Thirty-three cases of the fracture of the femur and tibia on the same limb were treated at the Orthopedic Department of the Chosun University Hospital during the period from January 1977 to December 1983. The following results were obtained. 1. The incidence of trauma was high in the young man, most frequent in the third decade (45.4%). 2. The most common cause of the fracture was traffic accident (81;8%). 3. The most common shape of the fracture was comminuted in both femur and tibia. 4. The common fracture site were middle one-third in both femur and tibia. 5. Eight patients were treated by conservative means on both femxr and tibia. The patients were treated by internal fixation on femur and by conservative means on tibia. Internal fixation was .done in ten patients on both femur and tibia. Two patients were treated by inteinal fixation on tibia and by conservative means on femur. Three patients were amputated. 6. Average healing time of fracture was 21 weeks in femur and 24.2 weeks in tibia. 7. Functional end results were assessed and rated with satisfactory results in rigid internal fixation of the femur and tibia.
Accidents, Traffic ; Clinical Study ; Extremities ; Femur ; Humans ; Incidence ; Inteins ; Orthopedics ; Tibia

Limb salvage operation in primary malignant bone tumors is increasing recently, according to the improvement of diagnostic methods, surgical technique and adjuvant chemotherapy. The purpose of this study is to obtain the interim results of survival rate and the functional grade of the limb in primary malignant bone tumors treated by limb salvage operation. Between 1985 to 1993, 63 primary malignant bone tumors treated by limb salvage operations. Tumor prosthesis arthroplasty was performed in 49 patients, resection arthrodesis in 9 patients, and IM nailing with cement molding in 5 patients. Autoclave autograft was combined in 2 patients. Adjuvant chemotherapy and postoperative radiotherapy were performed in selected patients. The average follow-up period was 50 months(ranged 12 months to 116 months). In the cases of osteosarcoma, estimated survival rate was 61.9% based on Kaplan-Meier survival plot. In the parosteal sarcoma, the survival rate was 87.5% and 80% in chondrosarcoma patients. According to functional grading by Enneking, 66% was excellent, 20% was good, 11% was fair and one patients was poor. Complications occurred in 16 patients:wound infection was developed in 6 patients, local recurrence in 4, peroneal nerve palsy in 2 patients and femoral stem loosening in 2 patients. Fracture in resection arthrodesis and pulmonary metastasis were also occurred. Reoperation was performed in 10 patients at average 31 months after initial operation. Revision tumor persthesis arthroplasty was performed in one patient due to local recurrence and in 2 patients due to femoral stem loosening. Three amputations were done due to recurrence of tumor. IM nailing with cement molding was performed in one patient due to deep infection and repeated arthrodesis was done in a fracture patients. Scheduled custom-made tumor prosthesis arthroplasty was performed within a year in 2 patients treated with IM nailing with cement molding. In conclusion, with the careful preoperative assessment, adjuvant chemotherapy and skillful surgical technique, limb salvage operation would provide the primary malignant bone tumor patients for longer survival and better quality of life.
Amputation ; Arthrodesis ; Arthroplasty ; Autografts ; Chemotherapy, Adjuvant ; Chondrosarcoma ; Extremities ; Follow-Up Studies ; Fungi ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Osteosarcoma ; Paralysis ; Peroneal Nerve ; Prostheses and Implants ; Quality of Life ; Radiotherapy ; Recurrence ; Reoperation ; Sarcoma ; Survival Rate

PURPOSE: The purpose of this study is to identity the effects of a tailored health promotion program on rural residents' self efficacy, health problems and quality of life. METHOD: Data were collected from May 13th, 2006 to July 29th, 2006. The subjects were selected at Gajo-myeon, Geochang-gun, Gyeonsangbuk-do, Korea. Forty three residents were included in the experimental group and 39 in the control group. The 12-week health promotion program was given to the experimental group. Data were analyzed by descriptive statistics, chi2-test, t-test and ANCOVA test with the SPSS/Win 12.0 program. RESULT: The experimental group showed higher scores of self efficacy and quality of life than the control group, and a lower score of health problem than the control group. CONCLUSION: From the above results, it can be concluded that the tailored health promotion program for rural residents is an effective intervention for improving their self efficacy and quality of life and reducing their health problems. Therefore, it is necessary to spread the tailored health promotion program for residents in other rural areas in Korea.
Gyeongsangbuk-do ; Health Promotion* ; Korea ; Quality of Life* ; Self Efficacy*

