No abstract available.
Diagnosis*

The elbow is the most frequent area of complaint in children and adolescent baseball players. The physical stresses associated with repetitive throwing create extra-ordinary forces, which may affect the normal osteochondral and soft tissue developmental process and are the important factors causing the decrease of competitive power and shortening of life as a baseball player in adolescents. We surveyed the 114 baseball players of middle & high school in Taegu in order to evaluate the prevalance of symptoms and radiologic findings of the elbow and correlation of these findings to career & position of the baseball game. The results were as follows. 1. Of 114 players, 83 were non-pitchers and 31 were pitchers. The mean career was 3.8 years (7 months to 6 years). 2. The 77 players (67.7%) had the pain on their elbow during or after daily exercise. Other clinical symptoms were locking (30.7%), limitation of motion (18.4%), swelling (16.6%) and clicks on motion (10.5%). 3. On the radiogram of the elbow, hypertrophy or separation of medial epicondyle were seen in 34% of players, loose bodies in 17%, hypertrophy of the humerus in 12% and cystic change of the capitellum in 11%. 4. The mean career of symptomatic players was 4.4 years but non-symptomatics was 2.7 years. The mean career of players who had abnormal radiologic findings was 5.1 years but 3.1 years in players who had no abnormal radiologic fingings. 5. Symptoms and pathologic changes were more common in the elbow of pitcher' s group due to throwing frequency & pitching style. 6. Among the 77 players who had any kinds of problem of the elbow, 49 players of them had no experience of visiting hospital. 7. To prevent these injuries of the elbow, the following recommendations were made. First, restrict the number of innings pitched per game. Second, avoid throwing the curve ball in this age group. Third, ensue an adequate warm up period before exercise or rest after games. Fourth, inform parents and coaches of possible harmful nature of excessive throwing.
Adolescent* ; Baseball* ; Child ; Daegu ; Elbow* ; Humans ; Humerus ; Hypertrophy ; Parents

We developed Extor pins for Extor external fixator, it made of stainless steel and applied it clinically to manage open fractures and chronic osteomyelitis from December, 1993 to January, 1995. The main aim of present study is to compare the mechanical strength and biocompatibillity between Extor pins and AO Schanz pins, and to determine the safety and possibility of clinical use. We performed the biomechanical test for bending, tension, and shearing of pin itself using universal testing machine (LR5OK) and pullout test in cadeveric cortical femur to determine the bone holding power. There was no significant difference between Extor and AO Schanz pin (p>0.05). Clinically, the incidence of pin site infection, pin lossening, radiological rarefaction, and pathological change were not different significantly (p>0.05). Although Extor pins are somewhat different from AO Shanz pins in material and design characteristics, we can find the safety and possibility of clinical use of Extor pins made in Korea.
External Fixators* ; Femur ; Fractures, Open ; Incidence ; Korea ; Osteomyelitis ; Stainless Steel

Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon* ; Ankle ; Braces ; Calcaneus ; Electricity ; Exercise ; Female ; Follow-Up Studies ; Foot ; Humans ; Hydrotherapy ; Immobilization ; Leg ; Male ; Membranes ; Needles ; Orthotic Devices ; Rehabilitation ; Rupture* ; Suture Techniques ; Sutures ; Tendons ; Ultrasonography ; Weight-Bearing

No abstract available.
Ligaments*

Isoniazid (INH), a hydrazide of isonicotinic acid, has been used for more than 30 years for the treatment of tuberculosis and is one of the most effective anti-tuberculous agents so far. In spite of the widespread use of INH, very few accidental or suicidal poisonings have been reported, Acute INH intoxication is characterized by hyperpyrexia, respiratory distress, coma seizure, metabolic acisosis, hyperglycemia and acetonuria Especially metabolic acidosis is not corrected by alkali therapy in which usual dose of bicarbonate supply, and seizure attacks also has not controlled by common anti-epileptic drugs, so it needed a large quantity of intravenous pyridoxine and diazepam infusion. This report describes an adult who ingested large amount of INH with the intent of suicide and was presented with the fatal status epilepticus and severe metabolic acidosis.
Acidosis ; Adult ; Alkalies ; Coma ; Diazepam ; Humans ; Hyperglycemia ; Isoniazid* ; Isonicotinic Acids ; Ketosis ; Poisoning ; Pyridoxine ; Seizures ; Status Epilepticus ; Suicide ; Tuberculosis

