No abstract available.
Inflammation* ; Rheumatic Diseases*

The incidence of trochanteric fracture of the femur is increasing, which is likely to continue for many years because of an increase in traffic accidents and the population of elderly people. The primary goal in the treatment of an elderly patient with an intertrochanteric hip fracture is to return the patient to his prefracture activity without any complication, as soon as possible. Rapid mobilization with stable internal fixation helps to prevent skin ulceration, pneumonia, urinary stasis, thromboembolic disease and other complications of confinement to bed in the elderly. Stable internal fixation depends mainly upon the fracture type and operative techniques. A clinical study of operative techniques was done in twenty three patients with trochanteric fracture of the femur who had been admitted and treated surgically at the Orthopaedic Department of W.M.B.H. during of two years from Mar. 1982 to Feb. 1984. The following are brief descriptions of the operative techniques. l. An L-shape incision and refiection of the vastus lateralis muscle provided wide exposure and facilitated anatomical reduction under direct vision. 2. The nail insertion site was selected at a slightly eccentric position anterior to rather than exactly midway from the opposite lateral cortex of the lesser trochanter. Therefore the nail could be laid rigidly between the thick anteromedial cortex and the posteromedial calcar portion. 3. The best stable position among the fracture line, the neck shaft angle and the nail plate could be obtained by the yoking procedure. It also allowed for later proximal migration of the shaft fragment and fracture impaction without impingement on the base of the barrel.
Accidents, Traffic ; Aged ; Clinical Study ; Femur ; Hip ; Humans ; Incidence ; Neck ; Pneumonia ; Quadriceps Muscle ; Skin Ulcer

No abstract available.
Child* ; Humans ; Hypertension*

OBJECTIVE: Uterine cervical cancer is the most common malignant tumor in Korean women. Human papillomaviruses are associated in 85-90% of the cases. However, other cofactors are considered to be important in carcinogenesis. There is an evidence that the uterine cervix is the site of shedding of the Epstein-Barr viruses(EBV). Furthermore the virus has been detected in cervical intraepithelial neoplasia and invasive carcinoma of the uterine cervix. We studied to evaluate the role of EBV in cervical carcinogenesis. METHODS: Non-neoplastic cervices(12), carcinoma in situ(32), microinvasive squamous cell carcinomas(9), invasive squamous cell carcinomas(37) and adenocarcinomas and adenosquamous carcinomas(14) were studied for EBV infection. PCR and in situ PCR for EBNA-1 were done and subtyping was done using PCR for EBNA 3C. RESULTS: In non-neoplastic cervix, EBV was detected in 16.7% by PCR and found in normal epithelial cells and lymphocytes in in situ PCR. By PCR technique, EBV was detected in 65.6% of CIS, 66.3% and 51.4% of microinvasive and invasive squamous cell carcinomas, 57.1% of adenocarcinomas and adenosquamous carcinomas. EBV subtyping was done in EBV positive cases by PCR and all showed type 1. CONCLUSION: EBV was detected in higher frequency in cervical cancer than in non-neoplastic cervix. However the frequency was not correlated to the invasion depth and histologic types of cervical carcinomas. EBV was detected in tumor cells as well as normal epithelial cells and lymphocytes also. It was suggested that EBV may play a role in cervical cancers but the mechanism in carcinogenesis remains to be solved.
Adenocarcinoma ; Carcinogenesis ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Epithelial Cells ; Epstein-Barr Virus Infections ; Female ; Herpesvirus 4, Human* ; Humans ; Lymphocytes ; Polymerase Chain Reaction* ; Prevalence* ; Uterine Cervical Neoplasms*

No abstract available.

