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

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

No abstract available.
Anxiety* ; Depression* ; Humans ; Kidney Transplantation* ; Kidney* ; Renal Dialysis*

BACKGROUND: We studied how periodic and complex heart rate dynamic changes as pulmonary artery pressure increases in 32 infants with ventricular septal defet. In addition, we tested the possibility that the dynamical changes can be used to noninvasively predict the pulmonary artery pressure. METHODS: During cardiac catherterization, mean pulmonary artery pressure was measured and, at the same time, 5minute segments of continous electrocardiographic recording was stored. High-(>0.15 hertz) and low-(0.03-0.15 hertz) frequency components of heart rate variability were computed using spectral analysis. Yhe overall complexity of heart rate time series was quantified by its approximate entropy. RESULT: Pulmonary hypertensive infants(mean pulmonary artery pressure>20mmHg, n=17) had significantly lower low-(p<0.05)and high-(p<0.05) frequency power and lower approximate entropy(p<0.0001) than pulmonary normotensive infants(mean pulmonary artery pressure20mmHg, n=15). The mean pulmonary artery pressure was significantly correlated not with the spectral powers but with approximate entropy(=-0.51, P=0.0001). Conclusion: It can be concluded that, in infants, pulmonary hypertension induced by left-to-right shunt lesions suppress both periodic and complex heart rate oscillation and that mean pulmonary artety pressure can be predicted by calculating approximate entropy of heart trate variability.
Electrocardiography ; Entropy ; Heart Rate* ; Heart Septal Defects, Ventricular* ; Heart* ; Humans ; Hypertension, Pulmonary ; Infant* ; Pulmonary Artery*

Congenital dislocation of the hip has been known as one of the most common congenital anomalies in the orthopedic field since the time of Hippocrates (460-357 B.C.). The occurence of C.D.H. in twin babies is extremely rare thus few if any papers have been reported. During the period of January 1971 through June 1976 the authors have treated a total of 49 cases as inpatients. Two of these were twin babies. In both cases the hip was surgically reduced and followed by open reduction and femoral derotation osteotomy. Clinically and radiologically the results were good during the duration of follow-up seven months after operations.
Dislocations ; Follow-Up Studies ; Hip ; Humans ; Inpatients ; Orthopedics ; Osteotomy ; Twins

The pinching motion is thought to be one of fundamental hand functions, the power of which has been quantified by measuring it isometrically with variously devised pinch-meters. The present authors describe the investigations on the pinching power of 350 healthy persons, 200 male and 150 female Koreans, by the use of Preston Pinch Gauge. Six kinds of pinch were chosen: (1) thumb index finger tip pinch (1-2TP), (2) thumb-middle finger tip pinch (1-3TP), (3) thumb-index finger pulp pinch (1-2PP), (4) thumb-middle finger pulp pinch (1-3PP), (5) thumb-index-middle finger pulp pinch (3PP), (6) key pinch (KP), which were classified again into 19 kinds according to the shape of thumb, index, middle, or other fingers during each pinch. We describe those as principal type, hyperextension-flexion type, hyperextension type and other type into four. It should be justified to calculate the mean normal value of principal type pinching power in Korean. Principal type of pinch involves 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP, as to Hyperextension type of 1-2PP, 1-3PP, 3PP and KP. Other type of pinch involving 1-2TP, 1-3TP, 1-2PP, 1-3PP, 3PP and KP is different from Principal type simply because of the shape of nonjoining fingers during pinch. Generally, the pinching power of Principal type was clearly highest among the four types except for pulp pinches.
Asian Continental Ancestry Group ; Female ; Fingers ; Hand ; Humans ; Male ; Reference Values ; Thumb

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

The distal tibial physeal plate is the second most frequently injured physis and the percentile incidence of its injury is reported to reach 11 percent of all physeal injuries. After physeal injuries, many complications may follow such as angulatory deformity, incongruity of the joint surface, and growth disturbance, which are well recognized. Therefore, for preventing these complications, we have to know mechanism of injury and position of foot in injury. There are several published articles about classification of these injuries. The first traumatological classification of ankle injuries in children is the one proposed by Bishop. Although there were many reports about classification since Bishop, those did not mention the position of foot in injury. Recently a modified classification by Dias and Tachdjian added the postiton of the foot during injury to the direction of the force as Lauge-Hansen did. There were only few reports about epiphyseal and physeal injuries of the ankle in Korea. Also, we could not find the reports which dealt with more than forty cases. The authors have made a clinical analysis on forty cases of childrens ankle fractures, and among them twenty-two could be followed over a year, who were treated at the Department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, from June 1981 to December 1986. Children were in age of 3 to 16 years. Forty cases were classified according to modified Dias and Tachdjians. 15 out of 40 cases (37.5%) had supination and external rotation injury, which is the most frequent mechanism of injury in this series. However, one case (2.5%) which was suspected to be axial compression type could not be accommodated to this classification. Twenty-seven cases were treated by gentle closed reduction and immobillization in a plaster cast, and thirteen by open reduction and internal fixation. Among the 22 cases who were followed over a year, five cases had complications, such as angulatory deformity, incongruity of the joint surface, and growth disturbance. Three cases out of these five cases had incongruity of the joint surface.
Ankle Fractures ; Ankle Injuries ; Ankle ; Casts, Surgical ; Child ; Classification ; Congenital Abnormalities ; Foot ; Humans ; Incidence ; Joints ; Korea ; Supination

Femoral fractures are difficult to treat in the child with head or multiple injuries. Traction may fail due to spasticity and restlessness. Poor results after closed reduction have led some authors to advocate open reduction and internal fixation which facilitates overall care. Anatomical reduction with internal fixation leads to limb overgrowth. We report our experience in anatomical open reduction of femoral fracture which had head or multiple injuries or difficult to maintain traction in children at the Kang-Nam St. Mary's Hospital. The results are as follows : 1. Among the 28 cases, there were 20 cases in male and 8 cases in female. Average age was 9.4 years. 2. Plate fixation was used in 27 cases and Kuntscher Kuentscher nail was used in one case. 3. Average union period was 11.5 weeks. There was one delayed union which was completely united in 20 weeks. 4. Average overgrowth of femur was 5.2mm. The overgrowth was related with age and handedness but it was not related with fracture site. For children who have head or multiple injuries or difficult to maintain the skin traction, open reduction with plate fixation appears the most satisfactory treatment. The overgrowth of the femur after open reduction was not significant problems clinically.
Child ; Extremities ; Female ; Femoral Fractures ; Femur ; Functional Laterality ; Head ; Humans ; Male ; Multiple Trauma ; Muscle Spasticity ; Psychomotor Agitation ; Skin ; Traction