The results of treatment of fracture of the femoral shaft with interlocking nailing were evaluated to determine the clinical usefulness. Eighty-two femoral fractures that had been treated by interloking nailing between October 1988 and June 1993 and had been followed for more than one year were included in this study. Fifty-one cases were fresh closed fracture and twenty-four, fresh open fracture. Five cases were delayed union and two were non-union. Closed intramedullary nailing was used in seventy-five cases and open intramedullary nailing in seven cases. The results were as follows; 1.According to Winquist-Hansen classification, 30 cases were type I, 16 type II, 13 type III, 14 type IV, and 9 type V 2. Static and dynamic interlocking nailing were done in 67 and 15 cases respectively. 3. The mean fracture healing period was 17 weeks with a range of 9 to 52 weeks. 4. Intraoperative complications were new fracture near the original fracture site(7 cases), femur neck fracture(l case), pudendal nerve neuropraxia(1 case). Postoperative compliction were delayed union(13 cases), limb shorteniln(4 cases), nonunion(3 cases), infection(3 cases), disal screw brokening(3 cases), nail breakage(l case), proximal screw brodening(1 case) and 12 valgus angulation(l case).
Classification ; Extremities ; Femoral Fractures ; Femur Neck ; Femur ; Fracture Fixation, Intramedullary ; Fracture Healing ; Fractures, Closed ; Fractures, Open ; Intraoperative Complications ; Pudendal Nerve

BACKGROUND: Respiratory depression with high dose of propofol during induction is one of the major complications. We studied the effects of midazolam as premedicant on frequency and duration of apnea and frequency of loss of consciousness in relation to single dose of propofol. METHODS: We selected 194 adult patients who had clear consciousness and no depression of respiration. We allocated patients randomly to control group and midazolam group. In midazolam group, we injected 0.06mg/kg of midazolam intravenously 10min before induction, and in control group, we did nothing. Under mask oxygenation with 100% oxygen, we administered a bolus of propofol (1, 1.5, 2 mg/kg to subgroup 1, 2, 3 respectively) intravenously. The change of respiration and loss of consciousness were observed. RESULTS: The frequency and duration of apnea increased with the dose of propofol in both control and midazolam group. But there were no difference between groups except frequency of apnea with 1.5 mg/kg of propofol. In control group, frequency of loss of consciousness increased with the increasing dose of propofol. But in midazolam group, nearly all the patients was slept without difference by the dose. CONCLUSIONS: Premedication with midazolam reduce the sleeping dose of propofol to induce anesthesia, so the frequency and duration of apnea which is caused by high dose of propofol can be decreased.
Adult ; Anesthesia ; Apnea* ; Consciousness ; Depression ; Humans ; Masks ; Midazolam* ; Oxygen ; Premedication ; Propofol* ; Respiration ; Respiratory Insufficiency ; Unconsciousness*

Progressive Muscular Dystrophy is a hereditary disorder characterized by progressive weakness and wasting of muscules. The etiology of muscular dystrophy is unknown, and no from of pharmacological treatment is considered effective. We report 2 cases of progressive muscular dystrophy occuring in a family, which were diagnosed by clinical findings, serum enzyme study and electromyography.
Electromyography ; Humans ; Muscular Dystrophies

No abstract available.
Osteoporosis* ; Tibial Fractures*

Pigmented Bowen's disease (PBD) is a rare variant of Bowen's disease(BD). Most of the reported cases showed pigmented patches or thin plaques. Thus its clinical manifestations may simulated other various pigmented skin lesions. We experienced 2 cases of PBD in patients with multiple BD developed after taking Korean proprietary pills (KPP, "Hwan-Yak"), which were suspected to contain certain amount of arsenics. Both patients also showed arsenical keratosis on their palms and soles. The darker pigmentation of the PBL led us to differentiated them from melanoma.
Bowen's Disease* ; Humans ; Keratosis ; Melanoma ; Pigmentation ; Skin

No abstract available.
Female ; Fetal Heart* ; Heart Rate, Fetal* ; Meconium* ; Pregnancy

Paragonimus westermani mainly infests the lung parenchyma, and it is also causes ectopic parasitism of various sites, such as brain, liver and subcutaneous tissue but there have been no reports in literature about paragonimiasis infesting lumbar epidural space. A 58-year-old housewife complained of lumbago and radiating pain to both lower extremities for 20 years. Calcified extradural masses were found by preoperative plain X-ray, myelogram, and CT scan. Intraoperatively, cystic mass in the epidural space at L2-3 was found and confirmed to be paragonimiasis by histopathological study. A case of ectopic paragonimiasis in the lumbar epidural space at L2-3 level is presented.
Brain ; Epidural Space ; Humans ; Liver ; Low Back Pain ; Lower Extremity ; Lung ; Middle Aged ; Paragonimiasis ; Paragonimus westermani ; Subcutaneous Tissue ; Tomography, X-Ray Computed

