No abstract available.
Cerebrospinal Fluid* ; Child* ; Humans ; Lymphocytosis* ; Meningitis, Bacterial*

Seidel nail is one of locked humeral nail and Seidel himself reported excellent result in his preliminary report using his nail. But our early experience showed disappointing result with high rate of complications, So we reviewed our 16 cases of humeral shaft fracture with polytrauma treated with Seidel nail and studied anatomical fitness of the nail within the distal medullary space using CT scan. The most frequent complication was intraoperative fracture of the proximal humerus < 4 cases> and this seemed to be due to lateral placement of pilot hole. There were 3 cases of nonunion and these cases showed insufficient distal anchorage, either primarily or postoperatively. Anatomical fitness study showed insufficient spreading of nail flanges in 5 cases of distal canal width below 9mm and nonunion cases were in this group. Other problems of Seidel nail were technical difficulties due to occasionally incorrect proximal targeting device and frequent breakage of adaptor screw. Study of more cases may be needed to confirm the design problem of Seidel nail.
Humerus ; Multiple Trauma ; Tomography, X-Ray Computed

No abstract available.
Hydronephrosis*

Urea reduction ratio (URR) and Kt/Vurea are objective parameters of dialysis delivery in hemodialysis patients and correlate with nutritional status and patient outcome. URR and Kt/Vurea depend on postdialysis blood urea nitrogen (BUN). In patients with severe postdialysis urea rebound (PDUR), these parameters do not accurately reflect dialysis adequacy. We measured PDUR 30 minutes after dialysis in 26 chronic stable hemodialysis patients. The impact of PDUR on dialysis delivery assessed by URR and Kt/Vurea and the independent factors affecting on PDUR were evaluated. All patients had been dialyzed for 4 hours thrice a week using hemophan membrane. 1) The mean age of patients was 48.6+/-14.8 years and sex ratio was 1:2.3. The mean duration of hemodialysis was 42.7+/-45.0 months. Primary renal diseases were chronic glomerulonephritis 11 (42.3%), diabetic nephropathy 7 (26.9%), and hypertension 4 (15.4%). 2) The mean blood flow was 209.2+/-17.4ml/min. URR, Kt/Vurea, and nPCR using immediate postdialysis BUN were 60+/-7%, 1.13+/-0.21, 1.09+/-0.28g/kg/ day, respectively. The mean recirculation rate was 4.4+/-2.3%. 3)The mean PDUR was 12.2+/-4.6% (range:6-22 %). URR, Kt/Vurea, and nPCR using BUN 30 minutes after dialysis were 55+/-7%, 0.99+/-0.18, and 1.02+/-0.25 g/kg/day, respectively and were significantly lower than those using immediate postdialysis BUN (P<0.05). 4) When the patients were divided according to the degree of PDUR (low PDUR group:<12%, high PDUR group: > or = 12%), high PDUR group was significantly higher than low PDUR group in hematocrit (27.0+/-2.6 vs. 23.5+/-3.6%, P=0.008), URR (64.3+/-5.4 vs. 55.8+/-6.8%, P=0.002), Kt/Vurea (1.26+/-0.17 vs. 1.03+/-0.18, P=0.002), and total recirculation rate (5.6+/-2.7 vs. 3.6+/-1.7%, P=0.05). There were no differences in age, sex, postdialysis body weight, ultrafiltration rate, blood flow, serum albumin, predialysis BUN, creatinine, and nPCR. 5) In multiple regression analysis, the independent factors affecting on PDUR were Kt/Vurea (beta=0.546, P<0.001), recirculation rate (beta=0.422, P<0.001), and hematocrit (beta=0.366, P=0.0017). In conclusion, we think that PDUR should be considered in hemodialysis patients when estimating dialysis delivery, especially if they had high Kt/ Vurea, recirculation rate, and hematocrit.
Blood Urea Nitrogen ; Body Weight ; Creatinine ; Diabetic Nephropathies ; Dialysis* ; Glomerulonephritis ; Hematocrit ; Humans ; Hypertension ; Membranes ; Nutritional Status ; Renal Dialysis* ; Serum Albumin ; Sex Ratio ; Ultrafiltration ; Urea*

No abstract available.
Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Fracture Fixation, Intramedullary*

Two cases of vertebra plana due to eosinophilic granuloma were experienced and successfully treated by anterior fusion of the involved spines at the department of Orthopedic Surgery in Seoul National University Hospital. Literature on the subject was reviewed.
Eosinophilic Granuloma ; Granuloma ; Orthopedics ; Seoul ; Spine

Osteopoikilosis is a familial, rare condition only discovered on radiological examination for a coincident disease. It is characterized by numerous nodules of dense bone in the spongiosa of the metaphysis or in the epiphysial nucleus. They are particularly seen in the small bones of the hands and feet and at the ends of the large bones of the extremities. Most of the bones have been reported as being affected but the skull is rarely involved. This condition is usually symptomless and no specific treatment is necessary. A case of osteopoikilosis is presented with a brief review of literatures.
Extremities ; Foot ; Hand ; Osteopoikilosis ; Skull

Combined injury of peroneus brevis rupture and bimalleolar fracture is very rare. The avulsion of peroneus brevis tendon from insertion maybe neglected and may prevent anatomic reduction of lateral malleolar fracture. We have treated open bimalleolar fracture with avulsion of peroneus brevis tendon from its insertion.
Ankle Fractures ; Rupture ; Tendons

Current treatment strategies for levodopa-induced psychosis in advanced Parkinson's disease have had limited success. Reduction or discontinuation of levodopa and coadministration with dopamine-blocking neuroleptics may attenuate the psychotic symptoms, but these strategies are associated with worsening of parkinsonian symptoms. Administration of 5-HT3 receptor antagonist ; ondansetron, a newer strategy to attenuate psychosis of Parkinson' disease without motor deterioration was introduced. A 41-year-old young-onset male, who was diagnosed as Parkinson's disease 7 years ago, was treated with levodopa therapy, and had levodopa-induced psychosis(delusion, hallucination, paranoid, insomnia). After trial of ondansetron, he showed improvement in the Brief Psychiatric Rating Scale(from 21 points to 9 points) in spite of increasing the dosage of levodopa. With ondansetron, we could increase the dosage of levodopa without psychotic complications(esp, hallucination), and he showed improvement in the motor fluctuation.
Adult ; Antipsychotic Agents ; Hallucinations ; Humans ; Levodopa ; Male ; Ondansetron ; Parkinson Disease ; Psychotic Disorders* ; Receptors, Serotonin, 5-HT3

For the purpose of elucidating relation between red cell electrolyte concentrations and serum digoxin level, measurement of red cell electrolyte concentrations and seum digoxin level by radioimmunoassay were done in 46 normal controls and 63 patients of CHF including 8 patients with digitalis intoxication. The results obtained were as follows: 1. Red cell sodium concentration and ratio of red cell sodium to red cell potassium concentration in normal males were significantly higher than those of females, and red cell potassium concentration in normal males was significantly lower than that of normal females. 2. Red cell potassium concentration in patients of CHF was significantly higher than that of normal controls, but there was no difference in the red cell sodium concentration between the groups. 3. There was no relation between red cell electrolyte concentrations and serum digoxin level, and red cell electrolyte concentration did not exactly estimate serum digoxin level. 4. Red cell electrolyte concentrations in the patient of CHF were valuable in detecting digitalis toxicity.
Digitalis ; Digoxin* ; Female ; Humans ; Male ; Potassium ; Radioimmunoassay ; Sodium