Total 40 cases of serial bone scans with Tc99-m-MDP performed on less than 24 hour, 2nd day, 3rd day, 5th day, 1 week, 4 week, 12 week and 1 year respectively after fractures in tibia were analysed. All 5 cases of bone scans performed within 24 hour after injury showed increase in generalized tracer uptake and 3 cases of them(60%) showed localized increase in tracer uptake at the fracture sites. The earliest bone sean performed 9 hour after injury showed generally and locally increased uptake at the fracture sites. All 5 cases of bone scan performed 1 year after injury sinowed localized increased uptake at the fracture sites and 2 cases of them (40%) showed generalized increase in tracer uptake. Bone scans performed 12 week after injury showed the most outstanding increase in generalized and localized tracer uptake. Bone scans performed 1 year after injury showed decreased amount of generalized increase in tracer uptake (but more increased uptake than normal) but the localized increase in traccer uptake at the fracture sites was observed persistently. More study should be needed to clarify the corelationship between the presence of cold spots during the fracture healing and the union of the fractures. It is difficult to differentiate the old fractures to fresh fractures with the bone scans performed within 1 year because of persistent increase in tracer uptake to 1 year after fracture.
Fracture Healing ; Tibia ; Tibial Fractures

After femur neck fracture, many techniques have been known for early detection of the viability of the femoral head which is very important to decide method of treatment. At the present time, bone scan with 99mTc-MDP is the best available radioistope for use in scanning, because it is very sensitive, non-invasive and simple, minimal radiation dose, easily reproducible. Bone scanning was carried out in 18 cases of femur neck fractures from July, 1981 to October, 1982 in Kyung Hee University Hospital. The results were as follows: l. In twelve cases in which radiological confirmation of viability of the femoral head was difficult to make, we could confirm the presence or absence of vascularity of femoral head using bone scan. 2. Six cases which were considered to have vascular impairment to the femoral head radiologically, were identified to have vascular impairment to the femoral head by bone scan and these were evidenced by operative findings and by histology of biopsy specimen. 3. In fresh fractures, we identified the vascular impairment by the bone scan minimally 5 days after injury. 4. In old fractures, we could confirm the viability of the femoral heads by bone scan. 5. Bone scan is considered to be the excellent technique for early detection of the vascular impairment to the femoral head after femur neck fractures.
Biopsy ; Femoral Neck Fractures ; Femur Neck ; Head ; Methods ; Technetium Tc 99m Medronate

No abstract available in English.
Arthroplasty, Replacement, Hip ; Ceramics ; Hip Prosthesis ; Hip

Fracture dislocation or dislocation of the knee can produce a popliteal artery injury that may be difficult to evaluate clinically. Diagnosis of disruption or thrombosis of the popliteal artery is frequently delayed until the opportunity to salvage the extremity is lost. 22 cases of popliteal artery injury were reviewed from July 1978 to December 1983, associated with severe knee trauma at the Orthopaedic department of Kyung Hee University Hospital, of whom average follow-up for about 52 months. The results obtained were as follows; 1. In all 22 cases, 14 cases (63. 6%) were amputated. The amputation rate was correlated with ischemic time after injury. 2. Resection of all injuried vessels with reconstitution of continuity by the use of an interposed saphenous vein graft is often warrented to avoid tension. 3. All 8 patients, which was managed conservatively, were amputated in all cases(100%). In cases of suspicious popliteal artery injury, early aggressive exploration and obvious microvascular reconstruction should be mandatory. 4. Subperiosteal fibulectomy-fasciotomy should be done routinely immediately after vascular injury. 5. Diagnosis of popliteal artery injury was based on the clinical findings but the capillary filling was not contributary. 6. The use of Doppler flowmeter and emergency arteriography was recognizedtobeanexcellent methods in determination of arterial injury.
Amputation ; Angiography ; Capillaries ; Diagnosis ; Dislocations ; Emergencies ; Extremities ; Flowmeters ; Follow-Up Studies ; Humans ; Knee ; Popliteal Artery ; Saphenous Vein ; Thrombosis ; Transplants ; Vascular System Injuries

