A fatigue or stress fractures is one in which there is no initial overt break in bone continuity. Rather, there is a gradual alteration in bone architecture as a result of repeated stress. The stresses are submaxmum and usually are the result of unaccustomed activity. If continued, they may eventually result in a complete fracture. Fatigue fractures have been described in almost every bone in the body, but they are more common in the bones of the lower extremities. Fatigue fractures are commonly seen in military personnel, especially at basic training center, and have been noted in athletes, ballet dancers, laborers, and even pregnant women. The following clinical results were shown by analysis of 57 cases of stress fractures experienced in the Department of Orthopaedic Surgery, Capital Armed Forces General Hospital from Jan. 1978 to Sep. 1979. 1. In 57 fatigue tractures in military recruits, 48 were in the tibial shaft and 9 were in the fibula. 2. The main cause of the fatigue fractures was running on hard roads, and the other causes were marching on hard surfaces, playing football, and long jumping. 3. The site of predilection in the tibia was the proximal one third of the shaft, occurring in 35 (72.9%) of the cases. In the fibula the junction of the upper and middle thirds was most frequently affected, occurring in 4 (44.4%) of the cases. 4. Most of the tibial and fibular fatigue fractures were grade I (40 cases among 57), showing periosteal reaction only on one or two cortices. 5. All soldiers were treated by immediate stoppage of physical activity, with no plaster immobilization or non weight bearing.
Arm ; Athletes ; Dancing ; Fatigue ; Female ; Fibula ; Football ; Fractures, Stress ; Hospitals, General ; Humans ; Immobilization ; Lower Extremity ; Military Personnel ; Motor Activity ; Pregnant Women ; Running ; Tibia ; Weight-Bearing

The symptom of tennis elbows is a syndrome of pain and point tenderness localized at either extensor or flexor epicondylar origin at the elbow. One hundred and ninety-seven cases of tennis elbow seen from Jan. 1985 to Dec. 1988 were managed by mean of conservative treatments firstly such as rest, medication, immobilization, P-T and local steroid injection. Among the 197 cases, 32 cases were treated with Nirschl and Pettrone operation. The results were summerized as follows, l. Of 197 cases, 139 cases were female, and 96 cases were in the age group 41 to 50. 2. One hundred and thirty-two cases were housewives. 3. Only 11 cases had history of sports. 4. By Nirsch and Pettrone assessment, the end results of conservative treatment were excellent and good in 117 cases(59.4%), fair and failure in 80 cases(41.2%). 5. Among the 11 cases treated with Nirsch and Pettrone operation, excellent result was obtained in 6 cases, good in 3 cases, fair in one case and failure in one case.
Clinical Study ; Elbow ; Female ; Humans ; Immobilization ; Sports ; Tennis Elbow ; Tennis

A study on prevalence of hepatitis B surface antigen(HBsAg) in 1,292 grade-school children(548 of rural area, 744 of urban area) by Counterimmunoelectrophoretic method: various liver fuction tests and liver biopsy were performed, and the results obtained are as follows: 1) Fifty four of 1,292 children who were selected randomly were positive for HBsAg(4.2%) and incidence of HBsAg was higher in rural area(4.6%) than in urban area(3.9%). 2) The incidence of HBsAg was higher in male children(4.5%) than female Children(3.7%). 3) Age distribution revealed highest incidence at 10(5.9%), years old lowest incidence at 9(2.9%), but any significant interrelationship wasn't found between ages. 4) The order of liver function tests which showed abnormal values by numver are as follows: GGT(26.2%), SGOT(23.6%), Total protein(7.1%), SGPT(4.8%), TTT(4.8%), BSP retention test(2.4%), PT(0%). The values of GGT and SGOT were thought to be most useful in HBsAg positive children. 5) All tests showed normal values in 22 children(52.4%), one test and more than 2 tests showed abnormal values each in 18 children(42.8%) and in 2 children(4.8%). 6) On liver biopsy performed in nine HBsAg positive children, one showed normal liver tissue, two showed mild hepatocellular degenerative change, five showed chronic persistent hepatitis and showed chronic active hepatitis. On orcein staining, three showed intracytoplasmic inclusion bodies thought to be HBsAg.
Age Distribution ; Aspartate Aminotransferases ; Biopsy ; Child* ; Female ; Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis, Chronic ; Humans ; Incidence ; Inclusion Bodies ; Liver ; Liver Function Tests ; Male ; Prevalence ; Reference Values

A study of normal value of fetal hemoglobin concentration at each age in 1213 cases (852 patients, 361 normal children) who visited Chonnam university hospital from June 1977 to November 1978 was performed by alkali denaturation method, and following results were obtained. 1) The mean value of Hgb F at each age in normal children group was 65.5+/-1.8% in newborn infants during 24 hours, 40.5+/-1.6% in 1 month, 24.3+/-1.2% in 2 months, 15.3+/-1.4% in 3 months, 4.5+/-1.2% in 1 year 1.3+/-0.5% in 5 years, 0.9+/-0.7% in 10 years, 0.5+/-0.3% in 15 years. 2) The mean value of Hgb F at each age in patients group was 68.6+/-2.5% in newborn infants during 24 hours, 42.5+/-1.7% in 1 month, 22.9+/-1.1% in 2 months, 15.2+/-0.9% in 3 months, 5.5+/-1.0% in 1 year, 1.4+/-0.4% in 5 years, 0.9+/-0.6% in 10 years, 0.6+/-0.2% in 15 years. 3) The mean value of Hgb F at each age in both group was 67.5+/-2.0% in newborn infants during 24 hours, 41.8+/-2.1% in 1 month, 23.4+/-1.9% in 2 months, 15.2+/-1.0% in 3 months, 5.1+/-1.1% in 1 year, 1.4+/-0.8% in 5 years, 0.9+/-0.2% in 10 years, 0.6+/-0.2% in 15 years. 4) No significant correlation was found in the concentration of Hgb F at each age between normal children group and patients group, and either in the concentration of Hgb F at each sex of two groups.
Alkalies ; Child* ; Fetal Hemoglobin* ; Humans ; Infant, Newborn ; Jeollanam-do ; Reference Values*

BACKGROUND: This study was intended to present the importance of insight status concerning the abstinence of alcoholics. METHODS: The 214 subjects, who participated in insight improving programs during hospitalization in an alcohol treatment center, were followed up for their abstinent status during the 12 month period after discharge. The relation between their abstinence results and insight status was investigated. To find out the influence of other factors upon abstinence, stepwise multiple regression was performed over variables including disease severity, sociodemographic, therapeutic and familial features. RESULTS: The 73 individuals (34.1%) had 'no remission', 110 (51.4%) 'early full remission', and 31 (14.5%) 'sustained full remission'. The insight degree was significantly correlated with both 'initial consecutive months of sobriety'(IMS) after discharge and 'total months of sobriety'(TMS) during the follow up. The 153 subjects (71.5%) relapsed within four months after discharge, and the rate of continuous abstinence at each month differed significantly among three insight groups. On the inter group shifts during hospitalization, the abstinent months were greater in the group whose insight changed from 'poor ' to 'good insight' than the one from 'fair ' to 'good insight'. By stepwise multiple regression analysis, the higher insight scores, older age and shorter hospital days, in a decreasing order of association, the longer IMS and TMS, while absence of religion and lower MAST scores was associated only with IMS, with their overall R2 value of 18.5% and 20.8%, respectively. CONCLUSION: The insight degree was related to the length of abstinence and thus it is necessary to develop insight improving programs which can be of help to recovering patients.
Alcoholics ; Alcoholism ; Follow-Up Studies ; Hospitalization ; Humans ; Prognosis

BACKGROUND: Such screening tools for alcoholism as MAST, NAST, CAGE focused on the alcohol-related psyhosocial problems. But some men can be exduded in a study using these tools whereas they might be at risk for alcohol related physical problems. From this perspective the new tools focusing under quantity and frequency of intake for detection of early-stage drinkers not yet manifesting evident psychosocial problems but having alcohol- related potential harms, are being developed. With focus on these aspects, 10 itemed AUDIT was developed by WHO and this study was developed to provide standard points for screening alcohol problems in Korea with cultural difference through AUDIT. METHOD: The subjects were 85 drinking men and 11 male alcohol dependents who visited Kangmung hospital af Asan foundation from July until August 1998. The team composed of 2 family physicians and 1 psychiatrist, who delivered structured interviews based on DSM-IV criteria in terms of psychosocial problems, and examined them and reviewed the patient records in terms of alcohol-related physical problems. Accordingly the subjects were classified into 'normal', 'physical problems-related drinkers' without psychosocial problems, and 'alcohol abuser' and 'alcohol dependent' according to DSM-IV criteria. Aside from physicians diagnostic procedures, they were again made to complete a questionnaire induding all the items of AUDIT, MAST, NAST and CAGE. RESULTS: As regards physicians' diagnostic results, 31 were normal, 8 had physical problems without psychosocial problems, 36 abused alcohol, and 21 were alcohol-dependent. The mean AUD1T scores of all the sub were 17.5(+/-9.5) and the mean AUDIT scores of each group were 7.1(+/-4.3), 16.6(+/-3.4), 19.9(+/-5.0), 29.3(+/-5.1), respectively and revealed significant difference among them AUDlT scores were significantly correlated with those marked from physicians' diagnostic results and also significantly correlated with MAST, NAST and CAGE, respectively. After consideration of mean AUDIT scores and standard deviations of each group according to diagnostic results, the preliminary standard AUDIT scores for detection of a broader sense of 'problem drinker' including physical as well as psychosocial problems were most possibly 12, 13, 14 points. Their sensitivity and specificity were 96.9% and 87.1% in 12 points, 92.3% and 90.8% and 90.3% in 14 points, respectively. The preliminary standard AUDIT scores concerning alcohol use disorders hased on DSM IV criteria were most possibly 14, 15, 16 with its sensitivity and specificity of 91.2% and 74.4% in 14 points, 89.5% and 79.5% in 15 points, and 84.2% and 84.6% in 16 points. The preliminary standard AUDIT scores for 'alcohol dependence' were most possibly 25, 26, 27 with its sensitivity and specificity of 85.7% and 90.7% in 25 points, 85.7% and 93.3 in 26 points, and 71.4% and 94.7% in 27 points. CONCLUSIONS: The authors recommend AUDIT cut-off scores of 12 points as the standard value for a broader sense of problem drinking including physical as well as psychasocial problems, 15 for 'alcohol use disorders' based on DSM IV criteria, and 26 for 'alcohol dependence' in Korea.
Alcoholism* ; Chungcheongnam-do ; Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Humans ; Korea* ; Male ; Mass Screening* ; Physicians, Family ; Psychiatry ; Sensitivity and Specificity ; Surveys and Questionnaires

STATEMENT OF PROBLEM: Current tendencies of the implant macrodesign are tapered shapes for improved primary stability, but there are lack of studies regarding the relationship between the implant macrodesign and primary stability. PURPOSE: The purpose is to investigate the effect of implant macrodesign on the implant primary stability by way of resonance frequency analysis in the bovine rib bones with different kinds of quality. MATERIAL AND METHOD: Fifty implants of 6 different kinds from two Korean implant systems were used for the test. Bovine rib bones were cut into one hundred pieces with the length of 5 cm. Among them forty pieces of rib bones with similar qualities were again selected. For the experimental group 1, the thickness of cortical part was measured and 20 pieces of rib bones with the mean thickness of 1.0mm were selected for implant placement. For the experimental group 2, the cortical parts of the remaining 20 pieces of rib bones were totally removed and then implants were placed on the pure cancellous bone according to the surgical manual. After placement of all implants, the implant stability quotient(ISQ) was measured by three times, and its statistical analysis was done. RESULTS: There are statistically significant differences in ISQ values among 4 different kinds of Avana system implants in the experimental group 2. For the experimental group 1, Avana system implants showed significantly different ISQ values, but when differences in the thickness of cortical parts were statistically considered, did not show any significant differences in ISQ values. Among Oneplant system implants, there are no significant differences in ISQ values for the experimental group 2 as well as for the experimental group 1. CONCLUSION: Within the limits of this study, bone quality and implant design have some influences on the primary stability of implants. Especially in the bone of poor quality, tapered shape of implants are more favorable for the primary stability of implants.
Ribs

To evaluate the follow-up management state and related factor of lead battery workers in periodic health examination as part of program of group occupational health service, author studied 293 workers with questionnaire on knowledge of results and follow-up management state and related factors, and compared the responses to their periodic health examination result charts. The results were as follows: 1. 252(86%) workers responsed that they had received the health examination result chart, but only 116(39.6%) workers responsed that they had been educated or explained about the result of health examination, and 11(57.9%) workers among 19 workers with non-occupational disease D, 101(44.3%) workers among 228 workers with non-occupational disease C, and 19(28.4%) workers among 67 workers with occupational disease C knew accurately their health examination results. 2. 78(24.8%) of the workers responsed that they had follow-up management, and contents of follow-up management were follow-up(36.6%), out-patient treatment(31%), change worksite(8.5%), temporary retirement(7.0%) and others(16.9%). 3. Most of the workers responsed that the health examination were necessary, but three-fourths of the workers responsed that the health examination had been superficial or that they didn't know. 4. In this study, follow-up management show significant association with only explanation or education about health examination result chart.
Education ; Follow-Up Studies* ; Humans ; Knowledge of Results (Psychology) ; Occupational Diseases ; Occupational Health Services ; Outpatients ; Surveys and Questionnaires

OBJECTIVES: The hippocampal atrophy has been known to be an important biological marker for the early diagnosis of mild cognitive impairment (MCI). The aims of this study are to disclose the differerence in the interuncal distance (IUD) between MCI, dementia of the Alzheimer's type (DAT) and healthy aged controls, and to identify the affecting factors. METHODS: In transaxial plane, the IUDs at the level of the suprasellar cistern on the T1-weighted images on the brain MRI were measured in patients with MCI (N=30), those with DAT (N=34), and healthy aged controls (N=20). Furthermore, demographic data about age, sex, educational level as well as cerebrovascular factors were obtained by structured interviews and medical records, and the severity of cognitive disorders were assessed using the Mini-Mental Status Examination (MMSE), the Clinical Dementia Rating (CDR) and the Global Deterioration Scale (GDS). RESULTS: 1) The mean (+/-S.D.) IUD of DAT group (26.52+/-3.37 mm) was significantly different from that of healthy aged controls (24.35+/-2.91 mm)(p=0.044). However, there were no significant differences between IUD of MCI group (25.60+/-2.66 mm) and that of DAT group (p=0.483) as well as that of healthy aged controls and that of MCI group (p=0.363). 2) Variables such as age, sex, educational level, cerebrovascular risk factors and severity of cognitive disorder were not related to the IUD. CONCLUSIONS: The measurement of IUD on the brain MRI did not seem to be a helpful biological marker for the early detection of MCI in clinical practice.
Atrophy ; Biomarkers ; Brain ; Dementia ; Early Diagnosis ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Mild Cognitive Impairment* ; Risk Factors

BACKGROUND: There is still risk of acquiring HCV and HIV by transfusion due to window phase. Screening for HCV and HIV-1 by nucleic acid amplification testing (NAT) may improve blood safety allowing detection during the preseroconversion window in donors. METHODS: We investigated NAT usefulness using COBAS AMPLICOR analyzer (Roche). The following sample population were tested:1) 15,552 HCV/HIV-1 seronegative random blood donor samples for HCV and HIV-1 NAT;2) 696 high ALT and 271 HCV EIA positive samples for HCV NAT;3) 1,152 HIV-1 EIA reactive samples for HIV-1 NAT. NAT was performed on pools of 24 donations according to the assay protocol. RESLUTS: Six pools showed initial reactive reactions in HCV NAT and one pool showed initial reactive reaction in HIV-1 NAT. But no donor sample was found repeatedly reactive by this assay. CONCLUSIONS: Although there were false positive reactions, specificity of the NAT assay was high enough for the assay to be applied as a blood screening test and implementation of this assay is expected to improve blood safety and be useful for blood products use.
Blood Donors* ; Blood Safety ; False Positive Reactions ; HIV ; HIV-1* ; Humans ; Mass Screening ; Nucleic Acid Amplification Techniques ; Sensitivity and Specificity ; Tissue Donors