The tibia is the most commonly fractured bone of all the long bones. In this age of vehicular accidents, the tibia is frequently subjected to high energy trauma. Anatomically the tibia has poor soft tissue coverage and poor blood supply. Therefore severe injury on the tibia can lead to severe complication and major disability. 41 adult patients with comminuted fracture of the tibial shaft were treated by OR/IF with D.C.P. and bone graft at the Department of Orthopedic Surgery, Kyungpook University Hospital from January 1978 to June 1986. These were analysed according to mechanism of injury, degree of comminution, timing of operation, soft tissue injury and operation time. Bone union and end results of treatment were reviewed. The results were as follows Of 41 cases, causes of injury were vehicular accident in 32 cases. 34 cases had associated injury on other part of body and average injury per case was 1.7 injuries. Based on the classification of Johner and Wruhs, the B group with butterfly fragment was 27 cases and C group was 14 cases. Among the B group, B2 was most common as 14 cases. Average union time was 18 weeks and delayed union and nonunion were 6 cases. Degree of comminution of fracture might be important fractor to bone union. According to the end result of Johner and Wruhs, excellent and good were 31, fair and poor were 10. Of the 41 cases, 10 cases had permanent disability. 4 cases had angular and rotational deformity alone and 1 case had shortening of tibia more than 1 cm, 1 case had both of them. Limited R.O.M. of ankle joint (>50%) occured in 4 cases. The post-operative infection occured in 6 cases, 3 were superficial infection but 3 cases were osteomyelitis. OR/IF with D.C.P. on comminuted tibial shaft fracture was a risk operation. Therefore proper method of treatment should be selected according to degree of comminution, timing of operation, presence or abscence of open wound and associated injury.
Adult ; Ankle Joint ; Butterflies ; Classification ; Clinical Study ; Congenital Abnormalities ; Fractures, Comminuted ; Gyeongsangbuk-do ; Humans ; Methods ; Orthopedics ; Osteomyelitis ; Soft Tissue Injuries ; Tibia ; Transplants ; Wounds and Injuries

Soft tissue defect on dorsum of hand requires immediate soft tissue cover to achieve early wound closure and to minimize wound infection and scarring. If the tendon or bone was exposed and the deep structures were absent, flap was required to provide adequate protection and allow proper function of the underlying structures. Small size in skin loss can easily be covered with local flaps but major defects involving the dorsal aspect of the hand should be coverd with distant flaps, free flaps or radial forearm flaps. Techniques in distant flaps require staged procedures and free flap transfer to obtain soft tissue cover in a single stage require microsurgical techniques. The reverse radial forearm flap is a fasciocutaneous flap based on the radial artery which together with its two venae comitantes lies invested in a condensation of the deep fascia known as the lateral intermuscular septum. The authors had treated 5 cases of distally based reverse forearm flap for soft tissue reconstruction on 2 patients of crushing injury with soft tissue defect on hand, a patient with Marjolin's ulcer on dorsum of hand due to previous burn scar and a patient with soft tissue necrosis on dorsum of both hands due to extravasation of adriamycin during chemotherapy. It has proved to be one of the saftest, simple and effective one-stage method of soft tissue reconstruction in hand without long term immobilization. The results of these operation in cover of soft tissue defect have been satisfactory.
Burns ; Cicatrix ; Doxorubicin ; Drug Therapy ; Fascia ; Forearm ; Free Tissue Flaps ; Hand ; Humans ; Immobilization ; Methods ; Necrosis ; Radial Artery ; Skin ; Tendons ; Ulcer ; Wound Infection ; Wounds and Injuries

A prospective study of 99 pediatric patients were performed to investigate the incidence of perioperative airway complications presenting for various surgery with mild upper respiratory infections(URI's). Anesthesia administered via either face mask or endotracheal intubation. The severity of respiratory complications were scored. Endotracheal intubation in itself increased complication score compared to inhalation anesthesia with face mask. There were significant differences in the complication scores between control children and children fulfilling predetermined URI criteria. Complications showing significant differences were cough, airway obstruction, secretion. However, mean scores were too low to draw CONCLUSION that children with URI's should be postponed elective surgery.
Airway Obstruction ; Anesthesia ; Anesthesia, Inhalation ; Child* ; Cough ; Humans ; Incidence* ; Intubation, Intratracheal ; Masks ; Prospective Studies

