Dislocation of both ends of a clavicle in a 49-yesr-old man during an auto-accident is presented. The medial end of the right clavicle was severely displaced antero-inferiorly while the 1ateral end displaced posteriorly. And the clavicle was rotated along its long axis. Sever al attempts of manual and a surgical reduction through separate incision on both ends of the clavicle failed to have anatomical reduction. It was presumed that the cause of failure in reduction were delayed reduction due to combined chest injury, blockade by first rib that was broken and was anteriorly displaced as well as the complexity of the dislocation. It is speculsted that anatomic reduction in this rare injury require wider surgical exposure. Though authors failed to have anatomic reduction in present case, stabilization of the medial end of the clavicle with a strip of fascia lata after medial clavicular resection and ligament repair at the lateral end resulted in satisfactory regain of shoulder motion and cosmetic improvement.
Clavicle ; Dislocations ; Fascia Lata ; Ligaments ; Ribs ; Shoulder ; Thoracic Injuries

Supracondylar fracture of femur is not well suited to internal fixation. A wide canal, thin cortex, comminution and compound wound make open reduction difficult. And the associated injuries, such as popliteal artery rupture are not infrequent. Some authors reported the favorable results with open reduction and rigid internal fixation. But still we have had failure cases with loosening or breakage of plate and screws, infection, post-operative joint stiffness and non-union etc. The present paper reports the result of surgically treated supracondylar fracture. From March 1982 to February 1989 25 patients who were treaed at Department of Orthopedic Surgery, St. Vincent Hospital were analysed. The results obtained as follows:l. Age distribution was between 29 and 74 years of age, and the ratio between males and females was 1.8:1. The most common of injury was traffic accident. 2. According to Neer's classification, there were 5 patients of type I, 7 patients of type II
Accidents, Traffic ; Age Distribution ; Amputation ; Classification ; Clinical Study ; Female ; Femur ; Fractures, Open ; Humans ; Joints ; Knee ; Leg ; Male ; Orthopedics ; Osteoarthritis ; Patella ; Popliteal Artery ; Rupture ; Tibia ; Wounds and Injuries

No abstract available.
Cytomegalovirus Infections*

No abstract available.
Femur* ; Osteosarcoma*

OBJECTIVE: The purpose of this study was to evaluate the survival rate of vitrified blastocyst according to the freezing vessels, equilibration time in cryoprotectant and artificial dehydration method. METHODS: Human blastocysts were vitrified after loading onto the plastic straw, open-pulled straw (OPS), electron microscopy grid (EM grid) for 1.5 min or 3 min. They also were directly plunged into LN2 within 30sec. For artificial shrinkage of blastocysts, 36 gauge fine needle was pushed at the cellular junction of the trophectoderm into the blstocoele cavity until it shrank without damage of inner cell mass. RESULTS: The survival rate of vitrified blastocysts on plastic straw, OPS, EM grid as freezing vessels were 26.7, 13.0 and 60.5%, respectively. The survival rate of EM grid was significantly higher than that of plastic straw and OPS (p<0.05). For 1.5 min equilibrium, the survival rates of early blastocyst (EB), middle blastocyst (MB) and late blastocyst (LB) were 64.4, 81.0, and 20.0% respectively. For 3 min equilibrium, the survival rates of EB, MB, and LB were 69.9, 50.0 and 57.5% respectively. The survival rates of EB and MB were significantly higher than that of LB in 1.5 min equilibrium group (p<0.05), however, the significance was not observed in 3 min equilibrium groups. In cytoplasmic shrinkage before vitrification, the survival rates of EB, MB and LB were 92.9, 100 and 75.9% respectively. The survival rate of MB was significantly higher than that of LB (p<0.05). The survival rates of vitrified blastocysts by artificial dehydration and slow-frozen blastocysts were not significantly different as 88.9 and 66.7%, respectively. CONCLUSION: This study showed that the vitrification of human blastocysts using EM grid and artificial dehydration is an effective method. Therefore, these methods would be an useful techniques for blastocyst cryopreservation.
Blastocyst* ; Cryopreservation ; Cytoplasm ; Dehydration ; Freezing ; Humans* ; Microscopy, Electron ; Needles ; Plastics ; Survival Rate ; Vitrification*

Total of 311 cases who were admitted to pediatric departmenr of Kyung Hee University Hospital from October, 1971 to December, 1975 were studied clinically about the cases in various age group. The results are as follows. 1) Convulsion was most frequent in children between 6months and 3years (38%), but it was least frequent in children from 10years to 15 years (7%). 2) The most common cause of convulsions in children was febrile convulsion(30.5%). 3) Tetanus (50.9%) was most frequent cause of convulsion in the neonatal period. 4) Febtile convulsion was most common in infants from one month to six months. 5) The most common cause of conculsions in infants from six months to three years was febrile convulsion (47.8%). 6) In children more than three years of age, idiopathic epilepsy was most frequent cause of convulsion (3 to 10 years and 10 years to 15years , 36%, 72.7% respectively).
Child* ; Epilepsy ; Humans ; Infant ; Seizures* ; Seizures, Febrile ; Tetanus

