A consensus of current surgical practice favors external skeletal fixation in the patients with open fractures, where it can be difficult to achieve a good position and fixation by the usual methods and ipsilateral multiple fractures where it is desirable to avoid prolonged immobilization of adjacent joints. From March, 1979 to December, 1981, 34 patients with lower limb fractures were treated by the method of external skeletal fixator. 22 patients had open comminuted fractures with extensive soft tissue injuries and 12 patients had multiple fractures which were difficult to reduce and maintain in alignment. In the 30 patients which could be assessed, the final result was excellent or good in 23 patients, acceptable in 5 patients, and poor in 2 patients.
Consensus ; Fracture Fixation ; Fractures, Comminuted ; Fractures, Multiple ; Fractures, Open ; Humans ; Immobilization ; Joints ; Lower Extremity ; Methods ; Soft Tissue Injuries

The aim of the present study is to demonstrate the usefulness of intraoperative fine needle aspiration (FNA) of pancreatic lesions in 30 patients. A conclusive diagnosis was done in 27 patients and the diagnoses of three patients were deferred. No complications followed the procedure. Based on histologic findings of the resected specimens in 20 cases and of cell blocks in 10 cases, the final diagnoses were adenocarcinoma in 19 cases, chronic pancreatitis in nine cases and tuberculosis in two cases. The sensitivity, specificity and diagnostic accuracy were 95%, 100% and 96% resepectively and there were no false positives. The smear of aspirate was stained with toluidine blue and examined by light microscope. The presence of there-dimensional clusters of disoriented cells and the increased nuclear/cytoplasmic ratio with large prominent nucleoli were the most helpful criteria for a diagnosis of malignancy in the pancreas. The intraoperative FNA of pancreatic lesions was considered as a simple, safe, and highly specific and sensitive tool in differentiating benign from malignant lesions. The intraoperative FNA can be recommended as the first tool of choice of intraoperative diagnostic procedure in lesions of the pancreas.
Child ; Male ; Female ; Humans ; Adenocarcinoma

No abstract available.
Hepacivirus* ; Hepatitis C Antibodies* ; Hepatitis C* ; Hepatitis* ; Prevalence*

Melanoacanthoma is an extremely rare pigmented benign mixed epithelial tumor of both melanocytes and keratinocytes. A 52-year-old female presented an asymptomatic, slightly elevated, 1. 2 cm x 0. 8 cm, dark black-colored plaque on her right buttock of 2 years' duration. Histopathologic finding of the plaque shows hyperkeratosis, focal parakeratosis, follicular plugging, acanthosih, papillomatosis and pseudo-horn cyst in the epidermis. The tumor is composed of basaloid and squarnous cells with many foci of clusters and whorls of melanin pigment-laden cells. Electron microscopic finding reveals many scattered melanocytes in the entire epidermis. Melanin granules are found mostly in the melanocytes but can also be found in a few keratinocytes.
Buttocks ; Epidermis ; Female ; Humans ; Keratinocytes ; Melanins ; Melanocytes ; Middle Aged ; Papilloma ; Parakeratosis

Psychopharmacotherapy is one of the effective treatments for the children and adolescents with attention-deficit hyperactivity disorder (ADHD). If there were a marginal improvement or significant adverse effects after having the first line medication such as psychostimulants and atomoxetine, the youth with ADHD can take alternative medications. If they have comorbidities such as disruptive behavior disorder, bipolar disorder, mental retardation and tic disorder, they need to have more medications. Recently, prescriptions of atypical antipsychotics were increasing among them. The efficacy, safety, and tolerability of atypical antipsychotics in the youth should be considered.
Adolescent ; Antipsychotic Agents ; Attention Deficit and Disruptive Behavior Disorders ; Bipolar Disorder ; Child ; Comorbidity ; Humans ; Intellectual Disability ; Prescriptions ; Propylamines ; Tic Disorders ; Atomoxetine Hydrochloride

Human Papillomaviruses(HPVs) are regarded as sexually transmitable and closely associated with precancerous lesions or invasive cancers of the vulva, vagina, and cer V1X. In situ hybridization, besides showing higher sensitivity, allowed the identification of specific viral types. We studied 12 cases of condylomata accuminata for HPV typing by in situ hybridization techenique. Ten cases(83.3 % ) showed positive for HPV type 6/11, and 2 cases(16.7% ) were positive for HPV type 16/18.
DNA Probes* ; DNA* ; Humans* ; In Situ Hybridization* ; Vagina ; Vulva

