Seventy consecutive ipsilateral fracture of the femur and tibia in sixty-eight patients from December 1974 through December 1984 treated at Severance Hospital were analysed in clinical and radiological aspect. 1. Fifty-nine patients were male and nine patients were female. The male patients were more injured in the ratio of 6: 1. The avarage age was 34. 2. The main cause of injuries were traffic accidents; 59 patients. (86.8%). 3. The majority of the fractures were shaft fracture; for example, femur shaft 57% and tibia shaft 47%, The open fracture of the tibia was 34% and the femur was 17%. 4. There were 24 cases of concomitant fracture and dislocation of other sites. A fat embolism was disgnosed in 4% of the patients. Four patients had died one month after sustaining injuries. 5. Over-all, a good or excellent functional result was achieved in 76% of the patients treated with internal fixation of both fracture, 65% of the patients with intexnal fixation for the femur fracture only and 35% of the patients managed conservatively.
Accidents, Traffic ; Dislocations ; Embolism, Fat ; Female ; Femur ; Fractures, Open ; Humans ; Male ; Tibia

The superficial sural artery flap is supplied by the superficial sural artery that accompanies the sural nerve. The superficial sural artery connects distally with a peroneal artery septocutaneous perforator via a suprafascial network of vessels that permits the flap to be raised on its distal pedicle. We treated 10 patients who showed soft tissue defect of the lower third of the leg, around the ankle and the hindfoot with this flap. The causes of the soft tissue defect were trauma in 6 cases, pressure sore in 2 cases, squamous cell carcinoma in 1 case and osteomyelitis in 1 case. The sites of the soft tissue defect were the lower third of the leg in 5 cases, around the ankle in 2 cases and the hindfoot in 3 cases. The size of the soft tissue defect was from 5x6 cm to 8xl2 cm. All 10 flaps survived. Two flaps showed slight venous congestion which cleared in a few days. The time for flap dissection was 15 minutes in average. The results of our cases show that the distally based superficial sural artery flap is useful for the soft tissue coverage of the lower third of the leg, around the ankle and the hindfoot. The advantages of the flap are that the blood supply is reliable, elevation is easy and quick, the major arteries are not sacrificed and the donor site morbidity is negligible.
Ankle ; Arteries* ; Carcinoma, Squamous Cell ; Humans ; Hyperemia ; Leg ; Lower Extremity ; Osteomyelitis ; Pressure Ulcer ; Sural Nerve ; Tissue Donors

The aims of this experiment were to investigate the strain and temperature changes simultaneously within autopolymerizing acrylic resin specimens. A computerized data acquisition system with an electrical resistance strain gauge and a thermocouple was used over time periods up to 180 minutes. The overall strain kinetics, the effects of stress relaxation and additional heat supply during the polymerization were evaluated. Stone mold replicas with an inner butt-joint rectangular cavity (40.0x25.0mm, 5.0mm in depth) were duplicated from a brass master mold. A strain gauge (AE-11-S50N-120-EC, CAS Inc., Korea) and a thermocouple were installed within the cavity, which had been connected to a personal computer and a precision signal conditioning amplifier (DA 1600 Dynamic Strain Amplifier, CAS Inc., Korea) so that real-time recordings of both polymerization-induced strain and temperature changes were performed. After each of fresh resin mixture was poured into the mold replica, data recording was done up to 180 minutes with three-second interval. Each of two poly (methyl methacrylate) products (Duralay, Vertex) and a vinyl ethyl methacrylate product (Snap) was examined repeatedly ten times. Additionally, removal procedures were done after 15, 30 and 60 minutes from the start of mixing to evaluate the effect of stress relaxation after deflasking. Six specimens for each of nine conditions were examined. After removal from the mold, the specimen continued benchcuring up to 180 minutes. Using a waterbath (Hanau Junior Curing Unit, Model No.76-0, Teledyne Hanau, New York, U.S.A.) with its temperature control maintained at 50degrees C, heat-soaking procedures with two different durations (15 and 45 minutes) were done to evaluate the effect of additional heat supply on the strain and temperature changes within the specimen during the polymerization. Five specimens for each of six conditions were examined. Within the parameters of this study the following results were drawn : 1. The mean shrinkage strains reached -3095mu epsilon, -1796mu epsilon and -2959mu epsilon for Duralay, Snap and Vertex, respectively. The mean maximum temperature rise reached 56.7degrees C, 41.3degrees C and 56.1degrees C for Duralay, Snap, and Vertex, respectively. A vinyl ethyl methacrylate product (Snap) showed significantly less polymerization shrinkage strain (p<0.01) and significantly lower maximum temperature rise (p<0.01) than the other two poly (methyl methacrylate) products (Duralay, Vertex). 2. Mean maximum shrinkage rate for each resin was calculated to ?31.8mu epsilon/sec, -15.9mu epsilon/sec and ?31.8mu epsilon/sec for Duralay, Snap and Vertex, respectively. Snap showed significantly lower maximum shrinkage rate than Duralay and Vertex (p<0.01). 3. from the second experiment, some expansion was observed immediately after removal of specimen from the mold, and the amount of expansion increased as the removal time was delayed. For each removal time, Snap showed significantly less strain changes than the other two poly (methyl methacrylate) products (p<0.05). 4. During the external heat supply for the resins, higher maximum temperature rises were found. Meanwhile, the maximum shrinkage rates were not different from those of room temperature polymerizations. 5. From the third experiment, the external heat supply for the resins during polymerization could temporarily decrease or even reverse shrinkage strains of each material. But, shrinkage re-occurred in the linear nature after completion of heat supply. 6. Linear thermal expansion coefficients obtained from the end of heat supply continuing for an additional 5 minutes, showed that Snap exhibited significantly lower values than the other two poly (methyl methacrylate) products (p<0.01). Moreover, little difference was found between the mean linear thermal expansion coefficients obtained from two different heating durations (p>0.05).
Acrylic Resins* ; Electric Impedance ; Fungi ; Heating ; Hot Temperature ; Kinetics ; Microcomputers ; Polymerization* ; Polymers* ; Relaxation

Irritant or allergic contact dermatitis presents usually eczematous process or occasionally noneczematous lesions like in this case. We report a case of erythema rnultiforme-like eruptions in a 40-year-old female who presented multiple iris or annular shaped maculopapular eruptions on both hands and forearms after contact of lacquer tree. Being performed with standard patch test screening series, lacquer tree extracts and urushiol, she showed significant reactions to the lacquer tree and urushiol. Histopathologic findings showed both features of erythema multiforme and suh acute contact dermatitis.
Adult ; Dermatitis, Allergic Contact ; Dermatitis, Contact ; Erythema Multiforme* ; Erythema* ; Female ; Forearm ; Hand ; Humans ; Iris ; Lacquer* ; Mass Screening ; Patch Tests ; Trees*

The ankle joint plays important biomechanical role in erect position or ambulation. The ankle injury includes bony structures with articular surface, ligaments and soft tissue injury. So the goal of treatment is anatomical reduction of ankle mortise. Fifty two patients of ankle fractures which were admitted and treated in Seoul Adventist Hospital from January, 1980 to December, 1984, were analysed in the clinical and radiological aspect. The results obtained from this study were as follows; l. Of the 52 cases, male was 39 cases(75.0%) and female was 13 cases(25.0%). The average age of the patients was 33 years with range from 18 years to 75 years. 2. The most common cause of injury was traffic accidident. Nexts were fall down, sports injury, slip down and industrial injury in orders. 3. The most common type of the ankle fractures, according to the classification of Lauge-Hansen, was supination-external rotation type(40.4%). 4. 36 cases(69.2%) were treated with open reduction and internal fixation and 16 cases(30.8%) were treated with closed reduction. Poor outcome seemed closely related to the severity of the injury and degree of fracture displacement. 5. Accurate reduction and rigid internal fixation of the lateral malleolus without shortening was important factor. Classification of Lauge-Hansen was useful in the diagnosis and treatment of the ankle fractures.
Ankle Fractures ; Ankle Injuries ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Female ; Humans ; Ligaments ; Male ; Seoul ; Soft Tissue Injuries ; Walking

We report a 44-year-old female patient with Eosinophilic cellulitis who had developed pruritic erythematous plaque on the right lower abdomen since two months ago. The blood eosinophil count was 2,066/mm at first visit. This lesion responded well to cortieosteroid therapy. However new erythematous swelling reappeared on the left lower abdomen and left inner thigh 3 months after the first treatment. A biopsy specimen taken from an erythematous plaque showed many flame figures and diffuse infiltration of eosinophils and histiocytes in the lower dermis and subcutaneous fat tissue.
Abdomen ; Adult ; Biopsy ; Cellulitis* ; Dermis ; Eosinophils* ; Female ; Histiocytes ; Humans ; Subcutaneous Fat ; Thigh

No abstract available.

A 72-year-old woman with a pea sized, bluish, firm nodule was diagnosed as having a cellular type of dermatofibroma histopathologically. A biopsy specimen revealed a relatively well circumscribed, non-encapsulated, nodular infiltration of irregularly distributed histiocytes in the deep dermis. Foam cells were also noted. Gomoris iron stain revealed large amounts of hemosiderin deposits and some collagen were present as individual fibers in the lesion with Masson's trichrome stain.
Aged ; Biopsy ; Collagen ; Dermis ; Female ; Foam Cells ; Hemosiderin ; Histiocytes ; Histiocytoma, Benign Fibrous* ; Humans ; Iron ; Peas

No abstract available.
Mortality*

PURPOSE: The aim of this study was to compare conventional scissors and Harmonic Scalpel(R) hemorrhoidectomy. METHODS: Two hundred and five patients were prospectively assigned to two groups in the consecutive order. The group was divided into Group A (Harmonic Scalpel(R) excision; n=101) and Group B (conventional scissor excision; n=104). All other aspects of surgery and anesthesia were standardized. Intramuscular opiate was available on demand during the postoperative period, and analgesic requirements were also recorded. All patients noted their pain on a daily basis using a visual analogue scale (0=no pain; 10=worst pain). The length of hospitalization, operative time and postoperative complications were also analyzed. RESULTS: The operative time was 16.6 +/- 0.9 minutes 25.3 +/- 0.8 minutes in Group A and B, respectively (p<0.01). Length of hospital stay was 4.1 +/- 0.1 and 4.5 +/- 0.1 days (p<0.05). Pain scores in the group A were significantly lower than in the group B (p<0.01). Analgesic requirements were also significantly less in group A (p<0.05). Postoperative complications, such as urinary retention, fecal impaction and skin tags were rarer in group A. One patient in group A and two patients in group B developed secondary hemorrhage, but no patient had anal stricture. CONCLUSIONS: The Harmonic Scalpel(R) excision significantly shortens the operative time for hemorrhoidectomy with less blood loss and postoperative pain without remarkable early or late postoperative complications.
Anesthesia ; Constriction, Pathologic ; Fecal Impaction ; Hemorrhage ; Hemorrhoidectomy* ; Hospitalization ; Humans ; Length of Stay ; Operative Time ; Pain, Postoperative ; Postoperative Complications ; Postoperative Period ; Prospective Studies ; Skin ; Urinary Retention