For the nonunion of humeral shaft, there have been many methods of treatment. We are aimed to analyse the causes of nonunion of humeral shaft fracture and present the direction of treatment. We reviewed total 21 cases which were diagnosed as delayed or nonunion of humeral shaft and analysed the causes. l. Initial method of treatment was surgical in 19 out of 21 cases. Among these 19 cases, 14 cases were operated with internal fixation with plate and screw. 2. The most common cause of nonunion was inadequate internal fixation in 26 cases(81%) in which were unstable fixation in 13 cases, choice of inadequate internal fixator in 11 cases, and failure of operative technique in 2 cases. Other causes were distraction between fracture fragments in 4 cases(13%) and open comminuted fracture in 2 cases. 3. Eighteen cases of established nonunion due to inadequate internal fixation were treated by rigid fixation with longer and broader plate and bone graft, and 1 case interlocking IM nailing, 1 case Ender nailing and 1 case bone graft only. 4. Union was obtained in all cases at least in 5 months. And there were no specific complications. In conclusion, surgeons should contemplate the operative indication and principles in primary treatment. In treatment of nonunion, surgeons should treat by more longer and broder internal fixator and additional bone graft.
Fractures, Comminuted ; Humerus ; Internal Fixators ; Methods ; Surgeons ; Transplants

From 1986 to 1995, 75 eyes of 75 patients who were admitted with a diagnosis of infectious corneal ulcer at Chunbuk university hospital were analyzed on the etiologic agents and clinical findings. Etiologic agents of infectious corneal ulcer were classified as 49 bacterial ulcers(65.3%) and 26 fungal ulcers(34.7%). The most common isolated bacteria was 8 cases of coagulase negative staphylococcus and pseudomonas species was the most common isolated gram negative organism. Candida species was the most commonly isolated fungus. Hypopyon was noted in 30 cases(40%) of infectious corneal ulcers, 14 cases in small ulcer group and 16 cases in large ulcer group. There was no difference between severity and presence of hypopyon of the 75cases (P>0.05. chi-square test).
Bacteria ; Candida ; Coagulase ; Corneal Ulcer* ; Diagnosis ; Fungi ; Humans ; Pseudomonas ; Staphylococcus ; Ulcer

In order to evaluate the efficiency of serological typing of A. baumannii in practical application, a total of 63 strains of A. baumannii and 234 strains of Gram-negative, lactose non-fermenting bacteria were tested with polyclonal rabbit immunized sera (RIS) against heat-killed A. baumannii strains by slide agglutination tests. Six typing sera of RIS were finally obtained after the checkerboard agglutination test and reciprocal cross-absorption. Species identification of sixty-three strains of A. baumannii were confirmed by ribotyping. Forty-seven (74.6%) of the 63 strains of A. baumannii showed strong positive reaction by slide agglutination tests. Thirty-nine strains could be serotypable and thus classified into 6 distinct serovars of A. baumannii, but 8 strains were unable to classify into specific serovar. Serovar 4 was the most frequent arbitrary serovar and included 17 strains among the 39. When slide agglutination tests were performed with 50-fold diluted pooled polyclonal RIS, there was no cross-reactions except one of E. coli strain among 234 strains of various Gram-negative lactose non-fermenting. Although each profile of LPS-gel electrophoresis of A. baumannii appeared to be unrelated with serovar, the patterns of western-blot of LPS after immunostaining with homologous RIS showed serovar-specificity. Several fractions of low molecular weight LPS showed cross-reaction with antisera of other serovars. In conclusion, the sensitivity and specificity of serological identification of A. baumannii strains were 74.6% and 99.6%, respectively. This result suggests that serotyping is a useful method for the identification of A. baumannii strains as well as is the epidemiological tool to trace back the source of the nosocomial outbreaks.
Acinetobacter baumannii* ; Acinetobacter* ; Agglutination Tests ; Bacteria ; Disease Outbreaks ; Electrophoresis ; Immune Sera ; Lactose ; Molecular Weight ; Ribotyping ; Sensitivity and Specificity ; Serotyping