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

Authors were reviewed clinically for the patients who revealed ocular manifestations related to systemic diseases in year of 1968 (Table 1). The incidence of ocular changes related to systemic diseases (Table 2, 3, and 4), and ocular mansfestations of various systemic diseases such as infectious diseases, allergic diseases, endocrine diseases, nutritional and metabolic, central nerve system, cardiovascular diseases, hematopoietic diseases and connective tissue disorders (Table 5 to 22) were statistically and clinically observed in many respects. We observed some interesting cases such as macular edema (OU, aged 22, male) related to epidemic homorrhagic fever, monocular pseudoptosis in ocular conversion reaction and optic nerve atrophy (OU, aged 34, female) in toxemia.
Atrophy ; Cardiovascular System ; Communicable Diseases ; Connective Tissue ; Conversion Disorder ; Endocrine System Diseases ; Fever ; Humans ; Incidence ; Macular Edema ; Optic Nerve ; Toxemia

A relationship between preceding acute paralytic poliomyelitis and the later development of motor neuron disease has only occasionally been suggested since it was first postulated by Charcot in 1875. The authors recently experienced a 20-year-old male who was considered to have postpoliomyelitis muscular atrophy. We report this case in view of its rarity and necessity of differential diagnosis from other neuromuscular disorders. Clinical presentation included slowly progressive muscle wasting of left thigh for 4 years, mild weakness of left arm and both thigh, intermittent fasciculation, and previous history of acute paralytic poliomyelitis. Electromyographic findings showed fibrillation potentials, positive sharp waves, fasciculations, giant motor unit potentials and reduced interference patterns. Muscle biopsy revealed scattered small angulated fibers, individual myofiber degeneration and mild inflammatory cell infiltration.
Arm ; Biopsy ; Diagnosis, Differential ; Fasciculation ; Humans ; Male ; Motor Neuron Disease ; Poliomyelitis ; Postpoliomyelitis Syndrome* ; Thigh ; Young Adult

One case of fungus infection of the cornea, which led to enucleation, is reported. The fungus of Fusarium species was demonstrated on culture media and microscopic examination. The necessary for awareness of mycotic infections of the cornea, especially in antibiotic or/and cortisone topical treated eyes, is stressed.
Cornea ; Cortisone ; Culture Media ; Fungi ; Fusarium*

OBJECTIVE: The goal of this study was to review the etiologies, phathophysiology, clinical presentations and to compare the results of the surgical methods of subdural empyema especially in infants. PATIENTS AND METHODS: We reviewed the clinical data of five infantile subdural empyemas experienced in our hospital from 1993 to 1998 which were all surgically treated by craniotomy or burr hole trephination. We experienced five cases of infantile subdural empyema: two males and three females. The ages ranged from 40 days to 11 months. RESULTS: The etiologies of all five cases were unproven but all five cases had meningitis before the subdural empyemas were diagnosed. The causative organism in one was streptococcus pneumoniae, and the other were unknown. Two were treated with craniotomy(one with a good outcome and the other died) and three were treated with burr hole trephination(all three had a good outcome). CONCLUSION: Subdural empyema is a rapid progressing disease and it is important to detect and treat in the early stages of disease. The choice of surgical method must be based on the stage of the disease and its location in the cranial cavity.
Craniotomy ; Empyema, Subdural* ; Female ; Humans ; Infant* ; Male ; Meningitis ; Streptococcus pneumoniae ; Trephining

The authors studied the diagnostic usefulness of the Topographic analysis of EEG, using Topography ststem 700 (San-ei), in evaluation of supratentorial focal cerebral lesions of 27 patients with various etiology, comparing with visual anslysis of EEG. Focal cerebral lesions, which were proven with brain C-T, were 11 cases of cerebral infarction, 6 of intracranial hematoma, 6 of cerebral gliolysis and 4 of others. The topography system displays the spatial distribution of activity in the classic delta, theta, alpha and beta frequency and computed mapping of EEG displays equipotential maps of square of roots of power spectra over each frequency band. For visual analysis of slow waves and background activity changes, Mayo classification system of EEG abnormality was used and for visual evaluation of topographic display, above system was also applied with some modification in order to compare with the data of visual analysis of conventional EEG. The results of the study were as follows; 1. While visual analysis of conventional anlysis of EEGs showed abnormality only in 13 cases (48.1%) of 27, topographic analysis showed abnormality in 22 cases (81.5%). Topographic analysis was more sensitive than than visual analysis of the EEG and topographic analysis was thought to be more sensitive in assessment of local slow waves as well as minor changes, especially slight asymmetry, of background EEG activity. 2. Topographic analysis showed higher concor dance rate (55.6%) to the brain C-T finding in lateralization of supratentorial focal cerbral lesion than that (44.4%) of visual analysis of the conventional EEG.
Bisoprolol ; Brain ; Cerebral Infarction ; Classification ; Electroencephalography* ; Hematoma ; Humans