The author fractographically analyzed the cause of metal failure (the first time this procedure has been used for this metal failure) and also analyzed in clinically. In this study, I selected eight cases which have been analyzed fractographically. In all these cases, the analysis was done after treatment of metal failure of implants internally fixed to femur shaft fractures at the Department of Orthopedic Surgery, Yeung-Nam University Hospital during the six year period from May 1983 to September 1989. 1. Metal failure occurred in five dynamic-compression plates, one Jewett nail, one screw in Rowe plate, and one interlocking nail. 2. The clinical cause of metal failure was deficiency of medial buttes in five cases, incorrect position of implant in one case, and incorrect selection of implant in two cases. 3. The time interval between internal fixation and metal failure was four months in one case, between five months to twelve months in six cases, three years in one case. 4. The fractographically analytical cause of metal failure was ; first, impact failure, one case, second, fatigue failure, six cases, machining mark (stress riser), four case type: low consistent cyclic fatigue failure irregular cyclic fatigue failure third, stress corrosion crack, one case. 5. 316 L Stainless Steel has good resistance to corrosion. However, when its peculiar surface film is destroyed by fretting, it shows pitting corrosion. This is, perhaps, the main cause of metal failure. 6. It is possible that mechanical injury occurred in implants during the manufacturing of implants or that making a screw hole in the main cause of metal failure.
Corrosion ; Fatigue ; Femur* ; Orthopedics ; Stainless Steel

No abstract available.
Humans ; Specialization*

The effects of hind-limb immobilization by skeletal fixation of bilateral ankle and knee joints. for sither one or five weeks on glycogen concentrations, glycogen resynthetic activities and insulin responses to glucose uptake of hind-limb muscles were studied on male Splague-Dawley rats. There were significant drops in muscle wet weight to body weight ratio of immobilized soleus and plataris. In the group immobilized for one week, the ratios of sleous and plantaris were decreased by 11% and 38% respectively; and in the group immobilized for five weeks, the ratios were decreased by 42% in both muscles equally. The glycogen concentration and glycogen resynthetic activities of soleus and plantaris muscles in immobilized rats were decreased significantly in the one week group. However, in the five week group, these values were increased significantly compared to the values of those muscles of the one week group. The increased values of the five week group did not exceed those of the control group. The glucose uptake rate of the soleus muscle of the hind-limbs immobilized for one week and for five weeks were studied in vitro. The basal glucose uptake rate of the muscle of the control group was 8.4 ± 0.77Mol/gm/20min. The values of basal rate and insulin responses to the glucose uptake rates in the doses of physiological and supramaximal on the soleus muscles immobilized for one week was significantly decreased, but after immobilization for five weeks, these values were not significantly different statistically those from of the control group statistically.
Animals ; Ankle ; Body Weight ; Extremities ; Fracture Fixation ; Glucose ; Glycogen ; Humans ; Immobilization ; In Vitro Techniques ; Insulin ; Knee Joint ; Male ; Metabolism ; Muscle, Skeletal ; Muscles ; Rats

OBJECTIVES: The authors conducted the study to evaluate bias when potentially diseased subjects were included in cohort members while analyzing risk factors of chronic liver diseases. METHODS: Total of 14,529 subjects were followed up for the incidence of liver diseases from January 1993 to June 1997. We have used databases of insurance company with medical records, cancer registry, and death certificate data to identify 102 incident cases. The cohort members were classified into potentially diseased group(n=2,217) when they were HBsAg positive, serum GPT levels higher than 40 units, or had or has liver diseases in baseline surveys. Cox' model were used for potentially diseased group, other members, and total subjects, respectively. RESULTS: The risk factors profiles were similar for total and potentially diseased subjects: HBsAg positivity, history of acute liver disease, and recent quittance of smoking or drinking increased the risk, while intake of pork and coffee decreased it. For the potentially diseased, obesity showed marginally significant protective effect. Analysis of subjects excluding the potentially diseased showed distinct profiles: obesity increased the risk, while quitting smoking or drinking had no association. For these intake of raw liver or processed fish or soybean paste stew increased risk; HBsAg positivity, higher levels of liver enzymes and history of acute liver diseases increased the risk. CONCLUSIONS: The results suggested the potential bias in risk ratio estimates when potentially diseased subjects were included in cohort study on chronic liver diseases, especially for lifestyles possibly modified after disease onset. The analytic strategy excluding potentially diseased subjects was considered appropriate for identifying risk factors for chronic liver diseases.
Bias (Epidemiology) ; Coffee ; Cohort Studies* ; Surveys and Questionnaires ; Death Certificates ; Drinking ; Epidemiology ; Hepatitis B Surface Antigens ; Incidence ; Insurance ; Life Style ; Liver Diseases* ; Liver* ; Medical Records ; Obesity ; Odds Ratio ; Risk Factors* ; Smoke ; Smoking ; Soybeans

