Eighty one cases of the pelvic fractures treated at the orthopedic department of Pusan National University Hospital during the period from January 1960 to August 1970, were analyzed clinically. The results obtained were as follow: 1. The causes of fractures of the pelvic bone were mostly due to traffic accident (83%), industrial injury (7.4%), fall from a height (6%) and direct injury (3.7%). 2. 60% of the pelvic bone fractures were complicated by other bone fractures and soft tissue injuries. 3. The most common complication was the injury of the urinary system, and in neglected cases to treat it, severe sequellae such as stricture and urinary fistula were developed. 4. In cases of perineal laceration, it was possible to associate the infection to the adjacent hip joint by direct spread. 5. Open fracture associating severe soft tissue injury had poor prognosis. 4 cases out of 5deaths had open fractures. 6. The main cause of death was the hypovolemic shock due to intrapelvic bleeding. Therefore, immediate massive transfusion as life-saving measure was stressed.
Accidents, Traffic ; Busan ; Cause of Death ; Constriction, Pathologic ; Fractures, Bone ; Fractures, Open ; Hemorrhage ; Hip Joint ; Lacerations ; Orthopedics ; Pelvic Bones ; Prognosis ; Shock ; Soft Tissue Injuries ; Urinary Fistula

Five cases of corticosteroid-induced avascular necrosis of femoral head which were experienced at the Department of Orthopaedic Surgery, Catholic Medical College, are reported with review of literature. All patients received corticosteroids for the treatment of rheumatoid arthritis. Prednisolone was the most common drug used, having been given to 3 patients. Two patients has received Dexacortisil alone or in combination with other corticosteroids. There was a considerable variation in the dosage, but in every case the dosage was in excess of physiological replacement. The total dosage administered in each patient was impossible to determine with any degree of accuracy. The duration of corticosteroid treatment varied. The shortest known period of treatment in this series was 12 months, the longest 60 months. The avascular necrosis noted in the eight femoral heads was treated conservatively in three and surgically in five. As a whole, metallic pinning in two cases, associating the fracture of the neck, cup arthroplasty in one and Austin-Moore hip prosthesis in two cases were performed. Five hips restored satisfactory range of motions, despite of the types of surgery.
Adrenal Cortex Hormones ; Arthritis, Rheumatoid ; Arthroplasty ; Head ; Hip ; Hip Prosthesis ; Humans ; Neck ; Necrosis ; Prednisolone

This study was carried out to evaluate the immunohistochemical expressions of p53, E-cadherin, and nm23 proteins in 114 cases of metastatic carcinoma of the neck lymph node (MTLNCA) and corresponding primary carcinoma (PRCA). The positive expressions of p53, E-cadherin, and nm23 proteins were 62.3%, 58.8% and 64.0%, respectively in PRCA, and 40.4%, 38.6%, and 43.9%, respectively in MTLNCA with significant down-regulation from PRCA to MTLNCA (p<0.05). The down-regulation was correlated with female gender, moderate and poor differentiation, and adenocarcinoma in p53 protein, female gender, respiratory and gastrointestinal carcinoma in E-cadherin protein, and female gender, respiratory carcinoma, moderate differentiation, and squamous cell carcinoma in nm23 protein (p<0.05). There was no significant relationship among expressions of p53, E-cadherin, and nm23 proteins (p<0.05). In conclusion, these results suggest that the expressions of p53, E-cadherin, and nm23 proteins seem to be down-regulated from PRCA to MTLNCA and this down-regulation may play a role in invasion and metastasis.
Adenocarcinoma ; Cadherins* ; Carcinoma, Squamous Cell ; Down-Regulation ; Female ; Humans ; Lymph Nodes* ; Neck* ; Neoplasm Metastasis

