Twenty five cases of fractures of the femur & tibia on the same leg (floating knee) in 24 patients were treated in St. Mary's Hospital, Catholic Medical College and Center during the period 1977-1985. We studied all of these patients, divided by four groups according to the methods of treatment, retrospectively with analysis of treatment and end result. Our policy of treatment for these multiple fractures in single extremity was directed toward early weight bearing, active and passive knee exercise by early open reduction and rigid internal fixation for both fractures. The results obtained were as follows: l. Of 25 cases, 20 patients were male and 5 were female. 2. The right lower extremity has constituted 56% of the cases. 3. Average age of patients were 37 years. 4. Most common level of fractures was on middle one third of femur (71.4% ) and proximal one third of tibia (46.2%). Of these 25 cases, three cases of femur and one case of tibia were segmental fractures, and one case of femur and five cases of tibia were open fractures initially. 5. Of 28 cases of femur fracture, 23 were given operative treatment and five conservative method. But out of 26 cases of tibia fracture, each half cases of fracture were treated operatively and conservatively. 6. We analysed the final results of treatment by the time of fracture union roentgenologically and five lower limb functions clinically at the termination of treatment. The average time for fracture union was 20.5 weeks for femur and 21.9 weeks for tibia roentgenologically. The acceptable clinical results could be achieved in 18 cases (72%) of early open reduction and rigid internal fixation for both tibia and femur as early as possible after accident for early knee exercises. 7. The status of fractured tibia was the most important factor to treat these multiple fractures in single extremity because of troublesome to start knee exercise and weight bearing.
Clinical Study ; Exercise ; Extremities ; Female ; Femur ; Fractures, Multiple ; Fractures, Open ; Humans ; Knee ; Leg ; Lower Extremity ; Male ; Methods ; Retrospective Studies ; Tibia ; Weight-Bearing

OBJECTIVE: Lectins are cell-agglutinating and sugar specific proteins or glycoproteins of non-immune origin that precipitate glycoconjugates having saccharides of appropriate complementarity. Because of these properties, plant lectins have been used to help characterize the carbohydrate moieties of glycoproteins in the zona pellucida (ZP) of several mammalian species including pigs. Treatment of oocytes with various lectins blocks sperm binding to the ZP in various mammalian species. This study was undertaken to examine the distribution of sugar residues in the ZP of pig oocytes matured in vitro and the ability of spermatozoa to bind to ZP and in vitro penetration in oocytes treated with fluorescein isothiocyanate (FITC)-labelled lectins. MATERIALS AND METHODS: The lectins of Banderiaea simplicifolia (BS-II, bind to beta-D-Nacetylglucosamine), Canavalin ensiformis (Con A, bind to alpha-D-Mannose), Lens culinaris (LCA, bind to alpha-D-Mannose), Ricinus communis (RCA-I, bind to beta-D-Galactose) and Ulex europaeus (UEA-I, bind to alpha-L-Fucose) were examined for spermatozoa penetration, binding capacity to ZP and distribution of lectins. RESULTS: The penetration rates were significantry (p<0.05) higher in control oocytes (63%) than those treated with all lectins, but penetration rates (40~49%) were simililar in group treated with lectins. The incidence of monospermy was similar in oocytes untreated and UEA-I, but it was higher in oocytes treated with BS-II, Con A, RCA-I and LCA. The porcine oocytes cultured for 48 h in TC-199 medium were freed from cumulus cells and treated for 30 min with fluorescein isothiocyanate-labelled lectins. When examined under fluorescein illumination, higher (p<0.001) proportions of oocytes showed fluorescein of zona pellucida after treatment with Con A (93%), LCA (93%) and RCA-I (100%) than BS-II (37%) and UEA-I (50%). All of the oocytes treated with RCA-I exhibited strong fluorescein in the outer region of the zona pellucida while those treated with LCA exhibited strong fluorescein throughout the zona pellucida. BS-II bounded mainly to the outer region and UEA-I bounded mainly to the inner region of the zona pellucida, with either strong or weak fluorescein. At 120 min after insemination in vitro, fewer spermatozoa were bound to the zona pellucida of the oocytes treated with BS-II, Con-A and RCA-I. Of the lectins, Con A most inhibited sperm binding. CONCLUSIONS: These results suggest that beta-D-Galactose residues in the porcine zona pellucida may act as primary sperm receptors and inducers of the sperm acrosome reaction and these sugar residues may be involved in the block to polyspermy.
Acrosome Reaction ; Cumulus Cells ; Fluorescein ; Glycoconjugates ; Glycoproteins ; Herpes Zoster* ; Incidence ; Insemination ; Lectins* ; Lens Plant ; Lighting ; Oocytes ; Plant Lectins ; Ricinus ; Sperm-Ovum Interactions ; Spermatozoa ; Swine ; Ulex ; Zona Pellucida*

No abstract available.
Asthma* ; Child* ; Humans

Open frsctures with extensive soft tissue injuries resulting from motor vehicles and sccidents present serious problems in the management. Authors present the cases who had open, severely com-minuted fractures of femurs with inoperable conditions and we present their follow up analysis.
Femur ; Follow-Up Studies ; Fractures, Comminuted ; Motor Vehicles ; Soft Tissue Injuries