BACKGROUND: Gastrointestinal (GI) symptoms are believed to be common in the general population, and constipation is one of the most representative GI symptoms. However, the prevalence and risk factors of functional constipation are not well known in Korea. We aimed to study the prevalence of, and risk factors for, constipation in the elderly. METHODS: We randomly selected 852 among 854 (excluded by cancer and dementia) subjects, ages 65 yr and older, in three different geriatric welfare facilities in December, 2003. The prevalence of functional constipation was based on the Rome II criteria and the survey on risk factors for constipation was performed. RESULTS: Functional constipation had a prevalence of 26.6% and there was no difference between men and women. Exercise, fluid, fruit, vegetable intake, anal diseases and age related risk factors were associated with constipation. CONCLUSION: In the elderly, constipation is a common complaint. Further studies are now required for risk factors of constipation.
Aged* ; Constipation* ; Female ; Fruit ; Humans ; Korea ; Male ; Prevalence* ; Risk Factors* ; Vegetables

In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices(e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.)through the program of biennial health check-up offered by Korean Medical Insurance Corporation(KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were -0.4+/-3.56mg/dl for those drinking less than 1 cup a day, -0.6+/-3.60mg/dl for those drinking 1 cup a day, and 7.1+/-3.41mg/dl for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total cholesterol, we re-analyzed those relationship in smokers and non-smokers separately. Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index(cigarette-years; r=0.10), Quetelet's index(kg/m2, r=0.16), daily calory expenditure(kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption(g/week, r=0.08), other caffeinated beverage intake(cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index(in smokers)were remained in the models. After adjustment, the corresponding differences of total cholesterol in smokers were changed to 0.4+/-5.24mg/dl, -0.5+/-4.97mg/dl, and 8.9+/-4.78mg/dl, which were significantly different among themselves(P=0.011). In non-smokers, however, the differences were not statistically significant(P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, P=0.48 for DBP). Assuming instant coffee on the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers , is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.
Alcohol Drinking ; Beverages ; Blood Pressure ; Body Mass Index ; Cardiovascular System ; Cholesterol* ; Coffee* ; Cohort Studies ; Drinking ; Humans ; Insurance ; Korea ; Male ; Meat ; Motor Activity ; Postal Service ; Poultry ; Surveys and Questionnaires ; Seoul ; Smoke ; Smoking ; Tobacco Products

INTRODUCTION: Recent investigations have demonstrated that citrus red mite is a common sensitizing allergen in children and adults living in rural areas of Cheju island. OBJECTIVE: The aims of this study were to evaluate the sensitization rate to the citrus red mite and to determine the risk factors for this sensitization in adolescents living in rural areas of Cheju island. SUBJECTS AND METHODS: A total of 3,395 adolescents (from ages 13 to 15 years old) living in rural areas of Cheju island were enrolled in this study. Each subject was evaluated by a modified ISAAC questionnaire, and a skin prick test with 11 common inhalant allergens including citrus red mite. RESULTS: On skin prick test the most common sensitizing allergen was D. pteronyssinus (27.9%), followed by D. farinae (23.9%), citrus red mite (18.3%), and cockroach (16.7%). Sensitization rate to citrus red mite was higher in those living near citrus orchards than in those living far from the orchards, and higher in those visiting citrus orchards more frequently than in those visiting less frequently. CONCLUSION: Citrus red mite is a common sensitizing allergen in adolescents living in rural areas of Cheju island. The sensitization rate to citrus red mite may be partially determined by environ- mental exposure.
Adolescent* ; Adult ; Allergens ; Child ; Citrus* ; Cockroaches ; Humans ; Jeju-do* ; Mites* ; Risk Factors* ; Skin ; Surveys and Questionnaires

