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

n-Hexane and benezene are organic compounds which have been widely used as industrial solvents. However, they are also increasingly recognized as important pollutants in working environment. The purpose of this study is to analyze neurotoxicity of benzene and n-Hexane. In this study, tibial nerve of Sprague-Dawley rats were observed after exposing them to two different concentrations of these compounds (6000 ppm of n-Hexane and 2000 ppm of benezene) which were known to be the levels to cause subacute toxicity for the three different periods; two weeks, four weeks, and sex weeks. The following results were obtained from the analysis of variance, Duncan's multiple comparison test, and regression analysis: 1) Myelin sheath thickness of nerve fiber for two n-Hexane exposed groups (four weeks and six weeks) were both reduced compared with the control group and the benezene exposed group. 2) There were positive relationships between nerve fiber diameter and myelin sheath thickness for both exposed and control groups. 3) There were significant difference in myelin sheath thickness from equal diameter nerve fibers between benzene exposed group and control group, but the greater number of thin myelin sheath were observed for n-Hexane exposed group compared with control group. Thus, it is concluded that n-Hexane tends to reduce the rate of growth of nerve fiber more than the benzene and control group. While these results shed light on understanding the effects of benzene and n-Hexane, the duration of exposure was not long enough to apply these results to real working environments. In addition, to further understand the mechanism of nerve degeneration caused by organic solvents, both epidemiological and biochemical studies should accompanied by this kind of study.
Animals ; Benzene* ; Myelin Sheath ; Nerve Degeneration ; Nerve Fibers ; Rats* ; Rats, Sprague-Dawley ; Solvents ; Tibial Nerve*

The bone formation of periarticular connective tissue after head injury and total hip arthroplasty is included in the category of heterotopic ossification. Induction of a new bone formation in the soft tissue is related to various materials such as bone morphogenic protein. The alkaline phosphatase and acid phosphatase act as important factors in the formation and absorption of the bone. The acid phospatase has the important function of acting as the control with specific activity of phosphatase in vivo. Cholecalciferol induces absorption of the calcium in the alimentary tract and bone resorption and increment of bone calcification, whereas disodium etidronate inhibits the deposition and dissolution of calcium salt and formation of heterotopic bone. This paper reports on the relationship of alkaline phosphatase and various phosphoaminoacid phosphatase which affect the cellular differentiation and remodelling in the heterotopic ossification, with the effect of cholecalciferol and disodium etidronate on the heterotopic bone induction in rats. The following results were obtained: 1. The contents of the calcium in the implanted bone matrix increased markedly from two to five weeks. There was no changes in the calcium content by cholecalciferol or in the administration of small doses of disodium etidronate (5mg/kg). However, in the administration of large dose of disodium etidronate (25mg/kg), calcium mobilization was totally suppressed for the whole period of the experiment. 2. The protein content in the implanted bone matrix did not much change for the whole period of the experiment and the administratinn of cholecalciferol or disodium etidronate also had no effect on the protein content. 3. The activities of alkaline phosphatase in the implanted bone matrix peaked at two weeks in control or cholecalciferol group, whereas disodium etidronate admninstration caused the highest activity in the third week. 4. The activity of acid phosphatase in the implanted bone matrix increased in first and third weeks by cholecalciferol treatment. Disoidum etidronate inhibited the activity of the acid phosphatase in the first, fourth & sixth weeks of implantation. 5. The activity of phosphoserine phosphatase increased due to cholecalciferol treatment, but was significantly inhibited by disodium etidronate (25mg/kg) treatment. 6. The activity of phosphothreonine phosphatase in the implanted bone matrix slightly increased due to cholecalciferol treatment, whereas the activity decreased significantly for the whole period of the experiment by disodium etidronate (25mg/kg) treatment. 7. The activity of phosphotyrosine phosphatase in the implanted bone matrix was not change much for the whole period of the experiment and the administration of cholecalciferol or disodium etidronate had no effect on the activity of phosphotyrosine phosphatase. In conclusion, the disodium etidronate (25mg/kg) almost completely inhibited the molilization of calcium and the activities of acid phosphatase, phosphoserine and phosphothreonine phosphatases. Therefore, it can be suggested that the above phosphatases are closely related to the action mechanism of disodium etidronate.
Absorption ; Acid Phosphatase ; Alkaline Phosphatase ; Animals ; Arthroplasty, Replacement, Hip ; Bone Matrix ; Bone Resorption ; Calcium ; Cholecalciferol ; Connective Tissue ; Craniocerebral Trauma ; Etidronic Acid ; Ossification, Heterotopic ; Osteogenesis ; Phosphoric Monoester Hydrolases ; Phosphoserine ; Phosphothreonine ; Protein Tyrosine Phosphatases ; Rats

The objective of this study is to examine the correlation between the tolylene concentration in the work environment of organic solvents and the concentration of hippuric acid in urine of workers exposed toluene, and to acquire the fundamental materials of workers' health care and to assist the assessment of the biological permissible exposure limit. The control groups are 72 workers who had never been exposed to toluene and the case groups are 101 workers who had been exposed to toluene. This study was conducted to examine the correlation between the concentration of toluene in work environment and workers' hippuric acid concentration, to investigate the complaint difference of subjective symptoms by means of questionnaire, between the case groups and control groups. The results and conclusions are as follows: 1) The highest mean concentration of toluene in the air is 544.13+/-7.75 ppm in the Printing Department of mixing organic solvents. The concentrations of the others are 463.27+/-5.24 ppm in Department of mixture for organic solvents, and 393.56+/-45.69 ppm in the Printing Department(1), and 248.38+/-45.16 ppm in the Printing Department(2), and 159.38+/-18.51 ppm in the Printing Department(3). 2) The highest mean concentration of hippuric acid in urine is 6034.84+/-1298.35 mg/l in the Printing Department with mixing organic solvents. The concentrations of the others are 4798.44+/-784.53 mg/l in Department of mixture of organic solvents, and 2883.06+/-701.90 mg/l in the Printing Department(1), and 1449.98+/-905.19 mg/l in the Printing Department(2), and 598.52+/-299.43 mg/l in the Printing Department(3). 3) As the toluene concentration in the work environment becomes higher, the concentration of hippuric acid in urine also becomes higher. It is found that the coefficient of correlation between toluene concentration and the concentration of hippuric acid are positive (r=0.868, Y=7.18X+349.57). 4) It is found that the case groups complain of much more subjective symptoms than the control groups.
Delivery of Health Care ; Surveys and Questionnaires ; Solvents ; Toluene*

The purposes of operative treatment in unstable thoracolumbar and lumbar spine fractures are anatomical reduction and stabilization of the fractures and thus promote neurological recovery and early rehabilitation. To achieve these goals, complete preoperative assessment and recognition of the fracture pattern is necessary in addition to good surgical technique. The authors analyzed 47 cases of thoracolumbar and lumbar spine fractures operated from Jan. 1989 to Dec. 1991 at the Department of Orthopaedic Surgery, National Medical Center. All cases were classified according to Denis classification and in deciding the appropriate surgical approach, fracture type, stability, neurologic status and degree of deformity were all considered. Anterior approaches were performed in 23 cases of burst fracture and 3 cases of fracture-dislocation, and posterior approaches were performed in 1 case of compression fracture, 7 cases of burst fracture, 4 cases of seat-belt type injury and 5 cases of fracture-dislocation, In 3 cases of burst fracture and 1 case of fracture-dislocation, both anterior and posterior approaches were combined. With the analysis of postoperative changes in sagittal and coronal angle, translation and degree of rotation, we evaluated the results of operative reduction in terms of restoring normal anatomical configuration of injured spinal segments. So we tried to find the attributing factors in the operative reduction of the thoracolumbar and lumbar spine fractures and suggest the proper surgical approach that provides better reduction and stabilization.
Classification ; Congenital Abnormalities ; Fractures, Compression ; Rehabilitation ; Spine

Persistent trigeminal artery is an embryonic remnant of the anastomotic channel linking the internal carotid artery and the basilar artery. Cases of vertebrobasilar insufficiency caused by the persistent trigeminal artery with internal carotid artery stenosis has been described previously, but vertebrobasilar insufficiency entirely due to in situ stenosis of the persistent trigeminal artery has not been reported. A 71-year-old man presented with frequent dizzy episodes. The brain MRI showed no parenchymal lesions. MR angiography showed poor visualization of vertebrobasilar system. He was diagnosed as having vertebrobasilar insufficiency. Cerebral angiography revealed that there was complete occlusion at the vertebrobasilar junction, and the basilar artery was supplied by the persistent trigeminal artery which had severe stenosis at its origin. There was no stenosis of the internal carotid artery of both sides. We believe that this is the first report of vertebrobasilar insufficiency due to stenosed persistent trigeminal artery, without internal carotid artery stenosis.

No abstract available.
Anterior Cruciate Ligament* ; Autografts* ; Tendons* ; Transplants*

Primary extrapulmonary small cell carcinoma (EPSCC) of the appendix is an extremely rare entity, and there has been only one previous report on this in the English medical literature. We report here on the first Korean case of EPSCC of the appendix in a 55-year-old woman. The patient had no history of an identified pulmonary tumor, and she presented with constipation and lower abdominal pain. The patient underwent right hemicolectomy with regional lymph node dissection and bilateral salphigo-oophorectomy. The histology of the entire appendiceal tumor revealed pure EPSCC with diffuse immunoreactivity for pancytokeratin, cytokeratin 7, cytokeratin 20, CD56, thyroid transcription factor 1, c-kit and carcinoembryonic antigen, and there was focal weak immunoreactivity for chromogranin A and synaptophysin. After the second cycle of chemotherapy, the condition of the patient gradually deteriorated due to cancer peritonei and the patient died 7 months later. EPSCC of the appendix is a distinctive clinicopathological entity that displays highly aggressive behavior and an unfavorable outcome.
Abdominal Pain ; Appendix ; Carcinoembryonic Antigen ; Carcinoma, Small Cell ; Chromogranin A ; Constipation ; Female ; Humans ; Keratin-20 ; Keratin-7 ; Lymph Node Excision ; Middle Aged ; Nuclear Proteins ; Synaptophysin ; Thyroid Gland ; Transcription Factors

No abstract available.
Management Information Systems* ; Occupational Health Services* ; Occupational Health*

No abstract available.
Delivery of Health Care* ; Hearing Loss* ; Hearing* ; Noise*