Acute unstable tibial shaft fractures are common in these days of high energy trauma. There are many options for this common and complicated fracture. Flexible intramedullary nailing using closed technique is prevalent in that this has much technical, functional, and physiological advantages. We reviewed 51 cases of acute tibial shaft fractures treated with flexible intramedullary nailing. There were 3 nonunions (6%), and two refractures. Among 46 united cases, 8 cases (17 %) showed no bridging callus formation within 20 weeks. Followings are the results of average time reaching each of radiological bony progression stage for 46 united cases. l. Average time to earliest discernible callus formation (stage I) was 13.3 weeks (range:8-21 weeks). 2. Average time to definite and bridging callus formation (stage II) was 18.1 weeks (range:8-32 weeks). 3. Average time to some oblitetation of fracture line (stage III) was 32.8 weeks (range:17-50 weeks). 4. Average time to complete obliteration of fracture line (stage IV) was 14.0 months(range:12-18 months).
Bony Callus ; Fracture Fixation, Intramedullary ; Tibia

No abstract available.
Breast* ; DNA* ; Proliferating Cell Nuclear Antigen*

Sea urchin granuloma is a rare skin disorder, considered to be allergic or foreign body reaction caused by stick of spines of sea urchin. However, detection of the spine in the granuloma is quite difficult. A 27 year-old marine was seen with several asymptomatic hard nodules on the dorsum of hands, fingers, forearrns and knees at the injured site of the spines after a latent period of 6 rnonths. Histolagical examination revealed dermal granulomatous inflamation with hyperkeratotic and acanthotic epidermis. On examination with polarized microscopy, sea urchin spines in the granuloma were seen as bright white fragments in the dark field. Those nodules were regressed with intralesional injection of triamcinoIone.
Adult ; Epidermis ; Fingers ; Foreign-Body Reaction ; Granuloma* ; Hand ; Humans ; Injections, Intralesional ; Knee ; Microscopy ; Sea Urchins* ; Skin ; Spine

No abstract available.
Gerbillinae* ; Vestibular Nuclei*

Many kinds of operations have been devised to treat Kienböck's disease with variable results. But no one have mentioned about the advantage of early motion in distraction to prevent the fibro-osseous ankylosis and carpal collapse. Two cases with Kienböck's disease were treated by the complete excision of the lunate and replacement of it with pronator quadratus muscle pedicled rectangular bone graft. Once these procedures were accomplished, the distraction-motion devices were used to maintain the joint surfaces separated at predetermined distances while kinematically normal joint motion was gradually restored. Although the experience is limited to two cases, the final results seem to be very promising.
Ankylosis ; Arthroplasty ; Joints ; Transplants

Treatment of femoral shaft fractures in children is varying according to age. Satisfactory results have been obtained with longitudinal skin traction, split Russell traction, ordinary Russell traction, 90-90 skeletal traction, and immediate application of a spica cast(2,4,6,11,15). Most authors use one or more techinques routinely. It is safe and convenient to use single treatment protocol to treat all fractures of same type, Distal femoral skeletal traction with the knee and hip flexed 90 degrees and with the thigh hanging free, using the trunk as counter traction, has been used routinely for femoral shaft fractures in children(age 4-12). We reviewed 30 cases of femoral shaft fractures in children treated with 90-90 skeletal traction. 1. The average age of the patients was 6.8 years(range, 4-12 years), and almost all were caused by pedestrian injury. 2. The average time of traction was 48 days(range, 28-75), and 12 cases(40%) were treated without spica cast application. 3. Four among 30 cases developed angular deformity exceeding acceptable range(15° in AP view, 20° in lateral view), and three of them were proximal third fractures. 4. The older the patient, the longer the duration of limited activity and the more tendency of angular deformity. 5. 90-90 skeletal traction is easy, safe and convenient to treat all femoral shaft fractures of the children between four and ten years old.
Child ; Clinical Protocols ; Congenital Abnormalities ; Hip ; Humans ; Knee ; Skin ; Thigh ; Traction

The Palmaris longus tendon is important not because of its function but because of its usefulness as a donor tendon. Variations in the palmaris longus muscle ar elfrequent and the most common variation of the muscle is its absence. The incidence of absence of this muscle varies in different racial groups. Reinmann and his coworkers found the palmaris longus muscle absent in 12.9% of in their 1,600 limbs surgery. We have experiened 307 cases of palmaris longus graft surgery and found that there were 4 cases of absence of the palmaris longus tendon. We examined 2,000 limbs of Korean to see the presence of the palmaris longus muscle. Among 1,000 persons, the muscle was absent bilaterally in 11 persons(1.1%). It was absent unilaterally in 32 persons(3.2%). The probability that the muscle is absent in any single limb is 2.7%. There was no significant differences in the incidence of absence by sex or right and left side.
Extremities ; Humans ; Incidence ; Tendons ; Tissue Donors ; Transplants

We made a clinical study on 10 cases of histiocytosis syndrome who had been admitted to the pediatric department of Soon Chun Hyang University Hospital from Jan. 1982 to Dec. 1991. The results were obtained as follows 1) The sex incidence revealed male predominance with the ratio 4:1. 2) Among 10 cases, 4 cases were classified as eosinophilic granuloma, 1 case as Letterer-Siwe disease, 1 case as linfection associated hemophagocytic syndrome and 4 cases as malignant histiocytosis. 3) The mean age of symptom onset was 4 and 7/12 years in all disease group. 4) The common clinical symptoms and signs at dignosis were dyspnea, mass, pain on lower extremities and fever. 5) The most common organ involved among 9 organ systems was liver-spleen and the number of organ systems involved were 1 in 3 2 ases(30%), 3 in 2 cases(20%), 8 in 2 cases (20%) and 6, 7 and 10 organs in each 1 case. 6) The abnormal hematologic findings (Hb; 10g/dl and/or WBC; 4,000/mm3 and/or PLT; 100,000/mm3) were found in 6 cases. 7) Low serum albumin was found in 2 cases. Results of blood culture were Pseudomonas aeruginosae and Salmonella typhi in each 1 case. 8) The common findings on tissue biopsy were histiocytic proliferation and infiltration. 9) 4 patients of MH who recieved chemotherapy, a combination of adriamycin, vincristine, cyclophosphamide and prednisone were given in a total of four courses every 2 weeks ad induction therapy. When complete response was attained, a combination of adriamycin, vincristine, prednisone (AOP) and cyclophosphamide, vincristine, prednisone(COP) was administered alternately every 4 weeks as maintenance therapy for 6-64 months. 10) Among 4 patiens of MH who recieved chemotherapy, 1 patient was lost during induction chemotherapy, for 1 day.2 patients expired during induction chemotherapy, for 1 month, 1 patient expired during maintenance chemotherapty, for 8months, Eosinophilic granuloma cases (3) were recieved currettage and no recurrence. IAHS case due to typhoid fever was improved spontaneously.
Biopsy ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Dyspnea ; Eosinophilic Granuloma ; Fever ; Histiocytic Sarcoma ; Histiocytosis* ; Histiocytosis, Langerhans-Cell ; Humans ; Incidence ; Induction Chemotherapy ; Lower Extremity ; Lymphohistiocytosis, Hemophagocytic ; Male ; Prednisone ; Pseudomonas aeruginosa ; Recurrence ; Salmonella typhi ; Serum Albumin ; Typhoid Fever ; Vincristine

No abstract available.
Immunization, Passive* ; Immunoglobulins*

A clinical observation was performed on 2,122 cases of premature infants who were admitted to Ilsin Christian during the past 5 years from Jan. 1986 to Dec. 1990. The results were as follows; 1) The incidence of prematurity was 5.7%, overall mortality rate was 15.8%, and the sex ratio of male to female was 1.5:1. 2) Concomitant maternal diseases were premature rupture of membrane 457 cases (21.5%), preeclampsia & eclampsia 424 cases (19.9%), multiple pregnancy 250 cases (11.7%) etc, in the order of frequency. 3) Prematurity was most prevalent among multipara over 3. 4) Incidence of prematurity according to maternal age was frequent in woman more than 35 years old. 5) Mortality of prematurity was higher inversely propotional to birth weight & gestational age. 6) Main causes of death were IRDS 45 cases (43%), congenital anomaly 72 cases (21.6%), sepsis 31 cases (9.3%), and unknown 84 cases (25.0%). 7) Clinical problems were hyperbilirubinemia 38.9%, hypoglycemia 28.6%, IRDS 18%, sepsis & other infections 8.1% etc, in the order of frequency. 8) Most deaths were seen within first 24hr (74.5%).
Adult ; Birth Weight ; Cause of Death ; Eclampsia ; Female ; Gestational Age ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Incidence ; Infant, Newborn ; Infant, Premature ; Male ; Maternal Age ; Membranes ; Mortality ; Pre-Eclampsia ; Pregnancy ; Pregnancy, Multiple ; Rupture ; Sepsis ; Sex Ratio