Recently the incidence of intertrochanteric factures of the femur has been increasing progressively due to prolongation of average life span and increased activity. Most of intertrochanteric fractures of the femur occur in elderly patients with osteoporotic bone change and general weakness. The goal of treatment is early mobilization with immediate weight bearing to prevent the complications such as deep vein thrombosis, pulmonary embolism, pneumonia or atelectasis, and pressure sore. We have tried to assess the outcome and complications of bipolar hip prostehsis for the femoral intertrochanteric fracture in elderly patients. The twenty octogenarian patients received a bipolar hip prosthesis due to femoral intertrochanteric fractures from January 1989 to December 1994 at the Department of Orthopedic Surgery of Chonbuk National University Hospital. The results were as follows: 1. The average age of patients was 83.5 years and underlying problems are hypertension, cerebral vascular accident, pulmonary problem, diabetes mellitus, and osteoarthritis. 2. By Tronzo classification, Type III was the most common (80%) type. 3. Complications were peroneal nerve palsy, intraoperative femoral shaft fracture, postoperative stem tip fracture, dislocation and shortening. 4. Postoperative ambulation was possible at 2 weeks after surgery. 5. In elderly unstable osteoporosis patient, bipolar hemiarthroplasty can be recommended for the first treatment of intertrochanteric fracture.
Aged ; Aged, 80 and over ; Classification ; Diabetes Mellitus ; Dislocations ; Early Ambulation ; Femur ; Hemiarthroplasty ; Hip ; Hip Fractures ; Hip Prosthesis ; Humans ; Hypertension ; Incidence ; Jeollabuk-do ; Orthopedics ; Osteoarthritis ; Osteoporosis ; Paralysis ; Peroneal Nerve ; Pneumonia ; Pressure Ulcer ; Pulmonary Atelectasis ; Pulmonary Embolism ; Venous Thrombosis ; Walking ; Weight-Bearing

A study was made of the respiratory effects of acute carbon monoxide poisoning in mongrel dogs. In this study the dogs were divided into two groups, namely the control and the experimental. In the experimental group, carbon monoxide poisoning was induced by the rebreathing of about 2% carbon monoxide gas mixture for 15 minutes, and the respiratory functions in this group were compared to those in the control group. A significant increase in the minute ventilation was noted in both the control and the experimental groups, and in the latter there was an increase in the respiratory rate and a decrease in the tidal volume compared to those in the control group. In both groups, oxygen consumption showed no significant change and there was a fall in the arterial carbon dioxide tension, but the carbon dioxide elimination was slightly lower in the experimental group.
Animals ; Carbon Dioxide ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Dogs ; Oxygen Consumption ; Respiratory Rate ; Tidal Volume ; Ventilation

Treatment of open tibial shaft fracture is difficult, especially when there are severe soft tissue damage. Various complications are noted. The aims of treatment for the open fractures are to promote primary wound healing and union of the fractured bone. We have employed external skeletal fixation devices those are Hoffmann apparatus and pin & resin external fixator for the treatment of 34 cases of open tibial shaft fractures from March, 1981 to May, 1984. Each fixation method was divided into two type, one-plane bilateral frame (180' frame) and two-plane bilateral frame(120') Following results were obtained. 1. Open tibial shaft fracture was most commonly occured in age of high activity of male. 2. External fixation was very useful as a primary treatment method in open tibial shaft fracture. 3. The most common complication was pin tract infection. 4. Mean duration of fixation was 12.6 weeks. After removal of extemal fixation, 8 cases of delayed or nonunion were noted. In addition to bone graft, secondary open reduction and internal fixation with plate and screws (7 cases), only bone graft (1 case) were carried out. Good results were obtained. 5. There was no significant difference in bone union time between 180' frame and 120' frame. The complications were more frequently occured in 120' frame than in 180' frame.
External Fixators ; Fracture Fixation ; Fractures, Open ; Humans ; Male ; Methods ; Tibia ; Transplants ; Wound Healing

