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Arthroscopic Cannulated Screw Fixation Technique for Avulsion Fracture of the Intercondylar Eminence of the Tibia (삽관 나사못(Cannulated screw)을 사용한 경골 과간 융기부 견열 골절의 관절경적 치료 기법)

  • Lee, Kee-Byoung;Chang, Ho-Guen;Lee, Seok-Beom;Moon, Young-Wan;Kang, Ki-Hoon;Lee, Wook-Hyung
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.127-131
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    • 1999
  • Avulsion fractures of the intercondylar eminence of the tibia are not uncommon. In the displaced avulsion fracture, anatomical reduction and firm fixation of fracture fragments are needed but the most of the conventional operative techniques including arthroscopic technique are relatively complex and need. The results were not always satisfactory due to the risk of postoperative complications such as wound infection, premature epiphyseal closure and loss of fixation after early motion etc. So we describe a simple and safe modified method of arthroscopic reduction and fixation for avulsion fractures of the intercondylar eminence of the tibia. In our thirteen cases, we achieved anatomical reduction and secure fixation using cannulated screw through the three arthroscopic portals (anterolateral, medial mid-patellar and central). Postoperatively, immediate limited range of motion of the knee and partial weight bearing were possible. Additional use of the washer afforded safe fixation of comminuted avulsion fracture. The advantage of this technique includes its technical simplicity, easy removal of hardware, ability to treat comminuted type IV fracture with washer, no additional skin incision, no damage to growing plate in growth children and less morbidity.

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TRAUMATIC BONE CYST : A CASE REPORT (외상성 골낭의 치험례)

  • Oh, Min-Hyung;Kim, Dae-Eop;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.1
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    • pp.18-25
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    • 2005
  • Traumatic bone cyst is a nonodontogenic cyst without epithelial-linig which contains fluid in it's cavity, and it is limited by bone walls with no evidence of infection. Traumatic bone cyst is asymptomatic and appears more frequently in the second decade. Gender distribution is approximately equal, although males are affected slightly often than females. Radiographically the lesion shows a well demarcated radiolucent lesion of variable size and the lesion may have scalloped margins. The adjacent teeth to traumatic bone cyst remains vital. Traumatic bone cyst is usually treated by surgical exploration and currettage of the lesion. In the first case of this case report, the patient was refered from the local dental clinic for the radiolucent area under the left mandibular first molar. From the panorama radiograph at the first visit, the radiolucent area of the left mandible showed a well defined scalloped margin and identified as traumatic bone cyst. In the second case, the patient have visited for the chief complaint of swelling and abcess of right maxillary second premolar. In the radiographic check up with panorama radiograph, the radiolucent lesion with well demarcated scalloped margin was found in the right mandible body, and identified as traumatic bone cyst. In the first case, overinstrumentation was done through the mesial root canal to irrigate the lesion. In the second case, not any treatment was done, and watched the progression of the lesion. And in both cases, after two month, the radiolucency and the size of the lesion has decreased to show healing in progress.

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Clinical Significance of the Routine "Dipstick" Urinalyses in Pediatric Inpatients (입원 환아에서의 "dipstick" 소변검사의 임상적 의의)

  • Park, Yong-Hoon;Jun, Jin-Gon
    • Journal of Yeungnam Medical Science
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    • v.1 no.1
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    • pp.115-120
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    • 1984
  • To find clinical significance of routine "dipstick" urinalysis on admission, we analyzed the results of the "dipstick" urinalyses performed in 844 patients admitted to the pediatric department of Yeungnam University hospital from May 1, 1983 to October 31, 1984. Ketonuria, proteinuria, hematuria and glucosuria were found in 9.5%, 4.9%, 2.4% and 1.1% of the patients respectively. There were no significant differences by sex, age and presence of fever. However, proteinuria and ketonuria were found more frequently in the patients with dehydration (p<0.05). The degree of ketonuria showed a positive association w:th the severity of dehydration (p<0.005). All of the patients with proteinuria and ketonuria showed negative results on follow up. However, among 13 patients with hematura, 9 patients showed negative results and 4 patients had persistent hematuria on follow up. These 4 patients were found to have chronic pyelonephritis (2), asymptomatic urinary tract infection (1) and benign recurrent hematuria (1). This routine "dipstick" urinalysis on admission seems to be simple test which is useful in detecting unrecognized kidney and other urinary tract disease.

