According to the Letournel classification, a transverse fracture is the only elementary fracture pattern that breaks both the anterior and posterior border of the innominate bone. A transverse acetabular fracture separates the innominate bone into two segments: the iliac segment and the ischiopubic segment. Therefore, minimally displaced transverse fractures can be stabilized by purchasing both segments with a large-diameter single screw. Although it is not a stable internal fixation construct compared with plates and screws, it provides sufficient stability to promote early mobilization and early weight-bearing while minimizing the risk of secondary displacement and preventing secondary complications associated with prolonged bed rest and immobilization. The authors successfully treated a case of minimally displaced transverse acetabular fracture with percutaneous column fixation using a retrograde fashion of a single anterior column screw. This report discusses the case with a literature review and deliberates the usefulness of the procedure.

The demand for hospitalists is increasing due to decreasing numbers of clinical residents and increased concerns regarding patient safety. However, several limitations in the surgical hospitalist role exist. The personnel of the surgical hospitalist, rapid response team (RRT), surgical critical care, and trauma surgery teams were unified under the admission, critical care, and trauma surgery (ACTs) team at this institution. The ACTs target are patients with severe disease not undergoing general postoperative course, or patients with the potential for severe conversion. Two surgical intensivists are on duty once a week and oversee the intensive care unit (ICU), the back-up treatment of critically ill patients, and the immediate treatment of trauma patients. ACTs also participate in the surgical RRT and select patients with a high probability of severe exacerbation. Between 2019-2021, the cardiopulmonary resuscitation incidence per 1,000 hospitalized patients in the surgical department decreased significantly from 0.81 to 0.55. From March to December 2021, the ACTs team were involved with 101 of 158 surgical patients admitted to the ICU: 62 with postoperative status, 29 with severe trauma, and 10 transferred to the ICU via RRT screening. Based on our experience, the role of the ACTs team can help improve patient safety.

BACKGROUND: In the mid-1970s and late 1980s, outbreaks of erythromycin-resistant streptococci in Japan and Finland were likely to be associated with the increased consumption of macrolides. Because of the lack of routine antibiotic sensitivity for Streptococcus pyogenes, the reported percentage of resistant strains was only 2% in 1994 in Korea. We tried to determine the rate of resistant strains considering the high occurrence of penicillin-resistant pneumococci and antibiotic purchase without prescription in our country. METHODS: Twenty-four strains of S. pyogenes were isolated from children with pharyngotonsillitis in Kyunghee University Hospital, Seoul, Korea from Feb. through Aug. 1998. Forty-four strains obtained from healthy school children living in Uljin, Kyongsang-bukdo and Hongreung, Seoul in 1998. All isolates were serotyped by T-agglutination (Sevapharma, Czech Rep) and minimal inhibitory concentrations were determined for penicillin, erythromycin, vancomycin, tetracycline, cefotaxime, and clindamycin by agar dilution method according to National Committee for Clinical Laboratory Standards. RESULTS: The carrier rates in Hongreung and Uljin were 4.1% and 13.3%, respectively. Twenty-two out of 24 (91.6%) strains from pharyngitis and 32 out of 44 (72.7%) strains from normal children were typed by T agglutination test. The most common T types were T12 (54.2%) and T4 (33.3%) in pharyngitis, whereas the most common T types were T12 (45.5%), non typable (27.3%), and T4 (15.9%) in healthy carriers. All of the strains from pharyngitis were susceptible to penicillin, vancomycin, and cefotaxime. However, 13 out of 24 (54.2%) strains were resistant to erythromycin, and 11 isolates (45.8%) were resistant to clindamycin and tetracycline. Ten out of 13 isolates of T12 and one isolate of T28 were multi-resistant to erythromycin, clindamycin, and tetracycline. Two isolates of T4 were resistant to erythromycin. CONCLUSION: Almost half of isolates obtained from a university hospital in Seoul are multidrug-resistant Streptococcus pyogenes. Serial monitoring of antibiotic susceptibility test and a nationwide survey accompanied by molecular epidemiologic studies are needed to determine the occurrence and spread of resistant strains from different geographic areas.
Agar ; Agglutination Tests ; Cefotaxime ; Child* ; Clindamycin ; Disease Outbreaks ; Erythromycin ; Finland ; Humans ; Japan ; Korea ; Macrolides ; Penicillins ; Pharyngitis ; Prescriptions ; Seoul ; Serotyping* ; Streptococcus pyogenes* ; Streptococcus* ; Tetracycline ; Vancomycin