Electrical stimulation among several factors that influence bone remodeling has been studied by many investigators with great enthusiasm in orthodontic field. The action mechanisms of Pulsed Electromagnetic Field (PEMF) are different from those of the conventional electrode application method in that PEMF induces endogenous current in the living tissues. PEMF is known to have the healing effect in nonunion of bone and osteoporosis. It is widely used in orthopaedic scopes and the possibility of using the method in clinical orthodontics is also conceivable. But the exact mechanisms by which the PEMF exerts its effects are not clearly understood. Therefore, the author wanted to see the effect of PEMF on five groups of rat calvarial cells obtained by sequential enzyme digestion method, and observed the changes in enzyme activation, collagen synthesis and 3H-thymidine incorporation. The results were as follows: 1. Under the effect of PEMF, there were no changes in the alkaline phosphatase activity in five groups of cell populations. 2. Both the PEMF group and the PTH with PEMF group showed no changes in acid phosphatase activities and there were no differences between two experimental groups. 3. Under the effect of PEMF, there was significant increase of collagen synthesis in the group V cell population. 4. Under the effect of PEMF, there were significant increases of 3H-thymidine incorporation in the group IV and V cell populations.
Acid Phosphatase ; Alkaline Phosphatase ; Animals ; Bone Remodeling ; Collagen ; Digestion ; Electric Stimulation ; Electrodes ; Electromagnetic Fields* ; Enzyme Activation ; Humans ; Magnets* ; Orthodontics ; Osteoporosis ; Rats* ; Research Personnel

The subject of ankle injuries has for a long time been embedded in controversy. The injuries to the ankle joint complex include not only injuries that cause disruption of the bone architecture of the ankle joint but often significant ligamentous and soft tissue components. Strong differences of opinion exist regarding the preferred method of treatment, the length of time immobilization is necessary, the postreduction management and the criteria of what constitutes an acceptable reduction. Follow up of 52 cases was possible which were admitted to the department of orthopedics, Kyung- pook University Hospital during the period of January, 1974 to december 1983. The results obtained from this study were as follows; 1. Among the 51 patient, male was 45 (88.2%) patients and female 6 (11.8%) patients. Most of the patient were in the ages between 20 and 30. 2. Of the 52 cases, the main cause of fractures were traffic accident 33 (63.5%) cases and the other causes were falling from a height 9 (17.5%), slipping down 3 (5.7%) and sport injury 1 (1.9%) in order. 3. Open fracture was 16 (31%) and closed fracture was 36 (69%). 4. According to the classification of Lauge-Hansen, the supination-external rotation type 18 (34.6%) was the commonest type. 5. Among the 52 cases, 32 cases were treated by open reduction and 20 cases by closed reduction. 6. The average peried of the cast immobilization after the open reduction was 6Wks. but the closed reduction was 8Wks. 7. According to clinical and radiological accessment of the result of treatment for bimalleolar Fx, internal fixation of both medial & lateral malleolus was better than medial malleolus only. 8. The fibular fracture involving lateral malleolus and the diastasis of the distal tibiofibular syndesmosis were very important in ankle stability and were treated by internal fixation for accurate anatomical reduction.
Accidental Falls ; Accidents, Traffic ; Ankle Fractures ; Ankle Injuries ; Ankle Joint ; Ankle ; Classification ; Clinical Study ; Female ; Follow-Up Studies ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Ligaments ; Male ; Methods ; Orthopedics ; Sports

Dislocation of the metacapophalangeal joint of the finger is apparently rare except thumb. The mecchanism of injury seems to be direct injury that produces hyperextension of metacapophalangeal joints. In 1957, Kaplan advocated the triple incision, that is release of the volar fibrocartilaginous plate, the natatory ligament, and the superficial transverse metacapal ligament, expose the operation field through palmar approach. In 1975. Becton advocate direct dorsal longitudinal incision. The advantages of this approach as compared with the volar approach are 1. There is full exposure of the fibrocartilaginous volar plate, the main structure blocking reduction. 2. Digital nerves are not as apt to be damaged. 3. Accurate reduction and fixation of the osteochondral fracture of the metacarpal head is possible. We exprenced 6 cases of index metacarpophalangeal dislocation and treated with dorsal approach.
Dislocations ; Fingers ; Head ; Joints ; Ligaments ; Metacarpophalangeal Joint ; Thumb