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Effectiveness of a Health Educational Program Based on Self-Efficacy and Social Support for Preventing Liver Fluke Infection in Rural People of Surin Province, Thailand

  • Kaewpitoon, Soraya J;Thanapatto, Sirisuda;Nuathong, Wimonya;Rujirakul, Ratana;Wakkuwattapong, Parichart;Norkaew, Jun;Kujapun, Jirawoot;Padchasuwan, Natnapa;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1111-1114
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    • 2016
  • Opisthorchiasis is a major problem in Thailand particularly in northeast region which also has a high incidence of cholangiocarcinomas. Since health modification is needed, this quasi-experimental study aimed to assess the effectiveness of a health education program based on self-efficacy and social support in Tha Tum district, Surin province, Thailand. A total of 70 participants were purposive selected with a history of opisthorchiasis. Participants were divided into experimental and control groups, each with 35 subjects. The experimental group received a health education program composed of: (1) knowledge improvement, lectured with multimedia, demonstration, brochure, and handbook; (2) group discussion about their health beliefs, sharing their ideas and experience; and (3) social support from village health volunteers (VHV), heads of villages (HV), friends, and members of families, and public health officer (PHO). Follow-up was by PHO/VHV/HV, with provision of certificates and flasg for household that did not eat raw fish. Data were collected by predesigned questionnaires after implementation of the program for 3 months. Comparative data was analyzed by paired simple t-test and independent t-test. The results revealed that the experimental group had mean score of knowledge higher more than before the experiment (mean difference=3.1, t=3.915, 95%CI-3.3, -1.8 p-value=0.001), and the control group (mean difference=2.5, t=4.196, 95%CI=1.4, 3.6, p-value=0.001) with statistical significance. The mean scores of practice were higher than before the experiment (mean difference=4.6, t=4.331, 95%CI-5.3, -3.1, p-value=0.001), and control group (mean difference=4.4, t=6.142, 95%CI=4.2, 7.9, p-value=0.001). The mean scores of perceived susceptibility and perceived severity of opisthorchiasis, al well as perceived benefits and perceived barriers to prevention of opisthorchiasis, were also higher than before the experiment and in the control group (p-value <0.001). In conclusion, this was a successful health education program for liver fluke avoidance. Therefore, it may useful for further behavior modification in the other epidemic areas.

Correction of Recurrent Ingrowing Toenail Using Partial Matricectomy and Paronychial Advancement Flap (부분기질절제술과 발톱주위전진피판을 이용한 재발성 내증식발톱의 교정)

  • Kim, Eui Sik;Kim, Sung Nam;Noh, Bok Kyun;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.347-352
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    • 2006
  • Ingrowing toenail has been treated conventionally by various surgical treatment modlities. However, none of these procedures are perfect to achieve esthetic results with low cost, recurrence, and complication rates. Although mild cases can be treated conservatively, in severe recurrent cases, surgical treatment is preferred. The purpose of this study is to evaluate the effectiveness and safety of using partial matricectomy and paronychial advancement flap for correction of recurrent ingrowing toenail. Eight patients suffering from recurrent ingrowing toenail were operated using partial matricectomy and paronychial advancement flap in our department from August 2004 to August 2005. The number of recurrent episodes ranged from 2 to 5. With digital nerve block, the excision area was marked on nailplate and inflammed lateral nail fold. The horizontally designed paronychial flap considering defect size was effective for wide exposure of the neighboring germinal matrix, which is later to be completely excised or cauterized because remnant germinal matrix made postoperative spicule formation. The nailplate on the affected side was removed about 3-5 mm width longitudinally, being cautious not to damage the proximal dorsal nail fold. The same width of the sterile matrix including germinal matrix was excised longitudinally with inflammed granulation tissue and partial lateral nail fold on the affected side. The subcutaneously elevated paronychial flap was advanced to cover the defect and was anatomically sutured with 5-0 nylon sutures. We evaluated our procedure's effectiveness by examining some factors such as cosmetic results, recurrence, spicule formation, postoperative pain and duration of return to normal activities. In eight patients, no complication was observed such as recurrence, severe pain and spicule formation except for 1 case of infection. Postoperative discomfort was minimal. Average duration of return to normal activities was 12 days. Cosmetically the results were acceptable in all patients. The partial matricectomy and paronychial advancement flap for correction of recurrent ingrowing toenail were found to be technically simple, efficient procedure with a relative low recurrence rate and better cosmetic results.

Prevalent Characteristics of Fowl Typhoid and Antibiotic Susceptibility of Salmonella gallinarum (닭 티푸스의 발생상황과 Salmonella gallinarum의 항균제 감수성)

  • 박노찬;도재철;조광현;장성준;권헌일;박덕상
    • Korean Journal of Veterinary Service
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    • v.18 no.2
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    • pp.113-123
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    • 1995
  • The present study was conducted to investigate the prevalent characteristics of Fowl Typhoid and antibiotic susceptibility of Salmonella gallinarum isolated from 56 infective or dead chickens of 20 egg laying farms in Kyung Buk province during the period from August to December 1994. 1. Among 416, 000 chickens of 92 flocks in 20 egg laying farms, 17, 360 chickens of 31 flocks were died of Fowl Typhoid. 2. Salmonella gallinarum was isolated from 56 chickens in liver and spleen, and then blood of infective chickens was positive to Pullorum antigen. 3, In the survey of gross lesion of 56 chickens, 43 chickens(76.8%) were swelled at liver, 39(69.6%) were swelled at spleen, 12(21.4%) were changed with bronze, 3(5.4% ) were hemorrhagic in peritoneal cavity. 4. In transmission pattern, 4 farms were outbreaked the entrance of chicken house at first, but the others were outbreaked at various place. They were transmitted at right and left directions in flock. 5. 2 farms confirmed at the early stage of infection were eradicated by removing infective chickens and administrating antibiotics, but 18 farms at chronic stage were not. 6. The biochemical properties of 112 Salmonella gallinarum from chickens were generally identical to those of the referance, but H$_2$S was not productive, cellobiose was fermentive. 7 Minimum inhibitory concentration(MIC) of 20 isolates was performed by using 21 antibiotics, MICs of Amikacin(Ak), Gentamicin(Gm), Kanamycin(Km), and Tetracycline (Tc) were below 1.6 ug/ml, Ampicillin(Am), Furazolidone(Fu) and Neomycin(Nm) were below 3.1 ug/ml, Cephalothin(Ce), Cefazoline(Cf) and Chloramphenicol(Cm) were below 6.3 ug/ml, Nalidixic acid(Na), Polymyxin(Po) and Rifampicin(Rf) were below 12.5 ug/ml, Penicillin (Pm) was below 25 ug/ml, Colistin(Co) and Streptomycin(Sm) were below 50 ug/ml, Sulfamerazine(Sr) and Sulfamethazine (St) were below 200 ug/ml, Lincomycin(Lm) and Spiramycin(Sp) were below 400 ug/ml, Bacitracin(Ba) was below 800 ug/ml. 8. Among the 20 isolates, all(100%) of those were sensitive to Ak, Am, Ce, Cf, Cm, Fu, Gm, Km, Na, Nm, Po, Rf, Sr, St and Tc, but 6 isolates(30%) were resistent to Co, 20(100% ) to Ba, Lm, Pm, Sm, and Sp. The drug resistance patterns were simple which 6 strains were BaCoLmPmSmSp type, and 14 were BaLmPmSmSp type.

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Reconstruction with Extracorporeally Radiated Autogenous Bone Graft After Wide Resection of Bone Tumors (골종양 절제후 방사선 조사한 자가골을 이용한 재건술)

  • Lee, Jong-Seok;Jeon, Dae-Geun;Kim, Sug-Jun;Lee, Soo-Yong;Yang, Hyun-Seok
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.1
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    • pp.32-38
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    • 1997
  • PURPOSE : For the reconstruction of large bone defect after tumor resection, it is possible to reuse the bone involved by tumor with some treatment to it. Several bone-reusing methods have been reported such as autoclaving, low-heat treatment(pasteurization) and intraoperative radiotherapy. We have used extracorporeally radiated autogenous bone graft for reconstruction after tumor resection, and analyzed the periods for junctional union, functional results and complications to know the indications of this method. METHODS : From Dec. 1993 to Sept. 1995, nine patients had taken autogenous bone graft with extracorporeal irradiation. Eight cases were osteosarcoma and 1 giant cell tumor. The graft sites were 5 in femur, 3 proximal tibia and 1 femur and tibia. Stage 3 was 1 case(GCT), Stage IIB 3 and Stage IIIB 5. After wide resection, surrounding soft tissue and intramedullary and extramedullary portion of the tumor were removed. Radiation was done in 5000cGy to the resected bone. Ender nails and bone cement were inserted and filled into the medulla to prevent fracture. RESULTS : Average follow-up period was 12.3(4 to 21) months. Average junctional union period in simple X-ray was 6.5 months in 4 cases. Average functional score following Enneking's criteria was 19(12-27). Complications were as follows ; condylar fractures and femur neck fracture in 4 cases, subluxation of the knee joint 3 and infection 1. Although local recurrence was detected in 1 case, the site of recurrence was not in the radiated bone but surrounding soft tissue. At final follow-up, no recurrence was found in one case(GCT), CDF 2, AWD 2, DOD 3, and died of chemotherapy related sepsis 1. CONCLUSIONS : Extracorporeally radiated bone autograft is considered to be a method for reconstruction of the large bone defect made by tumor resection, especially in the reconstruction around the joint.

