Seventy consecutive ipsilateral fracture of the femur and tibia in sixty-eight patients from December 1974 through December 1984 treated at Severance Hospital were analysed in clinical and radiological aspect. 1. Fifty-nine patients were male and nine patients were female. The male patients were more injured in the ratio of 6: 1. The avarage age was 34. 2. The main cause of injuries were traffic accidents; 59 patients. (86.8%). 3. The majority of the fractures were shaft fracture; for example, femur shaft 57% and tibia shaft 47%, The open fracture of the tibia was 34% and the femur was 17%. 4. There were 24 cases of concomitant fracture and dislocation of other sites. A fat embolism was disgnosed in 4% of the patients. Four patients had died one month after sustaining injuries. 5. Over-all, a good or excellent functional result was achieved in 76% of the patients treated with internal fixation of both fracture, 65% of the patients with intexnal fixation for the femur fracture only and 35% of the patients managed conservatively.
Accidents, Traffic ; Dislocations ; Embolism, Fat ; Female ; Femur ; Fractures, Open ; Humans ; Male ; Tibia

The head patient with musculoskeletal trauma is a challenge to the orthopedic surgeon and its incidence is increasing markedly with the development of modern culture and a high velocity motor vehicle. So, for the purpose of studying the difference between lower extremity fracture concomitant with head injury and only lower extremity fractured patients, we studied the radiologic bone union time, serologic test and heterotopic ossification. For the control group we analysed each 10 patients of only femur and tibia fractures. The following clinical results were obtained by analysis of 46 patients of lower extremity fracture concomitant with head injury, experienced in the Department of Orthopedic Surgery, Yonsei University College of Medicine in past 5 years from Jan. 1980 to Dec. 1984. 1. The mean age was 24.5 yrs old (2~6 yrs old) and the prevalent age was 1st and 3rd decade, and the sex ratio between males and females was 2.8: l. 2. The most common mode of injury was auto-pedestrian injury (84.8%) and the other was falling down injury(15.2%) . 3. The common brain injuries were cetebral contusion with skull fracture (37.0%) and cerebral contusion only(34.8%) . Among 26 patients whos mental states were not alert, 23 patients recovered mental states completely. 4. Serum Calcium, Phosphate, and Alkaline Phosphatase level were no difference between the head injury with lower extremity fractured patients and only lower extremity fractured patients. 5. There were no evidence of early bony union in the patients with head injury. 6. The formation of callus were abundant in the patients of lower extremity fracture with head injury rather than the only lower extremity fractured patients. 7. The incidence of heterotopic ossification was 10.9% and all patients with heterotopic ossification were treated with physiotherapy and all patients recovered fully. 8. The incidence of complication was 17.3% and there was no fat embolic patients. In conclusion, there was no evidence of early bony union, but the callus formation was abundant in the patients of lower extremity fracture concomitant with head injury.
Accidental Falls ; Alkaline Phosphatase ; Bony Callus ; Brain Injuries ; Calcium ; Clinical Study ; Contusions ; Craniocerebral Trauma ; Female ; Femur ; Head ; Humans ; Incidence ; Lower Extremity ; Male ; Motor Vehicles ; Orthopedics ; Ossification, Heterotopic ; Serologic Tests ; Sex Ratio ; Skull Fractures ; Tibia

We measured poiyethylene wear radiographically in 85 cementless primary total hip arthroplasties by the modified technique of Livermore et al. All the patients were followed up for at least five years (mean, 6.31 years; range, 5 years-8 years 2 months). The mean extent of linear wear was 0.88mm (range, 0.0083-3.2839mm), and the mean rate of linear wear was 0.14mm/year(range, 0.00-0.47mm /year). The mean volumetric wear was 539.42mm (range, 5.11 2022.09mm), and the mean rate of volumetric wear was 87.69mm/year(range, 0.65-290.12mm/year). The polyethylene wear was correlated inversely with the patients age only, but was not influenced by weight or gender of the patients, Harris hip score, thickness of the polyethylene, the abduction angle of acetahular cup, or the duration of in situ implantation. Osteolysis developed in the femur of 34 hips(40%) and in the acetabulum of 11 hips(12.9%). Radiographic loosening was found in one case in the femur and none in the acetabul pm. The extent of polyethylene wear was significantly correlated with frequencies and sizes of the osteolytic lesion and was not directly associated with radiographic loosening of the prostheses. Calcar resorption was observed in 39 hips(45.9%) and was not associated with polyethylene wear. These results indicated that polyethylene wear of primary total hip arthroplasty should be considered one of major causes of osteolysis and has no direct relationship with prosthesis loosening. To reduce the extent of polyethylene wear, the material characteristics of polyethylene should be improved or new, durable, articulating materials should be researched.
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Femur ; Hip ; Humans ; Osteolysis* ; Polyethylene* ; Prostheses and Implants ; Prosthesis Failure

OBJECTIVES: To investigate the frequency and clinical characteristics of premenstrual syndrome(PMS)/premenstrual dysphoric disorder(PMDD) in high school students, and determine the correlates of PMS/PMDD in association with comorbid depression and anxiety. METHODS: A total of 1688 students were recruited from 5 high schools in Seoul, Korea. Subjects completed the questionnaire composed of scales to measure premenstrual symptoms, depression, and anxiety, as well as sociodemographic and reproductive variables. Subjects were categorized into 3 groups by using the Premenstrual Symptom Screening Tool(PSST) to determine the frequency and clinical characteristics of PMS/PMDD. Multivariate logistic regression was used to identify the correlates of PMS/PMDD. RESULTS: The frequency of moderate to severe PMS and PMDD was 20.1% and 6.4%, respectively. Irritability (78.8%), fatigue(76.4%), and emotional sensitivity(69.8%) were common premenstrual symptoms, and functional impairment in academic performance(67.1%) was dominant. Dysmenorrhea[odd ratio(OR)=3.68, 95% confidence interval(CI) 2.45-5.55], family history of PMS(OR=1.91, 95% CI 1.35-2.71), and use of oral contraceptive (OR=1.85, 95% CI 1.16-2.94) were associated with the increased risk of PMS/PMDD after adjustment for depression and anxiety. Negative attitude to menses(OR=15.60, 95% CI 3.61-67.42) was associated with the increased risk of PMS/PMDD, particularly in subjects without depression and anxiety. CONCLUSIONS: PMS was common, as the frequency of PMS more than moderate severity including PMDD exceeded 25%, and disrupted daily functioning in adolescents. PMS is associated with various sociodemographic and menstrual characteristics, and these associations are affected by comorbid depression and anxiety.
Adolescent ; Anxiety ; Depression ; Humans ; Korea ; Logistic Models ; Mass Screening ; Premenstrual Syndrome ; Questionnaires ; Weights and Measures

Myocarditis is defined as the myocardial inflammation caused by various infectious agents (such as virus, rickettsia , bacteria, protozoa, fungus and parasites). The clinical manifestations of myocarditis ranges from the asymptomatic state due to focal inflammation to fulminant fatal congestive heart failure secondary to diffuse myocardial involvement. Clinically, in some cases, it may simulate an acute myocardial infarction. We experienced a case of acute fulminant myocarditis that presented as acute myocardial infarction initially, and then progressed into and recovered from congestive heart failure and multiorgan failure.
Asymptomatic Diseases ; Bacteria ; Estrogens, Conjugated (USP)* ; Fungi ; Heart Failure* ; Inflammation ; Myocardial Infarction ; Myocarditis* ; Rickettsia

Due to an increasing interest in esthetics and concerns about toxic and allergic reactions to certain alloys, patients and dentists have been looking for metal-free tooth-colored restorations. Recent improvement in technology of new all-ceramic materials and composite materials has broadened the options for esthetic single crown restorations. The aim of this investigation was to study the fracture strength of the metal-free posterior single crowns fabricated using two recently introduced systems, Empress 2 ceramic and Targis-Vectris. Forty premolar-shaped stainless steel dies with the 1mm-wide circumferential shoulder were prepared. Ten cylindrical crowns having a diameter of 8.0mm and total height of 7.5mm were fabricated for each crown system respectively (PFM, Empress staining technique, Empress 2 layering technique, and Targis-Vectris). The crowns were filled with cement and placed on the stainless steel dies with firm finger pressure. The crowns were then stored in distilled water at room temperature for 24 hours before testing. The crowns were tested for fracture strength in an Instron universal testing machine (Instron 6022). With a crosshead speed of 1mm/min the center of the occlusal surface of the crown was loaded using a 4mm-diameter stainless steel ball until fracture occurred. The fracture surfaces of the crowns were gold coated and examined using scanning electron microscopy (Jeol JSM-840 Joel Ltd., Akishima, Tokyo, Japan). Within the parameters of this study the following conclusions were drawn: 1. The mean fracture strength for PFM crowns was 5829(+/-906)N; for Empress staining technique the fracture strength was 1697(+/-604)N; for Empress 2 Layering technique the fracture strength was 1781N(+/-400)N, and the fracture strength for Targis-Vectris was 3093(+/-475)N. 2. The fracture strength of the PFM crowns was significantly higher than that of the Empress 2 and the Targis-Vectris crowns (P<0.05). 3. The fracture strength of the Targis-Vectris crowns was significantly higher than that of the Empress 2 crowns (P<0.05). 4. No statistical difference was found when Empress staining technique was compared with Empress 2 layering technique. 5. The SEM image of fracture surface of Empress 2 crown showed a very dense microstructure of the lithium disilicate crystals and the SEM image of fracture surface of Targis-Vectris crown showed indentations of Vectris and some fibers torn off from Vectris.
Alloys ; Ceramics* ; Crowns* ; Dentists ; Esthetics ; Fingers ; Humans ; Hypersensitivity ; Lithium ; Microscopy, Electron, Scanning ; Shoulder ; Stainless Steel ; Water

No abstract available.
Hypoglycemia*

No abstract available.
Education ; Humans

Laparotomy performed for resection of hepatoma in 34 cases at Seoul National University Hospital for 3 .5years since Oct. 1978. Resection of hepatoma was done in 21 cases, ligation with or without canulation of hepaticartery was performed in 12 cases, and open and closure was made in 1 case. Angiographic findins were analyzed forresectability of hepatoma. The results of hte analysis were as follows; 1. Most reliable signs for resectablehepatoma were peripheral location and confinement in one hepatic lobe. Most reliable signs for non-resectablehepatoma were presence of tumor thrombus in portal vein, bilateral hepatic arterial feeding. 2. Less reliablesigns for resectable hepatoma were absence of portal vein invasion, less than 10cm in size and absence of findingsof liver cirrhosis. Less reliable signs for non-resectable hepatoma were right or left massive type. 3. Presenceof arteriovenous fistula, more than 10cm in size, and presence of findings of liver cirrhosis were no reliablecriteria for resectability of hepatoma. 4. Predictability for resectability with those reliable signs ofangiography was around 80%. 5. In addition to routine celiac angiography, oblique celiac angiography or superiormesenteric arteriography for portal vein opacification will be helpful in order to obtaine highly reliable signsfor resectability of hepatoma.
Angiography ; Arteriovenous Fistula ; Carcinoma, Hepatocellular ; Laparotomy ; Ligation ; Liver Cirrhosis ; Portal Vein ; Seoul ; Thrombosis

No abstract available.
Osteomyelitis*