BACKGROUND: Aspiration pneumonia remains a serious result associated with general anesthesia. Therefore, we studied the effectiveness of preanesthetic ranitidine in increasing gastric pH to prevent aspiration pneumonia. METHODS: Eighty patients scheduled for elective surgery were randomly divided into four groups with twenty patients in each group. Patients in control group were not given preanesthetic ranitidine; patients in group I received 300 mg of ranitidine orally at night before surgery, patients in group II received 150 mg of ranitidine orally both the night before surgery and one hour before surgery respecvtively and patients in group III recieved 150mg of ranitidine orally one hour before surgery. RESULTS: Compared with control group, the mean gastric pH of preanesthesia and 1 hour after anesthetic induction increased significantly in the group I, II, III (P<0.0001). There was significant increased gastric pH in the group II compared with group I and III. CONCLUSIONS: These results demonstrate that ranitidine markedly increase the gastric pH. So, we recommend that patients receiving general anesthesia would be taken Hz-antagonist such as ranitidine preoperatively.
Anesthesia, General ; Humans ; Hydrogen-Ion Concentration* ; Pneumonia, Aspiration ; Premedication ; Ranitidine*

No abstract available.
Femur* ; Hip Fractures* ; Hip*

OBJECTIVES: The purpose of this paper is to determine an efficient operation plan for a smoking cessation clinic in public health centers. To do so, the primary success factors in smoking cessation have been analyzed after classifying the smoking cessation programs of public health centers into urban and rural areas. METHODS: A study was conducted with 262,837 smokers age 19 or older who were provided with smoking cessation services for more than 6 months through smoking cessation clinics at public health centers(250 clinics nationwide) from July 16, 2006 to July 15, 2007. RESULTS: Urban areas indicated that gender, age, social security, the frequency of counseling, re-enrollment in the program, the number of cigarettes per day and alcohol problems were all factors that influenced the success of smoking cessation. On the other hand, in the rural areas the total number of counseling, re-enrollment in the program, the number of cigarettes per day and alcohol problems were the influential factors. Furthermore, the urban area confirmed that the frequency of counseling, re-enrollment in the program, the number of cigarettes per day and alcohol problems affected traveling while the rural area was affected by social security, the frequency of counseling and re-enrollment. CONCLUSIONS: It has been confirmed that the success rate and factors of smoking cessation clinics can vary depending on the region and enrollment method.
Counseling ; Hand ; Public Health ; Smoke ; Smoking ; Smoking Cessation ; Social Security ; Tobacco Products

OBJECTIVETo observe the effect of Tiaozhi Jiangtang Tablet (TJT) on insulin resistance (IR) in rats with diebetes mellitus type 2.

METHODSThe model rats of diebetes mellitus were induced by intraperitoneal injection of streptozotocin (30mg/kg) and feeding with high lipid forage. The rats in the TJT group were treated with TJT and those in the metformin group treated with metformin as positive controls. The glucose infusion rate (GIR) was detected by glucose clamp technique after treatment for 8 weeks. At the same time, fasting blood glucose ( FBG), fasting insulin ( FINS), free fatty acids ( FFA), total cholesterol ( TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) were measured respectively, and insulin sensitivity index (ISI) and HDL-C/TC calculated. The changes of insulin sensitivity and lipid metabolism were evaluated.

RESULTSTC, TG, HDL-C/TC, FINS, and FFA significantly reduced in the TJT group as compared with those in the control group, while ISI and GIR significantly increased, the effects of TJT were similar to those of metformin.

CONCLUSIONTJT is effective in increasing insulin sensitivity and improving glucose and lipid metabolisms in rats with diebetes mellitus type 2.

Animals ; Blood Glucose ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Diabetes Mellitus, Experimental ; blood ; drug therapy ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Acids, Nonesterified ; blood ; Hypoglycemic Agents ; therapeutic use ; Insulin ; blood ; Insulin Resistance ; Rats ; Tablets ; Triglycerides ; blood