Eighty long bone open fractures were treated with immediate internal fixation within an average of 7.4 hours after trauma from June, 1984 to September, 1989. Mean follow-up was 17 months ranging from 1 year to 3 years and 4 months. Fifty-four tibia, 11 femur, 9 forearm, and 6 humerus open fractures were encountered. According to Gustilo and Anderson's wound classification, there were 19 Type I, 26 Type II, and 35 Type III open fractures. Internal fixation was facilitated with plate and screws in 58 cases, Ender nails in 13 cases, Kuntscher nails in 3 cases, and screws only in 5cases. Bone grafting was performed in 47 cases. Uncomplicated union was achieved in 16cases (84 %) in type I, 23 cases (88%) in Type II, and 18 cases (51%) in Type III. Transient soft tissue infection was noted in 3 cases(16%) in Type I, 3 cases(8%) in Type II, and 5 cases(14%) in Type III. Transient osteomyelitis was present in 1 caes(4%) in Type II, and 4 cases(11%) in Type III, and all were resolved within 1 month. Three cases of Type III open fractures where mutilated injury was associated with severe vascular injuries were ended up with amputation. Five unions (14%) in Type III were complicated with chronic osteomyelitis. Overall uncomplicated union was achieved in 38 cases (87%) in Type I & II, and 18 cases (51%) in Type III. Soft tissue coverage especially with viable muscle and stable fixation with good cortical contact seemed to be important prognostic factors. While there exists potential disadvantages of higher minor and major complication rates and more sophisticated management of the patient, this one-stage open reduction and internal fixation with bone graft which converts open fracture into stable closed fracture might be of some value especially in Type I & II open fractures in terms of simultaneous management of fracture and open wound, prevention of secondary infection, anatomical reduction including joint congruity, stable maintenance of reduction, elimination of deformity, and early joint motion.
Amputation ; Bone Transplantation ; Classification ; Coinfection ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Forearm ; Fractures, Closed ; Fractures, Open ; Humans ; Humerus ; Joints ; Osteomyelitis ; Soft Tissue Infections ; Tibia ; Transplants ; Vascular System Injuries ; Wounds and Injuries

Benign epiepsy of childhood with centrotemporal spikes (BECCT) is an electroclinical syndrome characterized by noctural seizure that remit spontaneoully before adulthood, and belong to idiopathic age and location related epilepsies. We reviewed the medical records to analyse the seizure the seizure pattern, and also inspect the EEG recording to identify topography of the epileptiform discharge of 24 patient who met the following criteria: 1) presence of nocturnal seizure or partial seizure confined to the face, 2) normal intecual and development, 3) normal background EEG feature, 4) monomormhic spikes or sharp wave that increase in the frequency during sleep if those state were achieved. The result as follow: 1) The age of seizure onset were 3 to 11 years old (7.08 1.89) and male to female ratio was 1, 4:1. 2) Past history of birth trauma, CNS infection and other diseases involving CNS, were not found. There was past history of febrile convulsoin 33.3% of patient and epilepsy in 8.3%. One of paient's sister had childhood abscence epilepsy and never a nocturnal partial seizure, also and had centrotemporal spikes in EEG. 3) In 91.7% of Seizures occurred during sleep, especially short after sleep onset and the symptomatology of seizure was shown 66.7% of oropharyngeal sign, such as hypersalivation and gargle sound, and 54.2% of hemifacial involvement, 33.3% of speech arrest, 25.5% of upper limb involement, 18.3% of lower limb involvement, and 45.8% of general seizure. 4) In 91.5% of patients had on location of epileptiform discharge that located central (37.5%) midtemporal (33.3%), parietal and frontal. We could observe tangental dipole in 16.7% of patients.
Child ; Electroencephalography ; Epilepsy ; Epilepsy, Rolandic* ; Female ; Humans ; Lower Extremity ; Male ; Medical Records ; Parturition ; Rabeprazole ; Seizures ; Sialorrhea ; Siblings ; Upper Extremity

We performed anthralin comparative study(0.01% vs 0.1%) to assess the effectiveness of low-strengh anthralin therapy in 34 psoriatic patients and the resu1ts can be summarized as follows. 1. In the case of 13 patients using Burdick UVB larnp, in 1 patient the effect of 0.1% anthralin was superior to that of 0.01% anthralin from the start to the end of treatment, in 5 patients(38.5%) initially the effect of 0.1% anthralin was superior but in time became equal to that of 0.01% anthralin, and in 7 patients (53.8%) the effect of either side was same throughout the courae of the treatment. In the case of 21 patients using Waldmann UVB cabinet, there were 2(9.5 %), 3(14.3%) and 16 patients(76.2%) in the order named above. 2. The side effect of 0.1% anthralin was more severe than or at least the same as that of 0.01% anthralin in every patient who complained about side effects. So low-strengh anthalin-UVB phototherapy was thought to be the effective and alternative method of treatment particularly for the purpose of lessening the side effects.
Anthralin* ; Humans ; Phototherapy ; Psoriasis*

Our study was performed to evaluate the efficacy of anthralin-UVB therapy for psoriasis by simplifying the conventional Ingram regimen, 34 patients(21 admitted, and 13 OPD patients) were included in our study and the resulti can be summarized as follows. 1. There were no cases of treatment failure. 16 patients(76. 2%) out of the 2l admitted patients and 7 patients(53.8%) out of the 13 OPD patients showed clearing. 2. In the case of the admitted patients, the mean numbers of therapy(days) of the improved patients reaching grade 4 were 12. 0(18. 1 days) in the trunk lesions and 15. 5 (22. 0 days) in the extremity lesions' and those of the cleared patients reaching grade 4 were 11. 2(16. 0 days) in the trunk lesions, and 13. 4(lg. 5 days) in the extremity lesions, but the difference was not significant statistically(pp o.ps). The difference between the therapeutic effects of the admitted and the OPD patients was significant statistically(p<0. 05). 3. There were some notable side effects such as staining, pruritus, and erythema, but there were no cases of therapy termination.
Erythema ; Extremities ; Humans ; Pruritus ; Psoriasis* ; Treatment Failure

We experienced a case of purpura pigmentosa chronica in a 9-year-old girl whose skin lesions are widespread, so that face is also involved in addition to the lower extremi ties, trunk, and upper extremities.
Child ; Female ; Humans ; Purpura* ; Skin ; Upper Extremity

Microvascular anastomosis has become an essential technique in reconstructive surgery. A lot of techniques have been developed to improve patency rate and reduce operation time. But interrupted suture technique is still most widely used because of limited indication and inconvenience of other methods. A comparative study was undertaken to evaluate new microvasular anastomosis technique using fibrin glue. In this report 40 femoral arteries of Sprague-Dawley rats were anastomosed by utilizing four stay sutures which were placed 90 degrees apart and the intervals covered with fibrin glue, and by conventional eight suture method served as control. The patency rate(immediate postoperative, postoperative two weeks), time needed for vascular anastomosis, and microscopic evaluation were compared to those of conventional microvascular suture technique. Postoperative patency rate was 100% and 85% by fibrin glue technique compared to 100% and 90% by conventional technique at immediate postoperative and postoperative two weeks. Less time consumed with fibrin glue technique by 16 minutes compared to conventional technique by 21 minutes. Microscopically reendothelization was complete with smooth and less injured inner lining and also less inflammatory response by fibrin glue technique compared to conventional technique.
Femoral Artery ; Fibrin Tissue Adhesive* ; Fibrin* ; Rats, Sprague-Dawley ; Suture Techniques ; Sutures

A Statistical analysis was made on 275 cases of urinary calculi During the period from Jan.. 1963 to Aug. 1972, on the Department of Urology of Han-il Hospital and the results were obtained as following; 1. The incidence of urinary calculi was 3.09 % of out-patients. 2. The age of the patients ranged from 20 to 30 years in approximately 70 percent. 3. A seasonal occurrence was highest during summer on 31 percent. 4. The locational distribution of urinary calculi was 71.6 percent in ureter, 18.2 percent in kidney, 7.5 percent in bladder, 2. 7 percent in urethra. 5. The locational distribution of ureter calculi was 66 percent in lower, 22 percent in middle and 12 percent in upper portion. 6. In a number of urinary calculi, 89. 8 percent was single and 5.8 percent was double and 4.4 % was more than 2. 7. The ureterolithotomy was performed on 74 of 197cases requiring surgical intervention. Cystoscopic manipulation (Spontaneous Expelled) and conservative treatment were 120 cases of 197 cases. Other manner on 3 cases. 8. The results of qualitative analysis of 240 urinary calculi showed cal. Phosphate + oxalate in 53.7 percent, Cal phosphate in 13.7 percent, Calcium phosphate + ammonate in 7.5 percent, Ca phosphate +carbonate in 7.1 percent, Ca carbonate in 5.O percent. Ca oxalate in' 4.2 percent. etc.
Calcium ; Calculi ; Carbon ; Humans ; Incidence ; Kidney ; Outpatients ; Seasons ; Statistics as Topic* ; Ureter ; Urethra ; Urinary Bladder ; Urinary Calculi ; Urolithiasis* ; Urology

Our study was performed to evaluate the efficacy of anthralin-UVB therapy on patients with psoriasis. We studied twenty two patients suffering from plaque-type psoriasis of varying degrees of severity. The results can be summarized as follows. l. 2p patients(90.9%) out of the total 22 patients showed grade 4 improvement. The rernaining 2 patients failed to respond to treatment, 2. Arnong the improved 2Q patients, 2 patients who were treated more than 3p times for grade 4 improvement were excluded, so cleared patients were 18(81.8%). 3. Arnong the 18 cleared patients, the mean nurnber of therapy wasg. 6 for grade 3 and 12. 5 for grade 4 in the cases of trunk lesiona, and 13. 2 for grade 3 and 17. 8 for grade 4 in the cases of extrernities lesions. With above results, anth-ralin-UVB therapy was rnore effective in lesions of the trunk than in those of extremi.ties. 4. Notable side effects were pruritus in 6 patients(27.3pg), staining in 4 patients (18,2%), and 1ITltatioB in 2 patients(9.1%)
Anthralin* ; Humans ; Phototherapy* ; Pruritus ; Psoriasis*

No abstract available.
Humans ; Irritable Bowel Syndrome*

Spinal stenosis is a localized narrowing of spinal canal due to strurctural abnormalities. Its symptoms are obscure, and characterized by chronic, poorly localized, bilateral nerve root compression signs. Computerized tomography(CT) has been accepted as almost an absolute diagnostic method for spinal stenosis after its application in the orthopedic field. During the period of 2 years, from March 1982 to March 1984, 26 cases of spinal stenosis were treated surgically after botlt CT scanning and myelography. We obtained following results about advantage of CT scanning in spinal stenosis. 1. Myelography showed following findings: Hourglass defect 9, Complete block 8, Unilateral focal defect 4, Uniform narrowing 1, Mixed 2, Negative finding 2. Myelographic finding was not specific for spinal stenosis and diagnostic accuracy was inferior to CT. 2. The type of spinal stenosis was identified by CT scan finding. Of 26 cases, 21 cases were degenerative spinal stenosis, of which central stenosis was present in 7 cases, and lateral stenosis was present in all cases. The remaining 5 cases were combined type, and both central and lateral stenosis were present in all cases. 3. The diagnostic accuracy,in localizing the level of stenosis was 61.5% by myelography, and 96.2% by CT scan. CT was especially superior to myelography in the localization of the multi-segmental stenosis. 4. CT gives valuable information about extent and degree of stenosis, especially lateral recess stenosis, thus helping the surgeon to decide on the extent of decompressive lamininectomy preoperatively.
Clothing ; Constriction, Pathologic ; Methods ; Myelography ; Orthopedics ; Radiculopathy ; Spinal Canal ; Spinal Stenosis ; Tomography, X-Ray Computed