The distal tibial physeal plate is the second most frequently injured physis and the percentile incidence of its injury is reported to reach 11 percent of all physeal injuries. After physeal injuries, many complications may follow such as angulatory deformity, incongruity of the joint surface, and growth disturbance, which are well recognized. Therefore, for preventing these complications, we have to know mechanism of injury and position of foot in injury. There are several published articles about classification of these injuries. The first traumatological classification of ankle injuries in children is the one proposed by Bishop. Although there were many reports about classification since Bishop, those did not mention the position of foot in injury. Recently a modified classification by Dias and Tachdjian added the postiton of the foot during injury to the direction of the force as Lauge-Hansen did. There were only few reports about epiphyseal and physeal injuries of the ankle in Korea. Also, we could not find the reports which dealt with more than forty cases. The authors have made a clinical analysis on forty cases of childrens ankle fractures, and among them twenty-two could be followed over a year, who were treated at the Department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, from June 1981 to December 1986. Children were in age of 3 to 16 years. Forty cases were classified according to modified Dias and Tachdjians. 15 out of 40 cases (37.5%) had supination and external rotation injury, which is the most frequent mechanism of injury in this series. However, one case (2.5%) which was suspected to be axial compression type could not be accommodated to this classification. Twenty-seven cases were treated by gentle closed reduction and immobillization in a plaster cast, and thirteen by open reduction and internal fixation. Among the 22 cases who were followed over a year, five cases had complications, such as angulatory deformity, incongruity of the joint surface, and growth disturbance. Three cases out of these five cases had incongruity of the joint surface.
Ankle Fractures ; Ankle Injuries ; Ankle ; Casts, Surgical ; Child ; Classification ; Congenital Abnormalities ; Foot ; Humans ; Incidence ; Joints ; Korea ; Supination

Low back pain is probable the second most common disease entity to upper respiratory infection in developedconuntry. We were missing at least 50% of the pathologic conditions by using conventional diagnostic modalities inlow back pain. They did tell us nothing or little about facet abnormalities, lateral recesses, vertebral canal andsoft tissues surrounding lumbar spines. High resolutional CT has been the biggest turning point in the diagnosisand management of low back pain. CT make a contribution to reducing the morbidity and probable the cost ofevaluating patiens with low baack pain, and to increasing diagnostic accuracy. We observed 100 cases of lumbar CTusing TCT 80A scanner for the evaluation of low back pain during the period from Apr. 1985 to Sept. 1985 atChung-Ang University Hospital. Lumbar CT scan reveals high-positive findings(98%) in low back pain patients.Common low back disorders in CT are disc bulging(53%), herniated nucleus pulposus(32%), degenerative arthritis inposterior facet joints (27%), spinal stensosis(20%) and postoperative spines(15%). Uncommon low back disorders inCT are compression fracture of verebral bodies, spondylolysis or spondylolisthesis, tropism, transitionalvertebra, Scheuerman's disease, limbic fracture, transverse process or articular process fracture, sacroiliacjoint subluxation, conjoined nerve root and meningocele.
Back Pain ; Fractures, Compression ; Humans ; Low Back Pain ; Meningocele ; Osteoarthritis ; Spine ; Spondylolisthesis ; Spondylolysis ; Tomography, X-Ray Computed ; Tropism ; Zygapophyseal Joint

188Re (beta=22 MeV; gamma=155 keV; T1/2=16.9 hours) is an attractive therapeutic radioisotope which is produced from decay of reactor-produced tungsten-188 parent (T1/2=69 days). 188W has been produced from the double neutron capture reaction of 186W. 188Re can be easily obtained by elution of saline on alumina based 186W/188Re generator, which is commercially available. Complexes labelled with 188Re have been developed for the radiotherapy treatment of diseases because of the desirable nuclear properties of the radioisotope and it's chemical properties similar to those of technetium, a well established diagnostic agent.
Aluminum Oxide ; Humans ; Neutrons ; Parents ; Radiotherapy ; Technetium

Purpose: Dislocation is the second most common cause of failure, after implant loosening, in revisional THA (Total hip arthroplasty), and its evaluation and treatment still remain controversial issue. This study was undertaken to evaluate the risk factors after THA using the posterolateral approach and posterior soft tissue repair. Materials and Methods: Between January 1998 and May 2003, 211 consecutive primary total hip replacement arthroplasties using the posterolateral approach and posterior soft tissue repair were performed by the same surgeon. To compare the dislocation groups (6 cases) with the non-dislocation groups (205 cases), we randomized 120 of the non-dislocation cases. The risk factors for hip dislocation were categorized into patient factors and surgical factors. Patient factors included gender, age, preoperative diagnosis, underlying systemic disease, and alcoholic history. Surgical factors included position of the component (acetabular version and inclination, femoral anteversion), leg length discrepancy, and sum of anteversions of the cup and stem. Their parameters were measured on postoperative radiographs. Statistics were performed with Fishe`s Exact test and T test. Results: Dislocations occurred at an overall incidence rate of 2.8% (6/211cases). There were 4 (1.9%) cases of anterior dislocations and 2 (0.9%) cases of posterior dislocations. Dislocations occurred on average at postoperative day 6.1 and all dislocated hips were reduced with the closed method, except for one case that was treated surgically. There was no statistical significance in patient factors between the two groups, except for neurologic disease and alcoholic history. However, the sum of the acetabular and femoral anteversions in the anterior dislocation group was larger than that of the non-dislocation group by approximately 19 degrees. Conclusion: Our results demonstrated that by using the posterior approach and repair of soft tissue, the posterior dislocation rate after total hip replacement arthroplasty can be reduced and the sum of the acetabular and femoral anteversions had more influence on dislocations after THAs than did either anteversion alone.
Acetabulum ; Alcoholics ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Diagnosis ; Dislocations ; Hip Dislocation* ; Hip* ; Humans ; Incidence ; Leg ; Risk Factors*

