The early weight bearing in treatment for tibial fractures was reporded first by Gurd(1940) and in recent by Weissman(1966), Sarmiento(1967), and Brown(1969). 1. One hundred and fifty cases of fractures of the tibia treated at the Orthopedic Department f the 17 th Army Hospital during period of January 1968 to June 1970 were subjected to analysis. Of three groups, first group was applied functional below the knee cast after mannual reduction and started weight bearing on the 5 th weeks from injury, second group was treated with same method as first group except the reduction was achievd surgically, and third group was applied toe-to-groin cast after manipulation with no weight bearing until union. 2. Casting method; The toe-to-groin cast was applied on the day of injury after manipulation and functional below the knee cast was applied tightly after swelling was subsided. Supporting the leg on the table, we could obtain satisfactory alignment in all cases. Especial firm molding over the medial flare of the tibia, Patellar tendon and popliteal space was the most important step in applying this type of the cast. Finally rubber walking heel was held in place throught the tibial axis. 3. Traffic accident was the most common cause of the fractures in this series and it was 78 cases out of 150. 4. The average healing time of the first group was 15.7 weeks, of second group was 19.4 weeks, and of third group was 23.5 weeks. 5. The open and/or comminuted fractures would delay healing time, and prolonged convalescent period. 6. Though slight shortening and angulation was observed in the early weight bearing groups, the final function was excellent.
Accidents, Traffic ; Fractures, Comminuted ; Fungi ; Heel ; Hospitals, Military ; Knee ; Leg ; Methods ; Orthopedics ; Patellar Ligament ; Rubber ; Tibia ; Tibial Fractures ; Walking ; Weight-Bearing

No abstract available.
Ependymoma* ; Epidermal Cyst* ; Third Ventricle*

PURPOSE: This study aimed to investigate the factors of occurrence of amenorrhea and the severity of climacteric symptoms in breast cancer patients who underwent chemotherapy. METHOD: Women diagnosed with breast cancer without metastasis or recurrence, had surgery followed by chemotherapy, and had menses at the time of surgery were recruited from S hospital located in Seoul. A total of 99 women aged 31 thru 55 years participated and filled out a structured questionnaire including the Functional Assessment Cancer Therapy-Breast plus Endocrine Symptom when they visited the clinic for follow-up. RESULT: In 88 women amenorrhea occurred within an average of 2 months since beginning chemotherapy, and menstruation was resumed in only 11 women. About 98% of women aged over 40 experienced a cessation in menses thus age was an apparent factor of amenorrhea (Exp(B)=.76, p<.05). Presence of chronic disease (beta=.25, p<.05) and body weight change (beta=.30, p<.01) were significant factors influencing the severity of climacteric symptoms. CONCLUSION: Nurses need to have clinical evidences of menstrual changes due to breast cancer treatment. Information about premature menopause and climacteric symptoms should be provided according to women's health conditions so that they cope better during their survival.
Aged ; Amenorrhea ; Body Weight Changes ; Breast ; Breast Neoplasms ; Chronic Disease ; Climacteric ; Female ; Humans ; Menopause, Premature ; Menstruation ; Neoplasm Metastasis ; Phosphatidylethanolamines ; Surveys and Questionnaires ; Recurrence ; Women's Health

We experienced 4,945 cases of surgical operation at the Busan National University Hospital from Jan. 1966 to Dec. 1970. The cases that expired within the first 24 hours pastoperatively, were recorded as the postoperative death in this analysis. Thus, postoperative deaths were 126 cases, comprising 2,6 per cent of all the surgical operation. Emergency operation was 119 cases and neurosurgery was 90 cases among 126 cases, Above results imply that more careful attention and efforts to every emergency and neurosurgical case were needed.
Busan ; Emergencies ; Mortality* ; Neurosurgery

CT findings and comparison between clinical and CT staging were reviewed in 45 consecutive patients withbiopsy proven carcinoma of the cervix. CT was done for staging of primary untreted cercial cancer in 36 patientsand for diagnosis of recurrent cervical cancer or follow-up study 14 times in 9 patients . The results are asfollows; 1. As comparing with clinical staging in 36 cases, CT agreed with clinical stage in 19 cases (52.8%),upstaged in 10 cases(27.8%) and downstaged inn 7 cases (19.4%). 2. The main upstaged CT findings are detection ofunsuspected bladder or rectal invasion and paraaortic lymph node metastasis. Inadequate delineation ofintravaginal tumor was the leading causes of understage of CT than clinical one. 3. CT detected all 10 cases ofthe hydronephrosis shown by IVP and detected unsuspected bladder invasion in 3 cases. 4. CT was valuable in thediagnosis of recurrent tumor and follow-up study after treatment. 5. CT offeres distinct advantages over clinicalstaging and can be integrated into the present FIGO classification of uterine cervix carcinoma. CT can served asan initial radiological staging work-up of primary of recurrent cervical carcinoma.
Cervix Uteri ; Chungcheongnam-do ; Classification ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis ; Lymph Nodes ; Neoplasm Metastasis ; Urinary Bladder ; Uterine Cervical Neoplasms

Between 1989 and 1993, 13 patients with pituitary adenoma underwent operation/radiosurgery at Yonsei University Hospital before their 18th birthday. This comprises an incidence of 5.3%(13/247) of all pituitary adenoma patients who were treated at our institution during the study period. There were 7 boys and 6 girls ranging in age from 10.6 to 17.9 years(average, 14.9 years). The mean follow-up period was 22.4 months(7-55 months). Immunohistochemical study revealed 4 prolactin(PRL)-secreting, 3 growth hormone(GH)-secreting(PRL was also positive in one), 1 adrenocortical hormone(ACTH)-secreting, 1 thyroid stimulating hormone(TSH)-secreting, and 4 non-functioning adenomas. Nine of 13 patients(77%) presented with symptomatic endocrinopathy due to hormonal hypersecretion and/or delay in linear growth or onset of puberty. Microadenomas comprised one of nine functionng adenomas, and one of 4 nonfunctioning adenomas, or 15% overall. In 10 patients(77%), at least one pituitary hormonal axis was abnormal. Transsphenoidal and transcranial resections were employed in 8 and 4 patients, respectively. One patient with nonfunctioning microadenoma underwent gamma knife radiosurgery. Endoclinologically successful treatment was possible in 4 of 9 functioning adenomas(44%). Gross total resections confirmed by follow-up study were achieved in 2 of 3 nonfunctioning adenomas. One nonfunctioning microadenoma treated by radiosurgery showed no progression on follow-up study 20 months after radiosurgery. Seven patients(54%) were treated successfully with either operation or radiosurgery. Adjuvant therapy was applied to 5 patients. Overall tumor control was achieved in 91%. Long-term partial or full hormone replacement was necessary in 69%. It is concluded that early diagnosis, vigorous approach to complete cure, and more strict endocrinological management for sexual maturation and growth are mandatory in management of pediatric pituitary adenomas.
Adenoma ; Adolescent* ; Axis, Cervical Vertebra ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Pituitary Neoplasms* ; Puberty ; Radiosurgery ; Sexual Maturation ; Thyroid Gland

No abstract available.
Hypopituitarism*

PURPOSE: Improvements in the prevention or control of rejection of kidneys and livers have been largely interchangeable and then applicable. However, the mechanism by which antirejection treatment permits any of these grafts to be accepted has been an immunological enigma. Recently, the exchange of migratory leukocytes between the transplant and the recipient, with consequent long-term cellular chimerism in both has been the basis for acceptance of all whole-organ allografts and xenografts. METHODS: The donors of liver transplants were male Lewis rats weighing 100-150 g in all experiments groups. Male Brown Norway rats were the experimental group and female Lewis were the control group. Heterotopic partial liver transplantation was performed by Lee's method without arterial reconstruction. All procedures were performed under ether anesthesia. Bone marrow was taken from the tibias and femurs and was processed in RPMI 1640. The cell counts of suspensions were 2.5x10(8) per experiment. Genomic DNA prepared from peripheral blood and various tissues. Male Lewis Sry-specific oligonulceotide primers were used. RESULTS: In allogenic liver transplantation with bone marrow transplants (LEW-BN), donor cells were detected in the liver, and the spleen by day 7. However, in rejection cases, donor cell were not detected in any tissues. In isografted transplants (LEW-LEW), after bone marrow transplantation, donor cells were found in lymph nodes, the liver, and peripheral blood. In isografted transplants (LEW-LEW), after liver transplantation donor, cells were only found in the grafts. CONCLUSION: In allogenic liver transplantation with bone marrow transplantation, chimerism induction was augmentedwith bone marrow-derived stem cells. Therefore, it is necessary to have many samples to investigate more precisely chimerism and rejection after liver transplantation with bone marrow transplantation.
Allografts ; Anesthesia ; Animals ; Bone Marrow Transplantation* ; Bone Marrow* ; Cell Count ; Chimerism* ; DNA ; Ether ; Female ; Femur ; Heterografts ; Humans ; Isografts ; Kidney ; Leukocytes ; Liver Transplantation* ; Liver* ; Lymph Nodes ; Male ; Norway ; Rats* ; Spleen ; Stem Cells ; Suspensions ; Tibia ; Tissue Donors* ; Transplants

OBJECTIVES: To assess height, weight and body mass index from childhood to adolescence according to the age at menarche and hence to study the influence of childhood growth on the menarche age. METHODS: "The Kangwha Study" was a community-based prospective cohort study which included the entire population of 219 female first graders in Kangwha county in 1986. Among the 219 girls, 119 girls who had received complete follow up checks during the study period(1986~1997), were included in this study, except one for whom menarche age information was unavailable. The remaining 118 girls were divided into three groups according to the timing of menarche : early(<25 percentile), intermediate and late(> or =75 percentile) maturers. RESULTS: The average age at menarche was 12.7 years : early 11.3 years, intermediate 12.6 years and late 13.7 years. The early maturers were taller and heavier between 6~8 years. But, the mean weight and body mass index at the menarche age did not differ statistically among the three groups. The weight and body mass index of the early maturers were consistently higher than those of the late maturers over the entire period of the study. CONCLUSIONS: Critical body weight and body mass index must be attained for menstruation to be attained and the age at menarche is largely determined by the childhood growth. In addition, it seems that childhood growth and age at menarche are associated with adolescent weight and body mass index.
Adolescent* ; Body Mass Index ; Body Weight ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Menarche* ; Menstruation ; Prospective Studies

BACKGROUND: With advances in the techniques of liver resection as well as with better improvement of preoperative and postoperative care, hepatic resections for liver disease have become more common. This study presents a review of our experience for hepatic resection and an analysis of potential risk factors affecting the morbidity and the mortality in a hepatectomy. METHOD: From 1970 to 1996, 506 patients underwent hepatic resections; 139 patients with benign hepatic diseases, 329 patients with primary hepatic malignancy, and 38 patients with secondary hepatic malignancy. RESULTS: We divided the patients into two groups. Group 1 had 272 patients (from 1970 to 1990), and group 2 had 234 patients (from 1991 to 1996). As compared with group 1, group 2 had more malignant diseases than non-malignant diseases as operative indications. In the patients resected for primary hepatic malignancy, the 1-, 2-, 3-, and 5-year survival rates were 56.6%, 36.7%, 30.1%, and 15.2%, respectively, and 1-, 2-, 3-, 4-, and 5-year survival rates for a hepatocellular carcinoma were 58.5%, 41%%, 30.1%, 25.3%, and 17.2% and for a cholangiocarcinoma 39.5%, 22.5%, 19%, 8.3%, and 5.2%, respectively. The overall operative mortality rate was 5.9% (30/506), 7.4% in group 1 and 4.3% in group 2. The significant risk factors for perioperative mortality were liver cirrhosis, jaundice, increase of postoperative alkaline phosphatase, extended time needed for operation (above 4 hours), massive transfusion during operation (above 5,000 cc), malnutrition and/or weight loss (above 10%), low hemoglobin (below 10 gm%) and low serum albumin level (below 3.0 gm). Also, the major complicationsinfluencing perioperative mortality were liver failure, perioperative hemorrhage, cholangitis, intraabdominal abscess, sepsis, pulmonary lesions, and renal failure. CONCLUSION: After 1990, minor resections having enough margin from the hepatic malignant lesion have increased. However there has been no difference in the survival rate compared with that for a major resection for hepatic malignant diseases. Rather, operative morbidity, perioperative mortality, and postoperative complications have decreased in favor of a minor resection for hepatic malignant diseases.
Abscess ; Alkaline Phosphatase ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Cholangitis ; Hemorrhage ; Hepatectomy ; Humans ; Jaundice ; Liver ; Liver Cirrhosis ; Liver Diseases ; Liver Failure ; Malnutrition ; Mortality ; Postoperative Care ; Postoperative Complications ; Renal Insufficiency ; Risk Factors* ; Sepsis ; Serum Albumin ; Survival Rate ; Weight Loss