Segmental fractures of the femoral shaft result from high energy trauma such as a traffic accident or falls, and it is frequently accompanied by multiple fractures and severe injuries to other organs. Thus it is very difficult to treat these fractures satisfactorily and several complications can be caused. Early operative intervention and rigid fixation is important to mobilize the patient and to ensure early rehabilitation. Nineteen cases of segmental fractures of the femoral shaft were treated with operative intervention(intramedullary nailing) and followed up between May 1989 and Nov. 1993.; minimal follow-up period was more than one year. Results were obtained as follows: 1. The methods of treatment were interlocking intramedullary nailing in 16 cases(colsed nailing in 7 cases, open nailing in 9 cases) and Kiintscher nailing in 3 cases. Bone grafts were done in 11 cases among 19 cases(8 cases in the interlocking nail group). 2. The closed interlocking intramedullary nailing could be obtained in more shortened operation time than in the open method. 3. There was earlier bone union time in the closed intramedullary nailing than in the open method with bone graft, but there was no statistical significance(SPSS/pc+progam). 4. There was a tendency of earlier bone union time in the proximal fracture site than in the distal fracture site.
Accidental Falls ; Accidents, Traffic ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Multiple ; Humans ; Methods ; Rehabilitation ; Transplants

The disc internal disruption syndrome is not well known to us, but the following hypothesis is widely accepted in clinical practice. The disc internal disruption syndrome may develop intractable back pain with aggravated of pain, loss of spinal motion with any physical exercise, leg pain, loss of energy, marked weight loss, and profound depression. The patient with this syndrome will be found to have normal plain roentgenograms, myelograms, CT scans, results of blood examination and neurologic findings. For these reasons, this syndrome was frequently diagnosed by abnormal discographic findings. We had experience with two cases of disc internal disruption syndrome with clinical, roentgenographic and discographic evaluations. Thus we present these case with a brief review of the concerned literature.
Back Pain ; Depression ; Exercise ; Humans ; Leg ; Neurologic Manifestations ; Tomography, X-Ray Computed ; Weight Loss

No abstract available.
Collagen Type IV* ; Mucocutaneous Lymph Node Syndrome* ; Ventricular Function, Left*

A clinical study of traumatic amputation by railroad accidents was made an 124 patients with 154 amputee, who had been treated at Department of Orthopaedic Surgery, National Seoul Hospital, during the 4 years period from January 1976 to December 1979. The results of this study are as follows: 1. The ratio of male to female was 9 to 1. The 3rd decade of age group showed the hightest number of accident causalties, as much as 37.1%. 2. Causalties showes a maximum during the sprlng (37.1%) and a minimum during winter. 3. The most common injured sites of the amputee were B–K in 44 cases among 154 cases of the amputee. 4. Considering the number of the multiple amputee in 26 casee among 124 cases, frequently they developed in 2 sites with 22 cases, 3 sites with 4 cases. 5. The frequent fracture sites with combined amputation were 18 cases of the pelvic bone, 12 cases of femur in amputation of the lower extremity. 6. Our methods of treatment were debridement, debridement and primary skin closure, debridement with open amputation, circular amputation, closed amputation with skin graft, and closed amputation. 7. The major complications were phantom limb in 108 cases (70.1%), infection in 44 cases (28.6%). 8. The most frequent infectious agent was pseudomonas (16 cases).
Amputation ; Amputation, Traumatic ; Amputees ; Clinical Study ; Debridement ; Female ; Femur ; Humans ; Lower Extremity ; Male ; Pelvic Bones ; Phantom Limb ; Pseudomonas ; Railroads ; Seoul ; Skin ; Transplants

Amipaque is a water soluble, non-ionic myelographic contrast media, and owing to its high diagnostic accuracy and safety, its use is gradually increasing. The authors studied the complications after Amipaque lumbermyelography in 61 patients with low back pain during the period from Jan. 1981 to Nov. 1981 in Chung Ang University Hospital. The results were as follows; 1. Total complication rate was 52%(32 of 61) and there was nosexual difference in its occurrence. 2. In total, no difference in complication rate was found between head-up positioned group with a degree of 30degrees (group I) after procedure and head-up positioned group with a degree of 70degrees (group II) but female patients had more complication rate in group I than in group II (75% vs 50%).Headache was more common in group I and nausea was more common in group II. 3. Headache was most common complicaiton (44%) and there was no sexual difference in its occurrence. 4. No significant difference in complication rate was found between patients proved to have HBP and patients to have not. 5. Complications were less common in patients with punctured level of L4-5 than in patients with L2-3 or L3-4 level puncture.
Contrast Media ; Female ; Headache ; Humans ; Low Back Pain ; Metrizamide ; Myelography ; Nausea ; Punctures ; Water

Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So compliactions of the supracondyle fractures 'including joint.. stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed. 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989. Dec. To 1992. Jan. The results were as follows 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification, 4 cases were type A, 4 in type B, 12 in type C (10 in type C2&C3). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in consevative treatment and 67 in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.
Accidents, Traffic ; Classification ; Femoral Artery ; Femur* ; Fractures, Open ; Humans ; Joints ; Knee ; Male ; Weight-Bearing

