An anatomical reduction and maintainance of articular fracture is on of the basic principles In Orthopedic Surgery if good function is to ensue, especially in a major welght bearing joint such as hip knee ankle. In displaced articular fractures, excellent results can be achieved mainly by an open anatomical reduction and firm internal fixation. We performed an open reduction and internal flxation with plates and screws in a patient with the severely comminuted acetabular fracture, and a satisfactory result is obtained.
Acetabulum ; Ankle ; Hip ; Humans ; Joints ; Knee ; Orthopedics

Pott's paraplegia has been frequently serious complication of tuberculous spondylitis, although antituberculous drugs have improved the prognosis and healing of the disease. There are much controvercy on treatement of Pott's paraplegia, which comprises immobilization with or without anterolateral antituberculous drugs, immobilization and early posterior arthrodesis, anterolatear decompression and radical anterior decompression with anterior spinal fusion. The method of anterior decompression and anterior interbody fusion which was introduced by Hdgson since 1956 has good reults. The author analyzed 27 consecutive cases of Pott's parsplegia operated at orthopedic departement, In Je Paik Hospital from May 1980 to August 1988. The results were as follows, 1. Number of cases in child was nine(33%), both sexes were similar. 2. Regions of spine involved were most common at thoracic spine(62%). Number of affected vertebrae was averaged 3.3 vertebrae. 3. There were nineteen early(70%) and eight late(30%) paraplegia. 4. There were two complete and twenty five incomplete paraplegia. 5. In operative finding, inflammatory products and sequestrated material was extrinsic factor in early in paraplegia. 6. The recovery of the paraplegia occur in twenty cases(74%) 7. The recovery of paraplegia after treatment was far better in type of early onset, type of incomplete paraplegia less than one year duration. 8. The radical anterior decompression and anterior interbody fusion was considered as recommendable method for remove of all pathologic foci, recovery of paraplegia and healing the tuberculosis with stability.
Arthrodesis ; Child ; Decompression ; Humans ; Immobilization ; Methods ; Orthopedics ; Paraplegia ; Prognosis ; Spinal Fusion ; Spine ; Spondylitis ; Tuberculosis ; Tuberculosis, Spinal

Component fixation on the acetabular side is not as much of a problem because of the simpler geometry and loading configuration. It is generally accepted that hemispheric component design is preferable and immediate implant stability can be achieved by using screws or spikes in the porous coated implants. The authors reviewed 130 primary noncemented porouscoated, press fit acetabular component in 110 patients; 84 were AML (Anatomical Medullary Locking) and 46 were HarrisGalante acetabular component. Radiologic analysis at a minimum of 3 years(average 4.5 years) was done with special regards to the vertical and medial migration, screw size and numbers, change of the radiolucent line and its zone with its fate and acetabular cup angles on the acetabular component by the 2 observers. Progressive radiolucent line at the component-bone intersurface were found in 14 cases(11%), frequently located in zone I and zone I & II. No significant vertical, medial migration and change of the acetabular cup angle were found. No screw and spike failure had occurred. No component had to be revised because of loosening. As a whole, in our 3-years experience we report excellent results with porous coated acetabular component although it dose not ensure long-term sucess.
Acetabulum ; Hip ; Humans

Moyamoya disease is a particular disease of the circle of Willis which is characterized by its progressive obstruction and associated with different cerebral vascular malformations and infrequently associated with aneurysms. A 23 year old Korean woman was admitted to the Department of Neurosurgery, Korea University Hospital, because of stuporous mentality and Rt. Sided hemiplegia. She fell down and almost immediately lost consciousness on the day morning of admission. Neurological findings included neck stiffness, moderately bilateral dilated pupils, Rt. Sided hemiplegia, positive bilateral Babinski's sign and positive Kernig's sign. Lumbar angiogram revealed grossly bloody cerebrospinal fluid. Carotid angiogram revealed marked stenosis of supraclinoid portion of intracranial internal carotid arteries with extensive collateral small arterial net work at the base of the brain. Small aneurismal sac was visualized at the distal end of the small arterial nerwork probably distal portion of posterior choroidal artery. Brain computed tomography showed hematoma at the posterior portion of left side thalamic area and in the left lateral ventricle. The patient had operation for removal of hematoma and died on the 2nd day of postoperation. Based on this case, mechanisms of formation of aneurysms in moyamoya disease are discussed.
Aneurysm ; Arteries ; Brain ; Carotid Artery, Internal ; Cerebrospinal Fluid ; Choroid ; Circle of Willis ; Consciousness ; Constriction, Pathologic ; Female ; Hematoma ; Hemiplegia ; Humans ; Intracranial Aneurysm* ; Korea ; Lateral Ventricles ; Moyamoya Disease* ; Neck ; Neurosurgery ; Pupil ; Reflex, Babinski ; Stupor ; Vascular Malformations ; Young Adult

