In spite of highly advanced technology in orthopaedic field, management of femoral neck fracture presents difficult problems due to frequent non-union or avascular necrosis of femoral head even with adequate treatments. Intracapsular fracture of the femoral neck heals in the same way as other intra-articular fractures only by endosteal and not by periosteal repair. Avascular necrosis occurred in one-third of displaced fractures with more than a two-year follow-up and is the most serious remaining factor affecting the result. Many attempts have been made to achieve early diagnosis of nonunion and avascular necrosis of the femoral head. Yet, there is still no reliable clinical method of early detection of the union of femoral neck fracture and the viability of the femoral head. For the early detection of union and viability of femoral head, we performed femoral trochanteric intra-osseous venographic technique. Intraosseous venography was performed in 19 cases of femoral neck fractures in the orthopaedic department of National Medical Center during the period from Jan. 1979 to Dec. 1981. The results were as follows: l. 19 patients of femoral neck fracture were performed osteomedullography. Intra-osseous venous flow across the fracture line was seen in 11 cases from 19 patients. 2. Intra-osseous venous flow across the fracture line was seen between the 6th and 12th week following fracture treatment in rigid fixation and adequate reduction. 3. Osteomedullography is considered as very important study for the early diagnosis of the fracture healing and non-union.
Early Diagnosis ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Fracture Healing ; Head ; Humans ; Intra-Articular Fractures ; Methods ; Necrosis ; Phlebography

One may sometimes complicated with non-union of the tibia with intact fibula or comparatively early united fibular fracture during the cause of treatment of crural fractures. So that the fibula is to strut the tibial fragment preventing effective contact. Several authors have sporadically reported the removal of a portion of fibula may increase potential compression force across the tibial fracture site and promote bony union of non-delayed union of the tibia. Partial fibulectomy was performed in 9 patients with established nonunion of the tibia at National Medical Center from 1975 to 1982. The results were as follows: 1. Healing occurred in 8 of the 9 cases, and average time to union was 7.4months after fibulectomy. 2. In one case performed B-K amputation due to intractable infection after partial fibulectomy. 3. The average shortening of the involved lower limb was about 1.9cm. 4. All cases did not have significant symptoms at the fibulectomy site after union. 5. Partial fibulectomy proved to be a relatively effective method for the treatment of nonunion of the tibia.
Amputation ; Fibula ; Humans ; Lower Extremity ; Methods ; Tibia ; Tibial Fractures

Scleroderma renal crisis is defined as the new onset of accelerated arterial hypertension and/or rapidly progressive oliguric renal failure. The pathogenesis is not well understood but there is increasing evidence that renin- angiotensin system is involved. We report an one female patient with diffuse scleroderma and renal crisis. Initial treatment with ACE inhibitor was not effective in controlling blood pressure until the temporal initiation of hemodialysis. Predialysis serum creatinine level was 8.4 mg/dL, but after initiation of hemodialysis, adequate control of blood pressure was achieved with ACE inhibitor alone. This case illustrated many features of the syndrome of scleroderma renal crisis and supported the early use of captopril and emergency hemodialysis if indicated.
Angiotensins ; Blood Pressure ; Captopril ; Cough* ; Creatinine ; Emergencies ; Female ; Humans ; Hypertension ; Renal Dialysis ; Renal Insufficiency ; Scleroderma, Diffuse ; Tic Disorders* ; Tics*

Apraxia of speech (AOS) is the impairment of motor programming. However, the exact nature of this deficit remains unclear. In particular, AOS without other speech-language deficit is called pure AOS, but it is very rare. When diagnosing AOS, the characteristic of articulation is considered a crucial criterion, which has been proposed for differentiating AOS from phonological and dysarthric disorders. The present study reports on pure AOS in a 37-year-old right-handed male after a left insular, front, temporal infarction. This report may be useful for further AOS study and diagnosis in the clinical setting.
Adult ; Apraxias ; Humans ; Infarction ; Male

