Between July 1982 and July 1985, we treated thirty-one fractures of the tibial shaft by intramedullar ary Ender's nailing at the Department of orthopedic Surgery of Pusan Paik Hospital. Reductions of the fractures were achieved by closed method in 25 cases and open method in 6 cases. The results were as follows. 1. The average age was 34. 5 years and the most common cause of injury was traffic accident(67.7%) 2. Nineteen cases (61%) were closed fracture and 12 cases (39%) open. Seventeen cases (55%) were simple fracture and 14 cases (45%) comminuted. The most common level of the fracture was middle third of the tibial shaft. 3. Twenty cases (64.5%) had associated injuries and average interval from injury to operation was 11. 8 days. 4. The average healing time was 16.7 weeks and the time prolonged in comminuted fractures than in simple fractures. 5. Complications were one case of valgus deformity (11°), one case of delayed union with pseudoane urysm of anterior tibial artery on fracture site and one case of infected nonunion in Grade III open comminuted fracture. 6. Ender nails are relative ease of nailing, allow early weight bearing and decrease complication. Ender nailing is considered to be a good method in treating tibial shaft fracture especially for management of multiple injured patient and when other procedures have failed.
Busan ; Congenital Abnormalities ; Fractures, Closed ; Fractures, Comminuted ; Humans ; Methods ; Orthopedics ; Tibia ; Tibial Arteries ; Weight-Bearing

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

STUDY DESIGN: The authors reviewed the dural tears in the thoracolumbar fractures treated surgically. OBJECTIVES: To evaluate the incidence and the predictive values for the presence of dural tears in the thoracolumbar fractures. SUMMARY OF LITERATURE REVIEW: Many authors reported that the dural tear was usually related to the thoracolumbar fractures especially with laminar fracture and neurologic deficit. The dural tears may lead complications such as the entrapment of spinal nerve root, delayed wound healing, cerebrospinal fluid fistula, and myelomeningocele. Previous reports emphasized posterior approach to confirm and treat the dural tears using laminectomy. So it is very important that surgeons should identify the presence of dural tear preoperatiyely to determine the surgical approach and treatment options. MATERIALS AND METHODS: The authors reviewed 22 patients of thoracolumbar fractures treated with posterior laminectomy, posterior decompression, posterolateral fusion, and instntmentation from August 1993 to August 1996. The follow-up period was minimally 12 months. We checked the canal compromise, the injury of the posterior column including laminar fracture and ligamental injury, and neurologic deficits as the predictive values. The statistical analysis was done to evaluate the relationship between the dural tear and the predictive values. RESULTS: The incidence of dural tear was 54.4% of the thoracolumbar fractures. The canal encroachment, the injury of the posterior column, and the neurologic deficits were not significantly related with the dural tears in statistical analysis. But we could find the tendency that is related to the dural tear and posterior column injury. CONCLUSION: The authors concluded that we could find the possible presence of dural tears in the severe thoracoiumbar which were needed the surgical treatment and we could suggest the injury of posterior column was a possible value that could predict the presence of dural tear.
Cerebrospinal Fluid ; Decompression ; Fistula ; Follow-Up Studies ; Humans ; Incidence ; Laminectomy ; Ligaments ; Meningomyelocele ; Neurologic Manifestations ; Spinal Nerve Roots ; Tears* ; Wound Healing