OBJECTIVE: The purpose of this study was to evaluate the motor recovery of initial and plateau period in the patients with subcortical stroke lesion which were different locations. METHOD: We studied the 42 stroke patients with subcortical lesions who had been admitted to the Department of Rehabilitation Medicine from 1998 to 2000, retrospectively. Patients were divided into four groups according to the information from brain CT or MRI; Group 1: basal ganglia, group 2: anterior limb of internal capsule and/or basal ganglia, group 3: posterior limb of internal capsule and/or basal ganglia and group 4: thalamus only. Quantitative assessments of motor recovery using the Brunnstrom stage and results were correlated with sites of lesion. RESULTS: 1) Brunnstrom stages at initial and plateau period were the highest in the patients with thalamic lesion and the lowest in the patients with posterior limb of internal capsule and/or basal ganglia lesion. The patients with thalamic lesion showed higher stage than the patients with basal ganglia with anterior limb lesion in hand and low extremity (p<0.05). 2) Significant motor recovery was occurred in all patients except the lesion located in thalamus (p<0.05). CONCLUSION: There were significant differences of motor recovery at plateau period in the patients with thalamic lesions comparing with basal ganglia with anterior limb lesion about hands and lower extremities and patients with basal ganglia and/or capsular lesion showed good motor recovery.
Basal Ganglia ; Brain ; Extremities ; Hand ; Humans ; Internal Capsule ; Lower Extremity ; Magnetic Resonance Imaging ; Rehabilitation ; Retrospective Studies ; Stroke* ; Thalamus

Transhiatal gastric transpositions were performed in two case of long gap esophageal atresia without tracheoesophageal fistula. The patients were a 12 months old female and an 18 months old male. Stamm type gastrostomies were performed at other hospitals in both cases. The stomach was mobilized preserving the right gastric artery, the right gastroepiploic artery and spleen. The proximal and distal esophageal pouches were excised by transcervical and transhiatal route, respectively. The mobilized stomach was pulled up to the neck through esophageal hiatus and posterior mediastinal route. The esophagogastrostomy, the only one anastomosis of this procedure, was performed in the neck. There was no clinical evidence of anastomotic leakage, stricture, regurgitation, difficulty of gastric emptying, hoarseness or respiratory problem. Transhiatal gastric transposition seems to be a safe and easy alternative surgical procedure for esophageal replacement in long gap esophageal atresia.
Anastomotic Leak ; Arteries ; Constriction, Pathologic ; Esophageal Atresia* ; Female ; Gastric Emptying ; Gastroepiploic Artery ; Gastrostomy ; Hoarseness ; Humans ; Infant ; Male ; Neck ; Spleen ; Stomach ; Tracheoesophageal Fistula

In humans, the major stimulus for cutaneous pigmentation is ultraviolet radiation. Little is known about the mechanism underlying this response, in part, because of the complexity of the interactions involving the whole epidermis. The present stucy was undertake to evaluate the effects of a single exposure of UVB on cultured normal melanocytes. Melanocytes were exposed to UVB from 5.1 mJ/cm to 203 mJ/cm. The results were as follows : 1. The main morphologic changes in UVB-exposed groups w re larger sized cells, more blunted dendrites, and shorter dendrites than in the control group. These cells increased sized according to the increased doses of VVB, but above 101.5 mJ/cm, the melanocytes shrunk and were destroyed. 2. From 20.3 mJ/cm of UVB, the proliferation of melanocyte was decreased, Especially, there was statistical!y significant difference above 50.8 mJ/cm (p<0.05, p<0.01). 3. The antiproliferativo effect increased with the passage of tirie after UVB exposure. So, cell count could not be done in 101.5 mJ/cm and 203 mJ/cm on the third day, and in 50.8 mJ/cm, 101.5 m J/cm and 203 mJ/cm on the seventh day. 4. Statistically the melanin content per well was significantl dicreased to 11-28% of each control group with dose above 50.8 mJ/cm (p<0.05, p<0.01). The melanin content per cell was increased to 107-128% of each control group when doses were below 20.3 mJ/cm and decreased to 49-79% of each control group when above 0.8 mJ/cm on the third day, but there was no statistically significant difference. In summary, when melarocytes were exposed to UVB, morphclogic changes progressed to cell differentiation. The results also suggested that a low or dose of UVB has an antiproliferative arid mild melanogenic effect, and a higher dose of UVB has a direct cytotoxic effect.
Cell Count ; Cell Differentiation ; Dendrites ; Epidermis ; Humans ; Melanins ; Melanocytes* ; Pigmentation