Seasonal variations of fractures are concerned with seasonal sports injuries and pathologic fractures in elderly osteoporotic patients. Despite various attempts at prevention, injuries in downhill skiing especially free style, snowboarding, snowmobile, and tobogganing continue to be seasonal recreational problem. Knee injuries in skiing can be prevented by health education as well as self-releasing test for the binder. Injury of the upper extremity in snowboarding and of the spine in snowmobile also can be reduced by education program. Another aspect of seasonal variation of fractures is related to the osteoporosis in elderly patients. Distal radius fractures, hip fractures, and compression fractures of the spine are common problems in winter. The high incidences these fractures in winter are not only due to ice and snow but also related to the daylight hours and level of vitamin D. So we can reduce the incidence of these fractures by snow clearing, sand and salt spreading in strategic areas, slip-preventive aids on shoes, sometimes padding for older women, and most of all, early detection and treatment of osteoporosis in elderly people.
Aged ; Athletic Injuries ; Education ; Female ; Fractures, Compression ; Fractures, Spontaneous ; Health Education ; Hip Fractures ; Humans ; Ice ; Incidence ; Knee Injuries ; Off-Road Motor Vehicles ; Osteoporosis ; Prevalence* ; Radius Fractures ; Seasons* ; Shoes ; Skiing ; Snow ; Spine ; Upper Extremity ; Vitamin D

No abstract available.
Animals* ; Ketogenic Diet* ; Models, Animal*

In recent years, the rate of the spine fracture tends to be on the increase year by year as rate of traffic and industrial accidents are increased. 111 patients with paralysis caused by thoracic, thoracolumbar, lumbar spine injuries were evaluated from January, 1979 to December, 1988 in our study. 1. In patients with paralysis caused by thoracic, thoracolumbar, lumbar spine injuries, most common site of injuries was “thoracolumbar junction” (47.7%) and most common cause was “fall down” (48.7% ). 2. “Burst fracture” was most common type of injuries which were classified by 3-column concept according to Denis & McAfee(52.3%) 3. In early 1980's the operation was performed with Harrington rod, anterior decompression & AIF, posterior decompression & PIF and from 1984, mainly Luque sublaminar wiring, and in 1988, SSI was commonly used. 4. There was no difference in neural recovery between conservative and operative treatments. 5. There was statistic significance in the incidence of complications between conservative and operative treatments(p <0.05). 6. The more severe neurologic damage at injury, the higher incidence in complication(p<0.05). Therefore, although there was no significant difference in neural recovery between conservative and operative treatments in the care of paralysed patients caused by thoracic, thoracolumbar, lumbar spine injuries, rigid internal fixation and rapid mobilization can be recommended for decreasing complications by prologed bed rest and active rehabilitation.
Accidents, Occupational ; Bed Rest ; Decompression ; Humans ; Incidence ; Paralysis ; Rehabilitation ; Spine

The anterior horn of the medial meniscus is the site of most variations, but anomalies of the medial meniscus are extremely rare. From July 1990 through December 1994, the authors performed arthroscopy on 1068 symptomatic knee joints and incidentally found anomalous insertion of the anterior horn of the medial meniscus into the anterior cruciate ligament in eleven knees. They had another lesion(7 discoid lateral meniscus with or without tear, medial collateral ligament tear, Posterior cruciate ligament avulsion fracture). All but one discoid lateral menisci were reshaped, one had to be treated by total lateral meniscectomy, discoid medial meniscus also by reshaping, torn medial meniscus by partial meniscectomy, torn medial collateral ligament by repair and avulsion fracture of posterior cruciate ligament by arthroscopic pinmonths(average, 21.7 months) after surgery. The results were satisfactory except for 2 patients. One damaged his knee in a traffic accident and the other was treated by total meniscectomy of discoid lateral meniscus. It was concluded that this anomaly was not related to the patient's symptoms and mainly associated with discoid lateral meniscus.
Accidents, Traffic ; Animals ; Anterior Cruciate Ligament ; Arthroscopy ; Collateral Ligaments ; Horns ; Humans ; Knee ; Knee Joint ; Menisci, Tibial ; Posterior Cruciate Ligament ; Tears

The angiopathy and neuropathy is the basic mechanism causing diabetic gangrene, but the exact mechanism is still unknown. The foot is especially susceptible to diabetic complication of angiopathy and neuropathy. In such a vulnerable foot, trivial trauma may quickly lead the foot to ulceration, infection, gangrene, and to the cataclysmic amputation. Twenty nine patients with diabetic gangrene were studied, the conclution were as follow. 1. Overall incidence is 1.8%, most common age over 50 years of age, and the most common disease durstion is from 10 to 14 years. 2. The most common site is toe (56% of cases). 3. The most common predisposing factor was local pressure (41% of cases), the radiographic bone change was seen in 14% of cases. 4. The FBS level is from 200 to 300 in 35% of cases. 5. Bacterial infection was seen in 80%, and staphylococcal aureus was most common. 6. The surgical or conservative treatment were effective in 80% of cases and mortality was 14%. 7. Diabetic retinopathy was most common associated complication (47% of cases).
Amputation ; Bacterial Infections ; Causality ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Retinopathy ; Foot ; Gangrene ; Humans ; Incidence ; Mortality ; Toes ; Ulcer

Stress fractures have been well documented in the lower extremity. Stress fractures of the upper extremities are uncommon. We report a case of an ulna stress fracture in a 32 year old female non-professional golfer.
Female ; Fractures, Stress ; Humans ; Lower Extremity ; Ulna ; Upper Extremity