PURPOSE: Bipolar hemiarthroplasty of the hip has been used as a treatment modality for displaced femoral neck and intertrochanteric fractures in elderly patients, inflammatory and degenerative diseases of the hip, osteonecrosis of femoral head and limb salvage procedure after tumor resection. Because of the intrinsic stability of the biarticular structure, it is also used for treatment of recurrent dislocation after total hip replacement arthroplasty. However, despite its intrinsic stability, dislocation does occur even after bipolar hemiarthroplasty, and poor prognosis after the dislocation has been reported. So, we tried to investigate the incidence, risk factors, treatment and preventive methods of dislocation after bipolar hemiarthroplasty. MATERIALS AND METHODS: We reviewed 138 patients and 138 bipolar hemiarthroplasties retrospectively to analyze the incidence, timing, risk factors, treatment and preventive methods of the dislocation. RESULTS: The incidence of dislocation was 5.8% (8/138). Female gender, intertrochanteric fracture, pre-existing neuromuscular disorders including cerebrovascular accident, long period of pre-operative and postoperative immobilization were statistically significant (P<0.05) as a risk factor. Related muscular weakness was the most significant predisposing factor for dislocation. CONCLUSIONS: In order to prevent dislocation after bipolar hemiarthroplasty performed in the patients with above risk factors, we must try and encourage early operation, early ambulation, muscle strengthening exercise and application of abduction hip brace.
Aged ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Braces ; Causality ; Dislocations* ; Early Ambulation ; Female ; Femur Neck ; Head ; Hemiarthroplasty* ; Hip Fractures ; Hip* ; Humans ; Immobilization ; Incidence ; Limb Salvage ; Muscle Weakness ; Osteonecrosis ; Prognosis ; Retrospective Studies ; Risk Factors ; Stroke

In order to inquire the most-effective management of increased intracranial pressure(ICP), mannitol, steroid and hyperventilation were used in rabbits after ligation or non-ligation of the carotid artery. Mannitol was more effective than steroid and hyperventilation in the degree of the reduction of ICP. The intracranial pressure was decreased 43~45% for 25~30 minutes after injection of mannitol. Steroid was less effective than mannitol in the degree of the reduction of ICP. But the time of reduction of ICP was longer, that is, the degree of reduction was 24~60 minutes after injection of steroid. Hyperventilation is effective in the initial time only, for 10 minutes after hyperventilation. The degree of ICP reduction was 13.5~16.7 % for 10 minutes after hyperventilation. The combined group, that is three kinds of mangenent were used, is the most effective treatment to reduce ICP of ICP. The degree of the reduction of ICP was 42.1~49.3% for 20 minutes, 47.7~52.5% for 30minnutes. There was no significant difference between and non-ligation group.
Carotid Arteries ; Carotid Artery, Internal* ; Hyperventilation ; Intracranial Pressure* ; Ligation ; Mannitol ; Rabbits*

A 61-year old female presented with intermittent abdominal pain. Further examination showed an pelvic mass, partially obstructing the sigmoid colon. A search of the past medical records revealed that a primary low-grade ESS of the uterus had been treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy 10 years earlier. Surgical resection was performed under suspicion of recurrent ESS and subsequent pathologic examination of the tumor mass specimen established the recurrent LGSS and free resection margin. Then she has been treated with megestrol acetate and doing well for about 1 year since the surgical resection of the pelvic mass.
Abdominal Pain ; Colon, Sigmoid ; Female ; Humans ; Hysterectomy ; Medical Records ; Megestrol Acetate ; Middle Aged ; Recurrence* ; Sarcoma, Endometrial Stromal* ; Uterus

The cello-tape anal swab specimens from 936 primary school children in Seoul, 308 primary school children in a rural area and 92 children in Nanjido, were examined for Enterobius vermicularis eggs. Out of 936 specimens from a primary school in Seoul, E. vermicularis eggs were detected in 114 specimens, the egg detection rate being 12.2 percent. In 308 specimens from a primary school in a rural area, 77 (25.0 percent) were positive for E. vermicularis eggs. Among 92 specimens from Nanjido children in Seoul, egg positive rate of E. vermicularis was 28.3 percent. The egg detection rate of primary school children in Seoul was significantly lower than that of primary school children in a rural area and of Nanjido children. The egg detection rate in boys was lower than that of girls. As the age of children increased, the egg detection rate decreased.
parasitolgy-helminth-nematoda ; Enterobius vermicularis ; egg ; epidemiology

