The result of clinical survey of seventy-five children with supracondylar fractures of the humerus is presented. Sixty-eight fractures had gross displacement, and seven were undisplaced ones. Seven children with undisplaced fractures were treated with simple splinting. Twenty-one fractures with gross displacement were closedly reduced and immobilized by cast. Twenty cases treated with over-head skin traction or skeletal traction, and followed by cast immobilization, and twenty-seven were operatively reduced and were fixed with 2 K-wires. The results obtained were as follows: 1. The average age of children was 6.8 years, and the male and female ratio was 2.1:l. 2. 97.1% (66 cases) was the extension type and 2.9% (2 cases) was the flexion type. 3. Good end results were obtained in the well-reduced groups, such as undisplaced fractures and surgically reduced fractures. Of 27 operated cases, 19 who had early operation without manipulative trial or traction, had excellent results, while 8 who had surgery in delay developed limitation of flexion and/or extension motion of the elbow. Of these 19, two cases developed mild extension limitation as sequella. 4. As complications, incomplete ulnar nerve palsy developed in one case, but it spontaneously recovered in 3 weeks after open reduction. During treatment utilizing the olecranon pin traction, pin tract infection developed in 2 cases, but the infection was controlled by the antibiotic administration and wound dressing. Severe cubitus varus deformity developed in 4 cases among the conservatively treated group (manipulatively reduced group and skeletal traction group). These 4 children had corrective osteotomy. Mild deformity was the inevitable one when it is treated conservatively. Limitation of elbow motion developed in 23 cases (32%) as a sequella. 5. Fracture healed mostly in three weeks after reduction and immobilization. Average hospital stay for conservatively treated patients was 17.2 days, whereas that for surgically treated patients was 5.8 days in average. 6. Early anatomical reduction by any means whether it is surgical or nonsurgical, proved to be only the methods which bring the satisfactory results, and minimize the sequellae.
Bandages ; Child ; Congenital Abnormalities ; Elbow ; Female ; Humans ; Humerus ; Immobilization ; Length of Stay ; Male ; Olecranon Process ; Osteotomy ; Skin ; Splints ; Traction ; Ulnar Neuropathies ; Wounds and Injuries

Mechanical properties of trabecular bone were major particulars to understand a bone's quality and a information of osteoporotic patients. In a measurement of trabecular bone's properties, however, it was very difficult to extract and prepare it's specimen. Thus the goal of this study was to estimate the validity for indentation test which widely used as a non-destructive test of porous materials such as a trabecular bone using a FE analysis. We composed the FE model based on uniaxial compression test and clinical observation. It was able to extend for the simulation of indentation test. In addition to that, this FE model well imitated a behavior of a trabecular bone. We obtained a load-displacement curve by the indentation simulation and calculated the elastic modulus using Pharr's hypothesis. We estimated the validity of the indentation test by comparing compression simulation and indentation simulation. When indenter diameter was five times of pore size, the result of indentation simulation converged on compression simulation. If indentation depth was insufficient, the result of indentation simulation made serious errors. Therefore, to obtain the appropriate result of the indentation test, indenter diameter have to be five times of pore size and indentation depth should be about 8% of indenter diameter at least.
Elastic Modulus ; Humans

The wear or deformation of UHMWPE contact surfaces, one of the major causes of the failure in total knee replacement arthroplasty (TKRA), results from the stress concentration. Thus the kinematics of knee implant should be considered. The objective of this study was to investigate the stress distribution and kinematics of UHMWPE in TKRA. Geometry analysis of UHMWPE was performed using FEM program(ABAQUS 5.8, 1998). 3D auto meshing preprocessor, which made it possible to perform rapid geometry modeling, was developed for the generation of computer model including the effect of the nonlinear soft tissue. For the linear analysis, 2 steps of loading conditions (i) 550N axial compression, (ii) 550N axial compression with 150N shear in AP direction were applied. The compression test using Fuji pressure sensitive film was utilized to validate this finite element analysis. Increasing the femoral frontal radius and closing the frontal clearance reduced the maximum contact stress in inverse proportion to the contact area. Increasing the tibial sagittal radius increased the AP laxity but little affected the conformity.
Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Biomechanical Phenomena ; Computer Simulation ; Finite Element Analysis ; Knee ; Radius

An irreducible atlanto-axial rotatory dislocation(so-called fixation) is an extremely rare deformity. Its stricking features are the delay in diagnosis and the persistent clinical and roentgenographic deformities. The diagnosis is suggested by the plain roentgenograms and is confirmed by operation. A 9 year-old boy having the atlanto-axial rotatory fixation was examined at Pohang St. Mary's Hospital in July 1985 and was treated with skull traction followed by Gallie fusion. He was followed up over a year, and had satisfactory result at last follow-up.
Congenital Abnormalities ; Diagnosis ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Male ; Skull ; Traction

Many researchers report that the measurement of urine calcium concentration during antenatal period is helpful in prediction of having preeclampsia,but some don`t. The purpose of this clinical study is to evaluate the relationship of low calcium level in urine and the develpoment of preeclampsia, and effects of other variables. 24hour urine were collected and measured for the concentration of calcium and creatinine from 769 pregnant women who visited our department of obstetrics at Young-Dong Severeance hospital, Yonsei university medical college for antenatal care from March 1, 1993 to May 31, 1996. One group of 41 women developed preeclampsia and the other didn`t. There were no diffrences in ages and gestational age at urine collection between two groups, but a group with preeclampsia had an increased mean arterial blood pressure. There were signiificant difference in calcium concentration in urine and ratios of concentration of calcium and creatinine from urine collected between gestational ages of 25 weeks and 32 weeks and also in those women younger than 25 years old and their first pregnancy. Our study suggests that the measure ment of calcium level and ratios of urine calcium concentration and creatinine concentration at gestational ages between 25 weeks and 32 weeks in women younger than 25 year old with their first pregnancy is quite helpful inpredicting the develpoment of preeclampsia.
Adult ; Arterial Pressure ; Calcium ; Creatinine ; Female ; Gestational Age ; Humans ; Obstetrics ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Urine Specimen Collection ; Weights and Measures

OBJECTIVE: In the case of internal carotid-posterior communicating (ICPCom) artery aneurysm it is possible to successfully clip the aneurysmal neck without any difficulty. However, if the aneurysmal neck is wide, the aneurysmal sac is giant, the aneurysmal sac is hidden by the anterior clinoid process (ACP), or its dome is located in ventral portion or low-lying ICPCom aneurysm, it is difficult to open the proximal aneurysmal neck and we encounter a barrier in controlling bleeding in case of premature rupture of the aneurysm. They need to be resected the ACP for successful aneurysmal clipping. We propose angiographic criteria for predicting necessity of resection of the ACP before clipping of the ICPCom artery aneurysm. METHODS: Between 1999 and 2003, 16 patients with ICPCom artery aneurysm were treated with the resection of the ACP prior to applying the clip on the neck of the aneurysm. We retrospectively analyzed the preoperative cerebral angiographies, and the clinical and operative findings. We measured various radiometric parameters to reveal the angiographic characteristics. RESULTS: The mean value of the radiographic measurement in case of the cerebral angiography in 16 patients is as follows: angle A (the angle between the midline of the skull and the axis of the C1 segment on A-P view) ranged from 15 to 80 degrees (mean+/-SD, 42+/-5 degrees), angle B (the angle between the axes of the C1 and C2 segments on A-P view) ranged from 70 to 150 degrees (mean+/-SD, 110+/-15 degrees), and distance C (the distance between the tip of the ACP and the most proximal portion of the aneurysmal neck on the lateral view) ranged from 2 to 9 mm (mean+/-SD, 4.5+/-1 mm). CONCLUSION: We have resected the ACP in 16 of the 40 ICPCom aneurysms. The mean values of angle A, angle B, and distance C is 42+/-5 degrees, 110+/-15 degrees, and 4.5+/-1 mm, respectively. We did not encounter any difficulty in clipping in all the cases in which there was no premature rupture of the aneurysm. Most of cases had a good outcome.
Aneurysm* ; Arteries* ; Axis, Cervical Vertebra ; Cerebral Angiography ; Hemorrhage ; Humans ; Neck ; Retrospective Studies ; Rupture ; Skull

A plain abdominal X-ray film (simple abdomen or KUB) is often used to display several types of urinary stones in vivo, or at least for a differentiation between calcium-containing 'radio-opaque' and calcium-noncontaining 'non-opaque' stones. We evaluated whether a KUB film could offer the information on composition of urinary calculi or not. The radiodensity of stone itself, the ratio of radio-opacity between the stones and the 2nd lumbar vertebra or lower renal pole parenchyme were measured in each 20 patients with renal stones above 1cm in diameter and variable compositions. However, such a definite distinction could not be resulted in our study. Therefore, we think that it is not possible to achieve a predictability of stone composition by measuring of its radiodensity on KUB film.
Abdomen ; Humans ; Spine ; Urinary Calculi* ; X-Ray Film

No abstract available.
Urinary Incontinence*

Primary undifferentiated small cell carcinoma of the urinary bladder is a rare tumor. This tumor is basically identical to that of the small cell carcinoma of the lung in clinicopathologic aspect. The origin of the tumor is still obscure, but two hypothesis are proposed. The first is normal and metaplastic neuroendocrine cells located in the bladder mucosa. The second is proliferating mucosal stem cells with multidirectional differentiation. We report a case of undifferentiated small cell carcinoma of the urinary bladder in a 65 year-old man, who presented symptom of hematuria.
Aged ; Carcinoma, Small Cell* ; Hematuria ; Humans ; Lung ; Mucous Membrane ; Neuroendocrine Cells ; Stem Cells ; Urinary Bladder*

Here we report a case of the classical inclusion body myositis. The muscle pathology in a 61-year-old male patient with slowly progressive proximal muscle weakness and atrophy revealed basophilic rimmed vacuoles on light microscope and intracytoplasmic filamentous inclusions with membranous whorls through electron microscope. He did not respond to steroid therapy.
Atrophy ; Basophils ; Humans ; Inclusion Bodies* ; Male ; Middle Aged ; Muscle Weakness ; Myositis, Inclusion Body* ; Pathology ; Vacuoles