We determined the ultimate anatomic success and visual outcome for rhegmatogenous retinal detachment with spared macula, and compared the preoperative findings and success rate with those involving the macula in the 445 eyes treated with scleral buckling for rhegmatogenous retinal detachment and the causes of decrease in visual acuity after operation were evaluated. Seventy-seven (67%) of the 115 eyes with rhegmatogenous retinal detachment with spared macula and 28 (8%) of the 330 eyes with that involving the macula had preoperative visual acuity of 0.3 or better. In comparision to the findings of the eyes with retinal detachment involving the macula, in the eyes with rhegmatogenous retinal detachment with spared macula the extent of retinal detachment was less, the retinal break was located more anteriorly, the demarcation line was less frequently noted, and the incidences of high myopia and lattice degeneration were higher. Postoperatively all 115 eyes with spared macula were anatomically reattached, 99 eyes (86%) had visual acuity of 0.3 or better and success rates were significantly better in comparison to those involving the macula (p<.05). Seventeen eyes had a significant decrease in visual acuity postoperatively, the causes included macular detachment after failure of the first operation, macular pucker, progression of cataract, etc.
Cataract ; Incidence ; Myopia ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Scleral Buckling ; Visual Acuity

No abstract available.
Child* ; Humans ; Learning Disorders* ; Learning*

PURPOSE: Transforming growth factorbeta (TGFbeta) is an extracellular ligand that binds to a heterodimeric receptor, initiating signals that regulate growth, differentiation, and apoptosis. Many cancers, including pancreatic cancer, harbor defects in TGFbeta signaling and are resistant to TGFbeta-mediated growth inhibition. Recently, it has been reported that enhanced expression of TGFbeta1 is associated with the progression of a pancreatic ductal cell carcinoma (PCA) and chronic pancreatitis (CP). We investigated the difference in the expressions of TGFbeta1 and the TGFbeta receptor II (TbetaRII) in PCA and CP and the clinical significance of TGFbeta1 and TbetaRII in PCA. METHODS: Surgically resected pancreatic specimen were obtained from 26 patients with a PCA and 12 with CP; 5 normal pancreatic tissue specimens were also obtained. The specimens were immunostained for TGFbeta1 and TbetaRII. RESULTS: Immunohistochemical analyses of TGFbeta1 and TbetaRII revealed positive immunostaining in 73.1% and 66.7% of the tumors, respectively. In the ductal epithelial cells of PCA and CP, there were no significant differences in the expressions of TGFbeta1 and TbetaRII. In contrast, their stromal expressions tended to be stronger in PCA than in CP; especially, the expression of TbetaRII was significantly higher in PCA (p=0.008). Also the presence of TGFbeta1 and TbetaRII in the cancer was significantly associated with node metastasis, advanced tumor stage (p<0.01), and short survival time (p<0.05). CONCLUSION: There might be some pathological difference in the stromal reactions of TGFbeta1 or TbetaRII between PCA and CP. The presence of TGFbeta1 or TbetaRII indicates a role in disease progression.
Apoptosis ; Disease Progression ; Epithelial Cells ; Humans ; Neoplasm Metastasis ; Pancreatic Ducts ; Pancreatic Neoplasms* ; Pancreatitis, Chronic* ; Passive Cutaneous Anaphylaxis ; Transforming Growth Factor beta*

The use of intravitreal corticosteroids in the management of endophthalmitis remains controversial. This study was performed to evaluate the effectiveness of dexamethasone(DXM) in Candida endophthalmitis. In rabbits, Candida albicans(3,000 blastospore: Group A, 30,000 blastopore: Group B) was inoculated intrabitreally. At 24, 48, and 72 hours postinoculation, single intravitreal dose of amphotericin B(AMP, 5microgram/0.1ml) with DXM(400microgram/0.1ml) or AMP alone was given. Clinical examination, protein analysis, electrophysiological and histopathologic measures were utilized to rate DXM effectiveness. Dosage of 5microgram AMP resulted in no culture in both Group A and B, On examinations including the electrophysiologic and histopathologic studies, eyes treated with AMP and DXM did not differ from eyes treated with AMP alone in the Group A(p>0.05). On protein analysis for vitreous in the Group B, however, eyes treated with AMP alone at 24 and 48 hours postinoculation(p<0.05). On electrophysiologic study the decrease rate of the amplitude showed the difference between at 24 hours postinoculation and at 48 or 72 hours postinoculation(p<0.05). Histologic preparations showed a mild or moderate cellular infilteration in the vitreous and swelling in the sensory retina, but small abscess in the vitreous observed when treatment was delayed more than 72 hours following inoculation in both Group A and B. DXM in the experimental Candida endophthalmitis had the beneficial effect in eyes with 30,000 blastspore inoculation and in eyes treated with AMP and DXM at 24 hours postinoculation.
Abscess ; Adrenal Cortex Hormones ; Amphotericin B ; Candida* ; Dexamethasone* ; Endophthalmitis* ; Gastrula ; Intravitreal Injections ; Rabbits ; Retina

