A clinical study of the tibial fracture was made on patients, total 234 tibias, who were treated at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from 1974 to 1979. The results were as follows: 1. The ratio between male and female was 5. 5: 1 and majority was found between 3rd decade and 5th decade. 2. In the shape of fracture, commiuted fracture, transverse fracrure were common in order. 3. The most common cause of these fractures was traffic accident and the ratio between open and closed fracture was 1:2. 4. The most common associated injury was the fibular fracture. 5. More complications ensued in open reduction and internal fixation than in closed reduction. of 50 cases, which were treated by open reduction and internal fixation, delayed union in 32 cases (64%) and infection in 11 cases (22%) resulted. 6. In the treatment of open comminuted tibial fractures with skin and soft tissue loss or marked displacement, Hoffmans external fixation method and pin and resin external fixation method bad good results, Early motion of adjacent joint, easy care of wound and rigid fixation were obtained by it.
Accidents, Traffic ; Clinical Study ; Female ; Fractures, Closed ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Skin ; Tibia ; Tibial Fractures ; Wounds and Injuries

Among 334 thoracolumbar spinal injury patients who were admitted to this hospital from June 1972 to June, 1982, 66 patients with fracture and fracture dislocation of thoraco-lumbar spine which were defined as unstable clinically and radiologically were treated with surgical measures. The ratio between male and female was 7.3:1, the majority was found in third and fourth decade (46 cases, 69%), and the most common cause of injury was falling from a height (38 cases, 58%). The most common site of the injury was lumbar spine (29 cases, 44%) and the most common mechanism of injury was flexion-rotation (29 cases, 44%). Our surgical measures were Harrington rod instrumentation with either anterior or posterior fusion (25 cases, 38%), posterior wiring and fusion (14 cases, 21%), anterior decompression and anterior fusion (14 cases, 21%), posterior fusion (4 cases, 6%), anterior fusion and posterior fusion (3 cases, 5%) and etc. The average correction of displacement was 65% and the average correction of kyphotic deformity was 50%. The most remarkable correction was found at the cases of Harrington rod instrumentation (71%, 74%). Neurological deficit had already developed in 43 cases(65%) prior to operation, and the recovery was observed in 18 cases(42%). Most excellent recovery of neural deficit was found also at the cases of Harrington rod instrumentation (11 cases, 52%). We have analysed the results of these treatment and obtained following conclusions. 1. For the unstable fracture and fracture-dislocation of thoraco-lumbar spine with or without neural involvement, immediate surgical treatments were valuable to expect restoration of anatomical reduction and promotion of every possible recovery of neural function with spinal stability and fewest complication. 2. Fixation with Harrington rod instrumentation appears to provide better reduction and stability with neural improvement than other methods, and therefore early undertaking of rehabilitation activities is possible. 3. For the patients who are seriously compromised or require anterior decompression, immediate posterior reduction and fixation with Harrington rod instrumentation followed anterior decompression and anterior fusion of the involved segments at the eariest feasible time, we feel, is the treatment of choice.
Accidental Falls ; Clinical Study ; Congenital Abnormalities ; Decompression ; Dislocations ; Female ; Humans ; Male ; Mortuary Practice ; Rehabilitation ; Spinal Injuries ; Spine

