The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. The injuries to the ankle joint result in a severe functional disturbance because of complex anatomical characteristics around the ankle joint. 69 patients(72 cases) of the ankle fracture that were treated in Orthopedic Dept. Chonbuk National University Hospital from Jan. 1979 to Dec. 1983 were analized in clinical and radiological aspects. The following results were obtained: 1. Among the 69 patients, male was 54 and female 15 with ratio of 3.5: 1.The average age was 32. 2. Main cause of fracture was traffic accident(58%). 3. The musculoskeletal system was injured most frequently associated with the ankle fracture(66%). 4. According to the ankle fracture classification, the most common type was Pronation-external rotation type in Lauge-Hansen classification, and the type C in Weber classification. 5.The average duration of cast immobilization was 8.8 weeks in closed reduction and 7.4 weeks in open reduction. 6. The lateral malleolar fracture involving the distal tibiofibular syndesmosis was very important in ankle stability so accurate anatomical reduction by internal fixation was necessary for satisfactory functional results. 7. In clinical and radiological analysis, the better results were obtained from open reduction.
Ankle Fractures ; Ankle Joint ; Ankle ; Classification ; Clinical Study ; Female ; Humans ; Immobilization ; Jeollabuk-do ; Male ; Musculoskeletal System ; Orthopedics ; Walking

Displaced acetabular fractures have given rise to difficulty to the management, It has been unique diagnostic and operative challanges for the surgeon. We made a retrospective study of hip arthroplasty in fourteen patients who had a history of previous acetabular fracture. The most of patients was sutfered from traumatic osteoarthritis, We performed two bipolar hemiarthroplasty, eleven non-cement cup and one case Charnley cup replacement were done. The purpose of this stady was to determine the outcome long-term cup. The clinical results showed that pain was most improved at foliow-up, but the incidence of radiographic loosening and revisions were higher 42.8% within 10 years. We conclude that a history of prior acetahular fracture has a significant adverse impact on the long term out come of acetabular cup in total hip arthroplasty.
Acetabulum* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Hemiarthroplasty ; Hip ; Humans ; Incidence ; Osteoarthritis ; Retrospective Studies

BACKGROUND: After multiple trauma, blood coagulation activity is enhanced and fibrinolytic activity is suppressed by overproduction of plasminogen activator inhibitor-1 (PAI-1). Intermittent sequential pneumatic compression (ISPC) is an effective method to prevent deep vein thrombosis. Its action is explained by the mechanical effect on blood flow, as well as by the enhancement of fibrinolysis by the reduction of PAI-1. The aim of this study was to determine the effects of ISPC on coagulation and fibrinolysis after multiple trauma. METHODS: Thirty-nine trauma patients were either treated with ISPC (ISPC group, 20 patients) or without ISPC (control group, 19 patients). We measured the plasma levels of the thrombin antithrombin III complex (TAT), the plasmin alpha 2 plasmin inhibitor complex (PIC), the tissue plasminogen activator (t-PA), and the plasminogen activator inhibitor-1 (PAI-1) on admission and at 1, 2, 3, 6, 12, and 24 hours after admission. RESULTS: The TAT was higher than normal in both groups, with no significant difference between the two groups throughout the study period. The PIC level of ISPC group was significantly higher than that of the control group. In the ISPC group, the PIC level increased gradually, reaching a peak at 3 hours and decreasing thereafter. In the control group, the PIC level increased to a peak level at 2 hours. The TAT/PIC ratio dropped in the first two hours and increased at 3 hours, dropping again thereafter. In the ISPC group, the ratio dropped gradually without an intermittent fluctuation. At 3 and 6 hours, the control group showed a significantly greater ratio compared to the ISPC group. PAI-1 was higher than normal in bothgroups, with a significantly lower level in the ISPC group from 2 hours to 24 hours. For the t-PA level, no difference was noted between the two groups, with the peak level occurring at 1 hour. The PAI-1/t-PA ratio was significantly greater in the control group from 2 hours to 12 hours than in the ISPC group, but the difference was not significant at 24 hours. CONCLUSIONS: In multiple trauma patients, ISPC does not seem to affect coagulation, but enhances fibrinolysis through suppressed PAI-1 production. This effect of ISPC may be maintained for 12 hours.
alpha-2-Antiplasmin ; Antithrombin III ; Blood Coagulation ; Fibrinolysin ; Fibrinolysis* ; Humans ; Multiple Trauma* ; Plasma ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Thrombin ; Tissue Plasminogen Activator ; Venous Thrombosis

No abstract available.
Blood Platelets* ; Fetal Growth Retardation* ; Platelet Count* ; Pregnancy*

The onset of systemic scleroderma in the first. decade of lif occurs in less than 1.5% of instances. Systemic sclerodrma in childhood have been characterized by less severe visceral involvement and a benign course We report a boy, aged 7 years, with a history of Raynaid; phenomenon and dysphagia. He had a mask-like face, flexion contracture of hands and knee joints, digital pitting scars, ichthyosiform skin change on leg and hyperpigrnented induration on all extremities and trunk. Antinuclear antibodies were positive in nucleolar type and Scl-70 antiocy was also present. On radiologie study, the pattern of reflux esophagitis and resorption of the listal ends of all phalanges were nated. Histopathological findings were compatible with sclerodma. He was treated with Penicillamine-D and oral corticosteroic with good improvernent.
Antibodies, Antinuclear ; Cicatrix ; Contracture ; Deglutition Disorders ; Esophagitis, Peptic ; Extremities ; Hand ; Humans ; Knee Joint ; Leg ; Male ; Scleroderma, Systemic* ; Skin

No abstract available.
Humans ; Hyoid Bone ; Orthognathic Surgery

OBJECTIVE: Arrhythmogenic right ventricular cardiomyopathy(ARVC) is a progressive cardiac muscle disease characterized as progressive fibrofatty replacement of the right ventricle, severe ventricular arrhythmia, and sudden death. However, there is no report of ARVC as a cause of sudden death in Korea. METHODS and RESULTS: Postmortem studies were done to 115 cases of sudden unexplained death at department of legal medicine, school of medicine, Kyungpook national university in year 1999. We identified 7 cases(6%) of typical ARVC with no other identifiable cause of sudden death. The subjects included 5 males and 2 females, ranging in age from 19 to 41 years (mean 29.7 years). All were found dead at bed (5 cases) or workshop (2 cases). Five cases were fibrofatty types and two cases were fatty types. Right ventricular aneurysm, inflammatory infiltrates and left ventricular involvement were found in 4, 2 and 1 cases, repectively. Two cases had family history of sudden death before age 40. No one was suspected of having cardiovascular disease or ARVC before death. CONCLUSION: These findings indicate that ARVC in Taegu-Kyungpook area may be more frequent than previously thought. ARVC may be a major cause of sudden unexplained death.
Aneurysm ; Arrhythmias, Cardiac ; Arrhythmogenic Right Ventricular Dysplasia* ; Cardiovascular Diseases ; Death, Sudden ; Education ; Female ; Forensic Medicine ; Gyeongsangbuk-do ; Heart Ventricles ; Humans ; Korea ; Male ; Myocardium

For the study on the effect of retinoic acid on the formation of palatal rugae and the cleft palate, retinoic acid was administered orally 150mg/kg of body weight by gastric tube at GD 10.5 to Sprague-Dawley rats. The pregnant rats were sacrificed on GD 17.5 under ether anesthesia, and laparatomized. After removal of uterus, the number of pregnant sacs and fetuses were counted. The fetuses weighed, the MEE (medial edge epithelium) thickness measured and the mitotic figures counted after routine processing and H·E stain. All the palates were photographed, and the number of rugae & the rugal pattern analysed. TEM photographs of MEE cells were observed after routine processing. The results were as follows ; 1. Rat fetus body weight after retinoic acid treatment increased significantly compared with the control group. 2. Mitotic figures in the retinoic acid treated group increased significantly compared with control group. 3. In the retinoic acid treated group, 79.3% of fetuses had cleft palates. Among fetuses with cleft palates, complete cleft palates were 10.6%, incomplete cleft palate 89.4%. Incomplete clefts were of two types ; median type (cleft palate at the intermolar region) and soft palate type (cleft posterior to the 8th rugae). Median type was 64.6% and the soft palate type 35.4%. 4. 2.3% of the fetuses had the numerical anomaly of the palatal rugae in the control group, but that of retinoic acid treated group 87.7%. 5. 17.4% of palatal rugae of the control group was disrupted, but 100% of the retinoic acid treated group disrupted. 6. Rugal papillae were observed in the 15.1% of fetuses of the control group and 63.1% of fetuses of the retinoic acid treated group. 7. Longitudinal rugae were observed in 19% of fetuses of the retinoic acid treated group, but not in the control group. 8. In TEM photographs, cytoplasmic processes, intercellular space, and desmosomes decreased. Swelling of mitochondria & ER were also found in the retinoic acid treated groups. According to the above results, it appears that there is close relationship between palatal rugae and cleft palates, and that excess retinoic acid induces disruption of pattern and numerical variations of rat fetus palate rugae. Also retinoic acid has an inhibitory effect on the proliferation of medial edge epithelial cells of palatal shelves. The cleft palates may be induced by the above mentioned retinoic acid effects. But, the exact mechanisms of retinoic acid on cleft palate formation is not thoroughly known and should be further studied.
Anesthesia ; Animals ; Body Weight ; Cleft Palate* ; Cytoplasm ; Desmosomes ; Epithelial Cells ; Ether ; Extracellular Space ; Fetus ; Mitochondria ; Palate ; Palate, Soft ; Rats ; Rats, Sprague-Dawley ; Tretinoin* ; Uterus

PURPOSE: Accurately measuring urinary urgency is important for diagnosing overactive bladder (OAB) and quantifying improvements in treatment outcome. Various methods have been recommended for evaluating urinary urgency, but these methods assess individual perceptions and preferences. To overcome the subjectivity in measuring urinary urgency, we evaluated the relationship between uroflowmetric parameters and urinary urgency in women with OAB. METHODS: Consecutive female patients with lower urinary tract symptoms (n=110) were prospectively enrolled in this study between April 2011 and September 2012. Individuals with a history of using medications that are known to affect bladder function were excluded. All enrolled patients completed uroflowmetry with a delayed time to voiding (T2V). After urination was completed, patients were asked whether they experienced any urinary hesitancy or urgency at that time. RESULTS: The mean patient age was 56.1 years; 70 out of 110 patients reported some degree of urinary urgency. T2V decreased with increased urgency. Several uroflowmetric parameters were observed to have a significant correlation with urinary urgency. T2V had a meaningful correlation coefficient for individuals with urgency, regardless of the voided volume. There was no significant correlation between the presence of urinary hesitancy and T2V. CONCLUSIONS: We believe that T2V would be a complementary tool for diagnosing and determining the degree of urinary urgency in women with OAB.
Female ; Humans ; Lower Urinary Tract Symptoms ; Prospective Studies ; Treatment Outcome ; Urinary Bladder ; Urinary Bladder, Overactive* ; Urination* ; Urodynamics

PURPOSE: The treatment of choice for well-differentiated thyroid cancer is surgical excision. However, the operation method is still controversial. Also, the operation method has been changing gradually. Thus, we reviewed the records of patients with well-differentiated thyroid cancer who had received operations in our hospital to assess the trend in surgical procedure, and to determine the proper procedure, method, considering both recurrence and complications. METHODS: We retrospectively analyzed the cases of 452 patients with differentiated thyroid cancer who had received operations from January 1989 to December 1998. We divided the 10 years into two periods; period I was from 1989 to 1993 (254 patients) and period II was from 1994 to 1998 (198 patients). We analyzed recurrences and complications according to the operation method, including neck lymph-node dissection. The incidences and locations of lymph- node metastasis were taken into account, too. The statistical analysis was done by using the Fisher's exact test. RESULTS: In period I, 147 patients (58%) received a total thyroidectomy, and in period II, all patients received total thyroidectomy. In period I, 24 patients (9.4%) had a recurrence, and in period II, 13 patients (6.6%) had a recurrence. In period I, 55 patients (21.7%) had postoperative hypoparathyr oidism, and in period II, 38 patients (19.2%) had postoperative hypoparathyroidism. In period I, 15 patients (5.9%) had postoperative hoarseness, and in period II, 7 patients (3.5%) had postoperative hoarseness. Two hundred eighty-one patients (62.2%) had lymph-node metastasis, and the anterior neck region was the most common site of metastasis (60.2%). CONCLUSION: In the operation method for differentiated thyroid cancer, the trend is toward a total thyroidectomy away from a lobectomy. Also, a skillful and experienced surgeon can reduce the incidence of postoperative complications. Thus the best operation method for differentiated thyroid cancer is a total thyroidectomy, including a preventive anterior-neck lymph-node dissection, which is done by a skillful and experienced surgeon.
Hoarseness ; Humans ; Hypoparathyroidism ; Incidence ; Neck ; Neoplasm Metastasis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy