BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

Eye alignment is related with binocular connection in the visual cortex during critical period between postnatal 3 and 5 months. Authers examined horizontal pursuit and latent fixation nystagmus using electronystagmogram(ENG)in 6 year old female patient, who was diagnosed a congenital esotropia showing V patten esodeviation, both inferior oblique overaction, dissociated vertical deviation and head turn. In the pursuit examination, symmetric pursuit was observed under binocular viewing. However asymmetric pursuit was observed with smooth pursuit toward temporo-nasal direction and irregular saccade toward naso-temporal direction under monocular viewing. We could observe jerky nystagmus with decelerating velocity under monocular viewig, direction of which was toward fixating eye and degree of which was increased in abduction and decreased in adduction. The direction of pursuit asymmetry and nystagmus were instantaneously reversed when changing occluding eye. The results of ENG were not changed after successful strabismus surgery. We report a typical case of congenital esotropia as one of oculomotor disorders showing asymmetric pursuit and latent fixation nystagmus, which findings were proved by ENG.
Child ; Critical Period (Psychology) ; Esotropia* ; Female ; Head ; Humans ; Pursuit, Smooth ; Saccades ; Strabismus ; Telescopes ; Visual Cortex

No abstract available.
Arteries* ; Head* ; Necrosis*

Intraosseous ganglion of the scaphoid associated with occult ganglion is rare. A 27-year-old man who presented with a 4-month history of progressive left wrist pain visited our institution. The patient was diagnosed intrasosseous ganglion of the carpal scaphoid assosiated with occult ganglion. We obtained satisfactory result by arthroscopic procedure and report this case focusing on surgical technique with literature review.
Adult ; Arthroscopes ; Bone Cysts ; Ganglion Cysts ; Humans ; Wrist

To investigate the relationship of the density, thickness of lens nucleus and cortex with phacoemulsification time, we measured the preoperative density and length of lens nucleus and cortex of 100 eyes with a Scheimpflug camera. We performed phacoemulsification on the same phacoemulsification technique using a phacoemulsifier aspirator by the same surgeon. The preoperative mean values of the density of lens nucleus and cortex were 127. 09+/-57.44 and 30. 33+/-15. 24, respectively. The mean values of the thickness for both were 3.05+/-0.42mm and 0.65+/-0.17mm, respectively. The mean value of phacoemulsification time was 92.68+/-56.98 seconds. The phacoemulsification time was increased significantly as the density of lens nucleus was increased (P<0.0001). However, the thickness of the lens nucleus and cortex and the density of cortex had no significant effect on the phacoemulsification time (p=0. 235, p=0.811). Preoperative evaluation with a Scheimpflug camera is particularly valuable for cataractous patients with corneal endothelial disease deciding on phacoemulsification.
Cataract ; Humans ; Phacoemulsification*

In hypertensive patients it is very important to detect renal artery stenosis or pheochromocytoma, since both diseases are curable causes of hypertension. However, renal artery stenosis can be induced by pheochromocytoma, when the diagnosis of the two simultaneous disease is very difficult. We experienced two cases of pheochromocytoma presented as renal artery stenosis. Pheochromcytoma was overlooked when renovascular hypertension was diagnosed. Pheochromocytoma was found during surgery in one patient and after angioplasty in the other. In both cases, BP returned to normal after surgical removal of pheochromocytoma without repair of the stenosis. Prevention of ineffective and unnecessary renal artery angioplasty of surgery requires knowledge of this unusal association between pheochromocytoma and renal artery stenosis and a high degree of clinical alertness for pheochromocytoma.
Angioplasty ; Constriction, Pathologic ; Diagnosis ; Humans ; Hypertension ; Hypertension, Renovascular ; Pheochromocytoma* ; Renal Artery Obstruction* ; Renal Artery*

Congenital absence of the gallbladder is a rare anomaly and an interesting subject. The overall incidence of gallbladder agenesis is said to approximately 0.035% to 0.065%. It is extremely difficult to make the correct diagnosis of gallbladder agenesis preoperatively in symptomatic patients because its clinical and radiological features are like those of cholecystitis, cholelithiasis, or choledocholithiasis in patients with anatomically normal biliary tracts. Gallbladder agenesis is suspected when the surgeon or the pathologist has failed to identify the gallbladder in its usual position but ectopic location or necrosis of the gallbladder from any causes should be ruled out. Recently, two cases of gallbladder agenesis were encountered in adult patients. We summarize our experience and give a brief review of the literature.
Adult ; Biliary Tract ; Cholecystitis ; Choledocholithiasis ; Cholelithiasis ; Diagnosis ; Gallbladder* ; Humans ; Incidence ; Necrosis

