Many factors exert an influence on enzyme activity and thus on the rate of reactions that they catalyse. The most important of these factors are pH, temperature, substrate concentration, and the concentration of some inhibitors present. A solution of the enzyme diastase, which breaks down molecules of the polysaccharide starch to the disaccharide maltose by hydrolysis, was provided. Activity of these enzyme was measured by the rate at which starch was removed from the reaction mixture. These experiments were designed to study this reaction rate under varying conditions and the following results were obtained. 1. The range of optimum pH for this enzyme at room temperature was 4.0-7.0 and the optimum pH was 5.0. 2. The range of optimum temperatures for this enzyme at pH 7.0 was 30-50 degrees C and the optimum temperature was 40 degrees C. 3. The relationship between the enzyme activity and substrate concentration could be expressed by the Michaelis-Menten equation. The limiting velocity of these enzyme at room temperature and pH 7.0 was 415 microgram starch removed/ml of reaction mixture/min and Km, Michaelis constant, was 343 microgram/ml. 4. Inhibitors NaCl and HgCl2 blocked this enzyme activity completely at 1% and 0.01% respectively.
Amylases* ; Hydrogen-Ion Concentration ; Hydrolysis ; Maltose ; Mercuric Chloride ; Starch ; Water*

Fixation failure is a major complication of intertrochanteric fracture. The causes of fixation failure were assessed in a series of 80 patients with intertrochanteric fractures, which had been internally fixed with either a sliding hip screw or a Gamma interlocking nail. The overall rate of fixation failure was 16.3%, in which the cutting-out of the implant from the femoral head was the only cause of the instance. The cutting-out rate was influenced by the accuracy of fracture reduction, the position of implant placement within the femoral head, and the bone mineral density. Anatomical reduction and the central placement of implant within the femoral head showed the most excellent results compared to other treatment modalities. Age, gender, fracture type and a kind of fixation implant had no significant effect. Our results showed that the intertrochanteric fractures should be reduced as anatomically as possible and it is essential that the central placement of the implant within the femoral head be obtained.
Bone Density ; Head ; Hip ; Hip Fractures* ; Humans

Colon has the highest bacterial concentration in the gastrointestinal tract. When the colon is perforated, the operator has to decide whether to perform primary closure, resection with anastomosis, proximal colostomy, and exteriorizatoion. In this retrospective study, from October, 1993, through July 1998, 56 patient with panperitonitis due to colon perforation were operated at Ewha womans University medical center. The rectal perforation was limited the intraperitoneal portion. Our cases were divided into two groups. Group I included 34 patients who treated with one step operations of primaryrepair or resection anastomosis. Group II included 22 patients who treated with two step operations of proximal colostomy or exteriorization. The one step operations were performed in 34 patients, proximal colostomy in 21 patients, and exteriorization in 1 patient. There was 13.7% in the incidence of motality and 33.3% in the incidence of morbidity. The Chi-square test was used to evaluate the significance of differences between two groups. Independent risk factors for adverse outcomes were compared and used to analyse the probability for adverse outcomes with respect to the mode of treatmen. The mode of treatment was not dependent on the risk factors. These results suggest that one could select positively primary closure or resection with anastomosis for the treatment of patients with panperitonitis due to colon perforation.
Academic Medical Centers ; Colon* ; Colostomy ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Retrospective Studies ; Risk Factors

No abstract available.
Autografts* ; Heterografts* ; Transplants*

No abstract available.
Ganglion Cysts* ; Knee Joint* ; Knee*

Hereditary sensory motor neuropathy type V (HAMN V) is very rare disease entity. The authors experienced a patient who had the findings of peroneal muscular atrophy and pyramidal tract feature. A 20 year-old man was admitted to our hospital due to gait disturbance. Scissoring gait and peroneal muscular atrophy were observed. The findings of electrophysiologic studies were compatible with axonal type peripheral neuropathy. The results of other evaluations were compatible with HAMN V. To our knowledge, it is the first report in Korea.
Axons ; Charcot-Marie-Tooth Disease ; Gait ; Humans ; Korea ; Peripheral Nervous System Diseases ; Pyramidal Tracts ; Rare Diseases

Thirty-seven discoid lateral menisci of thirty-six patients were treated by arthroscopic means between January, 1987 and June, 1989. A discoid lateral meniscus was present in 15.3% of all patients who have underwent arthroscopy of the knee in this period. It was present in 25.7% of all meniscal lesions and in 39.4% of all lateral meniscal lesions. The average age was 22.7 years and the average length of follow up was thirteen months. Clinically, click sound was the most frequent symptom comprising 86% except knee pain, which was present in all. On physical examination, joint tenderness was present most frequently in 75%. On arthroscopic findings, twenty-eight discoid menisci had the tear and one had severe degenerative change. A tear was most frequently found in posterior horn and the most frequent pattern of tear was longitudinal including bucket-handle and peripheral type. Partial meniscectomy was performed on twenty-nine knees and subtotal meniscectomy on eight knees. At follow up, twenty-nine knees (78.4%) were rated excellent or good and eight knees (21.6%) were rated as fair. There were no poor results. We suggest that arthroscopic partial resection with preservation of normal meniscal shape as much as possible is more excellent than total meniscectomy for the symptomatic discoid meniscus.
Animals ; Arthroscopy ; Follow-Up Studies ; Horns ; Humans ; Joints ; Knee ; Menisci, Tibial ; Physical Examination ; Tears

