BACKGROUND AND OBJECTIVES: Primary intervention by stent implantation during acute myocardial infarction is a novel strategy to provide better myocardial perfusion compared to thrombolysis or baloon angioplasty. We aimed to assess the reperfusion achieved by primary stenting, employing TIMI frame count for more objective and quantitative measurement. MATERIALS AND METHOD: Measurements for number of frames required to opacify standardized angiographic landmark branch(TIMI frame count) were determined for the coronary arteries of 77 normal controls and 65 patients with acute myocardial infarction who underwent primary stenting within 12 hours of symptom onset. RESULTS: In normal subjects, TIMI frame count for left anterior descending artery(LAD) was 1.3 times of mean count of right coronary artery(RCA) and left circumflex artery(LCx), and significant less than that of TIMI study(22.3+/-4.9 vs 36.2+/-2.6, p<0.05). TIMI frame count for RCA and LCx was similar to results of TIMI study. In infarct related arteries(IRA), corrected TIMI frame count(CTFC) after primary stenting was similar to those of normal control. Frame counts of RCA was larger compared to that of normal control, but statistically insignificant(23.0+/-7.5 vs 17.6+/-3.5, p>0.05). There was no difference of CTFC of non-infarct related arteries between patients and normal controls. CONCLUSION: The TIMI frame count of LAD artery in normal Korean subjects was significantly less than that of American counterpart. In patients with acute myocardial infarction, primary stenting appeared to provide improved coronary flow similar to that observed in normal subjects, as measured by TIMI frame counting.
Angioplasty ; Arteries ; Coronary Vessels ; Humans ; Myocardial Infarction* ; Perfusion ; Reperfusion ; Stents*

No abstract available.
Knee Joint* ; Knee* ; Tuberculosis*

We built the hypothesis that the hypertrophic callus formation is mediated by beta-endorphin that stimulates secretion of GH and increase circulation growth factor activity in head injury patient. We classified 4 groups such as 5 normal person(control), group I;5 patients with only fracture, group II;5 patients with fracture and head injury, group III; 5 patients with only head injury, group IV. We obtained the samples of serum from each group at 0, 2, 4, 6, 8 weeks after trauma and assessed the serum level of GH, GHRH, somatostatin. The serum level of GH was statisticallyu higher in group III, IV than group I, II. There was not significant difference in serum level of GHRH. The serum level of somatostatin was higher in group II, III, IV than group I, but there was no statistical significance in each group. GH has a important role in hypertrophic callus formation in severe head injury patients, but there was no evidence that the mechanism is mediated by beta-EndorphinGHRH & somatostatin-GH-GF-1, beta-FGF axis. There may be a another mechanism in increasing GH that was stimulated by beta-endorphin in thalamus and lateral ventricle, and it should be necessary for further evaluation of it.
Axis, Cervical Vertebra ; beta-Endorphin ; Bony Callus ; Craniocerebral Trauma* ; Head* ; Humans ; Lateral Ventricles ; Somatostatin ; Thalamus

Fracture of scaphoid is relatively common, and accurate and prompt diagnosis leads to bony union with good clinical outcome. However, it can be easily missed due to vague symptomatic complaints by patients, which in turn leads to negligence of a doctor in making the diagnosis or anatomical shape of scaphoid that causes minute fracture to be ignored while viewing simple radiography. When missed, nonunion of scaphoid gradually progresses to arthritic change in the wrist. Thus when fracture of the scaphoid is suspected, further evaluation should be initiated with care, and if the diagnosis is confirmed, a proper treatment plan must be set with assessment of stability of the fracture fragment. Internal fixation is usually proposed since solid fixation of the fracture provides early return to daily activity. When nonunion of the scaphoid is present, most patients can achieve bony union with avascular bone graft and internal fixation. However, if there is sclerotic change, large bone cyst or avascular necrosis of the fracture fragment, internal fixation with bone graft that includes vascular supply should be introduced in order to achieve bony union.
Bone Cysts ; Diagnosis ; Humans ; Malpractice ; Necrosis ; Radiography ; Transplants ; Wrist

Anatomically, we have known that the first toe is composed of 2 phalangeal bones (proximal and distal phalanx) and the second, third, fourth, fifth toe are composed of 3 phalangeal bones (proximal, middle, and distal phalanx). But in Korean the 5th toe is commonly seen as 2 phalangeal bones in foot plain X-ray. In this study, we observed the numbers of phalangeal bones of fifth toe in Korean and analyzed the relation with several environmental factors and genetic factor. The data of occupation, age, body weight and foot length as well as the foot radiograph were obtained in 175 persons without any foot lesion. With the coorperative persons among them showing triphalangeal 5th toe as the index cases, radiograph of 12 family were studied to analyse the pedigree. As result, total frequency of the 5th toe symphalangism was 74.29% (male 74.2%, female 73.36%). There was no statistical difference between male and female. The bilaterality of the symphalangism was 98.46%. The occupation group were farmer, labor, self-support, white collar, student, housewife, there was no correlation between the kind of occupation and the frequency of the symphalangism. Also there was no correlation between body weight or foot length and the symphalangism. In conlusion, the two-phalanged fifth toe might be related with genetic factor rather than several environmental factors such as sex, age, occupation, body weight and length of foot. From the pedigree study we concluded the genetic trait of the triphalangism might be the autosomal recessive.
Body Weight ; Female ; Foot ; Humans ; Male ; Occupations ; Pedigree ; Toes*