There was increasing tendency to stabilize unstable cervical spine injuries surgically with the benefit of good stability of the spine, easy nursing care, early mobilization and therefore early rehabilitation. A clinical study was performed on 47 patients with fractures and dislocations of the cervical spine treated at the department of orthopedic surgery, Inje Medical College, Paik Hospital from Jan. 1975 to Dec. 1981. Following is the summery of the our findings. 1. The prevalent age distribution was between 3rd and 6th decade and the ratio between males and females was 10:1. The most common cause of injuries was automobile accident (70%). 2. The most common site of the injuries was C5-6 (34%) and the most frequent mechanism of injury was flexion-rotation type (47%). 3. In overall patients, neurologic damage was found at first examination in 73% and among these, complete paralysis below the injured level in 26%, incomplete paralysis in 11% and nerve root injury in 35%. 4. Among 47 patients, conervative treatment was performed on 9 patients, anterior spinal fusion on 8 patients, anterior spinal fusion with Halo application on 4 patients, posterior wiring with posterior spinal fusion on 16 patients and posterior wiring with anterior spinal fusion on 8 patients. 5. In the several methods of treatment, the posterior wiring with anterior spinal fusion revealed the best results, the correction rate of displacement was 92%, the correction rate of angular deformity 98% and neural recovery rate 72%. 6. The posterior wiring with posterior spinal fusion revealed good results in correction of displacement and angular deformity but required rigid external support for a long time. The anterior spinal fusion revealed poor results in correction of displacement(67%) and angular deformity(38%) and required rigid external support for a long time and had increasing tendency of kyphotic angle after operation. 7. In the treatment of unstable cervical spine injury, we thoughy that early posterior reduction with posterior wiring and followed anterior spinal fusion was ideal for accurate reduction, rigid stability and early mobilization with simple external support.
Age Distribution ; Automobiles ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Early Ambulation ; Female ; Humans ; Male ; Nursing Care ; Orthopedics ; Paralysis ; Rehabilitation ; Spinal Fusion ; Spine

No abstract available.

OBJECTIVE: To investigate the clinical characteristics of fibromyalgia syndrome and to determine the usefulness of visual analogue scale (VAS) in global pain as predictor of symptoms and functional disabilities of daily activities and to evaluate the relationship between social environmental factors and fibromyalgia syndrome. METHOD: : Fourth-three patients with fibromyalgia syndrome who have met 1990 ACR criteria and 30 control patients with rheumatoid arthritis were included in the study. Clinical features, functional disabilities, VAS and psychological impact due to life stress by criteria and 30 control patients with rheumatoid arthritis were included in the study. Clinical features, functional disabilities, VAS and psychological impact due to life stress by social environmental factors were studied by direct interviews and questionnaires. RESULT: The mean age of the patients with fibromyalgia syndrome was 48+/-11 years old. The physical findings revealed that tender points were 15.5+/-1.4 and skin fold tenderness presented in 59% of patients. The most frequent symptoms with scores and ratio of symptom presented were fatigue(2.2, 93%), morning stiffness(2.2, 80%), arthralgia(2.1, 90%), lower back pain(2.1, 98%), depression(1.6, 95%). The majority of functional disabilities in fibromyalgia group were less severe than those of rheumatoid arthritis group. The VAS in global pain had correlationship with age, arthralgia, fatigue, hurt all over, morning stiffness, tender points as well as the majority of functional disabilities of daily activities. Although living together mother-in-law was not different significant ly from each other groups, the duration of living together was longer in fibromyalgia group. There were more histories and frequencies of artificial abortions in patients with fibromyalgia syndrome. CONCLUSION: The patients with fibromyaliga showed various symptoms. The visual analogue scale in global pain have had significant correlation with some symptoms and functional disabilities in daily activities. Fibromyalgia patients revealed more social and obstetrical life stress which may suggest more psychological impact.
Arthralgia ; Arthritis, Rheumatoid ; Fatigue ; Fibromyalgia* ; Humans ; Surveys and Questionnaires ; Skin ; Social Environment ; Stress, Psychological