The cause of osteoporosis are multifactorial; these include aging, immobilization, genetic fsctor, initial bone mass, nulliparity, postmenopause, cigarette, etc. Among them the hormonal factors are very important. It is worthwhile to study the effects of various hormones on bne cells. Authors evaluated the effects of TGB-B, 17-B estradiol, insulin, and human growth hormone as a stimulatory factors, and r-interferon as a inhibitory factor on the MC3T3 osteoblast cells with measurement of cell numbers, osteocalcin and 3[H]-thymidine incorporation. 1. TGF-B was a potent stimulator on ostoblast with increased change in cell morphology (number, size, shape), osteoclacin level and 3[H]-thymidine incorporation in dose depen- dant fashion. 2. 17-B estradiol was also a potent stimulator on osteoblast activity as well as TGF-B except osteoclacin level which w#as not shown in dose dependant fashion. 3. There were little changes on osteoblast with insulin, growth hormone, and r-interferon. Through this study it is confirmed that TGF-B and 17-B estradiol showed marked stimulatory effect on osteoblast cell in vitro.
Aging ; Cell Count ; Estradiol ; Female ; Growth Hormone ; Human Growth Hormone ; Immobilization ; In Vitro Techniques ; Insulin ; Osteoblasts ; Osteocalcin ; Osteoporosis ; Parity ; Postmenopause ; Tobacco Products

From Jan. of 1990 to Dec. of 1992, we have experienced three cases of multiple primary malignant neoplasms originated from different histogenesis, in the Department of Orthopedic Surgery of Korea Cancer Center Hospital. Liposarcomas, malignant fibrous histiocytoma were combined with renal cell carcinoma, mucinous cystadenocarcinoma of ovary or prostatic cancer. With Moertel's classification, synchronous tumors were found in 2 cases and metachronous in 1 case. Synchronous tumors were 2 liposarcomas-renal cell carcinoma or mucinous cystadenocarcinoma of ovary. Metachronous tumors were malignant fibrous histiocytoma-prostate cancer. We couldn t find any family history among them. The causes of these multiple malignancies were considered as the individual predilrection to tumors.
Carcinoma, Renal Cell ; Classification ; Cystadenocarcinoma, Mucinous ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Korea ; Liposarcoma ; Orthopedics ; Ovary ; Prostatic Neoplasms

The Kallmanns syndrome is the most common form of isolated hypogonadotropic hypogonadism in which anosmia or hyposmia resulting from agenesis of hypoplasia of the olfactory lobes is associated with LHRH deficiency, This syndrome is genetically heterogeneous and can be trans-mitted as an X-linked, autosomal dominant or autosomal recessive trait. The hypogonadotropic hypogonadism results in absent or incomplete pubertal development and may be associated with anosmia or hyposmia, mid-line defect(color blindness, cleft-lip or
Blindness ; Cryptorchidism ; Epiphyses ; Femur Neck ; Gonadotropin-Releasing Hormone ; Growth Plate ; Head ; Humans ; Hypogonadism ; Kallmann Syndrome ; Male ; Olfaction Disorders ; Olfactory Cortex ; Slipped Capital Femoral Epiphyses

The 5th year KONSAR surveillance in 2001 was based on routine test data at 30 participating hospitals. It was of particular interest to find a trend in the resistances of enterococci to vancomycin, of Enterobacteriaceae to the 3rd generation cephalosporin and fluoroquinolone, and of Pseudomonas aeruginosa and acinetobacters to carbapenem. Resistance rates of Gram-positive cocci were: 70% of Staphylococcus aureus to oxacillin; 88% and 16% of Enterococcus faecium to ampicillin and vancomycin, respectively. Seventy-two percent of pneumococci were nonsusceptible to penicillin. The resistance rates of Enterobacteriaceae were: Escherichia coli, 28% to fluoroquinolone; Klebsiella pneumoniae, 27% to ceftazidime, and 20% to cefoxitin; and Enterobacter cloacae, > or =40% to cefotaxime and ceftazidime. The resistance rates of P. aeruginosa were 21% to ceftazidime, 17% to imipenem, and those of the acinetobacters were > or =61% to ceftazidime, aminoglycosides, fluoroquinolone and cotrimoxazole. Thirty-five percent of non-typhoidal salmonellae were ampicillin resistant, and 66% of Haemophilus influenzae were -lactamase producers. Notable changes over the 1997-2001 period were: increases in vancomycin-resistant E. faecium, and amikacin- and fluoroquinolone-resistant acinetobacters. With the increasing prevalence of resistant bacteria, nationwide surveillance has become more important for optimal patient management, for the control of nosocomial infection, and for the conservation of the newer antimicrobial agents.
Anti-Bacterial Agents/*pharmacology ; Cephalosporins/pharmacology ; *Drug Resistance, Microbial ; Enterococcus faecium/metabolism ; Human ; Imipenem/pharmacology ; Klebsiella pneumoniae/metabolism ; Korea ; Pseudomonas aeruginosa/metabolism ; Time Factors ; Vancomycin/*pharmacology

BACKGROUND: In general, higher resistance rates are observed among intensive care unit (ICU) isolates than non-ICU isolates. In this study, resistance rates of isolates from ICUs and non-ICUs were compared using the data generated from 20 hospitals in Korea. METHODS: Susceptibility data were collected from 20 hospitals participating in the Korean Nationwide Surveillance of Antimicrobial Resistance (KONSAR) program. Duplicate isolates were excluded from the analysis. The resistance rates did not include intermediate susceptibility. RESULTS: The most prevalent bacteria in the ICUs were Staphylococcus aureus (21%) and Acinetobacter spp. (19%), and those in non-ICU were Escherichia coli (27%) and S. aureus (14%). The resistance rates were higher in ICUs than in non-ICUs at 84% and 58% for methicillin-resistant S. aureus, 86% and 70% for methicillin-resistant coagulase-negative Staphylcoccus (CNS), 34% and 19% for vancomycin-resistant Enterococcus faecium, 38% and 19% for cefotaxime-resistant E. coli, 45% and 25% for cefotaxime-resistant Klebsiella pneumoniae, 42% and 24% for ceftazidime-resistant Enterobacter cloacae, 29% and 11% for ceftazidime-resistant Serattia marcescens, 83% and 44% for imipenem-resistant Acinetobacter spp., and 32% and 17% for imipenem-resistant Pseudomonas aeruginosa, respectively. CONCLUSION: The most prevalent bacteria in ICUs were S. aureus, CNS, and Acinetobacter spp., and high multi-drug resistance rates were observed in the Acinetobacter isolates. Therefore, infection control should be practiced in ICUs to prevent infections caused by multi-drug resistant bacteria.
Acinetobacter ; Bacteria ; Drug Resistance, Multiple ; Enterobacter cloacae ; Enterococcus faecium ; Escherichia coli ; Infection Control ; Intensive Care Units* ; Klebsiella pneumoniae ; Korea ; Methicillin Resistance ; Pseudomonas aeruginosa ; Staphylococcus aureus

Ganglionneuroma is slow-growing benign neoplasm that orignates from the sympathetic nervous system. A case of dumb-bell shaped Ganglionneuroma at first and second cervical areas is presented on this paper with chief complaint of neck pain and quadriparesis. The tumor was totally removed under operating microscope and the diagnosis was pathohistologically confirmed. The postoperative result was good and relative literatures were reviewed.
Diagnosis ; Ganglioneuroma* ; Neck Pain ; Quadriplegia ; Sympathetic Nervous System