No abstract available.
Trichotillomania*

Hypoxia is a serious aviation problem and will be a source of dangerous aerospace accidents. Hypoxia tolerance has been evaluated by the time of useful consciousness (TUC), subjective symptoms, hypoxic ventilatory responses (HVR), and cardiovascular changes. It is not clear which physiological factors relate to the former parameters and only few studies are occurred in Korea. From 15 May 1998 through 17 September 1999, 929 ROKAF pilots are checked CBC, blood chemistry, health-related physical fitness tests, pulmonary function tests, life-style, and we analyzed the variables showing significant correlation with TUC. Age, total flying time, grade, and smoking duration had negative correlation with TUC. BMI, FVC, TV, and flexibility had positive correlation. But the reasons why fighter pilots showed significantly shorter TUC than transporter pilots are needed more following study. Also further studies must be made on the intervention study for hypoxia tolerance promotion of ROKAF pilots
Anoxia ; Aviation ; Chemistry ; Consciousness* ; Diptera ; Korea ; Physical Fitness ; Pliability ; Respiratory Function Tests ; Smoke ; Smoking

No abstract available.
Nortriptyline* ; Pharmacokinetics*

Atlanto-axial instability is an important condition that may threaten the integrity of spinal cord, leading to tetraplegia or sudden death. Many of these require operative stability, and several different operations have been advocated. Among these methods, Brooks and Jenkins posterior fusion for eleven cases of atlanto-axial instability (fresh fracture of odontoid process in nine, nonunion of odentoid fracture in one, Cl-2 rotary subluxation in one) was performed in Baik Hospital from July 1978 to June 1987, and the following results were obtained. l. Accurate reduction and immediate rigid stability were obtained with Brooks and Jenkins posterior fusion, so early ambulation with simple external support was begun within 2 weeks after operation. 2. Radiological fusion of atlanto-axial instability were seen in average 12 weeks after operation. Therefore posterior atlanto-axial fusion by Brooks and Jenkins method is an excellent method for operative treatment of atlanto-axial instability.
Death, Sudden ; Early Ambulation ; Methods ; Odontoid Process ; Quadriplegia ; Spinal Cord

OBJECTIVE: To evaluate the efficacy of new protocol (Modified luteal long; MLL protocol) to improve the clinical outcomes in IVF-ET. METHODS: New protocol was applied to repeated ART failure group for 7 months (GroupI, n=106) after informed consent. Outcomes of new protocol group were evaluated and compared to conventional long protocol group (Group II, n=315) prospectively and compared to same indication group with GroupI (Group III, n=144) historical prospectively. RESULTS: There were no differences in the clinical characteristics except patient's age between GroupI and II (35.16+/-4.35 vs. 33.22+/-4.14, p<0.05). Outcomes of IVF-ET, such as numbers of retrieved oocytes, numbers of transferred embryos, numbers of 2 PN, rates of ICSI, rates of blastocyst ET, rates of fertilization, ampules of gonadotropin between GroupI & II, and GroupI & III, respectively. But the embryo quality score of GroupII was significantly higher than GroupI. There was significant increase of implantation rate (25.2 vs. 17.1%, p=0.02) in GroupII compared to GroupI, especially in 31-35 years old group. Implantation rate of less than 35 years old group and clinical pregnancy rate of 31-35 years old group in GroupII tubal factor patients were significantly higher than GroupI tubal factor patients. Clinical pregnancy rate (47.2 vs. 12.8%, p=0.001) and implantation rate (15.2 vs. 5.5%, p=0.009) of GroupI was significantly higher than GroupIII, especially in 36-40 years old group. Implantation rates of ES factor patients (especially in 36-40 years old) and unknown factor patients (especially less than 35 years old), and clinical pregnancy rate of ES factor patients (especially in 36-40 years old) were significantly higher in GroupI than III. CONCLUSION: These results suggest that new protocol may play some role in the increase of endometrial receptivity. Further investigation, including molecular research work will be needed to clarify the factors concerned in the increase of implantation rate.
Adult ; Blastocyst ; Embryo Transfer* ; Embryonic Structures* ; Fertilization ; Fertilization in Vitro* ; Gonadotropins ; Humans ; Informed Consent ; Oocytes ; Pregnancy Rate ; Prospective Studies ; Sperm Injections, Intracytoplasmic

Anticonvulsant hypersensitivity syndrome (AHS) is a rare and potentially life-threatening drug reaction, which has been associated with aromatic anticonvulsants such as phenytoin, carbamazepine, and phenobarbital. It is characterized by the triad of fever, rash and internal organ involvement, which mostly includes hepatitis. Histopathological findings usually show characteristic erythema multiforme. Lamotrigine is a new antiepileptic drug, chemically distinct from other anticonvulsant medication, however, AHS has recently been documented in patients treated with lamotrigine. We report a case of AHS in a 29-year-old man, thought to have been caused by the use of lamotrigine.
Adult ; Anticonvulsants ; Carbamazepine ; Erythema Multiforme ; Exanthema ; Fever ; Hepatitis ; Humans ; Hypersensitivity* ; Phenobarbital ; Phenytoin