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*

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

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

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

PURPOSE: Pilon fracture has several serious complications such as joint stiffness, arthrosis and delayed angular deformity. We report short-term results of new treatment modality using distracted dynamic external fixators and early controlled ankle motion. MATERIALS AND METHODS: Eight cases of severe pilon fractures for which we tried small plate fixation and additional distracted dynamic external fixators from July 2007 to June 2009 were included. Half passive continuous ankle joint motion was allowed under free hinged ring fixators after the operation. The external fixators were removed after two or three months from the surgery. We investigated joint space by radiograph, joint pain, range of motion, patient's satisfaction of treatment protocol. RESULTS: Joints were distracted when external fixators were applied and mean 28% of space loss developed after removal of external fixators. In most of cases, satisfactory alignments were maintained. Regarding range of joint motion, mean dorsiflexion angle was 15 degrees and mean plantarflexion angle was 32 degree in the condition of wearing external fixators. There was mean 8% reduction of range of motion but no further progression of ankle stiffness after removal of external fixators. Dorsiflexion was not improved after that, but plantarflexion angle was improved 10% even after removal of external fixators. Patients were generally in compliance with the treatment protocols with high level of satisfaction. CONCLUSION: We got good results with distracted dynamic external fixators and early continuous half-passive joint motion for pilon fractures in terms of joint pain and range of motion. Therefore we suggest this new protocol as an alternative modality for severe pilon fractures.
Animals ; Ankle ; Ankle Joint ; Arthralgia ; Clinical Protocols ; Compliance ; Congenital Abnormalities ; External Fixators ; Humans ; Joints ; Range of Motion, Articular

As the associations between pediatric overweight/obesity and bone health remain controversial, we investigated the effects of overweight/obesity as well as lean mass (LM) and fat mass (FM) on bone parameters in adolescents. Bone parameters were evaluated using dual-energy X-ray absorptiometry (DXA) data of 982 adolescents (aged 12–19 years) from the Korea National Health and Nutrition Examination Survey (2009–2010). Z-scores for LM, FM, bone mass, bone mineral density (BMD), and bone mineral apparent density (BMAD) using Korean pediatric reference values were used for analysis. Adolescents with overweight/obesity had significantly higher bone mass and density of the total-body-less-head (TBLH), lumbar spine, and femur neck than underweight or normal-weight adolescents (P < 0.001) after adjusting for vitamin D deficiency, calcium intake, and insulin resistance in both sexes. LM was positively associated with bone parameters at all skeletal sites in both sexes (P < 0.001). FM was negatively related to TBLH BMD in boys (P = 0.018) but was positively associated to BMD and BMAD of the lumbar spine and femur neck in girls. In conclusion, overweight/obesity and LM play a positive role in bone health in adolescents. The effect of FM on bone parameters is sex- and site-specific.
Absorptiometry, Photon ; Adolescent* ; Body Composition ; Bone Density ; Calcium ; Female ; Femur Neck ; Humans ; Insulin Resistance ; Korea ; Miners ; Nutrition Surveys ; Obesity* ; Overweight* ; Pediatric Obesity ; Reference Values ; Spine ; Thinness ; Vitamin D Deficiency