A study on the sickness distribution and mode of treatment in rural area was conducted during the period from July '75 to Aug. '75 using 1,225 households, 7,918 population (4,017 male, 3,901 female) and 343 cases that found during the period of survey who had been lived in nammyon, Hwasoongun, Chonnam. The summarized results were as follows : 1. Average family number per household was 6.5 and prevalence rate was 43.3 (21.2 for male, 22.1 for female). 2. General sickness distribution by classification of disease according to W.H.O. was highest in disease of the nervous system and sense organs (21.3%), and important others were disease of the digestive system (16.9%) and disease of the respiratory system (14.8%). In male, distribution was in order of downward disease of digestive system, disease of nervous system and sense organs, disease of skin, cellular tissue, bones and organs of movement , and disease of respiratory system. In female, distribution was in order of downward disease of nervous system and sense organs, disease of respiratory system, disease of digestive system, and disease of skin, cellular tissue, bones and organs of movement. 3. Types of treatment in both sexes were showed that home and folkmedicine (41.1%), pharmacy (24.5%), admission to hospital or clinic (16.9%), out-patient clinic (10.8%) ad herbmedicine (6.7%) in downward order. Hospital and clinic utility rate was 27.8% (31.5 for male, 24.0 for female) and it was highest in 0-4 age groups and lowest in 40-49 year age groups. 4. Hospital and clinic utility rate was highest in neoplasms, and the other hands, disease of the nervous system and sense organs and disease of the digestive system were the highest groups in the all types of treatment other than hospital and clinic. 5. On the results of treatment not, exactly replied answer was the highest (41.7%) and only 16.0% said complete recovery, In completely recovered cases, hospital and clinic using group was predominant (58.2%) and in aggravated cases home and folkmedicine using group was highest.
Classification ; Digestive System ; Family Characteristics ; Female ; Hand ; Humans ; Jeollanam-do ; Male ; Nervous System ; Outpatients ; Pharmacy ; Prevalence ; Respiratory System ; Sense Organs ; Skin

Dislocation of the metacarpophalangeal joint of the finger is rare except thumb. We experienced a case of volar dislocation of little finger and 2 cases of dorsal dislocation of index finger. The mechanism of injury seems to be direct trauma to the dorsum of hand with the metacarpophalangeal joint acutely flexed in volar dislocation and the dorsal dislocation is forced the metacarpophalangeal joint into hyperextension. In 1957, Kaplan advocated the triple incision, that is release of the volar fibrocartilageous plate, the natatory ligament, and the superficial transverse metacarpal ligament, exposing the operation field through a palmar approach. The recommended treatment for such very rare injury is open reduction through nalmar approach in dorsal dislocation, and dorsal approach in volar dislocation; the single most important element preventing reduction is interposition of the volar plate within the joint space in dorsal dislocation and the obstacles of volar dislocation are entraped dorsal capsule and partial ruptured extensor tendon. In dorsal dislocation, we advocated only half release of volar fibrocartilage for lessor trauma of soft tissue and reduction was made easily after release of 1/2 volar fibrocartilage. We report this rare and interesting cases with review of literature.
Dislocations ; Fibrocartilage ; Fingers ; Hand ; Joints ; Ligaments ; Metacarpophalangeal Joint ; Tendons ; Thumb

Stress fractures have been well documented in the lower extremity. Stress fractures of the upper extremities are uncommon. We report a case of an ulna stress fracture in a 32 year old female non-professional golfer.
Female ; Fractures, Stress ; Humans ; Lower Extremity ; Ulna ; Upper Extremity

To evaluate the intra-articular pathology of popliteal cysts of knee, we performed arthroscopy on patients with popliteal cysts between February 1992 and February 1995. Thirty-one patients (32 cases) have been treated by excision of cyst after arthroscopy. Mean duration of follow-up was 15 months (13-19 months). Location of cysts was in the right knee in 17 cases, in the left knee in 13 cases, and bilateral in one case. Pain or swelling was present in 12 (38%), giving-way was reported by 4 cases. Three cases revealed quadryceps atrophy. The McMurray test was postive in 6 cases. After arthroscopy, the cysts were excised. Ninteen cases (59%) had associated intra-articular lesions: seven medial meniscal tears, two lateral meniscal tears, seven had chondral damages, one had medial plica syndrome, and one had rheumatoid arthritis, Communication between the cyst and the knee was present in 7 cases (22%), all of whom were over 40 years of age. Thirteen cases was younger than 30 years of age, and 11 cases of these cases had no intra-articular pathology. Two other cases had lateral meniscal tears and medial plica syndrome, respectively. We recommend arthroscopy in middle and older aged patients with popliteal cysts for evaluating and treating intra-articular lesions.
Arthritis, Rheumatoid ; Arthroscopy* ; Atrophy ; Follow-Up Studies ; Humans ; Knee* ; Pathology ; Popliteal Cyst*

Eighty four patients with 104 calcaneal fractures which were treated at the dept. of orthopaedic surgery, Inchon Christian Hospital from October, 1979 to September, 1983 were clinically analysed and the results were as follows; 1. 72 patients were male and 12 patients were female. The male were more injuried in the ratio of 6:l. 2. Their ages were ranged from 6 yrs. to 66 yrs. (average; 35.4 yrs.) and the half of the patients were occured at the 3rd and 4th decade. They admitted for average 7.6/7 weeks. 3. The main cause was a fall from a height in 62 patients (73.8%) and its average height was 4.5m. 4. The open fractures were occured in 13 feet (12.5%) and the spine fracture was associated in 16 patient (19%). 5. The 104 cases were classified according to the Rowe and Essex-Lopresti classification. Fractures involving subtalar joint were 74 feet (71.2%) and the Rowes type V were 58 feet(55.8%). 6. The 22 cases were treated by elosed reduction and axial pin fixation, 10 cases were treated by open reduction and the subtalar fusion was done at 2 cases. Others were treated by cast immobilization with or without closed reduction. The satisfactory result was obtained in 64 cases(61.5%). 7. The most common problem after any treatment was persistent foot pain, especially beneath the lateral malleolus.
Calcaneus ; Classification ; Clinical Study ; Female ; Foot ; Fractures, Open ; Humans ; Immobilization ; Incheon ; Male ; Spine ; Subtalar Joint

After reconstruction of anterior cruciate ligament, increased idameter of femoral or tibia1 bone tunnel has been obsened on plain radiogram. The etiology of radiographic tunnel enlargement is not well understood and the significance of this tunnel enlargement is unknown. This retrospective study reviewed tibial tunnel diameter in 34 cases of anterior cruciate ligament reconstructions. And we evaluated the correlation between the tibial tunnel enlargement and the position of screw fixation, instability, choice of graft, and clinical results at 1 year postoperatively. AII operation was per formed using a single incision technique. After 3 or 4 months and one year after operation, the diameter of tibial tunnel was measured with digital caliper on the plain radiogram. Tibial tunnel sclerotic margins were measured in the level Of medial tibial plateau on the lateral view of knee. Average tunnel enlargement of 3 allografts was 1.62mm and that of 15 autografts was 2.03mm. No significant difference was seen in KT-10000 arthrometer measurements between enlarged group (amount of enlage-ent >+1 S.D) and not-enlarged group (less than +1 S.D). No coelation was present between the increased tunnel diameter and Lysholm score. Cases with 10mm or more vertical distance between the most proximal point of tihial interference screw and the level of m4eial tibial plateau had average 1.15mm tibial tunnel enlargement and cases with less than 10mm vertical distance ha & I average 2.52mm tibial tunne] enlargement;the difference was not significant (P>0.05). The tibial tunnel enlargement was not correlated with position of screw, clinical results, stability of knee. The tibial tunnel enlargement was not caused hy only mechanical factor such as motion of intra-tunnel portion of graft-tendon.
Allografts ; Anterior Cruciate Ligament* ; Autografts ; Knee ; Retrospective Studies ; Transplants

The original technique for endoscopic anterior cruciate ligament reconstruction has several potential complications because of constraints imposed by working through the tibial tunnel: improper femoral tunnel placement, violation of the femoral tunnel posterior wall, femoral interferenc screw divergence, graft laceration during screw insertion, and distal tibial bone block prr>trusion. We performed 25 endoscopic anterior cruciate ligament reconstructions with bone-tendon-bone graft using a mo3ified technique that minimizes each of these problems, through the use of a anteromedial portal more centrally and distally placed than the original that portal. Postoperative radiographic review showed femoral screw divergence in 20% of cases (2 in the anteroposterior plane, 2 in the lateral plane and 1 in both planes), but the average angles (AP: 0.52+- 1.85, Lateral: 1.48+-3.30) were insignificant. There was no graft damage during screw insertion or grafttunnel mismatch. We concluded that this modified technique allows simplified, reproducible tunnel and interference screw placement.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Knee ; Lacerations ; Transplants

Urea reduction ratio (URR) and Kt/Vurea are objective parameters of dialysis delivery in hemodialysis patients and correlate with nutritional status and patient outcome. URR and Kt/Vurea depend on postdialysis blood urea nitrogen (BUN). In patients with severe postdialysis urea rebound (PDUR), these parameters do not accurately reflect dialysis adequacy. We measured PDUR 30 minutes after dialysis in 26 chronic stable hemodialysis patients. The impact of PDUR on dialysis delivery assessed by URR and Kt/Vurea and the independent factors affecting on PDUR were evaluated. All patients had been dialyzed for 4 hours thrice a week using hemophan membrane. 1) The mean age of patients was 48.6+/-14.8 years and sex ratio was 1:2.3. The mean duration of hemodialysis was 42.7+/-45.0 months. Primary renal diseases were chronic glomerulonephritis 11 (42.3%), diabetic nephropathy 7 (26.9%), and hypertension 4 (15.4%). 2) The mean blood flow was 209.2+/-17.4ml/min. URR, Kt/Vurea, and nPCR using immediate postdialysis BUN were 60+/-7%, 1.13+/-0.21, 1.09+/-0.28g/kg/ day, respectively. The mean recirculation rate was 4.4+/-2.3%. 3)The mean PDUR was 12.2+/-4.6% (range:6-22 %). URR, Kt/Vurea, and nPCR using BUN 30 minutes after dialysis were 55+/-7%, 0.99+/-0.18, and 1.02+/-0.25 g/kg/day, respectively and were significantly lower than those using immediate postdialysis BUN (P<0.05). 4) When the patients were divided according to the degree of PDUR (low PDUR group:<12%, high PDUR group: > or = 12%), high PDUR group was significantly higher than low PDUR group in hematocrit (27.0+/-2.6 vs. 23.5+/-3.6%, P=0.008), URR (64.3+/-5.4 vs. 55.8+/-6.8%, P=0.002), Kt/Vurea (1.26+/-0.17 vs. 1.03+/-0.18, P=0.002), and total recirculation rate (5.6+/-2.7 vs. 3.6+/-1.7%, P=0.05). There were no differences in age, sex, postdialysis body weight, ultrafiltration rate, blood flow, serum albumin, predialysis BUN, creatinine, and nPCR. 5) In multiple regression analysis, the independent factors affecting on PDUR were Kt/Vurea (beta=0.546, P<0.001), recirculation rate (beta=0.422, P<0.001), and hematocrit (beta=0.366, P=0.0017). In conclusion, we think that PDUR should be considered in hemodialysis patients when estimating dialysis delivery, especially if they had high Kt/ Vurea, recirculation rate, and hematocrit.
Blood Urea Nitrogen ; Body Weight ; Creatinine ; Diabetic Nephropathies ; Dialysis* ; Glomerulonephritis ; Hematocrit ; Humans ; Hypertension ; Membranes ; Nutritional Status ; Renal Dialysis* ; Serum Albumin ; Sex Ratio ; Ultrafiltration ; Urea*

No abstract available.
Lithotripsy* ; Shock*

Essential hypertension is an important public health problem in Korea-being common, asymptomatic, easily treatable, and often leading to lethal complication in left untreated. The number of patients with hypertension has been significantly increased, and this factor may be an importnat one responsible for the increase in cardivascular mortality during past 20 years in Korea. As the drug therapy for hypertension needs longer period, it is very important to evaluate the efficacy and the adverse effects. Thirty patients(17 men and 13 womon) with essential hypertension were evaluated in this study. All patients had received oral Isradipine 1.25~2.5mg b.i.d. for 8 weeks. 1) The systolic and diastolic pressure were decreased significantly(166.8+/-9.0mmHg vs 147.3+/-12.0mmHg, p<0.001 and 100.3+/-4.0mmHg vs 90.3+/-6.1mmHg, p<0.001, respectively) 2) Heart rate, body weight, laboratory tests, chest X-ray, ECG studies were not changed significantly. 3) The systolic pressure was lowered by 20mmHg or more in 17 cases(56.7% of total), and the diastolic pressure was lowered by 10mmHg or more in 20 cases(66.7% of total) at 8 weeks after Isradipine administration. 4) The adverse effects of Isradipine were edema in 3(10%), constipation in 2(6.7%), headache in 2(6.7%), and insomnia, dizziness and dry mouth in 1 patient respectively, and none of them discontinued Isradipine administration due to adverse effects. In many patients with essential hypertension there is an effective response to Isradipine, even though there may be some mild adverse effects.
Blood Pressure ; Body Weight ; Constipation ; Dizziness ; Drug Therapy ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Hypertension ; Isradipine ; Korea ; Male ; Mortality ; Mouth ; Public Health ; Sleep Initiation and Maintenance Disorders ; Thorax