It is challenging for orthopedic surgeons to diagnose pain at the ulnar aspect of the wrist due to the small and complex anatomical structures involved. Ulnar-sided wrist pain can also result from tendon problems, including extensor carpi ulnaris tendon and flexor carpi ulnaris tendon. Disorders of the extensor carpi ulnaris tendon include subluxation, dislocation, stenosing tenosynovitis, and tendinopathy. Unlike the extensor carpi ulnaris tendon which is prone to subluxation, dislocation and stenosing tenosynovitis from passing through as sheath, a flexor carpi ulnaris tendon is unsheathed, and calcific tendinitis and crystal deposition disease can occur at the distal tendinous portion of the flexor carpi ulnaris tendon.
Dislocations ; Orthopedics ; Surgeons ; Tendinopathy ; Tendon Entrapment ; Tendons* ; Tenosynovitis ; Wrist*

While injuries of finger flexor tendons are relatively commonly encountered trauma in orthopedic clinics, a closed rupture of these tendons is known to be rare due to their large flexibility and tension. Closed rupture of the finger flexion tendons can occur due to repeated movements following the fracture or malunion of the fingers or distal radius, and it also occurs nonspecifically among patients with autoimmune diseases. We report a case of spontaneous rupture of flexor digitorum tendons in a 49-year-old male who was diagnosed with carpal tunnel syndrome after received several sessions of steroid injection at the wrist joint; he was monitored for two-months and recovered well following operation.
Autoimmune Diseases ; Carpal Tunnel Syndrome ; Fingers* ; Humans ; Male ; Middle Aged ; Needles* ; Orthopedics ; Pliability ; Radius ; Rupture* ; Rupture, Spontaneous ; Tendons* ; Wrist Joint

While injuries of finger flexor tendons are relatively commonly encountered trauma in orthopedic clinics, a closed rupture of these tendons is known to be rare due to their large flexibility and tension. Closed rupture of the finger flexion tendons can occur due to repeated movements following the fracture or malunion of the fingers or distal radius, and it also occurs nonspecifically among patients with autoimmune diseases. We report a case of spontaneous rupture of flexor digitorum tendons in a 49-year-old male who was diagnosed with carpal tunnel syndrome after received several sessions of steroid injection at the wrist joint; he was monitored for two-months and recovered well following operation.
Autoimmune Diseases ; Carpal Tunnel Syndrome ; Fingers* ; Humans ; Male ; Middle Aged ; Needles* ; Orthopedics ; Pliability ; Radius ; Rupture* ; Rupture, Spontaneous ; Tendons* ; Wrist Joint

PURPOSE: To evaluate clinical results between early fixation group and delayed fusion group in treatment of intraarticular fracture of 4th, 5th metacarpal base. MATERIALS AND METHODS: From March 2002 to December 2006, 21 cases of early fusion and 11 cases of delayed fusion of 4, 5th carpometacarpal joint were reviewed retrospectively or were included in this study. Average follow up period is 39.9 months. Bony union was checked by plain films at follow up. DASH-questionnaire, VAS pain scale, grip power and range of motion of 4th, 5th metacarpophalangeal joint were also checked at last follow up. RESULTS: In radiologic study, bony union was confirmed in all cases of two groups. Early fixation group showed better outcomes than delayed fusion group in range of motion, DASH-questionnaire and VAS pain scale with statistical significant (p<0.004). CONCLUSION: Because early fixation group showed better clinical outcomes than delayed fusion group, early diagnosis and proper surgical treatment are important for better outcomes in treatment of intraarticular fracture of 4th, 5th metacarpal base.
Carpometacarpal Joints ; Early Diagnosis ; Follow-Up Studies ; Hand Strength ; Intra-Articular Fractures ; Metacarpophalangeal Joint ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: To evaluate clinical and radiological results after screw fixation of the scaphoid and lunotriquetral ligament repair using a dorsal approach in the treatement of trans-scaphoid perilunate fracture dislocations. MATERIALS AND METHODS: From May 2003 to August 2007, 11 patients who underwent operative management of a trans-scaphoid perilunate fracture dislocation were included in this study. Average follow up period was 58 months. In all patients, screw fixation of the scaphoid and lunotriquetral ligament repair with a suture anchor after open reduction was performed. Clinical evaluation was done by measuring range of motion and grip power and disabilities of arm, shoulder and hand (DASH) score evaluation for functional recovery at the last follow up. Union of scaphoid, change in lunotriquetral distance, and development of any instability and arthritis of wrist joint were radiographically assessed. RESULTS: In clinical outcomes, 89.3% recovery of grip power and 87.5% recovery of range of motion compared to healthy side were observed at the last follow-up. Average range of motions of extension, flexion, ulnar deviation, radial deviation, supination and pronation were 51.8degrees, 58.4degrees, 21.2degrees, 16.2degrees, 74.3degrees, 75.1degrees respectively. Average DASH score was 13.2. Bony union of scaphoid was achieved in all cases at the average of postoperative 19.3 weeks. Lunotriquetral distance after the operation and at the last follow up were 1.9 mm and 2.0 mm, respectively. There were no radiographic evidence of instability or arthritis. CONCLUSION: Dorsal approach allows reduction of carpal bone, scaphoid fixation and lunotriquetral ligament repair in the treatment of trans-scaphoid perilunate fracture dislocations, providing satisfactory clinical and radiological results.
Arm ; Arthritis ; Carpal Bones ; Dislocations ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Ligaments ; Pronation ; Range of Motion, Articular ; Shoulder ; Supination ; Suture Anchors ; Wrist Joint