The management of fractures of os calcis remains highly controversial. The fractures involving subtalar joint may cause serious and persistent disabilities. Recently, the computed tomography (CT) scan has been shown to he superior in evaluating the intraarticular fractures of calcaneus and the most widely used classification is based on the number of fragments especially seen on. Although the classification of calcaneal fractures hy CT, tongue type and joint depression type fractures hy plain radiographic views have been commonly used. Generally, closed reduction and axial fixation with metallic pin for tongue type fractures and open reduction and internal fixation for joint depression type fractures have been performed. The authors did so. The 13 fractures were tongue types and 17 fractures were joint depression types. The intraarticular calcaneal fractures of 30 feet in 26 patients who were treated at Our Lady of Mercy Hospital were analyzed in clinical and radiological aspects from Mar.1991 to Apr.1996. The results were as follows: 1. Of 30 cases, 16 fractures were treated with closed reduction and pinning, and 14 fractures were treated with open reduction and internal fixation. 2. The preoperative, postoperative and the last follow-up average Bohlers angle were 6.0, 21.0 and 20.5 respectively. 3. The preoperative, postoperative and the last follow-up average Gissanes angle was 106, 129 and 126 respectively. 4. Based on assessment of the criteria of Salama et al 19), excellent results were 5, good results were 14, fair results were 6 and poor results were 5. 5. All the five cases of poor results were tongue type fractures and they were treated with closed reduction and axial pinning. 6. Of 7 fractures using autogenous iliac bone graft, 6 fractures were good, I fracture was fair and there was no poor results. Therefore, open reduction and internal fixation for joint depression type calcaneal fractures was thought to be a good method of treatment. But we must consider whether axial fixation with metallic pin for tongue type calcaneal fractures will be a good method of treatment.
Calcaneus ; Classification ; Depression ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures ; Joints ; Subtalar Joint ; Tongue ; Transplants

Degenerative lumbar spondylolisthesis requires fusion of the involved segments and decompression laminectomy because it is mechanically unstahle and usually associated with stenosis of the spinal canal. Transabdominal retroperitoneal approach through small longitudinal pararectal skin incision provides easy and safe access to L3-4 and L4-5 disc spaces with less bleeding. We thought that anterior interbody fusion enable us to restore the disc space and to reduce partially the listhesis with less hleeding and less harvest of graft hone compared to posterolateral fusion, and also without the risk of neural or dural damage which could he occurred in posterior lumbar interbody fusion 4.15.16.17). Thus, authors performed the same-day anterior and posterior spinal surgery (APSS) in 28 patients (30 disc spaces) from 1992 to 1996 and analyzed the clinical and radiological results. The most common site of involvement was L4-5 level (82.1%). The mean follow-up period was 2 years and 2 months (from l2 months to 4 years). Fusion was ohtained at 29 disc spaces (96.7%) within 24 weeks (average, I 6 weeks). The anterior displacement was corrected up to the average of 65.4% (5.8mm) postoperatively and the average of 60.7% (5.2mm) correction remained at last follow-up. The intervertebral disc space was restored up to the average of 96.9% (7.5mm) postoperatively and the average of 86.0% (6.2mm) restoration remained at last follow-up. Twenty-five out of 28 patients (89.2%) showed excellent or good clinical results hy the criteria of Kim, et al6). In conclusion, the same-day procedure of successive anterior interbody fusion, decompression laminectomy and posterior pedicular instrumentation for the degenerative lumbar spondylolisthesis associated with spinal stenosis was thought to be a good method of treatment.
Constriction, Pathologic ; Decompression ; Follow-Up Studies ; Hemorrhage ; Humans ; Intervertebral Disc ; Laminectomy ; Skin ; Spinal Canal ; Spinal Stenosis ; Spondylolisthesis* ; Transplants

To investigate the effect of carbon disulfide on blood pressure, the BP measurements in the periodic health examination results and the medical records of factory clinic were reviewed The study subjects were composed of 1336 male and 544 female workers, who were categorized into three groups by the exposure status-highly exposed, moderately exposed and non-exposed group. The results of the study were as follows; 1. The age-adjusted mean systolic and diastolic BP of male workers were 122.35 mmHg/79.11mmHg in highly exposed, 121.57mmHg/79.05mmHg in moderately exposed and 122.67mmHg/82.27mmHg in non-exposed group. For female workers, BP were 115.13mmHg/74.49mmHg in moderately exposed and 113.48mmHg/74.30mmHg in non-exposed group. 2. In multiple regression analysis of maximum BP against Age and tenure, the slope coefficients of age and tenure on the systolic BP were 0.379, 0.667 respectively and those on the diastolic BP were 0.331, 0.405 respectively in highly exposed male workers. Tenure was a significant variable in this study. For female workers, however, the slope coefficients of tenure on BP were significant only for systolic BP of moderately- expected group. 3. In multiple regression analysis of Bp against age, cumulative exposure index(CEI), cholesterol, all the variables showed significant slope coefficients in male, but age and CEl on systolic BP were significant for female workers (P<0.05). 4. In the multiple analysis of the amount of Bp change and the velocity of Bp change among male workers, the slope coefficients of tenure tended to increase as exposure level increased. Among female workers, the slope coefficients of tenure were significant on the amount of Bp change and the velocity of Bp change in moderately exposed group.
Blood Pressure* ; Carbon Disulfide* ; Carbon* ; Cholesterol ; Female ; Humans ; Male ; Medical Records

OBJECTIVES: To analyze factors associated with elderly falls in a community dwelling, a comparatively important, but somewhat neglected, health matter. METHODS: Data came from personal interview surveys using a questionnaire of 552 people aged 65 or older living in a community. Socioeconomic, and health related characteristics were investigated as independent variables and experiences of falling in the previous year as the dependent variable. RESULTS: 118(21.4%) of the elderly subjects experienced a fall in the previous year. 24 subjects experienced more than two falls, accounting for 20.3% of the elderly fall victims studied. Factors affecting the falls were families living together, level of daily activity, heart disease, and aconuresis;, therefore an elderly person who lives alone, lives independently, has heart disease, or suffers urinary incontinence had a demonstrated increased chance of falling. CONCLUSION: Groups at risk for falling included elderly persons living alone, living independently, suffering heart disease, or experiencing urinary incontinence. When an elderly fall prevention program is developed and implemented, these results should be considered.
Accidental Falls ; Aged* ; Heart Diseases ; Humans ; Prevalence* ; Questionnaires ; Urinary Incontinence

Metronidazole is a 5-nitroimidazole compound known as an antimicrobial agent widely used for the treatment of protozoal infection, anaerobic infection, Helicobacter pylori infection and hepatic encephalopathy. It may produce a number of neurologic side effects including peripheral neuropathy, seizure, encephalopathy, ataxic gait and dysarthritic speech. There have been ten or more reports of metronidazole-induced encephalopathy in the literatures including a few reports of brain imaging changes by magnetic resonance images (MRI). However, none of the case of metronidazole-induced encephalopathy in patients with hepatic encephalopathy has been reported yet. Recently, we experienced two cases of metronidazole-induced encephalopathy in patients with liver cirrhosis caused by chronic hepatitis B, which were diagnosed by brain MRI and MR spectroscopy. In this report, we present 2 cases of metronidazole-induced encephalopathy with MR imaging and MR spectroscopic changes including follow- up imaging performed after the discontinuation of the metronidazole with a review of the literatures.
Anti-Infective Agents/*adverse effects ; Brain Diseases/*chemically induced/diagnosis ; English Abstract ; Female ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Male ; Metronidazole/*adverse effects ; Middle Aged