Since Ender introduced the concepts of multiple flexible intramedullary nailing in 1970, Ender nailing has been mostly used in intertrochanteric fractures of the elderly patients, but it has been rarely used in younger patients because of serious complications such as shortening and external rotation deformity. Authors already contended that the incidence of such complications had intimate connection with the quality of bone, and accordingly with the age. To substantiate the contention, we analyzed thirty-four cases with more than one year follow-up among forty cases of intertrochanteric fractures treated with Ender nails during the period from 1982 to 1989. And the results are summarized as follows;1. The average age was 39 yrs., and the most common cause of fractures was fall from a height. 2. According to the Kyle et al. clsssification, stable fractures(type I & II ) were 13 cases(38%), and unstable fractures (type III & IV) were 21 cases(62%). 3. According to the Singh's index, the good in bone quality(Grade 4, 5, & 6) were 31 cases(91 %), and the poor(Grade 1, 2, & 3) were only 3 cases(9%). 4. Postoperative complications occurred in 6 cases(17%), which included ROM limitation of knee joint in three cases(9%), proximal migrations of nails in two(5%), and distal migrations of nails in one(3%). Among them, 4 cases required revisional operations. There was no case with apparent external rotation deformity over 20 and shortening over 2cm. 5. It is thought that, contradictory to common beliefs, Ender nailingis a safe method for intertrochanteric fractures of femur in younger patients with good bone quality, but requires some experiences and cautions to prevent such complications as external rotation deformity and shorterning.
Aged ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Incidence ; Knee Joint ; Methods ; Postoperative Complications

STUDY DESIGN: This is a retrospective study analyzing the clinical results of various surgical methods for the treatment of delayed posttraumatic kyphosis. OBJECTIVES: The purposes of this study are to define the risk factors of delayed postraumatic kyphosis and to establish a rational therapeutic guideline for the treatment of established kyphosis. METHODS: Sixteen cases of surgically treated delayed posttraumatic kyphosis were analyzed. Their initial injuries were burst type in 10, flexion-distraction in 5 and uncertain in l. Initial treatments were conservative in 10 and surgical in 6. Treatments for established kyphosis were posterior fusion in 2, anterior fusion in 5, combined anterior-posterior fusion in 9. Anterior decompression was carried out in 5 treated with anterior fusion and in 4 treated with combined anterior-posterior fusion. RESULTS: Mean follow-up was 2.7 years. The mean preoperative kyphosis of 28.6。 was reduced to 18.5。 (35.3% correction) with most pronounced correction in the group with combined anterior and posterior stabilization(44.8% correction). Early loss of correction averaged 2.7。 (18.5%) with least loss in the combined anterior-posterior group. Neurological improvement was related to the duration of the symptoms(P < 0.05). Back pain was improved in all patients. CONCLUSIONS: Thoracolumbar fractures with initial three column injuries or those rendered unstable by laminectomy are highly susceptible to development of delayed posttraumatic kyphosis; Combined anterior and posterior fusion offered the most satisfactory result in correction and stabilization of the deformity; Neurologic improvement was more pronounced with shorter duration of the symptoms.
Back Pain ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Laminectomy ; Retrospective Studies ; Risk Factors

In order to investigate the validity of the Steel's gluteus medius and minimus advancement, we reviewed 21 hips in 14 spastic cerebral palsy patients, who had advancement of the gluteus medius and minimus insertion for the correction of in-toeing gait between November 1985 and February 1992. The procedure was limited to those patients who had moderate to severe in-toeing gait with positive Steel's stretch reflex. There were eight boys and six girls. The average age at the time of surgery was 6.7 years(2.9 years-11.9 years). The procedure was performed on both hips in seven patients. Of the 14 patients, nine had diplegia, three hemiplegia, and two paraplegia. The average follow-up time was 4.3 years(1 year-8.5 years). In-toeing gait was converted to neutral or physiologic out-toeing gait in 17 hips(81%), excessive out-toeing in 2 cases(9.5%), and mild residual in-toeing in 2 cases(9.5%), Steel's stretch reflex, which was present in all cases preoperatively, disappered in 19 hips(90.5%) postoperatively, Abductor power, however, decreased from 4+ to 4− in average postoperatively, Among the 16 hips, which had no Trendelenburg sign or gait preoperatively, 8 hips(50%) showed positive Trendelenburg sign and gait postoperatively. In conclusion, Steel's gluteus medius and minimus advancement appears to be effective in the correction of in-toeing gait, but there is high risk of weakening the abductor power.
Cerebral Palsy ; Female ; Follow-Up Studies ; Gait ; Hemiplegia ; Hip ; Humans ; Muscle Spasticity ; Paraplegia ; Reflex, Stretch