Degloving injuries of the fingers receive digital sensory nerve damage as well as digital artery damage together with degloving of the finger skin at the time of injury. Although the finger is well covered with skin and the joint motion has completely recovered after the injury, if there is no sensation in the finger tip problems remain. From October, 1982 to December, 1985 Dong San Medical Center, Keimyung University did free digital sensory nerve grafts on 11 cases using the sural nerve. Follow up studies which lasted from 10 to 39 months showed good results. Therefore this free digital nerve graft operation is considered to be a favourable mothod in obtaining sensation for digital degloving injuries.
Arteries ; Fingers ; Follow-Up Studies ; Joints ; Sensation ; Skin ; Sural Nerve ; Transplants

Most proximal humeral fractures respond satisfactory to simple conservative treatment. But operative treatment is recornmended in the cases that poor results are anticipated by prolonged immobilization, or because of the severe displacement and comminution. After Neer. in 1970, emphasized the need for operative treatment in displaced proximal humeral fractures, many papers reported better results with the operative management. Twenty five cases of displaced fractures and fracture dislocations of the proximal humerus treated at the department of orthopaedic surgery, Keimyung University with open reduction and internal fixation were analyzed clinically and radiologically. The following results were obtained. 1. The prevalent age distribution was the second snd third decades(average 42.6 years) and ratio of male and female was 2.1: 1. 2. In 10 of the 25 cases, wire loop was used for internal fixation, and the result was satisfactory in 8 cases. However, the disadvantage was difficulty in wire removal after bony union because the loop was buried in the callus or cortex. 3. Over-all results were excellent or satisfactory in 64% of 25 cases. There were 4 excellent and 1 satisfsctory in 5 cases of type Il fracture, 7 excellent, 2 satisfactory and 3 unsatisfactory in 12 cases of type III fracture, 1 excellent and 4 unsatisfactory in 5 cases of type 1V fracture, and 1 excellent, 1 unsatisfactory and 1 failure in 3 cases of fracture dislocation. 4. In 6 patients with four part lesions treated with open reduction and internal fixation and followed up for an average of 23 months(from 18 months to 3 years and 2 months), only one case of fracture dislocation revealed avascular necrosis with resorption of the head.
Age Distribution ; Bony Callus ; Dislocations ; Female ; Head ; Humans ; Humerus ; Immobilization ; Male ; Necrosis ; Shoulder Fractures

Glutamate is an amino acid neurotransmitter capable of producing widespread receptor-mediated neuronal excitation. In this experiment, we examined the effect of saline, monosodium glutamate (MSG), phenylalanine and MSG-phenylalanine treatment on TH immunoreactivity in area postrema (AP) of medulla oblangata. An immunocytochemical method was used to visualize catecholaminergic neurons in the AP. Damage of TH neurons in the AP of adult Sprague-Dawley rats was induced by injection of MSG (4 mg/g bw) and was decreased by administration of MSG following phenylalanine treatment (15 mg/g bw). We conclude that phenylalanine protect from the neuroexcitotoxic effect of systemic glutamate.
Adult ; Animals ; Area Postrema* ; Glutamic Acid ; Humans ; Neurons ; Neurotransmitter Agents ; Phenylalanine* ; Rats* ; Rats, Sprague-Dawley ; Sodium Glutamate*

PURPOSE: The purpose of this study was to investigate the use of an AED by 119 rescuers in prehospital cardiac arrest. METHODS: 132 patients who experienced prehospital cardiac arrest and was defibrillated by 119 rescuers using AED from January 2003 to December 2004 were included in this study. They were reviewed retrospectively based on 119 rescue service records and ECG. We analyzed patients' general characteristics, types of ECG rhythm, time intervals from EMS activation to arrival and from EMS activation to the first defibrillation, numbers of defibrillation, and return of spontaneous circulation (ROSC). RESULTS: The mean age was 57.33+/-17.84 years with 92 males and 40 females. 68 patients showed shockable rhythms (coarse ventricular fibrillation 41, fine ventricular fibrillation 24, pulseless ventricular tachycardia 3) and 39 patients showed unshockable rhythms (pulseless electrical activity 19 , asystole 18, normal sinus rhythm 2) as an initial rhythm at EMS arrival. Unshockable rhythms were changed to shockable rhythms after cardiopulmonary resuscitation. 25 patients had no ECG rhythms on 119 rescue service records. In the patients with shockable rhythms initially (68 patients), 18 patients experienced ROSC, whereas only 1 patients experienced ROSC in the patients with unshockable rhythms initially (39 patients). The patients with shockable rhythms initially had higher ROSC rates than the patients with unshockable rhythms initially (26.1% vs 2.6%, p=0.001) and received less defibrillation than the patients with unshockable rhythms initially (1.37+/-0.60 vs 2.49+/-1.87, p=0.016). There were no significant differences in the time intervals from EMS activation to arrival (5.74+/-2.13 minutes vs 7.12+/-4.33 minutes, p=0.529) and from EMS activation to the first defibrillation (14.20+/-7.97 minutes vs 13.75+/-7.30 minutes, p=0.542) between ROSC group & non-ROSC group. There was no significant difference in ROSC between male and female (13% vs 17.5%, p=0.164). CONCLUSION: The patients with shockable rhythms initially had higher ROSC rates than the patients with unshockable rhythms initially (26.1% vs 2.6%, p=0.001) and received less defibrillation than the patients with unshockable rhythms initially (1.37+/-0.60 vs 2.49+/-1.87, p=0.016).
Cardiopulmonary Resuscitation ; Defibrillators ; Electric Countershock ; Electrocardiography ; Female ; Heart Arrest ; Humans ; Male ; Retrospective Studies ; Tachycardia, Ventricular ; Ventricular Fibrillation