BACKGROUND AND PURPOSE: The authors conducted the study to evaluate the incompleteness of follow-up as well as the validity of the diagnostic code in the medical insurance databases in a cohort study. They also suggested several useful regression models for the analysis of such incomplete data. METHODS: The subjects of Seoul Cohort(n=14,533) were followed up for three and a half years. Based on the chart reviews of the subjects who had the diagnostic code of gastric cancer in the medical insurance databases, forty-four cases of gastric cancer were idenfified, using cancer registry databases and death certificates as the secondary source. Regression coefficients and the associated p-values were estimated using the following six methods and the results were compared with each other. Method 1: The subjects with the diagnostic code in the medical insurance databases were considered as the cases of gastric cancer. Method 2: The confirmed cases were considered as the cases of gastric cancer. Method 3: The cases were the subjects with the diagnositc code whose diagnosis was confirmed by medical chart reriew. Method 4: Ordinal logistic regression. Method 5: Weighted logistic regression. Method 6: Polytomous logistic regression RESULTS: A total of 12,541 subjects were followed up excluding censored cases. One hundred and nine subjects were diagnosed with gastric cancer in the medical utilization databases: forty-three were probable cases whose dianosis was not confrimed by chart review, twenty-six were ruled out and 26 were confirmed cases. Another 14 cases were confirmed using the cancer registry and death certificates. Using the secondary sources, four another cases were confirmed and 44 cases were confirmed during follow-up. In method 1, past history of gastritis and gastric ulcer was significant risk factor whereas intake frequency of fresh vegetable, ice cream and coffee was associated with significantly decreased risk. In the second and the sixth method, green tea was a significant protective factor, whereas in methods 3-5, no significant variables were found. CONCLUSIONS: Polytomous logistic regression was the preferred method in the cohort study using secondary sources of information for the follow-up, and it provided additional information for the risk factor identification, especially for the specificity of the risk factors.
Bias (Epidemiology) ; Coffee ; Cohort Studies* ; Death Certificates ; Diagnosis ; Follow-Up Studies ; Gastritis ; Ice Cream ; Insurance ; Logistic Models ; Risk Factors* ; Sensitivity and Specificity ; Seoul ; Stomach Neoplasms* ; Stomach Ulcer ; Stomach* ; Tea ; Vegetables

BACKGROUND: A recent investigation has demonstrated that citrus red mite (Panonychus citri) is the most important allergen in citrus-cultivating farmers with asthma or rhinitis. METHODS: A total of 2,005 adolescents (aged 16 to 18 years) living in rural areas were enrolled in this study. Each subject was evaluated by a questionnaire developed by the International Study of Allergy and Asthma in Childhood(ISSAC), and a skin prick test with 11 common inhalant allergens including citrus red mite. RESULTS: Prevalence of recent wheezing, recent rhinoconjunctivitis symptoms and eczema was 13.0%, 13.6% and 9.9%, respectively. On skin prick test, the most common sensitizing allergen was citrus red mite (20.6%), followed by Dermatophagoides pteronyssinus (18.5%), Dermato-phagoides farinae (14.6%) and cockroach (9.8). The prevalence of eczema was higher in those with sensitization to CRM than in those without sensitization to any allergens(p< 0.05) but the prevalence of asthma was not different between adolescents with sensitization to CRM and those without sensitization to any allergens(p> 0.05). On the contrary, the sensitization to house dust mites were significantly associated with the prevalence of asthma and allergic rhinitis. CONCLUSION: Citrus red mite was the most common sensitizing allergen in 16-18 year-old adolescents living in rural areas with citrus farms and sensitization to CRM was significantly associated with the prevalence of atopic dermatitis.
Adolescent* ; Allergens ; Asthma ; Citrus* ; Cockroaches ; Dermatitis, Atopic ; Dermatophagoides pteronyssinus ; Dust* ; Eczema ; Humans ; Hypersensitivity ; Mites* ; Prevalence ; Pyroglyphidae* ; Respiratory Sounds ; Rhinitis ; Skin ; Surveys and Questionnaires

PURPOSE: To evaluate the usefulness of prone pad study in upper gastrointestinal series(UGIS) for thedetection of early gastric cancer(EGC). MATERIALS AND METHODS: During an eight-month period, 88 of 170 patientswho underwent gastrectomy due to EGC were also the subjects of prone pad study as well as double contrast(n=92),mucosal relief(n=76), or compression(n=91) studies. The EGCs were single in 84 patients and double in four. Wecompared prone pad study with the three other techniques for detecting a tumor and depicting the surroundingmucosal changes. Lesional conspicuity was rated 'complete', 'incomplete','suspicious'. or 'undetected'. Thedepiction of surrounding mucosal change was rated 'excellent', 'good', 'fair', or 'poor'. RESULTS: Mean tumorsize was 3.2cm, with a range of 0.3-9cm. Tumors were located in the antrum(n=55), angle(n=13), lower or midbody(n=16), or the sign body and cardia(n=5). Among the 92 EGCs evaluated, UGIS missed the lesion in threecases(sensitivity, 97%). The rates of 'complete' lesional conspicuity were 49% inn prone pad, 29% in compression,20% in double contrast, and 9% in mucosal relief. The rates of excellent' in depicting surrounding mucosal changewere 45% in prone pad, 11% in double contrast, 9% in mucosal relief, and 9% in compression. The tumor wasdemonstrated only in prone pad study in five(5%) of the 92 EGCs. CONCLUSION: prone pad study during UGIS improvesboth the detection rate of EGC and the depiction of mucosal change around the tumor.
Gastrectomy ; Humans