Forty five cases of adult tibial shaft fractures were treated with flexible intramedullary nails under image intensifier at the department of orthopaedic surgery, Capital Armed Forces General Hospital during between April 1986 to July 1988. The results were summarized as follows: 1. 45 cases were all male, the average age was 24.3 years and the most common cause of fractures was sports injury(20 cases) and the second most common cause was traffic accident(18 cases). 2. 11 cases out of 45 cases were open fracture and 34 cases were closed fracture. Eight cases of open fraeture were grade I and three cases were grade II. Twenty eight cases were comminuted fracture. The most common level of the fracture was middle third of the tibial shaft. 3. Average interval from injury to Ender nailing was 13.5 days and the mean duration of permission to full weight bearing was 9.2 weeks. 4. Out of 2 cases of delayed union, the average time of clinical bone union was 9.7 weeks and that of roentgenological bone union was 14 weeks. 5. 11 cases of complication were noted among the 45 cases of tibial shaft fracture which were treated by PGP nailing such as angulation, rotation, ankle joint stiffness, delayed union, shortening, and soft tissue infection. 6. PGP nailing is considered to be a valuable method in treating tibial shaft fracture because of their relative ease of nailing, allowing early weight bearing and decreased complication.
Adult ; Ankle Joint ; Arm ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Male ; Methods ; Soft Tissue Infections ; Sports ; Tibial Fractures ; Weight-Bearing

No abstract available.

PURPOSE: Tubularized incised plate (TIP) urethroplasty, with good results for hypospadias, has recently been reported. We analysed the surgical outcomes according to the site of the urethral opening in children with hypospadias, using TIP urethroplasty with a button hole flap. MATERIALS AND METHODS: Between August 1996 and May 2004, 40 patients with hypospadias were primarily corrected using TIP urethroplasty, with both a conventional and a button hole flap by one surgeon. The medical records of all patients; the levels of meatus, age at surgery, surgical outcomes, complications, methods of second operation and their outcomes, were reviewed retrospectively. The preoperative types of hypospadias were glanular, coronal, anterior penile, mid-shaft, posterior penile and penoscrotal in 8, 7, 9, 6, 4 and 6 boys, respectively. RESULTS: The mean age of the patients was 8.2 years. The overall success rate was 75.0% (30/40). The success rates, according to the type of hypospadias, were 87.5% (7/8), 75.0% (6/8), 77.8% (7/9), 66.7% (4/6), 75.0% (3/4) and 50.0% (3/6) in the glanular, coronal, anterior penile, mid-shaft, posterior penile and penoscrotal types, respectively. Postoperative penile distortion was seen in 37.5 (3/8) and 6.2% (2/32) of the conventional and button hole flap groups, respectively. The incidence of postoperative penile distortion in the button hole flap group was significantly lower than in the conventional group (p=0.046). Complications occurred in eleven patients, including urethrocutaneous fistula (9/11), urethral stricture (2/11) and depressed meatus (1/11). The patients with complications were treated with fistula repair, urethral dilatation and repeated TIP urethroplasty. CONCLUSIONS: Our surgical experiences and outcomes show a high success rate, low complication rate and excellent cosmetic appearance for all types of hypospadias. The incidence of postoperative penile distortion was significantly low. Therefore, TIP urethroplasty, with a button hole flap, can be used as a first choice for all types of hypospadias.
Child ; Dilatation ; Female ; Fistula ; Humans ; Hypospadias* ; Incidence ; Male ; Medical Records ; Retrospective Studies ; Urethra ; Urethral Stricture

Hemiballism-hemichorea is a rare movement disorder that presents unilateral flinging movements of the limbs. Recent studies pointed non-ketotic hyperglycemia as an underlying cause of this movement disorder. We report an elderly women with irregular, involuntary movement of the limbs after her uncontrolled diabetes mellitus was successfully managed by the control of glucose level. Characteristic magnetic resonance imaging findings and the management of this condition were discussed.
Aged ; Diabetes Mellitus ; Dyskinesias ; Extremities ; Female ; Glucose ; Humans ; Hyperglycemia ; Magnetic Resonance Imaging ; Movement Disorders*

The blue rubber bleb nevus syndrome(CRBNS) is a rare disorder characterized by distinctive vascular malformations of the skin and gastrointestinal tract. The syndrome is associated commonly with iron deficiency anemia due to gastrointestinal bleeding. Most cases are sporadic, although a few have been reported with autosomal dominant inheritance. We report a case with clinical characteristics of the blue rubber bleb nevus syndrome. The patient had typical skin manifestations of the BRBNS and chronic iron deficiency anemia. However, we could not find any gastrointestinal vascular malformations radiologically.
Anemia, Iron-Deficiency ; Blister* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Nevus* ; Rubber* ; Skin ; Skin Manifestations ; Vascular Malformations ; Wills

BACKGROUND: Improvements in catheter equipments and increasing experience of the operators have brought about a broadening of the indications and applications of percutaneous transluminal coronary angioplasty(PTCA). In particular, coronary angioplasty has been employed in total occlusions.We evaluated the initial success rate and safety of PTCA total occulsive coronary artery disease. METHODS: To assess the success rate and safety of PTCA total coronary artery occlusion, the data of 24 patients(male 19, female 5, mean age 55+/-9 years), in whom PTCA for total occlusion were performed, were examined. RESULTS: Primary success rate of procedure was 66.7%(16 out of 24 lesions).The success rate according to the duration of total occlusions was 8 out of 11(72.7%) with occlusions<4 weeks duration and 3 out of 7(42.9%) with occlusions>4 weeks duration(p=0.07). There was no difference in success rate according to vassel dilate(left anterior descending 75.0%, right coronary 44.4%) and length of occluded lesion(0.93%+/-0.47%cm, p=0.35). Eight procedural failures included inability to cross the lesion with a guide wire in 6 and inability to dilate the lesion in 2, but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Even though the recanalization of occluded coronary arteries has a lower initial success rate than angioplasty for stenotic arteries, PTCA in total occlusion can be performed as a safe and effective therapeutic modality in selective patients.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arteries ; Catheters ; Coronary Artery Disease ; Coronary Vessels* ; Death ; Emergencies ; Female ; Humans

BACKGROUND: Indications and applications of percutaneous transluminal coronary angioplasty(PTCA) have been broaden recent years. We evaluated the initial success rate and safety of PTCA in mulitiple lesions and vessels. METHODS: To assess the success rate and safety of PTCA In mulitiple lesions and vessels, the data of 60 lesions from 28 patients(male 23, female 5, mean age 56+/-12 years), in whom PTCA for multiple lesions and vessels were performed, were examined. Initial results and complications were compared in 37 lesions undergoing multivessel and 23 lesions undergoing multilesion PTCA. RESULTS: Overall primary success rate of procedure was 82%(49 out of 60 lesions). Angioplasty was attempted in mean 2.1 stenotic lesions per patient. Primary success rate per lesion was 84%(31 of 37) among those who underwent multivessel and 78%(18 of 23) among those who underwent multilesion PTCA(p>0.05). Success rate according to the combination of dilated vessels was 85.7%(12 of 14) in left anterior descending(LAD) and left circumflex(LCX), 83.3%(10 of 12) in LAD and right coronary artery(RCA), 100.0%(4 of 4) in LAD and diagonal branch, RCA and LCX in 75.0%(3 of 4), and 66.7%(2 of 3) in LAD, LCX and diagonal branch. Eleven failures(18.3%) included inability to pass the guide wire cross the lesion or inability to locate the balloon catheter in 5(8,3%), abrupt closure in 2(3,3%), coronary spasm in 1(1.7%) and major branch occlusion in 3(5.0%), but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Coronary angioplasty in selected patients with multivessel and multilesion coronary artery disease might be useful and have relatively good initial results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angioplasty* ; Catheters ; Coronary Artery Disease ; Death ; Emergencies ; Female ; Humans ; Spasm

No abstract available.
Mitral Valve*

PURPOSE: Escalator-related injuries have been considered uncommon and most likely to occur to children. We set out to describe the epidemiology of these injuries with focus on the aging population in order to determine whether or not escalators are safe for the aged, and in order to obtain information to help in preventing escalator-related injuries. METHODS: A prospective survey was undertaken to identify the number and nature of these injuries from May 2004 to June 2006. We enrolled patients who had sustained escalated- related injuries and a standard list of questions and answers were recorded by the emergency physician. A total of 54 Such questionnaires were completed during the study period. Data were analyzed using SPSS 12.0K. RESULTS: The average patient age 63.40+/-20.92 years (range 3-94). There were 18 (33.3%) males. Only 4 (7.4%) were younger than their sixteen year, but 36 (66.7%) were over age 65 and 17 of those were injured from standing on escalators. However of 18 patients younger than age 65, 13 were injured from walking on moving escalators. CONCLUSION: Escalator-related injuries are not as uncommon as previously believed and the aged population over 65 years old is the highest risk group. Additionally, walking on moving escalator was a cause of injuries. Therefore, two orimary prevention strategies are needed. Provision of alternatives to escalators for people over 65 and keeping passengers from walking on escalators.
Aged ; Aging ; Child ; Elevators and Escalators ; Emergencies ; Humans ; Male ; Prospective Studies ; Surveys and Questionnaires ; Walking

BACKGROUND: Vitiligo is an acquired depigmentary disorder characterized by loss of melanocytes from the epidermis. Autografting using the suction blistered epidermis technique is one of the surgical modalities of vitiligo treatment, and has been successfully used by several authots. OBJECTIVE: The purpose of this study was to evaluate the effect of the autografting using the suction blistered epidermis technique for the treatment of vitiligo. METHODS: 142 sites from 39 patients with vitiligo were treated with autografting using the suction blistered epidermis technique. The recipient sites were prepared by freezing with liquid nitrogen of the sites 48 hours prior to grafting. RESULTS: Better results were seen in cases with the following Factors: a) cases where the disease had been present for more than 3 years b) the post-operative period had been Longer than a year c) the Lesional sites of the vitiligo were on the trunk and neck rather than the neck and extremities d) the vitiligo had affected the grabous rather than the hairy areas on the face. However, there were no differences between the clinical types(such as generalized, localized, and segmental) in the success rate of treatment. Preopera'tive PUVA or post operative PUVA also did not affect the statistical results. CONCLUSION: On autografting using the suction blistered epidermis, it is better to select the patients who have had the disease for more than 3 years, and graft the epidermis which has increased melanocytes by preoperative PUVA for good treatment results and even pigmentation.
Autografts* ; Blister* ; Epidermis* ; Extremities ; Freezing ; Humans ; Melanocytes ; Neck ; Nitrogen ; Pigmentation ; Suction* ; Transplantation, Autologous* ; Transplants ; Vitiligo*