No abstract available.

Unstable Colles' fractures have an inherent capacity for loss of reduction or shortening, or both. The istability can be recognized by the presence of much comminution, severe dorsal angulation(20 degrees or more), or extensive intra-articular involvement. It is difficult to align the fracture fragments and to maintain the reduction. In twenty-nine patients with unstable Colles' fracture from Jan. 1982 to Mar. 1984, several invasive methods were used. The results were as follows: 1. Among 147 patients with Colles' fractures 29 patients(19.7%) had unstable fractures. 2. Colles' fracture was occurred more frequently in women(77%) and in 6th and 7th decades(56%). Unstable fractures showed no significant age and sex related propencity. 3. Mechanism of injury caused unstable Colles' fractures were fall on the outstretched hand(25 patients), traffic accident(3 patients) and crushing injury(1 patient). Open fractures were shown in 4 patients among the unstable fractures. 4. Most of the unstable fractures were comprised of type VII and VIII(49%) but type I and II fractures with marked comminution or displacement also showed instability. 5. Complications were such as, redisplacement of the fractures, temporary neuropathy of the median nerve, compartment syndrome, Sudeck's atrophy, and shoulder-hand syndrome. 6. Overall assessments showed excellent in 4 patients, good in 16 patients, fair in 7 patients and poor in 2 patients. 7. Overall results were mainly correlated with initial severity of the injury and anatomical restoration of the fractures.
Atrophy ; Colles' Fracture ; Compartment Syndromes ; Fractures, Open ; Humans ; Median Nerve ; Radius ; Reflex Sympathetic Dystrophy

No abstract available.
Depression* ; Mass Screening* ; Primary Health Care*

No abstract available.
Anterior Cruciate Ligament* ; Patellar Ligament*

Sixty six Colles' fracture were treated with radial slab or U-cast (sugar tong splint), from January 1982 through May 1984 at the Department of Orthopaedic Surgery of St. Mary Hospital. A prospective study was made and was evaluated under the subjective criteria of Gartland and Werley, and the objective criteria of Scheck. The results of this study were as follows: 1. All of 66 cases was closed fracture and the incidence was high in females who aged over 6thdecades. 2. In 43 cases of stable fracture, 18 (94.7 %) out of 19 cases treated with radial slab and 21 (87.5%) out of 24 cases treated with U-cast showed satisfactory result. 3. In 23 cases of unstable fracture, 6 (54.6%) out of 11 cases treated with radial slab and 9 (75%) out of 12 cases treated with U-cast showed satisfatory result. 4. As a result, we found that the result of the treatment with radial slab was superior to the U-cast for the stable Colles fracture, however, all of two methods were not staisfatory for the unstable Colles fracture although the U-cast group showed better result.
Colles' Fracture ; Female ; Fractures, Closed ; Humans ; Incidence ; Prospective Studies

Before beginning the extracorporeal circulation, perfusionists should supply oxygen into the oxygenator and establish blood flow through the blood line of the heart-lung machine. But these manipulation can induce severe hypocarbic state of priming solutions due to wash out of CO2 gas in the solution. This study was carried out to examine the relationship of blood gas changes between hypocarbic priming solutions and body circulation in 15 patients undergoing open heart surgery with extracorporeal circulation. PaCO₂, pH, buffer base and PaO2 were measured from priming solutions before and 15 minutes after the extracorporeal circulation. The results were as follows; 1) Before the extracorporeal circulation, mean PaCO₂ level was 12.1±7.8 mmHg in the priming solution. However, 15 minutes after extracorporeal circulation, the PaCO₂ level was maintained at 35.7±5.7 mmHg. 2) pH in the priming solution was variable from 6.93 to 7.99 (mean 7.45±0.29), but after 15 minutes it was ranged from 7.28 to 7.42 (mean 7.35±0.05). 3) Mean buffer base level in the priming solution was 7.9±3.5 mmol/l. but after 15 minutes, it was 19.6±1.2 mmol/l. 4) Mean PaO₂ level in the priming solution was 667.1±45.6 mmHg, but after 15 minutes, it was 280.7±131.7 mmHg.
Extracorporeal Circulation* ; Heart* ; Heart-Lung Machine ; Humans ; Hydrogen-Ion Concentration ; Oxygen ; Oxygenators ; Thoracic Surgery*

In the beginning of anesthetic training, one of the clinical practices that anesthetists have to learn is manually controlled ventilator techniques. The popularity of manually controlled ventilatory techniques has been gradually decreased with increased use for anesthetic ventilators. However it is important and basic for the anesthetists to master manually controlled ventilator techniques skillfully. Recently, we analyzed the arterial blood gas in 30 cases before and during general anesthesia, and studied the effects of the manually controlled ventilation on the pulmonary gas exchange. The results were as follow; 1) Mean value of PaCO₂ during the manually controlled ventilation, 29.9±2.0 mmHg was decreased statistically comparing with that of PaCO₂ before the anesthesia, 39.8±2.8 mmHg. 2) Mean values of pH and HCO₃⁻ during the manually controlled ventilation were 7.48±0.03, 22.2±2.4 mEq/1, respectively and values before the anesthesia were 7.41±0.02, 25.2±1.8 mEq/1, respectively. 3) Mean value of PaO₂ and O₂ saturation during the manually controlled ventilation were 270.0±28.8 mmHg, 99.6±0.2%, respectively and values before the anesthesia were 92.5±4.0 mmHg, 96.9±1.0%, respectively. These results indicates that manually controlled ventilation at our department of anesthesiology produced mild hyperventilatory state. However these were no significant changes in cerebral blood flow and other biochemical parameters.
Anesthesia ; Anesthesia, General* ; Anesthesiology ; Cerebrovascular Circulation ; Hydrogen-Ion Concentration ; Pulmonary Gas Exchange ; Ventilation* ; Ventilators, Mechanical

No abstract available.
Biopsy* ; Child* ; Humans

No abstract available.
Rupture* ; Thorax*

A 58-year-old female with an episode of gross hematuria two months before and fever and chill for the past three days presented oliguric acute renal failure. She has taken NSAID intermittently for 18 years due to rheumatoid arthritis, and herb medicine for one week two months ago when gross hematuria developed. Physical examination revealed mild tenderness on costovertebral angles. Her blood pressure was 170/100 mmHg, the urinalysis showed >300 mg protein with many RBCs and 10-20 WBCs and the serum creatinine was 5.8 mg/dl. A renal biopsy performed on the 4th hospital day showed that it was overwhelmed by severe tubular lesions which reveal intratubular obstruction by massive erythrocyte casts and tubular necrosis. The glomeruli showed focal minimal crescents with many red blood cells entrapped in the crescents and in the capillaries. Immune deposits were not present. A renal failure resolved spontaneously and the patient was discharged three weeks later with creatinine of 2.4 mg/dl. In this patient, acute renal failure was considered to be due to a tubular lesion related to the glomerular bleeding from focal glomerulonephritis revealing minimal crescents.
Acute Kidney Injury* ; Arthritis, Rheumatoid ; Biopsy ; Blood Pressure ; Capillaries ; Creatinine ; Erythrocytes ; Female ; Fever ; Glomerulonephritis* ; Hematuria* ; Hemorrhage ; Humans ; Middle Aged ; Necrosis ; Physical Examination ; Renal Insufficiency ; Urinalysis