No abstract available.

49 strains of Pseudomonas aeruginosa were isolated from chronic wounds associated with orthopedic surgical field at Taegu armed forces general hospital. In the present report, authors have studied the Pyocin type of isolated strains by Gillies and Govans method. Also observed various interrelationship in associaton with Pyocin type, Pyocyanine formation, Oxidase reaction and antibiotic sensitivity. The results were obtained as follows; 1) Among the 49 strains tested in term of pyocin type, 41 strains(81.6%) were found to be typable and 8 strains (16.4%) to be untypable. Among the pyocin type of 41 typables, unclassified type was the most prominent type 17 strains (41.5%) and followed by type I(11 strains), 10 (3 strains), 5 (2 strains) and other type. 2) In the relationship among pyocyanine formation, oxidase reaction and pyocin type, no definite conclusion can be reached due to the paucity of tested strains except that more strains belong to the pyocin type I of the Pyocyanine negative strains. 3) In antibiotic sensitivity of isolated strains tested by plate dilution method, most of all strains were resistant to Kanamycin and Neomycin but few strains were moderate sensitive to Colistin, Polymyxin B, and Terramycin. 4) The Pyocin type of isolated strains were not related with antibiotic sensitivity to Colistin, Polymyxin B and Terramycin substantially.
Arm ; Colistin ; Daegu ; Hospitals, General ; Kanamycin ; Methods ; Neomycin ; Orthopedics ; Oxidoreductases ; Oxytetracycline ; Polymyxin B ; Pseudomonas aeruginosa ; Pseudomonas ; Pyocins ; Pyocyanine ; Wounds and Injuries

Two hundred and eighty six cases of the fracture of the tibial shaft treated at Orthopedic Department of the Chosun University Hospital during the period from January 1974 to December, 1978. The following results were obtained. 1. Most common cases of the tibial shaft fractures were traffic accidents (66.1%). 2. The incidence of trauma was high in the young man, most frequent in the 2nd and 3rd decade (43.0%). 3. The evaluation was done according to the classification of Ellis. Among 286 cases of the fractures of tibial shaft, 139 being mild severity, 70 moderate severity and 77 major severity. 4. The group of mild severity at the fracture of upper 1/3 of tibial shaft was shown the best prognosis and the average healing period was 9.3 weeks. 5. The wound infections in the open fractures of tibial shaft were revealed 37 cases (35%) and 8 cases of chronic osteomyelitis (8%). 6. Of 54 cases, we experienced 38 cases of delayed union (13.3%), 16 cases of non-union (5.6%) and the highest rate of delayed or non-union was shown in the group of major severity at the fracture of lower 1/3 of tibiai shaft. 7. The open reduction by the compression plating reduced the time of healing period and delayed the time of healing period by the intramedullary nailing.
Accidents, Traffic ; Classification ; Fracture Fixation, Intramedullary ; Fractures, Open ; Incidence ; Orthopedics ; Osteomyelitis ; Prognosis ; Wound Infection

Achilles tendon is the most powerful and the biggest tendon of the body and its rupture is frequently sports-related. Many authors reported the effects of mobilization, electricity, ultrasound and various drugs as factors influencing the injured tendon. We studied the effects of early passive mobilization after firm suture using plantaris tendon as tension suture material and reinforcing membrane on the repair of a ruptured Achilles tendon. From March 1992 to December 1995, twenty-two operations on the Achilles tendon were carried out in our hospital. 1. Fourteen patients were male and eight patients were female. The mean patient age was 38 years, ranging from 13 to 68 years. Average follow-up periods was 2 years and 7 months, ranging from 12 months to 3 years and 8 months. 2. The rupture site was 4.7cm proximal to the tendon insertion into the calcaneus on average. 3. We performed the operations with end to end suture technique. After approximation of the ruptured ends of the tendon with a No. 5 Ethibond tension suture using a modified Kessler stitch, placed plantaris tendon in a fascial needle and pass it circumferentially and distal plantaris tendon is fanned out and tacked over the repair. 4. Postoperative treatment was done as following protocol Short leg cast was done with equinus position for initial 3 weeks, and then cast was removed, hydrotherapy and passive exercises was employed. About 6 weeks after operation when the foot can be brought to right angle, a reverse 90degrees ankle stop short leg brace was applied for additional 6 weeks and partial weight bearing was aUowed. 5. Follow-up results were classified according to the Arner-Lindholm scale. We had 16 excellent results and 6 satisfactory results. After rigid suture it may be possible to introduce a regimen of progressive isometric stimulation and protected loading and streching combined with removable orthosis. Such early exercises are likely to improve the rate of rehabilitation over plaster immobilization.
Achilles Tendon* ; Ankle ; Braces ; Calcaneus ; Electricity ; Exercise ; Female ; Follow-Up Studies ; Foot ; Humans ; Hydrotherapy ; Immobilization ; Leg ; Male ; Membranes ; Needles ; Orthotic Devices ; Rehabilitation ; Rupture* ; Suture Techniques ; Sutures ; Tendons ; Ultrasonography ; Weight-Bearing

