1. One hundred ninety cases of fractures of the shaft of the tibia treated at the 3rd Army Hospital during the period from January 1968 to July 1969, were analyzed. 2. Twenty eight cases revealed delayed union and nonunion, in which ten involved the lower third of the shaft, five the middle third, and three the upper third of the titial shaft. a) Continued cast immobilization was employed in seven of the delayed union cases for three months. b) Metal plate and screw fixation and bone graft was employed in fifteen cases and in three cases bone graft was employed. c) Tumbling skin graft and Huntington's operation were employed in one case and sequestrectomy and split skin graft were employed in two cases. d) In one case amputation was performed. e) The result of treatment of delayed union and nonunion of the tibia was revealed good union in twenty one cases, delayed union in four cases, nonunion in one case and amputation in one case.
Amputation ; Hospitals, Military ; Immobilization ; Skin ; Tibia ; Transplants

A case of bilateral hip flexion abduction deformity due to iliotibial band contracutre developed after prolonged sitting is reported. The patient was a 23 year-old Army convict who spent a month in a prison cell sitting on the floor all day and complained of pain in both buttocks, radiating to the knees along the hamstring muscles. There was limitation of extension of both hips and knees as well as of the thoracolumbar spine. Roentgenographic examinations revealed a diffuse irregular periosteal reaction on both ischial tuberosities. Laboratory findings were within normal limits. Yount s operation was combined with Soutter's fasciotomy on the left side and the patient was immobilized in a bilateral hip spica cast for 6 weeks. After surgery and cast immobilization, both hip and knee deformities were corrected and symptoms relieved.
Buttocks ; Congenital Abnormalities ; Contracture ; Hip ; Humans ; Immobilization ; Knee ; Muscles ; Prisons ; Spine

We report a case of drug eruption and liver damage due to diaminodiphenyl suIfone(DDS) ingestion in a 17-year-old female. This patient had taken DDS for 20 days, 100mg-200mg daily to treat an unknown skin disease. Thereafter, she had generalized erythematous eruption on whole body, icteric sclera and fever. Liver function test showed abnormality (SGOT 514 unit, SGPT 710 unit, alkarine phosphotase 4. 3 B.U., total biIirubin 7. Oml/dl, direct bilirubin 4. 8mg/dl). The adverse reactiions to DDS are gastrointestinal intolerance, hemolytic, anemia, methemoglobinemia, agranulocytoais, hepatitis, neuritis, psychosis and a skin rash described as a fixed drug eruption, erythema multiforme, exfoliative dermatitis and toxic epidermal necrolysis. In Korea, DDS has been used for the treatment of skin diseases of various types for a long time without prescription, especially in rural areas. This trend is a significant sociomediical problem in Korea.
Adolescent ; Alanine Transaminase ; Anemia ; Bilirubin ; Dermatitis, Exfoliative ; Drug Eruptions* ; Eating ; Erythema Multiforme ; Exanthema ; Female ; Fever ; Hepatitis ; Humans ; Korea ; Liver Function Tests ; Liver* ; Methemoglobinemia ; Neuritis ; Prescriptions ; Psychotic Disorders ; Sclera ; Skin Diseases ; Stevens-Johnson Syndrome

