As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

We report a case of a patient with cystic subdural hygroma who underwent pre-operative Tc-99m DTPA cistrenoscintigraphy to determine the course of operation. A 68-year-old female was admitted to the department of neurosurgery because of acute subarachnoid hemorrhage. After emergency ventricular drainage, the hydrocephalus and cystic subdural hygroma in the right fronto-temporal area developed. She underwent Tc-99m DTPA cisternoscintigraphy to evaluate the type of hydrocephalus, which revealed obstructive communicating hydrocephalus and the communication between the subdural hygroma and the subarachnoid space. As a result of these findings, she underwent the ventriculo-peritoneal shunt operation without removal of the subdural hygroma. Post-operative brain CT showed nearly normalized shape and size of the right ventricle and disappearance of subdural hygroma. We recommend the pre-operative cisternoscintigraphy in patients with complex hygroma to evaluate the communication between subdural hygroma and the subarachnoid space.
Aged ; Brain ; Decision Making* ; Drainage ; Emergencies ; Female ; Heart Ventricles ; Humans ; Hydrocephalus ; Lymphangioma, Cystic ; Neurosurgery ; Pentetic Acid ; Subarachnoid Hemorrhage ; Subarachnoid Space ; Subdural Effusion* ; Ventriculoperitoneal Shunt

Purpose: This study attempted to study the intra-articular changes due to intramedullary nailing through the suprapatellar approach by evaluating the joint cartilage damage and presence of foreign bodies through a comparison of the pre- and post-operative status evaluated by knee arthroscopy. Materials and Methods: This retrospective study analyzed fifteen patients who underwent intramedullary nailing through the suprapatellar approach for proximal tibial shaft fracture from January 2017 to March 2020. The condition of the joint cartilage and the presence of foreign substances in the patellofemoral joint were evaluated. The cartilage status of the patellofemoral joint was evaluated using the International Cartilage Repair Society (ICRS) grading system. Data from the ICRS grading and the visual analogue scale (VAS) scores of the femoral and patellar cartilage were compared to each independent variable surveyed. Results: All the intra-articular structures before nailing were normal. In all cases after nailing, articular cartilage damage of the patellofemoral joint and intra-articular debris were observed. The average VAS score was 0.6 (0-1) before surgery and 2.27 (0-4) after surgery. There were no statistically significant differences except for the correlation in the diameter of the tibia nail and femoral ICRS grade (p=0.001) and the damage to the cartilage was greater in the femoral cartilage than that to the patella (p=0.001). Conclusion Intra-articular damage appears to be unavoidable in suprapatellar nailing. Further research is needed on the long-term effects of intra-articular damage and on methods to reduce this damage.

The tear film break-up time test is a useful diagnostic test for dry eye syndrome,but it shows a wide range of results in normal subjects according to many factors, especially the methods of measuring it. We studied the factors having some influences on B.U.T. and tried to find out a standard method of measuring B.U.T. in normal subjects. The results were as follows: 1. The subjects were healthy without any ocular disease or symptoms. Total subjects were 200 persons, 400 eyes. 2. The standard method of measuring B.U.T. was as follows: a drop of 0.125% sodium fluorescein was applied into the conjunctival sac and the patient was allowed to blink for at least 1-2 minutes. The tear film was then scanned without holding the lids, using the slit lamp beam, 4-5mm in width. 3. The mean B.U.T. measured by the standard method was 20.35 +/- 6.45 sec in normal subjects. 4. The mean B.U.T. was 18.17 +/- 8.02'sec in the group using fluorescein paper, 9.68 +/- 6.19 sec in the group blinking just 4-5 times,16.54 +/- 8.32 sec in the group measured holding the lids with the fingers, and 18.36 +/- 7.95 sec in the group using a broad beam. 5. There were statistically significant decreases of B.U.T. in the group blinking just 4-5 times and in the group measured holding the lids with the fingers.
Blinking ; Diagnostic Tests, Routine ; Fingers ; Fluorescein ; Humans ; Tears*

A 47-year-old man with end-stage renal disease due to diabetic nephropathy underwent a peritoneal scintigraphy to evaluate the cause of recently developed scrotal swelling. Two liters of dialysate mixed with 111 MBq of Tc-99m sulfur colloid were administered into the peritoneal cavity via the dialysis catheter. Various anterior images of the abdomen and pelvis were obtained at 15 min, 2 hr and 4 hr after the tracer instillation. At 15 min, anterior images of the abdomen and pelvis demonstrated linear tracts of activity through both inguinal canals, which were more prominent in the right side (A). Images at 2 hr revealed a passage of the radioactive fluid into the right hemiscrotum. At the same time, there was a considerable accumulation of activity in the right inguinal canal (B). In the delayed image, there was a progressive accumulation of activity in the inguinal canals and a prominent passage of the tracer into the scrotum (C). Both abdominal and inguinal hernias are commonly associated with continuous ambulatory peritoneal dialysis (CAPD). Overall incidence of CAPD-induced hernia ranges from 2.7% to 25%.1) Inguinal hernias were frequently manifested as scrotal swelling. Leakages of dialysate fluid into the scrotum has been noted in CAPD patients with scrotal swelling, with or without clinical findings of inguinal hernia.1,2) In the present case, the right side had leakage from a clinical inguinal hernia and the left side, leakage from a subclinial inguinal hernia. A subclinical inguinal hernia was easily demonstrable with peritoneal scintigraphy. Peritoneal scintigraphy is extremely helpful in the evaluation of scrotal swelling in a patient on CAPD.
Abdomen ; Catheters ; Diabetic Nephropathies ; Dialysis ; Hernia ; Hernia, Inguinal* ; Humans ; Incidence ; Inguinal Canal ; Kidney Failure, Chronic ; Middle Aged ; Pelvis ; Peritoneal Cavity ; Peritoneal Dialysis, Continuous Ambulatory* ; Radionuclide Imaging* ; Scrotum ; Technetium Tc 99m Sulfur Colloid

PURPOSE: There was little evidence that Tc-99m labeled ciprofloxacin (Infecton) located inside of bacteria. Antimicrobial activity of Infecton could be an indirect evidence of its location. We compared in vitro antimicrobial activities of Infecton and ciprofloxacin. MATERIALS AND METHODS: Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of Infecton and ciprofloxacin against three standard strains of bacteria, Staphylococcus aureus ATCC 29213, Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853 were measured using modified broth macrodilution techniques and pour plate methods, respectively. Data were expressed as mean+/-SE (range). RESULTS: MICs of Infecton and ciprofloxacin were 1.12+/-0.20 (0.8~1.6) microgram/ml and 0.36+/-0.04 (0.2~0.4) microgram/ml for S. aureus, 0.03+/-0.005 (0.025~0.05) microgram/ml and 0.011+/-0.001 (0.006~0.012) microgram/ml for E. coli, and 0.96+/-0.16 (0.8~1.6) microgram/ml and 0.56+/-0.098 (0.4~0.8) microgram/ml for P. aeruginosa, respectively. MBCs of Infecton and ciprofloxacin were 2.56+/-0.39 (1.6~3.2) microgram/ml and 0.88+/-0.2 (0.4~1.6) microgram/ml for S. aureus, 0.04+/-0.06 (0.025~0.05) microgram/ml and 0.02+/-0.01 (0.025~0.05) microgram/ml for E. coli, and 2.24+/-0.39 (1.6~3.2) microgram/ml and 1.44+/-0.16 (0.8~1.6) microgram/ml for P. aeruginosa, respectively. CONCLUSION: Although both MICs and MBCs of Infecton were higher than those of ciprofloxacin, all three standard bacterial strains were sensitive to Infecton. It could be an indirect evidence that Tc-99m Infecton be a specific imaging agent for bacterial infection.
Bacteria ; Bacterial Infections ; Ciprofloxacin* ; Escherichia coli ; Microbial Sensitivity Tests ; Pseudomonas aeruginosa ; Staphylococcus aureus

Osteochondrodysplasia is a heterogeneous group of disorders appearing short limbed dwarfism. Because many of these entities are lethal and hereditary, an accurate diagnosis is mandatory. The purpose of this study is to define the clinicopathologic features and radiologic findings of osteochondrodysplasia. We reviewed 29 autopsy cases of congenital short limbed dwarfism, consisting of thanatophoric dysplasia (TD) (12 cases), osteogenesis imperfecta (OI) (12 cases), asphyxiating thoracic dysplasia (ATD) (3 cases), short-rib-polydactyly syndrome (SRPS) (1 case) and hypochondrogenesis (1 case). The gestational age ranged from 16 to 41 weeks. Of 6 fetuses that were born alive, 3 were ATD, 2 were TD and 1 was hypochondrogenesis. TD was frequently complicated by hydramnios. Of 8 cases studied chromosomally, only 1 showed chromosomal abnormality -46XY, inv 9. Intrauterine growth retardation was frequently associated with OI. Pulmonary hypoplasia was present in 23 cases (79%), including all cases of ATD, SRPS and hypochondrogenesis, 11 in TD and 7 in OI. Other associated anomalies were present in 17 cases (59%).
Autopsy* ; Chromosome Aberrations ; Diagnosis ; Dwarfism ; Extremities ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Osteochondrodysplasias* ; Osteogenesis Imperfecta ; Polyhydramnios ; Thanatophoric Dysplasia

No abstract available.
Nipples*

No abstract available.
Neurilemmoma* ; Toes*

No abstract available.
Chorion* ; Chorionic Villi Sampling* ; Chorionic Villi* ; Chromosome Aberrations* ; Female ; Pregnancy ; Prenatal Diagnosis*