Forearm bone fractures are difficult to manage, because of their special functions (pronation and supination) and peculiar anatomy. Authors have experienced 68 cases of various types of forearm bone fractures from January, 1968 to December, 1971. They were analized as following. 1. Out of 68 patients, males were 54 cases (79.4%) and females were 14 cases (30.6%). Among them, 91.2% of the cases were occured in people over 15 years old. About 47% of the cases were caused by automobile accidents. 2. Both forearm bone fractures were 51 cases (75%), and most common site of the fractures were mid 1/3(66.2%). Stable (transverse or incomplete) fractures were 24%, and unstable(comminuted, segmental, oblique or spiral) fractures were 76%. Open fractures were 26.5% 3. Conservative treatment was given to 41 cases (60.3%), and open reduction & internal fixation was given to 27 cases (39%). 4. A comparison has been made between the groups treated by conservative method and open reduction & internal fixation. 1) Average healing time of open reduction group was 19.5 weeks and conservative group was 16.4 weeks. 2) Non-union was occured in 7.4% of conservative treatment group, and 22.7% of open reduction group. 3) Satisfactory functional results were shown in 23.5% of conservative group and 54.5% of open reduction & internal fixation group. 4) Rotational deformities were noticed in 53.3% of the conservative treatment group and 54.5% of the open reduction group (No difference was noticed). 5) Angulatory deformities were shown in 70.4% of the conservative treatment group and 44.4% of the open reduction group. 5. Three cases were complicated by cross unoin, and no postoperative wound infection was noted. But two cases of open fracture developed to chronic osteomyelitis.
Automobiles ; Congenital Abnormalities ; Female ; Forearm ; Fractures, Bone ; Fractures, Open ; Humans ; Male ; Methods ; Osteomyelitis ; Surgical Wound Infection

To determine clinical features and outcomes of retinal detachments[RDs] following trans-scleral fixation of posterior chamber intraocular lens[PC-IOL], we reviewed the medical records of 249 eyes[239 patients] which had undergone trans-scleral fixation of PC-IOL and had been followed 6 months or longer. Retinal detachment occurred in 8 out of 249 eyes[3.2%]. The incidences of RDs were as follows:in 2/19 eyes[10.5%] with PC-IOL exchange for PC-IOL tilt, in 1/16 eyes[6.3%] with posterior capsule rupture during ECCE, in 1/26 eyes[3.8%] with ICCE, in 2/78 eyes[2.6%] with posterior capsule rupture during phacoemusification, in 2/106 eyes[1.9%] with aphakia, and in 0/4 eyes[0%] with anterior IOL exchange with PC-IOL. The sites of retinal break corresponded with the directions of needle during fixation in 5/8 eyes[62.5%] and all retinal breaks were located anterior to the equator. The timing of RD was between 2 weeks and 4.8 years after fixation although it occured within 2 months in most cases. Pars plana vitrectomy and scleral buckling were performed in 7 eyes and scleral buckling only in one eye. Retinal reattachment was achieved in seven eyes including three eyes which required two surgical interventions. The vitrectomy should be performed with meticulous care to reduce vitreous traction as much as possible during trans-scleral fixation of PC-IOL and a close follow-up examination for RD is required during the first two months.
Aphakia ; Follow-Up Studies ; Incidence ; Lenses, Intraocular* ; Medical Records ; Needles ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Rupture ; Scleral Buckling ; Traction ; Vitrectomy

