Object of treatment of long bone fracture is the reduction of fracture and maintenance of good alignment. Recently operative treatment has been attempted increasingly, but conservative treatment is considered important also. The authors have employed the multiple splint method that is modified from triangular splint method for humerus shaft fracrure originally having designed and reported by ourselves. In our experience of multiple splint method for long bone fracture and ligament injuries, some merits were noticed such as easiness of application, simplicity of removal and reapplication. We report this method with review of literature.
Casts, Surgical ; Fractures, Bone ; Humerus ; Joints ; Ligaments ; Methods ; Splints

Helicobacter pylori, loss of basement membrane, atrophy, type III intestinal metaplasia, adenomatous polyposis coli (APC) gene mutations and altered p53 function were believed as a factor to develop the gastric adenocarcinomas. To investigate the incidence and prevalence of Helicobacter pylori, intestinal metaplasia and atrophy, 120 gastrectomy specimens collected from patients with gastric adenocarcinoma (100 cases) and non-neoplastic conditions (20 cases) were studied. Intestinal metaplasia can be classified as type I (complete), type II (incomplete, sulfomucin-negative) and type III (incomplete, sulfomucin-positive) by Filipe and Jass. The incidence of intestinal metaplasia of gastric adenocarcinoma was 96% compared with the incidence of 75% in non-neoplastic conditions. The type I and type II were more common than type III and were present in both non-neoplastic conditions (75%) and adenocarcinoma (74%). In contrast, type III intestinal metaplasia was seen in only 20% of intestinal metaplasia-positive cases, all of which (22 of 22) were from patients with adenocarcinoma. The high specificity of type III intestinal metaplasia might be acceptable for screening purposes, but its sensitivity of 22% for gastric adenocarcinoma is low. Helicobacter pylori were detected in 96% of adenocarcinoma cases and 100% of non-neoplastic cases. Atrophy was detected in 50% of non-neoplastic cases and in 57% of adenocarcinoma cases. The data thus confirms a significant relation between incomplete sulfomucin-secreting intestinal metaplasia (type III) and gastric carcinoma, especially intestinal type (p<0.01). Thus, the type III intestinal metaplasia should be considered a risk factor and its presence in a biopsy specimen should prompt close surveillance.
Adenocarcinoma ; Adenomatous Polyposis Coli ; Atrophy ; Basement Membrane ; Biopsy ; Gastrectomy ; Helicobacter pylori ; Humans ; Incidence ; Mass Screening ; Metaplasia* ; Prevalence ; Risk Factors ; Sensitivity and Specificity

No abstract available.
Carbon Disulfide* ; Carbon* ; Humans ; Poisoning*

Acute generalized exanthematous pustulosis(AGEP) is a disease entity caused mostly by drugs or viral infections. Clinically it manifests as generalized erythema, erythema multiforme and amicrobial pustules with fever. Histologically, AGEP is composed of neutrophilic subcorneal and spongiform pustules. A 70-year-old female, with no personal or family history of psoriasis, was given medication including diltiazem for hypertension. Fourteen days after taking the medications, pustular eruptions appeared on the face and rapidly spread to the trunk and limbs. A Laboratory examination revealed neutrophilic leukocytosis and an elevated erythrocyte sedimentation rate. The skin biopsy showed subcorneal and spongiform pustules. We report here a case of AGEP probably due to diltiazem.
Acute Generalized Exanthematous Pustulosis* ; Aged ; Biopsy ; Blood Sedimentation ; Diltiazem ; Erythema ; Erythema Multiforme ; Extremities ; Female ; Fever ; Humans ; Hypertension ; Leukocytosis ; Neutrophils ; Psoriasis ; Skin

Forytfour-year-old female inpatient, who was gravely ill, developed vesicobullae on the greenish patches surrounded by narrow red to brown halo in the left lower extremity. Two years ago, she had treated by surgical operation and radiation therapy for cervix cancer. Blood and bullous fluid cultures showed Pseudomonas aeruginosa. She developed gangrenous and mummificated skin lesions after septic shock therapy but died due to disseminated intravascular coagulation.
Disseminated Intravascular Coagulation ; Female ; Gangrene* ; Humans ; Inpatients ; Lower Extremity ; Pseudomonas aeruginosa ; Pseudomonas* ; Shock, Septic ; Skin ; Uterine Cervical Neoplasms

