Fractures of the phalanges of the hand are very common. Many are minor and likely to have a good result. However many other phalangeal fractures cause significant and prolonged disability. Non-union of the tubular bones of the hand are uncommon occurrence, but are often associated with functional deficits. The authors have reviewed 7 cases of non-union of the phalanges which were treated in the department of orthopaedic surgery, National Medical Center from 1978 to 1985. The results were summarized as follows: 1. The non-union of phalangeal bone was defined by clinical symptoms and signs and roentgenological examination. 2. The incidence of non-union of phalangeal bone fractures was 0.9% (7/771 cases.) 3. of 7 patients, there were 6 in male and 1 in female. 4. Non-union occurred more commonly in the second decade and the group between 10 and 30 years of age. 5. Seven cases, all were the right handed, but injury was developed in the left hands except two cases. 6. The causes of non-union were thought as open wound (7 cases), type of fracture (simple or comminution:3 cases), inadequate immobilization (4 cases) and overtraction (1 case). 7. of 7 cases, 4 cases were treated with bone peg graft and K-wire fixation and 2 cases with excision of distal fragment. 8. The clinical union was 9 weeks in average.
Clinical Study ; Female ; Fractures, Bone ; Hand ; Humans ; Immobilization ; Incidence ; Male ; Transplants ; Wounds and Injuries

Motilitone(R) (DA-9701) is a new herbal drug that was launched for the treatment of functional dyspepsia in December 2011 in Korea. The heterogeneous symptom pattern and multiple causes of functional dyspepsia have resulted in multiple drug target strategies for its treatment. DA-9701, a compound consisting of a combination of Corydalis Tuber and Pharbitidis Semen, has being developed for treatment of functional dyspepsia. It has multiple mechanisms of action such as fundus relaxation, visceral analgesia, and prokinetic effects. Furthermore, it was found to significantly enhance meal-induced gastric accommodation and increase gastric compliance in dogs. DA-9701 also showed an analgesic effect in rats with colorectal distension induced visceral hypersensitivity and an antinociceptive effect in beagle dogs with gastric distension-induced nociception. The pharmacological effects of DA-9701 also include conventional effects, such as enhanced gastric emptying and gastrointestinal transit. The safety profile of DA-9701 is also preferable to that of other treatments.
Analgesia ; Animals ; Compliance ; Corydalis ; Dogs ; Dyspepsia* ; Gastric Emptying ; Gastrointestinal Transit ; Hypersensitivity ; Korea ; Nociception ; Pharmacology ; Rats ; Relaxation ; Semen

In spite of recent development in fixation technique we still have lots of complication including avascular necrosis of femoral head. For many years, orthopaedic surgeon have been searching for a simple, safe, accurate and reliable clinical test to asses the vascular status of the femoral head. In early detection of viability of the femoral head, nothing is more certain than bone scan at the moment. Bone scan can detect or predict the viability of the femoral head. Subramanian and McAfee introduced 99mTc-Sn-polyphosphate as a bone seeking agents. We applied serial bone scan in 19 cases of femur neck fractures from 1982 to 1985 at the department of orthopaedic surgery, National Medical Center. The results were as follows; 1. The uptake ratio of displaced and undisplaced group based on preoperative radiography was 1.ZO, 1.46, 1.52, 1.55, and 0.63, 1.23, 1.81, 1.58 in average in postoperative bone scan interval 1–2 wks, 3 months, 6 months, 12 months. The bone scan uptake ratio was lower in the former than the latter, but after 3 months, there was no remarkable difference between them. 2. At the time of 1 to 2 weeks, 3 months, 6 months and 12 months, uneventful group was 0.74, 1.27, 1.72, 1.62 and avascular necrosis group 0.13, 0.18, 0.30, 0.67 in the uptake ratio. In 2 cases of avascular necrosis, the uptake ratio was markedly decreased. 3. There was no difference between the group operated within 48 hour after injury and the group delayed later.
Equidae ; Femoral Neck Fractures ; Femur Neck ; Femur ; Head ; Necrosis ; Radiography

No abstract available.
Animals ; Calcitonin Gene-Related Peptide* ; Calcitonin* ; Cochlear Nucleus* ; Rats*