No abstract available.
Trophoblasts*

Dermatomyositis is a disease of unknown etiology characterized by inflammation and degeneration of skeletal muscles and cutaneous abnormalities. Cardiac involvement in dermatomyositis-polymyositis is thought to be rare. In recent year, however, there has been an increasing number of reports on cardiac abnormalities in adult dermatomyositis and polymyositis due to development of noninvasive diagnostic techniques. Categorically, these abnormalities have included electrocardiographic changes, cardiac arrhythmias, congestive heart failure, coronary artery disease, and pericarditis. A 56-year-old woman was admittied to the Ewha womans University Hospital with dyspnea and palpitation. She was diagnosed as having dermatomyositis and followed up our department of Dermatology. Electrocardiogram showed a paroxysmal supraventricular tachycardia at as rate of 195/min. The patient was treated with 240mg/day verapamil p.o, 60mg/day prednisone p.o, there was marked improvement of symptoms. Systematic study of cardiac function utilizing echocardiography, Holter monitoring, thallium-201-scan, and gated blood pool studies were conducted in five newly diagnosed patients with dematomyositis-polymyositis. A significant elevation of serum CPK-MB is indicative of cardiac involvement. Cardiac involvement is a serious prognostic sign. We report a case with the review of the literature.
Adult ; Arrhythmias, Cardiac ; Coronary Artery Disease ; Dermatology ; Dermatomyositis* ; Dyspnea ; Echocardiography ; Electrocardiography ; Electrocardiography, Ambulatory ; Female ; Heart Failure ; Humans ; Inflammation ; Middle Aged ; Muscle, Skeletal ; Pericarditis ; Polymyositis ; Prednisone ; Prognosis ; Tachycardia, Supraventricular* ; Verapamil

No abstract available.
Female ; Humans ; Hysterosalpingography*

No abstract available.
Animals ; Colloids* ; Mice*

BACKGROUND: Endocrine pancreas tumor is a rare disease which incidence is less than 2% of all pancreatic tumors. But it comprises various types of tumor and usually secretes several hormones from one type of tumor although the patient with this tumor complains of sole symptom associated with only one hormone. The mechanism and clinical significance of multiple hormone secretion in the endocrine pancreas tumom are not yet clearly defined. METHODS: We analyzed retrospectively the clinicopathologic features of 20 cases which were operated at Seoul National University Hospital during the period between February 1989 and May 1998. RESULTS: The most common tumor was insulinoma (13 cases) and the second most common tumor was nonfunctioning tumor (6 cases). There was one case of somatostatinoma. Most of the patients with insulinoma complained of neuroglycopenic symptoms. There were 9 cases (45.0%) in which the tumors secreted more than two kinds of hormones, 7 cases in insulinoma, 2 cases in nonfunctioning tumors. Whether the tumor secreted multiple hormones was detected by the method of immunohistochemical staining. Though the tumors secreted more than two kinds of hormones, the patients with the tumors complained of symptoms which were associated with the cell type most strongly stained by immunohistochemical method. Whether or not the tumors secreted multiple hormones was not associated with the pathologic features such as tumor size, histologic patterns of the tumor, status of tumor cell differentiation and malignancy. CONCLUSION: From this results, we suggest that endocrine tumors of the pancreas secreted multiple hormones not by the mechanism of dedifferentiation from already differentiated endocrine cells but by the mechanism of neogenesis of multipotent islet stem cells. Since the relationship between the function of multiple hormone secretion in the endocrine pancreas tumors and islet stem cell would be significant, further study should be needed to find out the function of stem cells and application of stem cells to clinical use.
Cell Differentiation ; Endocrine Cells ; Humans ; Incidence ; Insulinoma ; Islets of Langerhans ; Pancreas* ; Rare Diseases ; Retrospective Studies ; Seoul ; Somatostatinoma ; Stem Cells

E-cadherin is one of intercellular adhesion molecules, and it has been demonstrated that E- cadhedrin acts as an invasion suppressor in vitro and loss of its expression is an important prognostic factor in human malignancies. However the prognostic value of loss of expression of E-cadhedrin in renal cell carcinoma (RCC) remains to be defined. We herein immunohistochemically examined the expression of E-cadhedrin in paraffin- embedded tissues of 43 patients with RCC to investigate the prognostic value of loss of expression of E-cadherin. Twenty three of 43 patients (54.5%) showed loss of expression of E- cadherin. There were significant correlations between loss of expression of E-cadherin and histopathologic grade, Robson stage, T stage, N stage and M stage (all p<0.05). Patients with loss of expression of E-cadherin showed significantly decreased 2 year disease free survival as compared with those with normal expression of E-cadherin (p<0.001). These results suggest that loss of expression of E-cadherin has a ominous prognostic value in patients with RCC.
Cadherins* ; Carcinoma, Renal Cell* ; Cell Adhesion Molecules ; Disease-Free Survival ; Humans ; Prognosis