Most obviuos will be the several anatomic differences between the proximal femur of the child and the adult. Fractures of the femoral neck in the children are extremely rsre and usually are the result of severe trauma in 80% of the cases. This accounts for the high frequency of serious associated injuries. In this injury the vascular anatomy changing with age, continuing growth potential and the effect of deforming forces play critical roles in high complication rate and these make treatment difficult. But still any secure guidelines for the treatment of this injury are not established and this is a field which requires more active research and further progress in future. 26 cases treated at Paik Hospital from Jan. 1979 to June 1988 were analyzed in clinical and radiological aspect and the following results were obtained. 1. The commonest type was Cervicotrochanteric fracture in 13 cases(50%),displaced one 21 cases. 2. In Transepiphyseal, Transcervical and Cervicotrochanteric fracture by early reduction and internal fixation, and in Intertrochanteric fracture by conservative treatment we gained satisfactory results. 3. We experienced 2 cases of coxa vara in nonthreaded pin used cases, 4 cases of premature epiphseal closure and 4 cases of avascular necrosis in threaded pin used ones. 4. Complications were developed in 13 cases (50%). These were 5 cases of coxa vara(19.2%) 4 cases of premature epiphyseal closure (15.4%) and 4 cases of avascul necrosis (15.4%). 5. Avascykar necrosis was developed in displaced fracture of Transcervical or Cervico- trochanteric fracture beyond postoperative 1 year. So. we recommend periodic long follow up for evaluation of avascular necrosis.
Adult ; Child ; Clinical Study ; Coxa Vara ; Femur ; Femur Neck ; Follow-Up Studies ; Hip ; Humans ; Necrosis

The ankle joint is a modified complex hinge joint which plays an important role in weight bearing, walking and standing. Injuries about the ankle joint cause destruction of not only bony architecture but often also the ligamentous and soft tissue component. So the goal of the treatment of ankle fracture is restoring normal relations of ankle mortise and regaining a smooth articular surface. The author have reviewed 84 cases of ankle fractures which were treated through the admission in the Orthopedic Department, In Je Medical College Pusan Paik Hospital from June 1979 to August 1986. The average duration of the follow-up was one year. The results obtained from this study were as follows : 1. The most common type was Danis-Weber type C. Nexts were B and A in order. According to the classification of Lauge-Hansen, the most common type was Pronation-external rotstion(39.2%). 2. In Danis-Weber type B and C, satisfactory result was obtained by operative treatment. 3. Danis-Weber's classification was very practical criteria for treatment of the ankle fracture.
Ankle Fractures ; Ankle Joint ; Ankle ; Busan ; Classification ; Clinical Study ; Follow-Up Studies ; Joints ; Ligaments ; Orthopedics ; Walking ; Weight-Bearing

Paraplegia resulting from the operative treatment of scoliosis is a serious complication feared most by orthopedic surgerns. Scoliosis Research Society reported the incidence of acute neurological complications resulting from the treatment of scoliosis as 0.72% in 1975. Thus, the importance of the development of some form of adequate practical spinal cord monitoring during major corrective surgery of the spine has become increasingly recognized as the surgery in this area has accelerated. In order to reduce the incidence of such neurological complications, intraoperative spinal cord monitoring has introduced since nineteen seventies. Monitoring of cortical somatosensory evoked potentials (CSEP) were applied in surgery of 31 cases of scoliosis and 4 cases of cervical spine lesions at Department of Orthopedic Surgery at Seoul National University Hospital, from Jan. 1982 to May 1985, and the following results were obtained. 1) Quantitative analysis of CSEP was done in 31 cases of scoliosis as grouping into preincision, preinstrumentation, postinstrumentation and skin closure periods. From preincision period, P1 and N1 latencies prolonged significantly across all periods but not from preinstrumentation period to subsequent periods. P1-N1 amplitude and P2-N2 amplitude were decreased significantly between preincision period and other periods but no significant change was noted from preinstrumentation period to skin closure period. (P<0.05) 2) Abnormal CSEP findings were noted during operations in 4 cases, in which acute neurological complications were prevented with CSEP monitoring. 3) We experienced a case in which CSEP was abolished on the concave side of the curve while CSEP was normal on the convex side, during distraction. So it is considered that the ankle electrode should be placed on the concave side of scoliosis to detect neurological complication. 4) Correctibility of deformity in scoliosis surgery was increased from 44.1% to 51.3% with the use of intraoperative CSEP monitoring without acute meurological complications. 5) CSEP monitoring during spine surgery is an effective method to prevent neurological complication.
Ankle ; Congenital Abnormalities ; Electrodes ; Evoked Potentials, Somatosensory ; Incidence ; Intraoperative Complications ; Methods ; Orthopedics ; Paraplegia ; Scoliosis ; Seoul ; Skin ; Spinal Cord ; Spine

