One hundred forty eight complications in 135 cases of long bone fractures experienced during the period from May 1971 to December 1979, at the Chosun University Hospital and analysed its retrospectively. The results were obtained as follows. 1. The order of incidence of complications were as follows; infection (39.8%), delayed union(23.6%). malunion (13.5%), ankylosis of joint (12.2%). nonunion (8.1%) and peripheral nerve injury (2. 8%). 2. Of all 127 patients, 97 patients were male and 30 patients were female, and 72 patients (56.7%) were cauesd by traffic accidents. The sex ratio between male and female was 3.2: l. 3. The major complications were frequently associated with other fractures and dislocations, brain injuries. 4. Those of open, comminuted fracture and delayed transfer cases to the Orthopedic Surgeon were predisposing factors to development of the severe complication.
Accidents, Traffic ; Ankylosis ; Brain Injuries ; Causality ; Dislocations ; Female ; Fractures, Bone ; Fractures, Comminuted ; Fractures, Open ; Humans ; Incidence ; Joints ; Male ; Orthopedics ; Peripheral Nerve Injuries ; Retrospective Studies ; Sex Ratio

No abstract available.
Acoustic Stimulation* ; Acoustics* ; Pregnancy, High-Risk*

Regional anesthesia is generally recommended over general anesthesia for non-cardiac surgeries in patients with severe pulmonary hypertension (PH) caused by pulmonary disease. However, pre-, and intra-, postoperative management are critical for patients with severe PH even when regional anesthesia is performed. This is the first reported case of carbon dioxide retention and administration of the appropriate treatment during non-cardiac surgery performed under spinal/epidural anesthesia and analgesia in a patient diagnosed with chronic cor pulmonale accompanied by severe PH.
Analgesics, Opioid ; Anesthesia ; Anesthesia and Analgesia ; Anesthesia, Conduction ; Anesthesia, General ; Carbon Dioxide* ; Carbon* ; Critical Care ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary ; Lung Diseases ; Pulmonary Heart Disease*

The purpose of the present study was to elucidate the cytotoxical influence of mercurial compounds and the protective effect of selenium against mercurial compounds. The effects of mercury compounds and selenium on the syntheses of nitrite(NO2-) and ATP were observed in the cell cultures of EMT-6 cells and peritoneal macrophages from Balb/c mouse. The viabilities of EMT-6 cells and peritoneal macrophages at the end of culture were significantly decreased in dose-dependent manner by methylmercury chloride (CH3HgCl) added into the media. NO2- and ATP syntheses of the cells were dose-dependently inhibited by CH3HgCl. Simultaneous addition of the equimolar dose of selenium completely prevented mercury-induced inhibitions of NO2- and ATP syntheses, which were observed in both of EMT-6 cells and peritoneal macrophages. But these effects of selenium were not appeared in the new medium containing mercurials only which were removed the selenium after the pretreatment of selenium for 6 hours. These results suggest that protective effect of selenium against mercurial compounds was archived by the formation of a complex consisting of Se-Hg or Se-Hg-protein. Though its mechanism was not clear, the protective role of selemium against the mercury toxicity would be exhibited in the immunological system.
Adenosine Triphosphate ; Animals ; Cell Culture Techniques ; Macrophages, Peritoneal ; Mercury Compounds ; Mice ; Nitric Oxide ; Selenium*