Animal models for human chronic pain syndromes were developed and widely used for pain research. One of thsese neuropathic pain model by Kim and Chung[1992] has many advantages for operation and pain elicitation. We have examined the c-fos protein, substance P, CGRP immunoreactivity in dorsal root ganglia and dorsal horn in this neuropathic model. About 50 Sprague-Dawley rats were used for this study. L5 and L6 spinal nerve were ligated tightly to produce neuropathic pain model. After 2, 4, 8, 16, 24 hours and 1 week of surgery, rats were anesthesized and sacrificed by perfusion through the left ventricle with saline followed by 0.1M phosphate buffer[pH 7.4] containing 3% paraformaldehyde, 3% glutaraldehyde, and 0.1% picric acid. After confirmation of the roots transected by the surgery, the L5 and L6 dorsal root ganglion and spinal cord were removed and processed for immunohistochemistry. All tissue sections were immunohistochemically stained for substance P, CGRP and c-fos by using the peroxidase-antiperoxidase[PAP] method. Count the number of immunostained substance P and CGRP dorsal root ganglion cells and c-fos immunoreactive dorsal horn cells and analyzed statistically with Mann-Whitney U test. The results are as follows. 1. The number of c-fos protein immunoreactive neurons in the superficial layer of dorsal horn were increased markedly at 2 hours after operation, gradually decreased to normal level 1 week after operation. 2. The number of c-fos protein immunoreactive neurons in the deep layer of dorsal horn were gradually increased to the peak 24 hours after operation, decreased to normal level 1 week after operation. 3. The number of substance P and CGRP immunoreactive L5 and L6 dorsal root ganglion neurons were decreased markedly at 1 week after pain model operation. In conclusion, after neuropathic pain model operation, c-fos protein were immediately expressed in the superficial layer of spinal dorsal horn, thereafter c-fos protein in the deep layer of spinal dorsal horn were expressed. CGRP and substance P immunoreactive neurons were decreased markedly 1 week after neuropathic pain model operation.
Animals ; Chronic Pain ; Ganglia, Spinal* ; Glutaral ; Heart Ventricles ; Horns* ; Humans ; Immunohistochemistry ; Models, Animal ; Neuralgia ; Neurons* ; Perfusion ; Peripheral Nervous System Diseases* ; Posterior Horn Cells ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord ; Spinal Nerve Roots* ; Spinal Nerves ; Substance P

No abstract available.
Child* ; Hip* ; Humans ; Osteoma, Osteoid*

PURPOSE: The aim of this study was to determine the role of renal ultrasonography in neonates with isolated preauricular tags. METHODS: We performed a retrospective study of 10,997 newborn infants delivered from January 1995 to June 2003 in Wonkwang University Hospital. Nineteen newborns born with isolated preauricular tags were assessed for renal anomalies by performing renal ultrasonography within one week after birth. The study group was compared with a control group of 25 healthy neonates without preauricular tags during the same period, also using renal ultrasonography. RESULTS: Preauricular tags were detected in 19 of 10,997(0.17%) neonates; 57.9% were found on the right side. Renal anomalies in neonates with isolated preauricular tags were detected in four infants (21.1%); this incidence was higher, but was not significant, compared with the control group. Types of anomalies were mild hydronephrosis of grade 1(3 cases) and 2(1 case) which were normalized within one year. CONCLUSION: Routine renal ultrasonography is not recommended for newborn infant with isolated preauricular tags.
Humans ; Hydronephrosis ; Incidence ; Infant ; Infant, Newborn* ; Parturition ; Retrospective Studies ; Ultrasonography