No abstract available.
Animals ; Carbohydrate Metabolism* ; Hindlimb Suspension* ; Hindlimb* ; Insulin* ; Muscle, Skeletal* ; Rats* ; Receptor, Insulin*

The muscle glycogen is an important energy source for muscle contraction especially in prolonged exercise. One of the important factors for improvement of physical performance in athletes is the storage of extra-amount of glycogen (supercompensation) in liver and muscles. During 120 minutes treadmill exercise (intensity of exercise was approximatly 80% VO2max), the glycogen concentration was significantly decreased to 36% in liver and 46% in muscles after 60 minutes exercise. At 90 and 120 minutes of exercise, the level of glycogen concentration of liver and muscles statistically were not different from the levels of the 60 minutes exercise. The repletions of glycogen in the liver and muscles in overnight fasted control(C) and 120 minutes treadmill exercise(E) groups during l80minutes after glucose ingestion were investigatect. ln the liver, the concentration of glycogen in C and E groups were markdly increased till 120 minutes after zlucose ingestion, hut the levels of concentration at 180 minutes were decreased comparing to the levels of 120 minutes in both groups. In the muscles, the repletion of glycogen at 60, 120 and 180 minutes of C and E groups were significantly increased comparing to 0 minute of respective groups in the soleus and plantaris muscles. In soleus(SOL), the repletion of glycogen in all of the E groups was significantly higher than that of the respective C groups. However, the repletion of glycogen in all of the E groups of plantaris was revealed higher tendency comparing to respective C groups. Mean repletion rates of glycogen in liver and muscles after glucose ingestion were highest during the first 60 minutes in all groups and the rates of E groups were 2-3 times than those of respective C groups. These results suggest that the glycogen supercompensation in the muscle be provided with decrement of glycogen concentration by exercise, increment of glucose uptake by muscuiar contraction itself and increased insuJin level, and the activation of glycogen synthetase by insulin.
Animals ; Athletes ; Eating* ; Glucose* ; Glycogen Synthase ; Glycogen* ; Humans ; Insulin ; Liver* ; Muscle Contraction ; Muscles ; Rats*

Antihypertensive and beta-adrenoceptor blocking effect of long-acting propranolol were observed in the outpatient department, Department of Internal Medicine, National Medical Center during the period between December, 1981 and May, 1982. The clinical effects of long-acting propranolol were compared with those of conventional propranolol and following results were obtained. 1) Direct cross-over from conventional propranolol 20mg three times a day for several days to long-acting propranolol 160mg once daily was not accompanied by appreciable side effect and there was fairly good antihypertensive effect either in systolic or diastolic pressure. 2) Antihypertensive and bata-adrenoceptor blocking effect of long-acting propranolol 160mg once daily were comparable to those of conventional propranolol 40mg three or four times a day. The compliance of the patients to long-acting propranolol once daily was naturally better than that to conventional propranolol which must be taken three to four times daily. 3) In several cases of trial, the patients who tolerated the long-acting propranolol 160mg per day also well tolerated the regimen of long-acting propranolol 320mg per day, 4) The regimen of long-acting propranolol once daily was recommendable to those patients who were on beta-blocking agents for prolonged period of time for their indications such as hypertension and other chronic cardiovascular diseases, in view of the aspects of good patient compliance, good antihypertensive and beta-blocking effect.
Blood Pressure ; Cardiovascular Diseases ; Compliance ; Humans ; Hypertension ; Internal Medicine ; Outpatients ; Patient Compliance ; Propranolol*

This study conducted to evaluate the association of work posture with cervical spine abnormality toward 106 microwave-oven assemblers. A self-administered questionnaire was used to obtain a general characteristics and a work history of workers. The posture of neck and shoulder joint of workers were measured with video tape recording and the simple X-ray of cervical spine was checked-up to observe the X-ray abnormality including degenerative change, curvature abnormality, disc space narrowing or disc canal narrowing. The result were as follows. 1. The prevalence of degenerative change among cervicobrachial disorder workers was 44.3%(47 persons), curvature abnormality was 43.4%(46 persons), disc space narrowing was 21.7%(23 persons), and disc canal narrowing was 21.7%(23 persons). 2. The prevalence of degenerative change at cervical spine was increased with the degree of neck flexion(flexed versus neutral; odds ratio (OR)=2.7), the total work posture of neck(mild or severe awkward versus neutral; OR=1.2, 3.4). 3. The prevalence of degenerative change at cervical spine was increased with the degree of the right shoulder flexion, the heaviness of the materials carried by the right hand and the degree of awkwardness at the total work posture of right shoulder(p<0.05). 4. There was no evidence of association between curvature abnormality, disc space narrowing, disc canal narrowing and work posture. In conclusion the awkward work posture was related with degenerative change of cervical spine among microwave oven assembling workers and the further study in these field must be made to prove the association objectively.
Hand ; Microwaves ; Neck ; Odds Ratio ; Posture* ; Prevalence ; Surveys and Questionnaires ; Shoulder ; Shoulder Joint ; Spine* ; Videotape Recording