In the fractures and dislocations of the carpus, prompt and accurate diagnosis is the prime prerequisite for restoring function to this most complicated joint in the body. And then, early precise reduction and continuous maintenance of the reduced position until ligamentous and bone healing is complete provide the best chance of achieving a satisfactory restoration of function. We analysed forty five cases of fractures and dislocations of the carpus which were treated for 5 years from Jan. 1984 to Dec. 1988 at the Department of Orthopedic Surgery, College of Medicine, Hallym University. The following results were obtained; l. Of the total 45 injuries, scaphoid fractures were seen in 32(71.1%), other carpal bone fractures except scaphoid in 13 patients(28.9%), and carpal bone dislocation and fracture- dislocations in 11 patients(24.4%). 2. Carpal scaphoid fracture 1) 19 of the 32 patients(59.4%) had an associated ipsilateral upper extremity injury. 2) This fracture was common in the young male. 3) A union rate(95.6%) was achieved using a usual conservative treatment for undisplaced racture(14), operative treatment for displaced(18). 4) The mean time to radiological union for all fractures was 11.1 weeks. Old fracture by SotoHall classification took the longest time to union(18.2 weeks), subacute fracture 13 weeks, and acute fracture 9 weeks. 5) 10 cases were treated for nonunion, 5 of 10 nonunions were classified as type (50%). 2 cases showed ultimately nonunion in spite of various sorts of treatment, which belonged to waist fracture. 3. Other carpal bone fractures except scaphoid were seen in 13(15 bones) of 45 injuries, and pisiform(4) and triquetrum(4) fractures were common. 4. Carpal dislocation and fracture-dislocations were seen in 11 of the 45 injuries and dorsal transscaphoid perilunate dislocations(4) were common. These were treated by C.R. and cast immobilization or O.R. and K-wire fixation relatively good results were obtained.
Carpal Bones ; Classification ; Clinical Study ; Diagnosis ; Dislocations ; Humans ; Immobilization ; Joints ; Ligaments ; Male ; Orthopedics ; Upper Extremity

No abstract available.
Child* ; Humans

It is indispensable to cover the skin defect when bone or tendon is exposed. In case of inevitable amputation of an extremity, it is possible to harvest a free flap from the amputed limb for providing coverage of the other wound. This technique allows immediate wound coverage without the morbidity of an additional donor site. We experienced an electrical burn case with inevitahle wrist disarticulation and successfully treated soft tissue defect of ankle using free vascularized flap.
Amputation ; Ankle* ; Burns ; Disarticulation ; Extremities ; Free Tissue Flaps ; Hand* ; Humans ; Skin ; Tendons ; Tissue Donors ; Wounds and Injuries ; Wrist

The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wound. In cases of inevitable extremity amputation, the transfer of pedicled flap from the amputed part is possible. In such substance, it is possible to obtain the pedicled fillet flap from the amputed limb to provide stump coverage. We experienced two cases of below-knee amputation due to severe flame burn which the stump was covered with island pedicled sole-fillet flap.
Amputation Stumps* ; Amputation* ; Burns ; Extremities ; Knee* ; Lower Extremity ; Surgical Flaps ; Wounds and Injuries

The present study was designed to detect the distribution of the type I collagens in the three regions, papillary layer, reticular layer and subcutaneous layer of skin in the rats after administration of adriamycin. Intraperitoneally, 1 injections of 5 mg/kg of adriamycin for every 3 days were given and sacrificed 12 hours, 24 hours, 3 days and 1 week later respectively. For the immunoreactions of type I collagen, the specimens were incubated with rabbit anti rat type I collagen polyclonal antibody as primary antibody and biotinylated Goat anti rabbit IgG antibody as secondary antibody. And ABC peroxidase procedure was used. The reactions of type I collagen in the dermis of adriamycin treated rat skin were decreased from 12 hours to 3 day and from 7 day the immunoreactions are constant as like that of normal rats. Adriamycin seems to be suppressing normal components of type I collagen in rat skin.
Animals ; Collagen Type I* ; Dermis ; Doxorubicin* ; Goats ; Immunoglobulin G ; Peroxidase ; Rats* ; Skin*

PURPOSE: To evaluate the indication for intracavitary Urokinase(UK) in the treatment of Ioculated pleural effusion. MATERIALS AND METHODS: We analyzed CT and US in 31 patients who were treated with intracavitary UK in Ioculated pleural effusion. In each patient, a single chest catheter (10-12F) was insected under imaging guidance. When the amount of drainage was less than 100ml/day, UK was instilled through the catheter until less than 50ml/day was drained. On follow-up chest radiographs of more than 1 month, we classified the results of treatment into 3 groups:(1) completely effective (lung expansion, over 80%);(2) partially effective (20-80%); (3) ineffective (below 20%) group. Sonographic pattern of pleural fluid was classified into anechoic, septated, and honeycomb appearances and the thickness of parietal pleura was measured on CT. RESULTS: Sixteen patients were completely effective, nine were partially effective, and six were ineffective. patients with completely or partially effective outcome had anechoic and linear septated appearance on had less than 4mm of parietal pleural thickness on CT. Of six ineffective patients, US showed linear septated in one patient and honeycomb appearance in five patients and the thickness of parietal pleura on CT was 3 mm in one patient, 4ram in two patients, 5mm in one patient, and 6mm in two patients. CONCLUSION: UK instillation through percutaneous catheter was an effective method in the treatment of Ioculated pleural effusion. However, we found near complete reaccumulation of pleural fluid when honeycomb appearance of pleural fluid on US or more than 5mm parietal pleural thickness on CT was observed, which might suggest that we should consider the other kinds of treatment method in those patients.
Catheters ; Drainage ; Follow-Up Studies ; Humans ; Insects ; Pleura ; Pleural Effusion* ; Rabeprazole ; Radiography, Thoracic ; Thorax ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