Somatosensory evoked potential (SSEP) changes during cerebral aneurysm surgery and their relationship to postoperative neurologic complications have been studied on many occasions. However, it is still a matter of debate whether SSEP monitoring is really helpful in detecting or preventing neurologic complications. We studied 87 patients undergoing aneurysm surgery of the anterior cerebral circulation and SSEPs were monitored in 60 of these patients. All patients were grade 2 by the subarachnoid hemorrhage (SAH) grading system. Median nerve SSEP was monitored for middle cerebral or internal carotid artery aneurysms and posterior tibial nerve SSEP for anterior cerebral artery aneurysms. A decrease in the cortical amplitude of more than 50%, compared with control, was considered significant and interventions were then taken to reverse the SSEP. The pre- and postoperative neurologic deficits of each patient were evaluated immediately before and after surgery. No significant difference was found in the incidence of postoperative neurologic complications in the SSEP monitored (15% [9/60]) and unmonitored patients (22% [6/27]). In the SSEP monitored patients, the amplitudes of SSEPs decreased significantly in 14 patients and 4 of these showed neurologic complications. However, SSEP amplitudes were not significantly changed in 46 patients, and 5 of these showed neurologic complications. Significant changes in the amplitude of SSEP might represent neuronal injury, but the absence of change in the SSEP cannot guarantee patient safety. Our results suggest that SSEP monitoring may be useful for detecting the danger of neuronal injury, but that it does not reduce the incidence of neurologic complications in aneurysm surgery.
Adult ; Evoked Potentials, Somatosensory/physiology* ; Female ; Human ; Intracranial Aneurysm/surgery* ; Male ; Middle Age ; Monitoring, Physiologic* ; Nervous System Diseases/physiopathology ; Nervous System Diseases/etiology* ; Nervous System Diseases/diagnosis* ; Surgical Procedures, Operative/adverse effects*

PURPOSE: Trapdoor orbital blowout fracture is most common in orbital blowout fracture. Various materials have been used to reconstruct orbital floor blowout fracture. Absorbable alloplastic implants are needed because of disadvantages of nonabsorbable alloplastic materials and donor morbidity of autogenous tissue. The aim of the study is to evaluate usefulness of absorbable mesh plate as a reconstructive material for orbital blowout fractures. METHODS: From December 2008 to October 2009, 18 trapdoor orbital floor blowout fracture patients were treated using elevator fixation, depressor fixation, or elevator-depressor fixation techniques with absorbable mesh plates and screw, depending on degree of orbital floor reduction, because absorbable mesh plates are less rigid than titanium plates and other artificial substitutes. RESULTS: Among 18 patients, 5 elevator fixation, 4 depressor fixation, and 9 elevator and depressor fixation technique were performed. In all patients, postoperative computed tomographic (CT) scan showed complete reduction of orbital contents and orbital floor, and no displacement of bony fragment and mesh plate. Mean follow-up was 10 months. There were no significant intraoperative or postoperative complications. CONCLUSION: Three different techniques depending on the degree of orbital floor reduction are useful for open reduction and internal fixation of trapdoor orbital floor blowout fracture with absorbable mesh plates.
Displacement (Psychology) ; Elevators and Escalators ; Floors and Floorcoverings ; Follow-Up Studies ; Humans ; Orbit ; Postoperative Complications ; Tissue Donors ; Titanium

OBJECTIVE: This prospective, non-randomized study compared the safety and efficacy of the Angio-Seal(TM) Evolution(TM) to that of manual compression for common femoral artery punctures in neurovascular diagnostic angiography. METHODS: From June 2009 to September 2009, we performed 169 diagnostic trans-femoral cerebral angiographies, using either the Angio-Seal(TM) Evolution(TM) or manual compression to achieve hemostasis. We included 60 patients in this study, 30 in each group. We defined minor complications as those requiring no further treatment such as hematoma size less than 6 cm and bruise size less than 25 cm. Major complications were those requiring surgery of the femoral artery pseudoaneurysm and/or the second line increase of hospital stay even without further treatment. RESULTS: Mean time to hemostasis was 0.42+/-0.04 minutes for the angioseal and 15.83+/-1.63 minutes for manual compression (p<0.001). Overall complication rate did not differ between the 2 groups. After the patients were fully mobile, at 24 hours, the rate of onset of new complication differed significantly between the 2 groups (p=0.032). In the angioseal group, 5 (16.7%) of the 30 patients experienced the onset of a new complication after 24 hours, including 3 (60.0%) of the 5 who experienced major complications. CONCLUSION: The Angio-Seal(TM) Evolution(TM) is effective at decreasing mean time to hemostasis, like other closing devices. However, it may not be effective at producing early ambulation and discharge, compared to manual compression, because delayed complications may occur significantly after 24 hours.
Aneurysm, False ; Angiography ; Cerebral Angiography ; Contusions ; Early Ambulation ; Femoral Artery ; Hematoma ; Hemostasis ; Humans ; Length of Stay ; Prospective Studies ; Punctures

BACKGROUND: Inferior myocardial infarctions account for 40-50% of all acute myocardial infarctions and are generally viewed as having a more favorable prognosis than anterior wall infarctions. However, nearly 50% of patients suffering inferior infarction will have complications such as heart block, concomitant precordial ST-segment depression and right ventricular infarction or distinguishing features associated with an increased mortality that will substantially alter an otherwise favorable prognosis. METHODS: Clinical characteristics, electrocardiograms, and angiographic findings of coronary artery were viewed in 47 patients with inferior myocardial infarction. Significant ST-segment change was defined as > or =0.1mV horizontal or down sloping depression in acute inferior myocardial infarction patients with ST-segment elevation on leads II, III, aVF measured with reference to the TP segment, 80ms after J point. A group=no precordial ST-segment depression. B group=sum of ST-segment depression in leads V1 to V3 equal to or more than the sum of ST-segment depression in leads V4 to V6. C group=maximal precordial ST-segment depression in leads V4 to V6. RESULTS: 1) Incidence of multi-vessel disease in group A and in group B were 23% and 22%, respectively, compared with 60% for those of group C(p<0.05). 2) Incidence of Killip class III and IV rates in patients with group A and B were 8% and 12%, respectivly, compared with 47% for those patients with group C(p<0.05). 3) No significant difference of sex, age, peak CK level were found among three groups(p>0.05). CONCLUSION: The patients with acute inferior myocardial infarction with the maximal ST-segment depression in leads V4 to V6 would be at high risk for congestive heart failure and multi-vessel disease.
Coronary Vessels ; Depression* ; Electrocardiography ; Heart Block ; Heart Failure ; Humans ; Incidence ; Infarction ; Inferior Wall Myocardial Infarction* ; Mortality ; Myocardial Infarction ; Prognosis

The authors present a case of isolated dural arteriovenous fistula (DAVF) in the transverse sinus, which developed six years after microvascular decompression caused by hemifacial spasm via suboccipital craniectomy. The lesion was successfully treated by transarterial embolization using Onyx. We reviewed the related radiologic and therapeutic features of DAVF involving an isolated sinus and described the feasibility of the use of Onyx.
Central Nervous System Vascular Malformations ; Hemifacial Spasm ; Microvascular Decompression Surgery

Around the time of recovery from general anesthesia we usually use atropine and neostigmine to counteract the effect of muscle relaxant that is remaining in the body. We used various kinds of combinations of atropine and neostigmine to see the effect of them on heart rate. The combinations were as follows: I) atropine 0.02mg/kg+neostigmine 0. 02mg/kg. 2) atropine 0. 2mg /kg+neostigmine 0.03mg/kg. 3) atropine 0. 02mg/kg+neostigmine 0.04mg/kg. 4) atropine 0.02mg/kg+neostigmine 0.05mg/kg. 5) atropine 0.02mg/kg+neostigmine 0.06mg/kg. 6) atropine 0.02mg/kg+neostigmine 0.07mg/kg. Ten subjects(ps.I.ASA) were taken for each combination. Thus total sample size of the six combinations were sixty, Each study has been performed in the state of ASA P.S.1, and anesthetized for b but two hours. N2O-O2-Halothane technique was used for anesthesia. The dosage of pancuronium was 0. 08mg/kg. The age distribution of the sample was 2 to 60, and male to female ratio was 4 to 6. We came to the following conclusions from this study. 1) Types of dosage combinations those caused little change in heart rate were; atrop!ne 0.02mg/kg+neostigmine 0.02mg/kg, and atropine 0.02mg/kg+ neostigmine 0.03mg/kg. 2) Just after the simultaneous injection of the drugs, there appeared mild tachycardia, but fifteen minutes after the administration severe bradycardia came on and, after that the heart rate returned to normal. 3) The combinations which included neostigmine, more than 0. 04mg/kg, caused severe braycardia, and the most severe bradycardia was seen with a combination of atropine 0.02mg/kg and neostigmine 0.06mg/kg.
Age Distribution ; Anesthesia ; Anesthesia, General ; Atropine* ; Bradycardia ; Female ; Heart Rate* ; Heart* ; Humans ; Male ; Neostigmine* ; Neuromuscular Blockade* ; Pancuronium ; Sample Size ; Tachycardia