In the treament of the non-union or delayed union of the long bone, it is very difficult to achieve union. We have experienced 15 cases of non-union or delayed union of the tibia who were treated by sliding inlay bone graft with cancellous chip bone graft from June, 1979 to April, 1984. The results were as follows: l. In all cases cancellous iliac bone graft were performed, and additionally internal fixation or simple cast immobilization were done for stabilization of the fracture site. 2. The average bone union time was 2.8 months in delayed union and 4.4 months in non-union. 3. 1n 5 failed cases there were reactivation of previous infections. 4. In 5 cases of postoperative infection, sliding grafts were sequestrated in all. 5. The advantage of this procedure in the cases without infection were: 1) In the anteromedial cortex of tibia, such a surgical intervention permits easy skin closure and prevents skin necrosis. 2) Such a procedure can recanalize the obliterated medullary cavity without disturbance of the fracture ends during operation. 6. This procedure was proved to be one of valuable adjuvant method in the treatment of uninfected non or delayed union of the tibiae.
Immobilization ; Inlays ; Methods ; Necrosis ; Skin ; Tibia ; Transplants

BACKGROUND: The verse transcriptase polymerase chain reaction (RT-PCR) has been widely used to analyze the bcr/abl fusion mRNA in chronic myelogenous leukemia (CML). Fresh or cryopreserved cells may not always be available for molecular diagnosis. So we investigated the value of stored bone marrow aspirate smears as the sources of material for the detection of bcr/abl mRNA. METHODS: We extracted RNA using modified Chomczynski method, and amplified bcr/abl mRNA by RT-PCR from the 70 cases of bone marrow smear slides stored from 7 days to 7 years, which were comprised of 49 CML, 11 other chronic myeloproliferative disorders (CMPD) and 10 acute lymphoblastic leukemia (ALL). Sensitivity of RT-PGR was tested using the slide smears prepared with 10(0)-10(6) K562 cells, and RT-PCR results losing each fresh bone marrow cellular suspension and slide smears in 24 patients were compacted. For major bcr/abl rearrangement, RT-PCR was performed by nested PGR afters GDNA synthesis losing downward primer and beta2-microglobulin was used as RNA controls. RESULTS: The sensitivity of RT-PCR for detecting bcr/abl mRNA was l02 cells per slide. Sixty one cases (86%) of 70 bone marrow aspirate smears showed positive results of beta2-micyoglobulin cDNA as an indicator of intact RNA. Thirty nine cases of 42 beta2-microglobulin cDNA positive CML bone marrow aspirate smears showed 29 b3a2 type mRNA and 10 b2a2 type mRNA. Nine cases of 11 bone marrow aspirate smear with other CMPD showed negative results of bcr/abl mRNA. Two cases of 10 ALL bone mallow aspirate smears had b2a2 type mRNA and b3a2 type mRNA, respectively. The results for detection of bcr/abl mRNA with fresh cell suspensions of 24 patients were same as the bone marrow aspirate smears storied for 7 days to 1 year. CONCLUSIONS: These data indicated that RNA obtained from bone marrow smears storied for less than 1 year was valuable as the source of RT-PGR for the detection of bcr/abl mRNA in CML and the bone marrow smears stored for much longer period ould be assailable as the specimens for retrospective analysis of specific gene alter-ation in other hematologic malignancy.
Bone Marrow* ; Diagnosis ; DNA, Complementary ; DNA-Directed RNA Polymerases ; Hematologic Neoplasms ; Humans ; K562 Cells ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Myeloproliferative Disorders ; Polymerase Chain Reaction ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction* ; RNA ; RNA, Messenger* ; RNA-Directed DNA Polymerase* ; Suspensions

