From January 1985, to June 1986, 7 cases in which supracondylar and intercondylar fractures of the femur were treated at our orthopaedic department using the Extensile Approach for an anatomical reduction and firm internal fixstion, show successful results in follow up stuides. l. All 7 cases were type III fractures of Neers classification. 2. Among the 7 cases treated surgically using the Extensile Approach, 5 cases showed excellent and good results and the remaining 2 csses showed one fair and one failed results. 3. Probably due to the additional open proximal tibia and patella fracture and delayed surgery from trauma one case had a fair results. The case which failed wss due to ipsilsteral ligamentous injuries and a nerve injury in addition to the femur fracture and slso the impossibility of early knee joint exercise due to associated injuries. 4. None of the results of the 7 csses had any relationship with the patients age. 5. One case of postoperative skin necrosis developed around the tibial tuberosity and was treated successfully by a cross leg flap. 6. In comminuted supracondylar and intercondylar fractures of the femur, the Extensile Approach is thought to be an excellent surgical technique by means of a wide surgical field for an anatomical reduction and firm internal fixation with the repair of associated ligamentous injuries.
Adult ; Classification ; Femur ; Follow-Up Studies ; Humans ; Knee Joint ; Leg ; Ligaments ; Necrosis ; Patella ; Skin ; Tibia

Congenital pseudarthrosis of the tibia was accepted as one of the most difficult disease in respect of the frequency and treatment for the orthopaedists. Since April, 1984, we experienced 3 cases of congenital pseudarthrosis of the tibia, one 2 year-old boy involved left tibia only and the other 4 year-old female involved bilaterally, obtained solid bony union in all which were treated by massive surgical management that contained vascularized bone graft and electric stimulation. Several complications were faced such as refracture, valgus deformities of the ankle, skin irritation sign, angular deformities. But refracture was healed without delayed or nonunion by simple plaster cast immobilization. The vascularized bone graft snd electric stimulation is thought to be more improved methods for the treatment of congenital pseudarthrosis of the tibia. Althought solid bony union was obtained in congenital pseudarthrosis of the tibia, periodic follow-up and adequste management must be mandatory up to the end of the bony growth.
Ankle ; Casts, Surgical ; Congenital Abnormalities ; Electric Stimulation ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Male ; Pseudarthrosis ; Skin ; Tibia ; Transplants

No abstract available.

Lymphomatoid papulosis is a strange disease; clinically benign, histologically malignant. Clinically, it may simulate pityriasis lichenoides et varioliformis acuta. The diagnosis is based on the typical histopathological features suggestive of malignant lymphoma, due to the presence of polymorphous lymphoid infiltrate consisting of small lymphocytes intermingled with conspicuous large atypical cells. We experienced a case of lymphomastoid papulosis in 35-year-old woman. Initially, her skin lesions developed as erythematous papules on the extremities, gradually spreading centrifugally with a tendency to involute slowly without treatment, leaving brown wrinkled surface and shallow ulceration. These skin lesions tended to become worse in warm weather and better in cold weather. At first visit, multiple erythematous grouped, ulcerated papules and nodules are seen. 18 months after first visit, most skin lesions are regressed except 5 erythematous pinhead sized papules on right leg in spite of no treatrnent. Labcratory examiniations of CBC, VDRL, urinatlysis, blood chemistry and chest X-ray were all within normal limits. Histopathologically there were hygerkeratosis, mild acanthosis, exocytosis in epidermis, and numerous lymphoid cells were infiltrated especially on perivascular and periappendegeal area, and many atypical cells showing hyperchromatic nuclei, kidney-shaped nuclei and mitotic figures in dermis.
Adult ; Chemistry ; Dermis ; Diagnosis ; Epidermis ; Exocytosis ; Extremities ; Female ; Humans ; Leg ; Lymphocytes ; Lymphoma ; Lymphomatoid Papulosis* ; Pityriasis Lichenoides ; Skin ; Thorax ; Ulcer ; Weather