Subacute thyroiditis is a frequent benign thyroid disease associated with previous viral upper respiratory tract infection. Known complications of this disease are long-standing subclinical hypothyroidism, persistent anterior neck pain and rarely Graves disease. In general, thyroid abscess is an uncommon disease because of anatomic isolation of the gland and its rich system of drainage for blood and lymph. Especially, development of thyroid abscess in subacute thyroiditis is extremely rare phenomenan, but significant bad outcomes can be resulted. Its clinical BACKGROUND containes immune-suppressed state, anatomic defect, presence of underlying other thyroid disease and of non-thyroidal infectious foci. We experienced a case of subacute thyroiditis complicated with streptococcal thyroid abscess during glucocorticoid therapy. The patient was a 19-year-old female who was admitted due to anterior neck pain for 1 month. Typical subacute thyroiditis was suggested from initial laboratory findings including CBC, erythrocyte sedimentation rate, serum T3, T4, TSH levels, thyroid scan & thyroid uptake. But during oral prednisolone therapy, unexpected bacterial thyroid abscess was developed. We report this unusual case with review of literatures.
Abscess ; Blood Sedimentation ; Drainage ; Female ; Graves Disease ; Humans ; Hypothyroidism ; Neck Pain ; Prednisolone ; Respiratory Tract Infections ; Thyroid Diseases ; Thyroid Gland* ; Thyroiditis, Subacute* ; Young Adult

OBJECTIVE: A Study was undertaken to assess the family background of abandonment and clinical and social aspects in an institute for foreign adoption. The results were compared to the previous two reports from the institute. METHOD: A sample of 1,728 children from 1987 to 1992 formed the subjects of the study by the medical records in the institution. RESULTS: 1) The unmber of girls were more than that of male and ratio of male to female was 1:1.1, which was reduced compared to previous study. 2) The distribution less than one month of age was most commonly and increased compared to previous study. 3) The Place at birth was hospital most commonly. 4) The type of delivery was full-term one(61.5%) and tend to be increased. 5) Age distribution of monthers was from 16 years to 25 years mainly, 1,081 of them(62.5%) were from unmarried one and 409(37.4%) were from married one. 6) By classifying the cause of adoption, unmarried mothers occupied main one(62.5%), poverty(13.4%) extramarital relations(5.2%), divorce(2.9%) and death of parents in the order of frequency, tend to increased in unmarried mothers. 7) Disease pattern showed respiratory disease, jaundice, acute gastroenteritis, pneumonia, urinary tract infection, conjunctivitis in order of frequency. By care of foster mother at private home since 1988, the incidence of the transmissible disease was reduced. 8) Congenital anomalies were cleft and palate, hydrocele, umbilical hernia and congenital heart disease in order frequency. 9) Three hundred and eighty two babies were admitted to general hospital. The main disease were bhaline membrane disease. Jaundice, pneumonia and urinary tract disease, sepsis in the order of frequency. CONCLUSIONS: The ratio of male to female in the institution showed no definite difference and the age was tend to be younger. The cause of adoption was unmarried mother mainly. Respiratory disease in the institution and hyaline membrane disease in the hospitalized was most common.
Age Distribution ; Child* ; Child, Institutionalized ; Conjunctivitis ; Female ; Gastroenteritis ; Heart Defects, Congenital ; Hernia, Umbilical ; Hospitals, General ; Humans ; Hyaline Membrane Disease ; Illegitimacy ; Incidence ; Infant, Newborn ; Jaundice ; Male ; Medical Records ; Membranes ; Mothers ; Palate ; Parents ; Parturition ; Pneumonia ; Sepsis ; Single Person ; Urinary Tract Infections ; Urologic Diseases