Since the time when the lumbar discogram was used as the clinical diagnostic method for the first time in 1952, many problems have been pointed out to this method, and moreover, in presentday tendencies for the diagnostic method, the lumbar discogram is carried on even useless by majority. One of the important reasons is that so many studies for the lumbar discograms have reported so many false positive lumbar discograms at the high ratio. Hower we found a certain usefulness of the lumbar discogram incidental to the operation. The purposes of our operative lumbar discogram are those; 1) to observe the radiological configuration of the lumbar discogram. 2) to measure the amount of the the dye injected into normal and abnormal lumbar discs, especially in our Koreans. 3) for confirmation of the diagnosis when the myelographic finding is suspicious. 4) for confirmation of the Ievel especially when the number of the possible lesion is more than one. We investigated and analyzed the 35 lumbar discograms of 26 patients and compiled the statistics.
Diagnosis ; Humans ; Methods

Fractures of the patella are predominantly intra-articular fractures of a sesamoid bone. The options of treatment vary from closed treatment to total patellectomy, in the middle of the spectrum are osteosynthesis and partial patellectomy. In this series, we experienced 59 cases of patellar fractures from October 1974 to October 1983 at the Department of the Orthopedic Surgery, College of Medicine, Kyungpook National University. The results were as follows:1. Most fractures were encountered in man from twenties to forties. 2. The most common cause of fractures was traffic accident(34 cases, 59.7%), followed by slip down or falling down(15 cases, 26.3% ). 3. The most frequent configuration of fractures was the comminuted. 4. 36 cases were treated with osteosynthesis (32 cases), partial excision (1 case) or total excision (3 cases). Of the 32 cases treated with osteosynthesis, most were treated by modified tension band wiring (16 cases). And as compared with other fixation techniques, the best results were obtained by this method. 5. Modified tension band wire fixation has given accepatable results even in severely comminuted, displaced patellar fractures. Excision was sometimes unavoidable.
Accidental Falls ; Clinical Study ; Gyeongsangbuk-do ; Intra-Articular Fractures ; Methods ; Orthopedics ; Patella ; Sesamoid Bones

A retrospective study 40 patients with moderate or severe diffuse axonal injury which is defined as posttraumatic coma for over 24 hours without mass lesions or ischemic insults was conducted in order to identify prognostic parameters. The sign of hypothalamic damage and motor reactivities of 40 patients were reviewed and compared to the outcome. The results were as follows ; 1) The ratio of male to female was about 3 to 1 and the peak incidence was at the first decade. 2) Of abnormal brain stem signs, fever of central origin was observed at the early posttraumatic phase and correlated with nonrecovery of consciousness(P<0.05). 3) Of abnormal brain stem signs, abnormal ADH secretion was significantly correlated with nonrecovery of consciousness(P<0.005). 4) Abnormal motor reactivity to pain was significantly correlated with nonrecovery of consciousness(P<0.005). 5) In the group of recovery of consciousness, initial Glasgow coma scale in 40 patients with moderate or severe DAI was significantly correlated with their outcome(P<0.005).
Brain Stem ; Coma ; Consciousness ; Diffuse Axonal Injury* ; Female ; Fever ; Glasgow Coma Scale ; Humans ; Incidence ; Male ; Retrospective Studies

PURPOSE: The authors investigated the ability of cardiac blood pool clearance rates(CBCR) of 99mTc-DiSiDA in the measure merit of functioning hepatocyte mass. MATERIALS AND METHODS: We measured the volume of Iobectomized liver after completion of postoperative scanning with CBCR of 99rnTc-DISIDA in 5 rabbits who the functional hepatic Iobectomy performed by ligation of hepatic artery, portal vein and biliary tracts. Regarding the measurement of CBCR of 99mTc-DISIDA, we set the time which was decreased to the half of the clearance amount of the cardiac radioactivity by hepatic extraction of 99mTc-DISIDA at the point of 50 sec after the renal peak of the radioactivity to prevent confusing with the blood dilution of the radioactivity, that have called DI-K50. RESULTS: The results were followed that the volumes of the functional hepatic Iobectomy in 5 rabbits were 25%, 25%, 41%, 52%, 75% and the residual functioning hepatocyte masses measured by CBCR of 99rnTc-DISIDA were preserved to 75. 1%, 70. 8%, 63. 0%, 52. 2%, 30. 8% respectively. CONCLUSION: we made decision that CBCR of 99rnTc-DISlDA was useful to evaluate the functioning hepatocyte mass.
Biliary Tract ; Hepatic Artery ; Hepatocytes* ; Ligation ; Liver ; Portal Vein ; Rabbits ; Radioactivity ; Technetium Tc 99m Disofenin*

Because most of the benign skin appendage tumors arise from pluripotential cells that form during adult life and possess the potentiality of differentiating in more than one direction, combinations of several tumor types can occur. We report a case of combined with eccrine poroma, clear cell hidradenoma, and syringocystadenoma papilliferum as a single tumor in a 41-year-old male who had suffered from a tumor on posterior neck for 5 years. The tumor was a relatively oval shaped pedunculated, and rubbery hard mass, measuring 3.5*3.0* 1.3cm in size. The outer surface was variegated and covered with hair. The diagnosis was confirmed by histopathological findings and surgical excision was done.
Acrospiroma* ; Adult ; Diagnosis ; Hair ; Humans ; Male ; Neck ; Poroma* ; Skin

No abstract available.
Hepatitis* ; Humans

Thoracic epidural anesthesia has been used to manage intraoperative and postoperative pain for thoracic surgical patients with general anesthesia recently, And this combined anesthesia has been associated with less sedation, earlier ambulation, blunting of the stress response and better pain control in the post-operative period. But the effects of thoracic epidural anesthesia on pulmonary shunt, pulmonary vasoactivity and oxygenation are still unknown. The author has investigated the effects of thorarcic epidural anesthesia on pulmonary hypertension induced by acute diffuse alveolar hypoxia and N(W) -nitro-L-arginine(L-NNA) in 12 mongrel dogs. Acute diffuse alveolar hypoxia which is similar to the early stage of acute respiratory failure may induce the pulmonary hypertension. And L-NNA, inhibitor of endothelium derived relaxing factor(EDRF), may also induce pulmonary hypertension under hypoxic state. The measurements were made three times, the first was baseline at room air ventilation. Following baseline recordings, saline 4 ml(group A, n=6) or 2% lidocaine 4 ml(group B, n=6) was injected through the epidural catheter and ventilation was started with hypoxic gas mixture(10% O2, 90% N2). The seeond measurements was made 30 min after the hypoxic ventilation and third was 20 min after infusion of L-NNA(50 mg/kg mixed with distill water 50 ml, infusion rate is 50 ml/20min) under the continuous ventilation with hypoxic gas mixture. The results were as follows: 1) There were significant changes in mean pulmonary arterial pressure, pulmonary vascular resistance in group A(p<0.05) and in arterial and mixed venous oxygen tension, arterial and mixed venous oxygen content, intrapulmonary shunt in both groups(p<0.05) 30 minutes after hypoxia but there were not significant differences between groups. 2) There were significant changes in mean pulmonary arterial pressure, in group B (p<0.05) and pulmonary vascular resistance, systemic vascular resistance and mixed venous oxygen tension and content in both groups (p<0.05) 20 miniutes after infusion of L-NNA under the continuous ventilation with hypoxic gas mixture but there were not significant differences between groups. But there were significant changes in central venous pressure in group B(p<0.05) and significant differences between groups(p<0.05) at 20 miniutes after infusion of L-NNA. These results indicate that thoracic epidura1 anesthesia does not influence the pulmonary hypertension directly and does not praduce any unfavorable hemodynamic events during pulmonary hypertension induced by acute diffuse alveolar hypoxia and N(W)-nitro-L-arginine. Therefore thoracic epidural anesthesia shoud be valuable assistant to the general anesthesia for pulmonary hypertensive patients.
Anesthesia ; Anesthesia, Epidural* ; Anesthesia, General ; Animals ; Anoxia* ; Arterial Pressure ; Catheters ; Central Venous Pressure ; Dogs* ; Endothelium ; Hemodynamics ; Humans ; Hypertension, Pulmonary* ; Lidocaine ; Oxygen ; Pain, Postoperative ; Respiratory Insufficiency ; Vascular Resistance ; Ventilation ; Walking ; Water