The growth plate is responsible for longitudinal bone growth and is involved in 6–15% of children's fracture. Of these injuries, 25–35% have been reported to result in some shortening or deformity, but in only 10% are the deformities sufficiently severe to lead to functional problems. The problem of repair of a demaged growth plate in children has never been adequately solved. The purpose of this study is to clarify that allograft of cultured chondrocytes can survive in the growth plate defect and can prevent the angular deformity by avoiding the formation of bone bridge. The chondrocytes were obtained from the rib cartilage of rabbit weighing 500g. The chondrocytes were cultured by socalled micromass culture method. The rabbits were divided two groups; the group I in which medial proximal tibial growth plate was destroyed, and the group II in which the cultured chondrocytes were transplanted into the right medial proximal tibial physeal defect. Each group has 10 rabbits. The tibial growth was observed grossly, radiologically and histologically until 16 weeks after graft. The angular deformity was observed from 3 weeks after operation and histologically the fusion of growth plate was observed in all of group I. In group II, there were no angular deformity and no fusion of growth plate in 7 out of 10 rabbits. Allografted cultured chondrocytes survived and produced matrix in the physeal defects. Through this study it was inferred that allograft transplantation of cultued chondrocytes in the iatrogenical physeal defect is a useful method to keep the physeal growth without cessation. However, further studies will be necessary to prove that the longitudinal growth potential resides in the transplanted chondrocytes as growth plate cartilage.
Allografts ; Bone Development ; Cartilage ; Child ; Chondrocytes ; Congenital Abnormalities ; Growth Plate ; Humans ; Methods ; Rabbits ; Ribs ; Transplants

No abstract available in English.
Animals ; Dogs ; Spine

No abstract available.
Emergencies* ; Emergency Service, Hospital* ; Humans

Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modern diseases and death have come to be related to stress and mental health deeply, therefore noise-induced mental disorder, like a stress became very important. In this point, the purpose of this study was to analyze the relationship between noise exposure level in worksite and workers' stress symptoms. This study included a survey of 786 manual workers selected from 89 worksites in 21 factories in Puchon. The results were as follows: 1. For demographic characteristics, most of the workers were males(80.8%), the 20~29 years old were 34.5% and those who graduated from high school were 65.3%. The workers whose monthly income ranged from 500,000 to 800,000 won were 37.5% and who have a religion were 47.9%. 2. For occupational characteristics, workers who had worked 1~5 years in the factories were 33.0%. Those who felt much for them workload were 43.9% and who worked more than 8 hours a day were 73.9 %. Those who were dissatisfied with their job and pay were 31.9% and 50.6%. The workers who responded ventilation condition of their worksites were bad were 51.9% and the dissatisfied with working environment of their wofksites were 45.9%. 3. Workers who were suffering from tinnitus were 53.3% and those who perceived hearing loss were 50.l%. Persons who reported they always wore earplugs at work were 35.4%. Those who felt earplugs bigger than their ears were 30.6% and those who experienced eardiseases caused by earplugs were 25.6%. 4. For the noise exposure level in worksite, workers who were exposed to 80-90dB were 30.3%, 90-100dB were 26.4% and 50~70dB were 19.2%. 5. workers' stress symptoms were significantly related to marital status and their monthly income p< 0.05). Workers who were single and had lower monthly income showed higher PSl (Psychiatric symptom Index) scores than those who were married and had higher monthly income. Higher PSl scores were also significantly related to l~2 days night-work per week, much for them workload, dissatisfaction with their job, and bad relationship with their bosses and coworkers. 6. Higher PSl scores were significantly related to severe tinnitus and perceived hearing loss p<0.001). Workers who felt the earplugs they use did not fit their ears showed significantly higher PSl scores(p<0.01). Workers who reported that they did not feel they need earplugs showed significantly higher PSl scores(p<0.05). Increased experience of eardisease caused by earplugs that did not fit were also significantly related to higher PSl scores(p<0.001). 7. The higher noise exposure level in worksite from 80dB was, the more severe stress symptoms including PSl subparts were reported; Anxiety, Anger, Depression, and cognitive disorder(p<0.001). 8. According to the results of stepwise multiple regression analysis, factors affecting workers' PSl scores were perceived hearing loss(R2=0.160), noise exposure level jn worksite(R2=0.110), relationship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total R2 of this 6 factors was 0.371. 9. The most significant factors that have impact on manual workers' stress symptoms were perceived hearing loss and noise exposure level in worksite, especially noise exposure level in the worksite was the most affective factor on the depression symptom.
Anger ; Anxiety ; Depression ; Ear ; Ear Protective Devices ; Gyeonggi-do ; Health Services ; Hearing ; Hearing Loss ; Hearing Loss, Noise-Induced ; Humans ; Marital Status ; Mental Disorders ; Mental Health ; Noise* ; Tinnitus ; Ventilation ; Workplace*

Authors had reviewed the results of 20 anterior cervical fusions performed between 1975 and 1980 to determine which factors were important to a successful result. There had been 18 single level fusions and 2 fusions at two levels, the majority at C and C. The indications for fusion operation were: firstly in acutely traumatized patient was the spine representing radiologically the signs of segmental instability, secondly was the chronic segmental instability in old traumatized spine representing the nuchal rigidity and severe cervicobrachial pain which. was not ceased by conservative treatments. The index of successful fusion was complete relief of pain, loss of cervical rigidity and radiologlcal stability of fused segment indicated by no-movement in flexion-extension lateral radiograms, and the bony bridges between the fused segments. The postoperative stability of spine was assessed by measuring the changes of disc space and kyphotic angle. The result obtained were as follows: 1. Pre-and post-operative immobilization with cervical traction played an immportant role for successful results after fusion: 4–6 weeks of pre-operative traction in acutely injured spine provided the torn soft tissue structures with sufficient time needed for its healing, and 6 weeks of postoperative traction also provided the bone graft with sufficient time needed for its cooperation with graft bed. 2. ln all cases succeasful fusion was obtained. In a case a adjacent level was incorrectly fused, but it was fused soundly in time, while the unstable unfused segment was not fused spontaneously. 3. The fused segment or segments of spine stabilized clinically in 6-8 weeks after fusion operation which was proven by serial radiograms, and solid bony fusion was obtained radiologically averaging in 12 weeks after fusion operation. 4. The average increase of kyphosis after interbody fusion till solid fusion was negligible, averaging 3.0 degrees. 5. The solid fusion occurred in one to 2 weeks earlier in the spines with wedge and axial conpression fractures than the spines with flexion-rotation and shear types of fractures. 6. No further neurogical damage developed after successful fusion.
Dislocations ; Humans ; Immobilization ; Kyphosis ; Muscle Rigidity ; Spine ; Traction ; Transplants

Authors clinically analysed the end results of the 56 elderly patients having fresh femoral neck fracture who were treated with osteosynthesis procedures and 23 endoprosthesis replacement surgery. All these 79 patients were treated between 1970 and 1979 at the St. Marys Hospital, Seoul. The indications of primary endoprosthesis replacement surgery in femoral neck fractured patients were in elderly patients over 65 years, displaced, comminuted sub capital or transcervical fractures, irreducible fractures, pathological fractures and patients having generalized diseases or senile psychosis. The results for the operated hip joints were assessed by duration of hospitalization, early and late post-operative complication. and the Jessels hip grading method at least post-operative one and half year later. The results obtained were as follows: 1. The average age of the patients were 65 years in 56 cases with initial osteosynthetic group, and 73 years in 23 cases of initial endoprosthesis group. 2. The slip down was the most common cause of injuries. The transcervical type of fracture was 54% of all cases. 3. The eligibility of ambulation was average 34 days after surgery in cases having initial osteosynthesis and 18 days in cases having endoprosthesis. 4. Early post-operative complications such as pneumonia and urethritis etc. were more common in cases of endoprosthesis than in osteosynthesis. But we think these complications were not related with surgery itself and transient. 5. Late post-operative complications in cases of osteosynthesis were avascular necrosis of head (16%), nonunion (9%), osteoarthritis (4%), and deep wound infection (2%), but in cases with endoprosthesis, leg length discrepancy (12%), acetabular erosion (4%) and loosening (4%) in order. 6. We performed the second operation in 12 cases among the 56 patients of osteosynthesis because of post-operative complications. 7. Good end results were obtained 90% in 56 osteosynthesis and 91% in 23 endoprosthesis. Conclusively, author's observation time was relatively short (11/2–3 years) and it is impressed that long term study for the prosthetic group is necessary for the more accurate evaluation of their hip function.
Acetabulum ; Aged ; Femoral Neck Fractures ; Femur Neck ; Fractures, Spontaneous ; Head ; Hip ; Hip Joint ; Hospitalization ; Humans ; Leg ; Methods ; Necrosis ; Osteoarthritis ; Pneumonia ; Psychotic Disorders ; Seoul ; Urethritis ; Walking ; Wound Infection