OBJECTIVE: The study was performed to evaluate whether thallium reinjection (RI) distinguishes viable from nonviable myocardium among myocardial segments which showed persistent perfusion defect (PD) in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: We studied 22 patients underwent PTCA after AMI. SPECT was performed in all patients using dipyridamole stress- 4 hour redistribution (RD) followed by 24 hour RI protocols. Dysfunctional segs were classified into 5 groups: 1) normal, 2) reversible, 3) mild to moderate PD, 4) severe PD and 5) reverse redistribution (RR). All patients underwent follow up echocardiography after 4 months to assess regional wall motion (WM) improvement such as a criteria of viable myocardium. RESULTS: A total of 127 segs with abnormal WM was analyzed. Of 74 segs with PD, 17 (23%) showed enhanced uptake after 24 hour RI. Five of 17 segs (29%) with PD that responded to RI with enhanced thallium uptake showed WM improvement. WM improvement were seen in the 24 of 57 segs (42%) not responding to RI. All four segs (100%) with RR that responded to RI showed improvement. WM improvement were not seen in the 5 of 8 segs (71%) with RR not responding to thallium RI. Eleven (73%) of 15 segs with mild-moderate PD after RI showed improvement, but 33% of segs with severe PD after RI did not showed improvement. Segs with mild-moderate PD after RI and fill in after RI showed improvement in comparison to segs with severe PD after RI(p<0.05). CONCLUSIONS: These data indicate that because only small proportion of PD showed further perfusion improvement after RI and predictive value by the uptake after RI was low, there was limited role of RI after myocardial infarction. Usefulness of RI could be found in segs showing RR responding to RI in AMI reflects viable myocardium.
Dipyridamole ; Echocardiography ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Myocardium ; Perfusion ; Thallium ; Tomography, Emission-Computed, Single-Photon

The present study was carried out to clarify the anatomical changes of lumbar intervertebral discs by aging. Anterior height, posterior height, anteroposterior diameter of intervertebral discs were measured on 512 normal plain lateral radiographs of lumbosacral spine. And the indices of disc wedging and relative disc height were calculated. There was a cephalocaudal gradient of increase in the indices of disc wedging in all age groups. The indices of relative disc height were constant at all lumbar levels. These suggest that the lower disc is more wedge shaped and the height of discs changes in the constant ratio with that of vertebral body.
Aging* ; Humans ; Intervertebral Disc* ; Spine

BACKGROUND: Genus of Aspergilli are ubiquitous saprophytic molds in nature, but its change from a saprophytic fungus to a pathogenic organism has occurred since the use of various antibiotics. The fungus affects the chronically ill and debilitated population. Recently frequency of the fungal infection is increasing in Korea with abuse of antibiotics and glucocorticoids. METHOD: We analyzed medical records of 52 patients with pulmonary aspergillosis seen at Hanyang University Hospital from 1980 to 1994. The results were as follows; RESULTS: 1) Ages ranged between second to eighth decades with majority(50%) in the fourth to fifth decades. The male to female ratio was 1.1:1. 2) Hemoptysis and productive cough, the leading symptoms, occurred in 42.3% and 25% respectively. 3) On chest X-ray fingings, the characteristic 'fungus ball' pattern were observed in 53.8% of the 52 cases. 4) Sputum culture for aspergilli were positive in 21.6% of the cases. We performed foe needle aspiration in 22 patients and the diagnostic yield was 100%. 5) Thirty-six patients had history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis for an average of 27.3 months. But sputum analysis for acid-fast bacilli were positive in 5.6%(2cases of 36cases), and postoperative pathologic findings showed that 38.9% (12 cases of 28cases) were combined with tuberculosis. 6) Right upper and left upper lobes were predominantly involved(34.6% and 19.2% respectively) and lobectomies were performed in 21 cases. 7) Underlying diseases were present in 47 cases and 48.9% of them were pulmonary tuberculosis. CONCLUSION: These results showed that pulmonary aspergillosis usually develops in patients with open cavitary pulmonary tuberculosis. And we must consider the possibility of pulmonary aspergillosis in a patient with hemoptysis and cavitary lung lesion.
Anti-Bacterial Agents ; Aspergillus ; Chronic Disease ; Cough ; Diagnosis ; Female ; Fungi ; Glucocorticoids ; Hemoptysis ; Humans ; Korea ; Lung ; Male ; Medical Records ; Needles ; Pulmonary Aspergillosis* ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital hypothyroidism can ameliorate and possibly reverse its consequences. Treatment with L-thyroxine is started in case of suspicious hypothyroidism at the first visit. Serum concentration of total and free thyroxine become normal within 1week after start of therapy but TSH values become normal from 2 months to 6 months after L-thyroxine therapy. The possible explanations for prolonged TSH elevation in congenital hypothyroidism are poor compliance for therapy, an inadequate dose of L-thyroxine, elevated threshold for thyrotropin suppression and two novel mutations in the thyrotropin (TSH) receptor gene in a child with resistance to TSH. Authors have experienced two cases of prolonged TSH elevation with normal T3 and T4 levels till 18months and 27 months of age after optimal L-thyroxine therapy and literature were reviewed.
Child ; Compliance ; Congenital Hypothyroidism* ; Humans ; Hypothyroidism ; Infant, Newborn ; Mass Screening ; Thyrotropin ; Thyroxine