Pseudohypoparathyroidism (PHP) is a rare clinical type of hypoparathyroidism. The patients with PHP show classic clinical and biochemical features of hypoparathyroidism, but elevated serum level of parathyroid hormone (PTH) and characteristic physical appearances termed 'Albright's hereditary osteodystrophy' (AHO). PHP is classified into types Ia, Ib, Ic and II according to the presence of AHO phenotype and the mechanism of PTH resistance. We experienced a case of PHP in a 12 year-old girl with carpopedal spasm, syncope and partial AHO. She showed very low serum calcium level (1.4 mmol/L), high phosphorus level (3.62 mmol/L) and high immunoreactive PTH level (186.6 ng/L). In the Ellsworth-Howard test, urinary cyclic adenosine monophosphate and phosphorus levels after an exogenous PTH injection remained unchanged. Therefore, we were able to classify the patient as either PHP type Ia or Ic. After the patient had been treated with daily calcium carbonate (1 g), cholecalciferol (250 IU) and calcitriol (0.5 microgram), her neurological signs and symptoms as well as her biochemical abnormalities of hypocalcemia and hyperphosphatemia were improved.
Adenosine Monophosphate ; Calcitriol ; Calcium ; Calcium Carbonate ; Child ; Cholecalciferol ; Female ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Hypoparathyroidism ; Parathyroid Hormone ; Phenotype ; Phosphorus ; Pseudohypoparathyroidism* ; Spasm ; Syncope

Pseudohypoparathyroidism (PHP) is a rare clinical type of hypoparathyroidism. The patients with PHP show classic clinical and biochemical features of hypoparathyroidism, but elevated serum level of parathyroid hormone (PTH) and characteristic physical appearances termed 'Albright's hereditary osteodystrophy' (AHO). PHP is classified into types Ia, Ib, Ic and II according to the presence of AHO phenotype and the mechanism of PTH resistance. We experienced a case of PHP in a 12 year-old girl with carpopedal spasm, syncope and partial AHO. She showed very low serum calcium level (1.4 mmol/L), high phosphorus level (3.62 mmol/L) and high immunoreactive PTH level (186.6 ng/L). In the Ellsworth-Howard test, urinary cyclic adenosine monophosphate and phosphorus levels after an exogenous PTH injection remained unchanged. Therefore, we were able to classify the patient as either PHP type Ia or Ic. After the patient had been treated with daily calcium carbonate (1 g), cholecalciferol (250 IU) and calcitriol (0.5 microgram), her neurological signs and symptoms as well as her biochemical abnormalities of hypocalcemia and hyperphosphatemia were improved.
Adenosine Monophosphate ; Calcitriol ; Calcium ; Calcium Carbonate ; Child ; Cholecalciferol ; Female ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Hypoparathyroidism ; Parathyroid Hormone ; Phenotype ; Phosphorus ; Pseudohypoparathyroidism* ; Spasm ; Syncope

Extracellular ATP (exATP) has been known to be a critical ligand regulating skeletal muscle differentiation and contractibility. ExATP synthesis was greatly increased with the high level of adenylate kinase 1 (AK1) and ATP synthase beta during C2C12 myogenesis. The exATP synthesis was abolished by the knock-down of AK1 but not by that of ATP synthase beta in C2C12 myotubes, suggesting that AK1 is required for exATP synthesis in myotubes. However, membrane-bound AK1beta was not involved in exATP synthesis because its expression level was decreased during myogenesis in spite of its localization in the lipid rafts that contain various kinds of receptors and mediate cell signal transduction, cell migration, and differentiation. Interestingly, cytoplasmic AK1 was secreted from C2C12 myotubes but not from C2C12 myoblasts. Taken together all these data, we can conclude that AK1 secretion is required for the exATP generation in myotubes.
Adenosine Triphosphate/*biosynthesis ; Adenylate Kinase/*metabolism ; Animals ; Cell Line ; Extracellular Space/metabolism ; Isoenzymes/*metabolism ; Mice ; Muscles/cytology/*metabolism

Patients with nonfunctioning bladders, such as found in anuric renal failure, are prone to a severe form of urinary tract infection called pyocystis. Pyocystis is the accumulation of pus in the bladder. Anuric patients are often believed to be incapable of acquiring a urinary pathogen; thus, the urinary tract may be mistakenly discounted as a possible source of sepsis and bladder rupture. Although bladder rupture is normally associated with trauma, spontaneous bladder rupture may occur, especially in patients with mental disabilities, alcohol abuse and urinary tract infection. We report a rare case of a spontaneous intraperitoneal bladder rupture, probably precipitated by pyocystis. Symptoms and signs were atypical and included pain and vomiting with fever, abdominal distension and ascites. An abdominal CT and retrograde cystography showed a large quantity of intraperitoneal fluid and tearing in the dome of the bladder. Repair of the rupture site of the bladder after laparotomy was performed. However,, the patient expired due to peritonitis and pulmonary infection.
Alcoholism ; Anuria* ; Ascites ; Fever ; Humans ; Kidney Failure, Chronic* ; Laparotomy ; Peritonitis* ; Renal Insufficiency ; Rupture ; Rupture, Spontaneous* ; Sepsis ; Suppuration ; Tomography, X-Ray Computed ; Urinary Bladder* ; Urinary Tract ; Urinary Tract Infections ; Vomiting