No abstract available.
Child* ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans

Hypertrophic osteoarthropathy, known as Marie-Bamberger's Disease, is characterized by bone and joint changes and clubbing of the fingers and toes. It is well known to occur after longstanding disease of the thorax and intestines. The authors have tried to find patients with hypertrophic osteo-arthropathy in cases with pure silicosis and silscosis complicated by pulmonary tuberculosis. but failed. Recently, the authors discovered 3 cases of hypertrophic osteoarthropathy among some patients with pulmonary tuberculosis. All had had a long history of pulmonary tuberculosis, at least over 1 year duration.
Fingers ; Humans ; Intestines ; Joints ; Silicosis ; Thorax ; Toes ; Tuberculosis, Pulmonary

This study examined, among others, the relationship between the use of anticonvulsant and the bone mineral metabolism(measured via DR-XRA and biochemical study) in 46 adult epileptic outpatients who had been on anticonvulsant for more than one year at Seoul Red Cross Hospital. The study finding wet as follows. 1) There was statistically significant difference between index group(i.e. 46 adult epileptic outpatients) and control group(i.e. 46 healthy adults without previous exposure to anticonvulsant) in terms of bone mineral density. Specifically, the bone mineral density in the epileptic outpatients was significantly lower than that in the healthy adult. Although there was no statistically significant difference between male and female outpatients, their bone mineral density tended to decrease with the increase of age. 2) The bone mineral density in the epileptic outpatients was negatively correlated to both I) the age when the outpatients stared anticonvulsant treatment and ii) the period for which the outpatients were on anticonvulsant 3) Index group was further classified into three subgroup(i.e. low, normal and high subgroup) based on the mean and standard deviation of the bone mineral density in healthy adults control group. 24 outpatients(52.5%) out of 46 fell into low subgroup, of which 10 were male. Overall, there was no statistically significant difference between male and female outpatients in terms of their bone mineral density. 4) Low subgroup's average age(38.6 with SD of 12.5) was significantly higher than those of the other two subgroup. Low subgroup stained anticonvulsant treated when their average age was 24.8(SD 15.0) years, which was higher than those of the other two subgroups. Low subgroup was on anticonvulsant, on average, far 13.3(SD 7.6) years, which was also higher than those of the other two subgroups although there was no significant difference among the subgroups. 5) A series of comparison regarding the possible impact of various types of anticonvulsan(e.g. PHT, CBZ, FB, SV) in terms of i) overall dosage and ii) daily average dosage on bone mineral density showed no significant difference across the three subgroups. 6) There was no significant difference in terms of bone mineral density between the epileptic outpatients on only one type of anticonvulsant and those on two or more types of anticonvulsant. 7) A biochemical study showed that i) each subgroup fell into normal range in terms of blood serum Ca, F, and ALF with no significant difference among the subgroups, and ii) in low subgroup, there were 6 outpatients(25%) with Ca decrease, 2(9.5%) with P decrease, and 5(20.8%) with ALF increase.
Adult ; Bone Density ; Female ; Humans ; Male ; Outpatients* ; Radiography* ; Red Cross ; Reference Values ; Seoul ; Serum

Hepatocyte growth factor (HGF), a potent stimulator of hepatocyte growth, stimulates motility, invasiveness, proliferation, and morphogenesis of epithelium, and may be involved in physiologic and pathologic processes such as embryogenesis, wound healing, organ regeneration, inflammation, and tumor invasion. So we examined the role of the HGF/c-Met on invasion and metastasis of hypopharyngeal squamous cell carcinoma (SCC). We performed immunohistochemical stains on 40 normal mucosas and 40 SCCs of hypopharynx with HGF antibody and c-Met antibody. For RT-PCR and Western blot, fresh normal tissues and cancer tissues in hypopharynx obtained from five patients were used. The positive rates of HGF and c-Met expression in hypopharyngeal SCC were 77.5% and 70%, respectively. HGF staining was significantly correlated with lymph node metastasis and pathologic stage (p<0.05). c-Met staining was only significantly correlated with lymph node metastasis (p<0.05). The increased expresssion of c-Met mRNA (RT-PCR) and protein (Western Blot) were detected in hypopharyngeal cancer tissue. These results suggest that HGF may play an important role in the progression of hypopharyngeal cancer.
Blotting, Western ; Carcinoma, Squamous Cell* ; Coloring Agents ; Embryonic Development ; Epithelium ; Female ; Hepatocyte Growth Factor ; Hepatocytes ; Humans ; Hypopharyngeal Neoplasms ; Hypopharynx ; Inflammation ; Lymph Nodes ; Morphogenesis ; Mucous Membrane ; Neoplasm Metastasis ; Pathologic Processes ; Pregnancy ; Regeneration ; RNA, Messenger ; Wound Healing