The pulse transmission times measured from polygraphic recordings of cardiac events were studied in 52 cases of female hyperthyroidism and 60 cases of normal females. The pulse transmission times measured in this study were M1-S, R-S and C-S intervals, i.e., the time intervals from the mitral first sound, the R wave of an electrocardiogram and the onset of the upstroke of the ventricular contraction in an apexcariogram to the finger tip, respectively, and the A2-C interval, and interval from the aortic second sound to the finer tip. The M1-S, R-S and C-S intervals, which were measured during systole, were significantly shortened in proportion to the severity of the disease, whereas the A2-C interval, which was a measurement during diastole, was well within normal limits. By correcting these observed values for the heart rate, the A2-C interval became significantly longer than in the control, apparently in proportion ot the severity of the disease. The M1-S, R-S and C-S intervals, however, were normalized by the correction. In the analysis of the correlation of these observed values to the age and the various hemodynamic parameters, it was noted that the A2-C interval was negatively correlated to the diastolic and mean blood pressure, which tended to be low in this condition, and was positively correlated to the age, but had no correlation to the heart rate or the systolic blood pressure. The A2-C interval also showed positive and negative correlation to left ventricular ejection time/isovolumic contraction time ratio and preejection period/left ventricular ejection time ratio, respectively. On the contrary, there was a tendency for the remaining intervals measured during systolic to be negatively correlated to the systolic blood pressure, which tended to be high, heart rate and age, as well as systolic time intervals. These facts suggested that the shortening of the M1-S, R-S and C-S intervals was caused primarily by the rapid heart rate and also by the systolic hypertension. It was strongly felt that the A2-C interval was of a limited value as an index of the pulse transmission in hyperthyroidism.
Blood Pressure ; Diastole ; Electrocardiography ; Female ; Fingers ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Hyperthyroidism* ; Systole

No abstract available.
Aged* ; Femur Neck* ; Hemiarthroplasty* ; Humans

A case of congenital dislocation of the both knees in a newborn infant which is a very rare condition and difficult to treat, is reported together with the reviews of the literature and the discussion of the future therapeutic programme of the condition.
Dislocations ; Humans ; Infant, Newborn ; Knee

No abstract available.
Surveys and Questionnaires*

We reported the two cases of olecranon osteomyelitis secondary to the iatrogenic chronic relapsing septic olecranon bursitis. Infection was well eradicated by excision of the infected bursa and curettage of the eroded olecranon under the coverage of antibiotic therapy.
Bursitis* ; Curettage ; Cytochrome P-450 CYP1A1 ; Olecranon Process* ; Osteomyelitis*

No abstract available.
Accidents, Traffic* ; Aggression*

The mechanism of cytolysis by complement attack of nucleated cells(NC) is of special interest in comparison to that of red blood cells. It is known that NC death by membrane attack comples, C5b-9, is caused by many factors, i.e., efficiency of complex assembly, activation of intrinsic metabolic pathway by signal transduction, cytotoxic effect of the channel itself and natural repair ability. These factors suggest that colloid osmotic lysis, known in red blood cells, does not fully explain the complement-mediated cell death of NC. In this study, the authors investigated correlation between biochemical and morphological changes to prove "Ca2+-mediated metabolic death"8~13) representing a mechanism of NC death caused by C5b-9 attack. The L1210 cells, mouse leukemic cell line carrying small complement channel(TAC5b-91) were used in the experiments. The amounts of intracellular adenine nucleotides to extracellular Ca2+, ouabain, KC1 and dextran were analyzed by bioluminescence method using luminometer. Cell viability was checked by 0.4% trypan blue dye and LDH release. Morphological observation of TAC5b-91 was done by immunocytochemical staining and electron microscope. The results were as follows: 1) The release of ATP, ADP and AMP followed by cell death was rapid and progressive along the incubation time at 37 degrees C and it was accelerated in 1.5 mM of [Ca2+]0. 2) There was no evidence of ATP repairment in the TAC5b-91. 3) Extracellular KC1(150 mM), dextran(0.66 mM) and ATP supplement(0.2 microM) could not effectively inhibit ATP depletion and cell death. Ouabain(27 and 100 microM) enhanced cell death and could not completely prevent ATP loss. 4) Most of the mitochondria showed swelling, loss of cristae and Ca2+ deposit in matrix in the electron microscopic observation. Rapid, sustained and irreversible depletion of adenine nucleotides was due to Ca2+ deposit with destruction of mitochondria and also the leakage through transmembrane channels. Moreover this energy depletion was accelerated by high extracellular Ca2+ concentration. These results indicate that Ca2+-mediated, energy exhaustion is one of the mechanisms of the metabolic cell death by C5b-9 attack of NC.
Mice ; Animals

