The tibial plafond fractures result from an axial compression snd rotational forces causing variable degrees of metaphyseal disruption, articular damage, and malleolar displscement. It is relatively uncommon but a most difficult fracture to manage. It has been treated in a number of manners, but the best results have been occurred when stable internal fixation is accomplished using plates and screws. Basic steps in reconstruction are restoration of anatomic length of the fibula with plate fixation, reconstruction of the tibial articular surface, cancellous bone grafting of the metaphyseal defect and buttress plating of the distal tibia. The suthor analysed the 20 cases of the tibial plafond frsctures in 17 patients, which were trested at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from Jsnuary 1983 to March 1987. The longest durstion of followup was 2 years and 4 months and shortest one was 6 months, and the aversge was one year. The results were as follows : 1. Among the 17 patients, male were 16 and female was one. 2. The major causes of injury were a fall from a height. 3. The most frequent type of fracture was type C by Ruedi and Allgower classification. 4. Regardless of the method of trestment the type A and B were in good and fair result, but the type C were fair in 4 cases and poor in 8 cases. There were 7 cases of snkle fusion in poor group. 5. It is important to remind the basic steps in reconstruction and applied in sn individual csse especially in type C. If anatomic reconstruction of the joint surface can be restored and stable fixation achieved, esrly motion of the ankle joint is made possible. This early motion reduces stiffness of the ankle and win yeild the most sstisfying result. But the anatomic reduction of ank1 joint is difficult to be obtained in each case especially in type C and may consider an ankle fusion.
Ankle ; Ankle Joint ; Bone Transplantation ; Classification ; Clinical Study ; Female ; Fibula ; Follow-Up Studies ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Tibia

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*

No abstract available.
Autopsy* ; Statistics as Topic*

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

No abstract available.

No abstract available.
Adenocarcinoma* ; Diagnosis* ; Lung Neoplasms ; Lung* ; Neoplasm Metastasis*

No abstract available.

No abstract available.

No abstract available.
Cardiomyopathy, Dilated* ; Child* ; Humans

Coenzyme Q is concentrated in Golgi apparatus membranes and mitochondria, but not in other membranes. Although it is difficult to prove the metabolic action of coenzyme Q administered exogenously in clinical cases, the effect of this substance can be evaluated by criteria based on clinical findings. In an attempt to evaluate the effect of coenzyme Q for the treatment of 67 patients(male 26 cases, female 41 cases) of congestive heart failure, we administered Coenzyme Q1030mg daily for 4 to 8 weeks. Most of them were valvular heart disease(74.6%) and hypertension (14.9%). Clinical effects were evaluated at least 4 weeks later by the criteria using a scoring method of severity of congestive heart failure which was devised by Ishiyama, etc. In summary, a definite effect was found in 13 cases(19%) and a mild effect was observed in 46 cases(69%). During treatment there were no significant side effects, and also no significant changes in heart rate and blood pressure.
Blood Pressure ; Estrogens, Conjugated (USP)* ; Female ; Golgi Apparatus ; Heart ; Heart Failure* ; Heart Rate ; Humans ; Hypertension ; Membranes ; Mitochondria ; Research Design ; Ubiquinone