The stability of the Knowles pinning in the intertrochanteric fractures of the femur was studied to determine which state would best support the load and compared with that of others. Experimental stable and unstable four-part fractures of the intertrochanteric region were produced by manual straight cut in 20 embalmed adult femora. These fracture were stabilized using accurate or inaccurate reduction combined with implant of Knowles pin parallel to calcar femorale or femoral neck. Those specimen were examined for the maximum load supported with the Universal Testing Machine. The results obtained are as follows: 1. Those femora of stable fracture with accurate reduction and Knowles pinning parallel to calcar femorale were failed by load of 140±13kg. 2. Those femora of stable fracture with accurate reduction and Knowles pinning parallel to femoral neck were failed by load of 120±11 kg. 3. Those femora of stable fracture with minimal displacement and Knowles pinning parallel to calcar femorale were failed by load of 110±10.4kg. 4. Those femora of unstable four-part fracture with accurate reduction and Knowles pinning parallel to calcar femorale were failed by 80±9kg.
Adult ; Femur Neck ; Femur ; Hip Fractures ; Humans

Twenty-four hands of eighteen patients of carpal tunnel syndrome were treated with two or times injection of 5 mg dexamethasone and three weeks splinting at the department of orthopedic surgery, Korea University Hospital From Jan. 1980 to Feb.1985. The results obtained were as follows; 1. Physical findings consisted of sensory disturbances in sixteen hands, positive Tinel sign in thirteen, positive Phalen test in eighteen and thenar atrophy in eight. 2. On electromyographic study, delay of motor conduction velocity of the median nerve was noted in twelve cases and sensory nerve velocity in fifteen. 3. Fifteen patients(eighteen cases) were followed up from 6 months to 30 months. Twelve cases(60%) were improved and three cases were recurred.
Atrophy ; Carpal Tunnel Syndrome ; Clinical Study ; Dexamethasone ; Hand ; Humans ; Korea ; Median Nerve ; Orthopedics ; Splints

No abstract available.
Child* ; Humans ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux*

No abstract available.
Humans

A number of noninvasive technics have been advocated as reflecting left ventricular performance. These methods include systolic time intervals, echocardiography and imaging of the left ventricular chamber with radionuclides during systole and diastole. Radionuclide evaluation of left ventricular function by means of the gamma camera and gating currently appears to be the most reliable noninvasive method for approximating angiographic evaluation of left ventricular performance. Utilizing the radionuclide angiography, we measured the left ventricular function in 19 normal healthy control, 60 patients with coronary artery diseases 7 patients with dilated cardiomyopathy, 5 patients with hypertension. 1) Left ventricular ejection fraction decreased in 12 patients with anterior myocardial infarction (39.9+/-11.6%), 17 patients with inferior myocardial infarction (49.9+/-8.4%) and 7 patients with dilated cardiomyopathy (19.0+/-5.8%), and there was a statistically significant difference compared with 19 normal control group (63.5+/-8.2%)(p<0.005). However there were no statistically significant difference between normal control group, patients with hypertension (58.8+/-7.6%) and patients with angina pectoris (60.1+/-6.5%). 2) Left ventricular ejection fraction decreased in both anterior and inferior myocardial infarction, and there was a statisically significant difference between both groups (p<0.01). All 13 patients with acute myocardial infarction had abnormal LVEF (40.5+/-9.1%) whcih was significantly lower than that of 16 patients with old myolardial infarction (50.1+/-10.5%)(p<0.01).
Angina Pectoris ; Cardiomyopathy, Dilated ; Coronary Artery Disease* ; Coronary Vessels* ; Diastole ; Echocardiography ; Gamma Cameras ; Humans ; Hypertension ; Infarction ; Inferior Wall Myocardial Infarction ; Myocardial Infarction ; Radioisotopes ; Radionuclide Angiography* ; Stroke Volume ; Systole ; Ventricular Function, Left*

No abstract available.
Fracture Fixation, Intramedullary

Dysplasia epiphysealis hemimelica (DEH), known as Trevor's disease, tarsoepiphyseal aclasis or la tarsomegalie, is a rare disease characterized by cartilaginous overgrowth of one-half of a single limb. Until now only three cases have been reported in Korea. The ages at initial diagnosis were 2.3 years, 2.5 years and 11.5 years, and patients were two boys and one girl by sex. The chief complaints were genu valgum (2 cases) and valgus of the foot (1 case). Plain radiographs showed bony overgrowth and asymmetrical ossification centers in all cases. MRI showed a definite cartilaginous or osteocartilaginous lesion (T1-weighted: intermediate signal intensity (SI) and T2-weighted: intermediate SI mixed inner high SI). Arthroscopic removal of the loose body was performed in one case and spontaneous regression of the genu valgum was noted in one case. We report upon three additional cases and review the literature.
Diagnosis ; Extremities ; Female ; Foot ; Genu Valgum ; Humans ; Korea ; Magnetic Resonance Imaging ; Rare Diseases

