The discovery and synthesis of vitamin D and the elucidation of the role of sunlight in the activation of the vitamin D precursors changed the syndromes of rickets from a therapeutic enigma to a socioeconomic and public health problem. Since Albright in 1937 first described vitamin D resistsnt rickets, which did not respond to treatment with the usual dose of vitamin D, it has progressively become a common form of rickets in practice. In addition, as the result of increasing understanding of renal physiology and careful investigation, a spectrum of renal tubular abnormalities have been identified which cause clinical rickets and which in many cases are insensitive to even large doses of vitamin D. We have reported a case of an unusual form of vitamin D resistant rickets which did not easily respond to treatment with high doses of vitamin D and was associated with hypocalcemia in multiple pathologic fractures in the lower extremities of the patient.
Familial Hypophosphatemic Rickets ; Fractures, Spontaneous ; Humans ; Hypocalcemia ; Lower Extremity ; Physiology ; Public Health ; Rickets ; Sunlight ; Vitamin D ; Vitamins

BACKGROUND: The prevention of preterm deliveries still remains a major problem in ob-stetrics. The cause of preterm labor is poorly understood. Our purpose was to determine the risk factors for preterm labor associated with specific clinical and environmental factors. METHODS: Using a case-control design, 54 women with preterm labor and 134 controls with term labor, who were admitted to the department of Obstetrics and Gynecology, Dan- kook University Hospital from January, 1996 to August, 1996. The study groups were inte- rviewed and their medical records were reviewed. RESULTS: 1. There were no significant differences of maternal age, maternal weight at 20 weeks of gestation and maternal weight gain at the time of delivery. 2. There were no significant differences between housewives and working women. But the physical workload of the preterm labor group was significantly higher than the control group ( 16.0% vs. 4.0% ). 3. There were no significant differences in the smoking habit of mother or her husba- nd. The passive smoking of the preterm labor group was significantly higher than the con- trol group ( 43.8% vs. 26.8% ). 4. In vaginal bleeding at pregnancy, the preterm labor group was significantly higher than the control group ( 15.7% vs. 2.3% ). Especially, the third trimester vaginal bleeding of the preterm labor group was significantly higher than the control group. 5. There were no significant differences in the number of previous fullterm deliveries, previous abortions, and living children between two groups. The experience of the previous preterm deliveries of the preterm group was significantly higher than the control group ( 11. 5% vs. 0.8% ). 6. There were no significant differences of medications, consumption of alcohol, coffee, tea, green-tea, cola and nutritional beverages, the experiences of coitus, defecation numbers and accidents during pregnancy between two groups. 7. There were no significant differences in the plasma concentrations of hemoglobin, hematocrit, white blood cells, and in the blood pressure, and the body temperature between two groups. CONCLUSION: The risk factors of preterm labor were severe physical workload, vaginal bleeding at pregnancy, especially, the third trimester vaginal bleeding, and the experience of previous preterm deliveries.
Abortion, Induced ; Beverages ; Blood Pressure ; Body Temperature ; Case-Control Studies* ; Child ; Coffee ; Coitus ; Cola ; Defecation ; Female ; Gynecology ; Hematocrit ; Humans ; Leukocytes ; Maternal Age ; Medical Records ; Mothers ; Obstetric Labor, Premature* ; Obstetrics ; Plasma ; Pregnancy ; Pregnancy Trimester, Third ; Risk Factors* ; Smoke ; Smoking ; Tea ; Tobacco Smoke Pollution ; Uterine Hemorrhage ; Weight Gain ; Women, Working

The purpose of this paper is to define the bacterial sources of wound infection after surgery including debridement for open fractures. Total number of patients were 123 during surgery July 1975 to Oct. 1976 at Hangang Sacred Heart Hospital. Out of 123 cases 17 were infected postoperatively. Serial bacterial cultures were performed for specimens taken from the contaminated wound in emergency room and by exposing the Petri-dishes in the operating room. Additional cultures were carried out for 17 specimens taken from the infected wounds postoperatively. Positive bacterial cultures from the initial wounds were obtained in 71 cases (57.7%) out of 123 contaminated wounds in emergency room. Setting monitoring of air contamination in conventional operating room, 51 colonies of bacterial growth per 1 hour exposure were noted and common organisms were colliform bacilli, streptococci and staphylococci in order. Postoperative wound infection rate was 13. 8%. Common pathogens were staphylococcus aureus, coliform bacilli and pseudomonas and kanamycin was most effective antibiotics. The retrospective bacteriological studies for 17 infected cases elucidated following results: 1) Organisms of same species; from initial wound and infected wound postoperatively 7 cases 2) Organisms of same species; from air contamination in the operating room and infectected wound postoperatiyely 5 cases 3) Organism of same species; from air contamination in the operating room, initial wound and infected wound postoperatively 1 case 4) Others (contagious or endogenous origin) 4 cases The results reveal that the initial contaminated open fracture and air contamination during surgery are the main sources of postoperative infection. Four cases which the infectious sources were not determined included in contagious origin dogmaticaIly.
Anti-Bacterial Agents ; Debridement ; Emergency Service, Hospital ; Enterobacteriaceae ; Fractures, Open ; Heart ; Humans ; Kanamycin ; Operating Rooms ; Pseudomonas ; Retrospective Studies ; Staphylococcus aureus ; Surgical Wound Infection ; Wound Infection ; Wounds and Injuries