This study was performed to observe the infection status of sweetfish, caught from Kwangjung-stream and Namdae-stream in Yangyang-gun, Kangwon-do in August 1989, with the metacercariae of Metagonimus yokogawai. All of 28 sweetfish from Kwangjung-stream were infected with the metacercariae of M. yokogawai. The number of metacercariae in a fish ranged 89-521(224 on average), and the number of larvae/g of flesh was 12 approximately 55 (22 on average). On the other hand, no metacercariae were detected in the fish from Namdae-stream. It has been confirmed that the Kwangjung-stream in Yangyang-gun, Kangwon-do is one of the endemic foci of metagonimiasis in Korea.
English-Abstract ; Fish-Diseases-parasitology ; Heterophyidae-isolation-and-purification ; Korea-epidemiology ; Trematode-Infections-parasitology ; *Fish-Diseases-epidemiology ; *Fresh-Water ; *Heterophyidae- ; *Trematode-Infections-epidemiology

This study was performed to observe the infection status of sweetfish, caught from Kwangjung-stream and Namdae-stream in Yangyang-gun, Kangwon-do in August 1989, with the metacercariae of Metagonimus yokogawai. All of 28 sweetfish from Kwangjung-stream were infected with the metacercariae of M. yokogawai. The number of metacercariae in a fish ranged 89-521(224 on average), and the number of larvae/g of flesh was 12 approximately 55 (22 on average). On the other hand, no metacercariae were detected in the fish from Namdae-stream. It has been confirmed that the Kwangjung-stream in Yangyang-gun, Kangwon-do is one of the endemic foci of metagonimiasis in Korea.
English-Abstract ; Fish-Diseases-parasitology ; Heterophyidae-isolation-and-purification ; Korea-epidemiology ; Trematode-Infections-parasitology ; *Fish-Diseases-epidemiology ; *Fresh-Water ; *Heterophyidae- ; *Trematode-Infections-epidemiology

No abstract available.
Germ Cells* ; Neoplasms, Germ Cell and Embryonal*

Local anesthesia for arthroscopic procedure of the knee is an increasinglv popular technique that avoids the use of general anesthesia and the associated risks of respiratory depression, aspiration, and postoperative sedation. Many authors, for example McGinty etc., Martin, Yoshiya etc., advocated local anesthesia as safe and efficient method for arthroscopic procedures of the knee. We performed arthoroscopy of the knee under local anesthesia on 150 patients for diagnostic and operative purposes between January l993 and December l996. The technique of local anesthesia that we used was that 20cc of 0.5%; bupivacaine with I:200,000 epinephrine was injected into superolateral portal of the knee joint and additional 10-20cc ot 1% lidocaine into the arthroscopic portals. Pnevmatic tourniquet wa, not applied in all cases. We analysed the 150 cases and the results were as follows; The diagnostic arthroscopy was performed in 50 cases and the operative arthroscopy was in 100 cases. The duration ot local anethesia was from 4 hours to 12 hours, with an average of 6 hours. In 35 cases arthroscopy was performed as outpatient procedure and average hospital stay excluding other problem was 5 days. No complication related to systemic toxicity by local anesthetics was observed. Conclusively arthroscopy of the knee under local anesthesia is safe and effective procedure to avoid the risks of general anesthesia but patients selection is very important.
Anesthesia, General ; Anesthesia, Local* ; Anesthetics, Local ; Arthroscopy* ; Bupivacaine ; Epinephrine ; Humans ; Knee Joint ; Knee* ; Length of Stay ; Lidocaine ; Outpatients ; Respiratory Insufficiency ; Tourniquets

