Concomitant ipsilateral fractures of the humerus, radius and ulna are uncommon combined injury and are also called "floating elbow". It was found that this injury was usually a result of rather severe trauma and frequently associated injuries to other organ systems. It is controversial in the treatment of the "floating elbow", but the current treatment recommendations are open reduction and internal fixation of both the humerus and the forearm fracture with early initiation of range of motion exercises. The authors reviewed thirteen cases of ipsilateral fractures of the humerus, radius and ulna treated in our clinic from January 1992 to March 1997, and average follow-up period was over 18 months(range, 12 to 36 months). The results obtained were as follows; 1. The most common cause of injury was traffic accident and most common location of fractures was mid-third in both humerus and forearm. 2. The shape of fractures was transverse or comminuted in most cases. 3. The good clinical results were obtained by open reduction and internal fixation of both the humerus and the forearm fracture with early initiation of range of motion exercises. 4. The recovery was affected by the severity of the initial trauma and method of the treatment. 5. According to the Lange and Foster method, the functional result was good in 8 cases, fair in 4 cases and poor in 1 cases.
Tae Suk-Kee;Jung Young Bok;Park Keun-Hyung;Song Kwang-Sup
Clinics in Shoulder and Elbow
/
v.1
no.2
/
pp.167-174
/
1998
Since the first description by Cotton, there have been sporadic reports about the inferior subluxation of the shoulder. Nevertheless there is still a lack of consensus regarding the mechanism of occurrence, evolution and treatment. We have experienced six cases of inferior sublusation(five cases after trauma and one case after surgery) which resolved over time. Analysis of the clinical informations including serial radiographs, data from clinical examination and electromyography(EMG) revealed the following results. All the five post-traumatic inferior subluxations were noted in women with an average age of 59 years after direct trauma resulting in fracture of the proxiaml hrnerus(4) or clavicle(1), of which nerve injury was proven by EMG in three. One case occurred after Bankart repair by stretch injury to the axillary nerve. The presenting symptom was unusually severe pain on passive motion. Absence of anterior or posterior displacement wasl confirmed by radiographs. All the cases seemed to have delayed onset of subluxation except one. The subluxed hu.meral head was concentrically reduced at an average 11 weeks(range 3-23 weeks) from the supposed time of occurrence and the acromiohumeral interval measUred on the standing anteroposterior radiographs decreased to 9.4 mm ftom 23 mm. Improvement of pain paralled the reduction. In conclusion, the most common cause of transient inferior subluxation was nerve injury in ou~ series and the prognosis was excellent, however protraction of recovery or leaving permanent subluxation would be possible if .the injured nerve is unrecoverable.
Protective effect of superoxide dismutase[SOD] and substrates on acute ischemic and reperfused myocardium was assessed by cardiac microdialysis. 30 Rabbits were divided into 4 groups; normal control group [group I, n=5], ischemic group [group II, n=5], SOD treated group [group III, n=10], and substrates treated group [group IV, n=10]. After a microdialysis apparatus was implanted in rabbit myocardium, coronary artery was occuluded for 5 minutes and reperfusion was performed for 30 minutes. Hemodynamic changes, CK-MB isoenzyme level and adenine ring compound level in effluent dialysates [equilibrated with interstitial fluid], and ultrastructural changes of myocardial cell were analysed. Systolic blood pressure at 10 and 30 minutes after reperfusion was higher in group III and IV than in group II [p<.05]. Also percent recovery of systolic blood pressure in group III [p<.01] and IV [p<.02] was higher than in group II. CK-MB isoenzyme level in effluent dialysates was peaked at 10 minutes after reperfusion, thereafter decreased in group II, III and IV. At 30 minutes after reperfusion, its level was lower in group III and IV than in group II[p<.05]. Adenine ring compound level in effluent dialysates increased till 10 minutes after reperfusion and progressively decreased. At 10 and 30 minutes after reperfusion, its level was lower in group III and IV than in group II without significance. Degree of myocardial damage was estimated by scoring of mitochondrial injury. Group I was within normal range and most severe injury was seen in group II. And the score of mitochondrial injury in group III and IV was lower than in group II. In conclusion, SOD and substrates[KMP solution] had protective effect on stunned myocardium. The microdialysis appratus was a good device for studying stunned myocardium, and cardiac microdialysis might be a unique technique for analysis of regional intramyocardial interstitial fluid.