PURPOSE:The incidence of glucose intolerance is increased in patients with Turner syndrome. Both noninsulin dependent diabetes mellitus and insulin dependent diabetes mellitus are increased. The purpose of this study was to investigate the impaired rate of carbohydrate metabolism in Turner syndrome after growth hormone treatment. METHODS:We investigated the incidence of carbohydrate intolerance and diabetes mellitus in 94 patients with Turner syndrome with NDDG and WHO criteria. The oral glucose tolerance test was performed in 78 patients. In 12 patients treated with growth hormone, the glucose tolerance test was performed before and after treatment. The insulin tolerance test was done in 20 patients. RESULTS:Only one patient had random plasma glucose level of more than 200 mg/dl. In results of the glucose tolerance test(n=78), 2 patients had glucose tolerance by NDDG criteria and 7 patients had it by WHO criteria. There was no change in glucose tolerance test results during growth hormone treatment. According to the results of the insulin tolerance test, we couldn't find any difference in insulin resistance between the growth hormone treatment group and the other treatments(oxandrolone, estrogen) group. CONCLUSION: The impaired rate of carbohydrate metabolism in Turner syndrome was much lower than in other reports. We observed that the impaired rate of carbohydrate metabolism did not increase after growth hormone treatment. However, the long-term effects in patients treated with growth hormone will be elucidated.
Blood Glucose ; Carbohydrate Metabolism* ; Diabetes Mellitus ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Growth Hormone* ; Humans ; Incidence ; Insulin ; Insulin Resistance ; Turner Syndrome*

BACKGROUND: In patients with severe chronic lung diseases even a small pneumothorax can result in life-threatening respiratory distress. It is important to treat the attack by chest tube drainage until the lung expands. Pneumothorax with a persistent air leak that does not resolve under prolonged tube thoracostomy suction is usually treated by open operation to excise or oversew a bulla or cluster of blebs to stop the air leak. Pleurodesis by the instillation of chemical agents is used for the patient who has persistent air leak and is not good candidate for surgical treatment. When the primary trial of pleurodesis with common agent fails, it is uncertain which agent should be used f or stopping the air leak by pleurodesis. It is well known tbat inappropriate drainage of hemothorax results in severe pleural adhesion and thickening. Based on this idea, some reports described a successful treatment with autologous blood instillation for pneumothorax patients with or without residual pleural space. We tried pleurodesis with autologous blood for pneumothorax with persistent air leak and then we evaluated the efficacy and safety. METHODS: Fifteen patients who had persistent air leak in the pneumothorax complicated from the severe chronic lung disease were enrolled. They were not good candidates for surgical treatment and doxycycline pleurodesis failed to stop up their air leaks. We used a mixture of autologous blood and 50% dextrose for pleurodesis. Effect and complications were assessed by clinical outcome, chest radiography and pulmonary function tests. RESULTS: The mean duration of air leak was 18.4 :1:6.16 days before ABP (autologous blood and dextrose pleurodesis) and 5.2 ± 1.68 days after ABP, The mean severity of pain was 2.3 ± 0.70 for DP(doxycycline pleurodesis) and 1.7 ± 0.59 for ABDP (p<0.05). There was no other complication except mild fever. Pleural adhesion grade was a mean of 0.6 ± 0.63. The mean dyspnea scale was 1.7 ± 0.46 before pneumothrax and 2.0 ± 0.59 after ABDP (p>0.05). The mean FEV1 was 1.47 ± 1.01 before pneumothorax and 1.44 ± 1.00 after ABDP (p>0.05). Exɡpt in 1 patient, 14 patients had no recurrent pneumothorax. CONCLUSION: Autologous blood pleurodesis (ABP) was successful for treatment of persistent air leak in the pneumothorax. It was easy and inexpensive and involved less pain than doxycycline pleurodesis. It did not cause complications and severe pleural adhesion. We report that ABP can be considered as a useful treatment for persistent air leak in the pneumothorax complicated from the severe chronic lung disease.
Blister ; Chest Tubes ; Doxycycline ; Drainage ; Dyspnea ; Fever ; Glucose ; Hemothorax ; Humans ; Lung ; Lung Diseases ; Pleurodesis* ; Pneumothorax* ; Radiography ; Respiratory Function Tests ; Suction ; Thoracostomy ; Thorax