Delayed clearing from the total hyphema resulting from ocular trauma and surgery causes intractable glaucoma and corneal staining by blood-pigments such as hemoglobin and small amounts of hemosiderin. The management of hyphema includes supportive medical care such as bed rest and surgical procedures such as paracentesis and removal of blood clot to enhance the secretory function of trabecular meshwork. However, surgical intervention has many complications and should be used only when it is absolutely necessary. We used the recombinant intraocular tissue plasminogen activator as a method for minimizing complications and sequeles in three patients with total hyphema. Hyphema resolved in all patients who had been treated with 10ug of recombinant tissue plasminogen activator following 5 days medical treatment. In study, we experienced a case of vitreous hemorrhage. In conclusion, we recommend that eyes with complicated large or total hyphema may be considered for intracameral tissue plasminogen activator as a first procedure comparing to surgical intervention, but further invesigation is needed for timing and dosage of drug usage.
Bed Rest ; Glaucoma ; Hemosiderin ; Humans ; Hyphema* ; Paracentesis ; Tissue Plasminogen Activator* ; Trabecular Meshwork ; Vitreous Hemorrhage

A survey was conducted by the staff of the College of Medicine and School of Public Health, Seoul National University in cooperation with Seoul Special City from 1 December 1967 through 28 February 1968, on such events as delivery, death, abortion and pregnancy. The survey directed to a total population of 47,811 residing in 9,157 households led us to the following findings: 1. Two year averages of crude birth rate, crude death rate and natural increase rate were 30.1, 5.6 and 24.5, respectively. 2. Of all deliveries, home and hospital deliveries constituted 61.1 per cent and 35.5 per cent, respectively. 3. Deliveries other than hospital deliveries were found to be attended more often by mother-in-laws(26.5 per cent) than by doctors or midwives(23.4 per cent). 4. About 52 per cent of all women having experiences in pregnancy during the last two years had an experience of consulting a doctor at least one time throughout whole period of pregnancy. 5. In most cases scissors were used to cut umbilical cords, of which 71.0 per cent were not sterilized and only 28.3 per cent sterilized. 6. In many cases placenta was incinerated(48,2 per cent) and on many other occasions it was thrown away into water(28.3 per cent). 7. Cement page(37.4 per cent), gauze and absorbent cotton(29.8 per cent)were found to be most frequently used to receive new-born babies. 8. In 1966 8.8 per cent of the women had at least one abortion induced and in 1967 the percentage was 9.2 per cent. 9. Nearly all(95.8 per cent) of the induced abortions reportedly were done at doctor's clinics. 10. Of all the abortions induced 65.3 per cent were done by specialists in obstetrics, 30.3 per cent by general practitioners and 2.7 per cent by midwives. 11. Those who experienced spontaneous abortions were 1.9 per cent of all women both in 1966 and 1967. 12. About 9.2 per cent of women investigated were found to be currently pregnant. 13. Age specific death rate turned out to be highest among those under 1 year of age. 14. Ten major causes of death in their order of frequency were: 15. Places of death can be classified into homes(75.3 per cent) and hospitals(13.2 per cent). 16. Method of disposing of corpses comprised burials(54.2 per cent) and cremations(44.6 per cent). 17. Infant, neonatal and hebdomadal mortality rates have been computed at 32.2, 18.9 and 13.7, respectively. 18. Infants were found to have died either at homes(81.5 per cent) or at hospitals(18.5 per cent). 19. Birth registrations had been done for about 18.5 per cent of the dead infants.
Abortion, Induced ; Abortion, Spontaneous ; Birth Rate ; Cadaver ; Cause of Death ; Family Characteristics ; Female ; General Practitioners ; Humans ; Infant ; Midwifery ; Mortality ; Obstetrics ; Parturition* ; Placenta ; Population Growth ; Pregnancy ; Public Health ; Seoul* ; Specialization ; Umbilical Cord

Punctate inner choroidopathy is a clinical disorder of unknown etiology that affects the retinal pigment epithelium and inner choroid resulting in visual loss. Punctate inner choroidopathy is characterized by multiple tiny punctate yellowish-white lesions in the deep retina of posterior pole. There is often an associated serous retinal detachment and subretinal neovascular membrane. The lesions are characterized by small punctate hyperfluorescent in the early phase and leak or stain in the late phase by fluorescein angiography. The authors experienced a case of suspected punctate inner choroidopathy associated with decreased visual acuity in a 24 year-old female and reviewed the available literatures regrading the disease.
Choroid ; Female ; Fluorescein Angiography ; Humans ; Membranes ; Retina ; Retinal Detachment ; Retinal Pigment Epithelium ; Visual Acuity ; Young Adult