Thromboembolism is the most common serious complication following total hip arthroplasty and most common cause of death after total hip arthroplasty. A prospective randomized study in 170 cases of elective cementless total hip arthroplasty was carried out to examine the incidence of deep vein thrombosis and pulmonary embolism after cementless total hip arthroplasty from Aug. 1993 to May 1995. Laboratory study, clinical symptoms and signs, chest roentgenograph and precipitating factors were analysed. Venography and lung perfusion scan using radionuclide scan were used for this study. The weight, height, sex, habitus of alcohol and smoking, hypertension, diabetes mellitus, previous operation history of ipsilateral lower extremity, etiology of hip joint disease, and transfusion of blood were not precipitating factors, but the age over 40 and previous history of pulmonary embolism had a significant effect on the incidence of deep vein thrombosis. There was no significant relationship between the incidence of deep vein thrombosis and the laboratory assay, clinical symptoms and signs. Deep vein thrombosis was detected in 29 cases(17.0%), pulmonary embolism in 22 cases(12.9%), and fatal pulmonary embolism in 1 case(0.6%). The most common location of deep vein thrombosis was the popliteal area.
Arthroplasty, Replacement, Hip* ; Cause of Death ; Diabetes Mellitus ; Hip Joint ; Hypertension ; Incidence ; Lower Extremity ; Lung ; Perfusion ; Phlebography ; Precipitating Factors ; Prospective Studies ; Pulmonary Embolism* ; Smoke ; Smoking ; Thorax ; Thromboembolism ; Venous Thrombosis*

We have employed the external akeletal fixation devices, that is Hoffmann apparatus and Pin and Resin fixation method, for the treatment of 44 cases of long bone fractures from Dec. 1978 to Dec. 1981. The following are our impressins. 1. Hoffmann apparatus and Pin and Resin fixation method proved to be effective and useful measure for the management of fractures of long bones, particulary in cases of the open tibial fractures. 2. Employing the Hoffmann apparatus to the tibial model, the possible limit of correction of the fracture alignment was calculated. It was found that the average angle of correction of deformity can be managed up to 20 degrees in varus and valgus deformity, 70 degrees in anterior angulation, 40 degrees in posterior angulation and 70 degrees in rotation. 3. Pin and Resin fixation method is one of effective means in immobilization of long bones. It is simple to apply, easy to manipulate and inexpensive while offering fair fixation without much complications and therefore we recommend the method as the best alternative to expensive Hoffmann apparatus. 4. The complications of Hoffmann apparatus and Pin and Resin fixation method were pin tract infections and ankle stiffness which were generally minor and prevented by more careful aseptic technique and encouraging early joint motion.
Ankle ; Congenital Abnormalities ; Fracture Fixation ; Fractures, Bone ; Immobilization ; Joints ; Methods ; Tibial Fractures

A random urine sample was obtained from each of 155 normal Koreans and its specific gravity (S.G.), the total osmolality (Uosm) and the concentration of chloride (UCl) and urea (Uurea) were determined. The Uosm, 2 X UCl and Uurea were then plotted as a function of the S. G., and the following regression equations were obtaind: Uosm (in mOsm/kg) = 34,500 (S.G.-1,000), 2xUCl (in mOsm/kg) = 20,000 (S.G. 1,000), and Uurea (in mOsm/kg) = 10,000 (S.G.-1,000). the analysis of these data indicated that 58.5% of the Uosm could be accounted for by NaCl and 28.8% by urea while 41.0% of the S. G. of urine could be accounted for by NaCl and only 14.5% by urea. A comparison of these data with corresponding figures obtained from occidentals suggests that, in the Korean, the contribution of NaCl to both the Uosm and S.G. of urine is considerably higher, while that of urea is significantly lower than that in the occidental. This peculiarity of the urinary composition in Koreans is attributed to their ingestion of a lowprotein, high-salt diet.

