No abstract available.
Tibial Fractures*

No abstract available.
Lower Extremity*

Squamous cell carcinoma is a primary malignant tumor of the skin arising from the epidermis with etiology unknown, and chronie irritations are considered as predisposing factors such as prolonged exposure to sunlight, chronic ulceration of the scar, persistent draining sinus of the chronic osteomyelitis. Habitual pipe smoking and exposure to heavy metal or chemical agents are also thought to be contributing factors to produce this tumor. Orthopaedic surgeons are occasionally concerned in case of patients with squamous cell carcinoma developed in the extremities particularly arising from the persistent draining sinus of the chronic osteomyelitis. We reviewed 12 patients with squamous cell carcinoma in the extremities treated at National Medical Center between 1963 and 1975. All cases were definitely diagnosed clinically and histopathologically. 1) Male to female ratio was 11:1. Average sge of the patients was 52. 2) Farmer is predominant in incidence as 10 out of 12. 3) Sites of invoIvement were buttock and lower extremities in all cases. 4) Predisposing factors of the tumor were chronic skin ulceration in 7 cases, persistent draining sinus of chronic osteomyelitis in two and unknown in three cases. 5) Duration of the skin ulceration or draining sinus before producing tumor was considerably long between 10 and 30 years in majority of the cases. 6) Duration of newgrowth before operation was less than one year in 5, between one and two years in three, and more than two years in four cases. 7) Pre-operative chest X-ray was normal in all cases. However X-ray of the bones of affected limbs showed no bony change in two cases, and various bony changes in 10 cases such as periosteal reaction, cortical erosion, findings of pre-existing chronic osteomyelitis etc. In detail, two cases revealed direct infiltration and active bony destruction into the cortex and medulla by tumor mass. 8) We performed amputation or disarticulation at various levels in 5 cases, radical excision in 3 and biopsy in one case. 9) Within 6 months postoperatively, four cases showed local recurrence of newgrowth as well as metastasis to the lung concomitantly. Three of them were the cases of radical resection. One of them developed distant metastasis to the clavicle.
Amputation ; Biopsy ; Buttocks ; Carcinoma, Squamous Cell ; Causality ; Cicatrix ; Clavicle ; Disarticulation ; Epidermis ; Epithelial Cells ; Extremities ; Farmers ; Female ; Humans ; Incidence ; Lower Extremity ; Lung ; Male ; Neoplasm Metastasis ; Osteomyelitis ; Recurrence ; Skin ; Skin Ulcer ; Smoking ; Sunlight ; Surgeons ; Thorax ; Ulcer

We reviewed thrity-one cases of unstable tibial fractures treated with Ilizarov method from January 1991 to December 1992. We attained satisfactory bony union in all cases without bone graft(Average time 19.2 weeks). There were numbers of complications, but its were soluble and careful management & numbers of minor surgery were needed to prevent & solve such complications. Post-op immediate weight bearing and ROM exercise were possible and showed no difficulty in getting mainteance of reduction & fracture healing, and serious joint ankylosis was not developed. In conclusions, Ilizarov method is an excellent treatment in getting reduction, maintenance of reduction, early ambulation and fracture healing in the cases of unstable tibia fractures.
Ankylosis ; Early Ambulation ; Fracture Healing ; Ilizarov Technique ; Joints ; Minor Surgical Procedures ; Tibia ; Tibial Fractures ; Weight-Bearing

BACKGROUND AND OBJECTIVE: The knowledge about the effects of the nebulized B2-agonist on serum potassium is limited. We aimed to assess the possible hypokalemia following nebulization of salbutamol. METHOD: Seven patients(mean age 60 +- 7.1years) with acute exacerbated asthma were treated with salbutamol nebulization(5mg nebulization at 1 hour interval, 3 times) without concomitant use of steroid or other bronchodilator such as theophylline. RESULTS: There was a significant increase in FEV1, from 46.41+-25.91% at baseline to 62.86+-22.38% at 3 hours after treatment. Serum potassium concentration was significantly decreased, from 3.93+-0.58mEq/L at baseline to 3.41+-0.62mEq/L and 3.46+-0.53mEq/L at 1 hour and 3 hours after third nebulization, repectively. There was a significant prolongation of the QTc interval in EKG from 454.36+-27.07msec at baseline to 479.41+-35.64msec and 505.09+-58. 69msec at 1 hour and 3 hours after third nebulization, respectively. Serum salbutamol concentration was 4.18+-3.39ng/ml at baseline, and increased to 7.69+-6.94ng/ml and 9.84+10.34ng/ ml at 1 hour and 3 hours after treatment, respectively. Magnitude of the hypokalemia and the degree of prolongation of the electrocardiographic QTc interval were significantly correlated with the level of serum salbutamol concenturation. CONCLUSION: The results suggest that cardiac complication could develop due to hypokalemia during repeated salbutamol nebulization. Caution should be done in monitoring of serum potassium concentration when using nebulized salbutamol repeatedly for the treatment of acute exacerbated bronchial asthma.
Albuterol* ; Asthma ; Electrocardiography ; Hypokalemia ; Potassium* ; Theophylline

