In treatment of infected ununited fractures of the tibia, We have solved this disastrous problems by posterior bone graft through posterolateral approach. By this posterior bone graft, We can achieve both bone union and infection contral simultaneously. The results were as follows: 1. Total cases of the infected ununited fractures were 17 cases, among them 16 cases were open fracture initially. 2. They occured more commonly in young adult, 7 cases(41%) were in 4th decade, and all cases were male. 3. Tibial union was achieved in 16 cases and one patient can not walk without brace due to ain on fracture site. 4. Infection was cleared in 16 cases, but one case had intermittent drainage of pus. 5. The most common complication was stiffness of the ankle and tarsal joint. 6. There was no infection in grafted bone.
Ankle ; Braces ; Drainage ; Fractures, Open ; Fractures, Ununited ; Humans ; Male ; Suppuration ; Tarsal Joints ; Tibia ; Transplants ; Young Adult

Squamous cell carcinoma is a malignant tumor arising from the epidermis or its appendages, Squamous cell carcinoma of extremity comprises approximately 1 to 2 percent of all squamous celi carcinoma and of these 0.2 to 1.7 percents are secondary to chronic osteomyelitis and 2 percents are secondary to the burn scar. We experienced 4 cases of squamous cell carcinoma invading bone directly, of these 2 cases are secondary to chronic osteomyelitis and 2 cases are secondary to the burn scar. With prompt and aggressive surgical treatment the prognosis is good. Routine regional lymphadenectomy is unnecessary because in most instances enlarged nodes are inflammatory and subside after amputation.
Amputation ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Epidermis ; Epithelial Cells ; Extremities ; Lymph Node Excision ; Osteomyelitis ; Prognosis

Fibromatosis in childhood is a rare tumor and also prone to aggressive behavior. This tumor may spread to involve contiguous soft parts and osseous structures, but does not metastasize. We experienced a case of fibromatosis in an 12-year-old giri who complained of palpable masses in the region of the right buttock and right foot. The case has been followed for 6-years since February 1973. Bony change has occured even after several attempts of surgical excision but a distant metastasis has not occured.
Buttocks ; Child ; Fibroma ; Foot ; Humans ; Neoplasm Metastasis

As Kelsey stated “Four out of five individuals will have a significant complaint of back painat one time or another in their lives and impairment of the spine are the most frequent cause of time lost from work”., low back pain affects the quality of life for just about everyone, medical and economic impacts of low back pain are enormous. Nevertheless, neither the government not industry has been seriously involved in the study of the cause, prevention, and management of back pain. The purpose of this study was to review and analysis the clinical materials of low back painand draw differences, if any, between discogenic and stenotic low back pain. Three hundreds and fourty nine cases suffering from low back pain and/or sciatic pain, excluded fresh traumatic and inflammatory conditions of the spine, have been admitted and treated at Dept. of orthopaedic surgery, Eul-Ji General Hospital, Dae-Jeon from May, 1981 to April, 1984. They were consisted of H.N.P. (172 cases), Spinal stenosis (61 cases), Spondylolisthesis (42) cases), Degenerative joint Disease of the spine (48 cases), and Others (26 cases). Among them, two hundred and twenty six cases who were followed more than four months were mainly subjectecl to this study.
Back Pain ; Clinical Study ; Hospitals, General ; Intervertebral Disc ; Joint Diseases ; Low Back Pain ; Quality of Life ; Spinal Stenosis ; Spine ; Spondylolisthesis

Spinal stenosis is defined as diminition in the size of the spinal canal that produces nerve entrapment resulting in symptoms, the most common of which is low back pain & radiating pain to leg. The central spinal canal contains the dura and other meninges, and inside these, the nerves of the cauda equina. The nerve root canal contains the spinal nerve from the point which the dura leaves the intervertebral foramina. Each foramen is a door through which the nerve enters to the nerve root canal. In its canal the nerve passes behind the disc and then in front of the superior articular process of the lower vertebra. Pathological and anatomical changes by various cases can produce narrowing of the central and nerve root canal. But they are sometimes not important because they are not severe enough to cause nerve entrapment and such medical treatment, Spinal stenosis is only significant when nerves are entraped, indicated by severe leg pain and sometime by sensory and motor changes. Spinal stenosis is classified into two groups: congenital and acquired. Among acquired groups, the combined type is most common and significant. Authors have experienced 61 cases of spinal stenosis and among these, 58 cases were treated surgically between 1981 and 1984 at the Department of Orthopaedic Surgery, Eulji Glneral Hospital, Daejeon. The following results were obtained. 1. There were 52 males and 33 females, and peak incidence in 5th and 6th decade(69%) 2. The most common type by Arnoldi's etiological classification was combined type(69%) 3. The most common chief complaint on admission was low back pain and radiating pain to leg (43%) 4. The most common sign was limitation of lumbar hyperextension (75.9%) and S.L.R.test was positive in only 12 cases(20.7%). 5. The common findings of myelography were hour glss appearance (39.7%) and complete block (27.6%), and simple radiologic findings were hypertrophy of facet joint, osteophyte formation in the periphery of vertebral bodies involved and narrowing of disc speace. 6. The A-P diameter of spinal canal was between 14.44 mm and 14.97 mm in simple findings, and the A-P diameter of dural sac between 8.10 mm and 9.19 mm in myelography. The spinal index was between 1:4.90 and 1:5.60. 7. Decompressive surgery was done in the 2 levels in 39 cases (67.3%), 3 levels in 10 cases (17.2%) and 1 level in 9 cases (15.5%). Discectomy was done in 40 cases (69%) and partial laminectomy was done in 58 cases (100%). 8. The most common site was L3,4-L4,5 (36.2%).
Cauda Equina ; Classification ; Dental Pulp Cavity ; Diskectomy ; Female ; Humans ; Hypertrophy ; Incidence ; Laminectomy ; Leg ; Low Back Pain ; Male ; Meninges ; Myelography ; Nerve Compression Syndromes ; Osteophyte ; Spinal Canal ; Spinal Nerves ; Spinal Stenosis ; Spine ; Zygapophyseal Joint

This erratum is being published to correct the printing error on page 286 of the article entitled 'Panton-Valentine leukocidin positive Staphylococcus aureus isolated from blood in Korea' by Kim JS, Park JS, Song W, Kim HS, Cho HC, Lee KM, Kim EC in Korean J Lab Med 2007;27:286-91. DOI 10.3343/kjlm. 2007.27.4.286 as follows. The heading of the right column of the Table 1 was misprinted as methicillin-resistant, so it should be corrected to methicillin-susceptible.
Adult ; Amino Acid Substitution ; Brain Neoplasms/radiotherapy/surgery ; Breast Neoplasms/diagnosis/radiotherapy/surgery ; Female ; *Genetic Counseling ; Genetic Predisposition to Disease ; *Germ-Line Mutation ; Humans ; Li-Fraumeni Syndrome/*diagnosis/genetics/therapy ; Mutation, Missense ; Pedigree ; Tumor Suppressor Protein p53/*genetics

PURPOSE: This study was conducted to develop an integrated undergraduate course including a PBL based on a blended learning strategy, and evaluate learners' responses. METHODS: The learning contents of cardiovascular, respiratory, and musculoskeletal medical systems, and nursing diagnoses of 'activity and rest' domain (NANADA's classification II, 2005) were analyzed. Six clinical scenarios with the clients in different life cycles were developed for PBL. Classical lecture and group presentation with on-line self learning were implemented in addition to PBL. The developed course was implemented on 84 junior nursing students in a university for 7 weeks with 5 hours per day, two days per week. Students were asked to complete structured questionnaires including problem solving, critical thinking, and nursing diagnosis differentiation abilities. RESULTS: Learner's evaluation was positive in problem solving skills and in the differentiation ability of nursing diagnoses relevant to an 'activity and rest' functional health pattern. CONCLUSION: Development and implementation of integrated courses based on a blended learning method need to be continued to enhance students' thinking and self-directed learning abilities. Supporting strategies for individual learners should be added for successful blended learning such as individual on-line feedback and consideration of individual learning outcomes.
Classification ; Humans ; Learning ; Life Cycle Stages ; Nursing Diagnosis ; Problem Solving ; Problem-Based Learning ; Students, Nursing ; Thinking ; Surveys and Questionnaires

Primary pulmonary hypertension is a rar, incurable, and progressive clinical entity. When associated with pregnancy, the prognosis of primary pulmonary hypertension is worsened with maternal mortality rates of at least 50%. The patient was a 29-year-old mother in her 2nd pregnancy, with previous uncomplicated gestation, 5 years ago. She had been well until the 28th week of present gestation when she was admitted because of increasing dyspnea on exertion. She was a housewife with no remarkable family and past histories. We have experienced a patient with primary pulmonary hypertension in pregnancy. She was treated with an oral calcium-channel blocker and low-molecular-weight heparin and was delivered vaginally with good maternal and fetal outcome. So we report a case of primary pulmonary hypertension associated with pregnancy and review literature.
Adult ; Dyspnea ; Heparin, Low-Molecular-Weight ; Humans ; Hypertension, Pulmonary* ; Maternal Mortality ; Mothers ; Pregnancy* ; Prognosis

Toxoplasma gondii is an intracellular protozoan parasite that infects approximately one third of the human popu- lation worldwide. Considering the toxicity and side effects of anti-toxoplasma medications, it is important to develop effec- tive drug alternatives with fewer and less severe off-target effects. In this study, we found that 4-hydroxybenzaldehyde (4- HBA) induced autophagy and the expression of NAD-dependent protein deacetylase sirtuin-1 (SIRT1) in primary murine bone marrow-derived macrophages (BMDMs). Interestingly, treatment of BMDMs with 4-HBA significantly reduced the number of macrophages infected with T. gondii and the proliferation of T. gondii in infected cells. This effect was impaired by pretreating the macrophages with 3-methyladenine or wortmannin (selective autophagy inhibitors) or with sirtinol or EX527 (SIRT1 inhibitors). Moreover, we found that pharmacological inhibition of SIRT1 prevented 4-HBA-mediated expres- sion of LC3-phosphatidylethanolamine conjugate (LC3-II) and the colocalization of T. gondii parasitophorous vacuoles with autophagosomes in BMDMs. These data suggest that 4-HBA promotes antiparasitic host responses by activating SIRT1- mediated autophagy, and 4-HBA might be a promising therapeutic alternative for the treatment of toxoplasmosis.

Subcutaneous fat necrosis of newborn is an uncommon disorder characterized by firm subcutaneous plaques and nodules usually appearing shortly after birth. A female newborn with brain death developed diffuse hardening of trunk, extremity, cheek and buttock in the first 5 weeks of the life. A clinical diagnosis of sclerema neonatorum was made. But histologic examination revealed patchy areas of fat necrosis with crystallization, infiltration of histologic cells and several multinucleated giant cells containing needle-shaped clefts. Calcium deposits were also demonstrated within the necrotic area. So, we diagnosed this case as subcutaneous fat necrosis of newborn with generalized hardening of the skin.
Brain Death ; Buttocks ; Calcium ; Cheek ; Crystallization ; Diagnosis ; Extremities ; Fat Necrosis ; Female ; Giant Cells ; Humans ; Infant, Newborn* ; Necrosis* ; Parturition ; Sclerema Neonatorum ; Skin ; Subcutaneous Fat*