No abstract available.
Psychotherapy*

Avulsion of triceps tendon from the olecranon is a rare injury. Since the first report of Partridge in 1968, fewer than 30 instances have been recorded in the English literature. The authors have experienced a case of the avulsion of the triceps tendon in 25 year-old male which was caused by a accidental fall from one meter height. The surgical treatment, the use of heavy wire sutures passed through the tendon and through holes drilled in the olecranon, produced successful results in two and half years follow-up period.
Accidental Falls ; Follow-Up Studies ; Humans ; Male ; Olecranon Process ; Sutures ; Tendons

The meniscus has improtant functions of shock absorption, load transmission, lubrication and significant contribution to stability of the knee. Accordingly, repair rather than excision can be expectd to be satisfactory and functional teatment for knee joint. We had Repaired 56 cases of meniscal tears from March, 1987 to September of 1992, among which 42 cases were followed up for at least 12 months to 60 months at most(in average 36 months). The results were as follows; 1) In medial meniscal tears, 26 cases were acute, while five were chronic. As for the lateral meniscus, acute and chronic teats were observed in nine and two cases, respectively. 2) Eleven of the 35 acute tears were associated with anterior cruciate ligament tears, while three of seven chronic tears were associated with anterior cruciate ligament tears. 3) Second-look arthroscopic examinations were performed on nine repaired cases. Retears occurred in two cases and seven cases revealed healing at repair sites. 4) Two cases(5%) out of 42 repaired menisci were return during follow-up. One was a case of isolated meniscal tear and the other was associated with rupture of anterior cruciate ligament. 5) Two return cases were repaired in the chronic stage of more than one year after trauma. 6) The standing radiographs which were taken in full extension and 45 flexion on eight out of 13 patients, who had been followed up for more than 4 years showed intact joint space without narrowing.
Absorption ; Anterior Cruciate Ligament ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Lubrication ; Male ; Menisci, Tibial ; Rupture ; Shock ; Tears

No abstract available.
Addison Disease*

BACKGROUND: To provide basic data to help construct regional EMSS. METHOD: Using preformed questionnaire, authors investigated prospectively data of 214 patients transferred directly to emergency medical center from other hospitals from May 11 to june 10,1998. RESULTS: 1. Total 214 patients were transferred directly to the emergency medical center of KNUH (14.4% of total), and 63.5% of patients excluding children were non-traumatic patients. 2. The peak age group was 5th decade (19.6%) with mean age of49.6 years old. The male to female ratio was 1.8 : 1. 3. The period between 08 : 00 to 16 : 00 was the most frequent arrival time of transfer patients (42.5%), and the proportion of patients for surgical departments were more common than those for other departments (53.7%). 4. the majority of patients were transferred from secondary hospitals (91.6%), but among them the proportion of mild non-traumatic and mild traumatic patients was 52.3%, and 72.0%. 5. The decision-maker for transfer was a patient himself or family members in 32.3% of severe and 26.8(/) of mild non-traumatic patients, compared with 37.5% of severe and 26.8% of mild traumatic patients. 6. The physician-to-physician communication prior to the patient's transfer was not carried out in 90.8% of severe and 85.9% of mild non-traumatic patients, compared with 75.0%of severe and 67.0%of mild traumatic patients. 7. The hospital ambulance was the most common mode of transfer (64.5%), but non-emergency vehicles such as a taxi or a private car was used for transfer in 21.5% of severe non-traumatic patients, and 12.5% in severe traumatic patients. 8. Transfer accompanied by medical personnel took place in 15.4% of severe non-traumatic patients, 25.0% in severe traumatic patients, and in 27.0% of severe non-traumatic patients, and 44.4% in severe traumatic patients transferred 4 by hospital ambulance. 9. Transfer took less than 1 hour in 66.9% of non-traumatic patients, and 45.2% of traumatic patients, but it took 1 hour or more in 27.7% of severe non-traumatic patients, and 43.7% of severe traumatic patients. 10. Transfer record accompanied the patient in 90.2% of total, but radiologic film and results of laboratory tests did not in 36.9% and 56.9% of severe non-traumatic patients, and in 12.5% and 43.7% of severe traumatic patients. CONCLUSION: It is considered that an appropriate triage system, interhospital transfer guidelines, good transfer records, cooperative interhospital communication, emergency medical information center, public information with education about regional EMSS, improvement of equipment in ambulance, and training of emergency personnel are necessary for effective and well-organized EMSS.
Ambulances ; Child ; Education ; Emergencies* ; Female ; Humans ; Information Centers ; Male ; Prospective Studies ; Surveys and Questionnaires ; Triage

Fractures at the lateral end of the clavicle inevitably require surgical treatment as there is high potential for delayed union or nonunion. Acromioclavicular dislocation also requires stable and solid fixation for healing, and surgical treatment is recommended for the maintenance of joint function. The hook plate maintains the biomechanics of the acromioclavicular joint, enabling early range of motion. Therefore, for the past 10 years, the hook plate has been widely used in distal clavicle fractures and acromioclavicular joint injuries. However, the hook plate is associated with several complications, such as proximal clavicle fractures, widening of the hook hole, rotator cuff tear, subacromial impingement, and often acromial fractures. We report on two unusual cases of acromion fracture after hook plate fixation in patients with distal clavicle fracture and acromioclavicular dislocation alongside a literature review.
Acromioclavicular Joint ; Acromion* ; Clavicle* ; Dislocations ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Rotator Cuff ; Tears

No abstract available.
Clavicle*

No abstract available.
Clavicle*

Premature rupture of membranes(PROM) means the rupture of amniotic membranes at any time prior to labor during the gestational period. The dilemma of correctly diagnosing rupture of the fetal membranes is well known as the consequences of management based on an incorrect diagnosis. This study was undertaken to determine if the measurement of B-hCG levels in the vaginal fluid is useful for the diagnosis of premature rupture of membranes. HCG is synthesized and secreted by the placental syncytiotrophoblast and it is normally found in amniotic fluid, maternal urine and blood. We used B-hCG for diagnosis of PROM to exclude the cross reaction with other hormones. After irrigating the posterior vaginal fornix with 3 ml of sterile saline and obtaining vaginal washings, we measured B-hCG levels. The groups were classified normal group(group I), confirmed PROM group(group II ), and suspicious PROM group(groupIII) during the third trimester. The median and 95% confidence intervals(CIS) of vaginal fluid B-hCG in each group(normal, confirmed PROM, suspicious PROM group) were 30.99mIU/ml(range: 0.32-209.89mIU/ml), 188.61mIU/ml(range: 9.65-2095.00mIU/ml), 69.63mIU/ml(range 4.76-349.56mIU/ml). There was significant difference between normal and confirmed PROM group(p<0.05), sensitivity was 95.00%, specificity 80.00%, positive predictive value 82.60%, negative predictive value 94.12%, and accuracy 87.50%, using threshold value of 60mIU/ml. There was significant difference between normal and suspicious PROM group(p<0.05) but the result of the B-hCG was not used in the obstetric decision. In terms of these results, the B-hCG level in vaginal fluid is a useful marker of PROM during the third trimester. A new technic is proposed to confirm the diagnosis of rupture of the membranes based on the introduction of B-hCG in vaginal fluid.
Amnion ; Amniotic Fluid ; Cross Reactions ; Diagnosis ; Extraembryonic Membranes ; Female ; Humans ; Membranes* ; Pregnancy ; Pregnancy Trimester, Third ; Rupture* ; Sensitivity and Specificity ; Trophoblasts

No abstract available.
Hair* ; Iron* ; Scalp*