PURPOSE: To compare the functional and radiographic results of the treatment in unstable intra-articular fractures of distal radius by closed reduction and external fixation versus open reduction and internal fixation. MATERIALS AND METHODS: Forty cases of unstable intra-articular fractures of distal radius were treated either by application of closed reduction and external fixation (CREF) or by open reduction and internal fixation (ORIF) between March 1989 and June 1997. They were followed up for more than one year. To assess the functional results, we used Green and O' Brien' s score system and for the radiographic results, measured volar tilt, radial inclination and radial length. RESULT: In functional results, excellent to good results were obtained in 19 cases (76%) in the CREF group and 10 cases (80%) in the ORIF group, and the average score was 81.4 and 82.8 by the Green and O' Brien' s score system. In radiographic results, mean loss of volar tilt, radial inclination and radial length were 1.4 degree (13.4%), 2.0 degree (9.0%), 1.3 mm (10.3%) in the CREF group and 1.2 degree (10.8%), 1.6 degree (6.1%) and 1.2 mm (11.5%) in the ORIF group on last follow-up radiographs. There was no evidence of statistical difference between two groups in functional and radiographic results (P>0.05). CONCLUSIONS: If an appropriate operative method is selected according to the presence of several properties, including the pattern of fracture, the general condition and activity of patient and the degree of soft tissue injury, the two operative managements are considered useful to restoring articular congruity and alignment and to allow early postoperative range of motion exercise
Follow-Up Studies ; Humans ; Intra-Articular Fractures* ; Radius* ; Range of Motion, Articular ; Soft Tissue Injuries

BACKGROUND: Urography(IVU) is considered the best first investigation in patient with suspected urinary calculi, but recently ultrasonography(USG), combined with a plain film of the abdomen, has been suggested as an alternative. METHODS: We undertaken study to see if this approch can be used in emergency patients and outpatients by radiologists with different amounts of ultrasound experence. Some 192 patients with suspected urinary colic presenting to Koo Hospital Emergency Department and Youngnam Universith Hospital outward Department(IM, URO, FM) over 12-month period were studied. They had a plain abdominal film(KUB) and USG examination of the kidney, ureter, bladder following hydration and subsequently underwent IVU. Of these, 22 patients passed a stone before their IVU. The data analysis was performed on the remaining 170 patients. Urography was used as the gold standard. RESULTS: Some 170 patients subsequently underwent IVU at a mean interval of 1.8 days after the ultrasound examination. In 91 of 170 patients the IVU was positive. In 97 of 170 patients the combination of JUB plus USG was positive, leaving three false negative KUB plus USG. Thus the sensitivity of KUB plus USG was 97%, specificity was 89%, positive predictive value was 91%, and negative predictive value was 96%. CONCLUSIONS: Our findings in this study suggest that in the hydrated patient the combination of KUB plus US is a very sensitive and relative specific screening test. Because of the high negative predictive value of KUB plus US, urography is not likely to be helpful when KUB plus US are negative. Urography is indicated only if KUB plus US findings are equivocal or if intervention is necessa.ry.
Abdomen ; Colic ; Emergencies ; Emergency Service, Hospital ; Humans ; Kidney ; Mass Screening ; Outpatients ; Sensitivity and Specificity ; Statistics as Topic ; Ultrasonography* ; Ureter ; Urinary Bladder ; Urinary Calculi* ; Urography*

PURPOSE: To evaluate the negative pressure wound therapy for traumatic soft tissue defects by vacuum-assised closure (V.A.C.(R)). MATERIALS AND METHODS: 33 patients with traumatic soft tissue defects were treated by using V.A.C.(R) which removes edema fluid, eliminates an extrinsic cause of microcirculatory embarrassment and may directly stimulate cellular proliferation of reparative granulation tissue. We removed all necrotic tissue prior to application of the V.A.C.(R). The foam dressing was placed into direct contact with wound and was changed every 48~72 hours. The setting for vacuum pump was continuous pressure of 100 to 125 mm Hg. C-reactive protein was checked to evaluate wound infection. We measured wound size and total duration of treatment. RESULTS: Mean duration of treatment was 25.2 days and mean decrease of wound size was 31.9%. The concentration of CRP after V.A.C.(R) therapy reduced by day 8 below 1.0 mg/dl and gradually decreased to normal level by day 10. All patients showed hastened wound healing by rapid formation of granulation tissue. CONCLUSION: Negative pressure wound therapy is useful in patients with traumatic soft tissue defects, which reduces treatment duration and cost by rapid wound healing and effective infection control.
Bandages ; C-Reactive Protein ; Cell Proliferation ; Edema ; Granulation Tissue ; Humans ; Infection Control ; Negative-Pressure Wound Therapy* ; Vacuum ; Wound Healing ; Wound Infection ; Wounds and Injuries

