No abstract available.
Vibration*

No abstract available.
Acrocephalosyndactylia*

In general. femoral neck fracture in young adult presents poor prognosis due to the high velocity injury, high angle shear fracture, and poor candidate for arthroplasty. In addition to the relative rarity of the injury, the high incidence of aseptic necrosis and nonunion have been reported in the management of these fractures. 25 cases of femoral neck fracture in young adult were treated with multiple pinning and analyzed at Sung-Ae general hospital from 1987 to 1994 after 28 months follow up in average with review of charts, X-ray and clinical result. There were 18 male and 7 female, 5 cases of them had significant polytrauma to other organs or skeletal system, authors tried to treat them as soon as possible to decrease the interval time between fracture and fixation (the average time was 39.7 hours.) Union occurred in all of Garden stage I (4 cases) and II (4 cases), but in Garden stage III (7 among 8 cases) and IV (7 among 9 cases) the union rate was lower. Average union time was 16.5 weeks. The incidence of complications (12%, 3 among 25 cases) was higher in displaced fractures group (Garden stage III, IV) and also in poorly reduced group of Garden’s alignment index. In conclusion, the prognosis of femoral neck fractures in young adult was related with mainly initial reduction and rigid fixation than the initial injury.
Agriculture ; Arthroplasty ; Female ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Hospitals, General ; Humans ; Incidence ; Male ; Multiple Trauma ; Necrosis ; Prognosis ; Young Adult

PURPOSE: To determine the plain film findings of acute neuropathic joint in diabetic foot. MATERIALS AND METHODS: Acute neuropathic joint in diabetic foot was considered when fragmentation of the articular ends of bone and subluxation of the affected joint developed within eight weeks after clinical onset of diabetic gangrene. Eight toes of six diabetics were satisfactory to our criteria. We analyzed plain radiographic findings of the affected joint and soft tissue, interval changes in follow-up radiographs, and deformities after healing. RESULTS: The time interval between clinical onset of gangrene and bone destruction ranged from 2 weeks to 4 weeks(mean 2.6 weeks). Plain radiographs showed fragmentation of the articular ends, subluxation, and soft tissue swelling of the metatarsophalangeal joint or interphalangeal joint. The significant feature of these patients was rapid progression of the lesions. Clinically, all patients had diabetic gangrene in affected toes, however, there was no evidence of osteomyelitis in our series. Amputation was done in 2 cases, and lesions in 3 of the remaining 4 cases were repaired spontaneously with regression of gangrene, leaving radiological residua such as pointed-end, tapered-end, and ball and socket deformity. CONCLUSION: Rapid disorganization of the joint with associated evidence of soft tissue gangrene in plain radiograph is believed to be valuable for the diagnosis of diabetic osteoarthropathy.
Amputation ; Congenital Abnormalities ; Diabetic Foot* ; Diagnosis ; Follow-Up Studies ; Gangrene ; Humans ; Joints* ; Metatarsophalangeal Joint ; Osteomyelitis ; Toes

A prospective study had been performed in infants with hydronephrosis due to ureteropelvic junction stenosis to determine adequate management plan. Forty infants (47 renal units) were selected for the study during the period from January 1995 to July 1997 in the Department of Pediatrics, Asan Medical Center. They were diagnosed prenatally or early postnatally (<3 months of age) on the basis of renal ultrasonography and techotium-99m-mercap- toacetyltriglycerine (MAG3) scan. The antero-poste- rior pelvic diameter (APPD) was measured from serial renal ultrasonography and relative renal function and clearance half time (T1/2) were calculated from serial MAG3 scan. Those who had accompanying other urogenital anomalies or vesicoureteral reflux were excluded in this study. Follow-up tests (ultrasonography and MAG3 scan) and surgical corrections, if necessary, were performed according to the predetermined algorithrn. The male to female ratio was 3: 1. Hydronephrosis was involved the left side in 24 renal units, the right side in 9 renal units, and the bilateral sides in 14 renal units. All the hydronephrotic renal units were divided into 2 groups; Group A (19 renal units) those had taken surgical correction, and group B (28 renal units) those revealed spontaneous improvement without surgical correction. The mean follow-up duration was 7.2+/-6.3 months in group A and 14.1+/-12.6 months in group B. The mean APPD in the first postnatal renal ultrasonography was 19.4+6.8 mm in group A and 10.0+/-3.0mm in group B and this was statistically significant (P<0.01). The rela- tive renal function of group A in the first MAG3 scan was under 35% in 7 renal units and over 35M in 12 renal units. In group B, the relative renal function was over 35% in the all 28 renal units. Tl/2 in the first MAG3 scan was longer than 20 minutes in the all 19 renal units in group A. In group B, Tl/2 was shorter than 10 minutes in 15 renal units, between 10 minutes and 20 minutes in 6 renal units, and longer than 20 rninutes in 7 renal units. The mean APPD of the 7 renal units in group B of which Tl/2 was longer than 20 minutes was 12.62.6mm and that of group A was 19.4+/-6.8mrn and this was statistically significant (P<0.01). In conclusion, the renal ultrasonography and MAG3 scan can be used effectively to determine the degree of the stenosis of the ureteropelvic junction in hydronephosis during infancy. When the babies are diagnosed with hydronephrosis due to ureteropelvic junction stenosis in the early infantile period, serial renal ultrasonography and MAG3 scan play an important role in the decision of the management.
Chungcheongnam-do ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis* ; Infant ; Male ; Pediatrics ; Ultrasonography* ; Vesico-Ureteral Reflux

