During ideal physiologic occlusion in the intercuspal position, all molars are occluded simultaneously and each occlusal contact evenly transmits similar pressure. The purpose of this study is to analyze the occlusion in the mandibular bone fracture patients treated by open reduction. This patients were selected according to the following criteria: 1) complete dentition without any missing teeth, 2) relatively normal occlusion without original TMJ disorder. Occlusal analysis using T-scan system were performed in 22 patients and 20 normal subjects. Our results were followed: 1. The number of occlusal contacts and the magnitude or occlusal force were increased with time. (p<0.05). 2. In the unilateral mandibular fracture patients, occlusal force and occlusal contacts were increased with time on the both sides. 3. There was significant difference in the number of occlusal contacts and occlusal force between postoperative 1 month and normal group(P<0.05), but there was no significant difference in the number of occlusal contacts and occlusal force between postoperative 6 month and normal group(p>0.05).
Bite Force ; Dentition ; Fractures, Bone ; Humans ; Mandibular Fractures* ; Molar ; Temporomandibular Joint Disorders ; Tooth

Tuberculosis of the spine is still prevalent in many parts of the world and still remains as an important orthopaedic problem in Korea. Moreover, spinal tuberculosis is the most common and dangerous form of skeletal tuberculosis. With the availability of very effective antituberculous drugs two divergent controversy in the management of tuberculosis of the spine have been reported. A large group of surgeons has advocated the radical excision of the tuberculous focus and replacement of the defect with autogenous bone grafts under cover of chemo-therapy, and another practise is typified by regimen of Friedman, Konstam, Kaplan, and Stevenson and Manning, who treated a large number of patients with spinal tuberculosis using antiuberculous drugs alone. Even now, because of the shortage of hospital beds and ancillary help, private poor economy and patients general condition, some group of patient with tuberclous spine have been treated conservatively using effective antituberculous drugs. In this study authors clinically analysed the 75 patients who had conservative treatment with triple drug therapy for 18 months at the department of Orthopaedics, Catholic Medical College and Center during the past 10 years, and the results were as follows: 1. There were two prevalent age groups. One is the first decade (30.6%) and the other is the third decade(30.7%). The age prevalence in children was 6 to 10 years of age. 2. The lesions were common in the lumbar spine(56.0%) and the most commonly involved vertebra was L3. The average initial number of involved vertebral body was 1.9 vertebrae and it was changed to 2.3 vertebrae at the end of treatment(18 months). 3. Active pulmonary foci was associated in 17.4%(6.7% of tuberculous pleurisy included). 4. Out of 75 cases twenty-six(34.7%) had new involvement at the adjacent vertebra within 18 months after treatment. 5. The radiographic activity was assessed as active in all cases initially, but at 18 months after treatment 83% of the cases were in quiescent condition, and this percentage was increased to 78.7% at 36 months. 6. Spontaneous fusion rate of involved vertebral bodies was 24% at 18 months and 36% at 36 months after treatment, respectively. 7. Radiologically observed deep seated abscess shadow disappeared slowly over 3 to 20 months, but this disappearance was observed mainly within 8 months after treatment. 8. Mean increment of the kyphosis was average 7.5 degree (9.3° in children and 6.6° in adults) at the end of the treatment(18 months), and average 8.6 degree(10.9° in children and 7.3° in adults) at 36 months, by. internal gibbus angle. 9. Almost in all the adult patients, kyphosis developed during the active phase of the disease, while in children kyphosis progressed even after the healing of the disease. Children who had multiple vertebral involvement at the dorsal area had a tendency to develop more severe kyphosis. 10. Decrement of the kyphosis angle which located at the lumbar area after the end of the treatment was considered to be an effect of narmal lordotic curvature. 11. Generally representation of the changes seen in children was almost osteolytic change without sequestrum in comparison to adults who had more sequestrum formation. 12. In 95% of cases a favourable results were obtained.
Abscess ; Adult ; Child ; Drug Therapy ; Humans ; Korea ; Kyphosis ; Prevalence ; Spine ; Surgeons ; Transplants ; Tuberculosis ; Tuberculosis, Pleural ; Tuberculosis, Spinal