PURPOSE: To investigate the expression of bone morphogenetic protein(BMP)-2/4 during eary tooth development after irradiation and calcium-deficient diet. MATERIALS AND METHODS: The pregnant three-week-old Sprague-Dawley rats were used for the study. The control group was non-irradiation/normal diet group(Group 1), and the experimental groups were irradiation/normal diet group(Group 2) and irradiation/calcium-diet group(Group 3). The abdomen of the rats at the 9th day of pregnancy were irradiated with single dose of 350 cGy. The rat pups were sacrificed at embryonic 18 days, 3 days and 14 days after delivery and the maxillae tooth germs were taken. The tissue sections of specimen were stained immunohistochemically with anti-BMP-2/4 antibody. RESULTS: At embryo-18 days, immunoreacivity for BMP-2/4 of the Group 1 was modetate in stratum intermedium of dental organ and weak in dental papilla and dental follicle, but that of Group 2 was weak in cell layer of dental organ, and no immunoreacivity was shown in dental papilla and dental follice of Group 2 and in all tissue components of the Group 3. At postnatal-3 days, immunoreacivity for BMP-2/4 of the Group 1 was strong in cell layer of dental organ, odontoblasts and developing alveolar bone, but that of Group of 2 and Group 3 was weak in odontoblasts and developing alveolar bone. At postnatal-14 days, immunoreacivity for BMP-2/4 of the Group 1 was strong in newly formed cementum, alveolar bone and odontoblasts, but that of Group 2 was weaker than that of Group 1. In the Group 3, tooth forming cell layer showed weak immunoreactivity, but other cell layers showed no immunoreactivity. CONCLUSION: The expression of bone morphogenetic protein(BMP)-2/4 during early tooth development was disturbed after irradiation and calcium-deficient diet.
Abdomen ; Animals ; Bone Morphogenetic Proteins ; Dental Cementum ; Dental Papilla ; Dental Sac ; Diet* ; Maxilla ; Odontoblasts ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Tooth Germ ; Tooth*

OBJECTIVES: Weight gain and glucose intolerance are the most common symptoms of metabolic syndrome. Certain patients complain of weight-change and hyperglycemia after receiving antidepressants. Our study evaluated the effects of antidepressants on serum glucose and energy metabolism. METHODS: Subjects were 32 Otsuka Long-Evans Tokushima Fatty (OLETF) and 35 wild-type Long-Evans Tokushima Otsuka (LETO) rats. From age 11 weeks, the rats were divided into 4 subgroups within each strain. We administered the designated antidepressant-amitriptyline, fluoxetine, or mirtazapine-to these subgroups, allocating the fourth as the control. After exactly 4 weeks' medication, we sacrificed the animals and checked their weight, glucose, insulin, leptin, adiponectin, and expression of adiponectin receptor mRNA. RESULTS: Fluoxetine subgroups in both strains gained the least weight. The glucose, triglyceride, and cholesterol levels of all OLETF antidepressant subgroups did not differ from the controls. Adiponectins in amitriptyline- and mirtazapine-subgroups were higher than control. All antidepressant subgroups showed elevated expressions of adiponectin receptor mRNA in fat, muscle, and the pancreas. CONCLUSION: Amitriptyline and mirtazapine seem to regulate adiponectin and expression of adiponectin receptor mRNA. Even though the underlying mechanisms were different, we conclude none of the antidepressants would have negative influences on energy metabolism in diabetogenic animals.
Adiponectin ; Amitriptyline ; Animals ; Antidepressive Agents ; Cholesterol ; Energy Metabolism ; Fluoxetine ; Glucose ; Glucose Intolerance ; Humans ; Hyperglycemia ; Insulin ; Leptin ; Mianserin ; Muscles ; Pancreas ; Rats ; Receptors, Adiponectin ; RNA, Messenger ; Sprains and Strains ; Weight Gain

BACKGROUND: Isolated coronary ostial stenosis presumed to be atherosclerosis in origin is a rare condition reported to have peculiar characteristics-that occurs primarily in premenopausal women, low incidence of risk factors, severe symptoms of short duration with absence of collaterals suggesting rapid development. METHODS: From Feb. 1979 to May. 1991, 11 patients with isolated left coronary ostial stenosis were identified among 2520 coronary angiographies and they were presumed to be athreosclerosis in origin by excluding other alleged causes. RESULTS: There were 5 males and 6 females with mean ages of 47.8+/-9.5 and 51.5+/-7.9 respectively. Clinical presentations were stable angina in 4, unstable angina in 6 patients, and unstable angina after myocardial infarction in 1 patient.Number of risk factors per patient was 0.82+/-0.98. Majority showed a relatively short history of angina(mean 3.6+/-2.8 months). Coronary angiographic findings showed collateral circulation in 7 patients-grade III in 5 of them. There was 1 death related to coronary angiography. Coronary artery bypass surgeries were performed in 7 patients and 5 of them were followed for mean 22+/-8 months without coronary events. CONCLUSIONS: In contrast to the previous reports, isolated left coronary ostial stenosis presumed to be atherosclerosis in orign did not showed female predelication and although their symptom durations were relatively short coronary angiographies showed well developed collaterals in the majority of patients.We experienced one coronary angiography related death in this group of patients. Coronary artery bypass surgery is to be recommended in these patients otherwise contraindicated.
Angina, Stable ; Angina, Unstable ; Atherosclerosis* ; Collateral Circulation ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Artery Bypass ; Female ; Humans ; Incidence ; Male ; Myocardial Infarction ; Risk Factors

BACKGROUND: Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. MATERIAL AND METHOD: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. RESULT: The study identified 15 men (65.2%) and 8 women (34.8%). There are right sided diaphragmatic injury in 11 patients (47.8%), left sided in 11 (47.8%), and both sided in 1 (0.4%). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). CONCLUSION: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.
APACHE ; Diaphragm* ; Early Diagnosis ; Female ; Hemodynamics ; Humans ; Male ; Mortality ; Multiple Trauma ; Prognosis