It is generally accepted that posterior cruciate ligament is the prime stabilizer and perhaps the most importent ligament in the knee. We agreed that primary repair or reconstruction of ruptured posterior cruciate ligament is essential. Recently Clancy reported good results to correct knee instability due to rupture of the posterior cruciate ligament with a procedure that employes a free graft of one-third of the patella tendon with its tibial and patella attachments. The free patella tendon graft has been shown to revascularize readly, develop resonably high tensile strengh, allow bone to bone healing, have excellent static stability and not to deprive the knee of a significant stabilizer. So, we analized the 10 cases of the posterior cruciate ligament injuries who were admitted and treated reconstruction using free patella tendon graft in Busan Paik Hospital between May, 1984 to Dec, 1986 and obtained the following results. 1. In 8 cases, obtained satisfactory results. In 2 cases, obtained unsatisfactory results due to combined other compartment injuries, but improved posterior stability than preoperative status. 2. Reconstruction of posterior crucitae ligament using free patella tendon graft was excellent procedure for regaining of static stability of the knee.
Busan ; Knee ; Ligaments ; Patella ; Patellar Ligament ; Posterior Cruciate Ligament ; Rupture ; Transplants

To compare the results of the chemonucleolysis and the automated percutaneous lumbar discectomy(APLD) for symptomatic lumbar disc herniation, retrospective study of 19 chemonucleolysis and 20 APLD was done from July, 1984 to February, 1993. Number of male patients was 23 and female 16. The patients ranged in age from 14 to 56 years. L4-5 was the most commonly involved level comprising 73.6%, and 2 level involvement was 20.5%. Clinical results were evaluated according to Mcnab s criteria. Excellent and Good result were 31.6% and 47.3% in chemonucleolysis with an average follow up period of 6.2 years, and those were 35% and 45% respectively in APLD with an average follow up period of 18.7 months. Among 19 chemonucleolysis, there were loss of disc height in 8, and lateral recess stenosis in 1. Among 20 APLD, there were loss of disc height in 2, and nerve root irritation symptoms in 2. Chemonucleolysis and APLD have a low morbidity, can be performed under the local anesthesia and are simple, rapid and less traumatic procedure.
Anesthesia, Local ; Constriction, Pathologic ; Diskectomy ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Chemolysis ; Male ; Retrospective Studies

OBJECTIVE: The purposes of this study were to evaluate the diagnostic value of dermatomal somatosensory evoked potentials (DSEPs) in the unilevel/unilateral lumbosacral radiculopathies. METHOD: The study was performed on 41 patients with herniated lumbosacral disc which was confirmed by magnetic resonance imaging, and the patients with clinical lumbosacral radiculopathies (L5 radiculopathy in 33 cases and S1 radiculopathy in 8 cases). Stimulation sites were over the dorsum of the foot on the distal fifth metatarsal bone for the S1 dermatome and at the interdigital web space between first and second toe for the L5 dermatome. Recordings were made at Cz' and reference to Fz. Conventional nerve conduction study, needle EMG and H-reflex were also examined. RESULTS: While the needle EMG showed abnormalities in 32 patients (78.0%), the abnormalities of DSEPs were in 13 patients (31.7%): 33.3% for the L5 radiculopathy and 25.0% for the S1 radiculopathy, respectively. Moreover, there was no significant relationship between the abnormal findings of needle EMG and DSEPs (p>0.05). The H-reflexes were abnormal in 6 of 7 patients (85.7%). And then two of them were found abnormal in S1 DSEPs. CONCLUSION: The conventional needle EMG appears to be the more useful electrophysiological technique in the diagnosis of lumbosacral radiculopathies. The ultimate diagnostic value of DSEPs in lumbosacral radiculopathies is doubtful and controversial.
Diagnosis ; Electromyography ; Evoked Potentials, Somatosensory* ; Foot ; H-Reflex ; Humans ; Magnetic Resonance Imaging ; Metatarsal Bones ; Needles ; Neural Conduction ; Radiculopathy* ; Toes

Captopril tablets of two different producers were tested for bioequivalence as well as therapeutic equivalence. The pharmacokinetics, the time course of plasma angiotensin-converting enzyme inhibition, and the changes of systolic and diastolic blood pressure after administration of drugs were studied. In a balanced, randomized two-way crossover design, two single doses of 50mg each of captopril were administered orally to twelve male volunteers. Peak blood levels of free captopril were observed about 0.85 hour after the dose, and practically free captopril could not be detected in blood within 8 hours. Peak free captopril levels of both compounds were almost identical(Capoten(R), 464.3ng/ml ; Capril(R), 504.6ng/ml). No statistically significant difference was identified between two compounds when area und the concentration time curve, peak level, time to peak were compared. Inhibition of plasma angiotensin-converting enzyme to blood free captopril concentration showed the hyperbolic concentration-response relationship with IC50 value of 7.4ng/ml. The area under the percent angiotensin-converting enzyme inhibition versus time curve were quite similar after administration of both drugs. The compounds were also found to be equivalent on the premise that no significant difference was detected when the time courses of systolic and diastolic blood pressure reduction were compared.
Biological Availability* ; Blood Pressure ; Captopril* ; Cross-Over Studies ; Humans ; Inhibitory Concentration 50 ; Male ; Pharmacokinetics ; Plasma* ; Tablets* ; Therapeutic Equivalency ; Volunteers

