The recent trend in method of long bone fracture had been toward bracing or closed medullary nailing except for certain fractures that fall within well-established surigcal criteria. Functional bracing is gaining widespread acceptance in management of tibial, femoral, and forearm fractures and is well suited to humeral shaft fractures. Twenty four cases of humeral shaft fractures were treated with functional brace and early mobiliza tion from October 19S2 to June 1984 at Busan National University Hospital and the results were as follows. 1. The fracture sites were composed of middle third in 15 cases, distal third in 6 cases, and proximal third in 3 cases and the fracture shapes were transverse in 10 cases, oblique and spiral in 5 cases respectively, and comminuted in 4 cases. 2. The average time from injury to functional bracing was 13.0 days and to discontinuance of the functional brace was 9.0 weeks. 3. Nonunions have not been encountered in all cases. The residual angulation was under 20degrees in all but one and the most common deformity was varus in 20 cases. Minimum limitation of motion, mostly a loss of the last few degrees of external rotation, was detected after follow-up of 2 months but did not present any clinical problem. 4. The achievement of rapid and uninterrupted osteogenesis without undesirable functional or cos- metic deficit could be listed as the advantage.
Braces ; Busan ; Congenital Abnormalities ; Follow-Up Studies ; Forearm ; Fractures, Bone ; Humerus ; Methods ; Osteogenesis

No abstract available.
Calcaneus*

Angioma serpiginosum is a rare acquired vascular lesion that usually presents in the first two decades of life with a predilection for females. A typical lesion is characterized by deeply red nonpalpable puncta that are grouped closely together in macular or netlike patterns on the lower extremities and buttocks. Histopathologically, thin-walled dilated capillaries are seen in some of the dermal papillae and the superficial reticular dermis without extravasation of red blood cells. We report a case of angioma serpiginosum developed on the left chest and left upper extremity in a 18-year-old man.
Adolescent ; Buttocks ; Capillaries ; Dermis ; Erythrocytes ; Female ; Hemangioma* ; Humans ; Lower Extremity ; Thorax ; Upper Extremity

BACKGROUND: Congenital aortic stenosis in children is characterized by "excessive" left ventricular hypertrophy with reduced left ventricular systolic wall stress that allows for supernormal ejection performance. We hypothesized that left ventricular wall stress was decreased immediately after surgical correction of pure congenital aortic stenosis. Also measuring postoperative left ventricular wall stress was a useful noninvasive measurement that allowed direct assessment for oxygen consumption of myocardium than measuring the peak systolic pressure gradient between ascending aorta and left ventricle for the assessment of surgical results. MATERIAL AND METHOD: Between September 1993 and August 1999, 8 patients with isolated congenital aortic stenosis who underwent surgical correction at Yonsei cardiovascular center were evaluated. There were 6 male and 2 female patients ranging in age from 2 to 11 years(mean age, 10 years). Combined Hemodynamic-Ultrasonic method was used for studying left ventricular wall stress. We compared the wall stress peak systolic pressure gradient and ejection fraction preoperatively and postoperatively. RESULT: After surgical correction peak aortic gradient fell from 58.4+/-17.6, to 23.7+/-17.7 mmHg(p=0.018) and left ventricular ejection fraction decreased but it is not statistically significant. In the consideration of some factors that influence left ventricular end-systolic wall stress excluding one patient who underwent reoperation for restenosis of left ventricular outflow tract left ventricular end-systolic pressure and left ventricular end-systolic dimension were fell from 170.6+/-24.3 to 143.7+/-27.1 mmHg and from 1.78+/-0.4 to 1.76+/-0.4 cm respectively and left ventricular posterior wall thickness was increased from 1.10+/-0.2, to 1.27+/-0.3cm but it was not statistically singificant whereas left ventricular end-systolic wall stress fell from 79.2+/-24.9 to 57.1+/-27.6 kdynes/cm2(p=0.018) in 7 patients. For one patient who underwent reoperation peak aortic gradient fell from 83.0 to 59.7 mmHg whereas left ventricular end-systolic wall stress increased from 67.2 to 97.0 kdynes/cm2 The intervals did not change significnatly. CONCLUSION: We believe that probably some factors that are related to left ventricular geometry influenced the decreased left ventricular wall stress immediately after surgical correction of isolated congenital aortic stenosis. Left ventricular wall stress is a noninvasive measurement and can allow for more direct assesment than measuring peak aortic gradient particularly in consideration of the stress and oxygen consumption of the myocardium therefore we can conclude it is a useful measurement for postoperative assessment of congenital aortic stenosis.
Aorta ; Aortic Valve Stenosis* ; Blood Pressure ; Child ; Equidae ; Female ; Follow-Up Studies* ; Heart Ventricles ; Humans ; Hypertrophy, Left Ventricular ; Male ; Myocardium ; Oxygen Consumption ; Reoperation ; Stroke Volume