BACKGROUND: The emergence of multidrug-resistant strains of Mycobacterium tuberculosis presents a significant challange to the treatment and control of tuberculosis, and there is an urgent need to understand the mechanisms by which strains acquire multidrug resistance. Recent advances in molecular methods for the detection of M. tuberculosis genetic targets have approached the sensitivity of culture Furthermore the prospect of determining resistance in mycobacteria at the nucleic acid level particulary to first-line drugs like rifampin, isoniazid has provided a glimps of the next generation of sensitivity test for M. tuberculosis. Previous studies in RMP resistant M. tuberculosis have shown that mutation in beta subunit of RNA polymerase is main mechanism of resistance. METHOD: In this study, rpoB gene for the ~3 subunit of RNA polymerase from M. tuberculosis of 42 cultured samples (32 were RMP resistant and 10 were sensitive cases) were isolated and characterised the mutations. Direct sequencing data were compared with the results of INNO-LiPA Line Probe Assay (LiPA, Innogenetics, Belgium), commercial RMP resistance detecting kit using reverse hybridization method. RESULTS: All of the RMP resistant samples were revealed the presence of mutation by LiPA. In 22 samples (68.8%) out of 32 RMP resistant cases, the mutation types were confirmed by the positive signal at one of 4 mutation bands in the strip. The most frequent type was R5 (S53 IL) which were 17 cases (77.3%). Results of direct sequencing were identified the exact characteristics of 8 mutations which were not comfirmed by LiPA. S522W type point mutation and 9 base pair deletion at codon 513-515 were new identified mutations for the first time. CONCLUSION: Mutations in rpoB gene is the main mechanism of RMP resistance in M. tuberculosis and LiPA is a very useful diagnostic tool for the early diagnosis of RMP resistance in M. tuberculosis.
Base Pairing ; Codon ; DNA-Directed RNA Polymerases ; Drug Resistance, Multiple ; Early Diagnosis ; Isoniazid ; Mycobacterium tuberculosis ; Point Mutation ; Rifampin ; RNA Polymerase I ; Tuberculosis*

A clinical observation was made on 116 patients of cryptorchidism who had been admitted to the Department of Urology, Gil Genersl Hospital during 34 months from March, 1992 to January l995. The results were as follows: 1. The age distribution varies from to 1 to 33 years and the most frequent group was l to5 years old(62%). 2. Bilateral cryptorchidism was found in 22 cases(19%), and in the case of unilatera1, right in 52 cases(44.8%) and left in 42 cases(36.2%). 3. Of the 138 testes, most frequent location was in the inguinal canal in 123 testes(89.1%). 4. Orchiopexy was perrormed on 130 testes(94.2%) by subdartos pouch technique and 7 testes were performed the orchiectomy 5. Among the associated anomalies, the most common anomaly was inguinal hemia in 131 cases and others were contralateral hydrocele, hypospadias, congenital heart disese and syndactyly.
Age Distribution ; Cryptorchidism* ; Female ; Heart ; Humans ; Hypospadias ; Inguinal Canal ; Male ; Orchiectomy ; Orchiopexy ; Syndactyly ; Testis ; Urology

Recently, the incidence of fungal infection increases because of immunosuppressive therapy and chemotherapy. In immunosuppressed transplant recipients, Aspergillus can be a dangerous pathogen, capable of inducing fulminant clinical disease. Invasive fungal infections are life-threatening complications in solid-organ transplantation. Although the rate of fungal infections in transplant recipients is lower than that of other infections, the mortality rate is higher. A 34 year-old male was admitted to our hospital with fever and gross hematuria. He had received renal transplantation 2 years ago and had been transferred the other hospital 1 month ago. Initial laboratory data evaluation showed a pancytopenia and azotemia. We thought that pancytopenia was caused by immunosuppressive agents and infection. The patient was treated with antibiotics but fever was not subsided. After 4 days, he complained of transplant site pain and tenderness to percussion. A percutaneous renal biopsy was performed. Microscopic examination showed invasive aspergillosis in transplanted kidney and perirenal area. We removed the transplanted kidney and perirenal tissue, and prescribed antifungal agents for 3 months.
Anti-Bacterial Agents ; Antifungal Agents ; Aspergillosis ; Aspergillus ; Azotemia ; Biopsy ; Fever ; Hematuria ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney ; Kidney Transplantation ; Male ; Pancytopenia ; Percussion ; Transplants

This study was performed to evaluate the relationship between biological markers of lead exposure and thyroid functions among male workers occupationally exposed to inorganic lead. 30 male workers exposed to inorganic lead at smelting and battery factories were investigated, and 30 male control workers who were not exposed to inorganic lead occupationally were chosen for this study. The data were obtained using direct interview and assessment of biological markers of lead exposure and thyroid indices. As biological markers for lead exposure, blood ZPP. blood lead, urine lead and hemoglobin were measured. As thyroid indices. TSH and FT4were determined. The results of the study were summarized as follows 1. Levels of ZPP, blood lead, and urine lead were significantly higher in lead-exposed group than in nonexposed control group(p<0.01 all). Hemoglobin level was significantly lower in lead-exposed group than in nonexposed group(p<0.01). 2. Study subjects had normal values of TSH and FT4 But TSH level was insignificantly lower in lead-exposed group than in nonexposed control group(p=0.11) and FT4 level was significantly lower in lead-exposed group than in nonexposed group(p<0.01). 3. As the result of simple regression analysis in lead-exposed group. FT4 level was negatively correlated with the amount of smoke, blood ZPP, and blood lead(p < 0.05 all). 4. In lead-exposed group, FT4 was used as a independent variable and age, the amount of smoke, blood ZPP, and blood lead were entered as a dependent variables in the model. As the result of multiple regression analysis with stepwise selection method, the amount of smoke and blood ZPP were negative predictors of FT4(p=0. 04, p=0.09, respectively). In conclusion, levels of TSH and FT4were lower in lead-exposed group than in nonexposed control group. In lead-exposed group, FT4 level was negatively correlated with amount of smoke, blood ZPP, and blood lead in simple regression analysis. To clarify this relation, further research between lead exposure and thyroid function may be required for worker with long-term lead exposure or high lead exposure.
Biological Markers ; Humans ; Male* ; Occupations* ; Osmeriformes ; Reference Values ; Smoke ; Thyroid Gland*