Accelerated atherosclerosis is not only a frequent complication but also the most common cause of death in patients with chronic renal failure (CRF). Although mechanisms are unclear, disorder of lipid metabolism may be a major factor. Since apolipo-protein (apo) E is known to play a major regulatory role in lipid metabolism, we evaluated apo E genotype in 72 male patients with CRF and compared with that in 194 rnale normal controls. In addition, we measured plasma lipid and apolipoprotein concentrations and evaluated them according to apo E genotype in patients and controls. Apo E genotype was determined with the INNO-LiPA Apo E kit (Innogenetics, Belgium), which is based on reverse hybridization. The results are as follows ; 1) The distribution of the three major apo E alleles in patients with CRF ( e 2: 6.2%, e 3: 80.6%, e 4: 13.2%) was not different from that in controls ( e 2: 4.1%, e 3: 87.6%, e 4: 8.3%). 2) In patients with CRF, total cholesterol, lowdensity lipoprotein (LDL) and high-density lipoprotein (HDL) levels were significantly lower and the triglyceride and lipoprotein (a) levels were significantly higher than those in controls. 3) In controls, E 4/3 group had significantly lower levels of HDL than E 3/3 and E 3/2 groups. In patients with CRF, E 4/3 group had significantly higher levels of total cholesterol and apo B lipoprotein than E3/2 group. In conclusion, although there was no significant difference in the apo E genotype frequencies between male patients with CRF and controls, apo E polymorphism may play an important role in the determination of individual differences in plasma lipids in male patients with CRF.
Alleles ; Apolipoproteins B ; Apolipoproteins E ; Apolipoproteins* ; Atherosclerosis ; Cause of Death ; Cholesterol ; Genotype ; Humans ; Individuality ; Kidney Failure, Chronic* ; Lipid Metabolism ; Lipoprotein(a) ; Lipoproteins ; Male* ; Plasma* ; Triglycerides

PURPOSE: To evaluate the usefulness of percutaneous catheter drainage (PCD) in patients who have abdominal abscesses or fluid collections. MATERIALS AND METHODS: We performed PCD for 165 abscesses and fluid collections in 148 patients. The follow-up periods in these patients ranged from 15 days to 42 months (mean, 274 days). The lesion sites were subphrenic space in 46 cases, liver in 33, perihepatic space in 20, pancreas or peirpancreatic space in 14, pelvic cavity in 13, and retroperitoneum in 13. We evaluated the success, failure, and recurrence rates, the causes of failure or recurrence, the mean duration of drainage, and the complications of PCD. RESULTS: Of the 165 cases, one hundred-fifty nine(96.5%) were successfully cured, Although a partial success could be achieved, 2(1.2%) cases were failed and 4(2.4%) were recurred. Multiloculation or fistula formation were the main causes of the unsullessful cases. The duration of drainage rainged from 2 to 605 days (mean, 1 days). Complications occured in 12 cases(7%) during or after procedures, which included fever and chill in 7, transgression of pleura in 2, bowel perforation in 2, and bleeding through catheter in 1. CONCLUSION: PCD is an effective and safe method for various abdominal abscesses or fluid collections.
Abdominal Abscess* ; Abscess ; Catheters* ; Drainage* ; Fever ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Pancreas ; Pleura ; Recurrence