Lead has been widely used in industry and contained in various household products. However, allergic reaction to lead is known to be extremely rare. A 23-year-old woman who had been working in an electronics company for 1 year presented with pruritic erythematous macules and papules on both arms and hands of 1 month duration. She was diagnosed as a contact dermatitis due to lead by patch test using lead nitrite(0.01% aq.). The cutaneous eruption subsided with treatment and has not recurred by changing the working place for 6 months. We report a case of contact dermatitis due to lead.
Arm ; Dermatitis, Contact* ; Female ; Hand ; Household Products ; Humans ; Hypersensitivity ; Patch Tests ; Young Adult

Lead has been widely used in industry and contained in various household products. However, allergic reaction to lead is known to be extremely rare. A 23-year-old woman who had been working in an electronics company for 1 year presented with pruritic erythematous macules and papules on both arms and hands of 1 month duration. She was diagnosed as a contact dermatitis due to lead by patch test using lead nitrite(0.01% aq.). The cutaneous eruption subsided with treatment and has not recurred by changing the working place for 6 months. We report a case of contact dermatitis due to lead.
Arm ; Dermatitis, Contact* ; Female ; Hand ; Household Products ; Humans ; Hypersensitivity ; Patch Tests ; Young Adult

BACKGROUND AND OBJECTIVE: : ?The etiology of atopic dermatitis is still not clear. Atopic dermatitis is known to develop through immunological and non-immunological pathomechanisms. The delayed hyper- sensitivity reaction in atopic dermatitis has been reported as decreasing due to disturbance of cellular immunity. However, in recent days, there is a dispute as to whether disturbed epidermal barrier of atopic dermatitis could elicit a delayed type hypersensitivity reaction by an acceleration in the penetration of allergen. The aim of this study was to determine whether transepidermal water loss (TEWL) increased in atopic dermatitis, and whether the TEWL differed with a presence of delayed type-skin reaction. In addition, the prevalence of positive patch test reaction and TEWL were measured in atopic dermatitis and normal controls. METHODS: We performed the patch test with 24 Korean standard allergens and 5 aeroallergens on 38 atopic dermatitis patients. TEWL was measured using DermaLab (Cortex technology, Denmark) on 38 patients with atopic dermatitis and 40 normal controls. RESULTS: 17 (44.7%) patients with atopic dermatitis had positive reactions on the patch test. The frequency of positive allergens was in the following order: nickel sulfate (18.4%), thimerosal (15.8%), D. pteronyssinus (15.8%), and potassium dichromate (13.1%). TEWL values of both clinically normal skin and eczematous skin in atopic dermatitis patients were higher than those of normal controls. There was no statistically significant difference in TEWL values of normal skin of atopic dermatitis between the positive patch test and negative patch test groups. In positive reaction sites of aeroallergen patch test, the TEWL increased in comparison with both the control site and the positive classical patch test reaction site but it was not statistically significant. CONCLUSION: These results revealed that epidermal barrier is disturbed in atopic patients and suggested that various allergens might easily penetrate the skin to induce the delayed-type hypersensitivity reaction.
Acceleration ; Allergens ; Dermatitis, Atopic* ; Dissent and Disputes ; Humans ; Hypersensitivity ; Immunity, Cellular ; Nickel ; Patch Tests* ; Potassium Dichromate ; Prevalence ; Skin* ; Thimerosal

