One hundred and four cases of the ankle fracture have been treated and managed in the Department of Orthopaedic Surgery, Catholic Medical College Hospital. During the period from January, 1968 to December, 1971. 104 patients were analyzed clinically and the results obtained were as follow. 1. The causes of ankle fractures were mostly due to traffic accident 49.9% and direct blow 30.7%. 2. The incidence of trauma was in the young man, most frequent in the 3rd decaed. 3. In classification of Lauge-Hansen, the type of pronation-external rotation is most common type in this series and the stage III of pronation-external rotation is more common than other stages. 4. The average duration of cast immobilization is 8.8 weeks after closed reduction performed but duration of cast immobilization is shorter after open reduction of cast immobilization. 5. Anatomical reduction was obtained in 64 patients 61.5% with good objective clinical results in 54 patients 51.9% 6. The quality of clinical results depends mostly on the accuracy of the reduction, to a lesser extent on the degree of initial displacements, and least on the type of fracture.
Accidents, Traffic ; Ankle Fractures ; Ankle ; Classification ; Humans ; Immobilization ; Incidence

The purpose of this study was to investigate the effects of combined exercise on visceral fat, cardiac function, adipocytokine, and NT-pro BNP concentration according to angiotensin-converting enzyme(ACE) genotype in obese middle aged men. Fifty three obese men (II type: 18, ID type: 20, DD type: 15), ratio of visceral and subcutaneous were over 0.4, were enrolled in the study. The combined exercise program included stretching, resistance training, aerobic exercise, and yoga. The exercise was conducted for 60 minutes, 4 times a week for 12 week period. ACE genotype was determined using a polymerase chain reaction (PCR), and the genetic subtype was classified in three patterns e.g. II, ID, DD. As a results, body weight, BMI, and WHR significantly decreased after 12 weeks of combined exercise in ID type and DD type. Body fat(%), visceral fat and V/S significantly decreased after 12 weeks in DD type. HDL-C and LDL-C significantly improved in II, ID and DD type. Cardiac structure decreased in all genotype and cardiac function increased in DD type. IL-6 and NT-pro BNP, the risk factors of cardiovascular disease, were significantly decreased in DD type, after 12 weeks. Therefore, exercises have shown to be most effective in type DD which is also considered as the risk of cardiovascular diseases. Among all the ACE genotype, DD type requires the most exercise.

No abstract available in English.
Tibia

Recently, nalbuphine has been used for reversal of opioid indueed respiratory depression. Because of its structural chsracter, nalbuphine has been known as a better nareotic antagonist with keeping analgesic potency and without considerable cardiovascular responses. Some investigators reported nalbuphine can decrease minimum alveolar concentration(MAC) of major inhalation anesthetic agents and can be a intravenous anesthetic adjuvant but can accompany several adverse reactions such as hypertension and tachycardia etc. To evaluate the eligibility and efficacy of nalbuphine as a intravenous narcotic adjuvant for cardiac anesthesia, we selected 24 adult cardiac patients and divided them into 3 groups. Valvular surgerys were performed for group I patients, aorto-coronary-bypass surgerys(CABG) for group II and correction of congenital heart disease for group III, respectively, All patients were inducted general anesthesia with 0.3 mg/kg nalbuphine+0.1 mg/kg diazepam+2 mg/kg thio- pental sodium and maintained with intermittent injection of 0.3-0.5 mg/kg nalbuphine and O.l mg/kg diazepam just before the time of most stressful surgical stimuli with 1/2 MAC halothane inhalation under vecuronization for muscle relaxation. We measured heart rate(HR), systolic blood pressure(BP), central venous pressure(CVP) at pre-induction as a control data, and just after endotracheal intubation, skin incision, sternotomy, and skin closure respectively to compare basic cardiovascular responses of patients at surgical stimuli with control data. We also checked recovery time of consciousness and presence of awareness during operation. The results were as follows: 1) Significant HR changes occurred in group I at just after intubation time from 104+/-18.6 to 134+/-25.9 and in group II from 83+/-10.5 to 115+/-32.3 respectively. 2) There were few significant changes of systolic blood pressure during anesthesia of all groups except just after intubation in group II from 135+/-32.8 torr to 168+/-37.9 torr.3) A significant CVP decrease occurred only in group I at the time of skin closure from 13+/-3. 5 cmHO to 10+/-3.8 cmH2O because of operative correction of tricuspid regurgitation of group I patients rather than anesthesia effects. 4) Recovery of consciousness needed average 1 hr 30 mins in group I and 2 hr 45 mins in group II. None of patients complained awareness during operations. Above results demonstrate that Nalbuphine-Diazepam-O2-1/2 MAC Halothane can be a anesthetic method for open heart surgery without any significant cardiovascular responses at surgical and anesthetic stimuli except intubation stimulus, but for more evaluation study of Nalbuphine-Diazepam-O2 Anesthesia will be needed.
Adult* ; Anesthesia ; Anesthesia, General* ; Anesthetics ; Blood Pressure ; Consciousness ; Diazepam* ; Halothane* ; Heart Defects, Congenital ; Heart* ; Humans ; Hypertension ; Inhalation ; Intubation ; Intubation, Intratracheal ; Muscle Relaxation ; Nalbuphine* ; Research Personnel ; Respiratory Insufficiency ; Skin ; Sodium ; Sternotomy ; Tachycardia ; Thoracic Surgery* ; Tricuspid Valve Insufficiency

To evaluate the effect of low lactose special formula (MF-1) for the treatment of acute diarrhea, we studied thirty nine infants who were admitted with acute diarrhea to the Department of Pediatics, Yeungnam University Hospital. 39 infants of under 6 months of age who had been fed on formula feeds were randomly allocated to receive either a diluted regular formula milk or a low lactose special formula. Each infant received intravenous rehydration during fasting for 6-12 hou s. Group 1 (n=15) was fed half strength of regular. formula (80-100cc/kg/day) for the first 24 hours, three quarters strength formula (100-120cc/ kg/day) for the next 24 hours, and continued feeding with the full strength regular formula milk. Group 2 (n= 24), who fed the same amount of milk as Group 1, continued feeding with the full strength low lactose special formula from the start of feeding. Male to female sex ratio was 1.6 to 1. The characteristics of infants on admission were comparable in the age, the duration of diarrhea and the stool frequency before admission, the degree of dehydration. There were no significant differences in the duration of hospitalization, changes in stool weight and stool frequency after admission between two groups.(p>0.05) The Body weight and skin fold thickness were increased in group 2 who fed low lactose formula, but those who fed diluted regular formula showed reduction of body weight and skin fold thickness (64.251.48 vs -11.452.2g, 0.60.8mm vs -0.10.3mm
Body Weight ; Dehydration ; Diarrhea* ; Fasting ; Female ; Fluid Therapy ; Hospitalization ; Humans ; Infant* ; Lactose* ; Male ; Milk ; Sex Ratio ; Skin

In complication of infective endocaditis splenomegaly and splenic infarction are not uncommon but splenic rupture is very rare. We report a case of splenic rupture complicated by infective endocarditis in 1 71-yr-old man who had been suffered from rheumatic heart disease (aortic regurgitation and stenosis and mitral regurgitation). The patient was admitted to mild fever and generalized weakness for 20 days. Diagnosis of infective endocarditis due to Staphylococcus epidermidis was made by clinical manifestaions and blood culture study.On 34th day of admissionthe patient suddenly displayed the symptoms and signs of massive intraperitoneal hemorrhage. Splenic rupture was revealed by paracentesis and radiologic studies. Rupture of spleen is an uncommon and usually fatal complication of infective endocarditis. Therefore early diagnosis and prompt treatment must be performed.
Constriction, Pathologic ; Diagnosis ; Early Diagnosis ; Endocarditis* ; Fever ; Hemorrhage ; Humans ; Paracentesis ; Rheumatic Heart Disease ; Rupture ; Spleen ; Splenic Infarction ; Splenic Rupture* ; Splenomegaly ; Staphylococcus epidermidis

BACKGROUND: The dipyridamole and dobutamine stress echocardiography have been studied as a non-invasive diagnostic test in coronary artery disease. Recently, some authors have extended the usefulness of these tests to predicting the prognosis of myocardial infarction patients. But as far as we know, there was no literature which tried boh tests to the same infarcted patients group. So, we performed both tests in the 23 infarcted patients to compare and evaluate both tests as predicting the prognosis in myocardial infarction. METHODS: Patients underwent (1) two-dimensional echocardiography under basal condition and after dipyridamole infusion for 4 minites at the dose of 0.14mg/kg/min, (2) another two dimensional echocardiography under basal and during dobutamine infusion at each dose of 5 to a maximum of 20microg/kg/min at 1 or 2 days after dipyridamole stress echocardiography, and (3) coronary and left ventricular angiography. Preinfusion and peak infusion images were analyzed independently by two different observers using Nova Micro Sonic soft were(DataVueII and ColorVue II analysis system). The segmental wall motions were scored as follows ; hyperkinetic : 1, normal : 2, hypokinetic : 3, akinetic : 4. THe test response was considered positive if abnormal wall motion and reduced myocardial thickening were observed during drug infusion at the vascular distributions except the akinetic infarcted segment identified during basal condition. The coronary angiography was analyzed by measuring the maximal luminal diameter stenosis with caliper and 50% or greater diameter narrowing was considered significant. The sensitivity and specificity were calculated by comparing echocardiographic prediction and angiographic findings. RESULTS: 1) Among 22 patients with sufficient image in dipyridamole stress echocardiography, 13 patients have myltivessel coronary disease without resting akinesia of non-infarcted segments. Only 5 patients showed positive findings in dipyridamole stress echocardiography(sensitivity, 38.4%). Among 9 patients who has single or minimal disease, 9 patients were negative finding(specificity, 100%). 2) Among 21 patients with sufficient image in dobutamine stress echocardiography, 12 patients have multivessel coronary disease without resting akinesia of non-infarcted segments. 7 patients showed positive finding in dobutamine stress echocardiography(sensitivity, 58.3%). Among 9 patients who has single or minimal disease, 8 patients showed negative finding(specificity, 88.8%). 3) In hemodynamic changes, dipyridamole stress echocardiography showed significant changes in heart rates and double products and dobutamine stress echocardiography showed significant changes in heart rates, systolic blood pressure and double products. 4) There was no significant side effect during both stress tests inacute and old myocardial infarction patients. CONCLUSION: 1) The dobutamine and dipyridamole stress echocardiography are safe and easy test for myocardial infarction patients. 2) The dobutamine stress echocardiography has higher sensitivity than dipyrdamole stress echocardiography for identifying multivessel coronary disease in myocardial infarction patients but the dose of both drugs were relatively small to get the adequate results. So the high dose of drugs must be tried in feature study.
Angiography ; Blood Pressure ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Diagnostic Tests, Routine ; Dipyridamole* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Exercise Test ; Heart Rate ; Hemodynamics ; Humans ; Myocardial Infarction* ; Phenobarbital ; Prognosis ; Sensitivity and Specificity

Tinea pedis is frequently found in those people with poor hygine and in hot and humid environments. The authors investigated the clinical, epidemiologicol a id mycological characteristics of tinea pedis in 138 sewerage workers attending a sewerage plant in Seoul. Tinea pedis was found in 82, with a prevalence of 59.4%. The prevalence of tinea pedis increased with age and the period working at sewerage plant, however, there was no statistical significance. Also there was no difference in the prevalence of tinea pedis between the clerical workers and the field workers. Positive rate for KOH smear was 73.2%, and culture positive rates were 42.7%, producing 35 strains of dermatophytes. Twertyeight strains of Trichophyton Rubrum and 7 strains of Trichophyton mentagrophytes were isolated. Twentyseven yeast-form colonies were isolated, and Trichosporon beigelii was foungl in 19 samples. Most of the yeast forms were found mixed with dermatophytes and moulcis, However, 6 were isolated from direct smear positive cases and yieIded pure colonies of yeast. These included 4 cases of T. beigelii, 1 case of Candida parapsilosis, and 1 case of Candida hormicola. In view of the recent report of these fungi as pathogenic organism, these isolates, rspecially T. beigelii, were considered as a causative agent of tinea pedis in certain groups like sewerage workers.
Arthrodermataceae ; Candida ; Fungi ; Health Personnel ; Humans ; Plants ; Prevalence ; Seoul ; Tinea Pedis* ; Tinea* ; Trichophyton ; Trichosporon ; Yeasts

Interventional procedures around the cervical spine have been classically performed under the guidance of fluoroscopy with radiation hazards to patients and doctors. Even though under fluoroscopic guidance, vascular and nerve structures cannot be shown and there are actual risks for the patient. Nowadays, we can use high resolution image ultrasound around cervical spine procedures. Real time imaging is possible. Cervical root block, medial branch block and many other interventions can be performed under ultrasound guidance. In out-patient clinics, ultrasound is very helpful in management of cervical problems in differentiating the origin of pain and treatment for the pain. Ultrasound is radiation free, easy to use and the imaging can be performed continuously while the injectant is visualized in real-time, increasing the precision of injection. Importantly, ultrasound enables visualization of major nerves and vessels and thus leads to improved safety of cervical interventions by decreasing the incidence of injury or injection into nearby vasculature. We therefore performed a review to investigate the feasibility of performing cervical interventions under real-time ultrasound guidance.
Fluoroscopy ; Humans ; Incidence ; Outpatients ; Spine* ; Ultrasonography

Subperiosteal Cortical Defect is a symptomless rarefaction of cortical bone which begins most often on the external surface of the medial and posterior cortical walls of the lower end of the femur in children between the ages of 3 and 6 years. The name of Subperiosteal Cortical Defect was first used by Aegerter who differentiated it from non-osteogenic fibroma. The authors found out 5 positive cases of incidental findings among 62 cases of both knee joint X-ray of which 3 was male and 2 was female. Also we experienced 3 cases which necessiat d a correct diagnosis and differential diagnosis. Because this is a common lesion, it frequently accompanies more serious bone conditions, and because this is self-limited disease, treatment is not necessary. It was emphasized that its nature should be understood by all those dealing with bone disease lest it be overdiagnosed and overtreated.
Bone Diseases ; Child ; Diagnosis ; Diagnosis, Differential ; Female ; Femur ; Fibroma ; Humans ; Incidental Findings ; Knee Joint ; Male