PURPOSE: To find out the process of bone remodelling and risk factors in birth-associated femoral fracture. MATERIALS AND METHOD: We evaluated the four femoral fractures in three neonates about the obstetric and family history, and measured the angulation at the fracture site and the angle between the proximal and distal epiphysis of the femur on the radiographies taken at regular intervals. RESULTS: The incidence of birth-associated femoral fracture was 0.06%. In two cases, fracture angulation and interepiphyseal angle had been decreased. However the angular deformity was worsened in two cases, but the interepiphyseal angle had been decreased regardless to the change of fracture angulation. So the alignment of epiphyseal plate came to normal alignment of joint surface. CONCLUSION: The underlying disorder should be searched, because of its rarity. The physeal reorientation that makes joint alignment near normal irrespective of amount of angular deformity is assumed as the predominant mechanism in remodelling process of the angular deformity.
Congenital Abnormalities* ; Epiphyses ; Femoral Fractures ; Femur ; Growth Plate ; Humans ; Incidence ; Infant, Newborn ; Joints ; Risk Factors

Purpose: To evaluate the clinical and radiographic results of primary bipolar arthroplasty during average 9.8-year period, using a non-cemented Multilock femoral stem and a biarticular acetabular cup. Materials and Methods: This study included 24 patients (29 hips) who underwent primary bipolar hemiarthroplasties with Multilock femoral stems and biarticular cups and who could be followed for more than seven years. Clinically, we evaluated the Harris Hip scores and patient complaints of thigh and inguinal pain. We also evaluated the radiographic measurements around the femoral stems and the bipolar cups. Results: The average Harris Hip score improved from 57.4 points to 91.6 points; and 3 (10.3%) hips were associated with thigh pain and 4 (13.8%) hips with inguinal pain. Around the femoral stem there was a non-progressive radiolucent line less than 1 mm in length in 4 (13.8%) hips and osteolysis was present in 6 (20.6%) hips. With respect to the stability of the fixations, there was osseous ingrowth in 26 (89.7%) hips and fibrous ingrowth in 3 (10.3%) hips. Around the acetabulum there was osteolysis in 5 (17.2%) hips, proximal migration of the cup in 2 (6.9%) hips, and erosion of the acetabular cartilage in 10 (34.5%) hips. There were 3 (10.3%) biarticular cups, which were converted to total hip arthroplasties, but no femoral stems were revised. The overall failure rate of the primary operations was 10.3%. Conclusion: The current study demonstrated favorable results after bipolar hemiarthroplasties with Multilock femoral stems. However, the osteolysis that occurred around the femoral stems and the acetabula emerged as a problem after the total hip arthroplasties. In particular, it is expected that the osteolysis would increase over time and become the main cause for the need for surgical revision.
Acetabulum ; Arthroplasty ; Cartilage ; Follow-Up Studies* ; Hemiarthroplasty* ; Hip ; Humans ; Osteolysis ; Reoperation ; Thigh

BACKGROUND: Angina with normal coronary angiogram has been called syndrome X or microvasclar angina. Pathophysiologic mechanisms for chest pain in this group of patients are not known exactly. This study was performed to compare the insulin level of the patients with syndrome X with that of the healthy asymptomatic volunteers. METHODS: The syndrome X group was consisted of 18 patients(11 men and 7 women). All patients had typical chest pain and positive exercise test with a completely normal coronary andgiogram. Patients with hypertension, diabetes mellitus, and there taking any drug known to affect the insulin secretion were excluded. The control group was consisted of 38 healthy subjects(25 men and 11 women) who were not taking any medications. We measured the plasma glucose insulin and C-peptide concentration during oral glucose tolerance test in both groups. RESULTS: Fasting plasma glucose was normal in all patients in both groups. There were no significant differences in plasma glucose level, during the oral grucose tolerance test. There were no significant differences between control and wyndrome X group in the fasting plasma insulin concentration(5.1+/-2.4 vs 5.9+/-2.7 microg/ml, p>0.05). However, the insulin levels at 60min(47.6+/-20.0 vs 84.0+/-68.0 microg/ml) and 120 min(31.4+/-18.2 vs 92.9+/-83.8 microg/ml)were significantly higher in the syndrome X group(p<0.05). THere were no significant differences in the C-peptide concentrations at fasting, 60 min and 120 min after oral glucose tolerance test between control and syndrome X group(p>0.05). CONCLUSION: As shown in above results, there were significant differences in insulin concentrations, but nor in C-peptide concentrations between control and syndrome X group. Thus it can be suggested that the increased dinsulin level in these patients is resulted from the altered insulin action to the target tissues, not from the pancreatic overproduction of insulin. We suggest that this hyperinsulinemia resulted from the insulin resistance play a possible role in the abnormality of microvascular circulation as a mechanism of Syndrome X.
Blood Glucose ; C-Peptide ; Chest Pain* ; Diabetes Mellitus ; Exercise Test ; Fasting ; Glucose Tolerance Test ; Humans ; Hyperinsulinism* ; Hypertension ; Insulin ; Insulin Resistance ; Male ; Plasma ; Thorax* ; Volunteers