We analyze ninty-seven cases of Colles fractures treated with closed reduction and sugar tong splint immobilization and followed for more than 1 year at Seoul National University from January 1981 to Decmber 1985. The results of this study were as follows; l. All of 97 cases were closed fractures and the incidence was high in females who aged over 6th decades. The main cause of this injury was slipping down accident comprising of 68.0%. 2. 63 cases (64.9%) were simple extra-articular fractures, and 34 cases (35.1%) were comminuted intra-articular fractures. 3. In a group of simple extra-articular fracture the functional end result was satisfactory in 88.9%, so closed reduction and sugar tong splint were thought to be a good procedure in this group. 4. In a group of comminuted intra-articular fracture the functional end result was satisfactory in 58.9% only. In the cases which show unacceptable loss of position during first two weeks of routine sugar tong splint immobilization we feel another technique is indicated, such as.pin and plaster immobilization or percutaneous pinning. 5. The main cause of unsatisfactory result was malunion, which was produced by loss of reduction position.
Clinical Study ; Colles' Fracture ; Female ; Fractures, Closed ; Humans ; Immobilization ; Incidence ; Intra-Articular Fractures ; Seoul ; Splints

No abstract available.
Liver Abscess* ; Liver*

No abstract available.
46, XX Disorders of Sex Development* ; Female* ; Humans

BACKGROUND: The causes of chest pain vary but the leading cause of chest pain is ischemic heart disease. Mortality from ischemic chest pain has increased more than two fold over the last ten years. The purpose of this study was to determine the data necessary for rapid treatment of patients with signs and symptoms of ischemic chest pain in the emergency department (ED). MATERIALS AND METHODS: We interviewed 170 patients who had ischemic chest pain in the emergency department of Yeungnam University Hospital over 6 months with a protocol developed for the evaluation. The protocol used included gender, age, arriving time, prior hospital visits, methods of transportation to the hospital, past medical history, final diagnosis, and outcome information from follow up. RESULTS: Among 170 patients, there were 118 men (69.4%) and the mean age was 63 years. The patients diagnosed with acute myocardial infarction (AMI) were 106 (62.4%) and with angina pectoris (AP) were 64 (37.6%). The patients who had visited another hospital were 68.8%, twice the number that came directly to this hospital (p<0.05). The ratio of patients who visited another hospital were higher for the AMI (75.5%) than the AP (59.4%) patients (p<0.05). The median time spent deciding whether to go to hospital was 521 minutes and for transportation was 40 minutes. With regard to patients that visited another hospital first, the median time spent at the other hospital was 40 minutes. The total median time spent before arriving at our hospital was 600 minutes (p>0.05). The patients who had a total time delay of over 6 hours was similar 54.8% in the AMI group and 57.9% in the AP group (p>0.05). As a result, only 12.2% of the patients with an AMI received thrombolytics, and 48.8% of them had a simultaneous percutaneous coronary intervention (PCI). In the emergency department 8.5% of the patients with an AMI died. CONCLUSION: Timing is an extremely important factor for the treatment of ischemic heart disease. Most patients arrive at the hospital after a long time lapse from the onset of chest pain. In addition, most patients present to a different hospital before they arrive at the final hospital for treatment. Therefore, important time is lost and opportunities for treatment with thrombolytics and/or PCI are diminished leading to poor outcomes for many patients in the ED. The emergency room treatment must improve for the identification and treatment of ischemic heart disease so that patients can present earlier and treatment can be started as soon as they present to an emergency room.
Angina Pectoris ; Chest Pain* ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Follow-Up Studies ; Humans ; Male ; Mortality ; Myocardial Infarction ; Myocardial Ischemia ; Percutaneous Coronary Intervention ; Thorax* ; Transportation

No abstract available.
Lung Neoplasms* ; Lung*

Soft-tissue sarcomas are derived from mesodermal tissues and with few exceptions are located in deeper planes of the musculoaponeurotic structures. Despite differences in histogenesis, the rate of locsl recurrence snd distant metastasis of these sarcomas reveals that their rstes are almost the same. These soft-fissue sarcomas do not respond well to chemotherpy or radiotheraphy. And soft-tissue sarcomas located on different anatomical sites, so the surgical approach to them located centrally is difficult than the approach to them located peripherally. The authors reviewed 75 cases of soft-tissue sarcoma, which were confirmed by pathological reports, and also analysed the results of some kinds of surgery on 60 cases of that tumor at the Department of Orthopedidic Surgery, Seoul National University Hospital during the period from January 1976 to Decomber 1985, and following results were obtained. 1. There were 54 males and 21 females, and the age incidence wss highest in 5th decade. There was no special age-peak. 2. Malignant fibrous histiocytomas accounted for 26.7% of the tumors in this study. Liposarcoma, rhabdomyosarcoma, and synovial sarcoma were the next common tumors. 3. The lower extremity was the most common anatomicsl site of malignant soft-tissue sarcomas, which acconted for 46.7% in this study. There showed low incidence below the wrist and ankle joints. 4. Enneking's stage II B was the most common tumor, which accounted for 41.7%. 5. When we decided the prognosis at 2 years postoperatively, in the inadequately treated group the local recurrence rate was 97.1%, distant metastasis rate was 80.0%, and 2 YSR was 28.6%. In the adequately treated group the local recurrence rate was 20.0%, distant metastasis rate was 24.0%, and 2 YSR was 84.0%. 6. The most common site of distant metastasis was the lungs, which accounted for 82.4%. So the significant factors affecting the prognosis of soft-tissued sarcomas were the location of sarcomas and the adequacy of sugical procedure.
Ankle Joint ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Incidence ; Liposarcoma ; Lower Extremity ; Lung ; Male ; Mesoderm ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Rhabdomyosarcoma ; Sarcoma ; Sarcoma, Synovial ; Seoul ; Wrist

BACKGROUND AND METHODS: We have tried to analyze the clinical findings from a total of 2503 emergent explo-laparotomic cases which had been performed during ten years from March 1989 to February 1999 at the Deptartment of General Surgery of Inchon Medical Center, Public Corporation. RESULTS AND CONCLUSIONS: 1) The total 2503 emergent explo-laparotomic cases were composed of 1992 cases (79.6%, most common) of acute appendicitis, 235 cases (9.4%) of panperitonitis, 93 cases (3.7%) of intestinal obstruction, 62 cases (2.7%) of hemoperitoneum (more than 2000 cc, without panperitonitis), 40 cases (1.6%) of gall bladder empyema, 16 cases (0.6%) of upper gastrointestinal bleeding, 15 cases (0.6%) of wound evisceration, 10 cases (0.4%) of incarcerated inguinal hernia, 9 cases (0.4%) of intra- peritoneal abscess, 9 cases (0.4%) of pancreatic abscess, 7 cases (0.3%) of septic cholangitis, 6 cases (0.2%) of diverticulitis, 5 cases (0.2%) of intussusception, 2 cases (0.1%) of liver abscess and 2 cases (0.1%) of retroperitoneal abscess. 2) Of the 1992 emergent explo-laparotomic cases which had been performed due to acute appendicitis, there were 1826 cases (more than 90%) of simple appendicitis, 95 cases of perforated appendicitis, and 71 cases of periappendiceal abscess. 3) The 237 explo-laparotomic cases of panperitonitis contained 147 cases (62%) of non-traumatic (by disease) panperitonitis and 90 cases (38%) of traumatic panperitonitis. Of the 147 cases of non-traumatic panperitonitis, there were 91 cases (62%, most common) of duodenal ulcer perforation, 21 cases of stomach ulcer perforation, 6 cases of bile peritonitis, 5 cases of colon cancer perforation, etc. Of the 90 cases of traumatic panperitonitis, there were 42 cases of small bowel rupture, 12 cases of colon rupture, 9 cases of stomach rupture, 8 cases of duodenal rupture, etc. 4) The 97 explo-laparotomic cases of intestinal obstruction were composed of 34 cases (35%, most common) of adhesive ileus, 18 cases of duodenal obstruction (16 cases due to duodenal ulcer obstruction, 2 cases due to periampullary cancer invasion), 16 cases of colon cancer obstruction, 7 cases of cancer peritoneii, 6 cases of incarcerated inguinal hernia, 4 cases of small bowel ileus, 3 cases of intestinal tuberculosis, etc. 5) The 61 cases of hemoperitoneum contained 56 cases (92%) of traumatic hemoperitoneum and 5 cases (8%) of spontaneous hemoperitoneum. Of the 56 cases of traumatic hemoperitoneum, there were 20 cases of splenic rupture, 18 cases of mesenteric tearing, 11 cases of liver laceration, etc. 6) The 148 cases of emergent explo-laparotomy for trauma contained 114cases (77%) due to blunt trauma and 34 cases (23%) due to penetrating trauma. Of the 114 emergent explo-laparotomic cases due to blunt trauma, there were 37 cases (32%, most common) of small-bowel rupture, 19 cases (17%, 2nd common) of splenic rupture, 17 cases of mesenteric tearing, 12 cases of colon rupture, 8 cases of liver laceration, 8 cases of duodenal rupture, 3 cases of stomach rupture, 3 cases of pancreas rupture, etc. Of the explo-laparotomic cases due to penetrating trauma, there were abdominal wall only penetration (most common), stomach, small bowel, liver organ injury, etc, in decreasing order.
Abdominal Wall ; Abscess ; Adhesives ; Appendicitis ; Bile ; Cholangitis ; Cholecystitis ; Colon ; Colonic Neoplasms ; Diverticulitis ; Duodenal Obstruction ; Duodenal Ulcer ; Hemoperitoneum ; Hemorrhage ; Hernia, Inguinal ; Ileus ; Incheon ; Intestinal Obstruction ; Intussusception ; Lacerations ; Liver ; Liver Abscess ; Pancreas ; Peritonitis ; Rupture ; Splenic Rupture ; Stomach ; Stomach Rupture ; Stomach Ulcer ; Tuberculosis ; Wounds and Injuries

