The intramedullary nailing is one of the most available method in the treatment of femoral shaft fracture. Since the development of Küntscher nail in 1940, new designs such as the Grosse-Kempf interlocking femoral nail, Ressell-Taylor Femoral nial, AO/ASIF universal nail, ACE titanium nail became widely used by more applicable level of femoral shaft fracture. But complication of intramedullary nailing was rarely seen. The authors analyzed the clinical and mechanical factors predisposing to failures of intramedullary interlocking nails in 6 cases whom treated the comminuted fracture of the femoral shaft, at the department of orthopaedic surgery, Sun General Hospital from 1991 to 1995 and the following results are obtained. 1. Initial fracture patterns were comminuted in all 6 cases. 2. The implant nails were AO nail in 4 cases, Grosse-Kempf nail in 1 case, Russell-Taylor nail in 1 case(nail diameter was 10mm to 12mm). 3. The failure sites of the interlocking nail were the initial bone fracture site in 2 cases, distal to the proximal screw hole in 1 case, proximal to the distal screw hole in 2 cases, fracture site and distal to the proximal screw hole in 1 case. 4. The average time to failure of implants were 11.5 months. 5. The average times to partical weight bearing were 6.3 weeks. In the analy of above results, by using diameter of nail more than 13mm and delaying weight bearing on the injured limb until there is clear radiographic evidence of early union of the femur fracture, we may reduce the metal failures of intramedullary interlocking nail in comminuted femoral shaft fractures.
Extremities ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Comminuted ; Hospitals, General ; Methods ; Solar System ; Titanium ; Weight-Bearing

Kaposis sarcoma is well recognized in patient,s with imrnunodef cienicy states such as organ trans plantation, malignancy, and acquired irnmunodeficiency syndrome(tILS). Kaposis sarcorna associated with organ transplantation is, however relatively uncomrnon in Konea. We report a case of Kaposi's sarcorna in a 23 year old male kidney recipient., who was on cyclosporine and prednisolone. The tumor involved the larynx and long as well as the skin. He was treated with radiation therapy and chemotherapy, and the dosage of immunosupressants were reduced.
Cyclosporine ; Drug Therapy ; Humans ; Kidney Transplantation* ; Kidney* ; Larynx ; Male ; Organ Transplantation ; Prednisolone ; Sarcoma, Kaposi* ; Skin ; Transplants ; Young Adult

No abstract available.
Epidemiologic Studies* ; Gwangju* ; Premature Birth*

It is been known that the deltoid ligament of the ankle joint plays an important role in the stabiliy of the ankle joint. In cases of deltoid ligament rupture, associated with lateral malleolar fractures, cannot be maintained the integrity of the mortise and the stability of the talus. Controversy remains about the treatment of deltoid ligament injuries. Many authors advocate an operative repair for deltoid ligament ruptures for optimal reduction of lateral malleolar fracture. However, according to recent cadaveric studies and many satisfactory results of clinical studies, excellent results have been reported regarding the ankle joint stability by anatomical reduction of the lateral structure, but only without surgical repair of the medial structure. Fourteen patients with lateral malleolar fractures with associated deltoid ligament injuries treated at Sun General Hospital between January 1990 and June 1995. There were examined clinically and radiologically. We concluded that deltoid ligament repairs should be considered unnecessary as long as fibular fracture are stabilized anatomically with normal medial joint space. However, in cases with higher fracture levels of lateral malleolus, associated with syndesmotic injury, we recommend syndesmotic screw fixation or deltoid ligament repair.
Ankle ; Ankle Injuries ; Ankle Joint ; Cadaver ; Fibula* ; Hospitals, General ; Humans ; Joints ; Ligaments* ; Rupture ; Solar System ; Talus

No abstract available.
Advanced Cardiac Life Support* ; Cardiopulmonary Resuscitation*

OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of mirtazapine treatment in multicenter population consisting of Korean patients suffering from moderate-to-severe depression. METHODS: Total 163 of in and outpatients with a diagnosis of major depressive disorder (DSM-IV) and 18 or over scores of 17-items Hamilton Rating Scale for Depression (HAMD) received treatment with mirtazapine (15-45 mg/day) for 6 weeks. Efficacy was assessed by HAMD, Montgomery and Asberg Depression Rating Scale (MADRS), Beck's Depression Inventory (BDI), and Clinical Global Impression (CGI) scales and statistical analyses were performed on the intent-to-treat sample (143 patients) using the last-observation-carried-forward method. In addition, reported adverse events, routine laboratory parameters, and vital signs were investigated to evaluate the safety of mirtazapine. RESULTS: Mean daily dose of mirtazapine was 28.4 mg. At the end of the study, the response rate (50% or more reduction from baseline in HAMD scores) was 75.5% and the remission rate (7 or less in HAMD score) was 42.7%. Mirtazapine treatment induced significant reduction in depressive symptoms at the 4(th) day and substantial reduction along the treatment period, as assessed by changes in HAMD, MADRS, BDI, and CGI scales. At the 4(th) day and first week of mirtazapine treatment, the mean HAMD-17 total score was significantly reduced compared that of the baseline and the response rates were 11.9% and 28.7%, respectively. Mirtazapine was well tolerated in general, and somnolence and sedation were the most common adverse events reported. In addition, there were no clinically relevant changes in laboratory parameters and vital signs, although body weight was increased. CONCLUSION: Although this trial had many limitations of open non-comparative study, mirtazapine was demonstrated to an effective treatment for moderate to severe major depressive disorder and was well tolerated. A potentially rapid onset of overall therapeutic efficacy of mirtazapine was suggested by significant changes in all major variables of efficacy after 4(th) day of treatment.
Body Weight ; Depression ; Depressive Disorder, Major ; Diagnosis ; Humans ; Outpatients ; Vital Signs ; Weights and Measures