Open fracture characteristically has higher chances of infection and sof tissue damage in comparison with closed fracture. In spite of the development of operation methods and antibiotics, complications such as infection, nonunion, delayed union, and joint stiffness are continuously confronted as problems in the field of orthopedics. Different methods of treatment have been advocated as regards the care of the open wound and the method of stabilization of the fracture fragments. Therefore a comparative analysis of the type of open fracture and the bone union time according to the initial treatment methods was made from 47 cases over the age of 20, who were followed up until bone union developed among the inpatients who were treated for open fracture of tibia in the period of 7 years from January, 1982 to December, 1988, and the results are as follows: 1. The highest incidence of fractures was encountered in 3rd decade(34%) and male to female ratio was 6:l. 2. The most common cause of fractures was traffic accident(76.6%). 3. The most common level of fracture was in mid one-third and the bone union time was longest in mid one-third. 4. The bone union time was longer, and the rate of complication was greater in order of type 1, 2 & 3 according to Gustilo's classification. 5. The good result was obtained in type 1 fractures, by using the closed reduction & cast immobilization and pin & plaster method; in type 2, the bone union time was shortest in the cases of pin & plater method; in type 3, the bone union time was shortest in the cases of closed reduction or open, reduction & external fixation. 6. Bone union was obtained in all cases of delayed union and nonunion and the bone union time was shortest in cases treated with plate & bone graft.
Anti-Bacterial Agents ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Inpatients ; Joints ; Male ; Methods ; Orthopedics ; Tibia ; Transplants ; Wounds and Injuries

We reviewed 7 cases of congenital mesoblastic nephroma (4 cases of classical mesoblastic nephroma (CMN) and 3 cases of atypical mesoblastic nephroma (AMN)) using immuno-histochemical and flow cytometric study. Results are as follows. 1) The mean tumor size was 5 (3 to 7cm)cm in CMN and 9 (7 to 10cm)cm in AMN. The AMN revealed hemorrhage and necrosis in two Of three cases. A case of AMN showed cystic change without hemorrhage and necrosis. Mitotic count ranged in 0~4/10HPF in CMN and 20-35/10HPF in AMN. 2) Immunohistochemistry for vimentin was all positive. Actin, desmin were weakly positive in CMN, but negative in AMN. The findings were consistent with myofibroblastic differentiation in CMN and AMN was considered to be the less differentiated form of CMN. 3) Flow cytometiic analysis showed diploidy in two of two CMNs and two of three AMNs. Only one AMN showed aneuploidy with DNA index of 1.41. %SG2M were 8.1 and 15.9 (mean 12.0) in CMN and 16.9, 32.9 and 19.3 (mean 22.9) in AMN, respectively. We concluded that AMN should be distinguished from CMN, clinicopathologically.

No abstract available.
Candidiasis* ; Humans ; Infant, Newborn ; Infant, Premature*

Traumatic dislocation of the hip presents serious problems that may lead to avascular necrosis, nerve palsy, post-traumatic arthritis even when reduction is promptly and adequately carried out. Among them avascular necrosis is the most important prognostic factor, so the early detection of this complication has critical significance for final result. Bone scan has been considered one of early diagnostic test, but recently MRI replaced its role for imaging in the detection of early AVN, treatment monitoring and prediction of prognosis. Authors prospectively studied the early finding of MRI to detect avascular necrosis of the femoral head and to predict prognosis in traumatic hip dislocation and fracture-dislocation. From December 1990 to November 1994, 12 case of dislocation and fracture-dislocation of the hip were studied . In follow up period ranging from 19 months to 65 months, 10 case had excellent or good result. All cases had abnormal MRI finding such as paraarticular edema, capsular bulging, joint effusion, femoral head fracture, but findings such as femoral head signal changes were dectected in only 3 cases. Among the 3 cases, 1 case had developed AVN and 2 cases were uneventful. Other complications were 3 cases of posttraumatic arthritis, 2 cases of incomplete sciatic nerve palsy, and 1 case of heterotrophic ossification. Although early MRI finding at posttrauma 2weeks gave less specific information, it could give good information for risk group and follow up control with more cases. Although it is expensive, MRI can be one of the most reliable reference in early diagnosis of AVN and prediction of prognosis in traumatic dislocation and fracture- dislocation of the hip with non-invasive method.
Arthritis ; Diagnostic Tests, Routine ; Dislocations ; Early Diagnosis ; Edema ; Follow-Up Studies ; Head* ; Hip Dislocation* ; Hip Joint ; Hip* ; Joints ; Magnetic Resonance Imaging* ; Necrosis ; Paralysis ; Prognosis ; Prospective Studies ; Sciatic Neuropathy

This erratum is being published to correct of affiliation and add an acknowledgement.

Congenital indifference to pain is a rare disorder chsracterized by absence of normal subjective and objective responses to noxious stimuli in patients with intact central and peripheral nervous system. It is attributed to an abnormal affective response rather than to defective perception. Sensory apparatus of the patient was intact as far as can be determined. We experieneed a csse of congenital indifference to pain with decreased sweating.
Humans ; Pain Insensitivity, Congenital ; Peripheral Nervous System ; Sweat ; Sweating

INTRODUCTION: Although it is well known that medical students are not getting an adequate amount of sleep, there have been only a few studies on the sleep patterns of medical students and the related factors. Therefore, the present study aimed to investigate the medical students' sleep patterns and the related factors. METHODS: A questionnaire package was administered to the 1st to 4th year medical students at one medical school. It consisted of questions asking about their lifestyles as well as Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), global assessment of recent stress scale (GASS), the center for epidemiologic studies-depression scale (CES-D), and Moudsley obsessive-compulsive inventory (MOCI). A total of 352 students (206 males and 146 females) responded to the survey and the result was analyzed using the independent t-test, the chi-square test, the paired t-test, Pearson's correlation and ANOVA. p-values of less than 0.05 were considered statistically significant in analyses. RESULTS: The weekend bedtime was significantly delayed (0 : 49 on weekday ; 1 : 34 on weekend ; t=-5.23, p<0.001), the weekend rise time was delayed (6 : 58 on weekday ; 9 : 30 on weekend ; t=-24.48, p<0.001) and the total sleep time was increased on weekends (5 : 36 on weekday ; 7 : 39 on weekend ; t=15.94, p<0.001). The PSQI score of all subjects was 6.43+/-2.64. PSQI was positively correlated with ESS (r=0.383, p<0.001), GASS (r=0.326, p<0.001), CES-D (r=0.393, p<0.001), and MOCI (r=0.247, p<0.001), but not with GPA (r=0.072, p=0.228. The more senior students had lower PSQI, GASS, CES-D, and MOCI score (p<0.05). CONCLUSION: Medical students were experiencing a lack of sleep during weekdays as they have a later bedtime and earlier rise time, and consequently had more hours of sleep on weekends. Overall, the medical students were experiencing poor sleep quality and sleep deprivation. Poor sleep quality is associated with psychological problems (daytime sleepiness, stress, depression, and obsessive tendency).
Depression ; Humans ; Life Style ; Male ; Surveys and Questionnaires ; Schools, Medical ; Sleep Deprivation ; Students, Medical*

The main trend moves towards early excision and skin grafting as treatment for the deep second degree burns and the third degree burns. The ability to excision & skin grafting. This study prospectively evaluated the ability of laser doppler flow measurements obtained within 72 hours after burn injury to predict the depth of burn wounds. A Periflux system 4001 laser doppler flowmetry had been used to measure cutaneous microflow circulation of 100 selected points of burn wounds in 44 admitted patients from March 1993 to February 1994. The mean value of superficial second degree burn checked by laser doppler was 194.6 perfusion unit(PU). The deep second degree burn was 59.7 PU and third degree burn was 5.1 PU. The blood flow of more than 100 PU reliably predicted the superficial second degree burn with 90.2 percents accuracy. The blood flow between 100 PU and 10 PU predict the deep second degree dermal burn with 96.2 percents accuracy. That of less than 10 PU predict the third degree burn with 100 percents accuracy. There was also a significant correlation between initial flow measurements and the depth of burn wounds. We conclude that laser doppler flow measurements performed early after burn injury are useful in predicting the depth of burn wounds. The laser doppler flowmetry has the advantage of being easy to use, noninvasive, provide immediate result for early determination of burn depth. The laser doppler flowmetry is useful in selecting patients for early excision and grafting of burn wounds.
Burns* ; Humans ; Laser-Doppler Flowmetry* ; Perfusion ; Prospective Studies ; Skin Transplantation ; Transplants ; Wounds and Injuries

Epiduroscopy is very useful in the treatment of not only low back pain caused by failed back surgery syndrome, epidural scar or herniated disc but also by chronic refractory low back pain which does not respond to interventional conservative treatment including fluoroscopically-directed epidural steroid injections and percutaneous adhesiolysis. Because cauterization using a laser fiber has become recently available, a wider opening is required to enter into the sacral canal in the case of epiduroscopic laser neural decompression (ELND). However, in a few patients, it is difficult to insert a device into the epidural space due to stenosis around the opening, and there is no alternative method. Herein, we report a case where a hiatus rasp specially designed for such patients was used to perform the operation.
Cicatrix ; Constriction, Pathologic ; Decompression ; Epidural Space ; Failed Back Surgery Syndrome ; Humans ; Intervertebral Disc Displacement ; Low Back Pain

No abstract available.
Abscess* ; Nocardia*