No abstract available.
Breast* ; Hamartoma*

An intra-articular fracture of the distal tibia or a fracture of the tibial plafond is a relatively uncommon but the most difficult fracture to manage. There are many treatment options and many authors have reported good results after open reduction and rigid internal fixation to restore the length with articular surface and bone-graft followed by early motion and prolonged non-weight bearing. But in the fractures with severe comminution or with severe soft tissue injury, tries for internal fixation with plate and screws in the distal tibia will result in extensive soft tissue stripping of the wound with precarious blood supply, high rates of wound breakdown, superficial and deep infection, and osteomyelitis. The purpose of this study is to evaluate the results of treatment of severely open (open type III-A and more by Gustilo and Anderson) or comminuted plafond fractures (fracture type III and more by Ovadia and Beals) with an Ilizarov method with a minimum follow up of one year (average: 27.9 months) and we have reviewed 12 cases from December 1990 to October 1995. The results were as follows. 1. The average time of bone union were 17.5 weeks (range: 6-42weeks). 2. The radiological results of the treatment were excellent in 4 patients (33.3%), good in 4 patients (33.3%) and poor in 4 patients (33.3%) by radiological assessment of Crutchfield and the clinical results of the treatment were excellent in 4 patients (33.3%), good in 5 patients (41.7%) and poor in 3 patients (25.0%) by functional rating scaie of Crutchfield. 3. It seems that prognosis depends on severity of comminution at the time of injury. 4. The complications were bony collapse of the distal tibia in 2 patients, nonunion in 1 patient, degenerative arthritis of the ankle joint in 2 patients and chronic osteomyelitis in 2 patients. 5. Ilizarov technique is an useful method in the management of severely open or comminuted plafond fracture of the tibia and it would be preferable to apply buttress plate or bone graft after improvement of skin condition to prevent the late collapse.
Ankle Joint ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Intra-Articular Fractures ; Osteoarthritis ; Osteomyelitis ; Prognosis ; Skin ; Soft Tissue Injuries ; Tibia ; Transplants ; Wounds and Injuries

In this study, the Periotest value was measured with Periotest to evaluate precision fit of the 2-unit and 3-unit implant-supported prosthesis by modifying the size and location of ill-fitted conditions. The 2-unit prosthesis was fabricated with the right implant fitted incorrectly and the 3-unit prosthesis with the right and center implant fitted incorrectly. To evaluate the effects of the ill-fitted sizes, 4 groups were divided.:The control group being the accurately fabricated sample group fitted properly. Group 1 was constructed with 40micrometer ill-fitted conditions, group 2 with 70micrometer and group 3 with 100micrometer ill-fitted conditions. The Periotest value was measured at each implant site after tightening 10Ncm. The result was follows: 1. The PTV on the ill-fitted area in the 2-unit implant-supported prosthesis increased as the ill-fitted conditions increased. There was a statistically significant difference among groups(p<0.05). In the same ill-fitted sample, the PTV depending on the measured location demonstrated a statistically significant difference (p<0.05). 2. The PTV on the ill-fitted area of the 3-unit implant-supported with an ill-fitted condition in the right implant increased as the ill-fitted conditions increased. There was a significant difference among groups (p<0.05). In the same ill-fitted sample, the PTV depending on the measured location demonstrated a statistically significant difference (p<0.05). 3. In the 3-unit implant-supported prosthesis with ill fitting conditions in the center implant, the PTV on the ill-fitted area demonstrated a statistically significant difference between the control group, group 1 and group 2 (p<0.05). In the same ill-fitted sample, the PTV depending on the measured location demonstrated significant difference between the gap side and the adjacent side with over 70micrometer ill-fitted conditions (p<0.05). The results suggest that Periotest is a valuable objective method for evaluating the precision fit of an implant superstructure.
Prostheses and Implants*

No abstract available.
Emergencies* ; Emergency Medicine* ; Internship and Residency*

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

No abstract available.
Child* ; Evoked Potentials, Auditory, Brain Stem* ; Humans

OBJECTIVES: Considerable variations in the contents of clinical practice are the natural consequences of the fact that so many factors can have influences on each clinical decision making processes in the psychiatric treatment, let alone the pharmacotherapy of schizophrenia. To attain the goal of rational treatment, it is needed to examine the actual contents of clinical practices and the degree of variations among diverse hospitals. In addition, it is also needed to look into the unique situations in which each hospital is situated. For this purpose, this study tried to investigate the degree of variations in several aspects of the treatment of schizophrenia with atypical antipsychotics currently practiced in Korea. METHODS: This study is based on the data from RODOS (Risperidone Olanzapine Drug Outcome Study) in Korea. This study had been designed as a multi-center naturalistic study, therefore, had many advantages for the survey study of actual clinical practices. The subjects of the study were the in-patients who had been given risperidone or olanzapine for the control of their psychotic symptoms. Clinical data had been gathered by retrospective chart review. The degree and the characteristics of the variations were examined by comparing the patient-characteristic variables and the treatment-related variables among each hospital. RESULTS: The differences in the baseline characteristics of the patients including the duration of illness and the past history of psychiatric treatment were substantial among each hospital, and these differences seemed to explain a great portion of the variations in the contents of treatment. The variations in the dosage of risperidone and olanzapine were not conspicuous among each hospital. However, the variations in other treatment-related variables, including duration of admission, proportion of combined therapy with other antipsychotics, usage of anticholinergics, detection rate of extrapyramidal symptoms, remained statistically significant after adjusting the baseline patient characteristics as covariates. Although no significant correlation among each variable was found, a couple of unique practice patterns common to several hospitals could be observed. CONCLUSIONS: Considerable variations in the diverse treatment-related variables were observed in the treatment of schizophrenic patients with risperidone and olanzapine. It seemed that the major portion of these variations could be explained by the characteristic of patient group. However, the possibility remained that the other factors including the socio-cultural environment of the community and the disposition of the clinician themselves were still the major contributing factors to these variations. It is expected that the future clinical practice surveys like this study can help the clinicians to reevaluate their current practices, and can help to accumulate the basic data needed to establish the more rational and customized treatment practices.
Antipsychotic Agents ; Cholinergic Antagonists ; Decision Making ; Drug Therapy ; Humans ; Korea ; Linear Energy Transfer ; Retrospective Studies ; Risperidone* ; Schizophrenia