No abstract available.
Hyperbilirubinemia, Neonatal*

The electrocardiographic and echocardiographic analysis was made on 23 patients with atrial septal defect of ostium secundum type, who were confirmed by right heart catheterization under admission at hanyang University Hospital from january 1979 to July 1981. Following results were obtained: 1) In the 23 patients, 13 were male and 10 female. Their ages ranged from 6 to 45 years, mean age being 19.9 years. 2) In 18 patients(78.3%), the QRS axis was between +90degrees and +150degrees. No significant correlations could be demonstrated between QRS axis and some hemodynamic parameters(right ventricular systolic pressure, pulmonary artery mean pressure and pulmonic to systemic flow ratio), and also, between QRS axis and the size of right ventricular dimension index. 3) Right ventricular outflow tract hypertrophy, right ventricular hypertrophy and complete right bundle branch block pattern in Lead V3R or V1were observed in 95.7% of ostium secundum defect. No significant correlations could be found between types of QRS complexes and some hemodynamic parameters(right ventricular systolic pressure, pulmonary artery mean pressure and pulmonic to systemic flow ratio), and also, between types of QRS complex and the size of right ventricular dimension index. 4) The mean amplitude of S wave in precordial Lead V6was 7.6mm. There was a definite correlation between the amplitude of S wave in Lead V6and right ventricular systolic pressure. No significant correlations could be demonstrated betwen the amplitude of s wave in Lead V6and some hemodynamic parameters(pulmonary artery mean pressure and pulmonic to systemic flow ratio), and also, the size of right ventricular dimension index. 5) Right ventricular dimension index was increased in all cases but one. A significant correlation was found between the size of right ventricular dimension index and pulmonary artery mean pressure, whereas no significant correlation could be demonstrated between the size of right ventricular dimension index and pulmonic to systemic flow ratio. 6) 95.7% of 23 patients with ostium secudum defect showed paradoxical septal motion was proved not to be associated with other congenital heart disease by cardiac catheterization. The pulmonic to systemic flow ratio in groups of septal motion type A was significantly increased than that of normal septal motion group, whereas no significantl relation between types of septal motion and the size of right ventricular dimension index was observed.
Arteries ; Axis, Cervical Vertebra ; Blood Pressure ; Bundle-Branch Block ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Electrocardiography* ; Female ; Heart Defects, Congenital ; Heart Septal Defects, Atrial* ; Hemodynamics ; Humans ; Hypertrophy ; Hypertrophy, Right Ventricular ; Male ; Pulmonary Artery

It appears that frequency of fractures of the aceta ulum is increasing with the number of automobiles on our roads and when they occur they seem to pose difficulties of management. Because, the anatomy of this region is complicated, making surgical approaches difficult. Second, the patients often have major associated injuries, making early operative treatment hazardous. Third, the fractures are often severly comminuted, leading many surgeons to beleave that operative reduction is impossible. Finally, and unfortunately, the fractures are often missed. The aim of treatment must be to restore the fractured acetabulum to its normal anatomy followed by early motion to promote healing and restore function. Undisplaced acetabular fractures have a good prosis with conservative treatment but patients with displaced fractures of the acetabulum not reduced by manipulation and traction should be considered candidates for open reduction. The author experienced 72 cases of acetabular fracture patients who were admitted to the department of Orthopaedic Surgery of Catholic Medical College and Center from January 1979 to August 1983. The results of 48 patients who were followed up over 6 months period were as follows; l. Among 72 cases(44 were male and 28 were female), the most common causes of acetabular fracture was pedestrian struck by car. 2. 56 were treated conservatively and 16 were treated surgically. The result were as follows; Excellent-15(31%), Good-23(48%), Fair-8(17%), Poor-2(4%). 3. 72 cases were classified by Letournel classification. The most common type was posterior wall fracture(14 cases), and second most was T-shaped fracture(13 cases). 4. If the grossly displaced fragments are present they should be reduced and fixed surgically if surgical approach can be done. 5. It is essential to understand the pathologic anatomy of the acetabulum in order to approach the acetabular fracture sefely and with maximum ease.
Acetabulum ; Automobiles ; Classification ; Clinical Study ; Humans ; Male ; Surgeons ; Traction

In order to clarify the preneoplastic nature of large regenerative nodules without dysplastic change, we analysed the clonality of hepatocellular carcinomas (HCCs) and large nodules, diameter > or =0.5 cm, of cirrhotic liver by X-linked human androgen receptor (HUMARA) gene assay, using the principle of random X chromosome methylation and inactivation in female. Ten cases of HCC and 5 cases of large nodules without dysplasia from 9 female patients were selected. All the tumors, large nodules and paired normal control cells were selectively microdissected from deparaffinized hematoxylin and eosin stained slides. Genomic DNA was isolated and digested with HhaI. Polymerase chain reaction(PCR) amplication of the HUMARA locus was performed using 32P-a-dCTP containing PCR mixtures. The PCR amplified products were separated by gel electrophoresis and analysed by autoradiography. Nine HCCs from 8 patients were monoclonal and 1 case was polyclonal and the remaining 1 case was not polymorphic at the HUMARA locus. The HCC case which showed polyclonality contained many inflammatory cells. All the large nodules were polyclonal by HUMARA assay. These results suggest that all or most of the cells composing the large regenerative nodules without dysplasia are polyclonal. This assay may be informative for the differentiation between regenerative and preneoplastic nodules in cirrhotic liver and the size of nodule may be not important in hepatocarcinogenesis.
Autoradiography ; Carcinoma, Hepatocellular* ; DNA ; Electrophoresis ; Eosine Yellowish-(YS) ; Female ; Fibrosis ; Hematoxylin ; Humans ; Liver ; Methylation ; Polymerase Chain Reaction ; Receptors, Androgen ; X Chromosome

