The Supracondylar fracture of the humerus is the most common elbow fracture in children. In general, accurate anatomic reductio, the least regional trauma as possible and the maintenance of the reduction are necessary to obtain excellent results. Lateral and posterior approach is commonly used method for the treatment of supracondylar fracture of the humerus in children. But lateral and posterior approach has some troubles in reduction of fracture and Kirschner wire fixation. From March 1988 to February 1993, seventeen supracondylar fractures of the humerus were treated by means of medial approach and followed from 8 monts to 13 months with an average 10 months. There were some advantages in medial approach. Reduction was easy and ulnar nerve was not damaged by medial approach at insertion of Kirschner wire and no more another incision. The results obtained are as follows. Postoperative vascular impairment or Volkmann's ischemia was not complicated and neurologic deficits accompanied with injury were all recovered completely. According to Mitchell and Adams' criteria, all had satisfactory results.
Child ; Elbow ; Humans ; Humerus ; Ischemia ; Methods ; Neurologic Manifestations ; Ulnar Nerve

The 35 patients of femur neck fracture treated with bipolar hemiarthroplasty were followed up for an average of 18 months with the range of 12 months to 5 years after bipolar hemiarthroplasty from Jan. 1986 to Dec. 1992. 1. Mean age of the patient was 68 years old(25-93) and mean hospitalization period was 55 days. 2. Associated medical problems were diabetes mellitus in 6 cases, cerebrovascular disease in 5 cases, rectal cancer in 1 case and pulmonary tuberculosis in 1 case. 3. An anterior dislocation, one of the early complication occured in 1 case, and superficial infection in 3 cases(8.5%), a deep infection, one of the late complication occured in 1 case. 4. The clinical result was focus on the functional hip assessment of bipolar hemiarthroplasty after femur neck fracture, and the functional results evaluated by Lunceford's Method were excellent in 22 cases(63%), good in 5 cases(14.3%), fair in 5 cases(14.3%), poor in 3 cases(8.6%). 5. The bipolar hemiarthroplasty was satisfactory method for the displaced femur neck fracture in the elderly patients, but to return the patient's preinjury activity level, more active postoperative rehabilitation should be required.
Aged ; Cerebrovascular Disorders ; Diabetes Mellitus ; Dislocations ; Femoral Neck Fractures ; Femur Neck ; Femur ; Hemiarthroplasty ; Hip ; Hospitalization ; Humans ; Methods ; Rectal Neoplasms ; Rehabilitation ; Tuberculosis, Pulmonary

BACKGROUND: There were many efforts to evaluate the relationship between cholesterol and mortality. But almost all of them have been performed on male western people who have higher mean cholesterol concentration than oriental people and have different disease pattern from women's. So, upto now, the relationship of cholesterol to mortality in women with low cholesterol concentration was not well known. We carried out this study to investigate the relationship in Korea women whose mean cholesterol level was lower than that of western people and men. METHOD: Study subjects included in were 100,363 Korean women aged 30-65 years. They undertook multiphasic health examination provided by Korea Medical Insurance Corporation between March 1990 and July 1990, and had no history of cancer and no significant medical illnesses which could change blood cholesterol level. Study subjects were followed for 5.5 years until December 1995 and it was determined whether each subject was dead or alive using the mortality data from the Korea National Statistical office and the Korea Medical Insurance Corporation. Nonlinear ralationship between serum total cholesterol and mortality was investigated with the use of quadratic regression and with dummy variables using the 158-180mg/dl group as the comparison group. To analyzing the relationship between cholesterol concentra-tion and mortality with controlling for age, smoking, alcohol drinking, exercise, diastolic blood pressure, body mass index, pay level, Cox propor-tional hazard model was used. RESULT: During the follow-up period, there were 369 deaths. Mean cholesterol concentration of study subjects was 182.8mg/dl There was no significant association between serum cholesterol and total mortality, but women with cholesterol concentrations below 130mg/dl showed slightly increased risk of death(RR=1.20). Cholesterol had an inverse relationship with mortality from stroke, and women with cholesterol concentrations below 130mg/dl had higher risk of death from stroke(RR=3.28). Although there was no statistical significance,risk of mortality from hemorrhagic stroke in women with very low cholesterol concentration was markedly higher than in women with cholesterol concentrations above 130mg/dl. Mortality relationship with cholesterol. And women with cholesterol concentrations higher than 203mg/dl had abruply increased risk for death from ischemic heart disease. CONCLUSION: Through this study, we could observe an inverse J shaped relationship between cholesterol concentration and mortality in Korean women. The increased risk of mortality from hemorrhagic stroke in people with very low cholesterol concentration supports the previous report which proposed low cholesterol level as a significant risk factor of hemorrhagic stroke. In spite of the lack of statistical signi-ficance, greately increased risk of mortality from ischemic heart disease in people with cholesterol higher than 203mg/dl suggests that cholesterol concentration at the upper end of distribution can be a significant risk factor of ischemic heart disease in women.
Alcohol Drinking ; Blood Pressure ; Body Mass Index ; Cholesterol* ; Female ; Follow-Up Studies ; Humans ; Insurance ; Korea ; Male ; Mortality* ; Myocardial Ischemia ; Proportional Hazards Models ; Risk Factors ; Smoke ; Smoking ; Stroke

PURPOSE: Altered mental status (AMS) is a collective phrase that describes an undifferentiated assortment of disorders of mentation including impaired cognition, attention, awareness, and level of consciousness. Although AMS is a common chief complaint and a frequent issue in the emergency department (ED), the clinical surveys of AMS have not been conducted in Korea. We analyzed the AMS patients on the clinical basis. METHODS: From march 2002 to may 2002, we had enrolled prospectively 256 adult patients who visited the ED of Sanggye Paik Hospital because of AMS. The patients accompanied by AMS clinically were included, excluding patients caused by trauma, cerebrovascular accident with alert mentality. The clinical records were reviewed to analyze the clinical features of AMS, 9 months after discharge from ED. RESULTS: AMS was found in 256 patients which comprised the 2.2% of the ED patients during the test period, and 112 patients were admitted. The most commonly encountered mental status was drowsiness(36.3%), and the overall mortality rate 10.2%. The AMS was caused by neurogenic, metabolic, alcohol-related, psychogenic disorders in frequency accounting for most of AMS etiologies. CONCLUSION: This survey shows that the incidence of AMS is 2.2%, old age increases the rate of admission, and the common etiologies are neurogenic, metabolic, alcohol-related disorders. It seems prudent to approach the patients with AMS on the basis of etiologies and age.
Adult ; Alcohol-Related Disorders ; Cerebrovascular Trauma ; Cognition ; Consciousness ; Delirium ; Emergency Service, Hospital ; Humans ; Incidence ; Korea ; Mortality ; Prospective Studies ; Seizures

BACKGROUND: We present here the annual data of the intensive care unit (ICU) module of the Korean Nosocomial Infections Surveillance System (KONIS) from July 2010 through June 2011. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 130 ICUs in 72 hospitals using KONIS. Nosocomial infection (NI) rates were calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: A total of 3,757 NIs were found: 1,978 UTIs (1,949 cases were urinary catheter-associated), 1,092 BSIs (with 932 being central line-associated), and 687 PNEUs (410 were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTIs) was 3.87 cases per 1,000 device-days (95% confidence interval, 3.70-4.05), and the urinary catheter utilization ratio was 0.86 (0.859-0.861). The rate of central line-associated BSIs was 3.01 per 1,000 device-days (2.82-3.21), and the utilization ratio was 0.53 (0.529-0.531). The rate of ventilator-associated PNEUs (VAPs) was 1.75 per 1,000 device-days (1.59-1.93), and the utilization ratio was 0.40 (0.399-0.401). Although both the ventilator utilization ratiosand the urinary catheter utilization ratios were lower in hospitals with 400-699 beds than thosein hospitals with 700-899 beds ormore than 900 beds, the rates of VAPsand CAUTIs were higher in hospitals with 400-699 beds than thosein hospitals with 700-899 beds or more than 900 beds. CONCLUSION: The risk of acquiring VAP and CAUTI is higher in the ICUs of 400-699 bed hospitals than in ICUs oflarger hospitals. Therefore, ongoing targeted surveillance and implementation of proven infection control strategies are needed especially for hospitals having fewer than 700 beds.
Benzamides ; Cross Infection ; Infection Control ; Critical Care ; Intensive Care Units ; Pneumonia ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

INTRODUCTION: Family history of psychopathology is a risk factor for mood and anxiety disorders in children, but little is known about rates of parental psychopathology among treatment-seeking youth with affective disorders in the Asia Pacific region. This study examined patterns of emotional and behavioural problems in parents of clinically-referred youth in Singapore. We hypothesised that parents would have higher rates of affective disorders compared to the Singapore national prevalence rate of 12%. MATERIALS AND METHODS: In this cross-sectional study, 47 families were recruited from affective disorders and community-based psychiatry programmes run by a tertiary child psychiatry clinic. All children had a confirmed primary clinical diagnosis of depression or an anxiety disorder. Parents completed the Mini International Neuropsychiatric Interview (MINI) to assess for lifetime mood and anxiety disorders. They also completed the Adult Self Report (ASR) and Adult Behavior Checklist (ABCL) to assess current internalising and externalising symptoms. RESULTS: Consistent with our hypothesis, 38.5% of mothers and 10.5% of fathers reported a lifetime mood and anxiety disorder. Nearly 1/3 of mothers had clinical/subclinical scores on current internalising and externalising problems. A similar pattern was found for internalising problems among fathers, with a slightly lower rate of clinical/subclinical externalising problems. CONCLUSION Our findings are consistent with previous overseas studies showing elevated rates of affective disorders among parents - particularly mothers - of children seeking outpatient psychiatric care. Routine screening in this population may help to close the current treatment gap for adults with mood and anxiety disorders.
Adult ; Anxiety Disorders ; diagnosis ; epidemiology ; psychology ; Child ; Cross-Sectional Studies ; Family Health ; statistics & numerical data ; Female ; Humans ; Male ; Mood Disorders ; diagnosis ; epidemiology ; psychology ; Parent-Child Relations ; Parenting ; psychology ; Parents ; psychology ; Psychiatric Status Rating Scales ; Psychopathology ; Singapore ; epidemiology