The carpal tunnel syndroms is the most common peripheral nerve entrapment syndrome. The typical symptom is pain, numbness and paresthesia in the median nerve territory of the hand and progressive thenar atrophy. When the symptom is mild and its duration is short, conservative treatment such as splinting or local steroid injection is considered, but when neurological deficit is promiment and conservative treatment is not effective, surgical decompression is indicated.Authors reviewed 15 patients (23 cases) of carpal tunnel syndrome treated with surgical decomression at the Department of Orthopedic Surgery, Kyung-pook National University Hospital from March 1983 to October 1988. The follow up results are as follows; 1. Preoperatively, Tinel sign was present in 17 cases. Phalen test was positive in 17 cases. Sensory disturbance was present in 8 cases. Thenar muscle atrophy was present in 19 cases. Motor weakness was present in 13 cases. 2. Preoperatively, delay of motor conduction velocity of median nerve was noted in 15 cases (65.2%) and sensory nerve conduction velocity in 20 cases (86.9%). Denervation findings such as fibrillation or sharp waves were seen in 15 cases (65.2%). 3. The operative findings were as follows; Synovial hypertrophy in 12 cases, hypertrophy of transcarpal ligament in 4 cases, pseudoneuroma in 3 cases, ganglion in 2 cases, neurilemmoma in 1 case, gout in 1 case. 4. As the operative findings, median nerve had evidence of compression beneath the transcarpal ligament, consisting of flattening. narrowing and decreased epineurial vascularity. 5. External neurolysis was performed in all cases. 6. In case of long duration and severe thenar atrophy, internal neurolysis would be recommendable. 7. Fllow up period was ranged from 7 months to 6 years. 8. 19 cases (82.6%) were excellent or good results.
Atrophy ; Carpal Tunnel Syndrome ; Decompression, Surgical ; Denervation ; Follow-Up Studies ; Ganglion Cysts ; Gout ; Hand ; Humans ; Hypertrophy ; Hypesthesia ; Ligaments ; Median Nerve ; Muscular Atrophy ; Neural Conduction ; Neurilemmoma ; Orthopedics ; Paresthesia ; Peripheral Nerves ; Splints

OBJECTIVES: In this study, the possibility of using existing test data provided in Korea and elsewhere for the registration of chemical substances was examined. Data on 510 chemical substances that are among the first subject to registration under the “Act on the Registration and Evaluation, etc. of Chemical Substances (K-REACH)” were analyzed. METHODS: The possibility of using existing data from 16 reference databases was examined for 510 chemical substances notified in July 2015 as being subject to registration. RESULTS: Test data with the reliability required for the registration of chemical substances under the K-REACH constituted 48.4% of the required physicochemical characteristics, 6.5% of the required health hazards, and 9.4% of the required environmental hazards. CONCLUSIONS: Some existing test data were not within the scope of this research, including data used for registration in the European Union (EU). Thus, considering that 350 of these 510 species are registered in EU Registration, Evaluation, Authorisation & Restriction of Chemicals, more test data may exist that can be utilized in addition to the data identified in this study. Furthermore, the K-REACH states that non-testing data (test results predicted through Read Across, Quantitative Structure- Activity Relationships) and the weight of evidence (test results predicted based on test data with low reliability) can also be utilized for registration data. Therefore, if methods for using such data were actively reviewed, it would be possible to reduce the cost of securing test data required for the registration of chemical substances.
European Union ; Korea

OBJECTIVES: In this study, the possibility of using existing test data provided in Korea and elsewhere for the registration of chemical substances was examined. Data on 510 chemical substances that are among the first subject to registration under the “Act on the Registration and Evaluation, etc. of Chemical Substances (K-REACH)” were analyzed. METHODS: The possibility of using existing data from 16 reference databases was examined for 510 chemical substances notified in July 2015 as being subject to registration. RESULTS: Test data with the reliability required for the registration of chemical substances under the K-REACH constituted 48.4% of the required physicochemical characteristics, 6.5% of the required health hazards, and 9.4% of the required environmental hazards. CONCLUSIONS: Some existing test data were not within the scope of this research, including data used for registration in the European Union (EU). Thus, considering that 350 of these 510 species are registered in EU Registration, Evaluation, Authorisation & Restriction of Chemicals, more test data may exist that can be utilized in addition to the data identified in this study. Furthermore, the K-REACH states that non-testing data (test results predicted through Read Across, Quantitative Structure- Activity Relationships) and the weight of evidence (test results predicted based on test data with low reliability) can also be utilized for registration data. Therefore, if methods for using such data were actively reviewed, it would be possible to reduce the cost of securing test data required for the registration of chemical substances.
European Union ; Korea

PURPOSE: Postoperative serial serum thyroglobulin (Tg) measurements on levothyroxine (L-T4) therapy in patients with differentiated thyroid carcinoma (DTC) is known to be useful in monitoring tumor progression or regression. The objective of this study was to evaluate the significance of serum Tg levels on L-T4 therapy after surgery. METHODS: To determine the basal serum Tg levels on L-T4 therapy after surgery in patients with DTC, Tg levels during the initial 2 year-period after surgery were analyzed retrospectively in 37 patients who had undergone a total thyroidectomy for papillary thyroid carcinoma with (Group 2) or without (Group 1) palpable cervical lymph node metastasis. The Tg levels had been measured 1 to 4 times for each patient with total of 53 and 35 times in Group 1 and Group 2 respectively. RESULTS: The basal Tg levels in Group 1 were all less than 4 ng/mL with 79.3% less than 2 ng/mL, and those in Group 2 were all less than 9 ng/mL with 71.4% less than 2 ng/mL. CONCLUSION: The data suggests that the postoperative serum Tg level of 10 ng/mL can be a useful reference value in long-term follow-up after total thyroidectomy for patients with DTC.
Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Reference Values ; Retrospective Studies ; Thyroglobulin* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyroxine