The ankle is a modified hinge joint consisting of tibial plafond, medial and lateral malleolus, talus and many soft tissue structures, which plays important role in weight bearing and walking. Hence, the ankle injuries include not only fractures of bone but often also the rupture of ligaments and soft tissues, so if the structures were not accurately repaired, many complications may develop. The authers analysed 98 cases (96 patients) of the ankle fractures which were admitted and treated in Orthopaedic Department, Soon Chun Hyang University Hospital from January 1979 to August 1983. The results obtained are as follows: 1. Of the 98 cases, male was 70 cases(71.9%), female was 28 cases and the average age of the patient was 31,1 years. 2. The most common cause of the fracture was traffic accident and the other causes were slip down, sports injury, fall down and industrial injuries in order. 3. 83 cases(84.7%) out of the 98 cases of ankle fractures were closed fracture and the rest was open fracture. 4. The most common type of the ankle fracture, according to the classification of Lauge-Hansen, was supination external rotation type. 5. 68 cases were treated with open reduction and internal fixation and 30 cases were treated with closed reduction, among the cases of closed reduction, the 14 cases were indicated to open redu- ction but it was impossible due to improper skin condition, severe comminution and anesthetic problem. 6. The average duration of the cast immobilization in closed treatment was 10.1 weeks and in operative treatment was 6.3 weeks. 7. The results of the treatment was better in those cases of the open reduction, the early reduction and the mildly displaced cases than the results of closed reduction, delayed reduction and severely displaced cases. 8. The incidence of complication, such as traumatic arthritis and nonunion occured higher in the cases treated with closed method.
Accidents, Traffic ; Ankle Fractures ; Ankle Injuries ; Ankle ; Arthritis ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Joints ; Ligaments ; Male ; Methods ; Rupture ; Skin ; Supination ; Talus ; Walking ; Weight-Bearing

BACKGROUNDS: Standardization of nucleic acid amplification techniques (NAT) which can be achieved by the use of standard to validate reproducibility and sensitivity in each assay run is necessary before the introduction of such methods for routine screening of blood and blood products for viral contaminants. The objective of this study was to analyze the serological and genotypic characteristics of HCV positive plasmas and to manufacture the HCV RNA national standard candidate. METHODS: We obtained three plasmas from Blood Transfusion Research Institute, Korea, with highly positive HCV RNA plasmas (#37, #40, #46) and with normal plasma for dilution. All the plasmas were confirmed by enzyme immunoassay (EIA) test for anti-HIV, HBsAg, anti-HCV and by polymerase chain reaction(PCR) for HBV DNA, HIV RNA, HCV RNA. The genotypes of those were confirmed by INNO-LiPA HCV II. HCV RNA national standard candidate was manufactured by dispensing the diluted plasma into about 2,000 vials. Each vial was rapidly frozen using liquid nitrogen and was kept in refrigerator at -70 degrees C. RESULTS: All plasmas were identified as anti-HIV, HBsAg, HBV DNA, and HIV RNA negative plasmas. The genotypes of those were confirmed as 1b for #37, 1b or 2 for #40 and 2a or 2c for #46, respectively. Sample #37 was selected as the candidate material. After manufacturing, we obtained 1,944 vials for the candidate. CONCLUSION: In this study, we analyzed HCV positive plasmas and manufactured the HCV RNA national standard candidate. In near future, this material would be established for national standard to increase in the safety of blood and blood products in Korea.
Academies and Institutes ; Blood Transfusion ; DNA ; Genotype ; Hepacivirus ; Hepatitis B Surface Antigens ; HIV ; Immunoenzyme Techniques ; Korea ; Mass Screening ; Nitrogen ; Nucleic Acid Amplification Techniques ; Plasma* ; RNA*

A 14-month-old girl presented with petechial skin lesions and polydipsia was diagnosed as Langerhans cell histiocytosis (LCH) and responded fairly well to multiple chemotherapies using vincristine, cyclophosphamide, and prednisone. 3 years later, relapses were more common with short periods of remissions in spite of using more intensive therapy with vinblatine and etoposide. At age of 4.5, sudden weight gain and abnormal behavior led to MRI study and revealed an hypothalamic mass. Radiation of 1, 800 cGy was given to the mass and followed by a 75% decrease in measuring and remission of the obesity. Although, there was no evidence of tumor progression in the hypothalamus, she died of sepsis due to systemic progression of the disease at age of 5. LCH commonly present with the symptoms of diabetes insipidus, but hypothalamic mass is not common. We report this case with a brief review of literatures.
Cyclophosphamide ; Diabetes Insipidus ; Drug Therapy ; Etoposide ; Female ; Histiocytosis, Langerhans-Cell* ; Humans ; Hypothalamus ; Infant ; Magnetic Resonance Imaging ; Obesity ; Polydipsia ; Prednisone ; Recurrence ; Sepsis ; Skin ; Vincristine ; Weight Gain

Rothmund-Thomson syndrome(RTS), or poikiloderma congenita, is a rare, multisystem disorder. It is inherited genetically as an autosomal recessive trait, occurring predominantly in females(1.4 : 1). The RTS is comprised of poikiloderma, short stature, sparse hair, juvenile cataracts, skeletal defects, dystrophic teeth and nails, photosensitivity, and hypogonadism. We report a case of RTS who died of bleeding from esophageal varices, pulmonary hemorrhage and septic shock at 25 years of age and had suffered from various diseases such as transient pure red cell aplasia, autoimmune hemolytic anemia, chronic maxillary sinusitis, bronchiectasis, secondary hemochromatosis, and liver cirrhosis in addition to poikiloderma, alopecia, and sexual infantalism which are typical of RTS.
Alopecia ; Anemia, Hemolytic, Autoimmune* ; Bronchiectasis ; Cataract ; Esophageal and Gastric Varices ; Hair ; Hemochromatosis ; Hemorrhage ; Humans ; Hypogonadism ; Infant ; Liver Cirrhosis ; Maxillary Sinus ; Maxillary Sinusitis ; Red-Cell Aplasia, Pure* ; Rothmund-Thomson Syndrome* ; Shock, Septic ; Tooth

BACKGROUND: The aim of this study is to assess the prevalence and to investigate the molecular epidemiology of Ambler class A extended-spectrum beta-lactamase (ESBL)-producing Enterobacter cloacae isolates in a university hospital in Busan, Korea. METHODS: Non-duplicated clinical isolates of E.cloacae from patients admitted in Kosin University Gospel Hospital were collected during the period from January through September, 2003. ESBL-production was examined by the double-disk synergy test (DDST) and the transferability of cefotaxime-resistance by conjugation. MICs of beta-lactam antibiotics were determined by the agar dilution method and Ambler class A ESBL genes were searched by PCR amplification. Enterobacterial repetitive intergenic consensus (ERIC) PCR was performed to investigate epidemiological relationships among bla CTX-M-9 gene-carrying E.cloacae isolates. RESULTS: Antimicrobial resistance rates of E.cloacae isolates (n=148) to ceftazidime, cefotaxime, and aztreonam were 50.0%, 29.6%, and 48.0%, respectively. Among 50 E.cloacae isolates intermediate or resistant to more than one expanded-spectrum beta-lactam agent, 41 (27.7%) showed positive results in DDST; of these 41 isolates, 1 was found to carry bla TEM-52 gene, 16 carried bla SHV-12 gene, 4 bla CTX-M-9 gene, and 19 both bla SHV-12 and bla CTX-M-9 genes. The 23 E.cloacae isolates carrying bla CTX-M-9 gene showed 9 different profiles by ERIC PCR. CONCLUSION: ESBL-producing E.cloacae was not uncommon in a university hospital in Busan, Korea. The commonest types of ESBLs produced by E.cloacae isolates were SHV-12 and CTX-M-9. CTX-M-9 ESBL-producing E.cloacae isolates showed diverse ERIC-PCR profiles, indicating that they were not originated from a common source.
Agar ; Anti-Bacterial Agents ; Aztreonam ; beta-Lactamases ; Busan ; Cefotaxime ; Ceftazidime ; Consensus ; Enterobacter cloacae* ; Enterobacter* ; Humans ; Korea ; Molecular Epidemiology ; Polymerase Chain Reaction ; Prevalence

In clinical practice, pharmacological treatment is mostly focused on behavioral symptoms in everyday life. Nevertheless, persistent effort continues to develop medication for causal treatment. Recent changes in diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) to DSM-5 would affect not only diagnosing approaches, but also therapeutic approaches. Because previous pervasive developmental disorders have been integrated into a single entity, the autism spectrum disorder (ASD), we have to prepare for what medications are valuable for the ASD. In this article, we reviewed the following etiological treatment: acetylcholine and glutamate related medicine; amino acid medicine such as secretin, endogenous opioid, and oxytocin; complementary and alternative medicine such as chelating agents, vitamins, and omega-3; promising drugs related to the scope of pharmacogenetics currently under study.
Acetylcholine ; Behavioral Symptoms ; Chelating Agents ; Child ; Autism Spectrum Disorder* ; Complementary Therapies ; Diagnostic and Statistical Manual of Mental Disorders ; Drug Therapy* ; Glutamic Acid ; Oxytocin ; Pharmacogenetics ; Secretin ; Vitamins

Eaton and Littler's ligament reconstruction is used to treat carpometacarpal instability of the thumb using the flexor carpi radialis tendon. This procedure involves a reconstruction of the deep anterior oblique ligament in patients with post-traumatic prearthritic unstable joints. According to a recent paper, the dorsoradial ligament as well as the deep anterior oblique ligament plays an important role in stabilizing the trapeziometacarpal joint. We report three cases of post-traumatic instability in a prearthritic thumb that was treated with Eaton and Littler's reconstruction using the flexor carpi radialis tendon.
Carpometacarpal Joints ; Humans ; Joints ; Ligaments ; Tendons ; Thumb

OBJECTIVES: This study, as a preliminary one attempting to develop the Korean version of Integrated Therapy for the rehabilitation of schizophrenic patients, was designed to investigate the results of Integrated Psychological Therapy(IPT) and review the problems during the program application. METHODS: Cognitive Differentiation Scale, Problem-Solving Scale, and PANSS(Positive And Negative Syndrome Scale) were administered to schizophrenic inpatients before and after IPT incorporating cognitive differentiation, social perception, verbal communication, social skill and interpersonal problem-solving skill subprograms. The therapy groups were offered activities three times per week during the 12-week program. The control groups were attention-placebo groups for control ling factors such as group interaction and social attention, and were offered psychoeducation. RESULTS: The 12-week IPT groups, compared with the control groups, demonstrated significant improvements in the general psychopathology and the total symptoms of PANSS, but did not in cognitive functions and problem-solving skill. Significant improvements in cognitive functions were found only after cognitive differentiation subprogram and social skill subprogram had limited effects on social skills. But within 12-week IPT groups significant improvements in the positive symptoms, negative symptoms and general psychopathology were found. CONCLUSION: These findings support some effectiveness of IPT, but do not address the unique contribution by cognitive components. Applied to schizophrenic patients in this country, this modality had the problems such as differences in sociocultural and lingual background, duration of treatment, homogeneity in the level of the functioning among group members, management of emotions in activities, and the therapists' skill in the training of cognitive components. So the modification of this modality will be required.
Humans ; Inpatients ; Psychopathology ; Rehabilitation ; Schizophrenia ; Social Perception

JL1, a specific epitope on CD43, is a potential biomarker for the diagnosis of acute leukemia. Although qualitative assays for detecting leukemia-specific CD43 exist, there is a need to develop quantitative assays for the same. Here, we developed two novel monoclonal antibodies (mAbs), 2C8 and 8E10, recognizing different epitopes on CD43. These clones are capable of pairing with YG5, another mAb against JL1 epitope, because they were selectively obtained using sandwich ELISA. Antigens recognized by 2C8 and 8E10 were confirmed as CD43 by western blotting using the CD43-hFC recombinant protein. When expression on various leukemic cell lines was investigated, 2C8 and 8E10 displayed a disparity in the distribution of the epitope. Enzyme assays revealed that these mAbs recognized a sialic acid-dependent epitope on CD43. Using normal thymus and lymph node paraffin-embedded tissues, we confirmed a difference in the epitopes recognized by the two mAbs that was predicted based on the maturity of the cells in the tissue. In summary, we developed and characterized two mAbs, 2C8 and 8E10, which can be used with YG5 in a sandwich ELISA for detecting leukemia-specific CD43.
Antibodies, Monoclonal ; Blotting, Western ; Cell Line ; Clone Cells ; Diagnosis ; Enzyme Assays ; Enzyme-Linked Immunosorbent Assay ; Epitopes* ; Leukemia ; Lymph Nodes ; Thymus Gland