No abstract available.

The os calcis is fractured more frequently than any other tarsal bone. Fractures involving subtalar joint can, be associated with prolonged and severe disability. So there is no universal agreement in the treatment of these fractures. Calcaneal fractures of 64 feet in 56 patients who were treated at Severance Hospital, Yonsei University College of Medicine from Jan. 1971 to Dec. 1980 were analyzed in clinical and radiological aspects. The results obtained from this study were as follows; 1. Of 56 patients, 46 patients were male and 10 female. 2. The main cause of fractures of calcaneus was a fall from a height in 71.4 percents of cases, and spine injury was associated in 15 patients (26.8%) with calcaneal fractures. 3. The fractures were almostly closed (89.1%). 4. Fractures involving subtalar joint were in 52 feet (81.3%) and Rowe's type 5 were 38 fractures (39.4%). Of these type 5 fractures, 31 fractures were treated by closed reduction and axial pin fixation and then favourable results were obtained. 5. The most common complication after treatment was persistant foot pain. Pain beneath the lateral malleolus was the most common (8 feet), and correlated with the decrease of Bohler's angle.
Calcaneus ; Clinical Study ; Female ; Foot ; Humans ; Male ; Spine ; Subtalar Joint ; Tarsal Bones

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

BACKGROUND: Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU). METHODS: This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016. RESULTS: The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively. CONCLUSIONS: LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.
Anoxia ; Critical Care* ; Critical Illness ; Diagnosis ; Diaphragm ; Fever ; Humans ; Lung* ; Medical Records ; Pneumonia ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema ; Radiography, Thoracic ; Retrospective Studies ; Ultrasonography* ; Weaning

A putative gamma herpesvirus, termed human herpesvirus 8 (HHV-8), discovered in recent years, has been implicated as a possible etiologic agent for Kaposi`s sarcoma (KS). In South Korea, the incidence of KS in HIV seropositive individuals is very low. The cause of its rarity as compared with other countries is unclear. The objective of this study was performed to determine the prevalence of infection with HHV-8 and to clarify the cause of low incidence of KS in Korean populations including HIV seropositive individuals. The study population was composed of 200 blood donors, 220 voluntary visitors for sexual transmitted infection (STI)-testing in the public health centers, and 214 HIV-seropositive individuals. For the detection of HHV-8 antibodies, all blood samples were tested using Advanced Biotechnologies Inc`s enzyme-linked immunosorbent assay (ELISA) kits and the reactive samples were retested using Biotrin International SARL`s immunofluorescent assay (IFA). Also, we investigated the seroprevalence of Cytomegalovirus (CMV), Varicella-Zoster virus (VZV) and Epstein-Barr Virus (EBV) in order to get more information of HHV-8 and other human herpesviruses transmission in Korea. The prevalence of specific IgG to HHV-8 among HIV seropositive individuals was 7.0% {95% confidential interval: 4.0-11.3%}. The specific antibody to HHV-8 could be detected only in HIV seropositive men. The prevalences of antibodies to other human herpesviruses unlike HHV-8 were very high even in blood donors. These observations strongly suggest that the rarity of KS in this country may be caused by very low prevalence of HHV-8.
Antibodies ; Biotechnology ; Blood Donors ; Cytomegalovirus ; Enzyme-Linked Immunosorbent Assay ; Herpesviridae ; Herpesvirus 3, Human ; Herpesvirus 4, Human ; Herpesvirus 8, Human* ; HIV ; Humans* ; Immunoglobulin G ; Incidence ; Korea* ; Male ; Prevalence ; Public Health ; Sarcoma* ; Sarcoma, Kaposi ; Seroepidemiologic Studies*

BACKGROUND: To investigate the risk factors for vaginal infections and antimicrobial susceptibilities of vaginal microorganisms among women who experienced preterm birth (PTB), we compared the prevalence of vaginal microorganisms between women who experienced preterm labor (PTL) without preterm delivery and spontaneous PTB. METHODS: Vaginal swab specimens from 126 pregnant women who experienced PTL were tested for group B streptococcus (GBS), Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Chlamydia trachomatis, Trichomonas vaginalis, Neisseria gonorrhoeae, Treponema pallidum, herpes simplex virus (HSV) I and II, and bacterial vaginosis. A control group of 91 pregnant women was tested for GBS. Antimicrobial susceptibility tests were performed for GBS, M. hominis, and U. urealyticum. RESULTS: The overall detection rates for each microorganism were: U. urealyticum, 62.7%; M. hominis, 12.7%; GBS, 7.9%; C. trachomatis, 2.4%; and HSV type II, 0.8%. The colonization rate of GBS in control group was 17.6%. The prevalence of GBS, M. hominis, and U. urealyticum in PTL without preterm delivery and spontaneous PTB were 3.8% and 8.7% (relative risk [RR], 2.26), 3.8% and 17.3% (RR, 4.52), and 53.8% and 60.9% (RR, 1.13), respectively, showing no significant difference between the 2 groups. The detection rate of M. hominis by PCR was higher than that by culture method (11.1% vs. 4.0%, P=0.010). The detection rates of U. urealyticum by PCR and culture method were 16.7% and 57.1%, respectively. CONCLUSIONS: There was no significant difference in the prevalence of GBS, M. hominis, and U. urealyticum between the spontaneous PTB and PTL without preterm delivery groups.
Female ; Humans ; Microbial Sensitivity Tests ; Mycoplasma Infections/complications/microbiology ; Mycoplasma hominis/isolation & purification ; Obstetric Labor, Premature/*epidemiology/etiology ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology/microbiology ; Premature Birth/*epidemiology/etiology ; Prevalence ; Risk Factors ; Streptococcal Infections/complications/microbiology ; Streptococcus agalactiae/isolation & purification ; Ureaplasma Infections/complications/microbiology ; Ureaplasma urealyticum/isolation & purification ; Vagina/*microbiology

BACKGROUND: Multi-drug resistant (MDR) Acinetobacter baumannii has emerged as a significant infectious agent in hospitals worldwide. The purpose of this study was to determine the molecular characterization of MDR A. baumannii clinical isolates. METHODS: Two hundred eighty-five strains of non-duplicated A. baumannii collected from March to November 2011 from a university hospital laboratory located in the Wonju area of the Gangwon province of Korea were analyzed for MDR genes. RESULTS: All of the 285 imipenem-resistant A. baumannii isolates were encoded by a blaOXA-23-like gene, and all isolates with the blaOXA-23-like gene had the upstream element ISAba1. The 16S rRNA methylase gene armA was detected in 153 (50.2%) clinical isolates, but rmtA, rmtB, rmtC, rmtD and npmA were not detected in any isolates in the present study. The gene encoding aac(6')-Ib was the most prevalent aminoglycoside-modifying enzyme. The sequencing data for the quinolone resistance-determining region of gyrA and parC revealed the presence of Ser (TCA) 83 to Leu (TTA) and Ser (TCG) 80 to Leu (TTG) substitutions. All but one of the 285 A. baumannii isolates showed similar band patterns on repetitive extragenic palindromic-PCR profiles. CONCLUSION: The molecular characteristics of the resistance genes of MDR A. baumannii isolates obtained from the Wonju area of Gangwon province were similar to those of other areas in Korea.
Acinetobacter ; Acinetobacter baumannii ; beta-Lactamases ; Genes, MDR ; Imipenem ; Korea ; Laboratories, Hospital ; Methyltransferases

PURPOSE: The objective of this study is to ascertain whether the positive relationship exists among the frenum length, the tongue movement and the speech and to present the normal range of tongue movement and guidelines for the choice of surgery, observation if necessary. MATERIALS AND METHODS: 180 patients were evaluated. We divided 180 patients into 6 groups by age. Each group was separated as follows; the age of 2.5-4, 5-6, 7-9, 10-12, 13-15, 16-18. We measured the frenal length, the range of tongue motion and evaluated the speech so that we really questioned about the positive relationship between the tongue-tie and speech. We let the patient exercise the protrusive, both(right, left) laterotrusive, superior movement of the tongue. During these movements, we measured the distance between the vermilion border and the tongue tip. We also measured the distance from the tongue tip to the point contacting the upper lip with dorsum of the tongue during the maximal protrusive movement of the tongue. Three linear measurements of the anterior, inferior segment of the tongue, including the lingual frenum, are made. These measurements are as follows: 1. Distance A. Free anterior portion of the tongue from the point of frenular insertion to the tongue tip. 2. Distance B. The distance from the initiating point of the lingual frenum to the point connecting the two sublingual caruncles to the lingual frenum perpendicularly. 3. Distance C. The distance from the point contacting the line crossing the sublingual caruncles with the lingual frenum to the terminating point of the lingual frenum. We transform three linear measures into a statistical ratio, A/(A+B+C), representing the length of the free portion of the tongue compared with the total sublingual dimensions. In addition, we assessed the speech through Picture Consonant Articulation Test (PCAT) and tried to find out the relationship between the length of the lingual frenum and speech. CONCLUSION: As people are born, they have small and restricted tongue. As people grow old, tongue motions are more liberate, and unrestricted and they can speak so freely. Therefore we suggest that until age 5, oral and maxillofacial surgeons postpone the surgery if not urgent, evaluate the maximal lingual motions and PCAT according to this article and observe their changes.
Humans ; Linear Energy Transfer ; Lingual Frenum* ; Lip ; Reference Values ; Tongue*

BACKGROUND: Coughing during emergence from general anesthesia may be detrimental. Propofol is known to inhibit airway reflexes. We evaluated the incidence and severity of coughing in adults who received a subhypnotic dose of propofol at the end of sevoflurane-remifentanil anesthesia. METHODS: Sixty patients, aged 18-65 years, undergoing elective nasal surgery under general anesthesia using sevoflurane and remifentanil were randomly allocated to the propofol group (n = 30) or the control group (n = 30). At the end of surgery, sevoflurane and remifentanil infusion was stopped. After 3 min, the propofol group received propofol 0.3 mg/kg and the control group received normal saline 0.03 ml/kg. The incidence and severity of cough, recovery time and hemodynamic parameters were evaluated during the emergence period. RESULTS: During emergence, the propofol group had the significantly lower incidence (60 vs. 87%) and severity of coughing compared with the control group (P = 0.04, P = 0.02, respectively). There were no significant differences in mean arterial pressure, heart rate, and recovery time during emergence between the two groups. CONCLUSIONS: During emergence from sevoflurane-remifentanil anesthesia, a subhypnotic dose (0.3 mg/kg) of propofol decreases the incidence and severity of coughing without delaying wake up in adults undergoing nasal surgery.
Adult* ; Anesthesia* ; Anesthesia, General ; Arterial Pressure ; Cough* ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Nasal Surgical Procedures ; Propofol* ; Reflex