BACKGROUND: It has been found that sterss challenge with heat shock produces the acquisition of cellular resistance to ischemin injury in the hearts, which is associated with stress protein induction. The conventional heat shock(42degrees C of rectal temperature for 15min, anesthetized animal), however, is strong enough to endanger the animal life and then not suitable for practiocal application in human. The present study was performedd in an attempt to search the safely applicabel stress modalities to acquire the myocardial tolerance to ischemia-reperfusion in jury. METHODS: Male, Sprague-Ddawley rats(200-250g) were exposed to various stressful conditions, such as heat stimulation(environmental temperature of 42degrees C for 30min, live animal), swimming(20min), immobilization(60min), treadmill exercise(20M/min, 30min) and hyperbaric oxygenation(3atm, 60min) given once a day for 5 days. Twenty-four hours after the last application the hearts were isolated and perfused with oxygenated Krebs-Henseleit buffer solution by Langendorff method. Ischemia-reperfusion injury was produced by 20 min-global ischemia followed by 30 min-reperfusion. Cardiac mechanical function, lactate dehydrogenase release, the induction of stree proteins were assayed and compared dbetween the stressed dand the control animals. RESULTS: Upon reperfusion after ischemia the recovery of cardiac function was significantly improved in the stressed animals. The percentile recovery at 30min of reperfusion was in a range from 55.3%(swimming) to 89.3%(treadmill exercise), which was significantly higher than that of the control hearts(38%). The functional recovery of the conventional heat shocked heart was 57.7%. In stressed animals, lactate dehydrogenase release, which indicates myocardial cell injury, was significantly reduced by 20 to 30% compared to that for the control. The expression of an inducible form of 70 series stress protein, SP72, which was assayed by immunoblotting method, was markedly increased by heat stimulation while the other stress modalities failed to increase, it. There were no appreciable inductions of SP73(constitutive form) and GRR78 in the stressed animals. CONCLUSION: These results suggest that the cardiac protection from the ischemia-reperfusion injury could be induced by the repetitive non-fatal stress stimulations and that SP70 family proteins may be partly involved in the cardioprotective effect produced by heat stimulation, but not play the essential roles in anti-ischemic effects produced by other stress modalities.
Animals ; Heart* ; Hot Temperature ; Humans ; Immunoblotting ; Ischemia ; L-Lactate Dehydrogenase ; Male ; Oxygen ; Rats* ; Reperfusion ; Reperfusion Injury ; Shock

The pulmonary arterial pressure(PAP) was reported to be higher in essential hypertensives than in normotensives, but the underlying mechanisms for the higher PAP were not known exactly. In order to observe the changes of pulmonary hemodynamics and to get an insight into the mechanism of the pulmonary hypertension, if any, in essential hypertensive patients, the autors performed the cardiac catheterization in 13 normal controls(group A), 14 coronary patients with normal systolic left ventricular function and systemic blood pressure(group B), and 15 essential hypertensives with normal coronary artery and systolic left ventricular function(group C). 1)Pulmonary arterial pressure(PAP) was 19.2+/-3.2/8.1+/-1.9/12.0+/-1.9(s/d/m)mmHg in group A, 25.0+/-6.2/12.8+/-4.0/16.3+/-4.5mmHg in group B, 29.3+/-6.1/12.8+/-4.0/18.2+/-3.6mmHg in group C. The PAP was higher in group B and C than that of group A(p<0.005). 2) Pulmonary vascular resistance(PVR) was 88.2+/-34.9 dyne.sec.cm(-5) in group A. 137.8+/-74.5 dyne.sec.cm(-5) in group B and 173.9+/-77.5 dyne.sec.cm(-5) in group C. In group B and C, PVR was increased compared to that of group A(p<0.05, p<0.005, respectively). 3) Pulmonary capillary wedge pressure(PCWP) was 6.6+/-2.8 mmHg in groupa A. 9.9+/-2.9mmHg, and 9.6+/-3.6 mmHg in group C. PCWP in group B and C were higher than that of group A(p<0.005). 4) Systemic vascular resistance(SVR) was 1298+/-340 dyne.sec.cm(-5) in group A, 1466+/-362 dyne .sec.cm(-5) i group B and 2255+/-439 dyne.sec.cm(-5) in group C. In group C, SVR was increased compared to that of group A and B(p<0.002). 5) Significant correlation was demonstrated between PVR and PCWP in group A(r=-0.74, p<0.05). 6) In group B, significant correlations were shown between PAP and PCWp(r=0.55, p<0.05), between PAP and PVR(r=0.69, p<0.05). 7) In group C, significant correlations were demonstrated between PAP and PCWP(r=0.55, p<0.05), between PVR and SVR(r=<0.51, p<0.01). Above results revealed that PAP and PVR were increased in essential hypertensives without left ventricular failure and this elevated PAPseemed to be affected in part by increased PCWP, and increased PVR in accordance with increased SVR.
Capillaries ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Hemodynamics* ; Humans ; Hypertension* ; Hypertension, Pulmonary ; Ventricular Function, Left

