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

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*

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

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.
Pancreatic Diseases*

No abstract available.
Hepatitis B* ; Hepatitis*

Purpose : Shortness is the most frequent and quite disturbing characteristics of patients with Turner syndrome. The aim of this study was to evaluate the factors affecting final adult height(FAH) in these patients. METHODS : The study group was comprised of 19 patients who were diagnosed as Turner syndrome and attained FAH. We analyzed the influences of various factors on FAH in GH treated group with those in GH untreated group. Results : Nineteen patients were enrolled; thirteen received GH treatment and six did not. The mean duration of GH treatment was 24.3 months(range : 9 to 50 months), and the mean dosage of GH was 0.98+/-0.35IU/kg/wk in GH treated group. The mean growth velocity during GH treatment was 5.6+/-1.8 cm/yr, which was significantly higher than that during pretreatment period(P<0.05). In GH treated group, the mean chronological age, bone age, mean height, and height SD score at GH therapy were 13.7+/-1.7yr, 11.3+/-1.9yr, 129.7+/-7.9cm, and -4.1+/-1.1, respectively, which were not statistically different from those at diagnosis of GH untreated group. In GH treated group, the mean FAH and FAH SD score were 144.8+/-5.0cm, and -3.2+/-0.9, respectively, which showed no significant difference compared with those of GH untreated group. Analyzing the factor affecting FAH in all Turner girls of both groups together, parental height, chronological age, bone age, and bone age delay at diagnosis(or at the initiation of GH therapy) were not related to FAH. Height and height SD score at diagnosis(or at the initiation of therapy) were positively related to FAH(P<0.05, r=0.72). CONCLUSION : The results suggest that GH treatment dose not improve FAH in patients with Turner syndrome, despite increased growth velocity during GH treatment, which might come from intermittern GH therapy. This should be remained to be clarified with more Turner patients who attained FAH.
Adult* ; Diagnosis ; Female ; Growth Hormone ; Humans ; Parents ; Turner Syndrome*

PURPOSE: The vessels of the finger tip are very small and fragile, have many branches, so the anastomosis of this vessel is very difficult. Guillotine type amputation of digits are rare, on the other hand, crush/avulsion injuries which require complex surgical solutions are more frequent. We often found that the arteries of distal amputee on crush/avulsion injuries are lost. In these cases, replantation is much more difficult even impossible. But when replantation is successes, the replantated finger tip provides adequate soft tissue, restoration of length, sensory and nail. MATERIALS AND METHODS: We report here our experience of finger tip replantation using afferent a-v anastomosis technique accumulated from March 2006 to March 2009. RESULT: The success rate was 96.4%. Complications occurred in eight patients. (5 digit atrophy, 1 osteomyelitis, 1 severe digit pain and 1 cold intolerance) CONCLUSIONS: We believe that the afferent a-v anastomosis replantation provides us wider range of indication of finger tip replantation on crush/avulsion injuries.
Amputation ; Amputees ; Arteries ; Arteriovenous Anastomosis ; Atrophy ; Cold Temperature ; Fingers ; Glycosaminoglycans ; Hand ; Humans ; Osteomyelitis ; Replantation

Lithium, first used by Cade in 1949 for the treatment of mania, is now commonly used in several affective disorders. The precise mechanism of its action is not clearly understood but the side effects may be severe. Prolongation of succinylcholine and pancuronium which possible mechanism of interaction involves impaired acetylcholine synthesis and release at nerve terminal has been reported. The present report describes a case of prolonged neuromuscular blockade induced by succinylcholine in a manic depressive patient being treated with oral lithium carbonate.
Acetylcholine ; Bipolar Disorder ; Humans ; Juniperus ; Lithium Carbonate* ; Lithium* ; Mood Disorders ; Neuromuscular Blockade* ; Pancuronium ; Succinylcholine*