PURPOSE: The purpose of this study was to evaluate the risks of undergoing intramedullary nailing with minimum surgical optimization (fast-track) for geriatric trochanter fracture due to fall from a standing height. MATERIALS AND METHODS: From May 2006 to August 2013, 48 fractures were enrolled in fast-track, and were an average age of patients was 77.6 years (range, 62-97 years). They underwent primary testing for anesthesia, including basic body fluid test, arterial blood, electrocardiography, and chest radiographs. The time from visit to surgery was 28.9 hours (range, 1-96 hours). RESULTS: During hospitalization, there was one case of stress-induced cardiac arrest; however, other complications, infection, and 30-day mortality did not occur. According to preoperative classic test, the average albumin was 3.45 g/dl, blood sugar, 169 mg/dl, blood urea nitrogen, 20.5 mg/dl, Cr, 1.5 mg/dl, Na, 135.3 mEq/L, and K, 4.21 mEq/L. The average PaCO2 of arterial blood was 37.6 mmHg. CONCLUSION: We found that the fast-track for trochanteric fracture due to slip-down was relatively safe, and could be considered as a therapeutic approach.
Aged* ; Anesthesia ; Blood Glucose ; Blood Urea Nitrogen ; Body Fluids ; Electrocardiography ; Femur* ; Fracture Fixation, Intramedullary ; Heart Arrest ; Hospitalization ; Humans ; Mortality ; Osteoporotic Fractures ; Prospective Studies* ; Radiography, Thoracic

Leber's Hereditary Optic Neuropathy(LHON) is a maternally inherited disorders that occurs primarily in young males and is characterized by subacute, sequential, bilateral central visual loss, ultimately, optic atrophy. We report 2 cases of molecularly confirmed LHON which reveal 11778 and 14484 mitochondral DNA mutation, respectively but there is no family history of visual loss. So the diagnosis of LHON deserves to be considered in all crypotogenic cases of acute or subacute optic or chiasmal neuropathy. Late or early age at onset, female gender, and a negative family history should not be dissuasive.
Diagnosis ; DNA ; Female ; Humans ; Male ; Molecular Biology* ; Optic Atrophy ; Optic Nerve Diseases*

OBJECTIVE: To compare key-person method with census method on the prevalence of physically disabled students and to obtain the prevalence of the physically disabled students in rural community. METHOD: Total 4,890 students of 20 schools in Kyungaido province were surveyed in 1997. Two-thousands and twenty-two students of 8 schools were surveyed by a census method and 2,868 students of 12 schools by a key-person method. RESULTS: The prevalence of the physically disabled students in rural community was 0.53% of the population. The prevalence of the physically disabled students was 0.69% by a census method and 0.42% by a key-person method. This result suggests that there is no significant difference in the prevalence of physically disabled students between the two survey methods (p>0.05). CONCLUSION: A key-person method is as effective as a census method for prevalence survey of physically disabled students in rural communities because of cost effectiveness and less personnel.
Censuses ; Cost-Benefit Analysis ; Surveys and Questionnaires ; Disabled Persons* ; Humans ; Prevalence* ; Rural Population*

BACKGROUND AND OBJECTIVES: This study was designed to identify whether canal type hearing aids can be used by the patients who have undergone epitympanoplasty with mastoid obliteration for postoperative rehabilitation of hearing impaired and also to investigate the advantages of the complete in the canal (CIC) hearing aid for the postoperative rehabilitation of hearing impaired. SUBJECTS AND METHOD: Fourty-three ears belonging to 40 adults, who were treated by epitympanoplasty with mastoid obliteration for cholesteatoma from April 1995 to May 1999 were involved in this study. The impressions were taken and measured postoperatively by Vernier calipers anteroposteriorly (AP) and superoinferiorly (SI). It is well known that the size of the external auditory canal (EAC) should be over 7 mm in diameter and over 2 cm in length to be able to wear the CIC type hearing aid. The shape of the EAC was also taken into consideration. RESULTS: Thirty-five out of 43 ears were large enough to wear CIC hearing aids and all 43 for the canal (ITC) hearing aids. No ears were excluded from being able to wear a CIC or ITC hearing aid with respect to the shape of the EAC. CONCLUSION: Canal type hearing aides can be used after epitympanoplasty with mastoid obliteration which is used as a treatment of cholesteatoma.
Adult ; Cholesteatoma ; Correction of Hearing Impairment* ; Ear ; Ear Canal ; Hearing Aids ; Humans ; Mastoid* ; Rehabilitation*

PURPOSE: We attempted to evaluate the usefulness of Doppler sonography in the diagnosis of uterine vascular abnormality caused by previous D&E, and to report that transarterial embolization is an exceelent treatment modality. MATERIALS & METHODS: We analyzed gray-scale US, color/duplex Doppler US and angiographic findings inseven patients with radiologically proven uterine vascular abnormality. Two of the seven cases were pseudoaneurysms and five of the seven cases were AVMs. In one of the AVMs, two small pseudoaneurysms were combined. In all cases, transarterial embolizations using 3mm coil or/and gelfoam particles were performed. Follow-up US studies, including color Doppler US, were performed. RESULTS: On color/duplex Doppler sonography, two cases of pseudoaneurysm showed blood pools with turbulent arterial flow, and five cases of AVM showed asymmetrically increased vascularity, with variable high velocities composed of the pulsatie arterial flow, with ahigh diastoic component. On angiography, the former showed pseudoaneurysmal sacs, and the latter densely opacified vascular tangles. No more abnormal uterine bleeding was shown, following transarterial embolization in all cases. CONCLUSION: Color/duplex Doppler sonography was valuable in the diagnosis or treatment of abnormal uterine bleeding caused by uterine vascular abnormality such as acquired AVM or pseudoaneurysm.
Aneurysm, False ; Angiography ; Diagnosis* ; Gelatin Sponge, Absorbable ; Humans ; Uterine Artery ; Uterine Hemorrhage*

Background: This study reports trends in pediatric out-of-hospital cardiac arrest (OHCA) and factors affecting clinical outcomes by age group. Methods: We identified 4,561 OHCA patients younger than 18 years between January 2009 and December 2018 in the Korean OHCA Registry. The patients were divided into four groups: group 1 (1 year or younger), group 2 (1 to 5 years), group 3 (6 to 12 years), and group 4 (13 to 17 years). The primary outcome was survival to hospital discharge, and the secondary outcomes were return of spontaneous circulation (ROSC) at the emergency department (ED) and good neurological status at discharge. Multivariate logistic analyses were performed. Results: The incidence rate of pediatric OHCA in group 1 increased from 45.57 to 60.89 per 100,000 person-years, while that of the overall population decreased over the 10 years. The rates of ROSC at the ED, survival to hospital discharge, and good neurologic outcome were highest in group 4 (37.9%, 9.7%, 4.9%, respectively) and lowest in group 1 (28.3%, 7.1%, 3.2%). The positive factors for survival to discharge were event location of a public/commercial building or place of recreation, type of first responder, prehospital delivery of automated external defibrillator shock, initial shockable rhythm at the ED. The factors affecting survival outcomes differed by age group. Conclusion This study reports comprehensive trends in pediatric OHCA in the Republic of Korea. Our findings imply that preventive methods for the targeted population should be customized by age group.