CT was done 81 times on 63 proven malignant maxillary sinus tumors for 3 years from Feb.1979 to May 1982 atSeoul National University Hospital. Pre-treatment CT were 54 and post-treatment CT were 31 on 28 patient. Theresult were as follows; 1. The most frequent histopathologic diagnosis was 44 cases (69.8%) of squamous cellcarcinoma. Others were 5 cases (7.9%) of adenoid cystic carcinoma, 3 cases (4.8%) of olfactory neuroblastoma, 3cases (4.8%) of malignant lymphoma, 2 cases (3.2%) of melanoma, 2 cases (3.2%) of malignant fibrous histiocytoma,a rhabdomyosarcoma, a basal cell carcioma, a fibrosarcoma and a metastatic carcinoma from thyroid follicular adenocarcinoma. 2. The CT findings in 54 untreated malignant maxillary sinus tumors were sinus opacification, softtissue mass, and bone destruction in all cases. Other findings were fat plane obliteration (70%),osteosclerosis(59%), bone erosion and displacement (46%), low densities within soft tissue mass (27%), and airdensitis wiithin soft soft tissue mass (27%), and air densities within soft tissue mass(13%). 3. The value of pre-treatment CT in malignant maxillary sinus tumors were outlining the disease process especially soft tissuesuch as orbit, infratemporal fossa, pterygopalatine fossa, nasopharynx, pterygoid fossa and intracranialextension, and CT is the choice of diagnostic modality to determine the prognosis and the therapeutic planning insurgery and/or radiotherapy. 4. Post-treatment CT is also helpful to evalute the change in tumor size andpost-treatment complication.
Adenocarcinoma, Follicular ; Carcinoma, Adenoid Cystic ; Diagnosis ; Esthesioneuroblastoma, Olfactory ; Fibrosarcoma ; Humans ; Lymphoma ; Maxillary Sinus ; Melanoma ; Nasopharynx ; Orbit ; Prognosis ; Pterygopalatine Fossa ; Radiotherapy ; Rhabdomyosarcoma ; Thyroid Gland

PURPOSE: Myocardial SPECT is an effective test for detecting coronary artery disease in the general population. But the diagnostic accuracy between sexes is not defined. The purpose of this study is to compare the diagnostic accuracy between males and females. MATERIALS AND METHODS: One hundred and seventy seven male and 98 female patients who underwent myocardial SPECT within 1 month of coronary angiography were studied. Myocardial SPECTs were considered abnormal if fixed or reversible perfusion defects were detected. Stenosis severity of > or = 50% luminal diameter reduction of any artery defined coronary artery disease (CAD). RESULTS: Overall sensitivity for detection of CAD was 98% in men and 97% in women (p=not significant). However, specificities, accuracies, and positive predictive values (PPV) in men and women were 49% vs 31% (p<0.05), 81% vs 57% (p<0.01), 78% vs 48% (P<0.01), respectively Diagnostic accuracies for detection of right coronary artery disease were not different in both sexes, however, accuracies for detection of left anterior descending artery disease and left circumflex artery disease were significantly lower in female (p<0.05). CONCLUSION: A significant difference of diagnostic accuracy between sexes, especially in LAD and LCx disease, was noted. Artifacts from breast attenuation might be a cause for the lower diagnostic accuracy in female.
Arteries ; Artifacts ; Breast ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Humans ; Male ; Perfusion* ; Phenobarbital ; Tomography, Emission-Computed, Single-Photon*

Intentional delay of aftercoming siblings in multiple gestation is an infrequent occurrence in obstetrics. After delivery of an immature twin, conventional treatment calls for induction and delivery of the aftercoming sibling. However, several case reports have documented the feasibility of an expectant management. And also, as in our case, an aggressive treatment consisting of cerclage, tocolysis, and broad-spectrum antibiotics has been shown to prolong pregnancy. We experienced an unavoidable delivery of a nonviable first twin after premature rupture of membranes at 16 weeks' of gestation. The placenta was left undisturbed. Twin B was confirmed to be alive within the intact second sac. Tocolysis was started and cervical cerclage was done directly after delivery of twin A. Pregnancy was successfully prolonged, which enabled the second fetus to remain in utero and grow for another 145 days. To our knowledge, this was the longest interval between deliveries in a twin pregnancy reported in the literature. A healthy 3,050 gm male was delivered by cesarean section at 37 weeks' of gestation. Below we present this case in detail and discussed with respect to the aggressive approach undertaken to prolong gestation.
Anti-Bacterial Agents ; Cerclage, Cervical ; Cesarean Section ; Female ; Fetus ; Humans ; Male ; Membranes ; Obstetrics ; Placenta ; Pregnancy* ; Pregnancy, Twin ; Rupture ; Siblings ; Tocolysis ; Twins*