PURPOSE: This study was aimed at exploring the current status of graduate programs for an advanced practice nurse(APN) to recommend future directions of APN education. METHODS: A total of 142 students enrolled in seven APN specialty programs, 67 professors who were involved in APN education, and nine nurse administrators participated in the study. Data was collected by questionnaires and focus group interviews. RESULTS: The current definition of APN was found not to be specific enough to represent expected roles of APN in regards to knowledge, attitudes, roles, and skills. Standard curricula employed regardless of the area of APN specialty, lack of qualified clinical practice settings, as well as prepared instructors were found to be problematic. CONCLUSION: The following needs to be addressed: 1. redefining of APN roles, 2. tailoring specialty areas of APN, 3. consolidating educational programs, and 4. ensuring APN role models and faculty. Suggesting a CNS role in Korean APN, areas of APN should be rearranged toclarify their roles and educational programs need to be further developed to meet the expectations and quality of APNs. It is necessary to ensure APN's employment in the health care system by laws and policies to perform advanced nursing roles.
Adult ; Curriculum ; Education, Nursing, Continuing ; Education, Nursing, Graduate ; Educational Measurement ; Focus Groups ; Humans ; Interviews as Topic ; Middle Aged ; Nurse Clinicians/*education ; Nurse Practitioners/*education ; Nursing Evaluation Research ; Questionnaires ; Societies, Nursing ; Specialties, Nursing/*education

The diffuse form of supravalvar aortic stenosis represents a surgical challenge when the ascending aorta, aortic arch, proximal descending thoracic aorta and arch arteries are involved. It can be treated by a variety of surgical approaches. We report a case of severe diffuse supravalvar aortic stenosis combined with an aortic valve anomaly and occlusion of the right coronary artery ostium in a 14-year-old boy with Williams syndrome. We enlarged the aortic root (Nick's procedure), ascending aorta, aortic arch, proximal descending thoracic aorta, and innominate artery with patches and replaced aortic valve with 19 mm St. Jude valve. Deep hypothermic circulatory arrest and retrograde cerebral perfusion were used during repair of the arch and arch artery.
Adolescent ; Aorta ; Aorta, Thoracic ; Aortic Stenosis, Supravalvular* ; Aortic Valve* ; Arteries ; Brachiocephalic Trunk ; Circulatory Arrest, Deep Hypothermia Induced ; Coronary Vessels ; Humans ; Male ; Perfusion ; Williams Syndrome

OBJECTIVE: We intended to know how the cryoprotectant ethylene glycol (EG) would affect the outcome of the embryo development when used in slow freezing method. And to know if there is any difference in the outcome of frozen-thawed embryos according to freezing methods and the timing. METHODS: We used 5-6 weeks old ICR female mice and T6 containing 0.4% BSA for basic culture media. The embryos at the developmental stages of 1-cell, 8-cell and blastocyst were cryopreserved respectively by slow freezing method using EG, propylene glycol (PROH), and glycerol as a cryoprotectant. We also compared the results of slow freezing and vitrification methods with the same cryoprotectant, EG. And finally, we evaluated the quality of blastocysts by counting the cell numbers in each group. RESULTS: The post-thaw embryo development were better in EG group when they were frozen at 1-cell and blastocyst stage (P<0.05). Although there were no differences in the recovery rate, the survival rate in vitrification group was significantly higher (P<0.05). Post-thaw embryo development to morula and blastocyst were better in vitrification group when frozen at 1-cell embryo (P<0.05), not at 8-cell and blastocyst group. The cell counts of blastocyst derived from 1-cell stage frozen EG group were significantly increased than that of PROH-glycerol groups (P<0.05), however, there was no difference between the two freezing methods. CONCLUSION: These results suggest that EG may be advantageous comparing with the conventional cryoprotectants, PROH and glycerol in slow freezing method for mouse embryo cryopreservation. In terms of freezing method, vitrification is better than slow freezing.
Animals ; Blastocyst ; Cell Count ; Cryopreservation ; Culture Media ; Embryonic Development ; Embryonic Structures* ; Ethylene Glycol* ; Female ; Freezing* ; Glycerol ; Humans ; Mice* ; Morula ; Pregnancy ; Propylene Glycol ; Survival Rate ; Vitrification

OBJECTIVE: Adiponectin is an adipocyte-derived hormone with profound insulin sensitizing, anti-inflammatory, and antiatherogenic effects. Apart from its obvious potential as a mediator of adult metabolic syndrome, in pregnancy, adiponectin could have a significant role in regulating energy homeostasis. However, correlations between umbilical cord and maternal serum adiponectin levels and neonatal birthweights are far from understood. The purpose of the present study was to clarify correlations between umbilical cord and maternal serum adiponectin levels and neonatal birthweights. METHODS: The study included 30 healthy mothers who had given birth to healthy neonates. Adiponectin levels in maternal serum and umbilical cord serum were determined by ELISA and analysed. RESULTS: The ranges of adiponectin levels for umbilical cord and maternal serum were 7.12-24.93 microgram/mL and 1.76-8.20 microgram/mL, respectively. Umbilical cord adiponectin levels (14.82+/-3.66 microgram/mL) were significantly higher than maternal serum levels (4.73+/-1.87)(p<0.001). Umbilical cord adiponectin levels were correlated positively with neonatal birthweights (r=0.459, p=0.011). No significant differences in adiponectin levels were found between female and male neonates. In addition, there was no correlation between umbilical cord adiponectin levels and maternal serum adiponectin levels, maternal body mass index, umbilical leptin, or insulin levels. CONCLUSION: The levels of adiponectin were higher in umbilical cord than in maternal serum. The adiponectin levels in umbilical cord were found to correlate positively with neonatal birthweights. Therefore, adiponectin may be involved in fetal energy metabolism in pregnancy.
Adiponectin* ; Adult ; Body Mass Index ; Energy Metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Homeostasis ; Humans ; Infant, Newborn ; Insulin ; Leptin ; Male ; Mothers ; Parturition ; Pregnancy ; Umbilical Cord

An infant having parents of Jehovah s Witnesses was 4 months old and 5.6 kg in weight. Echocardiographic diagnosis was complete transposition of great arteries(TGA), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA), and bilateral superior vena cava(SVC). The preoperative hemoglobin level was 14.9 g/dl. We performed an arterial switch operation(ASO) with VSD closure without transfusion and he was discharged uneventfully 16 days after the operation. At that time the hemoglobin level was 12.8 g/dl. We report that we could successfully correct the complex congenital heart disease without transfusion by the combined use of erythropoietin and aprotinin, intraoperative meti-culous hemostasis, and postbypass ultrafiltration.
Aprotinin ; Diagnosis ; Echocardiography ; Erythropoietin ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular* ; Hemostasis ; Humans ; Infant ; Jehovah's Witnesses* ; Parents ; Transposition of Great Vessels* ; Ultrafiltration

We report a case of prenatally diagnosed congenital perineal mass which was combined with anorectal malformation. The mass was successfully treated with posterior sagittal anorectoplasty postnatally. On ultrasound examination at a gestational age of 23 weeks the fetal perineal mass were found on the right side. Any other defects were not visible on ultrasonography during whole gestation. Amniocentesis was performed to evaluate the fetal karyotyping and acetylcholinesterase which were also normal. As the fetus grew up, the mass size was slowly increased more and more. At birth, a female neonate had a perineal mass on the right side as expected. During operation, the anal sphincteric displacement was found near the mass and reconstructed through posterior sagittal incision. This is the first reported case of prenatally diagnosed congenital perineal mass, after birth which was diagnosed as lipoblastoma and even combined with anorectal malformation. This case shows that it can be of clinical importance to be aware of this rare fetal perineal mass in prenatal diagnosis and counseling.
Adult ; Amniocentesis ; *Anal Canal/abnormalities/pathology/ultrasonography ; *Digestive System Abnormalities/diagnosis/pathology/ultrasonography ; Female ; Gestational Age ; Humans ; Infant, Newborn ; *Lipoma/diagnosis/pathology/ultrasonography ; Male ; *Perineum/pathology/ultrasonography ; Pregnancy ; Prenatal Diagnosis ; *Rectal Neoplasms/diagnosis/pathology/ultrasonography ; *Rectum/abnormalities/pathology/ultrasonography ; Ultrasonography, Prenatal/*methods