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.

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

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

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*

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

No abstract available.
Mitral Valve*

No abstract available.

No abstract available.
Nortriptyline* ; Pharmacokinetics*