PURPOSE: To improve the quality of the vaccination program, analyze the cause and identify the influencing factors for not being registered in the National Immunization Registry Information System even once. METHODS: We conducted one-on-one household visit interview surveys after, using a list supplemented with addresses from the Ministry of the Interior. We identified the basic respondent information, information on relevant children (those born in 2012), the reasons for omission from computerized vaccination registration, and the actual residence of the registered children. RESULTS: The total number of unvaccinated children born in 2012 was 1,870. The final contact result of the household surveys was 1,254 successful contacts, 51 refused to be interviewed, and 565 were not found. The reason for missed vaccination registration was 928 cases of long-term stay overseas, 241 cases of missing registration owing to intentional refusal of vaccination, and 57 cases of illness. A comparison of complete vaccination rates between non-registrants and those of computerized registrants revealed rates of 17.9% and 96.3% for the 3 doses hepatitis B vaccine, 14.9% and 95.6% for the 4doses DTaP vaccine, 16.1% and 97.4% for the 3 doses polio vaccine, and 3.9% and 92.5% for the 3 (or 2) doses Japanese encephalitis vaccine, respectively. CONCLUSION: Vaccination is the most effective national health policy and one of the most remarkable accomplishments in medical history. Through great effort, Korea has started to transcribe vaccination records since 2000, and the records are now reaching a considerable level. However, there is an unregistered population of around 0.3%. Several measures can be taken to improve the registration rate in the vaccination records, such as managing non-registrants through education and interviews, and sharing vaccination data with foreign countries. The non-registrant management plan should include periodically compiling a list of children who are not registered in the National Immunization Registry Information System, conducting of household visits using survey forms, and data analysis to establish appropriate measures.
Child* ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Education ; Encephalitis, Japanese ; Family Characteristics ; Health Policy ; Hepatitis B Vaccines ; Humans ; Immunization* ; Information Systems* ; Korea ; Poliomyelitis ; Statistics as Topic ; Surveys and Questionnaires ; Vaccination*

OBJECTIVE: To evaluate the usefulness of alendronate for prevention and treatment of postmenopausal osteoporosis this study was taken. METHODS: This prospective randomized clinical trial examined the effects of oral alendronate and HRT(conjugated estrogen plus medroxyprogesterone acetate), in combination and seperately, on BMD, biochemical markers of bone turnover in 79 women with low bone mass. Treatment included alendronate(10mg daily) plus HRT(group I, n=38), or HRT(group II, n=41) for 6 months. Bone density measurements were performed at months 0 and 6 at the lumbar spine. Biochemical markers of bone turnover were also measured every three months. RESULTS: Serum Osteocalcin decreased by 19.2% in group I and by 10.0% in group II at 3 months(p<0.05), and by 30.9% in group I and by 19.8% in group II at 6 months(p<0.05). Urinary deoxypyridinoline showed decrease of 19.75%(I) vs. 10.4%(II) at 3 months, 30.1%(I) vs. 20.7%(II) at 6 months, the difference was significant. Percent change of BMD measurements from baseline at 6 months in group I was 6.2% and in group II 0.6% on the lumbar spine(p<0.05). CONCLUSION: The treatment with alendronate is useful to postmenopausal women with osteoporosis by decreasing bone turnover markers, and by increasing the BMD.
Alendronate* ; Biomarkers ; Bone Density ; Estrogens ; Female ; Humans ; Medroxyprogesterone ; Osteocalcin ; Osteoporosis* ; Osteoporosis, Postmenopausal ; Prospective Studies ; Spine

OBJECTIVE: The aim of this study was to determine firstly the characteristics of esthetic lips in Korean females and secondly to measure the changes of the lips before and after anterior segmental osteotomy in bimaxillary protruded patients. METHODS: Samples consisted of 30 models and 26 nonmodels, and 10 patients who had received anterior segmental osteotomy. Twelve linear measurements, 5 angular measurements, and the lip perimeter and area were measured. These results were compared for each group using unpaired and paired t-tests. RESULTS: Full face width, nose to chin, upper vermilion height and angle, lateral heights at the point of the tips of Cupid's bow, central bow angle, and the lower lip to chin lengths were significantly greater in nonmodels than in models. However, overall lip width, lower vermilion height and angle, tip-to-tip of Cupid's bow lip perimeter, and lower vermilion area were greater in models than in nonmodels. Comparison of before and after anterior segmental osteotomy revealed that the values for the upper vermilion and lateral heights, the angle to Cupid's bow tip lengths, and upper vermilion area of post-operative patients had become similar to those of Korean female models. Our findings demonstrated that Korean female models have a fuller lower vermilion & thinner upper vermilion compared with nonmodel controls, as determined by the vermilion heights, angles, and areas. CONCLUSIONS: It will be helpful for clinicians to use these measurements as guidelines for improving patients' facial esthetics.
Chin ; Esthetics ; Female* ; Humans ; Lip* ; Nose ; Osteotomy*