BACKGROUND: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. METHODS: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). RESULTS: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. CONCLUSIONS: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.
Elbow ; Follow-Up Studies ; Fracture Fixation* ; Humans ; Humeral Fractures ; Humerus* ; Muscles ; Peripheral Nervous System Diseases ; Traction ; Transplants ; Treatment Outcome

No abstract available.
Animals ; Rats* ; Wounds and Injuries*

No abstract available.
Brain Neoplasms* ; Brain* ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVE: The justification of informed consent requires that a patient be provided with the information necessary for deciding treatment and able to use such information based on reasonable thinking. The clinical decision to consider anyone who has mental disorder as incompetence without objective assessment does not only encroach human rights of the persons with mental illness, but seriously prevent them from being recovered. Hence the objective assessment of competency is needed in mental health. Our study aimed to develop the Korean Tool of Competency to Consent to Psychiatric Hospitalization and to analyze the reliability and validity of this tool. METHODS: Totally 98 patients with mental illness who were hospitalized in mental hospital, participated in this study. For the subjects a questionnaire composing of 22 questions of understanding, appreciation, reasoning and expression of a choice was used. To investigate validity of this tool, MMSE-K, insight test, estimated IQ, BPRS were conducted. Its reliability and usefulness were examined with Cronbach's alpha, ICC and ROC analysis respectively and criterion related validation performed. RESULTS: As results, this tool shows that agreement between raters is relatively high and the confirmatory factor analysis for constructive validation shows that the tool is valid. Also, for criterion related validation, estimated IQ, insight and MMSE are significantly correlated to understanding, appreciation and reasoning. However competence to express a choice did not show any significant correlation with criterion variables, nor showed BPRS any significant correlation with sub-competences. CONCLUSION: Our study developed the Korean Tool of Competency to Consent to Psychiatric Admission Treatment in the Mentally Ill, verified the reliability and validity of the tool and analyzed the optimum cutoff to distinguish between competence and incompetence in sub-competences. Korean Assessment Tool of Competency to Consent to Psychiatric Hospitalization (KATOC), analyzed the reliability and validity of this tool and presented the cutoff points by subarea. As a result, the reliability and validity of satisfactory levels were verified, the ROC analysis was implemented based on the clinical assessment and the cutoff points were found in understanding, appreciation, expression of a choice and reasoning. Such findings showed that the tool developed by researchers could be very favorably used in Korea.
Hospitalization ; Hospitals, Psychiatric ; Human Rights ; Humans ; Informed Consent ; Korea ; Mental Competency ; Mental Disorders ; Mental Health ; Mentally Ill Persons ; Surveys and Questionnaires ; Reproducibility of Results ; ROC Curve ; Thinking

Platelet-derived growth factor(PDGF) is known to accelerate soft tissue fracture and periodontal bone healing, but little information is available for characterizing the healing of articualr cartilage. This study was designed to demonstrate the regeneration potential of pasteurized autogeneous osteochondral graft when PDFG was applied locally in vivo. Eighteen rabbits in two groups were used in the experiment. The free osteochondral fragment(1x1x1 cm) were taken from distal femur. The fragment were pasteurized in 65degrees C for 5 minutes. In experimental group(group II), the fragment were soaked in 0.25 mg/ml of recombinant human PDGF mixed 5 ml normal saline and reimplanted to the resected site, and followed with local administration of 0.25 mg/ml PDGF to knee joint. In control group(group I), the pasteurized fragment were reimplanted in the resected site without any treatments. The histologic characteristics of the transplanted autografts for three rabbits in each group were observed at 3, 5 and 7 weeks postoperatively. The results were as follows; Group II revealed the more favorable regeneration of articular cartilage, less arthritic changes and more mature arrangement of chondrocytes than group I. Even thought the cartilage is avascular and the regeneration capacity of pasteurized cartilage is severely limited, the regeneration of grafted articular cartilage is thought to be accellerated by increased newly formed blood vessels and soft tissues due to the diffusion of PDGF on grafted cartilage, and probably also by differentiation of mesenchymal cells in the initial stage of experiment. The results of this study suggest that local administration of PDGF could be used for the treatment of posttraumatic or degenerative arthritis and various cartilage damages.
Autografts ; Blood Vessels ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Diffusion ; Femur ; Humans ; Knee Joint ; Osteoarthritis ; Platelet-Derived Growth Factor* ; Rabbits* ; Regeneration* ; Transplants*