PURPOSE: This study was conducted in order to investigate the nutrient and food intake status, and dietary quality in Korean adults according to abdominal obesity based on waist circumference. METHODS: We analyzed data from the combined 2010~2012 KNHANES (Korean National Health and Nutrition Examination Survey). The analysis included 6,974 adults aged 40 to 64 years. In this study, according to abdominal obesity based on waist circumference (male > or = 90 cm, female > or = 85 cm), we classified the subjects into the obesity group (male, n = 775, female, n = 1,113) and control group (male, n = 2,038, female, n = 3,048). The nutrient and food group intake, ND (nutrient density), NAR (nutrient adequacy ratio), MAR (mean adequacy ratio), INQ (index of nutritional quality), DDS (dietary diversity score), and DVS (dietary variety score) were analyzed using data from the 24-recall method. RESULTS: For male, no significant difference in quality index of the diet was observed between the obesity group and the normal group. In female, in diet quality (ND, NAR, and INQ), vitamin B2 (ND, NAR, and INQ) calcium (NAR), phosphorous (ND, INQ) and potassium (ND) of the obesity group was significantly lower than those of the control group. DDS and DVS in the obesity group (3.57, 30.95) were significantly lower than those of the control group (3.68, 32.84) (p = 0.0043, 0.0002). DVS (DVS > or = 39.9) showed association with lower risk of waist obesity in a logistic regression model after adjustments for multiple confounding factors including age, education, income, alcohol intake frequency, smoking, physical activity, energy intake, and body mass index (OR: 0.616, 95% CI: 0.420-0.903). CONCLUSION: In conclusion, females with abdominal obesity had lower micronutrient intake quality, DVS than those of the control group. In Korean females, food intake variety can adversely affect waist circumference.
Adult* ; Body Mass Index ; Calcium ; Diet ; Eating* ; Education ; Energy Intake ; Female ; Humans ; Logistic Models ; Male ; Micronutrients ; Motor Activity ; Nutrition Surveys* ; Obesity ; Obesity, Abdominal* ; Potassium ; Riboflavin ; Smoke ; Smoking ; Waist Circumference*

OBJECTIVES: Previous studies have shown that the endogenous opioid system, which plays an important role in drinking behavior, might be related to the genetic etiology of alcohol dependence. And a recent study reported that the affinity of micro opioid receptor, which is closely related to the endogenous opioid system activity, is affected by the genotype of micro opioid receptor gene (OPRM1) A118G. To investigate the gender difference in genetic etiology of alcohol dependence, this study examined the association of the genotype of OPRM1 A118G with female alcohol dependence in Koreans. METHODS: The author studied the genotype of OPRM1 A118G in 106 male and 35 female Korean with alcohol dependence and 80 male and 60 female healthy Koreans as control. RESULTS: 1) A statistically significant increase in A/G or G/G (G+) genotype of OPRM1 A118G was observed in women with alcohol dependence compared to the controls. 2) Among men with alcohol dependence, no significant difference in OPRM1 A118G polymorphism was observed relative to the age at which drinking started, age of onset of alcohol-related problems, age of first admission to psychiatric hospital for alcohol-related problems, drinking days per month, drinks per drinking day, family history of alcohol dependence in the first-degree relatives or history of severe alcohol withdrawal symptoms. But the drinking days per month is significantly less in those who have A/G or G/G genotypes of OPRM1 A118G. CONCLUSION: These results suggest that G+ genotypes of micro opioid receptor gene A118G are important genetic factors in the etiology of female alcohol dependence.
Age of Onset ; Alcoholics* ; Alcoholism ; Drinking ; Drinking Behavior ; Female* ; Genotype* ; Hospitals, Psychiatric ; Humans ; Male ; Receptors, Opioid* ; Substance Withdrawal Syndrome