No abstract available.
Parturition* ; Vital Statistics*

BACKGROUND/AIMS: Although the only therapy of proven benefit for chronic hepatitis C is interferon alpha, the rate of sustained response after treatment with interferon is less than 25%. A 6-month course of combination therapy with interferon and ribavirin was associated with higher rate of long-term response than either interferon or ribavirin alone. Pilot studies suggested that combination of interferon and ursodeoxy-cholic acid (UDCA) resulted in higher biochemical response than interferon alone. We investigated the rates of end of treatment response(ETR) and sustained response(SR) of combination therapy of interferon e2a, ribavirin and UDCA and compared it with interferon a 2a alone. METHODS: Ninty-five naive patients with chronic hepatitis C who have been positive for anti-HCV by 3rd generation EIA and HCV RNA by RT-PCR and had elevated level of ALT over 6 months were included. They were assigned to three groups. Thirty seven patients in group 1 were treated with interferon a 2a (3MU thrice weekly) in combination with ribavirin (600mg/day) and UDCA (600mg/day) for 6 months. Twenty nine patients in group 2 were treated with the same dose of interferon a 2a alone for 6 months. Changes of ALT and HCV RNA were observed over 12 months (average 3029 mos) after the end of treatment in both groups. Twenty nine patients in group 3 were observed over 12 months without antiviral treatment. HCV genotypes were tested by Innop-Lipa in 24 patients in group 1. RESULTS: In group 1, not only ETR (68%) but also 12 month SR rate (54%) was significantly higher than group 2(31%, 21% respectively). There was no difference in relapse rate between two groups. The level of ALT became normalized and HCV RNA negative within 1 month after treatment in most responders in group l. Genotype 1b was associated with lower ETR and SR than non-lb, although not significant stastistically. CONCLUSION: Both the ETR and 12 month SR rate were significantly higher after combination treatment of interferon a 2a, ribavirin and UDCA than interferon e 2a alone in chronic hepatitis C. It is suggested that this combination is preferable to interferon alone in the treatment of naive patients with chronic hepatitis C.
Genotype ; Hepatitis C, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Interferons* ; Recurrence ; Ribavirin* ; RNA

We observed 240 cases ranging in age from 3 months to 15 years seen by gastrofiberoscopy in the department of pediatrics of Seoul Red Cross Hospital from March 1990 to October 1992 and following results were obtained. 1) The male to female ratios in total cases and in 89 patients complaining of abdominal pain for more than one month were 0.94:1 and 1.02:1 respectively. The most prevalent age group was 10~12 years in both groups. 2) The indication in the order of frequency were chronic abdominal pain (37.1%), acute abdominal pain (32.5%), vomiting (7.9%), hematemesis and melena (5.4%), follow-up study (6.3%), further evaluation (3.8%), chest discomfort (2.5%), foreign body removal (2.1%), nausea (1.2%), dysphagia (0.8%) and abdominal mass (0.4%). 3) The common endoscopic findings in the 225 cases excluding follow-up ones were gastritis (34.7%), duodenitis (14.2%), ulcer (11.6%), esophagitis (7.6%) and foreign body (2.2%). 4) The common endoscopic findings in cases of chronic abdominal pain were gastritis (42.7%), duodenitis (16.9%) and ulcer (7.9%). 5) There was no complication except mild sore throat.
Abdominal Pain ; Deglutition Disorders ; Duodenitis ; Esophagitis ; Female ; Follow-Up Studies ; Foreign Bodies ; Gastritis ; Hematemesis ; Humans ; Male ; Melena ; Nausea ; Pediatrics ; Pharyngitis ; Red Cross ; Seoul ; Thorax ; Ulcer ; Vomiting

Predisposing factors for venous thrombosis can be identified in the majority of patients with established venous thromboembolism (VTE). However, an obvious precipitant may not be identified during the initial evaluation of such patients. In the present case, a 47-year-old female presented to the emergency department of our hospital after ingesting multiple drugs. She had no VTE-related risk factors or previous episodes, nor any family history of VTE. After admission to the intensive care unit sudden hypoxemia developed, and during the evaluation cerebral, renal, and splenic infarctions with pulmonary embolisms were diagnosed. However, the sources of the emboli could not be identified by transthoracic echocardiography or computed tomography angiography. Protein C deficiency was identified several days later. We recommend that hypercoagulable states be taken into consideration, especially when unexplained thromboembolic events develop in multiple or unusual venous sites.
Angiography ; Anoxia ; Causality ; Echocardiography ; Emergency Service, Hospital ; Female ; Humans ; Infarction* ; Intensive Care Units ; Middle Aged ; Protein C Deficiency ; Pulmonary Embolism ; Risk Factors ; Splenic Infarction ; Thrombophilia ; Venous Thromboembolism ; Venous Thrombosis

Colchicine poisoning is rare but can cause potentially life-threatening toxic complications such as hypovolemic shock, cardiovascular collapse and multiple organ failure. In this case report, we describe a case of a 20-year-old female who presented to the emergency department after suicidal ingestion of a toxic dose of colchicine. She developed thrombocytopenia, neutropenia and acute respiratory distress syndrome that required blood transfusion and administration of granulocyte colony stimulating factor for the prevention of infectious complications. With regard to the clinical manifestations of colchicine toxicity, we discussed suggested mechanisms.
Blood Transfusion ; Colchicine* ; Colony-Stimulating Factors* ; Eating ; Emergency Service, Hospital ; Female ; Granulocytes* ; Humans ; Multiple Organ Failure ; Neutropenia ; Poisoning* ; Respiratory Distress Syndrome, Adult ; Shock ; Thrombocytopenia ; Young Adult