BACKGROUND: Nitric oxide synthase (NOS) is known to mediate ultraviolet B (UVB)-induced skin inflammation However, there is still ambiguity as to which NOS isotype mediates the process in vivo. Furthermore, contradictory results have been reported on which cell types respond to UVB irradiation in vitro. OBJECTIVE: This study was performed to evaluate the change of inducible NOS (iNOS) expression in vivo as a result of UVB radiation on the skin of a rat. METHOD: To examine the time-course change in iNOS expression in the rat skin, the rats were exposed to 400 ml/cm2 of UVB radiation, and skin samples were taken at various time intervals up to 48 h. iNOS expression on the skin of a rat was evaluated by both Western blot analysis and immunohistochemical staining. RESULTS: From Western blot analysis, UVB irradiation induced inducible NOS (iNOS) expression in the epidermis at 12-48 h postirradiation with a peak expression at 24 h. Immunohistochemical staining revealed that UVB-induced iNOS expression was localized to the epidermis and infiltrating inflammatory cells in the upper dermis of the rat. CONCLUSION: iNOS was induced by UVB irradiation on the skin of a rat, mainly in the epidermis. Therefore, iNOS is supposed to be one of the major mediators with regard to inducing an inflammatory response in UVB-irradiated rat skin in vivo.
Animals ; Blotting, Western ; Dermis ; Epidermis ; Inflammation ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II* ; Rats* ; Skin*

A 30-year-old male was involved in a car accident. Radiographs revealed a depressed marginal fracture of the medial tibial plateau and an avulsion fracture of the fibular head. Magnetic resonance imaging showed avulsion fracture of Gerdy's tubercle, injury to the posterior cruciate ligament (PCL), posterior horn of the medial meniscus, and the attachments of the lateral collateral ligament and the biceps femoris tendon. The depressed fracture of the medial tibial plateau was elevated and stabilized using a cannulated screw and washer. The injured lateral and posterolateral corner (PLC) structures were repaired and augmented by PLC reconstruction. However, the avulsion fracture of Gerdy's tubercle was not fixed because it was minimally displaced and the torn PCL was also not repaired or reconstructed. We present a unique case of pure varus injury to the knee joint. This case contributes to our understanding of the mechanism of knee injury and provides insight regarding appropriate treatment plans for this type of injury.
Adult ; Fibula/*injuries/surgery ; Humans ; *Knee Injuries/complications/surgery ; Male ; *Multiple Trauma/complications/surgery ; *Tibial Fractures/complications/surgery

PURPOSE: There have been no studies employing a specific questionnaire relating to patient satisfaction following ambulatory hernioplasty. Via the production of a novel specific questionnaire, attempts were made to determine the factors associated with patient satisfaction following hernioplasty on an ambulatory basis. METHODS: Patient satisfaction was evaluated via cross-sectional telephone surveys administered 10.5 (range of 2~23) months after their operations, consisting of six questions, regarding; anesthetic technique, surgical method, necessity for admission, necessity for follow-up, intraoperative pain, and postoperative pain. Each of the questions was then scored using a 4-point scoring system, with global satisfaction determined via the addition of each score. Factors related to global satisfaction were determined among preoperative, intraoperative and postoperative factors. RESULTS: Telephone questionnaire interviews were conducted on all 131 consecutive patients. Four respondents (3.1%) expressed dissatisfaction with the ambulatory surgery. Twelve (9.2%) had been admitted overnight after the operation. Thirteen (9.9%) required analgesics for over 3 days. No patients required a re-operation, although 20 (15.3%) experienced minor postoperative complications. Significant factors for global dissatisfaction were analgesic requirement for over 3 days and the presence of surgical complication (P value <0.05). Time until return to work and required overnight admission were important factors for patient satisfaction, but these were not significant. CONCLUSION: Patient satisfaction was associated with postoperative pain and surgical complications. Therefore, a more appropriate method for pain control and prevention of minor surgical complication are suggested might serve to enhance patient satisfaction after hernioplasty on an ambulatory basis.
Ambulatory Surgical Procedures ; Analgesics ; Follow-Up Studies ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Pain, Postoperative ; Patient Satisfaction* ; Postoperative Complications ; Surveys and Questionnaires ; Return to Work ; Surveys and Questionnaires ; Telephone