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The association between patient safety culture perceptions and patient safety management activities in dental hospital workers (치과병원 종사자의 환자안전문화인식과 환자안전관리활동의 관련성)

  • Kim, Sun-Kyung;Choi, Jae-Woo;Lee, Sang-Gyu;Cho, Young-Dae;Han, Eun-A;Kim, Tae-Hyun
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.6
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    • pp.1033-1045
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    • 2016
  • Objectives: This research was conducted to recognize dental health care employees' awareness of patient safety culture and to examine the association between awareness of patient safety culture and patient safety activities. Methods: The subject of this research includes the dental health care employees from 11 different dental hospitals in the nation, dental offices in the 6 different general hospitals in Seoul, and 4 different private dental offices in 2014. A self-reported questionnaire was completed by 485 dental health care employees from March 17 to April 3, 2014. Multiple regression models were used in the analysis. Results: First, the dental health employees' awareness of patient safety culture was 3.25 on average. The extent of patient safety activities was 2.75. The behavior of the supervisor/manager and the adequate explanation showed positive correlation with r=0.213 (p<0.001). The process of communication and the preventative inspection of the medical equipment showed negative correlation with r=-0.258 (p<0.001), and especially the awareness of patient safety culture and the infection control exercise showed the most significant correlation (r=0.293, p<0.001). Second, hospital environment factor of patient safety perceptions positively were related to most of patient safety management activities after controlling several covariates. Conclusions: The result of this research showed that most of the patient safety culture perceptions positively were correlated with patient safety activities. We also found that proper hospital environment, simple communication process, and positive perceptions for patient safety level were more likely to perform patient safety management activities after controlling several covariates. Improving the patient safety perceptions of dental hospital workers is an important consideration.

Usefulness of Percutaneous Transluminal Angioplasty before Operative Treatment in Diabetic Foot Gangrene (당뇨병성 족부 괴저에서 수술 전 시행한 경피적 경혈관 혈관성형술의 유용성)

  • Im, Chul Soon;Lee, Myoung Jin;Kang, Jung Mo;Cho, Young-Rak;Jo, Jeong Hyun;Lee, Chan Soo
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.1
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    • pp.32-37
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    • 2018
  • Purpose: Diabetic foot gangrene has a high morbidity rate and a great influence on the quality of life. Amputation is an appropriate treatment if conservative treatment is impossible according to the severity of gangrene and infection. The purpose of this study was to evaluate the usefulness of preoperative percutaneous transluminal angioplasty for the postoperative outcome. Materials and Methods: From February 2013 to April 2016, among 55 patients with diabetic foot gangrene, who require surgical treatment, percutaneous transluminal angioplasty was performed on patients with an ankle brachial index (0.9 and stenosis) 50% on angiographic computed tomography. The study subjects were 49 patients, comprised of 37 males (75.5%) and 12 females (24.5%). The mean age of the patients was $70.0{\pm}9.6years$. The treatment results were followed up according to the position and length of the lesion and the changes during the follow-up period. Results: As a result of angiography, there were 13 cases of atherosclerotic lesions in the proximal part, 11 cases in the distal part and 25 cases in both the proximal and distal parts. As a result of the follow-up after angiography, in 13 patients, the operation was not performed and only follow-up and dressing were performed around the wound. Sixteen patients underwent debridement for severe gangrene lesions and 20 patients, in whom the gangrene could not be treated, underwent amputation (ray amputation or metatarsal amputation, below knee amputation). Conclusion: Preoperative percutaneous angioplasty in diabetic foot gangrene patients with peripheral vascular occlusive disease is simple, and 59.2% of the patients with diabetic foot gangrene could be treated by conservative treatment or debridement.

Giant Neurofibroma on Both Buttocks (양측 엉덩이의 거대 신경섬유종)

  • Kim, Ji Hoon;Burm, Jin Sik;Kim, Yang Woo;Kang, So Ra;Kim, Hyoung Kyoung
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.512-515
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    • 2009
  • Purpose: Neurofibromatosis(NF) is an autosomal - dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop - shaped ligation before removal of the giant NF in both buttocks. And then we could successfully reduce the amount of hemorrhage during the operation. Methods: A 46 - year - old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about $30{\times}20cm$ in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop - shaped suture ligation(weaving the thread up and down in a loop - shaped pattern, leaving a space of 2 cm between each loop) with a straight needle and prolene 2 - 0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged - shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop - shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. Results: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscense did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow - up, the functional and cosmetic result was excellent. Conclusion: A continuous loop - shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.