BACKGROUND: Ischemic preconditioning reduces the infarct size and the severity of arrhythmia in a post-ischemic reperfused heart although the detailed mechanism is unknown. In the ischemic heart, a large amount of catecholamine is released from the adrenergic nerve terminal and this aggravates cell destruction and arrhythmia. In this study, the possibility for ischemic preconditioning to inhibit the release of endogenous catecholamine from the ischemic heart was tested to investigate the probable cardioprotective mechanism of ischemic preconditioning. METHODS: In the isolated, Langendorff perfused rat hearts, we observed the protective effect of ischemic preconditioning against post-ischemic reperfusion injury, and measured the amount of catecholamine released into coronary effuent. In addition, we observed the effect of catecholamine depletion on reperfusion injury in non-preconditioned and preconditioned hearts. RESULTS: During the reperfusion(20min) after ischemia(30min), the cardiac function was markedly depressed with the development of severe contracture. In the heart preconditioned by three sequential episodes of 5min ischemia and 5min reperfusion, the reperfusion contracture decreased significantly and the cardiac function was almost recovered to normal after 20min reperfusion. The release of lactate dehydrogenase was also decreased in the preconditioned heart. The release of endogenous catecholamine was abruptly increased immediately after the reperfusion and the release was exponentially decreased throughout the reperfusion period. THe pattern of catecholamine release was much different from that of lactate dehydrogenase release. In the preconditioned heart, the release was significantly decreased to about half of that in non-preconditioned t\heart. Endogenous catecholamine depletion by reserpine treatment did not affect the post-ischemic functional recovery in both non-preconditioned and preconditioned hearts. CONCLUSION: It is suggested from these results that ischemic preconditioning inhibis the release of endogenous catecholamine during ischemic period, which may be partly related to cardioporotective effect of preconditioning in ischemic and reperfused heart.
Animals ; Arrhythmias, Cardiac ; Contracture ; Heart* ; Ischemia ; Ischemic Preconditioning* ; L-Lactate Dehydrogenase ; Rats* ; Reperfusion ; Reperfusion Injury ; Reserpine

No abstract available.
Aromatherapy* ; Primary Health Care*

The purpose of this study is to compare the biologic properties of tendon to hone healing and hone to hone healing in knee ligament reconstruction. The lateral 4mm of patellar tendon which was detached from its tihial insertion site either subperiostcally(group I) or with a bone block(group II) was implanted and fixed using pullout method to the proximal tihia. Ten rabbits were killed at each of four time periods (two, four, eight and twelve weeks after the implantation), and the histological and biomechanical characteristics of thc graft healing sites were evaluated. Serial histological analysis of tendon to hone healing group revealed organization of the healing site similar to normal tendon to hone attachment by twelve weeks, while hone to bone healing group demonstrated direct hony union by eight weeks. The tension failure test for the patellapatellar tendon graft - tihia complex revealed that group II had significantly higher values than group I at four and eight weeks. The findings ot this study demonstrated that bone to hone healing has more rapid process than tendon to hone healing, although no significant difference was noted once the healing has matured. We can suggest lhat the duration and extent of postoperative protection of the knee for pntients who had a reconstruction of a ligament using hone - lendon autograft should be longer and higher than lor patients who had a reconstruction using hone - tendon hone autogralf.
Autografts* ; Dronabinol ; Humans ; Knee ; Ligaments ; Patellar Ligament* ; Rabbits* ; Tendons* ; Transplants

No abstract available.
Electrocardiography* ; Inferior Wall Myocardial Infarction*

A case of the brain death confirmed by isotope angiogrphy is described. Isotope angiography is a simple and noninvasive technic compared to carotid angiography, and is recommended as a reliable test for the diagnosis of brain death.
Angiography* ; Brain Death* ; Brain* ; Diagnosis