The pelvis is a ring structure with strong ligamentous support. This support includes the symphysis pubis, the anterior and posterior sacroiliac ligaments, and the strong sacrospinous and sacrotuberous ligaments. Since the pelvis is a ring, disruption of any protion of the ring is always associated with disruption in another portion of the ring. Massive pelvic disruption is an important and often life threathening injury. It is usually due to a motor vehicle accident, a fall from a height, industrial injury, and so on. The authors reviewed 28 cases of unstable pelvic fracture treated at the orthopaedic department of Catholic Medical Center during the period from January 1975 to December 1980, and the injury was classified according to the Pennal and Tiles method, and analyzed the clinical data as to the cause of mechanical violence, type of fracture and treatment, post-traumatic pelvic instabilities, and the results. The persistant post-traumatic pelvic instability was assessed by physical examination, and Chamberlain and Trostlers stress Roentgen view of the pelvis. The clinical results obtained were as follows: 1. The incidence of the unstable pelvic fracture was 17.7% (28) of all pelvic fractures (158). The incidence of injury in male was approximately 5 times more frequent than female, and most of the patients were in the 3rd to 5th decade of their life. The causes of injury were road accident (54%), coal mine accident and fall from a height in orders. 2. The four-rami fracture with posterior disruption due to the lateral compression injury was the most common type of unstable pelvic fractures. 3. In conservatively treated patients, the pelvic instability persisted in 37.5% (6 in 16 cases) of the cases and all of them necessitated the joint stabilizing operation. Twelve cases were treated operatively. Among them, performed operations include wiring of symphysis pubis in 2 and sacroiliac joint fusion in 4 within 4 weeks after injury. But for the other 6 cases in which pelvic instability persisted in spite of the sufficient conservative treatment, sacroiliac joint fusion or sacroiliac joint fusion together with a symphyseal plate fixation were done. 4. Satisfactory results was obtained in 62.51% (10 in 16 cases) of nonoperated cases, and 91.7% (11 in 12 cases) of operated group. Authors consider that the most important step in the management of traumatic pelvic instability are; firstly the early recognition of the correlation of the fracture-fragments; the fracture mechanism, and the possible presence or the post-traumatic pelvic instability, and secondly finalizing the therapeutic plan. Early surgical stabilization of the duration of the treatment and the residual disability.
Clinical Study ; Coal ; Female ; Humans ; Incidence ; Joints ; Ligaments ; Male ; Methods ; Motor Vehicles ; Pelvis ; Physical Examination ; Pubic Bone ; Sacroiliac Joint ; Violence