Malignant tumors arising from tendon and aponeurosis are very rare. Among those reported most have been interpreted as synovial sarcoma or fibrosarcoma until Enzinger in 1965 described a new type which he called “Clear Cell Sarcoma of Tendon and Aponeurosis”. The tumor has a uniform and distinctive clinical and morphological pattern which distinguishes it from other groups of tenosynovial tumors. The problem of its histogenesis remains, especially its relation to synovial sarcoma. In this paper, we reported one case which is believed to be “Clear Sarcoma in the thigh”.
Clothing ; Fibrosarcoma ; Sarcoma ; Sarcoma, Clear Cell ; Sarcoma, Synovial ; Tendons ; Thigh

Delayed diagnosis of the compartmental syndrome and subsequent delay in performing the fasciotomy can result in needless loss of function and possible amputation of the involved extremity. Unfortunately early evidence of this syndrome is difficult to assess. A direct measurement of the tissue pressure within a closed compartment has been developed which provides physicians with reliable information for determining the need for fasciotomy. In the 27 cases of the tibia fracture, tissue pressure was measured directly by method of the needle manometer in the Department of Orthopedic Surgery, Han Kang Sung Sim Hospital from March, 1979 to August, 1979. The results were as follows: 1. The highest mean tissue pressure per hour was 28 mmHg in anterior compartment at 24 hours after trauma, and 28.4 mmHg in deep post compartment at the same hours. 2. The highest pressure measured in all cases was 38 mmHg in anterior compartment at 24 hours and 39 mmHg in deep posterior compartment at 48 hours after trauma. 3. The return of increased tissue pressure to less than 10 mmHg took 122.6 hours in anterior and 124.4 hours in deep posterior compartment. 4. Tissue pressre was higher when there was associated fibula fracture. 5. Tissue pressure was higher in displaced fractures than in undisplaced fractures. 6. Tissue pressure was higher when fracture was in its upper one-third. 7. Tissue pressure was higher in comminuted fracture than simple fracture.
Amputation ; Delayed Diagnosis ; Extremities ; Fibula ; Fractures, Comminuted ; Methods ; Needles ; Orthopedics ; Tibia

Spinal stenosis is defined as any type of narrowing of the main spinal canal, nerve canal or foramina caused by bony or sourrounding soft tissues. Its pressure symptoms are characterized by ill localized back pain, and usually bilateral chronic sciatica. During the past 80 years, the knowledge subjected to the spinal stenosis has been inproved but still many problems are remaining to be solved. Recently, the diagnosis and treatment of spinal stenosis have been facilitated due to introduction of computerized tomographic scanning apparatus. During the period of 3 years, from May 1979 to March 1982, we experienced 40 cases of spinal stenosis at Han Gang Sacred Heart Hospital and Gang Nam Sacred Heart Hospital. In study of this 40 cases clinical and radiological evaluation were made and obtained following result (25 cases of which were operated on). 1. The most common type was degenerative one (50%) 2. There were 16 males and 24 females (4:5) 3. The age distribution showed a peak incidence is the third decade (25%) 4. The most common chief complaint on admission was ill localized chronic sciatica (50%) 5. Decompressive surgery was carried on 25 cases such as; Laminectomy only (8%), Posterolateral fusion (20%), Both Laniinectomy and posterolateral fusion (72%) 6. The longest follow-up was 3 years and the shortest one was 4 months and the average was one year and four months. The outcome of follow-up were; excellent (52%), good (40%), fair (8%), poor (0%).
Age Distribution ; Back Pain ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Humans ; Incidence ; Laminectomy ; Male ; Sciatica ; Spinal Canal ; Spinal Stenosis

Papineau's technique represents an excellent method of dealing with serious bone infections with significant bone and soft tissue loss. The procedure is carried out in three stages: the 1st stage is the excision of infected bone and soft tissue, stabilization of the fracture site, the 2nd stage is the cancellous bone grafting, and the 3rd stage is the skin coverage. During the period from June 1980 to September 1982, our limited experience with 14 cases has been extremely satisfactory; 1. This method is applicable to traumatic osteomyelitis and some cases in which the infection has been blood borne. 2. Successful bone grafting in the presence of infection depends upon; a. complete sequestrectomy and removal of all infected tissue b. an adequate vascular bed for the graft c. no dead space d. sufficient immobilization.
Bone Transplantation ; Immobilization ; Methods ; Osteomyelitis ; Skin ; Transplants

Fractures of the femoral neck in children are rare and usually occur as a result of severe trauma. They are one of the most challenging injuries to treat. Their complication rate is high and their anatomic and physiologic characteristics make treatment difficult. The commonly encountered complications are avascular necrosis, nonunion, coxa vara and premature fusion of epiphyseal plate. Treatment of these fractures remains an unsolved problem but accurate reduction held with adequate internal fixation would appear to offer the best chance for succesful results. We report our observations in the treatment of eighteen cases of fracture of the femoral neck in children. Included is a review of references. The results obtained are as follows: 1. Among 18 patients, 11 were boys and 7 were girls. the highest incidence was between the ages of 5 and 7 years. 2. The main causes of fractures were traffic accidents in 10 cases (55.5%), falling from a height, and slipping down. 3. The commonest type of fracture was the cervicotrochanteric type (47.4%). Twelve cases were displaced fractures (66.7 %). 4. The range of Pauwels angle varied from 20° to 70°. 5. The commonly associated injuries were pelvic bone fractures, extremity fractures, skull fractures and soft tissue injuries. 6. Nine cases were treated by skin traction and plaster cast. Five cases ere treated by closed reduction and internal fixation with K-wires or knowles pins. 7. In 13 of the 18 cases, follow-up studies were done for an average period of 18 months. 8. The results were analyzed according to the Ratliffs assessment. Among the 13 cases, 10 cases showed good results, two fair and one poor. 9. All cases treated by closed reduction and internal fixation showed good results without complications. 10. Complications developed in five cases (38.5%), three cases of avascular necrosis and two cases of coxa vara. Among these five cases, one case of avascular necrosis developed as a result of neglect of the fracture and the others as a result of too conservative a treatment. 11. Secondary treatment of trochanteric arthroplasty was required in only one neglected case. This was further by avascular necrosis and the results were poor. 12. As a result, we recommond closed reduction and internal fixation as the most favorable method of treatment for the fracture of the femoral neck in children.
Accidental Falls ; Accidents, Traffic ; Arthroplasty ; Casts, Surgical ; Child ; Clinical Study ; Coxa Vara ; Extremities ; Female ; Femur ; Femur Neck ; Follow-Up Studies ; Growth Plate ; Humans ; Incidence ; Methods ; Necrosis ; Pelvic Bones ; Skin ; Skull Fractures ; Soft Tissue Injuries ; Traction

A total of 56 subjects with multiple nematode infections with T. trichiura, Ascaris, hookworms and Enterobius were treated with oxantel and pyrantel pamoate mixture in a paratable suspension(50 mg of each per ml). A single dose of 10 mg per kg body weight in each cured 100 per cent of 54 subjects with Ascaris, 97.1 per cent of 35 subjects with hookworms, 77.8 per cent of 36 with Enterobius and 73.2 per cent of 56 subjects with T. trichiura infestation. The mean egg per gram stool reduction rate in T. trichiura infection was 91.9%. Of the 31 subjects infected with Ancylostoma doudenale 96.8% were cured with a single dose and 4 infected with Necator americanus showed a 100% cure rate with a similar daily dose on 3 consecutive days. Side effects were few and mild. There was no clinical or laboratory evidence of drug toxicity. These findings show a single dose of oxantel and pyrantel pamoate mixture to be a highly effective and acceptable treatment for multiple infections with these nematodes.
parasitology-helminth-nematoda ; Trichuris trichiura ; Ascaris lumbricoides ; hookworm ; Enterobius vermicularis ; chemotherapy-oxantel pamoate-pyrantel pamoate

No abstract available.
Bronchiolitis*