Six. patients with clavicular nonunion were treated at the Daegu Catholic Hospital from Aug. 1980 to Jun, 1986. Five patients were male and one was female, and their ages ranged from 35 to 52 years. There were hypertrophic nonunion in four patients and atrophic nonunion in two patients; all six patients had symptoms due to nonunion. Factors that might have influenced the development of nonunion in our cases seem to be inadequate operative treatment, severe trauma and inadequate external fixation due to combined injuries. Five patients were treated with semitubular plating and iliac graft, and one was treated with intramedullary K-wire fixation and iliac graft. All patients achieved good union by average 10 weeks postoperatively and symptoms disappeared. It was concluded that symptomatic nonunion of the mid-clavicle could be treated by operation, and the procedure of choice seemed to be rigid internal fixation with plating applied in compression and bone graft.
Clavicle ; Clinical Study ; Daegu ; Female ; Humans ; Male ; Transplants

In 38 patients with femorsl neck fracture trested at Cstholic Hospital from Aug. 1980 to Jun. 1985, 24 patients were followed for more thsn 2 years. Preoperative bone scanning with 99m Tc MDP was performed in those 24 patients and postoperative follow-up bone scan assesment of the femorsl vascularity was done in 9 patients of them. Following results were obtained. 1 . Tc 99m methylenediphosphonate bone scanning was effective in assesing the femoral head vascularity in the femoral neck fracture patients. 2. The femoral head activity could be changed in the postoperative scanning : there could be further injury to the blood supply during operation or femoral head revascularization after operation 3. Some information about the possibility of future avascular necrosis could be obtained by comparing preoperative and postoperative bone scan in order that early preventive measures might be applied against the late head collapse. 4. It was conculuded that internal fixation should be considered first in the treatment of fresh femoral neck fracture : the indication of head replaement surgery could not be rnade by preoperative bone scan only.
Equidae ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Head ; Humans ; Neck ; Necrosis ; Prognosis

An isolated granulocytic sarcoma (chloroma) of the left ovary occured in the absence of leukemia in a 12-year-old woman. This lesion is defined as a localized tumor mass composed of immature cells of the granulocytic series. Granulocytic sarcomas can occur at extramedullary sites including ovary but, isolated myelosarcoma in the absence of usual manifestations of AML may be rare and has some difficulties in diagnosis. Contrary to findings in other series, granulocytic sarcoma arising in this nonleukemic patient did not progress to acute leukemia during two years she has been followed.
Child ; Diagnosis ; Female ; Humans ; Leukemia ; Ovary* ; Sarcoma, Myeloid*

No abstract available.
Biopsy, Fine-Needle* ; Melanoma*

We used skeletal scintigraphy which had a high sensivity in the diagnosis of acute fractures in clinically suspected scaphoid fracture to elevate diagnostic accuracy, and then evaluated the results. From February 1993 to April 1994, twenty patients with a clinical suspicion of a scaphoid fracture in spite of normal skeletal films had been examined with skeletal scinigraphy of the wrist Sensitivity was 100%, specificity 30.8%, positive predictable value 43.8%, and negative predictable value 100%. The patients with positive scintigraphy and normal x-ray were free from symptoms in 4-6 weeks in spite of no treatment. In conclusions, Skeletal scintigraphy is of major importance in carpal trauma to rule out scaphoid fracture. Information obtained through scintigraphy often proved a prerequisite both for the retrospective identification of the fracture and for repeat directed skeletal view. The lesions in the distal radius and other carpal bones may clinically mimic a scaphoid fracture. and the authors feel to need further specific diagnostic tools such as MRI in cases with carpal injuries and scinitigraphic uptake indicative of a fracture when even skeletal views turn out normal. However, scintigraphy doesn't seem to be a guide of trament in these patients.
Carpal Bones ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Radionuclide Imaging ; Radius ; Retrospective Studies ; Sensitivity and Specificity ; Wrist

Anterior plate fixation of the cervical spine enhance anterior grafting technique and provide good primary stability to allow early mobilization without significant external support. This facilitastes nursing and shortens rehabilitation time. Although these advantages, the screw technique is risky and time-consuming since purchasing of posterior cortex is needed for obtatining maximum stability. The authors have tried to a technique of purchasing only near cortex. The objectives of this study were review of the result of this technique and the determining the factor influencing screw loosening. One hundred and five screws used in twenty-one patients for conventional cervical plate fixation from September 1990 to February 1994 were reviewed. Average age was forty-two years old ranged from nineteen to sixty-five. Patients with trauma were six and degenerative diseases were fifteen. Two screws were inserted in C3 bodies, ten in C4, thirty-two in C5, thirty-four in C6, ten in C7, two in Tl and fifteen in grafted bone. Twenty-four screws(16%) in six patients(28.6%) were loosened. Usually the first loosening was noted at about one month after operation. The incidence of loosening was significantly higher in lower cervical region(p < 0.001) and older age(p < 0.05). The disease entity or sex were not significant factor. This technique showed high rate of screw loosening especially in older age group or lower cervical lesion. We think the indication of this technique should be limited in young patient with upper cervical lesion.
Early Ambulation ; Humans ; Incidence ; Nursing ; Rehabilitation ; Spine ; Transplants

A case of transient neonatal diabetes mellitus combined with congenital adrenal hyperplasia(CAH) is described. A female infant was born by cesarean delivery due to fetal distress, she had sunken eyeball and anterior fontanelle, large protruded tongue and thin subcutaneous tissues. She had large clitoris and progressive pigmentation on whole body was observed since 10th day of birth. Hyperglycemia and glycosuria was noted at 3rd day of birth. Level of insulin and C-peptide was 3.0 mU/L and 0.35 ng/mL respectively. Serum ACTH was 870.4 pg/mL and 17-hydroxyprogesterone was increased to 20,000 ng/dL. Serum Na was 124 mEq/L, K 5.6 mEq/L. Abdominal MRI showed no abnormality. Chromosomal study showed 46,XX. Genetic analysis with polymorphic DNA markers for chromosome 6 showed paternal uniparental isodisomy at D6S276, D6S1704 and DNA analysis of CYP 21 gene showed mutation at P435S. She required insulin therapy for 8 months after birth. Hydrocortisone and florinef was needed for the control of CAH.
17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital* ; Adrenocorticotropic Hormone ; C-Peptide ; Chromosomes, Human, Pair 6 ; Clitoris ; Cranial Fontanelles ; Diabetes Mellitus* ; DNA ; Female ; Fetal Distress ; Genetic Markers ; Glycosuria ; Humans ; Hydrocortisone ; Hyperglycemia ; Infant ; Insulin ; Magnetic Resonance Imaging ; Parturition ; Pigmentation ; Subcutaneous Tissue ; Tongue ; Uniparental Disomy

OBJECTIVES: The purpose of this study was to compare the effects of video-based contact with educational lectures on the stigma of mental illness and to follow-up to determine any changes in their effects on college students. METHODS: A total of 107 college students were randomly assigned to either an education group (n=50) or a video-based contact group (n=57). All were completed pre-tested, post-tested, and subjected to three month follow-up measures using the Community Attitudes to the Mentally Ill Inventory (CAMI). RESULTS: The video-based contact group showed significant positive improvement in the subtypes authoritarianism, social restrictiveness, and community mental health ideology of the CAMI at posttest and three month follow-up. The education group also showed significant positive improvement in subtypes social restrictiveness and community mental health ideology of the CAMI; however, its effects were limited only after education. There were no significant changes in the benevolence subtype of the CAMI in either group at post-test and three month follow-up. CONCLUSION: In comparison with education that utilizes lectures, the video-based contact showed more effectiveness in decreasing the stigma of mental illness and its effects were evident at posttest and three month follow-up.
Authoritarianism ; Beneficence ; Follow-Up Studies ; Humans ; Lectures ; Mental Health ; Mentally Ill Persons ; Schizophrenia

This study includes 19 cases of complicated low extremity injury to whom underwent microvascular free-tissue transfer in cases of open comminuted fracture, osteomyelitis, and vascular compromise or extensive soft tissue defect from Nov. 1994 to July 1997. The average time after injury to coverage was 25 days. The nineteen patients underwent a total of nineteen free tissue transfers primarily, and eighteen (94.7 per cent) of the transfers survived. Major complications were encountered recurrent failure of the free tissue transfer in one patient and partial necrosis in the other flap, which were successfully treated by flow-through radial forearm free flap and distally based superficial sural artery flap respectively. Two patients were sustained below knee amputation, one above knee amputation, despite of survival of flaps. This reveals limb salvage in 84 percent. The microvascular reconstruction is a versatile and reliable methods in complicated cases after severe trauma. Free tissue transplantation should be considered as a primary treatment in such complicated cases.
Amputation ; Arteries ; Extremities ; Forearm ; Fractures, Comminuted ; Free Tissue Flaps ; Humans ; Knee ; Limb Salvage ; Lower Extremity* ; Necrosis ; Osteomyelitis ; Tissue Transplantation ; Transplants

The t(3;21) (q26;q22) is associated with chronic myelogenous leukemia in blast crisis, leukemia evolving from therapy-related myelodysplasia, and with leukemia following other hematopoietic proliferative diseases. The t(3;21) is rare secondary aberration in blast crisis of Philadelphia(Ph)-positive chronic myeloid leukemia, which may be restricted to patients entering myeloid blast crisis. We report here in one case of chronic myeloid leukemia in blast crisis which reveals both t(9;22) (q34;q11), and t(3;21) (q26 ;q22). A 62-year-old male was diagnosed as chronic myeloid leukemia 5 years ago, received hydroxyurea therapy, and admitted because of gingival bleeding and fever. On examination, splenomegaly and leukocytosis with proliferated blasts(91%) in peripheral blood were noted. Bone marrow aspirate showed hypercellularity with severe blast proliferation(92.5%) which revealed all negative in peroxidase and PAS stain. Cytogenetic study of bone marrow cells showed the karyotype 46, XY, t(3;21) (q26;q22), t(9;22) (q34;q11), which might be suspected as myeloid blast crisis. Above finding was confirmed by the result of immunophenotyping(CD13 43.6%, CD34 68.2%, HLA-DR 91.6%). He received intensive chemotherapy, but still sustained proliferation of blasts was noted . The follow up cytogenetic study was as follows: 46, XY, 4(3;21) (q26:22), t(9;22) (q34;q11)/46, XY, t(3;21)(q26;q22), del(8) (q22), t(9:22) (q34,q11)/46, XY (16/3/1). He died soon from severe pancytopenia and sepsis.
Blast Crisis* ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Drug Therapy ; Fever ; Follow-Up Studies ; Hemorrhage ; HLA-DR Antigens ; Humans ; Hydroxyurea ; Karyotype ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Leukocytosis ; Male ; Middle Aged ; Pancytopenia ; Peroxidase ; Sepsis ; Splenomegaly