Nutrition is thought to be much more important to the handicapped for their growth and development and successful management of their disease because they have much more complexed problems in physical, emotional, familial, and socioeconomic aspects. The authors determined number of erythrocytes and leukocytes, quantity of hemoglobin, hematocrit, reticulocyte, number of platelets for the survey of anemia to evaluate the nutritional status in mental and physical handicapped. Mean Corpuscular volume, Mean Corpuscular Hemoglobin and Mean Corpuscular Hemoglobin Concentration were calculated as usual according to wintrobe. Total iron binding capacity and serum iron were also measured in the hadicapped. The study group consists of total III handicapped children, who were composed of 13 first visitors to Out Patient Department, 51 hopsitalized patients in Rehabilitation Hospital, and 47 patients attending a Special Elementary School for the handicapped. Of the III subjects, 58 had cerebral plasies, 49 poliomyelitises and 4 had other orthopedic problems. Results. 1. Anemia were seen in 14 subjects, composed of 4 first visitors to O.P.D.(28.6% of all the anemias, 30.8% of all the O.P.C. subjects), 7 hospitalized subjects(50% of all the anemias, 13.7% of all the hospitalized subjects) and 3 Special School subjects(21.4% of all the anemias, 6.4% of Special School subjects). Incidence of anemia was higher in O.P.D. subjects than in the subjects of other groups. 2. Incidence of anemia by the disease entities was higher in the indivisuals with cerebral palsy, 7 in number(50% of all the anemias, 11.1% of all the cerebral palsy subjects) than in 5 those with poliomyelitis (35.7% of all the anemias, 10.2% of all the poliomyelitis subjects), or in 2 other subjects. 3. Incidence of anemia by the age was higher in the subjects below 6 years of age whose number was 5(35.7% of all the anemias, 45.5% of all the subjects below 6 years of age) than in the subjects above 9 years of age whose number was 9(64.3% of all the anemias, 11.1% of all the subjects above 9 years of age). The incidence of anemia in the subjects above 12 years of age was 17.7%(seven of the nine anemias above 9 years of age). 4. Five of the seven cerebral palsy patients with anemia were below 6 yeas of age(45.5% of all the cerebral palsy subjects below 6 years of age). All of the five poliomyelitis patients with anemia were above 9 years of age(11.1% of all the poliomyelitis subjects above 9 years of age). 5. Iron deficiency anemia was noted in 6 of 14 anemia patients(43% of all the anemias), which were composed of 2 cerebral palsy patients below 6 years of age, 3 poliomyelitises and one patients with congenital hip dislocation above 9 years of age.
Anemia* ; Anemia, Iron-Deficiency ; Cerebral Palsy ; Disabled Children ; Disabled Persons* ; Erythrocyte Indices ; Erythrocytes ; Growth and Development ; Hematocrit ; Hip Dislocation, Congenital ; Humans ; Incidence ; Iron ; Leukocytes ; Nutritional Status ; Orthopedics ; Poliomyelitis ; Rehabilitation ; Reticulocytes

"Optic neuritis", described first by Nettleship in 1884, is the general term used to describe involvement of the optic nerve as the result of inflammation, demyelination, or infection. The majority or patients with optic neuritis are between the ages of 20 and 50 years, and the major symptom in most cases is sudden visual loss. It would appear that when optic neuritis occurs in childhood, it is more commonly bilateral and associated with disc swelling. In the majority of cases, the visual prognosis and eventual prognosis with regard to the development of multiple sclerosis is much better than in adult optic neuritis. The authors experienced a case of bilateral optic neuritis in a 14-year-old girl whose visual acuity progressed to no light perception with eventual visual recovery after treatment with steroid and mannitol. A brief review of literature is described.
Adolescent ; Adult ; Demyelinating Diseases ; Female ; Humans ; Inflammation ; Mannitol ; Multiple Sclerosis ; Optic Nerve ; Optic Neuritis* ; Prognosis ; Visual Acuity

"Optic neuritis", described first by Nettleship in 1884, is the general term used to describe involvement of the optic nerve as the result of inflammation, demyelination, or infection. The majority or patients with optic neuritis are between the ages of 20 and 50 years, and the major symptom in most cases is sudden visual loss. It would appear that when optic neuritis occurs in childhood, it is more commonly bilateral and associated with disc swelling. In the majority of cases, the visual prognosis and eventual prognosis with regard to the development of multiple sclerosis is much better than in adult optic neuritis. The authors experienced a case of bilateral optic neuritis in a 14-year-old girl whose visual acuity progressed to no light perception with eventual visual recovery after treatment with steroid and mannitol. A brief review of literature is described.
Adolescent ; Adult ; Demyelinating Diseases ; Female ; Humans ; Inflammation ; Mannitol ; Multiple Sclerosis ; Optic Nerve ; Optic Neuritis* ; Prognosis ; Visual Acuity