Objective : Intraoperative ventriculostomy is widely adopted to make the slack brain. However, there are few reports about hemorrhagic or parenchymal injuries after ventriculostomy. We tried to analyze and investigate the incidence of these complications in a consecutive series of patients with aneurysmal subarachnoid hemorrhage (SAH). Methods : From September 2006 to June 2007, 43 patients underwent surgical clipping for aneurysmal SAH at our hospital. Among 43 patients, we investigated hemorrhagic or parenchymal injuries after intraoperative ventriculostomy using postoperative computed tomographic scan in 26 patients. After standard pterional craniotomy, ventriculostomy catheter was inserted perpendicular to the cortical surface along the bisectional imaginary line from Paine's point. Results : Hemorrhagic injuries were detected in 12 of 26 patients (46.2%). Mean systolic blood pressure during anesthesia was with in statistically significant parameter related to hemorrhage (p=0.006). On the other hand, parenchymal injuries were detected in 11 of 26 patients (42.3%). Female and the amount of infused mannitol during anesthesia showed statistically significant parameters related to parenchymal injury (p=0.005, 0.04, respectively). However, there were no ventriculostomy-related severe complications. Conclusion : In our series, hemorrhagic or parenchymal injuries after intraoperative ventriculostomy occurred more commonly than previously reported series in aneurysmal SAH patients. Although the clinical outcomes of complications are generally favorable, neurosurgeon must keep in mind the frequent occurrence of brain injury after intraoperative ventriculostomy in the acute stage of aneurysmal SAH.
Kim, Do-Hyoun;Lee, Sung-Woo;NamGung, In;Park, Jong-Hak;Kim, Su-Jin;Hong, Yun-Sik
Journal of The Korean Society of Clinical Toxicology
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v.9
no.1
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pp.34-38
/
2011
Vinegar is a very popular ingredient used in many cuisines. It is also known for its beneficial health, beauty and possible weight-loss properties. The authors report on a patient who presented to the emergency department with unstable vital signs complaining of generalized abdominal pain after ingestion of 450 ml of apple cider vinegar. We documented a case of corrosive gastrointestinal injury with persistent metabolic acidosis occurring after ingesting apple cider vinegar with an acetic acid concentration of 12~14%. Toxic damage to the liver and kidney were also observed, peaking on post-ingestion day 3. The patient received supportive care and hemoperfusion for three days without much clinical improvement and died in the seventh day of intensive care due to disseminated intravascular coagulation and multi organ failure. Edible vinegar, when taken in large amounts, is capable of inducing corrosive injuries of the GI tract as well as severe systemic toxicities, such as metabolic acidosis. Safety precautions regarding vinegar deserve more public attention and clinicians also should be astute enough to recognize the potential damage accompanying vinegar ingestion.
Kim, Young-Yuk;Jeong, Yeon-Jun;Jung, Sung-Hoo;Kim, Jae-Chun
Advances in pediatric surgery
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v.16
no.2
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pp.177-189
/
2010
Traumatic injury is one of the leading causes of morbidity and mortality in children. This is a clinical review of pediatric blunt abdominal trauma. A retrospective analysis of the 112 children with blunt abdominal trauma aged 15 years or less treated at the Department of Pediatric Surgery, Chonbuk National University Hospital was performed. The analysis included age, sex, injury mechanism, number and site of the injured organ, management and outcomes. The average age of occurrence was 7.6 years, and the peak age was between 6 and 8 years. There was a male preponderance with a male to female ratio of 2.3:1. The most common cause of blunt abdominal trauma was traffic accidents (61.6 %), principally involving pedestrians (79.7 %). The accident prone times were between 8:00 AM and 8:00 PM, the weekends (40.2 %), and the winter respectively. Thirthy-five patients (31.2 %) had multiple intra-abdominal organ injuries and the most common injured organ was the liver. Seventy-four cases (66.1 %) were managed non-operatively and eleven cases (9.8 %) expired. Of the patients who were treated surgically or were to be operated on one patient died before surgery, the remainder died during or after surgery. Risk factors such as number of injured organ, systolic and diastolic blood pressure, and trauma scores by Glasgow coma scale (GCS), Pediatric trauma score (PTS), revised trauma score (RTS), injury severe score (ISS), TRISS were significantly correlated with mortality rate.