A twenty four-year-old female patient had suffered progressive dyspnea for 6 years until death. She denied any symptoms suggestive of connective tissue disease, or deep vein thrombosis. She suffered an episode of pontine infarct in 1995. Four years after diagnosis of primary pulmonary hypertension, she died of sudden death during hospitalization. Gross features of pulmonary arteries at autopsy were as follows: left main pulmonary artery showed dilation of the lumen and thickening of the wall, and right main pulmonary artery was markedly dilated and contained fresh thrombus. Hematoxylin and eosin-stained sections of lung tissue showed plexiform lesions of pulmonary arteries, complete luminal obliteration of pulmonary arterioles and dilated lesion of pulmonary arterioles, and capillaries. This patient represents a typical case with a primary pulmonary arteriopathy with plexiform lesions with thrombotic lesion, demonstrating the importance of thrombosis in situ in the pathogenesis of primary pulmonary hypertension. To our knowledge, this is the first autopsy report on the primary pulmonary hypertension in Korea.
Arterioles ; Autopsy ; Capillaries ; Connective Tissue Diseases ; Death, Sudden ; Diagnosis ; Dyspnea ; Female ; Hematoxylin ; Hospitalization ; Humans ; Hypertension, Pulmonary* ; Korea ; Lung ; Phenobarbital ; Pulmonary Artery ; Thrombosis ; Venous Thrombosis

No abstract available.
Postoperative Complications*

In the orthopedic Department of Jeonbug National University Hospital, twenty-five open tibial shaft fractures were reviewed and analyzed with osteomedullography and bone scanning with radioactive isotopes from June 1981 to October 1983. The results are as follows. 1. The cases of injury were mostly traffic accident(70.8%) and majority was found between second decade and third decade. Males were 11 times more frequent than females. 2. In the shape and location of fractures, comminuted fracture(60%) was most common, and fracture of middle one third(48%), lower one third(28%) were in order. 3. In the open tibial fractures, Grade I. of soft tissue injury was most frequent(64%). As inthe plate fixation was required, we should it placed atypically on the posterior surface of the tibia. 4. In the osteomedullography at 3 months after treatment, the rate of positive finding was 80 and intraosseous crossing vein(Kaski sign 1) was observed most frequently. 5. In the profile of the bone scanning with radioactive isotopes, the rate of single-peak uptake was 76% and twin-peak uptake was 24%. 6. In the negative Osteomedullogram and twin-peak uptake on the profile of the bone scanning, bone graft was necessary. 7. In the case of difficult diagnosis for union process of tibia fracture, osteomedullography and bone scanning with radioactive isotopes were considered useful method of early diagnosis.
Diagnosis ; Early Diagnosis ; Female ; Fractures, Comminuted ; Fractures, Open ; Humans ; Jeollabuk-do ; Male ; Methods ; Orthopedics ; Radioisotopes ; Soft Tissue Injuries ; Tibia ; Tibial Fractures ; Transplants

Erythromelalgia is a rare condition, of uncertain etiology, characterized by episodic erythema, intense burning pain and warmth of the hands and/or feet. We present here a case of erythromelalgia that was almost mistaken for lower leg pain of spinal origin. The diagnosis is based on a thorough history and physical exam during a painful episode along with diagnostic test to exclude other causes. A 69-year-old man developed recurrent attacks of redness, swelling and burning painful sensations of both feet. His symptom was aggravation of pain with warm water immersion. His symptom improved by antidepressant and steroid. To be learned an important general lesson is to pay attention to performing extensive diagnostic and therapeutic procedures. It should be appreciated that discontinuation of medication can also be used as a simple diagnostic test for clinical syndromes, such as erythermalgia.
Aged ; Burns ; Diagnostic Tests, Routine ; Erythema ; Erythromelalgia ; Foot ; Hand ; Humans ; Immersion ; Leg ; Sensation ; Water