No abstract available.
Humans ; Renal Insufficiency, Chronic*

No abstract available.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis

The result of forty cases of rheumatoid arthritis according to New York criterion, who underwent multiple operations(up to 10) in multiple joints hetween 1983 and 1986 were evaluated in 3 years and 8 months in average(range; 18 months to 5 years 2 months)postoperatively. The joints operated upon were knee, ankle, shoulder, elbow, wrist and finger joints. The surgery performed were 65 arthroscopic synovectomies, 17 total joint replacement(16 knees and 1 elbow) and 7 arthrodesis(1 knee, 1 ankle and 5 wrists). There were 10 males and 30 females, 27 “clsssic” and 13 “definite” rheumatoid arthritis according to the classification of American Rheumatism Association.Functional capacity of the patient was graded as I, II,III and IV according to the ARA. The final clinical results were graded as “excellent”, “good”, “fair” and “poor” according to the modified citeria of Sledge et al(20). The relationship between number of cases of recurred synovitis and various factors such as sex, classification according to the ARA, number of joints involoved and extent of synovectomy in the knee joint was analyzed statistically with chi-square test of the contingency table.The results are as follows; 1. The final results were 22 “excellent”(55.0%), 16 “good”(40.0%) (altogether 95% of cases were satisfactory) and 2 fair (5.2%), but there was no “poor” result. 2. All cases showed functional improvement, the commonest mode of improvement being from preoperative grade II to postoperative grade I(19 out of 40 cases, 47.5%). 3. There were 9 cases of recurrence of synovitis following arthroscopic synovectomy(22.5 %). They were controlled by medication in 2 cases, and by reoperation in 5 cases (resynovectomy ; 3, joint replacement; 1, arthrodesis ; 1). 4. The factors such as sex, classification and number of joints involved were not significantly correlated c the recurrence rate although there was a tendency of frequent recurrences in cases of female, classic RA and multiple joint involovement (P>0.05). 5. In the knee joint there was significantly less recurrence rate in total synovectomy cases (1/20, S.0%) than in anterior synovectomy cases (7/22, 31.8%) (P<0.01). 6. There was no recurrence following total joint replacment or arthrodesis. In conclusion the combined surgery of arthroscopic synovectomy, joint replacement and arthrodesis in the multiple joints was effective in relief of pain and effusion and improvement of functional capcity of the rheumatoid patient if proper medical treatment was given postoperatively.
Ankle ; Arthritis, Rheumatoid ; Arthrodesis ; Classification ; Elbow ; Female ; Finger Joint ; Humans ; Joints ; Knee ; Knee Joint ; Male ; Recurrence ; Reoperation ; Rheumatic Diseases ; Shoulder ; Synovitis ; Wrist

It is socially fortunate that there is little chance in the civil hospital to experience the victims of high velocity missiles. However it is reasonable thought to educate doctors about the gunshot and explosive injuries who might be mobilized in emergency condition. Authors have experiences to treat the high velocity missile wounds. In order to provide valid data to be an educational material, we clinically analyzed 41cases of those injuries who were treated at the Capital Armed Forces General Hospital from 19xx to 19xx. The results obtained were as follows: 1. In 15 cases there were only soft tissue injuries, The remaining 26 cases had the bone injuries and six of them had two injury sites. 2. In 28 cases the lower extremities were injuried, and they out-numbered the injury of upper extremities. The most frequent site of injuries was the thigh (31.7%). 3. Most common associated injuries were the periphenal nerve injuries, which numbered 10 cases. 4. The early operative treatments were given in 5 out of 32 cases having bone injuries. And the secondary operations, including bone graft and intemal fixation, had to be done in 10 out of the remaining 27 cases due to delayed union or nonunion. 5. There was no infection in cases having only the soft tissue injuries. But the localized osteomyelitis occurred in 4 cases among the cases having bony injuries. 6. Factors affecting the result of high velocity missile wounds were presence of bony involvement, site and extent of injuries, associated thoracoabdominal injuries and presence of peripheral nerve injuries and infection. 7. The evacuation time, chance of early adequate wound management, site of injury and extent of injury were the important factors in deciding the method of treatment. We suggest that the more selective and aggressive measures should be taken in the management of bony injuries.
Arm ; Emergencies ; Extremities ; Hospitals, General ; Lower Extremity ; Methods ; Osteomyelitis ; Peripheral Nerve Injuries ; Soft Tissue Injuries ; Thigh ; Transplants ; Upper Extremity ; Wounds and Injuries

This study was carried out to clarify the effect of dietary calcium, casein, and suet on the accumulation of cadmium in mice. It was performed for 30 days, from April 11 to May 10 1988. 90 mice were divided into 4 experimental groups and control group with 6 mice each dietary group, and measured survival rate, body weight, and weight ratio of organ to body. The contents of cadmium in liver, kidney, spleen, muscle and skin with hair, and faces were analyzed by atomic absorption spectrophotometer after sacrifice by anesthesia. After 30 days, the survival rate of control group was 100%, but 66.7% in group IV(basal+Cd+Ca) with single dose of 100 microgram cadmium and with free-intake of water containing 50ppm cadmium, and group V(basal diet+Cd+suet) with free-intake of water containing 50ppm cadmium. The rate of weight gain in the case of single dose of 100 microgram cadmium was highest in group IV as 42.3% and lowest in group V as 26.0%, whereas in the cases of free intake group IV was highest as 24.0% and group II(basal diet+Cd) was lowest as 11.6%. The body weight, in the case of single dose of 100 microgram cadmium showed no increase until 5th day after acute poisoning. But in the case of free intake group, it showed very increase through all the breeding period. The weight ratio of organ to body were lowest in the liver of group II in both occasions. The most of cadmium administered were excreted through feces within 2 days after single dose of 100 microgram cadmium. The contents of cadmium in each group were significantly higher than those of control group. In the liver, kidney, spleen and muscle, group II showed the highest level in both occasions of 100 microgram single dose and free intake of water containing 50ppm cadmium. In the skin with hair, group II of the occasion with single dose of 100 microgram and group V with free intake showed the highest level. And the contents of cadmium in tissue were markedly higher in the occasion of free intake of water containing 50ppm cadmium. From the above results I would conclude that the addition of casein and calcium are effective in the inhibition of intension absorption of cadmium esp. by calcium.
Absorption ; Anesthesia ; Animals ; Body Weight ; Breeding ; Cadmium* ; Calcium ; Calcium, Dietary* ; Caseins* ; Feces ; Hair ; Kidney ; Liver ; Mice* ; Poisoning ; Skin ; Spleen ; Survival Rate ; Water ; Weight Gain

No abstract available.
Thyroid Dysgenesis*

OBJECTIVES: This study was designed to evaluate the problems of pre-hospital Emergency medical care system (EMS) in workplace. We analysed 25 fatal work-place injuries during the recent 4 years and the work-place EMS of 8 enterprises located in Masan-city, Changwon-city and Kuje-island. METHODS: The safety managers and the members of Dept. of safety in the labor unions were interviewed about the work-place EMS. And we investigated on the injury reports, the work-place medical-room records and the medical records of emergency center for fatal 25 cases. RESULTS: The enterprises had the at-risk machines and processes, volatile materials and high-altitude working processes. There were duty doctors in only 3 enterprises but a few duty nurses or health-care providers in the others. The time spent for the education to the workers on safety was 24hrs/yr in 3 enterprises in 1998 but less than Bhrs in the others. There were medical service center in all enterprises but the ambulances in three. The time for activation of the ambulance was ranging from 5 minutes to 10 minutes in 6 enterprises, and from 10 minutes to 30 minutes in two. The patient transportation to the emergency center was possible within 30 minutes in all enterprises but there were no equipments for airway maintenance and shock management in all enterprises. The 15 (60%) fatal injuries were occurred at one enterprise. The 64% of casualties had the duration of job-employment more than 10yrs and the 68% were suffered the typical type of work-place injury as descending injuries, collisions and falls. Most of all primary calls for rescue were concentrated on the fire-service agencies. But in 85% of fatal injtories, the tome for the activation of ambulance was more than 10 minutes and no emergency care was taken in the field in 48 percent of casualtles. The transportation time to the emergency center was more than 30 minutes in 50 percent. It toolk from injury to death was less than one hour in the 40 percent of all cases, and from one hour to four in the 50 percent. The causes of death in the 68 percent were the head-and-neck injuries or thoracic injuries. CONCLUSIONS: We found that there was Insufficiency of the education associated with work-place injury for workers, manpower and facilities, equipments related to the work-place EMS, the problems of the delay in transportation system.
Ambulances ; Cause of Death ; Education ; Emergencies* ; Emergency Medical Services* ; Humans ; Labor Unions ; Medical Records ; Shock ; Thoracic Injuries ; Transportation

No abstract available.
Accidents, Traffic* ; Aggression*