of instruments related to CIC, sufficient explanation of questions about CIC, overall satisfaction of education, and confidence for CIC after education (p<0.05). There was a significant difference in the number of acquisitions of confidence for CIC between CIES and IWES, which were 3.1 (+/-2.0) times and 5.9 (+/-5.5) times, respectively (p<0.05). CONCLUSIONS: Our result shows that the CIES is superior to the IWES in CIC education. Further efforts are needed to enhance the understanding on the more detailed knowledge of the CIC and to increase the motivation of the patients.
Catheterization ; Catheters ; Education* ; Humans ; Intermittent Urethral Catheterization* ; Male ; Motivation ; Organization and Administration ; Prospective Studies ; Surveys and Questionnaires ; Social Class

Recently, new epicanthoplasty methods with reduced scarring have been developed, such as skin redraping method, periciliary epicanthoplasty, etc. Although these methods increase the length of horizontal palpebral fissure, the remnant skin and orbicularis oculi muscle portion that covers one third of medial canthus reduce satisfaction of aesthetic outcome. In order to overcome this limitation, the authors performed redraping after direct excision of medial orbicularis oculi muscle and excess skin to correct epicanthal fold. From April of 2006 to March of 2009, the authors performed medial epicanthoplasty using direct excision and redraping method to correct epicanthal folds in the eyelids of 72 Asian patients. The epicanthoplasty was performed combining with incisional or non-incisional double eyelid operation, ptosis correction, augmentation rhinoplasty and lateral canthal lengthening. Mean follow up was 11 months(6 months to 2 years). Most of the patients were satisfied with the results. Our technique has delivered esthetically superior results with minimal postoperative scar and no major complication. The advantages of our direct excision and redraping technique are as follows: 1) simple in design, 2) versatile in its application, 3) double fold looks clear especially in the medial 1/3 by eliminating the redundant skin and orbicularis muscle.
Asian Continental Ancestry Group ; Blepharoplasty ; Cicatrix ; Eyelids ; Follow-Up Studies ; Humans ; Muscles ; Rhinoplasty ; Skin

OBJECTIVE: To evaluate the usefulness of 10% dextrose swallowing test (DST) to detect aspiration for patient with tracheostomy in comparison with modified blue dye test (MBDT). METHOD: Fifteen brain injured patients with tracheostomy were tested by DST and MBDT. The newly developed DST consists of 3 steps. In the first step, 5 cc 10% dextrose solution is fed 3 times by spoon. In the second step, tracheal secretion is sampled by suction catheter just before swallowing, and 30 seconds, 90 seconds after swallowing. In the third step, tracheal secretion is smeared to glucose oxidase test strip to detect aspiration with color change from pink to purple. MBDT with 0.01 % methylene blue solution was also performed in the same order. The tracheal secretion was smeared to the white paper to see the color change to blue. Videofluoroscopic swallowing study (VFSS) was performed for 9 out of 15 patients. RESULTS: Fourteen out of 15 patients showed the same outcome in DST and MBDT (kappa=0.815). Seven out of 9 patients showed the same outcome in DST and VFSS (kappa=0.571). Eight out of 9 patients showed the same outcome in MBDT and VFSS (kappa=0.780). CONCLUSION: The DST is a reliable method to detect aspiration for patient with tracheostomy.
Brain ; Catheters ; Deglutition* ; Glucose Oxidase ; Glucose* ; Humans ; Methylene Blue ; Suction ; Tracheostomy*

OBJECTIVE: To develop and evaluate newly designed orthosis to control contracture of the shoulder and the forearm in the spastic upper limb. METHOD: Subjects were 6 hemiplegic patients and 1 tetraplegic patient who showed the features of spasticity. Volar wrist hand orthosis was modified to attach a plastic stick which can be easily separated. The orthosis was applied in supinated position for 8 weeks. The shoulder and elbow range of motion was measured every 2 weeks for 8 weeks. RESULTS: The subjects with spasticity showed significant improvement in the shoulder abduction (p<0.05), adduction (p<0.05) and external rotation (p<0.05) after applying modified volar wrist hand orthosis for 8 weeks. The forearm supination was well maintained for 8 weeks. CONCLUSION: The newly designed orthosis showed significant effects in the improvement of the shoulder abduction, adduction and external rotation and the forearm supination of spastic upper limbs.
Contracture* ; Elbow ; Forearm* ; Hand ; Humans ; Muscle Spasticity* ; Orthotic Devices* ; Plastics ; Range of Motion, Articular ; Shoulder* ; Supination ; Upper Extremity ; Wrist

BACKGROUND: Osteoporosis, one of the most common metabolic bone disease, might be influenced by the severity of Parkinson's disease (PD). Objectives : We investigated the relationship between the Bone Mineral Density (BMD) and the severity of PD in postmenopausal and senile women. METHODS: We measured BMD of lumbar spine (L1-L4) by Dual energy X-ray absorptiometry (DEXA; Hologic QDR-4500A). We compared BMD between patient group (30 patients with PD) and control (183 postmenopausal and senile health women). The patients were divided into two groups according to osteoporosis and analyzed the following potential factors influencing BMD in PD; age, duration of symptom, age of onset, Hoehn and Yahr stage (H-Y stage), UPDRS motor score, duration of treatment, body mass index (BMI), dominant symptom such as tremor or rigidity. RESULTS: 1. BMD was significantly decreased with aging (p <0.01) in control group, but BMD tend to decreased with aging in PD (p=0.08). 2. BMD of patient group was significantly lower than that of control group (p<0.001). 3. BMD of osteoporosis group was significantly related to BMI (p<0.05) and conversely related to H-Y staging(p <0.05), UPDRS motor score (p <0.01). 4. However, BMD of osteoporosis group were not related to age, duration of symptom, age of onset, dominant symptom and duration of treatment (p>0.05). CONCLUSION: Osteoporosis is related to H-Y stage, UPDRS motor score and BMI as well as aging in PD.
Absorptiometry, Photon ; Age of Onset ; Aging ; Body Mass Index ; Bone Density* ; Bone Diseases, Metabolic ; Female ; Humans ; Osteoporosis ; Parkinson Disease* ; Spine ; Tremor

We studied the onset of coronary artery aneurysm formation in 42 patients of Mucocutaneous lymph node syndrome (MCLS), the serial changes of T cell subsets, and serum immunoglobulin levels including lgG, lgA, lgM, in 13 patients among them during acute (before high dose gamma-globulin therapy ) and subacute phase (after gamma-globulin therapy) to evaluate the role of the immunoregulatory abnormalities in coronary artery aneurysm formation. The following results are obtainded : 1) The coronary artery aneurysm was found in 16 patients (38%). They were detected in between 6th and 13th day of illness with the mean of 8.8+/-2.1 day. 2) The total T lymphocyte (T1), helper T lymphocyte (T4), and helper/supperessor ratio (T4/T8) decreased during acute phase. 3) Following gamma-globulin therapy it showed a increase in T4,T8, and all immunoglobulines. Above results showed that the most of aneurysms developed during acute phase and suppressed, rather than enhanced, T cell function significantly contributed to aneurysm formation, whereas high dose gamma-globulin retarded or reversed this suppression which would be one of mechanism of beneficial effort of gamma-globulin in MCLS.
Aneurysm* ; Coronary Aneurysm ; Coronary Vessels* ; gamma-Globulins ; Humans ; Immunoglobulins ; Lymph Nodes* ; Lymphocytes ; Mucocutaneous Lymph Node Syndrome ; T-Lymphocyte Subsets*

PURPOSE: The purpose of this study is to evaluate the surgical outcomes of the clavicle lateral end fracture fixed with an oblique T locking compression plate (LCP). MATERIALS AND METHODS: Fourteen clavicle lateral end fractures were fixed with the oblique T-LCP and followed up for at least 1 year after the surgery. Thirteen cases were unstable Neer type II fractures and one case was nonunion of the Neer type I fracture. The mean age was 46 years of age (range, 26~70). In ten cases, augmenting sutures with the absorbable suture material were placed in the coraco-clavicular ligament and around the plate and the clavicle to improve the stability of fracture fixation. Autogenous iliac bone graft was done in four cases. The clinical outcomes were evaluated by using UCLA scoring system and KSS (Korean Shoulder Score). RESULTS: The mean UCLA score was 33.5 and the mean KSS was 94.9. Average time of bone union was 11.9 weeks (range, 6~28), including 1 case with a delayed union. There was no complication such as loss of fixation or nonunion. CONCLUSION: Fixation with the oblique T-LCP is a good option providing reliable functional results in clavicle lateral end fractures.
Clavicle ; Fracture Fixation ; Ligaments ; Shoulder ; Sutures ; Transplants