OBJECTIVE: This study is aimed to see ultrastructural changes of pineal gland in rats exposed to microwaves. METHODS: We conducted an experiment by exposing rats at the electromagnetic wave frequency of 2.45GHz, using with an EMR(electromagnetic radiation) emitting apparatus to study the effect of electromagnetic wave on the pineal gland. Paying especial attention to measure damages to pineal gland cells in the brain, we set the levels of EMR according to the duration of electromagnetic wave exposure at 1.2 joules(20min exposure), 2.4 joules(40min exposure), 3.6 joules(60 min exposure), and 4.8 joules(80min exposure) per 1cm2. RESULTS: Compared with normal cells, main histologic changes were observed with an electron microscope included swelling of the pineal gland cells, a decrease in the electron density of interstitial tissue, an increase in the distances between pineal gland cells, an increase in number of lipid-droplets, and swelling of mitochondria. Especially in those pineal cells exposed to EMR for 80 min, severe swelling of mitochondria and a slight increase in lysosome were observed. CONCLUSION: The authors could identify the harmful effect of microwave by observing abnormal ultrastructural changes of pineal cell in rat according to the increasement of electromagnetic radiation.
Animals ; Brain ; Electromagnetic Radiation ; Lysosomes ; Microwaves* ; Mitochondria ; Pineal Gland* ; Rats*

PURPOSE: The purpose of this study was to assess the clinical and radiographic results of total hip arthroplasty with using the double tapered Mallory-Head system. MATERIALS AND METHODS: The clinical and radiographic results of a consecutive series of 81 total hip replacements in 75 patients were reviewed at eight to twelve years (average: 9.8 years) postoperatively. The underlying diseases were avascular necrosis in 46 hips (57%), osteoarthritis in 12 hips (15%), RA in 9 hips (11%) and others. The clinical result was evaluated on the basis of the modified Harris hip score and the modified Merle d'Aubigne-Postel score. A radiographic analysis was also performed. RESULTS: The average modified Harris hip score was improved from preoperative 56 points to postoperative 92 points. The average modified Merle d'Aubigne-Postel score was 15 points at the latest follow up, and 55 hips (68%) were classified as having clinical grades of excellent or good results. One acetabular component was revised because of loosening, and one was revised because of recurrent dislocation. CONCLUSION: The clinical and radiological evaluations of the total hip replacements using the Mallory-Head system showed good results.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Dislocations ; Follow-Up Studies ; Hip ; Humans ; Necrosis ; Osteoarthritis

BACKGROUND: Auditory evoked potentials (AEPs) have assumed an essential role in the clinical practice of auditory and several other professions. AEP classification and nomenclature systems are generally based on such aspects as the time domain (short, middle, long), anatomic origin, stimulus-response relationship. The P300 component of the human event related potential is an endogenous positive wave with a latency of 300msec or greater. OBJECTIVES: Our purpose of this study was to estimate normal values of auditory late response (ALR) and P300 in adults and use them in mapping of the brain. MATERIALS AND MEHTODS: An auditory evoked potential was performed on 40 normal adults, and a scalp surface electrode with 30 electrodes was attempted. Forty adults with normal hearing were divided into 2 groups, one consisting of thirty persons under 30 years of age and the other consisting of ten persons over 30 years of age. RESULTS: The latencies of P1, N1, P2, N1-P2 were 53.17 +/- 19.57 msec, 98.25 +/- 32.68 msec, 166.12 +/- 44.0 msec, 65.12 +/- 23.68 msec, respectively, in the whole group and 54.23 +/- 20.86 msec, 98.7 +/- 34.35 msec, 160.93 +/- 44.02 msec 62.23 +/- 25.36 msec, respectively, in the group under 30 years old, and 50.0 +/- 15.57 msec, 96.9 +/- 28.69 msec, 181.7 +/- 42.28 msec 73.8 +/- 15.69 msec, respectively, in the group over 30 years old. The P300 latencies for the whole group and the two groups were 299.37 +/- 34.01 msec, 295.16 +/- 33.36 msec, 312.0 +/- 34.49 msec, respectively. There was no significant difference in the latency and amplitude of the ALR and P300 between the two groups (p>0.05). CONCLUSION: ALR and P300 were measured in 40 normal adults. Description of the normal topography of P300 may facilitate the examination of the P300 topography in cognitive disorders. Such an examination might help ALR and P300 to serve as better diagnostic tools of cognitive disorder in adults.
Adult* ; Brain ; Brain Mapping ; Classification ; Electrodes ; Event-Related Potentials, P300 ; Evoked Potentials ; Evoked Potentials, Auditory ; Hearing ; Humans ; Reference Values ; Scalp