The purpose of this study is to investigate the effect of the ball-cone contact interface variation on the ceramic ball stress which is the dominant factor of the design of the moldular artificial hip joint. A contact stress analysis problem is formulated using the optimization principle and finite element analysis technique on the ball-cone system of three dimensional axi-symmetrical model, Numerical procedure is employed to get the solution for varying angles of cones and angular mismatches between the ball and cone interfaces. There is a fair amount of friction in the interface and included in the analysis model.
Ceramics ; Finite Element Analysis ; Friction ; Hip Joint ; Hip

Isolated acute monoarticular septic arthritis of the sternoclavicular joint is a extremely rare disorder, and is usually associated with predisposing factors such as contiguous foci of infection, heroin addiction, rheumatoid arthritis, diabetes mellitus and maintenance hemodialysis. This case occurred in healthy adult. The etiological agent was staphylococcus aureus. Good result wads achieved by applying appropriate antibiotic therapy combined with an adequate drainage.
Adult ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Causality ; Diabetes Mellitus ; Drainage ; Heroin Dependence ; Humans ; Renal Dialysis ; Staphylococcal Infections ; Staphylococcus aureus ; Sternoclavicular Joint

PURPOSE: We investigated reproducibility of the quantification of left ventricular volume and ejection fraction, and grading of myocardial wall motion and systolic thickening when we used gated myocardial SPECT and Cedars quantification software. MATERIALS AND METHODS: We performed gated myocardial SPECT in 33 consecutive patients twice in the same position after Tc-99m-MIBI SPECT. We used 16 frames per cycle for the gatingof sequential Tc-99m-MTBI SPECT. After reconstruction, we used Cedars quantitative gated SPECT and calculated ventricular volume and ejection fraction (EF), Wall motion was graded using 5 point score. Wall thickening was graded using 4 point score. Coefficient of variation for re-examination of volume and fraction were calculated. Kappa values (k-value) for assessing reproducibility of wall motion or wall thickening were calculated. RESULTS: Enddiastolic volumes (EDV) ranged from 58 mi to 248 ml (122 ml +/- 42 ml), endsystolic volumes (ESV) from 20 mi to 174 mi (65 ml +1- 39 ml), and EF from 20% to 68% (51% +/- 14%). Geometric mean of standard deviations of 33 patients was 5.0 ml for EDV, 3.9 ml for ESV and 1.9% for EF. Their average differences were not different from zero (p>0.05). k-value for wall motion using 2 consecutive images was 0.76 (confidence interval: 0.71-0.81). k-value was 0.87 (confidence interval:0.83-0.90) for assessment of wall thickening. CONCLUSION: We concluded that quantification of functional indices, assessment of wall motion and wall thickening using gated Tc-99m-MIBI SPECT was reproducible and we could use this method for the evaluation of short-acting drug effect.
Heart ; Humans ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: For the purpose of using Re-188 as a therapeutic radionuclide, we performed the quality control of the W-188/Re-188 generation system. MATERIALS AND METHODS: Several quality control tests of the Re-188 eluate from generator were carried out of about 300 days. After elution of Re-188 with normal saline (20 ml), chromatogram and gamma-ray spectrum of Re-188 eluate were obtained. The presence of aluminum which was derived from the elumina bed of the generator was detected by using aluminum ion indicator kit. Re-188 eluate was allowed to decay for several days, and then W-188 breakthrough in the Re-188 eluate was measured by detecting gamma-ray at 227 keV and 290 keV. The pH and the pyrogenicity of the eluate were checked. The Re-188 eluate from the generator was 67.4+/-7.0% of W-188 during 270 days, and it was hightest at third day after previous elution. Radiochemical purity of Re-188 eluate obtained from chromatogram was higher than 99%. Gamma-ray spectrum of Re-188 eluate showed a peak at 155 keV. Aluminum ion and W-188 contamination were not detected. The pH of Re-188 eluate was 3 and the concentration yield was 85%. CONCLUSION: Our experiments and results on quality control tests of Re-188 eluate from W-188/Re-188 generator may be useful for setting W-188/Re-188 generator in hospitals.
Aluminum ; Hydrogen-Ion Concentration ; Quality Control*

PURPOSE: For the purpose of using Re-188 as a therapeutic radionuclide, we performed the quality control of the W-188/Re-188 generation system. MATERIALS AND METHODS: Several quality control tests of the Re-188 eluate from generator were carried out of about 300 days. After elution of Re-188 with normal saline (20 ml), chromatogram and gamma-ray spectrum of Re-188 eluate were obtained. The presence of aluminum which was derived from the elumina bed of the generator was detected by using aluminum ion indicator kit. Re-188 eluate was allowed to decay for several days, and then W-188 breakthrough in the Re-188 eluate was measured by detecting gamma-ray at 227 keV and 290 keV. The pH and the pyrogenicity of the eluate were checked. The Re-188 eluate from the generator was 67.4+/-7.0% of W-188 during 270 days, and it was hightest at third day after previous elution. Radiochemical purity of Re-188 eluate obtained from chromatogram was higher than 99%. Gamma-ray spectrum of Re-188 eluate showed a peak at 155 keV. Aluminum ion and W-188 contamination were not detected. The pH of Re-188 eluate was 3 and the concentration yield was 85%. CONCLUSION: Our experiments and results on quality control tests of Re-188 eluate from W-188/Re-188 generator may be useful for setting W-188/Re-188 generator in hospitals.
Aluminum ; Hydrogen-Ion Concentration ; Quality Control*