OBJECTIVE: The presence of the various cytokines in human peritoneal fluid has been evaluated incompletely. Changes in cytokine lefels may be related to activation of peritoneal macrophage and T-lymphocyte, development of endometriosis, and infertility. This study assesses peritoneal fluid levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-alpha) in infertile women with endometriosis and normal women without endometriosis. Design : Prospective and case-control study in university hospital. MATERIALS AND METHODS: Cytokine levels in peritoneal fluid obtained during laparotomy or laparoscopy from 21 patients in infertile patients in infertile patients with endometriosis and 24 controls undergoing laparotomy or laparoscopy with no evidence of pelvic endometriosis were determined by enzymelinked immunosorbent assay. RESULTS: The mean levels of interleukin-6 in infertile patients with endometriosis and controls were 72.7+/-23.7 pg/ml and 18.5+/-9.7 pg/ml respectively (p=0.02). Similarly, the mean levels of interleukin-8 in infertile patients with endometriosis was significantly higher than that of controls (445.0+/-89.6, vs 45.1+/-48.4, p=0.04). The mean concentration of interleukin-10 in infertile patients with endometriosis was significantly lower than that of controls (1.09+/-0.04 vs 2.19+/-0.03, p=0.03). The level of tumor necrosis factor-alpha was not significantly different between the two study groups. CONCLUSIONS: Increased IL-6 and IL-8 and decreased IL-10 levels in the peritoneal fluid may be related to pathogenesis in the endometriosis and infertility, suggesting that partially contribute to the disturbed immune regulation observed in infertili women with endometriosis.
Ascitic Fluid* ; Case-Control Studies ; Cytokines ; Endometriosis* ; Female ; Humans ; Infertility ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Laparoscopy ; Laparotomy ; Macrophages, Peritoneal ; Prospective Studies ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

PURPOSE: To determine (1) the relationship between the cortical defects seen on 99 mTc-DMSA renal scans and age, and (2) the presence and degree of vesicoureteral reflux, and then to depict the risk factors for cortical defects in children with acute urinary tract infection (UTI). Furthermore, to assess the diagnostic value of VCUG in predicting a defect on 99 mTc-DMSA renal scans. MATERIALS AND METHODS: We studied 134 kidneys in 67 children aged 15 days-10 years (M:F=39:28) in whom symptomatic UTI was present. In all these children, both DMSA renal scans and voiding cystourethrography (VCUG) were performed. Scanning took place within 7 days of diagnosis and VCUG was performed after one month of diagnosis. Scintigraphic findings were graded according to the extent and number of cortical defects. We evaluated the relationships between the cortical defects seen on DMSA scans and age, and the grade of vesicoureteral reflux. The diagnostic value of VCUG in predicting cortical defects was analysed. Results: The prevalence of cortical defects was greater in patients older than two years (38/54, 70%) than in those aged less than two (38/80, 48%). The frequency of cortical defects was related to vesicoureteral reflux (p<0.05) and grade of reflux (p<0.05). As this latter increased, the extent of cortical defects also increased (p<0.05), and DMSA scans revealed the presence of these in 76 of the 134 kidneys (57%) with acute UTI. In 30 of these 76 (39.5%), VCUG demonstrated the presence of vesicoureteral reflex. On the other hand, vesi-coureteral reflex was found in 36 of the 134 kidneys (27%), and in 30 of these 36 (83%), cortical defects were noted. The sensitivity of VCUG in predicting cortical defect was 39.5%, while specificity was 89.7%. The positive predictive value for defects was 83.3%, and the negative predictive value was 53.1%. The relative risk of cortical defect in the presence of vesicoureteral reflux was 1.78. CONCLUSION: Renal cortical defects are significantly related to age and grade of vesicoureteral reflux. Risk factors for developing cortical defects were older age (> or =2yrs) at the time of acute UTI, and high grade of vesicoureteral reflux. The specificity of VCUG in predicting cortical defects is relatively high but the sensitivitiy is low, and a significant proportion of cortical defects therefore occurred in the absence of vesicoureteral reflux.
Child* ; Diagnosis ; Hand ; Humans ; Kidney ; Prevalence ; Radionuclide Imaging* ; Reflex ; Risk Factors* ; Sensitivity and Specificity ; Succimer* ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux