Calcaneal fractures of 82 feets in 68 patients which were treated at the Dept. of Orthopedic Surgery, St. Mary's Hospital since 1974 to 1978 were cllnically analysed, and the following results were obtained. 1. Of 68 patient 50 patients were male and 18 female. Their ages ranged from 9 to 58 years and averaged 33 years. 2. Fourteen patients had both calcaneal fractures, and the spine fractures were associated in 14 patients with calcaneal fractures. 3. Of 82 fractures 50 fractures were Rowe's type 5. Of these type 5 fracture 14 cases of tongue type were treated by axial pin flxation and favourable result were obtained. All the other types of fractures were treated conservatively. 4. After treatment, the most common complication after treatment was presistant foot pain. The commonest site of residual pain was beneath the lateral malleculus. Of 82 fractures 22 cases had this complaint. This residual pain occured in the seventeen cases type 5 fracture. 5. Residual flat foot deformity and weakness of triceps power were clinically not significant if the residual foot pain is nat associated with those two factors.
Clinical Study ; Congenital Abnormalities ; Female ; Flatfoot ; Foot ; Humans ; Male ; Orthopedics ; Spine ; Tongue

Seventy consecutive ipsilateral fracture of the femur and tibia in sixty-eight patients from December 1974 through December 1984 treated at Severance Hospital were analysed in clinical and radiological aspect. 1. Fifty-nine patients were male and nine patients were female. The male patients were more injured in the ratio of 6: 1. The avarage age was 34. 2. The main cause of injuries were traffic accidents; 59 patients. (86.8%). 3. The majority of the fractures were shaft fracture; for example, femur shaft 57% and tibia shaft 47%, The open fracture of the tibia was 34% and the femur was 17%. 4. There were 24 cases of concomitant fracture and dislocation of other sites. A fat embolism was disgnosed in 4% of the patients. Four patients had died one month after sustaining injuries. 5. Over-all, a good or excellent functional result was achieved in 76% of the patients treated with internal fixation of both fracture, 65% of the patients with intexnal fixation for the femur fracture only and 35% of the patients managed conservatively.
Accidents, Traffic ; Dislocations ; Embolism, Fat ; Female ; Femur ; Fractures, Open ; Humans ; Male ; Tibia

The head patient with musculoskeletal trauma is a challenge to the orthopedic surgeon and its incidence is increasing markedly with the development of modern culture and a high velocity motor vehicle. So, for the purpose of studying the difference between lower extremity fracture concomitant with head injury and only lower extremity fractured patients, we studied the radiologic bone union time, serologic test and heterotopic ossification. For the control group we analysed each 10 patients of only femur and tibia fractures. The following clinical results were obtained by analysis of 46 patients of lower extremity fracture concomitant with head injury, experienced in the Department of Orthopedic Surgery, Yonsei University College of Medicine in past 5 years from Jan. 1980 to Dec. 1984. 1. The mean age was 24.5 yrs old (2~6 yrs old) and the prevalent age was 1st and 3rd decade, and the sex ratio between males and females was 2.8: l. 2. The most common mode of injury was auto-pedestrian injury (84.8%) and the other was falling down injury(15.2%) . 3. The common brain injuries were cetebral contusion with skull fracture (37.0%) and cerebral contusion only(34.8%) . Among 26 patients whos mental states were not alert, 23 patients recovered mental states completely. 4. Serum Calcium, Phosphate, and Alkaline Phosphatase level were no difference between the head injury with lower extremity fractured patients and only lower extremity fractured patients. 5. There were no evidence of early bony union in the patients with head injury. 6. The formation of callus were abundant in the patients of lower extremity fracture with head injury rather than the only lower extremity fractured patients. 7. The incidence of heterotopic ossification was 10.9% and all patients with heterotopic ossification were treated with physiotherapy and all patients recovered fully. 8. The incidence of complication was 17.3% and there was no fat embolic patients. In conclusion, there was no evidence of early bony union, but the callus formation was abundant in the patients of lower extremity fracture concomitant with head injury.
Accidental Falls ; Alkaline Phosphatase ; Bony Callus ; Brain Injuries ; Calcium ; Clinical Study ; Contusions ; Craniocerebral Trauma ; Female ; Femur ; Head ; Humans ; Incidence ; Lower Extremity ; Male ; Motor Vehicles ; Orthopedics ; Ossification, Heterotopic ; Serologic Tests ; Sex Ratio ; Skull Fractures ; Tibia