It appears that frequency of fractures of the aceta ulum is increasing with the number of automobiles on our roads and when they occur they seem to pose difficulties of management. Because, the anatomy of this region is complicated, making surgical approaches difficult. Second, the patients often have major associated injuries, making early operative treatment hazardous. Third, the fractures are often severly comminuted, leading many surgeons to beleave that operative reduction is impossible. Finally, and unfortunately, the fractures are often missed. The aim of treatment must be to restore the fractured acetabulum to its normal anatomy followed by early motion to promote healing and restore function. Undisplaced acetabular fractures have a good prosis with conservative treatment but patients with displaced fractures of the acetabulum not reduced by manipulation and traction should be considered candidates for open reduction. The author experienced 72 cases of acetabular fracture patients who were admitted to the department of Orthopaedic Surgery of Catholic Medical College and Center from January 1979 to August 1983. The results of 48 patients who were followed up over 6 months period were as follows; l. Among 72 cases(44 were male and 28 were female), the most common causes of acetabular fracture was pedestrian struck by car. 2. 56 were treated conservatively and 16 were treated surgically. The result were as follows; Excellent-15(31%), Good-23(48%), Fair-8(17%), Poor-2(4%). 3. 72 cases were classified by Letournel classification. The most common type was posterior wall fracture(14 cases), and second most was T-shaped fracture(13 cases). 4. If the grossly displaced fragments are present they should be reduced and fixed surgically if surgical approach can be done. 5. It is essential to understand the pathologic anatomy of the acetabulum in order to approach the acetabular fracture sefely and with maximum ease.
Acetabulum ; Automobiles ; Classification ; Clinical Study ; Humans ; Male ; Surgeons ; Traction

Tuberculosis of the spine is still prevalent in many parts of the world and still remains as an important orthopaedic problem in Korea. Moreover, spinal tuberculosis is the most common and dangerous form of skeletal tuberculosis. With the availability of very effective antituberculous drugs two divergent controversy in the management of tuberculosis of the spine have been reported. A large group of surgeons has advocated the radical excision of the tuberculous focus and replacement of the defect with autogenous bone grafts under cover of chemo-therapy, and another practise is typified by regimen of Friedman, Konstam, Kaplan, and Stevenson and Manning, who treated a large number of patients with spinal tuberculosis using antiuberculous drugs alone. Even now, because of the shortage of hospital beds and ancillary help, private poor economy and patients general condition, some group of patient with tuberclous spine have been treated conservatively using effective antituberculous drugs. In this study authors clinically analysed the 75 patients who had conservative treatment with triple drug therapy for 18 months at the department of Orthopaedics, Catholic Medical College and Center during the past 10 years, and the results were as follows: 1. There were two prevalent age groups. One is the first decade (30.6%) and the other is the third decade(30.7%). The age prevalence in children was 6 to 10 years of age. 2. The lesions were common in the lumbar spine(56.0%) and the most commonly involved vertebra was L3. The average initial number of involved vertebral body was 1.9 vertebrae and it was changed to 2.3 vertebrae at the end of treatment(18 months). 3. Active pulmonary foci was associated in 17.4%(6.7% of tuberculous pleurisy included). 4. Out of 75 cases twenty-six(34.7%) had new involvement at the adjacent vertebra within 18 months after treatment. 5. The radiographic activity was assessed as active in all cases initially, but at 18 months after treatment 83% of the cases were in quiescent condition, and this percentage was increased to 78.7% at 36 months. 6. Spontaneous fusion rate of involved vertebral bodies was 24% at 18 months and 36% at 36 months after treatment, respectively. 7. Radiologically observed deep seated abscess shadow disappeared slowly over 3 to 20 months, but this disappearance was observed mainly within 8 months after treatment. 8. Mean increment of the kyphosis was average 7.5 degree (9.3° in children and 6.6° in adults) at the end of the treatment(18 months), and average 8.6 degree(10.9° in children and 7.3° in adults) at 36 months, by. internal gibbus angle. 9. Almost in all the adult patients, kyphosis developed during the active phase of the disease, while in children kyphosis progressed even after the healing of the disease. Children who had multiple vertebral involvement at the dorsal area had a tendency to develop more severe kyphosis. 10. Decrement of the kyphosis angle which located at the lumbar area after the end of the treatment was considered to be an effect of narmal lordotic curvature. 11. Generally representation of the changes seen in children was almost osteolytic change without sequestrum in comparison to adults who had more sequestrum formation. 12. In 95% of cases a favourable results were obtained.
Abscess ; Adult ; Child ; Drug Therapy ; Humans ; Korea ; Kyphosis ; Prevalence ; Spine ; Surgeons ; Transplants ; Tuberculosis ; Tuberculosis, Pleural ; Tuberculosis, Spinal