Dislocation of the elbow joint is so frequent an injury, and its treatment so standardized, that most of the recent orthopaedic study devoted to the subject has focused on neurovascular complication or recurrent dislocation. Some authors reported minimal period of disability and better range of extension after three to five days short-term immobilization in simple acute dislocation. We, authors, had analyzed clinically 17 cases of acute dislocation of elbow joint who were treated at orthopaedic department of Catholic Medical College from Jan., 1978 to Dec., 1981. The results obtained were as follows: 1. The most prevalent age were second and third decades (76.5%). Males predominated by a ratio of 13:4. 2. The major mode of injury was slip down accident (58.8%). All cases were acute simple dislocation without open wound. 3. Posterolateral, dislocations were 13 cases (76.5%) and posterior dislocations were 3 cases (17.6%). These two type of dislocation were 94.1% of all cases. No anterior dislocation was noted. 4. Four fractures of radial head and one fracture of lateral epicondyle of humerus were seen. Associated fractures were noted in 29.4% of all cases. 5. Severe complication was none except one recurrent habituai dislocation and limitation of elbow extension, averaging 10.5 degrees, 6. In 9 cases which were immobilized for 3 to 5 days had an average loss of extension of 6 degrees and an average of 7 weeks of disability. In 7 cases which were immobilized for 3 weeks had an average loss of extension of 18 degrees and an average of 18.3 weeks of disability. Therefore, immediate reduction and 3 to 5 dhys of immobililization is excellent treatment for uncomplicated dislocations.
Clinical Study ; Dislocations ; Elbow Joint ; Elbow ; Head ; Humans ; Humerus ; Immobilization ; Male ; Wounds and Injuries

Most cases of spondylolisthesis are asymptomatic and successfully managed with conservative treatment. Operation was performed in 20% of symptomatic cases having severe back pain, neurological symptoms and or progressive slipping. Although surgical treatments are divided into decompression and fusion, various methods were tried frorn simple Gill's resection to posterior and/or anterior fusion with instrumentation in case of severe slipping. The authors reviewed 49 cases of symptomatic spondylolisthesis, who were surgically treated, and well followed up at Kang-Nam St. Mary's Hospital during past 6 years from January, 1981, to June, 1987. l. Among 49 cases, 23 were isthmic type and 26 were degenerative in nature, and 40 were females. 24 patients(92.3%) of degenerative type were female over 4th decade. Mean age was 47.9 years. 2. The most common site of involvement was L4–5 intervertebral space(25 cases,; 51.0%). 17 cases(73.9%) of isthmic thpe were involved in L5-Sl intervertebral space, and 21 cases (80.8%) of degenerative type were involved L4–L5 intervertebral space. 3. The symptoms were low back pain, intermittent claudication and sciatica in order of incidence. 4. The average slipping measured by Taillard method was 19.5%, and Meyerding's grade I slipping(69.3%) was the highest in the percentile incidence. The average degree of slipping in isthmic type(23.6%) was greater than that of degenerative type(16.4%). 5. Myelogram mainly showed complete or near complete block in degenerative type and ventral indentation in isthmic type. C–T myelogram showed mainly central stenosis in degenerative type, and nerve root compression in isthmic type. 6. In 9 cases,anterior fusions were done ; 5 degenerative and 4 isthmic. In 37 cases, decompression and posteriolateral fusions were done with or without instrumentation ; instrumented in 11 cases. 7. Clinically, the results were judged as excellent in 16 cases(32.7%), good in 26 cases(53.1 %), fair in 6 cases(12.2%), poor in 1 case(2.1%). Thus, 42 cases(85.8%) were considered satisfactory. The satisfactory results were obtained in 77.8% of anterior interbody fusion cases, 88 5% of posterolateral fusion cases, 90.7% of decompression and posterolateral fusion with instrumentation cases. There was no appreciable difference in clinical results between isthmic and degenerative types. 8. There were no changes in slipping in 35 cases(71.5%), Partial reduction were possible in 13 cases(28.5%), and further splipping developed in a patient who had decompression surgery alone. Among 46 cases of vertebral fusion, complete fusion was obtained in 43 cases(93.5%) within one year. 9. Solid anterior spondylodesis was obtained in all the cases of degenerative type, while in 2 cases(50%) of the isthmic type, graft crumbled with redisplacement and delayed fusion. Through the results, it is concluded that posterior instrumentation may not be essential for the successful spondylodesis in cases of posterolateral fusion, since there was no statistical significance in the results between the instrumented and non-instrumented, and isthmic type and degenerative type, and that anterior interbody fusion is best indicated for the treatrment of the degenerative type and not for the isthmic type. Therefore, if anterior interbody fusion is chosen for the successful treatment of isthmic type, a certain type of internal fixator should be combined.
Back Pain ; Clinical Study ; Constriction, Pathologic ; Decompression ; Female ; Humans ; Incidence ; Intermittent Claudication ; Internal Fixators ; Low Back Pain ; Methods ; Radiculopathy ; Sciatica ; Spinal Fusion ; Spondylolisthesis ; Transplants

The result of clinical survey of seventy-five children with supracondylar fractures of the humerus is presented. Sixty-eight fractures had gross displacement, and seven were undisplaced ones. Seven children with undisplaced fractures were treated with simple splinting. Twenty-one fractures with gross displacement were closedly reduced and immobilized by cast. Twenty cases treated with over-head skin traction or skeletal traction, and followed by cast immobilization, and twenty-seven were operatively reduced and were fixed with 2 K-wires. The results obtained were as follows: 1. The average age of children was 6.8 years, and the male and female ratio was 2.1:l. 2. 97.1% (66 cases) was the extension type and 2.9% (2 cases) was the flexion type. 3. Good end results were obtained in the well-reduced groups, such as undisplaced fractures and surgically reduced fractures. Of 27 operated cases, 19 who had early operation without manipulative trial or traction, had excellent results, while 8 who had surgery in delay developed limitation of flexion and/or extension motion of the elbow. Of these 19, two cases developed mild extension limitation as sequella. 4. As complications, incomplete ulnar nerve palsy developed in one case, but it spontaneously recovered in 3 weeks after open reduction. During treatment utilizing the olecranon pin traction, pin tract infection developed in 2 cases, but the infection was controlled by the antibiotic administration and wound dressing. Severe cubitus varus deformity developed in 4 cases among the conservatively treated group (manipulatively reduced group and skeletal traction group). These 4 children had corrective osteotomy. Mild deformity was the inevitable one when it is treated conservatively. Limitation of elbow motion developed in 23 cases (32%) as a sequella. 5. Fracture healed mostly in three weeks after reduction and immobilization. Average hospital stay for conservatively treated patients was 17.2 days, whereas that for surgically treated patients was 5.8 days in average. 6. Early anatomical reduction by any means whether it is surgical or nonsurgical, proved to be only the methods which bring the satisfactory results, and minimize the sequellae.
Bandages ; Child ; Congenital Abnormalities ; Elbow ; Female ; Humans ; Humerus ; Immobilization ; Length of Stay ; Male ; Olecranon Process ; Osteotomy ; Skin ; Splints ; Traction ; Ulnar Neuropathies ; Wounds and Injuries

No abstract available.
Anti-Bacterial Agents* ; Prevalence* ; Shigella*

No abstract available.
Intuition* ; Nursing* ; Philosophy*

This study aimed to evaluate the effect of seminal vesicle fluid (SVF) on the acrosome reaction (AR) occurred spontaneously or induced by Ca2+ ionophore A23187, follicular fluid, and progesterone in mouse epididymal sperm. SVF was divided into high (MW>10 kM)) and low (MW<10 kD) fractions by ultrafiltration. The low MW fraction of SVF decreased the rate of spontaneous AR, however the high MW fraction did not. It suggested that the low MW fraction of SVF might have contained decapacitation factor(s) responsible for prolonging of time need for capacitation. When sperm preincubated for 60 min in the presence of SVF, the rate of AR induced by A23187 was decreased, but prolongation of preincubation time for 120 min significantly potentiated the AR by A23187. It suggested that addition of SVF into sperm preincubation medium imposed the epididymal sperm a condition similar to ejaculation. AR induced by human follicular fluid or progesterone was also inhibited by SVF. It suggested that substance in SVF might have affected AR of mouse sperm by inhibiting the interaction between AR inducing ligands and sperm surface receptors involved in acrosomal exocytosis.
Acrosome Reaction* ; Acrosome* ; Animals ; Calcimycin ; Ejaculation ; Exocytosis ; Female ; Follicular Fluid ; Humans ; Ligands ; Male ; Mice* ; Progesterone ; Seminal Vesicles* ; Spermatozoa* ; Ultrafiltration

No abstract available.
Abortion, Spontaneous* ; Cytogenetics* ; Female ; Humans ; Pregnancy

The syndrome of lower-back pain associated with sciatic pain has probably been a problem since man first assumed the upright position. In 1937 Barr delineated herniation of the nucleu pulposus as a pathologic entity. Since that time, the standard surgical treatment has become laminectomy or laminectomy combined with fusion, with the emphasis on the disc between L4−5 and L5−Sl. Another mode of treatment was suggested when Smith and Brown” reported their clinical experience using intradiskal injection of chymopapain as the definite treatment of lumbar disk disease in 1967. In recent many years investigators in separate clinical studies showed that a benificial result can be achieved in a high percentage of patients treated by chymopapain injection. Our 29 patients who can be observed for more than 6 months after chemonucleolysis were clinically analysed. The results were as follows: 1. Of the 29 patients studied, 15 were males and 14 were females. 11 patients (37.9%) were in age between 41 and 50 years. 2. On clinical symptoms, 24 patients (82.8%) had radicular pain in the lower extremity. All patients had the limitation of the straight leg raising. 3. The most common level of herniated area was L4−5 disk as 22(75.9%) cases. In four cases (13.8 %) two levels of disks (L4−5 and L5−Sl) were involved. 4. On myelography the hour glass appearance was shown in 14 patients (49.3%).Complete block was found in 4 (13.8%) cases. 5. The increase of the straight leg raising was found within 3 weeks after chemonucleolysis in all cases. Motor power were recovered in 20 out of 22 cases and abnormal sensation were recovered in 17 out of 19 cases within 3 months after chemonucleolysis. 6. There were no correlation between persisting low back pain and narrowing of the disk space after chemonucleolysis, statistically. 7. In 23 out of 29 cases discometry test was positive. Among 23 cases, 21 cases recovered from their symptoms successfully after chemonucleolysis. 8. In chymo. R.A.S.T., 9 out of 15 cases were positive in 3 weeks after chemonucleolysis, and 12 out of 15 cases were positive in 3 months after chemonucleolysis.
Chymopapain ; Female ; Glass ; Humans ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Laminectomy ; Leg ; Low Back Pain ; Lower Extremity ; Male ; Myelography ; Research Personnel ; Sensation

External fixators are popular in treatment of the open fractures of long bones, especially tibia, associated with soft tissue injury, because they prevent further injury to the injured soft tissue and bone. Over the past ten years, bilateral frame external fixtors such as Hoffmann system had been used for lower extremity lesions. But they had many disadvantages like that bilateral frames were less rigid in A-P plane bending moment mechanically, therefore unilateral frame external fixators such as Monofixateur have been introduced recently. The Monofixateur was able to fix the fracture rigidly and compress, distract and neutralize the fracture site and could be used as a static and dynamic stabilizer. We have treated 19 cases using Monofixateur of the Gotzen type for open fractures of lower extremity from October 1984 to Febrary 1987. The summary of the results obtainained from this study are as follows : 1. Monofixateur was easy to use, simple and light. It provided a rigid stability to fracture. 2. It was possible to allow static stabilization on the unstable fracture, whereas dynamic stabilization on the stable fracture. 3. Application was easier than any other type of external fixators from the view point of using a few screws and unilateral frame, therefore it could prevent further soft tissue injury and was easy to secondary operation. 4. It was possible to use for short fracture fragment of the proximal or distal fractures of the long bone. 5. The fracture healing time averaged 32.5 weeks and there were marked differences of the fracture healing time between open type I, II and III fractures. 6. There was little complication such as pin tract infection and ankylosis of the joint.
Ankylosis ; External Fixators ; Fracture Healing ; Fractures, Open ; Joints ; Lower Extremity ; Soft Tissue Injuries ; Tibia

For the measurement of the bone quantity, various methods have been used. Recently, the methods such as a microdensiometry, single photon absorptiometry, quantitative computed tomography were introduced. However, these methods are expensive modalities to be used in daily clinical practice. For the evaluation of the osteoporosis, author's observed Saville's grades, spine contral score and spine fracture on the simple spine roentgenograms of 346 patients over 40 years of age who were exsmined due to their backache at the Department of Orthopedadic Surgery, Kang Nam St. Mary's Hospital, Seoul, and following results were obtained: 1. The percentile incidence of osteoporosis with regard to age and sex : (1) The percentile incidence of osteoporosis over Saville's Grade I was 59.2%(205 of 346 persons); in males 47.4%(55 of 116 persons) and in females 65.2%(150 of 230 persons). (2) The percentile incidence of osteoporosis over Grade 1 in 5th decade was 27.2%(17.1% in males and 33.9% in females), 55.8% in 6th decade(46.6% in males, and 60.4% in females), 78.1% in 7th decade(64.7% in males, and 82.9% in females), 93.7% in 8th decade(87.5% in males and 97% in females), and 100% in both sexes of 9th decade. (3) The percentile incidence of Grade 1 osteoporosis in 5th decade was 23.9%, and in 6th decade it was 46.7%. Thus, Grade I osteoporosis was most common in these age groups. In 7th and 8th decades, Grade I osteoporosis was more common in males, while in the females ot these age groups Grade II was more common. There was no sex difference in the incidence of osteoporosis after the age of 80. Grade IV osteoporosis was found only in a woman who had hysterectomy 7 years ago, and has suffered from Parkinsonism for 3 years. (4) The overall incidence of Grade I osteoporosis was 34.6%, and Grade II was 21.3 %. The incidence of osteoporosis over Grade III was 1.7% in males, and 6.5% in females. 2. Incidence of osteoporosis assessed by Barnett's central score and its correlation with Saville's assessment: (1) The central score obtained at the 3rd lumbar spine ranged from 71.4 to 106.4. The number of cases were 16 in the score range of 70 to 80, 93 in the score range of 101 to 110, and 5 in the score range of 111 to 120. In consequence the most high incidence was in the score range of 91 to 100. (2) Grade O Oxteoporosis corresponded with the central score of 96.4 on an average (range : 86.8 to 106.4), Grade I corresponded with 91.6 (range : 85.7–103.1), Grade II corrosponded with 86.4 (range : 78.3–96.9), Grade III corresponded with 79.4 (range : 71.4–91), and Grade IV corresponeded with 75.8. (3) Barnett defined the spine is osteoporotic, when the central score is below 80. However, in this study only 16 patients(4.6%) had the score below 80. No bodies having Grade 0 and I osteoporosis had the score below 80; of those 16 patients having the score below 81, 5 were Grade II, 10 Grade III, and one Grade IV. Through this study, it is clesr that there is no correlation in these two assessing methods. The central score below 80 was found in severely porotic patients such as Grade III and IV, but was not found in most cases of Grade I and II osteoporotic patients. (4) The vertebral defromity was found only in 38 cases (10.9%), and it was found only in 18.9% of osteoporosis patients. The percentile incidence of deformity was 5.3% of Grade I, 31% of Grade II and 52.9% of Grade Ill. (5) Of these deformities, wedge-shaped one was found in 6 cases of Grade I porosis, 20 of Grade II, and 3 of Grade III. Cod-fish vertebrae (biconcave) were found in 2 of Grade II and 4 of Grade III. The flattened body was found in 1 of Grade II and 2 of Grade III. Thus, biconcave and flattened vertebrae were found only in the porotics over Grade II severity. (6) In 24 cases, one body was deformed, and in 14 cases multilevel vertebral deformities were found. In these 20 cases had deformity in the Ll, 10 cases each in T12 and L2, 7 cases in L3, 6 cases in L4, and 4 cases in Tll. In summary, the most deformities were in the dorsolumbar region. (7) Fracture was induced by trauma in the 11 cases(29%), among which 10 were wedgeshaped, and the rest was flattened. The biconcave vertebra was found not to be related with injury.
Absorptiometry, Photon ; Back Pain ; Congenital Abnormalities ; Female ; Humans ; Hysterectomy ; Incidence ; Male ; Osteoporosis ; Parkinsonian Disorders ; Seoul ; Sex Characteristics ; Spine