PURPOSE: To evaluate the outcome of minimally invasive osteosynthesis using locking compression plate for distal tibia fractures. MATERIALS AND METHODS: Forty five patients (45 cases) who underwent minimally invasive osteosynthesis using locking compression plate for distal tibia fractures between January 2006 and June 2008, were followed for more than one year. The average duration of the follow-up was 30.5 months (12~54 months). The fracture types were as followed: 26 cases (58%) of extraarticular fractures, 19 cases (42%) of intraarticular fractures, and 16 cases (36%) of open fractures. RESULTS: All patients achieved bone union at average of 21weeks (12~36 weeks). The average American Orthopedic Foot & Ankle Society ankle-hindfoot scales was 84.6 points (65~100 points) and range of ankle motion averaged at 46.5 degrees (20~60 degrees). Complications included 6 cases of superficial infection, 3 cases of malalignment and 5 cases of skin irritation by plate. There were no cases of deep infection, skin necrosis, shortening and metal breakage. CONCLUSION: Minimally invasive osteosynthesis using locking compression plate for distal tibia fractures is considered to be an effective method with high healing rate, rapid functional recovery and low complication rate due to minimal disruption of bone and soft tissue biology and improved fixation strength.
Animals ; Ankle ; Biology ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures ; Necrosis ; Orthopedics ; Skin ; Tibia ; Weights and Measures

No abstract available.
Sepsis* ; Yersinia*

A 16-month-old boy swallowed accidentally a button type lithium battery with diameter 23 mm. The battery impacted at the upper esophagus was removed by endoscpy in 9 hours. At the time of removal, dark-crust and erythematous mucosal lesion was noted where the battery impacted. At the first hospital day, fever over 38.5 degrees C developed, and NPO, antibiotics and H-2 blocker started. At the third hospital day, he had melena, and endoscopy revealed huge active esophageal ulceration ranging from upper esophagus and lower body of the esophagus. Steroid started. At the 10th hospital day, endoscopy revealed much smaller-sized ulceration, but mucosa where the battery impacted initially showed deep depression which might imply developing diverticulum. At the 17th hospital day, endoscopy revealed complete diverticulum. At the 27th hospital day, endoscopy revealed complete resolution of diverticulum.
Anti-Bacterial Agents ; Child ; Depression ; Diverticulum ; Endoscopy ; Esophagus* ; Fever ; Humans ; Infant ; Lithium* ; Male ; Melena ; Mucous Membrane ; Ulcer*

No abstract available.
Perfusion* ; Stroke Volume* ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Perfusion* ; Stroke Volume* ; Tomography, Emission-Computed, Single-Photon*

A complete atrioventricular block is seen in patients due to a variety of causes, including drugs. The resolution of a drug-induced atrioventricular block is often accomplished by drug discontinuation. We report a case of a complete atrioventricular block in a 31-year-old woman following a month of treatment with evening primrose oils. After excluding all other likely causes of conduction disorders, an adverse effect of the evening primrose oils seemed to be the most likely diagnosis. After discontinuation of the oils, no associated symptoms or conduction disturbances were observed for 4 months after discharge. We stress the reconsideration of taking medicines and functional foods continuously as most patients are not aware of the hazards they pose.
Adult ; Atrioventricular Block* ; Diagnosis ; Female ; Functional Food ; Humans ; Oenothera biennis* ; Oils

PURPOSE: The purpose of this study was to determine the results of internal fixation with locking plate system for the unstable proximal humerus fracture. MATERIALS AND METHODS: Sixteen cases of unstable proximal humerus fracture were treated using locking plate system between September 2004 and June 2005. Average age of the patients was 55.6 years (range, 22 to 78), male was four patients, female was twelve. The clinical outcomes were evaluated by using Neer's evaluation criteria and Constant socring system. We analyzed the radiological results by bony union time and Paavolainen method. All data was analyzed statistically. RESULTS: According to Neer's evaluation ciriteria, eleven cases (69%) showed excellent or satisfactory results and according to Constant scoring system, twelve cases (75%) showed excellent or good result. Twelve cases (75%) showed good results by Paavolainen method. In all cases, bony union was obtained in average 12.8 weeks after operation. There were two complications; one screw irritation and one screw loosing. CONCLUSION: The patients treated using locking proximal humerus plate could exercise earlier due to good initial stability. And the clinical and radiological results were relatively good. The treatment of unstable proximal humerus fracture with locking plate system was considered as a good method.
Female ; Humans ; Humerus* ; Male