The aim of the present study was to investigate the effects of R-(-)-2,10,11-trihydroxy-N-propylnoraporphine [R-(-)-TNPA], a selective agonist of dopaminergic D2 receptor and S(-)-raclopride, a selective antagonist of dopaminergic D2 receptor, on the secretion of catecholamines (CA) evoked by cholinergic stimulation and membrane-depolarization in the isolated perfused model of the rat adrenal gland, and also to establish its mechanism of action. R-(-)-TNPA (10~100 micrometer) perfused into an adrenal vein for 60 min produced dose- and time-dependent inhibition in CA secretory responses evoked by ACh (5.32 mM), high K+ (56 mM), DMPP (100 micrometer) and McN-A-343 (100 micrometer). R-(-)-TNPA itself did also fail to affect basal CA output. Also, in adrenal glands loaded with R-(-)-TNPA (30 micrometer), the CA secretory responses evoked by Bay-K-8644 (10 micrometer), an activator of L-type Ca2+ channels and cyclopiazonic acid (10 micrometer), an inhibitor of cytoplasmic Ca2+-ATPase were also inhibited. However, S(-)-raclopride (1~10 micrometer), given into an adrenal vein for 60 min, enhanced the CA secretory responses evoked by ACh, high K+, DMPP and McN-A-343 only for the first period (4 min), although it alone has weak effect on CA secretion. Moreover, S(-)-raclopride (3.0 micrometer) in to an adrenal vein for 60 min also augmented the CA release evoked by BAY-K-8644 and cyclopiazonic acid only for the first period (4 min). However, after simultaneous perfusion of R-(-)-TNPA (30 micrometer) and S(-)-raclopride (3.0 micrometer), the inhibitory responses of R-(-)-TNPA (30 micrometer) on the CA secretion evoked by ACh, high K+, DMPP, McN-A-343, Bay-K-8644, and cyclopiazonic acid were significantly reduced. Taken together, these experimental results suggest that R-(-)-TNPA greatly inhibits the CA secretion from the perfused rat adrenal medulla evoked by cholinergic stimulation (both nicotininc and muscarinic receptors) and membrane depolarization, but S(-)-raclopride rather enhances the CA release by them. It seems that this inhibitory of R-(-)-TNPA may be mediated by stimulation of inhibitory dopaminergic D2 receptors located on the rat adrenomedullary chromaffin cells, while the facilitatory effect of S(-)-raclopride is due to the blockade of dopaminergic D2 receptors, which are relevant to extra- and intracellular calcium mobilization. Therefore, it is thought that dopaminergic D2 receptors may be involved in regulation of CA release in the rat adrenal medulla.
(4-(m-Chlorophenylcarbamoyloxy)-2-butynyl)trimethylammonium Chloride ; 3-Pyridinecarboxylic acid, 1,4-dihydro-2,6-dimethyl-5-nitro-4-(2-(trifluoromethyl)phenyl)-, Methyl ester ; Adrenal Glands ; Adrenal Medulla* ; Animals ; Calcium ; Catecholamines ; Chromaffin Cells ; Cytoplasm ; Dimethylphenylpiperazinium Iodide ; Membranes ; Perfusion ; Rats* ; Veins

About 40% of patients with diabetes mellitus develops to diabetic nephropathy, and these patients show increment of glomerular filtration rate and renal volume at early phase. 99mTc-DMSA SPECT (single photon emission computed tomography) can measure a functional renal volume because 99mTc- DMSA it is taken up by the viable proximal tubular cells located in the renal cortex. To evaluate the renal volume in early diabetic nephropathy, we compared functional renal volume between diabetic patients and control, renal transplantation donor. 99mTc-DMSA was injected intravenously and SPECT was done after 2 hours in 15 diabetic patients, 18 renal transplantation donors, and 2 patients with end stage renal disease due to chronic glomerulonephritis. In diabetic patients with creatinine clearance more than 30ml/min and proteinuria, right and left renal volume were 247+/-22ml/BSA(m2), 256+/-37ml/BSA (m2), which were greater than those of diabetic patients with normal renal function and without proteinuria, or renal transplantation donors(P<0.05). In conclusion, we measured the functional renal volume by 99mTc-DMSA SPECT. Renal volume of diabetic patients with proteinuria were larger than the volume of control group or diabetic patients with normal renal function and without proteinuria. 99mTc-DMSA SPECT was thought to be useful test a for the measurement of functioning renal volume.
Creatinine ; Diabetes Mellitus* ; Diabetic Nephropathies ; Glomerular Filtration Rate ; Glomerulonephritis ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Proteinuria ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tissue Donors ; Tomography, Emission-Computed, Single-Photon*