No abstract available.
Animals ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats* ; Sciatic Nerve*

No abstract available.
Femur* ; Osteosarcoma*

We have analyzed 27 cases(38.8%) of scapho-lunate(SL) dissociation which were the most com- mon type of total 72 cases of post-traumatic wrist instabilities since 1985. As a result, SL dissociations associated with wrist fracture were 23 cases, more common than simple dynamic SL dissociation(4 cases). Early diagnosis and treatment influenced on their prognosis, and both wrist PA roentgenograms were useful for the confirmative diagnosis of SL dissociation. In 16 cases with early diagnosis, closed reduction, 2 or 3 K-wires fixation under C-arm image and short arm cast for 8 weeks were effective. But in 11 cases with neglected diagnosis and with wrist fractures showed poor results. Excessive wrist ligamentous reconstruction in chronic cases should be avoided because of osteoporosis and wrist stiffness. Conclusively, clinical wrist symptoms are more important than radiological changes in wrist insta- bilites. So if the symptoms are not so severe, we must consider the patient's age, occupation and their social activities etc. to decide the proper way of treatment.
Arm ; Diagnosis ; Early Diagnosis ; Ligaments ; Occupations ; Osteoporosis ; Prognosis ; Wrist

Spinal tuberculosis is curable disease, and early diagnosis is mandatory for early treatment. We reviewedconventional radiographies and CT from Histopathologically confirmed 30 cases of spinal tuberculosis, and comparedthese findings with radiologic findings from 2 cases of pyogenic spondylitis and 4 cases of meastasis. The resultswere as follows: 1. The frequnet site of involvement were thoracolumbar juntion and low lumbar vertebrae, and themost frequent type is multisegmented subligamentous type (93.3%). 2. CT was not of great use in the diferentaldiagnosis of the tuberculosis. Dominant CT findings of tuberculous spondylitis were anterior vertebral bodydestruction, paravertebral soft-tissue mass and thick walled abscess formation occasionally containingcalcification and disc space narrowing, in the setting of an indolent or relatively benign course. 3. CT is thebest modality for imaging the extent and anatomy of the destructive process, the degree of canal encroachment, andthe change of adjacent vital structure. So CT was particularily useful in pre-operative planing of debridement andstabilization surgery. 4. The most common causes of neurologic manifestations in tuberculous spondylitis were thecompression of spinal cord by sequestrated bony fragments and disc material, granulation tissue or abscess in thespinal canal.
Abscess ; Debridement ; Early Diagnosis ; Granulation Tissue ; Lumbar Vertebrae ; Neurologic Manifestations ; Spinal Cord ; Spondylitis ; Tuberculosis ; Tuberculosis, Spinal

In treatment of infected ununited fractures of the tibia, We have solved this disastrous problems by posterior bone graft through posterolateral approach. By this posterior bone graft, We can achieve both bone union and infection contral simultaneously. The results were as follows: 1. Total cases of the infected ununited fractures were 17 cases, among them 16 cases were open fracture initially. 2. They occured more commonly in young adult, 7 cases(41%) were in 4th decade, and all cases were male. 3. Tibial union was achieved in 16 cases and one patient can not walk without brace due to ain on fracture site. 4. Infection was cleared in 16 cases, but one case had intermittent drainage of pus. 5. The most common complication was stiffness of the ankle and tarsal joint. 6. There was no infection in grafted bone.
Ankle ; Braces ; Drainage ; Fractures, Open ; Fractures, Ununited ; Humans ; Male ; Suppuration ; Tarsal Joints ; Tibia ; Transplants ; Young Adult