PURPOSE: We evaluated both the patients and the normal volunteers to determine the diagnostic criteria of subacromial impingement syndrome. MATERIALS AND METHODS: We analyzed the radiologic finding of Thirty degree of caudal tilt view (TCTV) and Supraspinatus outlet view (SOV) of 100 shoulders from 85 patients with clinically proved subacromial impingement syndrome and normal 100 shoulders from 60 volunteers. RESULT: In TCTV, the protrusion of acromion below the line of extension from inferior surface of clavicle was shown in 94% of the patient group and 48% in normal group. Sharp tip of acromial protrusion was detectable in 55.3% of the patient group and 10.4% in normal group. In SOV, curved type of acromion was seen in 53% of the normal and 50% in patient group. Hooked type of acromion was detected in 3% and 31% of the normal and patient group, respectively. CONCLUSION: Protrusion of acromion at TCTV itself was not a criteria of subacromial impingement syndrome, but more than 7 mm below the line of extension from inferior surface of clavicle was meanigful. In SOV, hooked type of acromion was a criteria of subacromial impingement syndrome but curved type is was not a finding of diagnostic significence. Acromial spur formation on TCTV and SOV was important criteria of subacromial impingement syndrome.
Acromion ; Clavicle ; Healthy Volunteers ; Humans ; Shoulder ; Shoulder Impingement Syndrome* ; Volunteers

PURPOSE: We evaluated both the patients and the normal volunteers to determine the diagnostic criteria of subacromial impingement syndrome. MATERIALS AND METHODS: We analyzed the radiologic finding of Thirty degree of caudal tilt view (TCTV) and Supraspinatus outlet view (SOV) of 100 shoulders from 85 patients with clinically proved subacromial impingement syndrome and normal 100 shoulders from 60 volunteers. RESULT: In TCTV, the protrusion of acromion below the line of extension from inferior surface of clavicle was shown in 94% of the patient group and 48% in normal group. Sharp tip of acromial protrusion was detectable in 55.3% of the patient group and 10.4% in normal group. In SOV, curved type of acromion was seen in 53% of the normal and 50% in patient group. Hooked type of acromion was detected in 3% and 31% of the normal and patient group, respectively. CONCLUSION: Protrusion of acromion at TCTV itself was not a criteria of subacromial impingement syndrome, but more than 7 mm below the line of extension from inferior surface of clavicle was meanigful. In SOV, hooked type of acromion was a criteria of subacromial impingement syndrome but curved type is was not a finding of diagnostic significence. Acromial spur formation on TCTV and SOV was important criteria of subacromial impingement syndrome.
Acromion ; Clavicle ; Healthy Volunteers ; Humans ; Shoulder ; Shoulder Impingement Syndrome* ; Volunteers

BACKGROUND: Alexithymia refers to a specific disturbance in psychic functioning characterized by difficulties in capacity to verbalize affect and to elaborate fantasies. Although initially described in the context of psychosomatic illness, alexithymic characteristics may be observed in patients with a wide range of medical and psychiatric disorders. OBJECTIVE: The present study was to evaluate the relationship between the alexithymia and bronchial asthma, and to compare the results with finding from a group of acute infectious illness subjects. MATERIAL AND METHOD: Alexithymia was measured with on Korean translation of the TAS-20 (Toronto Alexithymic Scale-20 Korea version) and the Scored Archetypal 9 Test(SAT9). Thirty patients with bronchial asthma and thirty patients with acute infectious illness completed these tests. The SAT9 and the TAS-20K scores were compared in the both group, considering the age, gender, education level, and duration of illness. RESULT: Bronchial asthma patients had significantly higher score of on the TAS-20K and SAT9 compared with those with infectious illness(p<0.05). The two scales correlated in expected direction. Alexithymia was significantly related to education level(SAT9: r=0.335, TAS-20K: r=-0.376, p<0.01) and duration of illness(asthma group, SAT9: r=-0.383, TAS-20K: r=0.288, p<0.05). CONCLUSION: Bronchial asthma patients had significantly higher alexithymic scores. This finding suggests that psycliathic consultation may be considered for the management of asthmatic patients with alexithyria.
Affective Symptoms* ; Asthma* ; Education ; Fantasy ; Humans ; Korea ; Weights and Measures

BACKGROUND: The majority of Staphylococcus aureus strains isolated from atopic eczema skin produce toxins like enterotoxin B or toxic shock syndrome toxin-1(TSST-1) as a superantigen and these toxins may contribute to the exacerbation of this skin disease. OBJECTIVE: We designed this study in order to investigate the effect of toxic shock syndrome toxin-1 on IL-4, interleukin-10(IL-10), interleukin-12(IL-12) and IFN- r production by peripheral blood mononuclear cells from normal and atopic patients. METHODS: Peripheral mononuclear cells obtained from ten patients with severe atopic dermatitis and ten healthy volunteers were stimulated with TSST-1 and cultured for 4 days. The amount of IL-4, IL-10, IL-12 and IFN- r in the culture supernatants were determined by a solid-phase enzyme- linked immunosorbant assay. RESULTS: l. After stimulation with TSST-1, IL-4, IL-10, IL-12 and INF- r, production of peripheral mononuclear cells from both atopic patients and healthy volunteers were increased. 2. After stimulation with TSST-1, the amount of IFN- r in the culture supernatants was significantly greater in the healthy controls than in the atopic patients. 3. After stimulation with TSST-1, the amount of IL-10 in the culture supernatants was significantly greater in the healthy controls than in the atopic patients. CONCLUSION: This data indicates that TSST-1 induces Thl-type and Th2-type cytokines associated with parallel Thl and Th2 stimulation in atopic patients and healthy donors. In addition, peripheral mononuclear cells from atopic patients have a diminished capacity to synthesize IFN- r and IL-10 in vitro in response to stimulation with TSST-1. Our results suggest that TSST-1 is not considered as a really important aggravating factor in atopic dermatitis.
Cytokines ; Dermatitis, Atopic ; Enterotoxins ; Healthy Volunteers ; Humans ; Interferon-gamma* ; Interleukin-10 ; Interleukin-12 ; Interleukin-4 ; Interleukins* ; Shock, Septic* ; Skin ; Skin Diseases ; Staphylococcus aureus ; Tissue Donors*

Lyme disease is an infecious disease caused by Borrelia burgdorfieii and has been reported world-wide. The spirochete invades multiple organs and induces manifesations in the skin, joints, neri us and cardiovascular systems. 13espite a considerable amount of serological evidence and isolation of R burgdorferi in ticks, no human case has yet been reported in korea. In this report, we present the first clinical case of Lyme disease in Korea. A female patient, 26 years old, developed clinical signs of eryth m,i chronicum migpans about ten days after traveling to a rural area and responded well to treatment ith entibiotions. Laboratory tests showed elevated IgM and IgG responses to B. burgdorferi, and a spirociete was found in a skin biopsy by electron microscopy.
Adult ; Biopsy ; Borrelia ; Borrelia burgdorferi ; Cardiovascular System ; Female ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Joints ; Korea ; Lyme Disease* ; Microscopy, Electron ; Skin ; Spirochaetales ; Ticks

A Clinical study was done on 90 cases of acute myocardial infarction admitted to Busan Wallace Memorial Baptist Hospital from January, 1977 to Febuary, 1983. The following results have been obtained. 1) The ratio of male to female was 2.2:1. The most age group were 5th decades(35.6%) and over 5th decades(5th decades and 6th decades) were two-thirds of all age group. And annual incidency were increasing tendencies, in 1980-1982 than 1977-1979. 2) Between the preceding diseases and the risk factors, the most common cause was the smoking (60%). And other associated diseases and factors were hypertension(54.4%), hypercholesterolemia (43.8%), hyperlipidemia(51.4%) and angina pectoris (34.4%). 3) The most common inducing factor was physical exertion(33.3%). And others were emotional stress(23.3%), alcohol drinking(10%), rest and sleeping(5.6%). 4) The major symptoms of acute myocardial infarction were precordial or epigastric pain(96.7%), dyspnea(53.3%), radiating chest pain (51.7%) and painless infarction(3.3%). 5) On laboratory data, there were leukocytosis in 50.5% increased SGOT in 68.6%, increased serum LDH in 75.9% and cardiomegaly in chest x-ray film were 82 percents. 6) The ratio between the anterior and inferior infarction on EKG was 1.9:1. 7) When admission, normal sinus rhythms on EKG were 59 percents. And the common associated electrocardiographic abnormalities were ventricular premature beat (23.6%), atrial fibrillation(15.7%), first degree A-V block (15.7%), left ventricular hypertrophy(15.7%). The most common abnormality was ventricular premature beat(23.6%). 8) The mortality rate of acute myocardial infarction was 10 percents. The causes of death were heart failure(33.3%), ventricular arrhythmia(33.3%), sudden death (22.2%) and cardiogenic shock(11.1%).
Angina Pectoris ; Aspartate Aminotransferases ; Busan ; Cardiac Complexes, Premature ; Cardiomegaly ; Cause of Death ; Chest Pain ; Death, Sudden ; Electrocardiography ; Female ; Heart ; Humans ; Hypercholesterolemia ; Infarction ; Leukocytosis ; Male ; Mortality ; Myocardial Infarction* ; Protestantism ; Risk Factors ; Smoke ; Smoking ; Thorax ; X-Ray Film