The methods available for arthroscopic debridement vary widely in cost and efficiency. The use of laser treatment is growing rapidly with advantages of production of smooth surface and avoidance of direct contact. Nevertheless, growing attention is directed to the negative side effects of laser-controlled cartilage ablation, especially to the depth effects of the various lasers on which various scientific studies have focused. The purpose of this study is to evaluate the thermal side effects of Ho: YAG laser and Excimer laser on human articular cartilage hy histological analysis. Sixteen human articular cartilages were obtained during total knee arthroplasty for patients with advanced degenerative arthritis. Three craters, 1cm in diameter, were created on each articular cartilage by shaver, Holmium: YAG laser and Excimer laser in the saline medium. These total 48 craters were prepared to tissue specimen by paraffin blocks and stained with Hematoxylin-Eosin(HE) and Massons trichrome. Under the light microscope, we analysed extents of thermal necrosis and thermal change in craters. Also some specimens were fixed by 2.5% glutaraldehyde and ohserved in changes of three different methods under scanning electron microscope. We report the results as follow: 1. The average times to making one crater were 25 seconds in shaver, 33 seconds in Holmium: YAG laser, and 65 seconds in Excimer laser respecti vely. 2. In gross inspection, the most smoothing surface of crater was seen on the specimens of Excimer laser. 3. In histological findings, thermal necrosis on hematoxylin and eosin sections was not noted after shaver use, whereas seen average of 243.8+/-159.6micrometer in Molmium: YAC laser and 36.6+/-17.1micrometer in Excimer laser(p=0.000). Thermal change on trichrome-stained sections was not noted after shaver use, hut showed average of 372.1 +/-203.1micrometer in Holmium: YAG laser and 76.0+/-47. Imicrometer in Excimer laser(p=0.000). 4. In scanning electron micrograph, coagulation of collagen fiher in the matrix was ohserved, with less extents in Excimer than Holmium: YAG laser. In conclusion, Excimer laser was superior to Holmium: YAG laser in terms of thermal necrosis and precision, whereas Holmium: YAG laser was more effective due to rapid time for procedure. To minimize the thermal necrosis during laser chondroplasty, we suggest it is desirable to less energy and reduce exposure time to laser beam on the articular surface.
Arthroplasty ; Cartilage ; Cartilage, Articular* ; Collagen ; Debridement ; Eosine Yellowish-(YS) ; Glutaral ; Hematoxylin ; Holmium* ; Humans* ; Knee ; Lasers, Excimer* ; Lasers, Solid-State* ; Necrosis ; Osteoarthritis ; Paraffin

No abstract available.
Cardiotocography* ; Meconium* ; Pregnancy*

No abstract available.
Child* ; Humans ; Joints* ; Tuberculosis, Osteoarticular*