For the evaluation of the clinical and radiologicaI result in the surgical reduction and internal stabilization of the fracture-dislocations in the thoracic and lumbar area, the authors analysed the 39 patients who were treated with Harrington instrumentation supplemented by segmental sublaminar wiring and were follow up 24 months in average. l. Indications for the operation were: compression type with more than 50% of body wedging, bursting type with less than 30% of canal involvement without cord injury, fracture-dislocation type with instability and any type with complete cord injury. 2. Amount of fusion were 6 segments in 25 cases, 7 segments in 11 cases, 5, 8 and 10 segments in 1 case each. 3. Among 31 cases whose lumbar segment were involved in fusion, numbers of movable lumbar motion segments were three or less in 26 and two or less in 8. 4. Angular deformity were changed from 27 preoperatively to 8 postoperatively and to 12 at the end of follow up. Wedging amount of anterior vertebral height were 53% preoperatively, 23% postoperatively and 27% at the end of follow up. 5. External support were applied for 4 months in 35 cases; Taylor brace in 22, TLSO in 10 and body cast in 3. Ambulation was started within a week according to the general status. 6. Solid bony union were observed in 38 cases within 4 months period. Dislodgement of instrumentation and deep infection in one each patient were observed as operative complications. 7. Among 21 cases with cord injury symptoms, 18 cases with complete type showed no neurological recovery, but 3 cases with incomplete type showed complete recovery. It is concluded that the Harrington instrumentation with sublaminar wiring is an effective method of reduction and stabilization for the fracture and dislocations of the thoracic and lumbar spine. On the other hand, the operation is an extensive procedure with significant involvement of lumbar motion segments.
Braces ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Hand ; Humans ; Methods ; Spine ; Walking

As gastroduodenoscopy performed more frequently, case reports of human echinostomiasis are increasing in Korea. A Korean woman presented at a local clinic with complaints of abdominal pain and discomfort that had persisted for 2 weeks. Under gastroduodenoscopy, two motile flukes were found attached on the duodenal bulb, and retrieved with endoscopic forceps. She had history of eating raw frog meat. The two flukes were identified as Echinostoma hortense by egg morphology, 27 collar spines with 4 end-group spines, and surface ultrastructural characters. This report may prove frogs to be a source of human echinostome infections.
Animals ; Duodenal Diseases/*parasitology ; Duodenum/*parasitology ; Echinostoma/*isolation & purification ; Echinostomiasis/*diagnosis ; Endoscopy ; Female ; Humans ; Korea ; Middle Aged

No abstract available.
Breast Neoplasms* ; Breast* ; Humans ; Soil*

Management of unstable angina has evolved progressively. Although coronary angioplasty has recently shown to be relatively safe and effective treatment strategy for unstable angina, aute occlusion due to intracoronary thrombus accumulation during or immediately after coronary angioplasty remains to be one of the most common serious complication of this procedure. Intracoronary urokinase has been used to treat flow-limiting intracoronary thrombus accumulation that complicated initial successful percutaneous transluminal coronary angioplasty(PTCA) in unstable angina patient, which made the patient stablilzed. Thus in patient with flow-limiting intracoronary thrombus accumulation complicating PTCA, intracoronary urokinase proved to be highly effective in restoring vessel patency and preventing acute myocardial infarction. We report a case of successful revascularization with intracoronary infusion of urokinase in patient with intracoronary thrombus accumulation that complicated PTCA.
Angina, Unstable ; Angioplasty ; Angioplasty, Balloon, Coronary* ; Humans ; Myocardial Infarction ; Thrombosis ; Urokinase-Type Plasminogen Activator

No abstract available.
Cardiomyopathies* ; Peripartum Period*

No abstract available.
Ascites* ; Liver Cirrhosis* ; Liver* ; Pleural Effusion*

PURPOSE: A technique of cerclage wire fixation in comminuted fracture of the clavicle shaft is thought to interfere the fracture healing, so authors studied radiographically and clinically about the cases of cerclage wiring of the fracture fragments with the plate and screws fixation in the comminuted fracture of the shaft of the clavicle. MATERIALS AND METHODS: According to following inclusion criteria, total 18 patients (male: 15, female: 3) were investigated; Patients who visited hospital due to clavicle shaft comminuted fracture from February 2005 to April 2009, who underwent surgery utilizing more than 2 cerclage wire fixation for the fragments when open reduction and plate fixation were operated and who could be follow-up over one year. The duration for fracture union, functional outcome and complications were investigated retrospectively. RESULTS: Radiological bone union was accomplished in average 13.3 weeks (12~16 weeks) and there was no complication such as nonunion, delayed union or infection. Range of motion of ipsilateral shoulder joint was recovered in all patients except one at the final follow-up. CONCLUSION: The clinical and radiographical results of the plate and screws fixation with cerclage wiring of the fragments in comminuted clavicle shaft fracture showed that the cerclage wiring does not interfere the fracture healing, so authors think that this method is a good alternative operation if it is performed carefully to minimize soft tissue dissection.
Clavicle ; Follow-Up Studies ; Fracture Healing ; Fractures, Comminuted ; Humans ; Range of Motion, Articular ; Shoulder Joint

BACKGROUND: The nutritional status of critical-ill patients is important for recovering from the disease itself. Therefore, this present study was designed to assess the biochemical and nutritional parameters of Intensive-Care Unit (ICU) patients on mechanical ventilation. METHODS: We retrospectively reviewed the medicial records of 126 patients (male/female=72/54) who were on mechanical ventilationin the ICU. The nutritional parameters such as serum total protein, albumin, hemoglobin, hematocrit, calcium, phosphorus, total cholesterol, % lymphocytes, blood urea nitrogen (BUN), and creatinine (Cr) were measured at the beginning of mechanical ventilation. We also measured the outcome variables such as the duration of mechanical ventilation, the ICU length of stay and the hospitalization period. We analyzed the relationship between the nutritional parameters and the outcome variables of ICU patients on mechanical ventilation. RESULTS: The level of hemoglobin was negatively correlated with the outcome variables; the ICU length of stay (p<0.05), the hospitalized period (p<0.01), and the duration of mechanical ventilation (p<0.01). The creatinine level was positively correlated with the outcome variables; the ICU length of stay (p<0.01), the hospitalized period (p<0.01) and the duration of mechanical ventilation (p<0.05). On the multiple regression analysis, the serum total protein, albumin, calcium, inorganic phosphorus, BUN and creatinine were independent factors affecting the duration of mechanical ventilation. CONCLUSIONS: These findings indicate that ICU patients with mechanical ventilation have a risk for malnutrition and anemia. So, an adequate nutritional intervention is required for these patients in order to decrease the prevalence of malnutrition and anemia.
Anemia ; Blood Urea Nitrogen ; Calcium ; Cholesterol ; Creatinine ; Hematocrit ; Hospitalization ; Humans ; Length of Stay ; Lymphocytes ; Malnutrition ; Nutrition Assessment ; Nutritional Status ; Phosphorus ; Prevalence ; Regression Analysis ; Respiration, Artificial* ; Retrospective Studies

Multiple gastric caner, now considered to be a sort of multiple primary cancer by Moertel's classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Although its incidence is rare and it has never been reported in Korea yet, the report of multiple gastric cancer is increasing with lengthened life survival and improved diagnostic method. We recently experienced two cases of triple gastric cancer, the one in 53-years-old male who had well differentiated adenocarcinoma(EGC IIb+c) on antrum, poorly differentiated adenocarcinoma on cardia and moderately differentiated adenocarcinoma on mid-body, and the other in 65-years-old female who had two poorly differentiated adenocarcinoma on cardia and anterior wall of low body and moderately differentiated adenocarcinoma (EGCIIc) on posterior wall of low body. Triple gastric cancer is rare, so we reported 2 cases of triple gastric cancer.
Adenocarcinoma ; Cardia ; Classification ; Female ; Humans ; Incidence ; Korea ; Male ; Stomach ; Stomach Neoplasms*

PURPOSE: To report the frequency, severity and various types of artifacts associated with spectral-domain optical coherence tomography (SD-OCT) based on macular pathologies. METHODS: Data was collected retrospectively from 116 eyes of 116 subjects. SD-OCT (3D-1000, Topcon Corp., Japan) imaging was performed in 40 healthy eyes, 45 eyes with intraretinal pathology (IRP) and 31 eyes with subretinal pathology (SRP). The scan protocol was 12x6 mm radial scan. The frequency and types of artifacts were investigated in each scan and were analyzed based on macular disease. Additionally, the effect of artifacts on the measurement of macular thickness was studied. RESULTS: Errors occurred in 77 eyes (66.38%). Inner retinal boundary misidentification (IRBM) was the most common error (25.86%), with the frequencies of other types of artifacts being 10.34% for off-center fixation, 15.52% for degraded image and 8.6% for outer retinal boundary misidentification (ORBM). The overall error rate of SD-OCT in the retinal pathology group was much higher than that in the normal group. Macular thickness was underestimated in the IRP group because the outer retinal boundary of the IRP group tended to be misidentified toward the inner retina (p<0.01). CONCLUSIONS: SD-OCT can frequently cause various types of artifacts in patients with macular disease. When interpreting OCT images, the artifacts of SD-OCT should be considered in order to obtain accurate macular thickness and to prevent erroneous clinical decisions.
Artifacts ; Eye ; Humans ; Retina ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence