In femorsl neck fracture, viability of the femoral head depends on the revascularization of the femoral head. The purpose of this study is to observe the effect of early fixation and anatomical reduction by measuring the Tc-99m-MDP uptake ratio of the femoral head in experimental animsls. Femoral neck region of 20 mature rabbits were osteotomized completely and divided into 2 groups ; each group consisted of 10 rsbbits. Group 1 had two Kirschner wire fixation after osteotomy and anatomic reduction. Group 2 had no fixation after osteotomy. The uptake ratio of Tc-99m-MDP of the femoral head in each group were measured st the intervals of 24 hours, 48 hours, 1 week, 2 weeks, 3 weeks, and 4 weeks, respectively. The results obtained were as follows ; 1. In experimental group 1, the mean uptake ratio of the femoral head was 0.72±0.13 at 1 day after operation, increased to a level of 1.44±0.14 at 1 week, increased to a maximal value of 2. 90±0.36 at 3 weeks and decreased to a level of 1.10+0.12 at 4 weeks. 2. In experimental group 2, the mean uptake ratio of the femoral head was 0.70±0.10 at 1 day, 0.64±0.13 at 1 week, decreased to a maximal value of 0.33±0.05 at 3 weeks and 0.47±0.05 at 4 weeks, showing decreased level below 1.0. The results suggest that early anatomicsl reduction and rigid fixation of femoral neck fracture is helpful for revascularization of the femoral head and prevention of non union.
Femoral Neck Fractures ; Femur Neck ; Head ; Neck ; Osteotomy ; Rabbits

INTRODUCTION: The reconstructions of posterior cruciate ligament (PCL) has been increasing because of increased incidence of insufficiency of the PCL and improved surgical skill Arthroscopic operation is known better than open in cruciate ligamet reconstruction in many respects. Arthroscopic PCL reconstruction, especially using hanstring tendon has some benefits. This study is retrospective study analyzing 20 patients treated by arthroscopically assisted PCL reconstruction using hamstring tendon. ALATERIAL AND METHODS: From November 1993 to June 1996, 20 patients with PCL insufficiency had heen treated by arthroscopically assisted PCL reconstruction using double-looped hamstring (semitendinosus and gracilis) tendon by first author. The isometric point was located slightly posterosuperior than anatomic attachment in femur and 0.8-1.0cm below articular margin in tibia. They were confirmed by intraoperative fluoroscopy. The remnants of intact PCL bundle and meniscofemoral ligaments were preserved and added to the graft. They were nineteen men and one women, with a mean age 31.8 years (range, 15-56 years). RESULTS: The results were as follows; 1. The patients were followed from 13 months to 44 months after operation (average 2years and 2months ). 2. Post operative neurovascular irjuries were not found. 3. No revision case was observed and second operations were made in two cases with posterolateral rotatory instability after primary reconstruction. 4. All patient has no symptom of instability after operation. S. At last follow up, Lyshohn knee scores improved from 62 preoperatively to 89 postoperati.vely on average. CONCLUSION: Arthroscopically assisted PCL reconstruction using double-looped hamstring (semitendinosus and gracilis) tendon is easier and less damage than using bone-patellar tendon-bone graft. It preserves intact meniscofemoral ligament, some intact fibers of PCL bundle and quadriceps mechanism. We think it is a effective treatment for PCL insufficiency patients."
Bone-Patellar Tendon-Bone Grafts ; Female ; Femur ; Fluoroscopy ; Follow-Up Studies ; Humans ; Incidence ; Knee ; Ligaments ; Male ; Posterior Cruciate Ligament* ; Retrospective Studies ; Tendons* ; Tibia ; Transplants

OBJECTIVE: Locking of the knee is usually attributed to a tear of meoiscus, or to a loose body that rnechanically obstructs the motion of joint. A less frequently recognized cause of a locked knee is a partial tear of the ACL. The purpose of this study is to report that the partial tear of,the ACL at the femoral attachment site of posterolateral bundle provided a mechanical obstruction in the knW, and it is convicted the injury mechanism of isolated ACL. MATEIRALS AND METHODS: The author presents 16 cases in which the torn ACL was observed knee locking under arthroscopy fram February 1993 to June 1996. Patients ages ranged from 22 to 54 years. The mechanism of injuries were 6 sports activity (Ski 4, Soccer 1, Badminton 1), 4 slip down, 3 pedestrian car accidents and 3 unknown causes with especially low velocity injuries. Although the chief complain in each case was knee pain, all had locking knee that, on physical examination, locked from 5 to 20 of full extension, and 4 locked full flexion. The positive Lachman test was obtained 3 of the 16 paiients. Associated intraarticular injuries were 2 tears of the medial meniscus, 1 lateral meniscus. RESULTS: The average time to arthroscopy was 3 nonths with a range of 1 month to 10 rnonths. An arthroscopic diagnosis and treatment were performed and meniscal tears were ruled out as the cause of locking in all patients. The injury mechanism of isolated ACL was the hyperextensioo of the knee with leg I/R and especially low velocity injuries. The ACL was found to have a partial tear at the site of femoral attachment of an estimated P-L bundle. The torn segment of the ACL to become interposed between the lateral femoral condyle and the latera1 tibial condyle and to act as mechanical block was demcinstrated. CONCLUSION: In all cases, the torn portion of the ACL was excised under arthroscopy and knee locking was resolved.
Arthroscopy ; Diagnosis ; Humans ; Joints ; Knee* ; Leg ; Menisci, Tibial ; Physical Examination ; Racquet Sports ; Soccer ; Sports

No abstract available.
Hyperthyroidism*

PURPOSE: Headache is a frequent symptom in pediatric practice, but the prevalence of chronic recurrent headache was estimated in several studies with wide variations, because of inadequate expression and differences in case definition in children. Headache classification of International Headache Society is usually used in adults, but the application of it to children is uncommon, so we tried to diagnosis children with headache by using International Headache Society Classification. METHODS: We analyzed the clinical pictures, physical examinations including neurologic examination, PNS series, EEG and CT or MRI in 53 children with nonprogressing recurrent headache over than one month, who visited to pediatric department of Dong-A University hospital from January, 1995 to Feburary, 1996 and diagnosed them by using International Headache Society Classification. RESULTS: 1) The sex ratio between male and female was 1:1.2. 2) Diagnosed groups consisted of children with migraines in 22 cases(41.5%), tension-type headache in 19 cases(35.9%), coexisting migraine and tension-type headaches in 5 cases(9.4%), miscellaneous headaches not associated with structual lesion in 1 case(1.9%), headache associated with vascular disorders in 2 cases(3.8%), headache associated with nonvascular intracranial disorder in 1 case(1.9%), headache due to facial pain in 3 cases(5.6%). 3) Of 22 migraine cases, 13 cases(59.1%) had migraine with aura, 8 cases(40.9%) have migraine without aura and of 19 tension-type headache cases, 8 cases(42.1%) have episodic type, 11(57.9%) cases have chronic type. 4) Of 53 cases with recurrent headache, 3 cases(6%) had abnormal findings in CT or MRI. 5) Of 53 cases with recurrent headache, 9 cases(17%) had abnormal findings in EEG. CONCLUSIONS: International Headache Society Classifications are useful, but the diagnostic criteria are too strict for children, especially in migraine and tension type headache.
Adult ; Child* ; Classification* ; Diagnosis ; Electroencephalography ; Facial Pain ; Female ; Headache* ; Humans ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Migraine with Aura ; Migraine without Aura ; Neurologic Examination ; Physical Examination ; Prevalence ; Sex Ratio ; Tension-Type Headache

This study was designed to assess the iron nutritional status and anemia of high school students. 383 female subjects in Ulsan Metropolitan city were evaluated using a questionnaire, and a measurement of hematological indices. The average height and weight of the respondents were 161.24+/-4.90 cm and 53.12+/-6.37 kg, repectively. The average BMI(body mass index) was 20.43+/-2.26 which was in the normal ramge. The average hemoglobin(Hb) concentration of the subjects was 13.14+/-0.97g/dl, and the average hematocrit(Hct) level was 40.84+/-17.40%. Transferrin saturation{TS(%)} was 20.86+/-10.32%, and the ferritin by Hct(<36%), 27.2%by TS(<14%),26.6% by ferritin(<12 ng/ml). As for clinical symptoms, the greatest number of respondents reported that they experienced 'decreased ability to concectrate'. Mean daily intakes of iron were 14.89+/-4.48 mg and heme iron intakes were 5.04+/-2.13 mg, which was 29.6% of total iron intake. The total iron binding capacity(TIBC) was negatively correlated with Hb concentration(r= -0.222, p<0.01). Serum ferritin was positively correlated with Hb concentration(r= - 0.323, p<0.05) and negatively correlated with TIBC(r= -0.367, p<0.01). TS(%) was positively correlated with Hb concentration(r= 0.402, p<0.01) and positively correlated with serum ferritin(r=0.413, p<0.01). As for the correlation between blood biochemistry and clinical symptoms related to anemia, the Hb concentration was negatively correlated with 'shortening of breath when going upstairs(p>0.05)' and 'cold hands and feet' significantly(r= -0.109, p<0.05). The level of Mean corpuscular volume(MCV) was negatively correlated with 'feel dizzy when standing up', 'tired out easily', and 'decrease ability to concentrate' significantly(p<0.05). In particular, the level of Fe was negatively correlated with 'shortening of breath when going upstairs' and 'feeling blue' significantly(p<0.01). These results suggest That the prevalence of iron deficiency of female high school students is very high, therefore guidelin......
Anemia* ; Biochemistry ; Surveys and Questionnaires ; Female* ; Ferritins ; Hand ; Heme ; Humans ; Iron* ; Nutritional Status ; Prevalence ; Transferrin ; Ulsan*

BACKGROUND: Recently elderly people have increased in Korea and increased demands of medical service. This study was carried out to identify diseases and health service utilization patterns of geriatric inpatients to provide better understanding and basis planning to meet the needs of expanding geriatric population. METHOD: We use data of `Patient Survey in Korea` in 1999 and analyzed characteristics of disease structure and utilization patterns of health care service of 54,013 cases of discharged patients aged 65 years or more. RESULT: The proportion of the elderly in total discharged patients is 14.7%. Male to female ratio is 1:1.3 and most common age group was between 65 and 69 years old. 84.2% of elderly patients were admitted at secondary or tertiary health care facilities. The most common disease in geriatric inpatients is malig- nancy in male and vascular disease in female. The average duration of hospitalization is 14.2 days. They stay longer than the nation wide average hospital length and stay longest when they are admitted by mental and behavioral disorders. CONCLUSION: Geriatric patients are admitted mostly with chronic degenerative diseases such as neoplasm and vascular disease. Elders prefer to be admitted to tertiary hospitals and oriental hospitals. They stay more in hospital.
Aged ; Delivery of Health Care ; Female ; Health Services* ; Hospitalization ; Humans ; Inpatients* ; Korea ; Male ; Tertiary Care Centers ; Vascular Diseases

A randomized, prospective study was conducted between October, 1994 and April, 1996 to compare the efficacy and safety of warfarin (group I) with dextran (group II) for the prevention of DVT after hip arthroplasty. 109 cases in 106 patients were included in the study. There were 60 cases in group I and 49 cases in group IL Risk factor for DVT were analysed before surgery and prophylactic modalities were performed. Color doppler was performed to all patients by one muskuloskeletal radiologist on 5th 8th post operative day and on 6 weeks after operation. DVT occurred in ten ( 16.6% ) of the 60 patients in group I, six ( 12.2% ) of the 49 patients in group II. but, this difference was not significant ( p= 0.582 ). Statistical analysis for the risk factors of age, sex, operation time, anesthetic method and operation method were performed and there were no statistical difference. Only statistical significance was a higher rates of DVT in cemented hip arthroplasty (p=0.028). There were seven proximal thigh DVT and nine calf DVT. We confirmed with sequential color doppler image that all cases of DVT except two complicated cases were resolved within 8 weeks after treatment: one case was expired for the reason of PE, and the other case had thigh hematoma during the treatment with warfarin. We could detect only one case of late onset DVT.
Arthroplasty* ; Dextrans ; Hematoma ; Hip* ; Humans ; Prospective Studies ; Risk Factors ; Thigh ; Venous Thrombosis* ; Warfarin

No abstract available.
Echocardiography, Transesophageal* ; Foramen Ovale, Patent*

No abstract available.
Brain Edema* ; Brain* ; Decompressive Craniectomy*