BACKGROUND: There has been no statistical study of dermatoses in the Suwon area and southern area of Kyonggi province which has been rapidly developing in the last 7 years. OBJECTIVE AND METHODS: We evaluated the recent distributions of dermatoses in the Suwon area and southern area of Kyonggi and compared them with the previous reports of other provinces of Korea. Fifty two thousand, one hundred fifty three new outpatients who visited the Ajou University Hospital from 1995 to 2001 were analysed statistically. RESULTS: The study results are summarized as follows: Among the 52, 153 outpatients, the total number of male patients were 24, 005(46.0%) and female patients were 28, 148(54.0%). The frequency of age groups are as follows; the age groups were the 3rd decade(22.0%), 4th decade(20.4%), 1st decade(18.7%), 5th decade(11.5%), 2nd decade(11.1%), 6th(8.5%), 7th(5.4%), 8th and above(2.4%). The distributions of dermatoses as disease groups were eczema(28.6%), dermatophytosis(8.7%), erythema urticaria and drug eruption(8.1%), disease of skin appendages(7.9%), viral infection(7.3%), etc. Those dermatoses which demonstrated a tendency to increase annually were seborrheic dermatitis, hyperpigmentary disorders, verruca, and alopecia areata. The incidence of dermatophytosis, in particular, decreased during the study period. Seasonal distribution showed that those diseases occurring the most frequently during the summer were dermatophytosis, allergic contact dermatitis, urticaria, verruca, and vitiligo. The incidence of atopic dermatitis and nevocellular nevi increased during the winter season. Acne vulgaris was the disease occurring frequently during summer and winter. Sexual distribution of dermatoses showed that hyperpigmentary disorder, nevocellular nevi, benign epidermal tumor, acne, allergic contact dermatitis, and irritant contact dermatitis were more frequent in females, and dermatophytosis, seborrheic dermatitis, alopecia were more frequent in males. Age distribution was as follows; atopic dermatitis, vitiligo and verruca was the most frequent in the 1st decade. Acne vulgaria was the most frequent in the 2nd decade and 3rd decade. Hyperpigmentary disorder and seborrheic dermatitis were the most frequent in the 4th decade. Hyperpigmentary disorder was the most frequent in the 5th decade and herpes zoster in 6th, 7th and 8th decade and above. CONCLUSION: In contrast to an earlier published report from Seoul, the infectious dermatoses, especially parasitic infestation, showed a tendency to decrease and nevocellular nevi, hyperpigmentary disorder and alopecia showed a tendency to increase. The distribution pattern of the skin disease did not differ from other provinces of Korea in general.
Acne Vulgaris ; Age Distribution ; Alopecia ; Alopecia Areata ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Epidemiology ; Erythema ; Female ; Gyeonggi-do* ; Herpes Zoster ; Humans ; Incidence ; Korea ; Male ; Nevus ; Outpatients ; Seasons ; Seoul ; Skin ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria ; Vitiligo ; Warts

PURPOSE: Medical professionalism has become a very popular theme in medical education since 2000. Despite the high interest, not alot of variety of studies have been done. In particular, it is very difficult to find a study focusing on the professionalism level of medical students; and none exists in Korea. The purpose of this study is to examine the level of medical professionalism in medical students and the differences between the academic years. METHODS: Of the 41 medical schools in Korea, eight were sampled randomly. From these, 2,590 medical students were finally chosen for the survey. Independent t-test and one-way Anova were used to analyse the differences between the academic years. RESULTS: The level of medical professionalism (medical knowledge, skills and attitude) of premedical students and medical students all appeared to be below average or average. For premedical students, differences were seen in 'professional knowledge' but still at a below average level. By graduation, medical students showed an overall increase in all three domains of medical professionalism, especially in 'professional attitude'. Their scores, however, did not reach more than average. CONCLUSION: There are specific areas of weaknesses in medical professionalism in students; and as their level of professionalism was not satisfactory even by the time of graduation, medical educators need to reconsider the present medical professionalism curriculum and investigate ways to improve the level of medical professionalism in medical students.
Curriculum ; Education, Medical ; Humans ; Korea ; Schools, Medical ; Self-Assessment ; Students, Medical ; Students, Premedical

The purpose of this study is to assess the accuracy of IOL power calculations using clinical history method in patients who undergo cataract surgery after previous PRK, RK, or LASIK.Five eyes of 3 patients who had previous PRK, RK, or LASIK underwent phacoemulsifications with IOL implantation.We calculated IOL power for target refractive error using clinical history method.We compared postoperative refractive error to target refractive error at 3 months after cataract surgery.In the first case (RK (od)& PRK (os)), there was 3.50 diopter undercorrection on the right eye and IOL was exchanged.And target refractive error was achieved on the left eye.In the second case (LASIK patient)there was 1.00 diopter undercorrection.In the third case (PRK (ou)), right eye achieved 0.75 diopter undercorrection and left eye achieved 0.50 diopter overcorrection.The types of cataract were nuclear sclerotic in 3 cases and anterior subcapsular in 2 cases.To determine the exact IOL power after refractive surgery, using clinical history method would be good alternative in these patients.
Cataract* ; Humans ; Keratomileusis, Laser In Situ* ; Lenses, Intraocular* ; Phacoemulsification ; Refractive Errors ; Refractive Surgical Procedures*

BACKGROUND: Although the incidence of resistance to macrolides in group A streptococci (GAS) was low in the past, high incidences have now been reported from several countries. We tried to find out trends of the incidence of erythromycin-resistant GAS in Korea before and after adopting the separation of the dispensary from medical practice in the middle of the year 2000. METHODS: Five hundred thirty two isolates from children with suspected pharyngotonsillitis from 1998 through 2002 were serotyped by T-agglutination. Minimal inhibitory concentrations of 330 out of 532 isolates were determined by agar dilution methods. RESULTS: The prevalent T-serotypes were T12 (36.1%), T4 (12.8%), T1 (10.9%), T2/28 (8.8%), and nontypable (7.1%). Resistance rates to erythromycin (EM) by year were 46.2% in 1998, 18.4% in 1999, 15.4% in 2000, 27.6% in 2001, 36.5% in 2002. T12 in 1999 and 2000 were 36.4% and 25.9%, respectively, which seem to be lower than any other year. This relative low percentage of T12 is associated with increasing percentage of T1 in the same year. The frequency of T12, T1,and T4 were high in each group of isolates of Seoul and Masan. From this viewpoint, there was a similarity between the distribution of T-serotypes of both groups of Seoul and Masan. CONCLUSION: The frequency of serotype T12 and T4 of GAS were relatively high in Korea from 1998 through 2002. The low rate of EM resistance in 1999 and 2000 seemed to be caused by a sudden increase of T1. The increasing rate of EM resistance from 2000 to 2002 seemed to be caused by the increase in consumption of new macrolides and the increase of T12.
Agar ; Child ; Erythromycin ; Humans ; Incidence* ; Korea* ; Macrolides ; Seoul

BACKGROUND: Although the incidence of resistance to macrolides in group A streptococci (GAS) was low in the past, high incidences have now been reported from several countries. We tried to find out trends of the incidence of erythromycin-resistant GAS in Korea before and after adopting the separation of the dispensary from medical practice in the middle of the year 2000. METHODS: Five hundred thirty two isolates from children with suspected pharyngotonsillitis from 1998 through 2002 were serotyped by T-agglutination. Minimal inhibitory concentrations of 330 out of 532 isolates were determined by agar dilution methods. RESULTS: The prevalent T-serotypes were T12 (36.1%), T4 (12.8%), T1 (10.9%), T2/28 (8.8%), and nontypable (7.1%). Resistance rates to erythromycin (EM) by year were 46.2% in 1998, 18.4% in 1999, 15.4% in 2000, 27.6% in 2001, 36.5% in 2002. T12 in 1999 and 2000 were 36.4% and 25.9%, respectively, which seem to be lower than any other year. This relative low percentage of T12 is associated with increasing percentage of T1 in the same year. The frequency of T12, T1,and T4 were high in each group of isolates of Seoul and Masan. From this viewpoint, there was a similarity between the distribution of T-serotypes of both groups of Seoul and Masan. CONCLUSION: The frequency of serotype T12 and T4 of GAS were relatively high in Korea from 1998 through 2002. The low rate of EM resistance in 1999 and 2000 seemed to be caused by a sudden increase of T1. The increasing rate of EM resistance from 2000 to 2002 seemed to be caused by the increase in consumption of new macrolides and the increase of T12.
Agar ; Child ; Erythromycin ; Humans ; Incidence* ; Korea* ; Macrolides ; Seoul

Sarcopenia is a progressive and generalized loss of skeletal muscle mass and function. The prevalence of sarcopenia was reported to be up to 29% in older persons in the community healthcare setting. Sarcopenia diagnosis is confirmed by the presence of low muscle mass plus low muscle strength or low physical performance. Sarcopenia management options include non-pharmacological and pharmacological approaches. Non-pharmacological approaches include resistance exercise and adequate nutrition. Of the two, resistance exercise is the standard non-pharmacological treatment approach for sarcopenia with significant positive evidence. Some dietary approaches such as adequate intake of protein, vitamin D, antioxidant nutrients, and long-chain polyunsaturated fatty acid have been shown to have positive effects against sarcopenia. Currently, no specific drugs have been approved by the Food and Drug Administration for the treatment of sarcopenia. However, several agents, including growth hormone, anabolic or androgenic steroids, selective androgenic receptor modulators, protein anabolic agents, appetite stimulants, myostatin inhibitors, activating II receptor drugs, β-receptor blockers, angiotensin-converting enzyme inhibitors, and troponin activators, are recommended and have been shown to have variable efficacy. Future research should focus on sarcopenia biological pathway and improved diagnostic approaches such as biomarkers for early detection, development of consistently pre-eminent treatment methods for severe sarcopenia patients, and establishing sensitive measures for predicting sarcopenia treatment response.

A thyroid storm is a rare complication of hyperthyroidism. Although a thyroid storm rarely presents with symptoms similar to those of an acute abdomen, and in cases where emergency surgery is needed, the thyroid function test is not performed routinely. In this study, we report a case in which hyperthyroidism was diagnosed after surgery in a patient with recurrent refractory peptic ulcer disease. Although peptic ulcer disease and hyperthyroidism rarely coexist, when the patient's initial condition was reviewed in the Emergency Department, the findings were reasonable for panperitonitis due to peptic ulcer perforation, which is considered as a condition suitable for a thyroid storm. This isolated case indicates a logical leap in the correlation between peptic ulcer and thyroid storm. In recurrent refractory peptic ulcer disease, the thyroid function test may be helpful as a routine laboratory test before emergency surgery.