The femoral neck fracture in children is rare and occurred by severe trauma and the treatment method and prognosis are different from adult, and it is difficult to treat due to frequent complication, which is so called “unsolved fracture”. Twelve cases of children's femoral neck fracture were treated at Chon Buk National University Hospital from July, 1981 to May, 1988 were analysed clinically and radiologically and following results were obtained 1. The commonest age group was between the age of 14 and 16 years and the ratio of boys and girls was 2:l. 2. The main cause of fracture was traffic accident(6 cases) and fall down was 5 cases and slip down was 1 case. 3. According to the Delbet and Colona's classification, the transcervical fracture was most common type and displaced fracture was 8 cases. 4. Associated injuries were extremity fracture(3 cases) and pelvic bone fracture(2 cases) and head injury(2 cases), etc. 5. Seven cases were treated by open reduction and internal fixation and five cases by cast immobilization after skin or skeletal traction. 6. The commonest complication was coxa vara(5 cases) and other complication was avascular necrosis of femoral head(3 cases) premature epiphyseal closure(3 cases), nonunion (2 cases). 7. According to Ratliff's assessment of results, eight cases were good result and two fair results and two poor results. 8. Secondary operation (muscle pedicle bone graft, corrective subtrochanteric valgus osteotomy) was done in three cases and showed one good result, one fair result and one poor result.
Adult ; Child ; Classification ; Clinical Study ; Extremities ; Female ; Femoral Neck Fractures ; Femur Neck ; Head ; Hip ; Humans ; Immobilization ; Methods ; Necrosis ; Pelvic Bones ; Prognosis ; Skin ; Traction ; Transplants

PURPOSE: This study aimed at developing a critical pathway for the children undergoing tonsillectomy. METHOD: Six steps of critical pathway developmental process were used based on the literature review. The researcher reviewed 70 medical records of children who had tonsillectomy between January 4th and April 30th, 2001. They received 76 kinds of medical services during six average hospitalization days. Five of them had post-operative bleeding problem. A professional group carefully screened 67 out of 76 medical services and adopted them with five average hospitalization days as the critical pathway framework. This framework was applied to 34 children undergoing tonsillectomy during June 1st through August 21st, 2001. RESULT: The children who used the pathways with five average hospitalization days had post-operative bleeding problem. In other words, the group who utilized the critical pathway resulted in better outcomes compared to the group who did not use the tool. CONCLUSION: Since the critical pathway is an efficient care management tool, nurses need to participate more positively participate in developing and utilizing the tool for other health problem.
Child ; Critical Pathways* ; Hemorrhage ; Hospitalization ; Humans ; Medical Records ; Methods ; Tonsillectomy*

This descriptive study identifies nursing students' methods of studying related to the learning stages, based on a sample of 251 nursing students in a Korean university. The main findings of the study are as follows. The major learning styles of nursing students were accomodation (68.6%), divergen (53.6%), and convergence (38.8%) for the first, second, third, and fourth year group. For all students, the majority (71.3%) showed accomodation or the divergence. The learning styles for grade level were significantly different, (x2=110.021, df=9, p=0.001). The stage of concrete experience was the majority for all of the first year group (51.8%), the second year group (57.1%), and the third year group (61.3%). But, active experimentation (41.9%) was the majority for the fourth year group. Also there were significant differences between the stages of learning by age (x22= 64.391, df=9, p=0.001). The most significant result of the study was the establishment of different modes of learning stages by year, thus supporting the experiential learning theory. The greatest change of style from the first year group to the second year group was reflective observation (7.3%-->12.9%). That from the second year group to the third year group was the abstractive conceptualization (14.3%-->21.3%); and that from the third year group to the fourth year group was active experimentation (12.0%-->41.9%). This reflects the same cycle as indicated by the experimental learning theory of Kolb. According to the study, nursing students' learning stages tended to be more unbalanced as year increases. Therefore this calls for a careful review of the current nursing curriculum.
Curriculum ; Humans ; Learning* ; Nursing* ; Problem-Based Learning ; Students, Nursing

Porokeratosis is a familial, chronic, progressive disorder which demonstrates a characteristic clinical and histologic picture. Since Mibelli described three cases in 1893, several clinical variants have been identified, all of which are delineated by a diagnostic histopathologic pattern. We reported a case of atypical linear porokeratosis that had three types of skin lesions. One was the plaque type, as originally described by Mibelli. And others were atypical lesions, as papules and verrucoid hyperkeratotic plaques.
Porokeratosis ; Skin