To evaluate the influence of hepatic oxygen free radical systems on liver injury by topical p-phenylenediamine (PPD) application on rat skin, PPD (25 mg/16.5 $\textrm{cm}^2$) was topically applied to the abdominal region 5 times every other day and sacrificed. By PPD treatment, increasing rate of liver weight/body weight (%), serum activities of alanine aminotransferase and aspartate aminotransferase and decreasing rate of microsomal glucose-6-phosphatase activity were higher in the rats fed tungstate supplemented diet than those fed a standard diet. These findings indicate that group fed tungstate supplemented diet have more severe liver injury compared with group fed standard diet on topical PPD application. However, the activities of oxygen free radical generating enzymes such as xanthine oxidase (XO) and cytochrome P450 dependent aniline hydroxylase and those of oxygen free radical scavenging enzymes were not found to be different between these two animal groups. In the present study, a novel monitoring method to detect the generating of oxygen free radicals in liver extract was devised. Throughout this method, the oxidized PPD produced by oxygen free radicals was determined colorimetrically. The increasing rate of PPD oxidation by liver homogenate was higher in tungstate fed animals than in standard diet fed ones. Among the fractionations of liver extract, the mitochondrial and postmitochondrial fractions in the liver extract of tungstate fed animals led to a higher availability of PPD oxidation by PPD treatment compared with standard diet fed ones. In conclusion, these results suggest that an enhanced liver injury in tungstate fed animals treated with PPD may be due to oxygen free radicals produced in other systems except oxygen free radicals generating from cytosolic XO system. Especially, oxidative availability by PPD can be used for oxygen free radical detection in some tissue.
Our experiment studied that grafted stem cells reduced behavioral deficiency in rodent animal models of clip compressive surgery inducing spinal cord infarction. Our research proved the effect of embryonic stem cells to the spinal cord infarction caused by compressing T9-10 with an aneurysm clip, focusing the application of grafted stem cells for reduction of infarction and regeneration of spinal cord nervous injury. Therefore, our research suggests manifest results that implantation of mouse embryonic stem cell could show behavioral improvement after severe spinal cord damage. Therefore, mouse embryonic stem cell (mESC) could be useful application for the method in neurological injury. Conclusively, stem cell implant therapy may enhance the effectiveness of stem cell implant for central nervous system injury.
Kim, Ran;Kwon, Hoin;Lee, Young-Ho;Yook, Ki-Hwan;Song, Jeongun;Song, Min-A;Hong, Hyun Ju
Journal of the Korean Academy of Child and Adolescent Psychiatry
/
v.26
no.3
/
pp.149-158
/
2015
Objectives : The objective of this study was to identify the risky behavior subtypes in adolescents with depression, and the relationship between those subtypes and suicide attempt. Methods : Ninety adolescents who met the Diagnostic and Statistical Manual of Mental Disorders-4th edition criteria for major depressive disorder, dysthymia, or depressive disorder not otherwise specified participated in the study. Participants were interviewed about suicidal attempts, non-suicidal self-injuries. Smoking, drinking behaviors, and searching for the word "suicide" on the internet, negative life events including bulling-bullied experiences, and history of abuse were also included with questionnaires. Results : The results of cluster analysis showed that four risky behaviors were divided into three clusters : non-risky type, characterized by few risky behaviors ; delinquency type, which was characterized by smoking and drinking ; non-suicidal self-injury type. In non-suicidal self-injury type, percentage of girls was higher and clinical symptoms were more severe than delinquency type. In addition, delinquency type members could be a bully, while non-suicidal self-injury type members could be abused by a family member. Logistic regression analysis showed that both risky behavior subtypes were significant predictors of suicide attempt. Conclusion : These results suggest that two types of risky behaviors of depressed adolescents have an effect on the suicide attempts independently. Then, the implications and limitations of the study were discussed and directions for future studies were suggested.
Choi, Jae Hong;Kim, Yoon-Joo;Kim, Young Don;Han, Kyoung Hee
Pediatric Infection and Vaccine
/
v.24
no.2
/
pp.112-116
/
2017
Kawasaki disease (KD) is an acute febrile mucocutaneous lymph node syndrome that commonly presents with stable hemodynamic status during the acute phase. An 8-year-old boy initially presented with severe hypotension and acute kidney injury. He was placed in the intensive care unit and was diagnosed with KD. Observed clinical features were defined as KD shock syndrome. His coronary artery was dilated during the subacute phase. Furthermore, he was given anti-hypertensive medications, owing to hypertension as an unusual complication of KD. We knew the importance of monitoring for blood pressure considering vasculitis as an aspect of the main pathogenesis of KD.
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