226 adult patients (235 fractures) with fractures of the shaft of the tibia were treated at the Department of Orthopaedic Surgery, Soon Chun Hyang College Hospital during the 6 and a half years from January 1975 to June 1981. These were analysed according to the methods of treatment and the results were categorized by the level, type, severity and whether open or closed in an attempt to seek the most suitable method of treatment. The following observations were made: l. Of the 226 cases, nine were bilateral, the total number of fractures being 235. Of these, 173 (73.6%) were treated conservatively, 26 (11.1%) by plate and screw fixation and the remaining 36 (15.3%) by in- tramedullary nailing. 2. There were no differences in the average healing time among the various levels of fractures. However, the upper one third and the lower one third healed more rapidly than the middle one third when treated con- servatively. When treated by intramedullary nailing, the middle one third healed most rapidly. 3. As to the types of freactures, spiral fractures healed most rapidly with 15.3 weeks and segmental fractures healed most slowly with 23.8 weeks. Transverse fractures and spiral fractures healed most rapidly when treated conservatively, oblique fractures healed most rapidly when treated by plate and screw fixation, segmental and comminuted fractures by intramedullary nailing. 4. The healing time was longer and complications were higher in open fractures than in closed ones. 5. Based on the modified Ellis classification of tibial fractures, the higher the severity, the longer the healing time and the lower the primary healing rate. 6. The primary intramedullary nailing group, which were treated within 24 hours of injury, was compared with the delayed intramedullary nailing group. The former showed faster healing and higher primary healing rate than the latter, while the infection rate was higher in the former.
Adult ; Classification ; Clinical Study ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Fractures, Open ; Humans ; Methods ; Tibia ; Tibial Fractures

STUDY DESIGN: Thirty-four cases of surgically treated spinal stenosis which were followed up for more than 5 yeras were analysed. OBJECTIVES: To know the relationship between long-term clinical results and various clinical factors. SUMMARY OF LITERATURE REVIEW: Pedicle screw fixation is a common procedure after wide decompression for spinal stenosis. But, there is few report showing its long-term result. MATERIALS AND METHODS: We evaluated the long term results of surgically treated spinal stenosis patients according to the sex, method of fusion, level of fusion, radiologic change of adjacent level, hardware problem and complication. There were 11 males and 23 females. Average age was 53.2 years(range 34-68 years). Radiographically follow up was averaged 72 months(range 60-104 months). Clinically follow up period was averaged 76 months(range 60-113 months). Eight patients were operated with PLIF and 26 patients were with posterolateral fusion. One level surgery was done in 18 patient and more than two level in 16 patients. RESULTS: Twenty-seven patients(79%) showed satisfactory result at 2year and 5 year follow-up. Two patients showed change of clinical result during follow-up. Clinical result was much better in monosegmental surgery and in male sex. Six patients showed narrowing of disc space at non-surgery level and 2 patients had compression fracture. Complications were 1 deep infection, 2 dural tears, 9 donor site pain, 2 metal failures and 1 metal pull-out. CONCLUSIONS: We concluded that there is no significant change of clinical results between two year follow-up and five year follow-up. Clinical complications and metal problems are not related with the unsatisfactory results. Multiple level surgery and female sex are two variables related with the unsatisfactory clinical outcome.
Decompression* ; Female ; Follow-Up Studies* ; Fractures, Compression ; Humans ; Male ; Spinal Stenosis* ; Tissue Donors

The survival of skin flap has vital importance in plastic surgery. Many clinical and experimental researches have been carried out to increase the survival of skin flap. As a result of these researches, many drugs have been used clinically and experimentally for increasing the survival of skin flap, and prostaglandin E1 is known to be used for improving peripheral circulatory disturbance. The pharmacophysiologic mechanisms of the effect of prostaglandin E1 are 1) increasing blood flow by dilatation of smooth muscle of small sized vessels, 2) inhibition of aggregation of platelets, 3) increasing arteriolar blood flow by improving fluidity of erythrocytes, 4) preclusion of free-radical formation, 5) decreasing the endothelial cell damage by down- regulation of sensitivity for eosinophils, 6) making the endothelial cell be refractory to adrenergic stimulation, and 7) promotion of secretion of erythropoietin in the kidney. In this terms, in order to validate effectiveness of preoperative administration of prostaglandin E1 as a pharmacological flap delay, following experimental study was performed. Forty male Sprague-Dawley rats were divided into 4 groups and caudally based 2x8 cmsized flap was elevated on dorsal surface. In group 1, normal saline (0.25 ml/kg) was injected intraperitoneally as control, in group 2, 1 microgram/kg of prostaglandin E1 was injected intraperitoneally for preoperative seven days, in group 3, 1 microgram/kg of prostaglandin E1 was injected intraperitoneally for seven preoperative days, and in group 4, 1 microgram/kg of prostaglandin E1 was injected intraperitoneally for seven days preoperatively and for seven postoperative days. On the seventh postoperative day, the animals were sacrificed and the flap survival area was measured. The following results were obtained. 1. On the seventh postoperative day, the flap survival rates of group 2, 3, 4 were higher than that of group 1 with a statistical significance. 2. On the seventh postoperative day, the flap survival rate of group 3 was higher than group 2, but there was no statistical significance. 3. On the seventh postoperative day, the flap survival rate of group 4 was higher than that of group 2 and 3 with a statistical significance.In conclusion, preoperative administrations of prostaglandin E1 increase flap survival equally as when it is administrated postoperatively, and the improvement in flap survival can be enhanced by continuous administration of prostaglandin E1 in preoperative and postoperative period. So it is expected that surgical flap delay procedure is replaced by pharmacological flap delay by the use of prostaglandin E1 preoperatively.
Alprostadil* ; Animals ; Dilatation ; Endothelial Cells ; Eosinophils ; Erythrocytes ; Erythropoietin ; Humans ; Kidney ; Male ; Muscle, Smooth ; Postoperative Period ; Rats* ; Rats, Sprague-Dawley ; Skin ; Surgery, Plastic ; Surgical Flaps ; Survival Rate

A new species of Acanthamoeba was isolated from a freshwater fish in Korea and tentatively named Acanthamoeba sp. YM-4 (Korean isolate YM-4). The trophozoites were 11.0-23.0 micrometer in length and had hyaline filamentous projections. Cysts were similar to those of A. culbertsoni and A. royreba, which were previously designated as Acanthamoeba group III. Acanthamoeba YM-4 can survive at 40 degrees C, and its generation time was 19.6 hr, which was longer than that of A. culbertsoni. In terms of the in vitro cytotoxicity of lysates, Acanthamoeba YM-4 was weaker than A. culbertsoni, but stronger than A. polyphaga. On the basis of the mortality of experimentally infected mice, Acanthamoeba YM-4 was found to be highly virulent. The isoenzymes profile of Acanthamoeba YM-4 was similar to that of A. royreba. An anti-Acanthamoeba YM-4 monoclonal antibody, McAY7, was found to react only with Acanthamoeba YM-4, and not with A. culbertsoni. Random amplified polymorphic DNA marker analysis and RFLP analysis of mitochondrial DNA and of 18S small subunit ribosomal RNA, placed Acanthamoeba YM-4 in a separate cluster on the basis of phylogenetic distances. Thus the Acanthamoeba Korean isolate YM-4 was identified as a new species, and assigned as Acanthamoeba sohi.
Acanthamoeba/*classification/genetics/isolation & purification/*pathogenicity ; Amebiasis/parasitology/*veterinary ; Animals ; DNA, Mitochondrial/analysis ; DNA, Protozoan/analysis ; Fish Diseases/*parasitology ; Gills/parasitology ; Goldfish/*parasitology ; Korea ; Mice ; Phylogeny ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 18S/genetics ; Random Amplified Polymorphic DNA Technique ; Virulence

Numerous studies on epidemiological aspects of contact dermatitis have been published in recent years since the introduction of a standardized method of patch test. We have performed the patch test on patients with contact dermatitis and on patients with other forms of dermatitis, A total of 153 patients were tested in this study between January 198l and August 1982. We have routinely attached 29 Hollister's standard batteries and 0. l% Tego, which is a commonly used antiseptic in our hospital, to the patients back. The tapes used were Leukotape and Finn chamber. Forty-eight hours after the tape had been attached, the patches were removed and read. The second reading was taken 24 or 48 hours after the patch had been removed. According to the results of this study, the most common allergens were cinnamic alcohol (11. 1%), ammoniated mercuric chloride (10. 5%), nickel sulfate (9. 2%), hydroxycitronellal(6. 5%), paraben mix(5. 9%), mercaptobenzothiazole(5. 9%) and thimerosal(5. 9%). In conclusion, cosmetics, metals, medicaments and rubber compounds were found to be the most common etiologic agents of contact dermatitis in this studyBackground and possible explanation of these rusults were discussed and a comparison was made between this report and others.
Allergens ; Dermatitis ; Dermatitis, Contact* ; Epidemiologic Studies* ; Humans ; Mercuric Chloride ; Metals ; Nickel ; Patch Tests ; Rubber

Acanthamoeba and Naegleria are widely distributed in fresh water, soil and dust throughout the world, and cause meningoencephalitis or keratoconjunctivitis in humans and other mammals. Korean isolates, namely, Naegleria sp. YM-1 and Acanthamoeba sp. YM-2, YM-3, YM-4, YM-5, YM-6 and YM-7, were collected from sewage, water puddles, a storage reservoir, the gills of a fresh water fish, and by corneal washing. These isolates were categorized into three groups based on the mortalities of infected mice namely, highly virulent (YM-4), moderately virulent (YM-2, YM-5 and YM-7) and nonpathogenic (YM-3). In addition, a new species of Acanthamoeba was isolated from a freshwater fish in Korea and tentatively named Korean isolate YM-4. The morphologic characters of its cysts were similar to those of A. culbertsoni and A. royreba, which were previously designated as Acanthamoeba group III. Based on experimentally infected mouse mortality, Acanthamoeba YM-4 was highly virulent. The isoenzymes profile of Acanthamoeba YM-4 was similar to that of A. royreba. Moreover, an anti-Acanthamoeba YM-4 monoclonal antibody reacted only with Acanthamoeba YM-4, and not with A. culbertsoni. Random amplified polymorphic DNA marker analysis and RFLP analysis of mitochondrial DNA and of a 18S small subunit ribosomal RNA, placed Acanthamoeba YM-4 in a separate cluster based on phylogenic distances. Thus Acanthamoeba YM-4 was identified as a new species, and assigned Acanthamoeba sohi. Up to the year 2002 in Korea, two clinical cases were found to be infected with Acanthamoeba spp. These patients died of meningoencephalitis. In addition, one case of Acanthamoeba pneumonia with an immunodeficient status was reported and Acanthamoeba was detected in several cases of chronic relapsing corneal ulcer, chronic conjunctivitis, and keratitis.
*Acanthamoeba/classification/genetics/immunology/pathogenicity ; Amebiasis/diagnosis/epidemiology/*parasitology/therapy ; Animals ; Antigens, Protozoan/analysis/genetics/immunology ; DNA, Mitochondrial/analysis ; DNA, Protozoan/analysis ; Korea/epidemiology ; Life Cycle Stages ; *Naegleria/classification/genetics/immunology/pathogenicity ; Phylogeny ; Polymorphism, Restriction Fragment Length ; Random Amplified Polymorphic DNA Technique/veterinary ; Virulence/genetics

No abstract available.

No abstract available.
Blepharoplasty*

This study was undertaken to investigate the response of non-immunologic contact urticaria(NICU) test before and after ingestion of cyclo-oxygenase inhibitors such as naproxene, ibuprofen and mefenamic acid. Forty patients who showed positive reaction to 5% benzoic acid (BA) in petrolatum by 20 minutes closed patch test were chosen and divided into 3 groups. Group I was consisted of 13 patients who were taken naproxene 250mg bid, group II, 14 patients, taken ibuprofen 600mg bid, and group III, 13 patients, taken mefenamic acid 500mg bid. All the patients were tested with 5%, 2.5%, 1%, 0.5% and 0.1% BA in petrolatum using Finn chamber on Scanpor tape on the right arm before medication and next day on the left arm after medication of each day. Mefenamic acid did not show any significant differences before and after ingestion of drug. Naproxene reduced reaction about half of patients. Ibuprofen reduced reaction in almost all patients and blocked reaction completely in 9 of 13 patients. This results suggested that there was no correlation between blocking effect to BA induced contact urticaria and so called anti-inflammatory potencies of naproxene and ibuprofen, and that NICU by BA is partly mediated by prostaglandins(PG) or mediated by other mediators, which were potentiated by PG, except histamin.
Arm ; Benzoic Acid ; Cyclooxygenase Inhibitors ; Eating ; Humans ; Ibuprofen ; Mefenamic Acid ; Naproxen ; Patch Tests ; Petrolatum ; Urticaria*

The health-promoting qualities of ultraviolet light have been well recognized, but it also induces deleterious effects from sunburn to skin cancer, Since our enviroment exposes us to both ultraviolet and infrared rays at the same time, the latter is considered to influence to some extent the cutaneous effects of the former. In recent years, it has become increasingly apparent that the biologic effects of one type of radiation may be modified by wavelengths of different energies. Interactions of this kind are complex and occasionally result in true synergy or antagonism. Although there are several reports on these interactions, the results are not in accordance. This study was undertaken to investigate the influence of infrared radiation (IR) on ultraviolet radiation (UVR)-induced skin injury, especially minimal erythema dose (MED). Thirty-five healthy medical students participated in this study between May and June, 1983. One side of the back was exposed to IR with UVR while as a control the other side was exposed only to VVR. The results were summarized as follows : 1. In one experiment treated with IR before UVR, the mean MED-S.D. of the treated site was 17 7+5 3 (sec) and that of the control site was 18. 3-+6. 4 (sec)- The increase of the MED was statistically significant. (p<0. 01], paired t-test) Among the fifteen subjects, the MED was increased in 73% (11/15), and the same in 27% (4/15).
Erythema ; Humans ; Infrared Rays ; Skin Neoplasms ; Skin* ; Students, Medical ; Sunburn ; Ultraviolet Rays