No abstract available.
Urolithiasis*

PURPOSE: The penis has been attracted to everyone associated with various diseases and sexual activity. Lots of materials and instruments has been applied to the penis for sexual arousal. Furthermore, those ar e usually made and applied in inappropriate ways by non-medical personnel. This resulted in lots of complications in various degrees. So, we investigated the real problems concerning various procedures performed on the genitalia by non-medical personnel. MATERIALS AND METHODS: We reviewed retrospectively medical records of 32 male and one female patients having complications which had been developed following some procedures on the genitalia by non-medical personnel from January 1995 to December 1999. These patients were analyzed according to characteristics of the patients, the methods, purposes, complications and treatments. RESULTS: Their age at first visit was various from 12 years to 70 years (mean, 35.8 years). At that time when procedures had been performed, their age were 12 years to 56 yeats (mean, 30.8 years) in 26 cases whose ages were identified. Among them 22cases (66.7%) were the married and 11 (33.3%) were the unmarried. Occupations were various and out-of-work were 10 (30.4%), commerce 8 (24.2%), firm worker 6(18.2%), student 5 (15.2%), and private job manager and the not-identified 2 (6.1%). according to the school career, the high school graduates were 18 (54.6%), the college graduates 7 (21.2%), middle school graduates 4 (12.1%), and 4 were under middle school. These procedures were performed for sexual satisfaction in 29 cases (87.9%) and for cheap and easy circumcision in 4 cases (12.1%), of which 26 cases (78.8%) had been performed by other person and 7 cases (21.2%) by himself. According to the materials used, 22 (66.7%) cases had been injected vaseline or paraffin in to the penis and one (3.0%) into the vulva, and one (3.0%) plicated his penile skin with rubber band using sewing needle, which 24 cases (72.7%) were for enlargement of the genitalia. 2 (6.0%) cases inserted plastic balls into the penile skin for sexual arousal of partner. 3 (9.1%) cases put a metallic ring, a ceramic ring, and a vacuum device over their penis for improving erection quality, respectively. 4(12.1%) cases had applied the commercially-maid self-circumcision devices over their prepuce, Complications were foreign body sensation, pain at erection, inflammation, skin necrosis, and septic condition, which were variable case by case. Treatments were removal of foreign materials and devices, necrotic tissue, and primary repair of defected skin, for that, in 2 (6.0%) cases, skin flap and graft were needed. CONCLUSIONS: Lots of complications, severe in some cases, had been developed on external genitalia following various procedures performed by medically unauthorized person. So, we have to strongly for their purpose and it would be rather harmful. At the same time, we have to strongly recommend the government to control strictly such materials and instruments not to be sold and used inappropriately.
Arousal ; Ceramics ; Circumcision, Male ; Commerce ; Female ; Foreign Bodies ; Genitalia ; Humans ; Inflammation ; Male ; Medical Records ; Necrosis ; Needles ; Occupations ; Paraffin ; Penis ; Petrolatum ; Plastics ; Retrospective Studies ; Rubber ; Sensation ; Sexual Behavior ; Single Person ; Skin ; Transplants ; Vacuum ; Vulva

No abstract available.
Leiomyosarcoma*

It has been generally agreed that most fractures of the humeral shaft are best treated non-operatively although occasionally there are indications for primary operative treatment. Recent advances in internal fixation techniques and instrumentation have led to an expansion of surgical indications, and operative treatment produces higher rates of nonunion, infection and other associated complication when compared with closed treatmet techniques. Because of the significant morbidity of the operative treatment, closed intramedullary fixation techniques that provide stability of the fracture site without opening and reduce the postoperative complications, were developed. In this paper we document forty two fractures of the humeral shafts that were treated by functional bracing(Group I: 24 cases) and intramedullary fixation with functional bracing(Group II: 18 cases) between October, 1982 and August, 1986. And the obtained results were as follows: 1. The everage healing time was 9 weeks in the Group I, and 11 weeks in the Group II . 2. The non-union has not been encountered in the Group I, but non-union and delayed union were 4 cases (22.2%) in the Group II. 3. The complication rate was 9 cases(37.5%) in the Group I, and was 12 cases(66.7%) in the Group II, but deep infection did not occured in all cases. 4. The residual angulation more than 5 degrees was 20 cases(83.3%) in the Group I, and was 2 cases(11.1%) in the Group Il. However the results of the group Il were inferior ot the group I, of more proper selection of the patients, more accurate technique and adequate type of nails have been used, the better results will be taken.
Braces ; Humans ; Postoperative Complications

PURPOSE: This study compared the results of PFC Sigma RP-F(R) total knee arthroplasty with those of conventional total knee arthroplasty using PFC Sigma PS(R) in order to assess the clinical results including the maximal flexion angle after a follow up of at least 2 years. MATERIALS AND METHODS: Forty one cases of total knee arthroplasty were performed with PFC Sigma RP-F(R), and the clinical results were analyzed after a follow up of at least 2 years. The patients were compared with a control group consisting of 41 cases, who underwent total knee arthroplasty with PFC Sigma PS(R) using the following parameters: gender, preoperative diagnosis, and preoperative range of motion, and postoperative range of motion. RESULTS: The mean follow up period was 26.7 months. The KSS score improved from 53.2 preoperatively to 95.6 postoperatively. The KSFS score also improved from 49.7 preoperatively to 96.1 postoperatively. The range of motion increased from 124.3degrees to 128.2degrees. The subjective pain score using visual analogue scale improved from 7.6 preoperatively to 1.4 postoperatively. The group with the PFC Sigma RP-F(R) showed similar clinical results to the PFC Sigma PS(R) except for the range of motion. CONCLUSION: Total knee arthroplasty with PFC Sigma RP-F(R) showed similar clinical results to other models, as well as excellent and predictable results of range of motion at the short-term follow up. A long term follow up study will be needed to demonstrate its effects on increasing the longevity.
Arthroplasty ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Range of Motion, Articular

Prosthetic valve endocarditis(PVE), although uncommon, is associated with significant mortality if the infection spreads into the paravavular structures with later abscess formation. However, combined antibiotic and surgical treatment is often successful. Accurate diagnosis by on echocardiography, effective myocardial protection during operation and increased surgical experience have improved the short-term and long-term outcomes for patients with PVE. A 35-year-old male had a history of replacement of aortic and mitral valve, and tricuspid annuloplasty on August 1994, was admitted due to sudden onset of aphasia, leftward deviation of both eyeballs and spiking fever and diagnosed of having PVE by echocardiography. Reoperation was done after 6weeks of antibiotic treatment. On the operative field, we could notice circumferential vegetation along aortic valve annulus, paravalvular leakage and abscess pocket. The mitral valve annulus was healthy. The patient underwent redo aortic valve replacement using cryopreserved aortic homograft after radical debridement of infected tissue. During the follow up of 7 months period the homograft was well functioning without recurrence of symptoms.
Abscess ; Adult ; Allografts* ; Aortic Valve ; Aphasia ; Debridement ; Diagnosis ; Echocardiography ; Fever ; Follow-Up Studies ; Humans ; Male ; Mitral Valve ; Mortality ; Recurrence ; Reoperation

A 69 year-old male patient was admitted for lumboperitoneal shunt operation due to normotensive hydrocephalus. There was not significant laboratory findings except slightly increased serum potassium(5.0 mEq/1). But we ignored this hyperkalemia probably due to hemolysis because ECG at word and operation room did not reveal any evidence of hyperkalemia. Following induction of an anesthesia with fentanyl 100 ug thiopental(2.5%) 100 mg injection, succinylcholine 60 mg was administered intravenously, and endotracheal intubation was performed. Vecuronium 5 mg was administered intravenously for neuromscular blook. Anesthesia was maintained with nitrous oxide, oxygen and enflurane. During the course of operative procedure, his vital signs were stable(blood pressure 120/70 mmHg, pulse 60/min). After lumboperitoneal shunt was completed without problem, neostigmine 5 mg and glycopyrrolate 0.2 mg was administered for reversal of vecuronium. About 10 minutes after arrival in recovery room, his general condition deteriorated suddenly and radial arterial pulse could not be palpated. Radial arteiial blood pressure wave did not appear and ECG showed asystole and stand-still. Cardiopulmonary resuscitation(CPR) was started with Ambu-bagging, sodium bicarbonate and epinephrine injection with external cardiac massage, but the immediate response was not so good. We re-examined the patients chart and found the past history of chronic renal function impairment. CPR was directed for hyperkalemia including calcium chloride, sodium bicar-bonate and 10% dextrose with insulin. At 5 minutes after CPR, ECG showed regular sinus rhythm with stable vital signs. But ECG still showed hyperkalemic pattern(high tented T wave and prolonged P-R interval). After vigorous and continous treatment for hyperkalemia in recovery room, he regained consciousness and he was transfered to the neurosurgical intensive care unit for further evaluation and treatment. Postoperative course was relatively good and he was discharged on 25th postoperative day without any sequale of cardiac arrest.
Aged ; Anesthesia ; Blood Pressure ; Calcium Chloride ; Cardiopulmonary Resuscitation ; Consciousness ; Electrocardiography ; Enflurane ; Epinephrine ; Fentanyl ; Glucose ; Glycopyrrolate ; Heart Arrest* ; Heart Massage ; Hemolysis ; Humans ; Hydrocephalus ; Hyperkalemia ; Insulin ; Intensive Care Units ; Intubation, Intratracheal ; Male ; Neostigmine ; Nitrous Oxide ; Oxygen ; Recovery Room ; Sodium ; Sodium Bicarbonate ; Succinylcholine ; Surgical Procedures, Operative ; Vecuronium Bromide ; Vital Signs