In the treament of the non-union or delayed union of the long bone, it is very difficult to achieve union. We have experienced 15 cases of non-union or delayed union of the tibia who were treated by sliding inlay bone graft with cancellous chip bone graft from June, 1979 to April, 1984. The results were as follows: l. In all cases cancellous iliac bone graft were performed, and additionally internal fixation or simple cast immobilization were done for stabilization of the fracture site. 2. The average bone union time was 2.8 months in delayed union and 4.4 months in non-union. 3. 1n 5 failed cases there were reactivation of previous infections. 4. In 5 cases of postoperative infection, sliding grafts were sequestrated in all. 5. The advantage of this procedure in the cases without infection were: 1) In the anteromedial cortex of tibia, such a surgical intervention permits easy skin closure and prevents skin necrosis. 2) Such a procedure can recanalize the obliterated medullary cavity without disturbance of the fracture ends during operation. 6. This procedure was proved to be one of valuable adjuvant method in the treatment of uninfected non or delayed union of the tibiae.
Immobilization ; Inlays ; Methods ; Necrosis ; Skin ; Tibia ; Transplants

OBJECTIVE: This study was performed to evaluate the clinical efficacy of high-risk HPV DNA test using Hybrid Capture System in the detection of high-grade cervical intraepithelial neo- plasia(CIN II, III) from patients with atypical squamous cells of undetermined significance(ASCUS) or a low-grade squamous intraepithelial lesion(LGSIL) on referral Papanicolaou smear. STUDY DESIGN: Fifty-four patients referred to our hospital with a Papanicolaou smear report of atypical squamous cells of undetermined significance or a low-grade squamous intraepithelial lesion underwent repeat Papanicolaou smear, cervical colposcopy and directed cervical biopsy. In addition, high-risk human papillomavirus(HPV) test by Hybrid Capture System was done. A comparison of detection rate of the high-grade CIN between positive and negative results of HPV test according to repeat Papanicolaou smear report was done. Biopsy result according to HPV test result in total patients was also compared. RESULTS: HPV of high-risk type was detected in 22 of 54 women(40.7%) by Hybrid Capture System. Prevalence rate of high-risk HPV in no CIN, CIN I, and CIN II, III was 13.6%, 18.2% and 68.2% respectively. As expected, high-risk HPV was detected with greater frequency in relation to increasing severity of CIN. In 18 women, the repeat smear obtained in our clinic was reported as negative. High-risk HPV types were found in 16.7% of theses women. In the HPV-negative women, 40% had CIN II or III confirmed on cervical biopsy. In comparison, 66.7% of those with a positive result of the HPV test had CIN II or III on biopsy(P<0.05). Among the women with ASCUS or LGSIL on repeat smear, there was no significant difference in the frequency of biopsy-proved CIN II or III between positive and negative results of high-risk HPV test. In total patients, the group that had positive results for high-risk HPV showed higher incidence of CIN II or III than group with negative results(P<0.05). CONCLUSION: From these results testing women with Papanicolaou smears showing ASCUS or LGSIL for infection with high-risk HPV types would identify the patients who are at risk for HGSIL or invasive carcinoma and who require aggressive intervention. High-risk HPV DNA test using Hybrid Capture System may be a usefule method in supplement the pitfalls of cervical cytology. This test might also have prgnostic value in the management of patients with cervical intraepithelial lesions.
Biopsy ; Colposcopy ; Female ; Human Papillomavirus DNA Tests ; Humans* ; Incidence ; Papanicolaou Test ; Papilloma* ; Prevalence ; Referral and Consultation

No abstract available.
Hemorrhage*

Between December 18, 1985 and May 31, 1986 at the VD Clinic, Choong-ku Public Health Center, in Seoul, 274 male patients with uncomplicated gonococcal infection, including 124 penicillinase producing Neisseria gonorrhoeae(PPNG) infection, were entered into the study. They were divided randomly into the group A and the group B. In the group A, treated with kanamycin 2g, im regimen, 126 of 137 patients were followed and 86 patients(68.3%) were cured. In the group B, treated with gentamicin 240mg, im regimen, 125 of 137 patients were followed and 78 patients(62.4%) were cured. The cure rates in PPNG urethritis were 63.9%(39/61) in the group A and 50.9%(29/57) in the group B. The cure rates in non PPNG urethritis were 72.3%(47/65) in the group A and 72.1% (49/68) in the group B. No significant difference was observed in cure rates between two groups. It is suggested that. both kanamycin 2g, im regimen and gentamicin 240mg, im regimen is not suitable for a first line treatment for uncomplicated gonococcal urethritis.
Gentamicins* ; Humans ; Kanamycin* ; Male* ; Neisseria ; Penicillinase ; Public Health ; Seoul ; Urethritis*

From November 18 to December 31, 1986, seventy-five male patients with unconplicated gonococcal urethritis at the Venereal Disease Clinic of Choong-ku Public Health Center in Seoul were allocated randomly into one of two treatment regimens, and seventy patients were followed. All thirty-five patients including PPNG infections, treated with single oral dose of norfloxacin 600mg, were recovered(100%). One of thirty-five patients treated with a single oral dose of norfloxacin 800mg, failed. This failed case was one of eighteen nonPPNG infections (failure rate of 5.6%). Susceptibility test with disks containing norfloxacin 10ug showed the inhibition zone greater than 30mm. It is suggested that a single oral dose of 600mg or 800mg norfloxacin has good effect in the treatment of gonococcal urethritis with minimal side effects. Because of high prevalence of PPNG, it can be recommended as the first line treatment for gonorrhoea in Korea.
Humans ; Korea ; Male* ; Norfloxacin* ; Prevalence ; Public Health ; Seoul ; Sexually Transmitted Diseases ; Urethritis*

CT was done 81 times on 63 proven malignant maxillary sinus tumors for 3 years from Feb.1979 to May 1982 atSeoul National University Hospital. Pre-treatment CT were 54 and post-treatment CT were 31 on 28 patient. Theresult were as follows; 1. The most frequent histopathologic diagnosis was 44 cases (69.8%) of squamous cellcarcinoma. Others were 5 cases (7.9%) of adenoid cystic carcinoma, 3 cases (4.8%) of olfactory neuroblastoma, 3cases (4.8%) of malignant lymphoma, 2 cases (3.2%) of melanoma, 2 cases (3.2%) of malignant fibrous histiocytoma,a rhabdomyosarcoma, a basal cell carcioma, a fibrosarcoma and a metastatic carcinoma from thyroid follicular adenocarcinoma. 2. The CT findings in 54 untreated malignant maxillary sinus tumors were sinus opacification, softtissue mass, and bone destruction in all cases. Other findings were fat plane obliteration (70%),osteosclerosis(59%), bone erosion and displacement (46%), low densities within soft tissue mass (27%), and airdensitis wiithin soft soft tissue mass (27%), and air densities within soft tissue mass(13%). 3. The value of pre-treatment CT in malignant maxillary sinus tumors were outlining the disease process especially soft tissuesuch as orbit, infratemporal fossa, pterygopalatine fossa, nasopharynx, pterygoid fossa and intracranialextension, and CT is the choice of diagnostic modality to determine the prognosis and the therapeutic planning insurgery and/or radiotherapy. 4. Post-treatment CT is also helpful to evalute the change in tumor size andpost-treatment complication.
Adenocarcinoma, Follicular ; Carcinoma, Adenoid Cystic ; Diagnosis ; Esthesioneuroblastoma, Olfactory ; Fibrosarcoma ; Humans ; Lymphoma ; Maxillary Sinus ; Melanoma ; Nasopharynx ; Orbit ; Prognosis ; Pterygopalatine Fossa ; Radiotherapy ; Rhabdomyosarcoma ; Thyroid Gland

BACKGROUND: Human metapneumovirus (hMPV) is a relatively recently identified respiratory virus that induces respiratory symptoms similar to those of respiratory syncytial virus infection in children. The characteristics of hMPV-infected adults are unclear because few cases have been reported. METHODS: We conducted a retrospective review of hospitalized adult patients with a positive multiplex real-time polymerase chain reaction assay result from 2012 to 2016 at a single tertiary referral hospital in South Korea. We analyzed clinical characteristics of the enrolled patients and divided patients into an acute respiratory distress syndrome (ARDS) group and a non-ARDS group. RESULTS: In total, 110 adults were reviewed in this study. Their mean age was 61.4 years, and the majority (n = 105, 95.5%) had comorbidities or were immunocompromised. Most of the patients had pneumonia on chest X-ray (n = 88, 93.6%), 22 (20.0%) had ARDS, and 12 (10.9%) expired during hospitalization. The mortality rate for patients with ARDS was higher than that of the other patients (36.4% vs. 5.7%, P = 0.001). The risk factor for hMPV-associated ARDS was heart failure (odds ratio, 5.24; P = 0.044) and laboratory values were increased blood urea nitrogen and increased C-reactive protein. The acquisition site of infection was divided into community vs. nosocomial; 43 patients (39.1%) had a nosocomial infection. The risk factors for nosocomial infection were an immunocompromised state, malignancy and immunosuppressive treatment. CONCLUSIONS: These data suggest that hMPV is one of the important respiratory pathogens important respiratory pathogen that causes pneumonia/ARDS in elderly, immunocompromised individuals and that it may be transmitted via the nosocomial route.
Adult* ; Aged ; Blood Urea Nitrogen ; C-Reactive Protein ; Child ; Comorbidity ; Cross Infection ; Heart Failure ; Hospitalization ; Humans* ; Korea ; Metapneumovirus* ; Mortality* ; Pneumonia ; Real-Time Polymerase Chain Reaction ; Respiratory Distress Syndrome, Adult* ; Respiratory Syncytial Viruses ; Retrospective Studies* ; Risk Factors ; Tertiary Care Centers ; Thorax

The thoracic and lumbar spine fractures were usually combined with neurological deficit. But the prognostic factors in degree of neurological damage and process of the recovery are controversial. The purpose of this study is to evaluate the factors affected neurological injury and the recovery. The 31 cases who had been performed surgical interventions due to traumatic thoracic or lumbar spine fractures with the neurological deficits were studied according to the radiographic findings of the spinal columns and neurological changes of the injured cord and/or the roots. The duration of mean follow-up was 32.6 months, and all cases were evaluated by motor index score and Frankel grade. Total cases were divided into complete paralytic (N=8) and partial paralytic(N=23) group. In incomplete paraplegia group, the neurological recovery rate was better than complete group(P < 0.001) and neurological recovery period was shorter than complete group (P=0.005). The neurologic deficits according to the Frankel grade were higher in Chance fracture, flexion-distraction and translation (complete paraplegia: 4/7 cases, 57.1%) than unstable bursting fracture (complete paraplegia: 4/24 cases, 16.7%)(P=0.031). The recovery rate of Chance fracture, flexion-distraction and translation were worse than unstable bursting fracture (0.001). The fracture which occurred in T5-11 showed higher incidence of complete paraplegia(75%) compared with that of the T12-L1(30.8%) & L2-4(7.1%)(p=0.021). The neurological recovery in motor index score in L2-4 was higher than T5-11 or T12-L1(P=0.0017). There was no correlation in kyphotic deformity and anterior body height loss between complete and incomplete paraplegia groups. But the A-P diameter of compromised neural canal showed significant difference between complete and incomplete paraplegia group(P=0.027)
Body Height ; Congenital Abnormalities ; Follow-Up Studies ; Incidence ; Neural Tube ; Neurologic Manifestations ; Paraplegia ; Spine

No abstract available.
Adult* ; Humans

No abstract available.
Adult* ; Humans