No abstract available.
Aluminum Hydroxide* ; Aluminum* ; Korea*

The immunohistochemical expression of transforming growth factor-beta(TGF-beta), epidermal growth factor(EGF) and alpha-1-antitrypsin(AAT) was studied in 47cases of endoscopic biopsy matearials of gastric carcinoma to determine me correlation to the expression of alpha fetoprotein(AFP). And immunoreactivity of the antigens was correlated to me degree of tumor infiltrating lymphocytes and histologic differentiation of the tumors. And the results were analyzed to elucidate pathological AFP-producing gastric cancer. The results were summarized as follows. AFP immunoreactivity was demonstrated in 30 cases(63.8%) of the tumors, TGF-beta in 26 cases(55.3%), EGF in l4 cases(29.8%) and AAT in l0 cases(21.3%). The incidence of expression of the antigens was significantly higher in the cases of elevated serum AFP(>2ng/ml) than that of the cases with normal serum AFP(p<0.05). There was no relation between the expression of antigens and histological differentiation of gastric cancer. The expression of AFP and TGF-beta revealed good correlation(k=0.72). The relation between expression of TGF-beta and AAT and the degree of tumor infiltrating lymphocytes disclosed negative correlation(p<0.05). These results suggest that TGF-beta and AAT prodution contribute to the worse prognosis of AFP-producting gastric cancer. Possible immunosuppressive action of TGF-beta and AAT in the cancer tissue is discussed.
Incidence ; Biopsy ; Stomach Neoplasms

BACKGROUND: Some research viewed that effective dietary therapy was enough to control proper blood glucose level, but in the most patient, dietary therapy was not practiced and the most difficult part of managing their diabetes. The purpose of this research study was to investigate dietary practice adherence and perceived barriers among the elderly diabetes. METHODS: The survey was mailed to 852 persons with diabetes member via diabetic educator of 156 hospitals or clinics and 24 health centers. Questionnaire had background information of patients, meal regularity, food intake as a dietary practice adherence, barriers of 36 items which have 3 areas such as motive/attitude, knowledge, authority/resource. We asked the person with diabetes to rate barrier to dietary practice adherence. 432 questionnaire were returned the response. we selected 69 persons who were over 65 year old. RESULTS: 1) meal regularity was more satisfactory than food intake. 2) deficit of meal regularity were evening snack and resonable spacing between evening meal and evening snack. 3) deficit of food intake was serving of milk. 4) main barrier to dietary practice adherence was that of knowledge. CONCLUSION: For practice effectively dietary therapy to elderly diabetes, individual consultation or small group education must be pursued and more easily educational skills should be required.
Aged* ; Blood Glucose ; Eating ; Education ; Humans ; Meals ; Milk ; Postal Service ; Surveys and Questionnaires ; Snacks

No abstract available.
Humans ; Magnetic Resonance Imaging, Cine* ; Spinal Cord Diseases*

BACGROUND: The accuracy and efficiency of a job performed by hospital employee can be linked directly with patients' health and life. It is considered that their irregular work and stress are relatively high as compared with other workplaces. In this article we tried to look into how job stress, working environment and factors of life-style influence sleep problems in hospital employees. METHODS: This research was conducted among 248 workers of a hospital in Busan on April, 2002. Sleep problems were categorized into insomnia, sleep deprivation, daytime sleepiness and snoring on the basis of the factor analysis of 11-item questions. The job stress was proposed by Karasek, etc., and measured by 14-item modified questions. The statistical analysis was conducted using Chi-square test and multiple logistic regression analysis. RESULTS: Statistically insomnia, sleep deprivation and daytime sleepiness showed a significant increase in women (OR:2.1/2.69/3.16) and shift workers (OR:4.67/3.28/1.98) and snoring showed a significant increase in obesity (OR:5.0) and smokers (OR:2.34). CONCLUSION: This research showed that many hospital employees perceive sleep disorders as critical. Especially, work shift seemed to be an important risk factor for sleep disorders.
Busan ; Female ; Humans ; Logistic Models ; Obesity ; Prevalence* ; Risk Factors ; Sleep Deprivation ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Snoring