Internal fixation of fractures always represents a race between the time required for bone healing and the inevitable fatigue failure of implant. The authors clinically analyzed the cause of metal failure in 34 cases at Department of Orthopedic surgery, Taegu Medical Center from Jan. 1981 to Dec. 1987. 1. Metal failure occured in 29 compression plates, 1 Kuntscher nail, 1 Jewett nail, 1 Ender nail, and 2 semitubular plates. 2. Involved bones were the femur in 28 cases, tibia in 3 cases, humerus in 1 cases, and the ulna in 2 csses. 3. The time interval between internal fixation and metal failure was average 7 months. 4. The cause of metal failure was deficiency of medial buttress in 14 cases and incorrect position of implant in 19 cases, and incorrect selection of implant in 1 case. 5. (Autogenic) Bone graft was not performed in the primary surgical treatment of 31 cases.
Continental Population Groups ; Daegu ; Fatigue ; Femur ; Fractures, Comminuted ; Humans ; Humerus ; Orthopedics ; Tibia ; Transplants ; Ulna

Infected nonunion continues to be a major therapeutic challenge. Twenty-five cases of infected nonunion of tibia were trested by Papineau's cancellous bone graft at Department of Orthopedic Surgery, Taegu Medical Center from Jan. 1981 to Dec. 1987. The results were as follows. 1. Decortication, sequestrectomy and cancellous bone graft were performed simultaneously in every case. 2. Osseous union and eradication of infection were obtained at average 8 months.
Daegu ; Orthopedics ; Tibia ; Transplants

Split thickness skin graft can be used as a one stage procedure for the immediate treatment of friction avulsion injuries in severe foot injuries. After cleaning the wound, a split thickness skin graft is taken from thigh and cover the wound. We have treated 6 patients with friction avulsion injuries of the foot.
Foot Injuries ; Foot ; Friction ; Humans ; Skin ; Thigh ; Transplants ; Wounds and Injuries

Reversible posterior leukonecephalopathy syndrome RPLS), a neurologie disorder associated with evidence of posterior cerebral edema on neuroimaging studies, has been described in both adults and children. Conditions predisposing to RPLS include malignant hypertension, renal dysfunction, toxemia of pregnancy, interferon therapy, and the use of immunosuppressive agents. When associated with acute hypertension, RPLS typically occurs concurrently with the fulminant clinical syndrome of hypertensive encephalopathy We describe occipital lobe seizures, in the setting of only moderate elevations of blood pressure, as the major clinical manifestation of RPLS.
Adult ; Blood Pressure ; Brain Edema ; Child ; Humans ; Hypertension ; Hypertension, Malignant ; Hypertensive Encephalopathy ; Immunosuppressive Agents ; Interferons ; Neuroimaging ; Occipital Lobe ; Posterior Leukoencephalopathy Syndrome* ; Pre-Eclampsia ; Seizures

Total hip arthroplasty was performed on a 32 year old man with hemophilia A. A series of complications were encountered; namely, femoral shaft fracture during arthroplasty, hemolytic anemia, Factor VII inhibition, pseudotumor formation and wound dehiscence and sepsis as a result of shortage of cryoprecipitate supply, and general debilitation and septicemia from fhe use of immunosuppressive agents, finally leading to death 67 days after operation. Initially, 399 bottles of cryoprecipitate (each containing approximately 100 units of Factor VII) were anticipated. In practice, however, a total of 660 bottles and packs had been consumed on the patient when the supply was exhausted. Total hip arthroplasty can be carried out on hemophilia patients, provided that the planning be impeccable and the supply of antihemophilic factor virtually unlimited.
Anemia, Hemolytic ; Arthritis ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Factor VII ; Hemophilia A ; Humans ; Immunosuppressive Agents ; Sepsis ; Wounds and Injuries

The main cause of vesicovaginal fistula is gynecologic or obstetric manipulation, but vesicovaginal fistula as a complication of genitourinary tuberculosis is extremely rare. The diagnosis is confirmed by the histological findings, and treatment is surgical repair with antituberculous medication. We report here on the presentation and management of extensive tuberculosis that led to formation of a vesicovaginal fistula in an adult.
Adult ; Diagnosis ; Humans ; Tuberculosis ; Vesicovaginal Fistula*

PURPOSE: To elucidate the mechanism of neoangiogenesis of human retinal pigment epithelium (HRPE) under hypoxia. METHODS: HRPE cells were cultured for 2 and 24 hours in a hypoxic chamber. Expression and production of the angiogenic factor, vascular endothelial growth factor (VEGF) and the anti-angiogenic factor, pigment epithelium-derived factor (PEDF) were analyzed by RT-PCR and Western blot, respectively. Neoangiogenesis was induced by adding culture supernatant harvested from cells exposed to hypoxic conditions. Neoangeogenesis was measured with a tube formation assay that uses ECV 304 cells and with a migration assay that uses human dermal microvascular endothelial cells. RESULTS: Competitive RT-PCR showed that the expression of the PEDF gene in HRPE cells under hypoxic state decreased compared to normoxic state (p<0.01) but the expression of the VEGF gene increased (p<0.01) when exposed to hypoxic conditions. These results corresponded to those of the Western blot analysis which revealed a significant increase of VEGF production (p<0.01) and a decrease of PEDF production (p<0.01). Moreover, the tube formation and migration assays demonstrated that angiogenesis was increased by exposure to hypoxic stress. Taken together, HRPE cells under hypoxic stress produce more VEGF and less PEDF, which lead to neoangiogenesis. CONCLUSIONS: These results suggest that the subretinal neovascularization that occurs under hypoxic stress might be caused by an imbalance of angiogenesis-related factors in HRPE cells.
Angiogenesis Inducing Agents ; Anoxia* ; Blotting, Western ; Endothelial Cells ; Epithelial Cells* ; Humans ; Retinal Pigment Epithelium ; Retinaldehyde* ; Vascular Endothelial Growth Factor A

No abstract available.
Cerebral Palsy* ; Congenital Abnormalities* ; Forearm* ; Humans ; Muscle Spasticity* ; Pronation* ; Wrist*

No abstract available.
Pregnancy* ; Pyelonephritis*

BACKGROUND: Although anticardiolipin antibody(aCL)-related stroke is far more frequently identified in younger populations, the role of aCL in the pathogenesis of cerebral infarction may be important also in the old, stroke-prone population. We studied the clinical profiles of aCL- related stroke in elderly patient to look at its role on the pathogenesis of ischemic stroke. METHODS: We analyzed unselected patients with acute ischemic stroke and age matched controls for the presence of aCL, prospectively. Also, we studied the characteristics of these patients based on the conventional risk factors and other clinical, laboratory and radiological features in them. RESULTS: aCL was positive 30 (14.7%) of 203 stroke patients, but 11 (6.1%) in 193 control patients. The proportion of patients having more than one of the risk factors was significantly greater in aCL-positive (24/30, 80.0%) than in aCL-negative patients (100/173, 57.8%). The incidence of aCL positivity was significantly greater in patients having one or more risk factors (24/124, 19.3%) than in patients not having any of the risks (6/79, 7.6%). Two of the patients had prolonged aPTT, and only one had a lupus anticoagulant. A positive ANA and false-positive VDRL were not found in our patients. Radiological findings confer subcortical infarction. CONCLUSION: The elevated aCL are a risk marker for stroke also in the elderly population. Our aCL-positive patients generally had multiple risk factors for stroke and are associated with subcortical infarctions, contrary to previous studies. The role of aCL as a disease marker for ischemic stroke in elderly patients warrants further investigations.
Aged* ; Antibodies, Anticardiolipin* ; Cerebral Infarction ; Humans ; Incidence ; Lupus Coagulation Inhibitor ; Prospective Studies ; Risk Factors ; Stroke*