The incidence of the bronchial rupture following blunt chest trauma has increased gradually with the increases of traffic accident and mechanization. We have experienced the 3 cases of the bronchial rupture following blunt chest trauma. The first case was a 38 year old man who was compressed into a blank wall by fork-lift. He complained of severe dyspnea with air leak through the chest tube and right pneumothorax with collapsed lung was seen in his chest X-ray film after closed thoracostomy. Emergency bronchoscopy showed disruptions of the right upper lobar bronchus and the membranous portion of the intermediate bronchus. The second was 8 year old boy who was sustained a crushing chest injury by bus. He also complained of severe dyspnea with air leak through the chest tube and right pneumothorax with collapsed lung was seen in his chest X-ray film after closed thoracostomy. We performed the computed tomogram of the chest and found the bronchial rupture at the distal portion of the right main bronchus. The third case was 40 year old male who was sustained a crushing chest injury by in-car accident. He complained of mild dyspnea without air leak through the chest tube and the left lung was well expanded in his chest X-ray film after closed thoracostomy. Bronchoscopy showed disruption of the 6th cartilaginous portion of the left main bronchus. Emergency bronchoplasties were performed with interrupted end-to-end anastomosis in all cases. Postoperative air leak occurred for 7 days in the third case. Others were uneventful.
Accidents, Traffic ; Adult ; Bronchi ; Bronchoscopy ; Chest Tubes ; Child ; Dyspnea ; Emergencies ; Humans ; Incidence ; Lung ; Male ; Pneumothorax ; Rupture* ; Thoracic Injuries ; Thoracostomy ; Thorax* ; X-Ray Film

No abstract available in English.
Dislocations ; Ulnar Nerve ; Ulnar Neuropathies

46 knees with injured meniscus diagnosed by the use of history and physical examination as well as by arthrography were meniscectomized from January in 1974 to June in 1978. Statistical analysis of data obtained from the histories, physical examinations and arthrographic studies of 46 knees with a mean follow up 6 months after meniscectomy revealed as follows. 1. Lateral meniscus injuries were higher incidence than medial meniscus. 2. In the posterior horn of the medial meniscus and in the middle third of the lateral meniscus on the injured location were more frequently encountered. 3. To compare the results of twe methods of diagnosis were obtained with 67% accuracy by the use of history and physical examination and with 85% accuracy by arthrography 4. We should be able to diagnosis with 91% armed with a history and physical examination and an arthrogram. 5. As being the excellent results after meniscectomy were classified with 78%.
Animals ; Arm ; Arthrography ; Clinical Study ; Diagnosis ; Follow-Up Studies ; Horns ; Incidence ; Knee ; Menisci, Tibial ; Physical Examination ; Tears

A case of Cleido-Cranial-Dysostosis, which characterized by deficient formation of the clavicle with delayed and imperfect ossification of the cranium, associated with other anatomical errors, was experienced at The Department of Orthopaedic Surgery of Kyung Hee University Hospital in January 73. We report this rare and interest case with reference review.
Clavicle ; Skull

Ossification of the ligamentum flavum(OLF) is a well recognized cause of acquired spinal canal stenosis resulting in myelopathy, radiculopathy, or a combination of both. OLF is extremely rare in caucasian patients, but is one of the most common causes of compression of the posterior thoracic spinal cord in Japan. In most cases, it has been found in the thoracolumbar regions, and rarely in the cervical region. It is frequently but not alwalys found in association with ossification of the posterior longitudinal ligament(OPLL) and may cause cumulative damage, if comhined with OPLL. We experienced a case of ossification of the ligamentum flavum and posterior longitudinal ligament with sacral radiculopathy, which was treated hy posterior decompressive laminectomy and removal of the ossified ligamentum flavum and posterior longitudinal ligament. The day after operation, the radiating pain and paresthesia dramatically improved.
Constriction, Pathologic ; Humans ; Japan ; Laminectomy ; Ligamentum Flavum* ; Longitudinal Ligaments* ; Paresthesia ; Radiculopathy* ; Spinal Canal ; Spinal Cord ; Spinal Cord Diseases

PURPOSE: In mammals, alphaand beta-defensins are antimicrobial peptides that are expressed in various epithelial and phagocytic cells. Human beta-defensin-1 and -2 (hBD-1, hBD-2) have recently been shown to be expressed in various epithelial cells. Vaginal mucosa can be a target of vaginitis and the site of uropathogens' colonization that precedes urinary tract infections. Therefore, innate host defense mediators like antimicrobial peptides in the vaginal mucosa are important. Estrogen and progesterone receptors have been shown to be expressed in the vaginal squamous epithelium. Sex hormones like estrogen and progesterone may cause vaginal atrophy or susceptibility to uropathogens. So, we performed this study to investigate the expression patterns of hBD-1 and -2 mRNA in vaginal squamous epithelium (VSE) with using lipopolysaccharide (LPS), 17beta-estradiol and progesterone. MATERIALS AND METHODS: Normal VSE cells that were retrieved from vaginal tissue during vaginoplasty were primarily cultured in keratinocyte growth medium and they we allowed to undergo their 3rd passage. Modulation of the expressions of hBD-1 and -2 mRNA by various stimuli (LPS 0.5microgram/ml, E2 2nM, P 1micrometer) was measured by semiquantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS: HBD-1 and -2 were constitutively expressed in the normal VSE cell lines, but the hBD-2 expression was not significant. A marked increase of the constitutive expression of hBD-2 mRNA was observed upon stimulation with LPS, but not upon stimulation with E2. A moderate decrease of the constitutive expression of hBD-2 mRNA upon stimulation with LPS was observed with administering progesterone. CONCLUSIONS: These expressions of hBD-2 mRNA may have important roles in the innate host defense of the urogenital area. Artificial intake of progesterone may lead to susceptibility via a decrease of defensins.
Atrophy ; beta-Defensins ; Cell Line ; Colon ; Defensins ; Epithelial Cells* ; Epithelium ; Estrogens ; Gonadal Steroid Hormones ; Humans ; Keratinocytes ; Mammals ; Mucous Membrane ; Peptides ; Phagocytes ; Polymerase Chain Reaction ; Progesterone* ; Receptors, Progesterone ; Reverse Transcription ; RNA, Messenger ; Urinary Tract Infections ; Vagina ; Vaginitis

No abstract available.
Breast Neoplasms* ; Breast*

Bone marrow pressure is neither arterial pressure nor venous pressure of extremity, that is thought the precapillary pressure of bone. It is different between long bone and flat bone, and is also different in various site of the bone. Author measured bone marrow pressure of 84 normal femoral heads of Korean adults for basic data of early diagnosis of avascular necrosis of femoral head. The results are followings : 1. The baseline bone marrow pressure of Korean healthy adults is average 22.5 ±7.2mmHg. 2. The most significant change of bone marrow pressure in stress test is observed at 5 min. after injection of 5cc normal saline. 3. The increase of bone marrow pressure at 5 min. after stress test was average 7.4 ±4.4 mmHg. 4. Sex and age factors do not influence bone marrow pressure.
Adult ; Age Factors ; Arterial Pressure ; Bone Marrow ; Early Diagnosis ; Exercise Test ; Extremities ; Head ; Humans ; Necrosis ; Venous Pressure

Spinal instrumentation is popular nowadays. After applying the Harrington distraction rod, there might be a severe, tragic complication, paraplegia. Recently SSEP is widely used to detect the early change of the spinal cord dysfunction. The force to correct the spinal deformity is usually distraction. The distraction force will stretch the spinal dura. But the relation of neural deficit between distraction force and duration is not clearly determined yet. Also the anatomical level of neural deficit is not known. The purpose of this study is to find that the distraction force of 200gm on the spinal dura will change the SSEP by the stimulation of the posterior tibial nerve and if there is change of SSEP, what portion of nerve stimulation pathway is responsible for. Results are as followings. 1) The distraction force of 200gm makes change of SSEP wave. 2) P2 wave is most susceptible, N1 wave is less susceptible and P1 is relatively contant for one hour dural traction. 3) After release of traction, the wave is partially reversible but not completely for next one hour recovery period. 4) While the wave of SSEP is changed by the dural distraction force, the nerve conduction between the nerve root just outside of the spinal dura and calf shows constant latency. That means the anatomical level responsible for the change of SSEP wave is proximal to the spinal dura, not the peripheral nerve distal to the spinal dura.
Animals ; Congenital Abnormalities ; Dogs ; Evoked Potentials ; Evoked Potentials, Somatosensory ; Neural Conduction ; Paraplegia ; Peripheral Nerves ; Spinal Cord ; Tibial Nerve ; Traction

There have been several reports that total knee arthroplasty(TKA) was most likely to survive successfully if the coronal tibiofemoral angle was close to 7 degree of valgus, the accepted normal. In order to know whether the postoperative coronal tibiofemoral angle influences the result of total knee arthroplasty, we examined the 152 TKA cases in 106 patients which had been performed at Department of Orthopaedic Surgery, Seoul National University Hospital from Jan. 1987 to Dec. 1991. In our series the average follow-up period was 31 months(range, 13 months to 75 months). Coronal tibiofemoral angles of all cases were checked on weight bearing anteroposterior plain X-rays and were divided into three groups(less than valgus 2° ; valgus 3° to 7° ; greater than valgus 8°). All cases were analyzed on the knee score of Hospital for Special Surgery and the American Knee Society total knee arthroplasty roentgenographic evaluation and scoring system and the cases with radiolucent lines wider than 2mm were checked. Three groups were analyzed comparatively with statistical means(Wilcoxon signed rank test, X² test). There were no significant differences in the clinical results of total knee arthroplasty according to the postoperative coronal tibiofemoral angle. Lateral subluxation of the patella occurred more frequently when the postoperative coronal tibiofemoral angle was above valgus 8°. In the tibial components of group lesser than valgus 2°, the frequency of radiolucent lines wider than 2mm was higher than those of other groups, but its significance should be examined through long term follow-up.
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Patella ; Seoul ; Weight-Bearing