Dislocation involving talus is a rare injury comprising less than 1% of all dislocations of the joint. One case of lateral subtalar di location of the talus treated at the Department of Orthopedic Surgery, Kang Nam General Hospital in Decernber 1985. The patient was followed for 6 months and satisfactory healing was obtained.
Dislocations ; Hospitals, General ; Humans ; Joints ; Orthopedics ; Talus

Twenty one cases of adult tibial shaft fractures were fixed with flexible intramedullary nails at the Department of Orthopedic Surgery, Kang Nam General Hospital. The results are summerized as follows; l. Average healing time was 17 weeks. No case of nonunion was experienced. 2. As the operation was perfomed by closed method under fluoroscopic control, reduction of operation time is a major advantage. 3. Fixation was usually strong enough to allow immediate weightbearing and mobilization of the adjacent joints without external immobilization. 4. Three cases of delayed union and 2 cases of rotational malunion were experienced, but shortening and angulation were not so severe as to affect overall functional results. 5. In conclusion, Ender nailing is considered to be a valuable method in treating tibial shaft fractures. Even in cases with multiple injuries and in selected open cases, Ender nailing can be a saft procedure.
Adult ; Hospitals, General ; Humans ; Immobilization ; Joints ; Methods ; Multiple Trauma ; Orthopedics ; Tibial Fractures ; Weight-Bearing

A 43-year-old female patient with a congenital right coronary artery to right atrial fistula presented as congestive heart failure and aortic valve infective endocarditis. The diagnosis was made on the basis of echocardiography, especially TEE and confirmed by tight heart catheterization & aortography. She underwent aortic valve replacement due to severe aortic valve regurgitation with vegetations, fistulectomy and coronary aneurysmorrhaphy. The postoperative course was uneventful. She was treated with antibiotics because of infective endocarditis for 6 weeks. At present she remains well and visits out patient clinic regularly for oral anticoagulation without problem.
Adult ; Anti-Bacterial Agents ; Aortic Valve* ; Aortography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Diagnosis ; Echocardiography ; Endocarditis* ; Estrogens, Conjugated (USP)* ; Female ; Fistula ; Heart Failure* ; Humans

PURPOSE: This study was designed to clarify the osseointegration of the titanium screw coated with CMP, in regard to the time schedule, through the characteristic of early osseointegration. MATERIALS AND METHODS: Mechanical, radiological and histomophometric measurements were performed in 28 rabbit tibial proximal metaphyseal cortical bone screws 6, 12, 26 and 52 weeks after surgery for the in vivo comparison of the osseointegration of titanium screws (3.75 mm diameter, 5 mm length) with different surface treatments: CMP coating group, with the sol-gel method (experimental group) and uncoated group (control group). RESULTS: 1. Radiology: There were no differences between the two groups without a radiolucent line or in regard to the time schedule. 2. Histology: There were no differences between the two groups without a fibrous tissue intervening surface or in regard to the time schedule. 3. Torque test: The test results for the CMP coated group were 1.5 times higher than those for the uncoated group, which was statistically meaningful, but there was no difference in regard to the time schedule. CONCLUSION: CMP coating is an option to increase the osseointegration of the titanium screw.
Appointments and Schedules ; Bone Screws ; Ceramics* ; Osseointegration* ; Tibia ; Titanium ; Torque

PURPOSE: Immunosuppression is important for early success of renal transplantation. Mycofenolate mofetil (MMF) has been substituted for Azathioprine (AZA) and has been shown to have greater effect on T cell and also on B cell function than AZA. Although many side effects like infections have been investigated in patients who received AZA based therapy, they have not extensively been studied in MMF based protocol. The aim of this study is to evaluate the differences in incidence and frequency of infections during the first 6 months in the patients who received AZA or MMF based therapy. METHODS: Renal transplant recipients who received either AZA or MMF based therapy were reviewed. From January 1994 to December 2003, 112 patients were enrolled and analyzed the types and frequency of infection. RESULTS: 78 patients received AZA based therapy, and 34 patients received MMF based therapy. Infection developed in 37 (47.4%) and 12 (35.3%) patients respectively. AZA group showed higher incidence of infection than MMF group (P<0.05). In AZA group, UTI developed in 15 patients (19.2%), URI in 7 patients(9%), CMV infection in 7 patients (9%), tuberculosis in 2 patients (2.6%), and wound infection in 6 patients (7.7%). In MMF group, UTI developed in 6 patients (17.6%), URI in 2 patients (5.9%), CMV infection in 2 patients (5.9%), tuberculosis in 1 patient (2.9%), wound infection in 1 patient (2.9%). There were no significant differences in the type of various infectious episodes between two groups. CONCLUSION: AZA group showed higher incidence in total infection, but there were no differences in the type of various infectious episodes between two groups. MMF has more powerful immunosuppressive effect (18) but has similar infectious adverse effects compared with AZA.
Azathioprine ; Humans ; Immunosuppression* ; Incidence ; Kidney Transplantation ; Transplantation* ; Tuberculosis ; Wound Infection

To clarify the correlations between the body height and maximum femoral length, we carried out orthoscanographic study in 187 normal adult Koreans (male; 80, female; 107). The results are as follws: 1. The average femoral length was 43.73±2.13cm for male, and 40.53±2.03cm for female. 2. The ratio of the femoral length to the height was 26.10±0.82% for male, and 35.91±0.77% for female. The coefficient of correlation was 0.78 and 0.80, respectively. 3. The regression equation was Y= −7.76+0.31X for male Y= −2.85+0.28X for female. (X: body height. Y: maximum femoral length)
Adult ; Body Height ; Female ; Humans ; Male

Case 1: A 39-year-old man underwent orthotopic heart transplantation on November 1994 for dilated cardiomyopathy. His postoperative course was unevenful and medications included daily cyclosporin A, Immuran and prednisone. On December 13.1994, he developed cough and sore throat. Chest radiographs revealed multiple patch growing lesions. Sputum fungus culture revealed Aspergillus Fumigatus. The patient was treated with daily infusion of amphotericin B. He remains well without evidence of relapse of Aspergillus, Case 2: This 39-year-old man had undergone orthotopic heart transplantation on November 16 1994 for dilated cardiomyopathy. In December 7.1994. he developed recurrent syncope. Chest radiographs revealed fungus ball like lesion on right lung field. On open lung biopsy and wedge resection of the mass was performed. Aspergillosis and CMV infection was demonstrated in the biopsy specimen. The patient was treated with conventional amphotericin B therapy for over 7weeks and Ganciclovir for over 2weeks. At the end of therapy chest X-ray showed only small residual scar in the area of previous mass.
Adult ; Amphotericin B ; Aspergillosis* ; Aspergillus ; Aspergillus fumigatus ; Azathioprine ; Biopsy ; Cardiomyopathy, Dilated ; Cicatrix ; Cough ; Cyclosporine ; Fungi ; Ganciclovir ; Heart Transplantation* ; Heart* ; Humans ; Lung ; Pharyngitis ; Prednisone ; Radiography, Thoracic ; Recurrence ; Sputum ; Syncope ; Thorax

PURPOSE: Emergency department (ED) overcrowding results in loss in timely, effective medical care, as well as in social and economical efficiency. This paper proposes a new overcrowding index to reduce and to prevent these losses. METHODS: We investigated the real-time situation of the emergency department in a major Korean hospital, compared to existing indices and to extracted factors to develop a new, customized overcrowding index based on the flow of patients, a reflection of emergency room conditions. We developed 3 indices, FFOI (Front Flow Overcrowding Index), BFOI (Back Flow Overcrowding Index), and TFOI (Total Flow Overcrowding Index). Each index was applied to test the period from 10 September 2007 to 16September 2007. We extracted values of each index at 3- hour intervals and estimated how they reflected the overcrowding situation compared with basic overcrowdingindices. We used the correlation coefficient and Kullback- Leiblur (KL) distance as the basis for measurement. RESULTS: Existing indices are emergency department work index (EDWIN), national emergency department overcrowding scale (NEDOCS), and real-time emergency analysis of demand indicator (READI) work score (WS). EDWIN and READI did not reflect accurately the overcrowding situation. Some factors extracted from NEDOCS and WS were not suited to the emergency department. We solved these problems by develop in new indices. CONCLUSION: In conclusion, the new indices are more effective and descriptive than the existing indices with respect to correlation to crowdedness in the emergency department. In the future, the new, customized overcrowding index will become more descriptive if the necessary data is gathered in real time and more effectively verified by the medical staffs and patients.
Crowding ; Emergencies ; Emergency Medical Services ; Humans ; Medical Staff

A 72-year-old man who had suffered several episodes of syncope was diagnosed as having hyperinsulinemic hypoglycemia. Although imaging studies and percutaneous transhepatic portal venous sampling did not reveal the existence of any tumors in the pancreas, distal pancreatectomy was performed because the possibility of a small pancreatic endocrine tumor could not be completely rejected. External examination of the surgically removed pancreas did not reveal any tumors. Microscopically, the pancreas exhibited diffuse islet cell hyperplasia without nesidioblastosis. The patient remains euglycemic and has tolerated 24-hour fasting without any medication for a period of 10 months after the operation.
Aged ; Case Report ; Human ; Hyperinsulinemia/etiology* ; Hyperplasia ; Hypoglycemia/etiology* ; Islets of Langerhans/surgery ; Islets of Langerhans/pathology* ; Male ; Pancreatectomy/methods ; Treatment Outcome

Malignant duodenocolic fistula is a rare complication of colon cancer, and this usually develops as the right-side colon cancer that invades the duodenal bulb. The fistula often results in watery diarrhea, weight loss and feculent vomiting. A barium enema or duodenography have been the most useful diagnostic procedures, and the fistula is directly confirmed by an endoscopic examination. Curative resection is not possible in many cases due to metastasis or local invasion, so a palliative operation can be performed to relieve symptoms, but it cannot completely prevent the vomiting or diarrhea. Seven Korean cases of malignant duodenocolic fistula have been previously reported on, and an operation was performed in six cases. We report here on a case of duodenocolic fistula with intestinal obstruction that arouse from a right-side colon cancer, and this was successfully managed by placing covered metallic stents at the duodenum and hepatic flexure.
Barium ; Colonic Neoplasms ; Diarrhea ; Duodenum ; Enema ; Fistula ; Intestinal Obstruction ; Neoplasm Metastasis ; Stents ; Vomiting ; Weight Loss