BACKGROUND: The increasing implementation of organ transplantation requires an unequivocal diagnosis of brain death for moral and legal reasons. Among instrumental investigations, angiographic demonstration of absent intracranial blood flow is considered to be the most reliable test in diagnosing brain death. This test should be easily accessible since most brain dead patients are vitally unstable and have various life-supporting equipments besides their beds. To investigate the usefulness of an intracranial CT angiography (CTA) for the diagnosis of brain death, we performed CTA in comatose patients who were either clinically brain dead or not. METHODS: Fourteen comatose patients (11 male and 3 female, aged from 17 to 63 years) with various brain insults were included in this study. Eleven patients were clinically brain dead. Among the remaining three patients, one showed subtle withdrawal movements in one extremity to noxious stimuli with absent brainstem reflexes, and the other two showed multifocal myoclonic seizures. CT scanning was performed with a table speed of 2 mm/sec, twenty seconds after beginning an injection of contrast media. The data were reformatted by maximum intensity projection (MIP) and shaded surface display (SSD) after the reconstruction of a 1 mm interval. A portable electroencephalography (EEG) was also taken serially in clinically brain dead patients except one. RESULTS: Intracranial arterial blood flow was preserved in those who showed either a seizure, abnormal posture or intact brainstem reflexes. On the other hand, intracranial arteries were not visualized in all brain dead patients with electrocerebral silence (ECS) on their EEG with the exception of one patient whose EEG was difficult to determine a ECS due to excessive mechanical artifacts. However, in the clinically brain dead patients, the intracranial arterial flow was preserved in those who suffered from widespread brainstem and cerebellar infarction or whose EEG demonstrated periodic lateralizing epileptiform discharges or a burst suppression pattern. CONCLUSIONS: Intracranial CTA seems to be a safe and noninvasive procedure for the determination of brain death that produces fast, reliable, and easy-to-interpret results. It can be used as an alternative method to the EEG when the EEG is not possible or difficult to interpret due to artifacts.
Angiography* ; Arteries ; Artifacts ; Brain Death* ; Brain Stem ; Brain* ; Coma ; Contrast Media ; Diagnosis ; Electroencephalography ; Extremities ; Female ; Hand ; Humans ; Infarction ; Male ; Organ Transplantation ; Posture ; Reflex ; Seizures ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed ; Transplants

There is increasing evidence that inactivation of tumor-suppressor genes can promote tumor growth. Retinoblastoma protein (pRb) is the product of the retinoblastoma gene located on chromosome 13q14. pRb negatively regulates cell growth when functioning normally. Mutational inactivation of the Rb gene has been observed in retinoblastomas, osteosarcomas and soft tissue sarcomas. Recently, several other human cancers have also been shown to carry abnormalities of the Rb gene. The potential role of the Rb gene in cutaneous squamous cell carcinomas (SCCs) and basal cell caicinomas (BCCs), has not been determined and was the focus of this study. Immunohistochemical expression of pRb in 16 cutaneous SCCs and 17 BCCs was examined. The expression of PCNA was studied in parallel to assess the cellular proliferation rate in these lesions. The pRb and PCNA immunoreactivity were localized to the nuclei of tumor cells. A few pRb and PCNA positive cells were seen in normal squamous epithelium, sebaceous glands, sweat glands and hair follicles. The loss of expression of pRb was seen in 3 of 16 SCCs(18.8%) and 6 of 17 BCCs (35.3%). PCNA immunoreactivity was slightly high in pRb-negative or lower-positive cases. PCNA immunoreactivity was similar to that produced by pRb in some cases. These results suggest that mutational inactivation of the Rb gene may be related to the carcinogenesis of cutaneous SCC and BCC, though the frequency is relatively low.
Carcinogenesis ; Carcinoma, Basal Cell* ; Carcinoma, Squamous Cell* ; Cell Proliferation ; Epithelium ; Genes, Retinoblastoma ; Hair Follicle ; Humans ; Osteosarcoma ; Proliferating Cell Nuclear Antigen ; Retinoblastoma Protein* ; Retinoblastoma* ; Sarcoma ; Sebaceous Glands ; Sweat Glands

No abstract available.
Pelvic Exenteration*