The authors investigated the radioallergosorbent test (RAST) for the specific IgE and the prick test with hose dust mite in 129 patients with atopic dermatitis(AD) wit4 four or more family numbers. RAST and prick test results were described according to family background of respiratory atopy(RA) and severity of AD. The results are summarized as follows : l. A comparison between the prick test results and RAST reactions gave a concordance of 88%. The prick test was more sensitive than the RAST. 2. The level of specific IgE in patients with personal history(PH) or family history(FH) of RA was significantly increased compared to those in patients with only AD. 3. In patients without PH and FH of RA, the level of specific IgE in patients with FH of AD was significantly increased compared to those in patients without FH of AD. 4. The level of specific IgE did not reflect the severity of AD. From the above results, it could be concluded that type I allergy to house dust mite is not directly related to AD and it occurs predominantly in those patients with AD wha have a predisposition to RA.
Dermatitis, Atopic* ; Dust* ; Humans ; Hydrogen-Ion Concentration ; Hypersensitivity* ; Immunoglobulin E ; Mites ; Pyroglyphidae* ; Radioallergosorbent Test

The authors compared the changes of morphology, blood brain barrier alteration, pathology, arterial blood lactate content and cerebrospinal fluid lactate content between an intermittent brain retraction group and a continuous brain retraction group in 56 mongrel cats. The results were as follows ; 1) Microscopically, hemorrhages were punctate in 15 cases among 25 cases in the intermittent retraction group. However, there were multiple or large hemorrhages in 13 cases among the 25 cases in the continuous brain retraction group. 2) All cases of the intermittent retraction group showed 0~25% Evans blue staining of the coronal section crossing the retraction site. However, 8 cases among the 25 cases of the continuous retraction group showed 51~75% Evans blue staining and 4 cases of this group showed 76~100% staining. 3) With photomicroscopy, the authors noted small hemorrhage and cellular swelling in the intermittent retraction group instead of pyknosis, hemorrhagic necrosis, vacuolation in the continuous retraction group. 4) The change of arterial blood lactate content was from 1.22+/-0.24mmol/L at preretraction time to 1.42+/-0.26mmol/L at 90 minutes after release of retractor in the intermittent retraction group(p<0.01). In the continuous retraction group, the authors noted a change in the lactate content from 1.20+/-0.38mmol/L to 3.15+/-0.97mmol/L for the same time as above(p<0.001). 5) The change of CSF lactate content in the intermittent retraction group was from 1.39+/-0.29mmol/L at preretraction time to 1.43+/-0.23mmol/L at 90 minutes after release of retractor(p>0.05). In the continuous retraction group, this author noted change in the lactate content from 1.37+/-0.28mmol/L to 2.11+/-0.52mmol/L for the same time as described above(p<0.01). From the above results, the superiority of the intermittent brain retraction was demonstrated as compared with the continuous brain retraction. Also the possible utilization of this experimental method was discussed for other wxperimental studies on ischemia.
Animals ; Blood-Brain Barrier ; Brain* ; Cats* ; Cerebrospinal Fluid ; Evans Blue ; Hemorrhage ; Ischemia ; Lactic Acid ; Necrosis ; Pathology

BACKGROUND: Isolated lung perfusion (ILP) was developed as a new treatment approach to non-resectable primary or metastatic lung cancer, because of its ability to reduce systemic toxicity while delivering high-dose chemotherapeutic agents to the target organs. This research was planned to evaluate the direct toxic effect of high-dose cisplatin to the lung tissue during isolated lung perfusion. MATERIAL AND METHOD: Fifteen mongrel dogs were divided in the perfusate for 40 minutes. The second group was composed of 5 mongrel dogs which underwent ILP with cisplatin 2.5 mg/Kg added to the perfusate for 30 minutes and 10 minutes with washing solution without cisplatin. The third group underwent the same procedure as the second group except cisplatin 5.0 mg/Kg in the perfusate. Activities of serum angiotensin converting enzyme (ACE), tumor necrosis factor-alpha (TNF-alpha), and concentration of serum lactate dehydrogenase (LDH) and blood urea nitrogen/creatinine (BUN/Cr) were analyzed in each groups at the time of pre-perfusion, 1 hour, 1 day, 1 week, and 2 weeks after ILP. RESULT: Serum ACE activities before and 1 hour, 1 day, 1 week, and 2 weeks after ILP in control group were 45.1+/-6.3, 44.6+/-9.3, 46.7+/-9.5, 50.8+/-9.1, 46.1+/-4.3 U/L. Those in cisplatin 2.5 and 5.0 mg/Kg groups were 49.4+/-12.6, 39.0+/-8.6, 42.3+/-15.9, 50.0+/-2.6, 53.8+/-8.3 and 55.5+/-12.3, 47.0+/-6.3, 45.1+/-6.9, 74.8+/-19.5, 60.2+/-12.0 U/L, respectively. Serum TNF-alpha activities in each group before and after ILP were 5.0+/-1.5 / 7.7+/-2.2 / 6.6+/-2.5 / 4.3+/-1.3 / 5.2+/-1.1 (control), 8.7+/-1.6 / 9.9+/-2.2 / 7.9+/-1.5 / 6.3+/-2.2 / 7.4+/-2.4 (cisplatin 2.5 mg/Kg), and 6.9+/-0.7 / 8.9+/-3.4 / 7.9+/-4.0 / 3.3+/-0.9 / 5.8+/-1.3 pg/ml (cisplatin 5.0 mg/Kg). Mean LDH levels of each group were 225.7 / 271.3 / 328.9 / 350.8 / 255.7(control), 235.7 / 265.7 / 336.0 / 379.5 / 299.2 (cisplatin 2.5 mg/Kg), and 259.6 / 285.2 / 340.6 / 433.4 / 292.4 IU/L (cisplatin 5.0 mg/Kg). So there was no significant difference in serum ACE, TNF-alpha, and LDH activity changes after ILP between the 3 groups. And, there was no significant changes in BUN/Cr in each groups, which was independent of ILP and perfused concentration of cisplatin. In addition, all dogs survived the ILP and there was no significant evidence of pulmonary vascular injury after 2 weeks of ILP with cisplatin. CONCLUSION: There was no harmful effect of cisplatin to the lund tissue of the mongrel dog up to 5.0 mg/Kg in perfusate. Therefore, it is perceived to be safe and effective to deliver high-dose cisplatin to the lung without pulmonary toxicity and renal damage with ILP.
Animals ; Cisplatin* ; Dogs* ; L-Lactate Dehydrogenase ; Lung Neoplasms ; Lung* ; Peptidyl-Dipeptidase A ; Perfusion* ; Tumor Necrosis Factor-alpha ; Urea ; Vascular System Injuries

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

Two cases of acquired absence of forearm bone secondary to compound comminuted fractures were treated by reconstructive surgery, which consist of surgical construction of one-bone forearm. The results of treatment were referred and the review of the literature was done concerning about surgical reconstruction of one-bone forearm.
Forearm ; Fractures, Comminuted

No abstract available in English.
Neurilemmoma

The developement of squamous cell carcinoma from the draining sinus of chronic osteomyelitis has long been recognized as a rare and late complication. The mode of developement of carcinoma at the site of chronic osteomyelitis is not well understood. This, however, is chiefly a disease of middle aged men, and tibia is the most common site. There are two types in this carcinoma; superficial and deep types. In the superficial type obvious presence of fungaiing growth makes diagnosis simple and easily confirmed by biopsy. In the deep type the diagnosis is difficult clinically, but the features most frequently described are an increase in pain and discharge with swelling and hemorrhage. Amputation at the adequate level is the treatment of choice. Three cases of the disease involving one left femur, and two left tibiae are reported with review of literature.
Amputation ; Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Epithelial Cells ; Femur ; Hemorrhage ; Humans ; Male ; Middle Aged ; Osteomyelitis ; Tibia