Recently, the frequency of meniscal injury of knee has been increasing due to increase of sports activities. It has been known that bucket handle tear is the most common type of the entire injuries of the meniscus. We found 127 cases of meniscal tears and experienced 42 cases of bucket handle tears in the arthroscopic findings from Jan. 1991 to April 1994 in our hospital. We analysed 31 cases which were followed up for at least 1 year. The purpose of this study is to analyse the locking history and frequency, to discuss the several types of bucket handle tear in arthroscopic view, to introduce three portal techniques using posteormedial or posterolateral portal to resect the meniscus, and to analyse our clinical results. So we concluded as follows. 1. Among the 31 cases, 23 cases(74%) had an episode of locking. 2. We found many different types of bucket handle tears in arthroscopic view and the most common type was complete tear in a classic type(11 cases). 3. We were able to resect the meniscal fragment very easily using posteromedial or posterolateral portal. 4. We obtained satisfactory results in 24 cases(77%).
Knee ; Sports ; Tears

OBJECTIVES: This study was conducted in order to evaluate the prevalence of posttraumatic stress disorder (PTSD) and related factors in male firefighters in Daegu, Korea. METHODS: A total of 1,261 firefighters from fire stations in Daegu were the subjects of this study. Each firefighter completed a questionnaire on general and occupational matters, experience of traumatic events, and impact of event scale (IES). The IES questionnaire was administered to subjects in order to determine the high risk group for PTSD. We calculated the IES score and determined that an individual was abnormal if the IES score was over 26. RESULTS: The average IES score of the firefighters was 11.0+/-14.3, and the prevalence of high risk firefighters with PTSD was 15.1%. It was found that 40 years of age, fire sergeant, and emergency medical service personnel showed higher prevalence of PTSD than other groups. The most experienced event among traumatic events was 'witness death of victims or patients'. The results of multiple logistic regression analysis for the high risk PTSD group showed that fire sergeant (OR=2.28, 95% CI: 1.28~4.06), fire lieutenant (OR=2.47, 95% CI: 1.14~5.37), fire captain (OR=2.88, 95% CI: 1.11~7.45), firefighting department (OR=2.04, 95% CI: 1.00~4.17), emergency medical service personnel (OR=3.68, 95% CI: 1.47~9.23), total frequency of traumatic events experienced (OR=1.01, 95% CI: 1.00~1.02), and total type of traumatic event experienced (OR=1.35, 95% CI: 1.25~1.46) were significant variables with regards to the reference group (fire fighter and administration department). CONCLUSIONS: These findings indicate that the prevalence of PTSD in firefighters is higher than that in the general population, and fire sergeant, fire lieutenant, fire captain, emergency medical service personnel, firefighting department, total frequency of traumatic events experienced, and total type of traumatic event experienced were significant variables for the PTSD high risk group.
Emergency Medical Services ; Firefighters ; Fires ; Humans ; Logistic Models ; Male ; Prevalence ; Questionnaires ; Stress Disorders, Post-Traumatic

No abstract available.
Hepatolenticular Degeneration*

Objectives: Korea’s National Health Insurance (NHI) coverage rate for dental services is 16.0%, far lower than the 33.0% average of OECD (Organization for Economic Co-operation and development) countries. In 2013, the government implemented a policy to pay for dental scaling service for adults over the age of 20. Then in 2017, the eligibility criteria was expanded to adults aged 19 or older the eligibility age was lowered expanded to 19 or older. Methods: The study aimed to determine the effectiveness of the policy by comparing the number of times per person the dental scaling service was used before and after the implementation of the new applicants group compared to the existing application/applicants group. The analysis was conducted among patients aged 19 and 20 who visited the hospital with gingivitis and periodontal disease and who used the dental scaling service more than once per year as a preventive measure, using the customized database of the NHIC (National Health Insurance Corporation). As of July 1, 2017 when the dental scaling service was implemented by the National Health Insurance Service, the period was set as “before enforcement” (January 2016 to June 2017) and “after enforcement” (July 2017 to December 2018). To evaluate the policy effectiveness of expandingthe ages of individuals eligible for the dental scaling service, Difference-in-Differences (DiD) analysis was conducted to examine the number of times per person the service was used, changes in personal contributions, and policy effectiveness. Results: Since the National Health Insurance policy to pay for dental scaling services, both the applicants group and the sustainable application group have increased the rate of inspection of preventive dental scaling services (19.82%→30.91%, 29.68%→31.18%). As a result of determining the pure effect of the NHI’s policy of covering the dental scaling service, it was found that the the number of times the dental scaling service was used per person increased significantly in the new application group (0.03 times, <.0001). Conclusions However, it was found that the cost of the dental scaling service per person while the cost of the dental scaling decreased was shown to decrease, it was not statistical significant. Therefore, additional policy support such as lowering the personal financial burden is needed for those who are unable to afford the service.

It is notoriously difficult to obtain a sound bony union of large segmental bone defects secondary to trauma or following tumor resection, infected nonunion, congenital pseudarthrosis of the tibia, and avascular necrosis of the femoral head with conventional methods. Recent advances in microsurgery have made it possible to provide a continuing circulation of blood in bone grafts so as to ensure viability. With the nutrient blood supply preserved, healing of the graft to the recipient bone is facilitated without the usual replacement of the graft by creeping substitution. Thus, the grafted bone is achieved more rapid stabilization of bone fragments separated by a large defect without sacrificing viability. Thirty nine cases of the free vascularized fibular graft had been performed in the Department of Orthopedic Surgery, Kyung Hee University Hospital during the period of 3 years from October 1978 to December 1981. Of these, ll cases were congenital pseudarthrosis of the tibia, 4 cases were tuberculous spondylitis, 4 cases were infected nonunion, 7 cases were large segmental bone defects secondary to trauma, 9 cases were avascular necrosis of the femoral head and the other was one case. The results were obtained as follows: 1. The advantages of free vascularized living fibular graft are one stage procedure, resistance of torsion and angular stress, union with rapid hypertrophy of the graft, a shorter immobilization period and more rapid incorporation of the graft into the recipient area. 2. Free vascularized fibular graft can be widely used in the field of Orthopedic surgery. 3. The fibula is the bone best suited for reconstruction of a defect in a long bone. 4. In children, distal tibiofibular synostosis must be performed. 5. For prevention of clawing toe, the muscles around the bone is meticulously dissected, 6. Evaluation by selective arteriography and isotopic scanning both before and after operation may be used to assess the viability of the fibula graft.
Angiography ; Animals ; Child ; Fibula ; Head ; Hoof and Claw ; Humans ; Hypertrophy ; Immobilization ; Microsurgery ; Muscles ; Necrosis ; Orthopedics ; Pseudarthrosis ; Spondylitis ; Synostosis ; Tibia ; Toes ; Transplants

Objectives: The high co-payment of dental care service providers reduces access to dental care and exacerbates health inequality among different social classes. Dental care services are affected by several socioeconomic factors including those related to the household, regional factors surrounding individuals, and individual factors. In this study, we identified household and regional factors that affect unmet dental care needs, after appropriately adjusting for individual-level and provided suggestions for improving the future coverage of dental and oral health care services. Methods: Using the 2019 Korean Community Health Survey data, 101,718 middle-aged (40-64 years old) and 72,807 elderly (65 years and older) individuals were analyzed to identify the unmet needs of dental care services by age group. To identify factors affecting unmet dental care needs by age group, a multilevel analysis of the overall rate (T1) was conducted with three dependent variables: (a)availability, (b)economic accessibility, and (c) acceptability. Results: The unmet need for dental care service rate (T1) was 15.43% for middle-aged individuals, 14.73% overall, and 13.00% for the elderly. The results of the multi-level analysis indicated that at the household level, the number of household members aged 19 years and above had an effect on the overall (T1) total unmet needs of dental care services and economic accessibility for the middleaged group. At the regional level, economic accessibility influenced the degree of financial independence and the number of dental hospitals and clinics per population. Conclusions In order to reduce the unmet needs of dental care services, it is necessary to comprehensively consider not only individual-level factors but also household-level factors and regionallevel factors according to age.

Objectives: The high co-payment of dental care service providers reduces access to dental care and exacerbates health inequality among different social classes. Dental care services are affected by several socioeconomic factors including those related to the household, regional factors surrounding individuals, and individual factors. In this study, we identified household and regional factors that affect unmet dental care needs, after appropriately adjusting for individual-level and provided suggestions for improving the future coverage of dental and oral health care services. Methods: Using the 2019 Korean Community Health Survey data, 101,718 middle-aged (40-64 years old) and 72,807 elderly (65 years and older) individuals were analyzed to identify the unmet needs of dental care services by age group. To identify factors affecting unmet dental care needs by age group, a multilevel analysis of the overall rate (T1) was conducted with three dependent variables: (a)availability, (b)economic accessibility, and (c) acceptability. Results: The unmet need for dental care service rate (T1) was 15.43% for middle-aged individuals, 14.73% overall, and 13.00% for the elderly. The results of the multi-level analysis indicated that at the household level, the number of household members aged 19 years and above had an effect on the overall (T1) total unmet needs of dental care services and economic accessibility for the middleaged group. At the regional level, economic accessibility influenced the degree of financial independence and the number of dental hospitals and clinics per population. Conclusions In order to reduce the unmet needs of dental care services, it is necessary to comprehensively consider not only individual-level factors but also household-level factors and regionallevel factors according to age.

Percutaneous balloon angioplasty has been reported to be useful in the treatment of intracranial atherosclerotic arterial stenosis. However, arterial dissection with increased risk of acute closure and stroke has limited its widespread implementation. Stenting of the intracranial vasculature recently has been shown to be feasible in a variety of circumstance. However, stenting of middle cerebral artery has been limited because of difficulty with tracking stents across the carotid siphon. We report a case of successful percutaneous stenting of a symptomatic middle cerebral artery stenosis using a balloon-expandible flexible coronary stent.
Angioplasty ; Angioplasty, Balloon ; Constriction, Pathologic* ; Middle Cerebral Artery* ; Stents* ; Stroke

No abstract available.
Staphylococcus aureus* ; Staphylococcus*

Pneumothorax was recognized as a potential hazard of mechanical ventilation during anesthesia. Because the gases used in anesthesia are delivered from cylinder and wall outlets at higher than atmospheric Pressure, the possibility of damage to the lung is over present. Alveolar rupture may occur when there is free transmission of high pressure to the alveoli during tracheal intubation at the start of anesthesia. We had a case of tension pneumothorax developed during the use of Jackson-Rees modification with Ayres T-piece for primary closure of laceration on right hand in 4 years old child under general anesthesia. The patient was presented of acute respiratory distress resulting from pneumothorax and subcutaneous emphysema just after tracheal intubation. The tension pneumothorax was noticed on chest X-ray. This complication was the result of undesirable alveolar ventilation with high fresh gas flow by accidental using of oxygen flush valve. With the prompt decision of diagnosis of tension pneumothorax and aggresive treatment, the patient recovered uneventfully and discharged 7 days later.
Anesthesia ; Anesthesia, General ; Atmospheric Pressure ; Child ; Child, Preschool ; Diagnosis ; Gases ; Hand ; Humans ; Intubation ; Lacerations ; Lung ; Oxygen ; Pneumothorax* ; Respiration, Artificial ; Rupture ; Subcutaneous Emphysema ; Thorax ; Ventilation