The metallic failure is one of the annoying problems after fracture surgery. The seventeen cases of metallic failures after compression plate fixation were treated at the Department of Orthopaedic Surgery. Yonsei University Wonju College of Medicine between January, 1980 and December, 1988. The results were summerized as follows: l. Among 17 cases, 12(70.5%) were under 40 years of age and 14(80%) were male patients. 2. The sites of fracture of the seventeen cases; 12 femurs, 3 tibiae, and 2 radii. Of the cases, there were breakage of plates in 13 cases, bending 1 case and failure of screw in 3 cases. 3. The pattern of fracture: communited fracture
Femur ; Fractures, Bone ; Fractures, Open ; Gangwon-do ; Humans ; Incidence ; Male ; Osteoporosis ; Radius ; Tibia ; Transplants ; Weight-Bearing

PURPOSE: The purpose of this study was to describe the clinical outcome after pancreatcetmy and its relationship with pathological appearances and clinical features in patients with persistent hyperinsulinemic hypoglycemia of infancy(PHHI). METHODS: Medical records of 10 patients(9 males and 1 female, mean age:40.4+/-1.5 months) who were diagnosed as PHHI and underwent pancreatectomy from 1988 to 2000 were reviewed. Clincal and biochemical data were recorded. Subjects were classified arbitrarily into early-onset or late-onset group according to age of onset. Pathologic appearance of pancreas was divided into 2 forms:diffuse or focal. The former had a focal pancreatic adenomatous hyperplasia and the latter was characterized by increased number of betacells with similar distribution seen in normal neonates. RESULTS: One patient had focal, and nine had diffuse lesions. After near-total pancreatectomy, 4 patients(40.0%) showed complete response, 4(40.0%) had persistent hypoglycemia, and 2(20.0%) developed diabetes mellitus. As neurological sequelae, 6 patients(60.0%) had persistent seizures, and 6(60.0%) had delayed motor and speech development. No clinical or biochemical factors related to postoperative outcome were found. CONCLUSION: This data indicate that early diagnosis of patients who present with hypoglycemic symptoms in infancy, especially early in life, and development of more effective therapy are warranted, because there is no clinical or biochemical factor predicting final outcome after near-total pancreatectomy and only 40% of patients with PHHI remained euglycemic after surgery with possible severe neurological sequelae.
Age of Onset ; Congenital Hyperinsulinism* ; Diabetes Mellitus ; Early Diagnosis ; Female ; Humans ; Hyperplasia ; Hypoglycemia ; Infant, Newborn ; Male ; Medical Records ; Pancreas ; Pancreatectomy* ; Seizures

No abstract available.
Pancreatic Diseases*

No abstract available.
Humans ; Male ; Nursing* ; Urinary Incontinence*

Until recently edrophonium has not been used in clinical anesthesis because of its short duration of action and poor anticholinesterase activity. However there has been a renewed interest in the use of edrophonium for the reversal of the new intermediate acting relaxants, vecuronium and atracurium, which have a fast spontaneous recovery rate. Edrophonim in sufficient dosages may produce a fast onset of antagonism of non-depolarizing neuromuscular blockade with minimal muscarinic side effects. The porpose of this study was therefore to compare the efficiency of edrophonium and neostigmine in reversal of a profound neuromuscular blockad following continuous infusion of vecuronium (0.06 mg/kg/hr). Recovery of T1 and T4 twitch height, change of heart rate and mean arterial pressure were obsered after antagonism with control mixture group (n=10): neostigmine 0.04mg/kg and atropin 0.02 mg/kg, and experimental mixture group (n=9): edrophoninm 0.5mg/kg and atropine 0.007 mg/kg were evaluated respectively at the 10% spontaneous recovery of T1 twitch height. Recovery of T1 was more faster in the edrophonium group than in the neostigmine group but it was significant until 5 minutes after antagonism (p<0.05) and recovery of T4 was also significantly faster in the edrophonium group until 5 minutes after antagonism but thereafter, conversly faster in the neostigmine group than in the edrophonium(p<0.05). Changes of heart rate with +/-5% after edrophonium administration were observed. We conclude that edrophonium provides a more rapid antagonism within 5 minutes after antagonizing vecuronium infusion, and small change in heart rate, but no other any advantage in using edrophomine instead of neostigmine for reversal after 5 minutes.
Arterial Pressure ; Atracurium ; Atropine ; Edrophonium* ; Heart Rate ; Neostigmine* ; Neuromuscular Blockade ; Vecuronium Bromide*

We recently observed a pancreatic islet cell adenoma with nesidioblastosis in a neonate which was confirmed after subtotal pancreatectomy. A nesidioblastosis, a term coined by Laidlaw in 1938 to describe the neoformation of islet tissue by differentiation of tortipotent pancreatic duct cell, is extremely rare as a cause of neonatal hypoglycemia. Persistent hypoglycemia which was temporarily responsive to hypertonic glucose therapy, convulsion, and apnea were noted frequently. Blood insulin level was elevated inappropriately with respect to the blood glucose level. Preoperative CBC, urinslysis, chest X-ray, serum electrolytes, and ECG were normal except low blood glucose leve(21mg%). The patient was not permedicated. With infusion of 15% D/W, anesthesia was induced by tracheal intubation with 3mg/kg of succinylcholine and was maintained by controlled ventilation with O2(3L/min)-N2O(3L/min)-halothane(1%) and pancuronium. Hyperglycemia and hypoinsulinemia were developed after pancreatectomy, these were controlled satisfactorily by administration of regular insulin. The patient was discharged with normal blood glucose level and no requirement of insulin at 38 days of postoperation.
Adenoma ; Anesthesia ; Apnea ; Blood Glucose ; Electrocardiography ; Electrolytes ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia ; Infant, Newborn* ; Insulin ; Intubation ; Islets of Langerhans ; Nesidioblastosis* ; Numismatics ; Pancreatectomy ; Pancreatic Ducts ; Pancuronium ; Seizures ; Succinylcholine ; Thorax ; Ventilation

No abstract available.
Blood Platelets* ; Leukocytes* ; Plateletpheresis*

PURPOSE: Congenital hypothyroidism(CH) is not uncommon disorder, leading to retardation of mental development and growth, if not treated early. The aim of this study is to determine the factors influencing IQ of children with CH, diagnosed after 1 month of life. METHODS : Thirteen children with CH were included. They had intelligence test by KEDI-WISC(Korean Educational Development Institute-Wechsler Intelligence Scale for Children) and their medical records were reviewed. Their T4, TSH, height, age at diagnosis were investigated retrospectively. To evaluate the influence of T4, TSH, height, age at diagnosis on IQ, children were divided into three groups ; athyroid(n=8), sublingual(n=3), inborn errors of thyroid hormone synthesis(n=2) according to the result of thyroid scan. Results : In athyroid group, IQ closely correlated to VIQ and PIQ and had close relationship to T4 at diagnosis(.p=0.0086, r=0.8427), but no relation to TSH. There was no difference in height, T4 TSH, and IQ between athyroid and sublingual group. CONCLUSION : The results suggest that intellectual function in children with CH, diagnosed after 1 month of life depends on serum level of T4 at diagnosis. Further study is mandatory to elucidate the relationship between final IQ and factors, including thyroid function, age at diagnosis, adequacy of treatment, etc.
Child* ; Congenital Hypothyroidism* ; Diagnosis ; Growth and Development ; Humans ; Intelligence ; Intelligence Tests ; Medical Records ; Retrospective Studies ; Thyroid Gland

Vecuronium induced intense neuromuscular blockade was evaluated in 40 USA class l, ll adult patients using the post tetanic count (PTC) and train-of-four(TOF) methods. All patients were anesthetized with thiopental sodium, nitrous oxide(50%), and enflurane(1~2%). Neuromuscular monitoring commended immediately after administration of thiopental sodium. The ulnar nerve was stimulated using surface electrodes and the mechanical response of the adductor policis muscle recorded using the Acclograph, neuromuscular transmission monitor. TOF nerve stimulation was used every 15s. After supramaximal stimulation was achieved a bolus of vecuronium 0.1mg/kg was injected intravenously. The traches was intubated when TOF response was depressed to 95% or above to control twitch height and the lungs ventilated with a tidal volume of 10ml/kg and a rate of 14 b.p.m. The patients were allocated randomly to two groups of 20 patients each. Patients in control group were allowed to recover TOF response spontaneously, and in PTC group were applied tetanic stimulation(50Hz for 5s) at 7 minutes intervals during no TOF response. In PTC group, the tetanic stimulation was preceded by a 30s period of 1Hz stimulation on each occasion, which was continued after the 3s pause. Duration of no TOF response in each group, and relationship between first post tetanic twitch height of PTC and time to first reaction to TOF nerve stimulation in PTC group were measured. In the results, duration of no TOF response was shortened by tetanic stimulation(p<0.01). There was a close inverse correlation between first post tetanic twitch height or PTC and time to first reaction to TOF nerve stimulation (p<0.01). It was concluded that PTC method appeared to be a valuable supplement to TOF nerve stimulation in assessment and trend for vecuronium induced intense neuromusclular blockade.
Adult ; Electrodes ; Humans ; Lung ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Thiopental ; Tidal Volume ; Ulnar Nerve ; Vecuronium Bromide*

No abstract available.
Hepatitis B* ; Hepatitis*