Followings are the results obtained from the observation on the microangiograms and Geon D11 Alatex molding casts in the rabbit, canine and Korean human Kidneys. 1. The findings of microangiograms in the rabbit and canine Kidneys are uniform interlobar arteries run toward lateral border of Kidney in radiating form without branching, divide the Kidney into similar sized segments and segmental distribution is evident. The arcuate arteries arising from the interlobar arteries run toward lateral border to form numerous interlobular arteries, make angle nearly horizontal with av. 152.8 degree in rabbit and with av. 151.6 degree in canine. In Korean human Kidney, it is difficult to confirm the interlobar arteries and arcuate arteries because of ununiform size and length of these. And the angle between arcuate arteries is sharp with av. 40.6 degree. 2. The findings of the molding casts in rabbit and canine Kidneys are that interlobar arteries running toward lateral border of Kidney with radiating form are evident, which are 6-9 branches from anterior division and 5-7 from posterior in rabbit and 7-9 from anterior and 5-7 from posterior in canine. The angle between arcuate arteries dividing from interlobar arteries with right angle is nearly horizontal with av. 162.3 degree in rabbit and with av. 159.8 degree in canine. The numerous interlobular arteries arise from arcuate artery with right angle. In Korean human Kidneys it is difficult to confirm interlobar arteries which are 2-4 branches originating from anterior because of ununiform size and length of these. And the angle between arcuate arteries in sharp degree with av. 43.7 degree. 3. The renal collecting system which has close relation to are pathway of interlobar arteries by molding casts shows that calyces are symmetrical, 2 rows and regular in rabbit and canine Kidneys while irregular in human. 4. Nephrotomy line, that is, junction of anterior and posterior division blood supply in the Kidney by molding casts is different between canine and human. Nephrotomy line in human is in posterior aspect of lateral border of Kidney almost 2/3 but there is no avascular area in the lateral borden of Kidney, the so called Brodels line as advocated by Brodel because interlobular arteries branching from arcuate arteries are interdigitated together as end arteries. 5. Gross anatomic differences of renal vasculature among rabbit, canine and human on the basis of microangiograms and molding casts suggest that rabbit and canine may not be suitable subjects for surgical experimentation.
Arteries* ; Fungi ; Humans* ; Kidney* ; Polyvinyl Chloride ; Renal Artery ; Running

PURPOSE: The purpose of this study was to evaluate the safety, feasibility and effectiveness of an endoluminally-placed bifurcated stent-graft (Vanguard) for the treatment of infrarenal abdominal aortic aneurysm (AAA). METHODS: Transluminal endovascular stent-graft placements were attempted in 29 patients (28 male, mean age 69+/-7 years) with AAAs involving the common iliac arteries from Aug. 1997 to Jan. 1999. Endovascular therapy was performed in the cardiac catheterization laboratory with epidural anesthesia. One side of the femoral artery was opened by surgical cutdown for the bifurcated stent-graft entry and the other side was punctured percutaneously for the straight stent-graft. Computed tomography and/or intraarterial angiography were performed during an average follow-up of 10 months (2-18 months). RESULTS: Primary success rate was 75.9% (22 of 29 patients) and the overall success rate was 79.3% with successful correction of one perigraft leak. Twenty patients (69.0%) had significant coronary artery disease. There were two technical failure cases, the one was tortuous iliac vessel with spasm, the other was disconnection of the stent-graft connecting portion. Complications related to procedure occurred in 13.8% of patients (4 of 29 patients) and two of these four patients had procedure-related mortality because of acute renal failure following contrast overdose and sepsis after operation. CONCLUSIONS: Endovascular treatment of infrarenal AAA with bifurcated stent-graft (Vanguard<0A397>) is effective, feasible and relatively safe. However, further investigation for the outcome, complication and long-term follow-up are needed.
Acute Kidney Injury ; Anesthesia, Epidural ; Angiography ; Aortic Aneurysm, Abdominal* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease ; Endoleak ; Femoral Artery ; Follow-Up Studies ; Humans ; Iliac Artery ; Male ; Mortality ; Sepsis ; Spasm

OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

The authors outline the method of orchiopexy and report the results of orchiopexy performed on 79 cases (113 testes) of cryptorchism. A. Method of orchiopexy 1) In inguinal oblique skin incision, while noting frequent keloid formation, no keloid formation was noted as the lower abdominal transverse incision. 2) It was easy to descend testes to the base of the scrotal sac by performing orchidofuniculolysis sufficiently. 3) Of the several methods of orchiopexy, dartos pouch method was most ideal. B. Operative results on the 79 cases (113 testes) of cryptorchism are as follows. 1) Of the 113 testes, there were noted sufficient descent to the scrotal base in 108 testes, and somewhat insufficient descent in 5 testes. 2) In the consideration that 5 case of unsufficient descent in the group of type IV which was not detectable on manual palpation, sufficient orchidofuniculolysis should be carried out preoperatively regarding difficulties in sufficient descent. C. While operation time of cryptorchism being 4-5 years old as a rule, 25% or so are performed at 1-5 years old in authors' cases. So more active instruction should be considered.
Cryptorchidism ; Keloid ; Male ; Orchiopexy* ; Palpation ; Skin ; Testis