Tibial tunnel placement during endoscopic anterior cruciate ligament (ACL) reconstruction has received increased emphasis in the recent literature. Tibial tunnel length is a factor that affect graft fixation, potential impingement, and graft abrasion. Appropriate tunnel length is a critical tecpnical consideration. A tunnel that is too long may make distal fixation and femoral tunnel placement difficult... A tunnel that is too short results in graft extrusion, necessitating supplemental fixation techniques. This grafl-tunnel mismatch can be avoided if fhe sum of the tibial tunnel length plus the intraarticular distance of ACL is equal to or greater than the graft tendon length plus 20mm (the minimum interference fixation possible when using the smallest available 20 mm long interference screw). Authors published an article to determine the reiationship between the length of patellar tendon and that of anterior cruciate ligament, to calculate the tibial tunnel length through the dissection of 19 cadaveric knees (ACL length (mm)=0.73 X Patellar tendon length-2.69 (p Anterior Cruciate Ligament ; Cadaver ; Humans ; Knee ; Patellar Ligament ; Tendons ; Transplants

No abstract available.
Electrolytes*

With the improvement of economic conditions and medical care, the average life span has increased, thus making geriatrics an important consideration in the medical field. Degenerative changes of the cervical spine in aged are not uncommon. Also it is well known tha subjects with radiologic features of cervical spondylosis may be symptom free. On the other hand, cervical myelopathy may occur in the presence of minimal spondylosis as shown radiologically. This discrepancy between symptoms and radiologic features seems to be attributed to the differences in the initial structure of the cervical spine. The authors surveyed at random the various radiographic measurements of 300 Koreans having normal cervical spines and 120 Koreans with cervical spondylosis. The results of the survey are as follows: 1. Osteophyte was noticed more frequently at the 3 rd, 4 th and 5 th cervical vertebrae. 2. Lordosis angle was greater in spondylosis group than in normal group, which might be attributed to paravertebral muscle spasm. 3. Normal sagittal diameter of the canal decreased between C3-C6 and the narrowest was at C4 level. The sagittal diameter, on the average, was 1.5 mm shorter than in European population and 1 mm longer than Japanese. This might be attributed to the difference in the body height. 4. In the normal spine group the average interpedicular distance was greatest at the 5 th, and 6 th cervical vertebra. In the cervical spondylosis group the average interpedicular distance was greater than in normal population it was greatest at the 5 th and 6 th cervical vertebra.
Animals ; Asian Continental Ancestry Group ; Body Height ; Cervical Vertebrae ; Female ; Geriatrics ; Hand ; Humans ; Lordosis ; Osteophyte ; Spasm ; Spinal Cord Diseases ; Spine ; Spondylosis

The widespread uae of colposcopy in the evaluation of abnormal cervical cytology has been accompanied by a trend toward decreased utilization of Papanicolaou smears and cone biopsy. But its accuracy is dependent on the criteria determining its limitations and the observer's experience. This study was performed to evaluate the diagnostic accuracy of Papanicolaau smear and eolposcopic finding and to campare these findinga with thase af colposcopically directed biopsy, conization and hysteretomy and to determine the value of endocervical curettage. Nine hundred twenty six patients were evaluated from Jan. 1, 1986 to Dec. 31, 1993 at the cancer detectinn center of the department of obstetrics and gynecology, Yonsei University, College of Medicine. Three major classes were involved in this study ; 662 cases with within normal limit Papanicolaou amears with cervical examination grossly suspicious for cancer, 187 cases with squamous intraepithelial lesion or greater, and 72 caees with reactiue or reparative change. The patients with inveaive rnalignancies of the cervix visihle to the naked eye were not included in this study. The majority of patients(75%) were 31 to 50 years of her age. The colposcopic examination wee deemed unsatisfactory in 45 cases in whom the upper limit, of the transformation zone could not be visualized. There were 881 cases each with a satisfactory colposcopie examination. We obtained the following results. In the satisfactory group with within normal limit Pap smears which had clinical impression of gross suspicion for cancer, 54 of 662 cases(8%) were diagnosed as more than cervical intraepithelial neoplasia I and 36(5.5%) were diagnosed as more than cervical intraepithelial neoplasia II with the histology of colposcopically directed biopsy. The analysis of the diagnostic values of Pap smears for cervical cancer screening showed that the sensitivity was 80.0%, the specificity was 93.8%, the false negative rate was 80.0%, the false positive rate was 15.2%, the negative predicitive value was 92.1%, and the positive predicitive value was 83.6%. In the satisfactory group with within normal limit Pap smears which had clinical impression of gross suspicion for cancer, 54 of 662 cases(8%) were diagnosed as more than CIN I and 36(5.5%) were diagnosed as more than CIN III with the histolgy of colposcopically directed biopsy. The accuracy of colposcopic impression when compared to histology of the colposcopically directed biopsy in the satisfactory group was 89.8% (within 1histologic degree) and 82.7% (precise agreement). Histologic comparision of colposcopically directed biopsy and final surgical specimen showed accuracy of 87.2% (within 1 histologic degree) and 66.5% (precise agreement). The accuracy of endocervical curettage with colposcopically directed biopsy when compared with final surgical specimen in unsatisfactory group was 82.2% (with 1 histologic degree) and 57.7% (precise agreement). In conclusion, satisfactory colposcopic evaluation in conjuction with Pap smear offers accurate method for cervical cancer detection. But endocervical curettage with colposcopically directed biopsy appears to be of less value in unsatisfactory group. Therefore futher evaluation is need.
Biopsy ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Colposcopy* ; Conization ; Curettage ; Female ; Gynecology ; Humans ; Mass Screening ; Obstetrics ; Papanicolaou Test ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*