No abstract available.
Titanium*

As trochanteric fractures frequently occur in the elderly patients and complications such as pneumonia, thrombo-embolic disease, decubitus ulcer, and urinary tract infection are common, early mobilization after open reduction and internal fixation with hip nail are the standard treatment. Since 1931 when Smith-Peterson first introduced a tri-flanged nail, further more, since 1941 when Jewett pioneered the one-piece nail by adding a solid plate to a Smith-Peterson nail, numorous implants including threaded pins, screws, nails, and plates have been modified and desiged for fractured hips till now to achieve early ambulation and to maintain stable reduction. In 1955 Pugh and Ken introduced a sliding nail-plate and Schumpelick described the use of sliding screw-plate, which was modified further by Callender and Holt pioneered the concept of heavy nail in 1963. Recently compression sliding screw-plate is popular. Also many surgeons such as Evans, Dimon and Hughston, Sarmiento, and Boyd and Anderson have attempted to provide stable fixation of fracture by altering the position of fracture fragments to improve the mechanical resistances of bone to disruptive forces of weight-bearing. The surgical procedures of open reduction and internal fixation were carried out and followed for more than 6 months on 45 intertrochanteric fractures at Department of Orthopedic Surgery, Seoul National University Hospital, from Jan. 1968 to June. 1975 and the results were observed as follows. 1. Of 45 cases of inter-trochanteric fractures 28 cases occurred in man, 17 cases in woman and each mean age was 54 years in man, 74 years in woman. 2. Of fixation devices, Smith-Peterson nail-plates were used in 19 cases, Jewett nails in 15 cases, compression sliding screw-plates in 9 cases, Smith-Peterson nail in 1 case, and Ken sliding nail-plate in 1 case. 3. Stable fractures occurred in 10 cases were fixed internaly after anatomical reduction. 4. Dimon-Hughston reductions and Jewett Nailing were achieved in 11 cases of 12 unstabIe fractures and had disadvantages such as some limitation of R.O.M. of the affected hip, shortening, and valgus deformity. 5. Of 9 unstable fractures treated by compression sliding screw-plate 7 cases were reduced as anatomicaly as possible and 2 cases were reduced non-anatomicaly because of impossible anatomical reduction but good results were obtained except one failed nailing. 6. Of 7 failures, 6 cases resuIted from failures of nailing during operation and only 1 failure resulted in varus defermity after Dimen-Hughston reduction with Jewett nail.
Aged ; Congenital Abnormalities ; Early Ambulation ; Female ; Hip ; Hip Fractures ; Humans ; Orthopedics ; Pneumonia ; Pressure Ulcer ; Seoul ; Surgeons ; Urinary Tract Infections ; Weight-Bearing

We experienced nutiple brain abscess in two neonates. Diagnosis was made CT scan, Which revealed multiple ring-like enhancing leason in both frontoparietal and left posterior parietal cerebral parenchyme. Therapy was consisted of systemic antibiotic treatment and CSF V-P shunt operation due to complicated hydrocephalus. One neonate was died and the other neonate has been followed up due to convulsion and neurological sequale.
Brain Abscess* ; Diagnosis ; Humans ; Hydrocephalus ; Infant, Newborn* ; Rabeprazole ; Seizures ; Tomography, X-Ray Computed

STUDY DESIGN: This is a retrospective study analyzing the results of chip PLIF with pedicle screw instrumentation for various spinal lesions. OBJECTIVES: To analyze the clinical and radiologic results of chip PLIF and to compare the amount of blood loss and transfusion and operation time with the ordinary PLIF. SUMMARY OF LITERATURE REVIEW: The ordinary PLIF has 86-95% of radiologic union rate and 80% of clinical satisfactory rate. The problems of ordinary PLIF were donor site morbidity, limited bone resources, prolonged operation time and excessive blood loss. MATERIALS AND METHODS: Forty patients were treated by chip PLIF utilizing cubical chip bone obtained from spinous process, facets and lamina from October 1995 to October 1997. Twenty-four patients, followed up over 12 months, were included in this study. Radiologic union, disc space collapse and change of kyphotic angle were assessed by simple X-ray and clinical results by improvement of back pain, radicular pain and change of neurological deficits. Twenty-nine patients treated by ordinary PLIF were compared concerning the operation time, amount of blood loss and transfusion. RESULTS: The mean age was 51.5 years(27-68 years) and mean follow-up was 20.7 months(12-30 months). Complete radiologic union rate was 47.6%, which was lower than ordinary PLlf. Satisfactory clinical result rate was 79%, which was similar with other fusion methods. Operation time, amount of blood loss and transfusion were less than the ordinary PLIF. There were three complications that were one dural tear ailed two pedicle screw breakages. CONCLUSION: There was no relationship between radiologic union rate and clinical satisfactory result after chip PLIF. Although operation time is relatively short and blood loss is less, it's not a good method to obtain nice bony union in spinal lesions.
Back Pain ; Follow-Up Studies ; Humans ; Retrospective Studies ; Tissue Donors