Basta(R) is one of the Phospho-amino acid group herbicide. It consist of glufosinate ammonium (18.5%), alkylether sulfate as surfactant (30%) and some solvents. Although it's WHO classification is Bade III, the intoxicated patient appears an serious clinical findings and have a 20% mortality rate. Nowadays, in Korea the ingestion of herbicidal agents for suicidal attempts is Sequent. The literature for intoxication of bipyridilium (Gramoxon(R)) as herbicide is varied, but the information for Basta(R) is poor even though the use of it tends to increase. Recently, We experienced six cases of Basta(R) intoxication and found that the patient expressed a gradually progressed depression of mentation, recent memory disturbances, convulsions, hypotension, or bradycardia because of CNS or cardiovascular effects of Basta(R) We report these cases with literature review.
Ammonium Compounds* ; Bradycardia ; Classification ; Depression ; Eating ; Humans ; Hypotension ; Korea ; Memory ; Mortality ; Seizures ; Solvents

In recent years the rate of the spine Injury tends to be on the increase year by year as the rate of traffic and industrial accidents are increased. During industrial, sports and automobile accidents are occurred, the various forces were exerted by the mechanism, “flexion, extension, flexlon-rotation, vertlcal compression and shearing.” These exercise their effects on the vertebral bodies, the neural arches and intervertebral disc and the contents of the spinal cord, depending on direction and intensity of the trauma, and the posture and muscular attitude existent at the movement. Once the neurological Iesion has been diagnosised and the type of vertebral injury has been established and particularly after a decision has been made as to whether the spinal injury is stable or unstable, a rational method of treatment can be decised upon: Our treatment consists of providing the best condition for recovery from the spine injury, preventlng further neurologlcal damage in the unstable area, achieving stable bone and llgament heallng ln satisfactory position, preventing metabolic compllcations from being fatal, mobllizing the patient early, and rehabilitating to provide maximum fuctlonal independence with the remaining-muscle power avallablc to the cord injury patient. One hundred and fifty seven spine fracture and dislocation patients were clinically observed and evaluated from Jan. 1972 to Dec. 1978 in our study. The result of this study may be summerized as follows: 1. Out of the patients, there were 135 male and 22 female cases. The ratio between male and female was 6.1:1. The majority (84.7%) of the spine injuries was found in the age of 20 to 50 years. Fifty-two percent of the cases was caused by industrial accidents. 2. The most common site of the lesion occurred between T-11 and L-2 vertebrae (71.8%). 3. In cervical injury, fracture dislocation type was most common (50%), and especially, pure dislocation by extension mechanism was 12.5% but in thoracolumbar iniury, simple anterior wedge compression fracture was most common (66.6%) and there were no pure dislocations just like cervical spine injury cases. 4. Fifty seven cases of the total were complicated by paraplegia, of which 62.5% in cervical region and 31.6% in thoracolumbar region were noticed. The most frequent type of the injury in which paraplegia developed was the fracture dislocation (73.8%) and the most common site of the lesion was between the T-12 and the L-2 vertebrae. 5. Open reduction was performed in 9 cases out of 24 cervical spine injury patients and in 41 cases out of 133 thoracolumbar injury patients. 6. Prognosis of neurologic recovery in initially complete lesion was poor, regardness of treatment. In the cervical lesion cases there were no patients who were recovered. But in the other sites about 10.5% of initially complete lesion showed partial neural recovery comparing to 62.5% of initially incomplete lesions. 7. Progressive deformity is often noted as a complication of spine fracture or dislocation when solid fusion fails to develop. The increment of kyphosis after treatment is as follows: Simple wedge fracture
Accidents, Occupational ; Automobiles ; Catheterization ; Catheters ; Clinical Study ; Congenital Abnormalities ; Diagnosis ; Dislocations ; Female ; Fractures, Compression ; Humans ; Intervertebral Disc ; Kyphosis ; Laminectomy ; Male ; Methods ; Paraplegia ; Posture ; Prognosis ; Spinal Cord ; Spinal Injuries ; Spine ; Sports ; Urinary Bladder

Segmental wiring to treat the unstable fracture and fracture-dislocation of the thoraco-lumbar spine is more effective method than Harrington instrumentation as primary procedure which afforded immediate rigid internal fixation of the spine and permitted mobilization without external support and immediate rehabilitation. A clinical study was made of twenty seven patients who were hospitalized and treated at the Department of Orthopaedic Surgery, Wonju Christian Hospital from Feb. 1979 to Apr. 1983. The following results were obtained: l. Of twenty seven patients, nine(33.3%) had a flexion rotation, eight(29.6%) had a shearing, eight (29. 6%) had a flexion compression and two(7.5%) had a vertical compression by Holdsworths mechanism of injury and by Pauls classification of fracture, thirteen(48. 1%) had a flexion distraction fracture, twelve(44. 4%) had a translation fracture and two(7. 5%,) had a unstable burst fracture. 2. Fifteen(55. 6%) had a complete neural deficit and five(18. 5%,) had an incomplete neural deficit. Six(22.2%) of the fifteen patients with complete neural deficit and one(3. 7%.) of the five patients with incomplete neural deficit showed slight neurological recovery, but eight(29.6%) gained complete recovery. 3. Correction of kyphotic deformity was average 12. 4 degree in Harrington instrumentation and average 18. 0 degree in segmental wiring, and during the follow-up periods, there was a final loss of 6. 3 degrees of kyphotic correction in Harrington instrumentation and 3. 0 degrees in segmental wiring. 4. In external support, fourteen(51.9%) had body jacket cast and four(14.8%) had back brace in Harrington instrumentation, but all patients except one brace had no external support in segmental wiring. 5. In complication, two hook dislocations and two pseudoarthroses were occurred in Harrington instrumentation, but any complication except only one cases of wound infection was not occurred in segmental wiring.
Braces ; Classification ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Gangwon-do ; Humans ; Methods ; Pseudarthrosis ; Rehabilitation ; Spine ; Wound Infection

No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus*

The decrease of bone density after fracture is a well-known phenomenon. Several studies of the changes of bone density after fracture demonstrated bone density decreased not only at the fracture site, b ut also along the whole fractured bone. Being treated with locked intramedullary (IM) nailing, 15 patients with the long bone fractures of lower limbs were examined by Quantitative Computed Tomography (QCT) or Dual-Energy X-ray Bone Densitometer (Lunar DPX-L) a few days after nail removal. In the cases of QCT (5 patients of the tibia shaft fracture), cortical bone density, cortical thickness and geometrical shape (i.e. external antero-posterior and medio-lateral diameters) of the fracture site were compared to those of the contralateral side. On the other hand, in the case of Lunar' (5 patients of the tibia shaft fracture & 5 patients of the femur shaft fracture), only cortical bone density was compared to that of the contralateral side. The results of this study were as follows: 1. When treated by the locked intramedullary nailing of the long bone fractures, the bone density of the tibia & femur shaft fractures measured from the fracture site, proximal and distal sites to mid-fracture decreased. 2. There was a difference in the bone density of the uninjured long bone diaphysis of the tibia & femur shaft fractures. That is, in the case of the tibia shaft fracture, the bone density of the ipsilateral femur diaphysis measured by QCT increased 2 %, and increased 7 % when measured by Lunar. But, in the case of the femur shaft fracture, the bone density of the ipsilateral tibia diaphysis measured by Lunar decreased 4%. 3. In the case of the tibia shaft fracture, the cortical thickness in the fracture site measured by QCT increased 72 %, and external antero-posterior and medio-lateral diameters increased 7 % and 63 %. It seemed to be the formation of peripheral callus due to medullary reaming preceding intramedullary nail insertion. Therefore, this clinical study demonstrated that the mechanical property of the long bone fractures was restored and restricted weight bearing hardly needs to recommended when the nail was removed after the fracture union. 4. The bone densities of the tibia shaft fratures measured by QCT were not different with those measured by Lunar.
Bone Density* ; Bony Callus ; Diaphyses ; Femur ; Fracture Fixation, Intramedullary* ; Fractures, Bone* ; Hand ; Humans ; Lower Extremity ; Tibia ; Weight-Bearing