PURPOSE: Extensor toe signs are neurologic abnormal finding in upper motor neuron impairment, such as spastic diplegia in cerebral palsy. Though classic Babinski sign is widely used, many other methods elicit extensor toe signs are used as substitutes. However, these methods are not tried whether they are clinically valuable or not. So, we carried out these methods to spastic cerebral palsy patients, compared the sensitivities of these extensor toe sign tests and estimated their clinical value. METHODS: From April, 2000 to August, 2001, thirty patients who had been diagnosed spastic cerebral palsy at Chungnam National University Hospital were tested for extensor toe signs at restful supine position. The sensitivity of every extensor toe sign was compared with each other. RESULTS: The sensitivity of Babinski sign is 76%, Gonda-Allen sign 86%, Allen- Cleckley sign 63%, Chaddock sign 63%, Oppenheim sign 50%, Gordon sign 22% and the others less than twenty percent. Although the sensitivity of Gonda-Allen sign is higher than Babinski sign, it is not statistically significant. But these two methods are superior than the others. CONCLUSION: In patients having upper motor neuron impairments, Gonda-Allen sign and classical Babinski sign are more useful and more sensitive than the other tests, which elicit of extensor toe signs.
Cerebral Palsy* ; Child* ; Chungcheongnam-do ; Humans ; Motor Neurons ; Reflex, Babinski ; Supine Position ; Toes*

Balloon angioplasty of stenosis involving a bifurcation of coronary arteries carries a significant risk of iatrogenic permanent occlusion of one of the adjacent branches. In order to prevent this complication, kissing balloon technique, inhitially, used for aortoplasty in Leriche synrome, was introduced into coronary angioplasty. Alternatively Oesterle described the single-guide, two-wire technique which is less traumatic with nearly equal outcomes. Among 200 coronary angioplasty cases done in our laboratory, 3 cases of unstable angina pectoris with stenosis involving major bifurcation sites were encountered. In 2 cases with stenosis involving left anterior descending artery and diagonal branch, kissing balloon technique was performed. Single-guide, two-wire technique was performed in remaining 1 case with stenosis of posterior descending and posterior lateral branchs. The outcome were successful without major complications.
Angina, Unstable ; Angioplasty* ; Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Coronary Vessels

Diabetes is a metabolic disease, leading to high blood glucose levels, and oral complications were as follows : cheilosis and a tendency toward drying cracking : burning sensations : decrease in salivary flow : alterations in the flora of the oral cavity with greater predominance of Candida albicans : and increased periodontal disease. The increase susceptibility of diabetics to infection has been well known. The cellular and humoral immune systems also require accessory cells, such as macrophages and antigen-presenting cells, for an optimal response to occur. Male rats weighing about 150-200 gm were induced to diabetes by streptozotocin, and were serially sacrificed on the 1st, 2nd, 3rd day and 1st, 2nd, 6th week of experiment. And then histologic examination on the cervical lymph node & S-100 protein positive dendritic cell were carried out under th light microscope. The results of this study were as follow : 1. In control group, cevical lymph node consists of a capsule, cortex, paracortex, medullary sinus and medullary cord. The germinal centers appear in the cortex. The medullary cord was composed of closely packed lymphocytes, and the medullary sinus was full of lymph. In the features of immunohistochemical stain, S-100 protein positive cells were seen in the germinal center. 2. In the 1 day experimental group, the germinal centers were more smaller than that of control group and most of them disappeared. The medullary cord was composed of loosely packed lymphocytes. In the features of immunohistochemical stain. S-100 positive protein cells were decreased and somewhere negative. 3. In the 3 day experimental group, it is similar to 1 day finding but the germinal center had clear margin than that of 1 day experimental group. In the features of immunohistochemical stain, the number of S-100 protein positive cell was decreased and somewhere negative. 4. In the 1 week experimental group, the germinal center was more clear than that of 3 day experimental group and T lymphocytes were scattered in the paracortex. In the medullary cord, density of lymphocyte was more increased. In the immunohistochemical stain, S-100 protein positive dendritic cells were increased in the margin of germinal center and somewhere negative. 5. In the 2 week experimental group, the germinal centers were more recovered. In the medullary cord, density of lymphocyte was increased. In the immunohistochemical stain, S-100 protein positive dendritic cell were increased in the germinal center. 6. In the 6 week experimental group, histologic pattern of cortex and paracortex was similar to control group finding, in the immunohistochemical stain, somewhere the number of S-100 protein positive dendritic cell was similar to control group. From above results, in the streptozotocin induced diabetic rat, as the germinal center of cervical lymph node were decreased and antigen-presenting cell, dendritic cell was affected, the function of cervical lymph node, which was responsible for maxillofacial immune system, was decreased.
Animals ; Antigen-Presenting Cells ; Blood Glucose ; Burns ; Candida albicans ; Dendritic Cells* ; Germinal Center ; Humans ; Immune System ; Lymph Nodes* ; Lymphocytes ; Macrophages ; Male ; Metabolic Diseases ; Mouth ; Periodontal Diseases ; Rats* ; S100 Proteins ; Sensation ; Streptozocin* ; T-Lymphocytes

We already achieved the goal of the elimination of leprosy that was recommended by WHO. But the amazing change of our country's situation of the economical & social conditions makes the need of the migrant worker. Especially, the portion of migrant workers form India, Nepal, Indonesia, Philippines, Bangladesh, & Vietnam, the countries of relatively high prevalence rate of Hansen's disease are increasing among them recently. It means the attention about the influx of Hansen's disease form the foreign countries. We perform the survey for Hansen's disease of the migrant worker. Total 603 workers were surveyed. We found only 4 persons, that had the high titer(above 500) of the result of PGL-1 ELISA, and only 3 persons, that had some findings, the suggestive finding of Hansen's disease, of cutaneous & neurological symptoms. In spite of the special study, we did not conform the diagnosis of Hansen's disease among them. During this survey, we did not find the conformed patients of Hansen's disease. But we think that we will be concerned about the influx of Hansen's disease from foreign countries, because of the recently significance change of the epidemiological situations of Hansen's disease in Korea.
Bangladesh ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; India ; Indonesia ; Korea ; Leprosy* ; Nepal ; Philippines ; Prevalence ; Social Conditions ; Transients and Migrants* ; Vietnam

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*