In the workshops where the rorating belts are used belt, injuries frequently occur for lack of a safety device. Those injuries have several characteristics compared with other long bone fractures. Those are mostly multiple open fractures with considerable soft tissue damages, forearm both bones and humerus fractures by bending force and rotational distraction as mechanism of the injury, and sometimes particularly segmental fracture of the radius. From Aug. 1972 to Jan. 1985, we have traced 47patients of multiple fractures of forearm and humerus by belt injuries except 17 patients of solitary fractures of forearm and humerus. 1. This injury is more prevalent in males(M:F=4:1) with the peak incidence between the third and fourth deades(59%). 2. Multiple fractures of forearm and humerus by belt injuries were classified by fracture numbers and mechanism of injury as follows: Type I Fractures of Forearm Both Bones(53.2%). Type II Fractures of Forearm Both Bones and Humerus(27.7%). Type IU Segmental Fracture of Radius and Ulna(10.6%). Type IV Segmental Fracture of Radius, Ulna and Humerus(8.5%). 3. Most were open fractures with soft tissue damages(74%). 4. Nerve paralysis was the most frequent associated injury(27%). 5. All but 7 cases were treated by open reduction. Implants used for internal fixation were compression plates in 20 cases as elective surgery and Rush pins in 15 cases of forearm open fractures as emergency surgery. 6. By Anderson's critcria, satisfactory result(excellent or good) was obtained in 55% of cases.
Education ; Emergencies ; Forearm ; Fractures, Bone ; Fractures, Multiple ; Fractures, Open ; Humans ; Humerus ; Incidence ; Paralysis ; Protective Devices ; Radius ; Ulna

No abstract available.

No abstract available.
46, XX Disorders of Sex Development* ; Adrenal Hyperplasia, Congenital* ; Female* ; Humans

We have experienced automated and computerized perimetry using a Humphrey Field Analyzer in our Glaucoma Services. To evaluate its clinical efficacy, we report the results of the Armaly central field screening test in comparison with those of central 30-2 threshold test of the Humphrey Field Analyzer. One hundred fortythree eyes of 83 cases of normotensives, ocular hypertensives and glaucoma patients with open-angle or narrow-angle were enrolled in this study. Fiftyfour out of 61 patients (88.5%) and 73 out of 81 eyes (90.1 %) with visual field defect were detected by the screening test of the Humphrey Field Analyzer. Eight out of 81 eyes (9.9%) with visual field defect detected by the screening test were confirmed as false positive. All points of false positive were solitary, which tended to occur more frequently on superior vusual field. False negative of 8 eyes (12.9%) detected by the screening test were confirmed by the threshold test. The point of false negative was more frequent on superior field and showed to locate more peripherally from the fixation point. There was no significant difference in either central sensitivity or age of the false ring.
Glaucoma ; Humans ; Mass Screening* ; Visual Field Tests ; Visual Fields*

The first comprehensive clinical description of exfoliation syndrome was published by Vogt. The appearance is described as a deposition of white granular fluffy material on the anterior lens surface, pupil margin, zonule, ciliary body and anterior chamber angle, and floating free in the aqueous. At past, this syndrome was thought to be rare outside of the Scandinavian countries, but the relatively high prevalence has been noted in many other countries outside of Scandinavia. The clinical significance of this syndrome is high frequency of glaucoma. Six cases in this report illustrate some of typical clinical features of exfoliation syndrome. The purpose of this study is to concentrate our attention upon the presence of this syndrome in Korea.
Anterior Chamber ; Ciliary Body ; Exfoliation Syndrome* ; Glaucoma ; Korea ; Prevalence ; Pupil ; Scandinavia

Six patients with exfoliation syndrome were seen in our glaucoma clinic. Four patients presented unilateral ocular involvement and the other 2 patients were bilaterally involved. Eight eyes had exfoliation material on the anterior surface of the lens and pupillary border, and 7 eyes exhibited it on the anterior chamber angle. Sampaolesi`s line was detected in 4 eyes. Five patients (6 eyes) of 6 patients (8 eyes) with exfoliation exhbited an elevated intraocular pressure (IOP) exceeding 21 mmHg. Among them, 3 patients (3 eyes) had an extremely high maximum IOP over 47 mmHg, and 2 patients (3 eyes) had a slightly elevated IOP less than 26 mmHg during the follow-up period. Argon laser trabeculoplasty (ALT) was performed twice on each unilateral eye of the 2 patients on whom the inital trabeculectomy failed. However, longterm IOP control after laser treatment was not obtained in either case, which might be due to the extremely high prelaser lOP level, in exoess of 40 mmHg.
Aged ; Anterior Eye Segment/*physiopathology/surgery ; Eye Diseases/diagnosis/*physiopathology/surgery ; Female ; Glaucoma/physiopathology/surgery ; Humans ; Intraocular Pressure ; Korea ; Laser Therapy ; Male ; Middle Aged ; Trabeculectomy

There is much controversy concerning the method of treatment on the tibial fracture because of frequent complications, such as non-union, delayed union and infection. Authors reviewed and analyzed 110 tibial fractures which had been treated at the Department of Orthopedic Surgery, Sung Ae General Hospital from June 1983 to March 1987 by the groups, conservative treatment, open reduction and internal fixation with compression plate and closed flexible intramedullary nailing. The results were as follows :1. In regard to the fracture location, there was no difference in the healing time among the treatment methods. The I.M. nailing group healed 1.5 weeks earlier than other groups in each location. 2. In minor and moderate severity by Ellis, the I.M. nailing group revealed better result, and in major one, the compression plate group showed better result. More complications occured in major severity. 3. Union time among the trestment methods was not affected by the fibular fractures, but most of the complications occured in the concomitant fibular fracture case. 4. In open fracture, the healing time showed no difference among the groups, and was prolonged about 2 weeks than closed fracture. In closed case, the I.M. nailing group showed good result. 5. The cases, which were reduced earlier in the conservative group, and treated within 3 days in the I.M. nailing group revesled better result. 6. The radiological union time from the definite treatment was 15.80 weeks in the conservative treatment group, 15.18 weeks in the compression plate group and 13.92 weeks in the I.M. nailing group.
Clinical Study ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Hospitals, General ; Methods ; Orthopedics ; Tibia ; Tibial Fractures

PURPOSE: Peripheral T-cell lymphomas(PTCL) show diverse clinical and histological characteristics and should be understood as mixtures of heterogeneous entities. Although many clinical and biological parameters have been proposed for classifying PTCL into different prognostic groups, few parameters have turned out to be appropriate for classification. To investigate the clinical significance of FUO presentation in PTCL, comparisons of clinical parameters were performed using non-FUO presentation as a control. MATERIALS AND METHODS: 66 cases of Korean PTCL were divided into FUO group and non-FUO group according to the presentation and compared with each other. RESULTS: Among 66 patients of PTCL, 19 patients presented with FUO. Compared with non-FUO group, FUO group showed no significant age and sex ratio differences. FUO group showed more advanced stage, worse performance status than non-FUO group. Predominant sites of definite diagnosis were skin, gastrointestinal tract and liver in FUO group and nasal cavity and paranasal sinus in non-FUO group. There were no significant differences between histologic classifications of both groups. Survival analysis revealed significant differences between both groups. FUO group showed significantly shorter survival. Prognostic factor analysis(multivariate) was done with stage, LDH level, performance status, and FUO status. FUO status, stage and performance status were significant determinants of survival, but LDH level proved to have no prognostic implication. CONCLUSION: PTCL with FUO presentation showed such distinct characteristics that the authors propose fever of unknown origin(FUO) as a clinical parameter for classifying PTCL. Further studies are needed to identify biological parameters which characterize PTCL with FUO presentation.
Classification ; Diagnosis ; Fever of Unknown Origin* ; Fever* ; Gastrointestinal Tract ; Humans ; Liver ; Lymphoma* ; Nasal Cavity ; Prognosis ; Sex Ratio ; Skin ; T-Lymphocytes

The effects of epidural bupivacaine with and without epinephrine and morphine on mat-ernal blood pressure, newborn Apgar scores, and duration of analgesia were compared in 40 parturients during Cesarean section and post operative periods. Patients in group 1(n= 16) received 0.5% bupivacaine 27cc and group 2(n=10) recelved bupivacaine with epinephrine, group 3 (n= 10) received bupivacaine with morphine 3mg, and those in group 4(n= 10) received bupivacaine with epinephrine and morphine 3mg. Maternal hypotension occured less frequently in group 2 than in group 1 (p<0.001). Apgar scores were equally good (more than 8) all four groups. Duration of analgesia was longer in group 2(199.50+/-70.73min) than in group 1(133.50+/-50. 11min) but significantly longer in group 3(471.50+/-174.90) and in group 4(684.00+/-276. 92min) . It is concluded that adding epinephrine and morphine to bupivacaine during epidural anesthesia in the normal parturient has no adverse effects on either mother or neonate; and that it significantly prolongs the duration of analgesia and decreases the incidence of maternal hypotension.
Analgesia ; Anesthesia, Epidural* ; Blood Pressure ; Bupivacaine* ; Cesarean Section ; Epinephrine* ; Female ; Humans ; Hypotension ; Incidence ; Infant, Newborn ; Morphine* ; Mothers ; Obstetrics* ; Pregnancy

PURPOSE: Hemodynamically significant patent ductus arteriosus (PDA) may increase the mortality of premature infants who received ventilator care by aggravating hypoxia, acidosis, pulmonary edema and hypotension. The risk factors for PDA in premature infants are low gestational age, infusion of excessive fluid, and severity of neonatal respiratory distress syndrome. We studied the risk factors of PDA in very low birth weight infants (VLBW) to establish a guideline for the treatment. METHODS: VLBW infants who were born at Severance Hospital, Yonsei Medical Center from January, 1989 through December, 1995 and survived for at least 5 days with ventilator care were recruited for this study. Patent ductus arteriosus was diagnosed according to the clinical diagnostic criteria of Yeh (Yeh et al, 1981b). Thirty six infants had diagnosed as PDA (PDA group), and thirty seven infants who had not PDA were selected as control. Both groups of infants received restrictive fluid therapy. RESULTS: 1) Gestational age, sex, Apgar score, administration of surfactant, mode of delivery, toxemia and use of antenatal dexamethasone were similar between PDA and control infants. 2) In PDA group, ventilatory index and duration of vetilator care were significantly greater (P<0.05), and a/ApO2 was significantly lower than control group (P<0.05). There was no difference in peak inspiratory pressure at initial setting, the highest peak inspiratory pressure and mean airway pressure during ventilator care. 3) During the first 3 days of life, the urine output was similar between groups. On the 4th and 5th days of life, PDA group had significantly reduced urine ouput compared with control (on day 4; 2.6+/-1.1 ml/kg/h vs. 3.2+/-1.2ml/kg/h, P<0.05; on day 5, 2.9+/-1.4ml/kg/h vs. 3.6+/-1.6ml/kg/h, P<0.05) . 4) The percent weight loss compared to birth weight was siginificantly lower in PDA group (12.5% vs. 15.1%, P<0.05). 5) The PDA group had higher incidences of bronchpulmonary dysplasia and intraventricular hemorrhage (P<0.05). CONCLUSION: Among Vlnfants who received restrictive fluid therapy during the first 5 days of life, infants with PDA had reduced urine output and percent weight loss than control group.
Acidosis ; Anoxia ; Apgar Score ; Birth Weight ; Dexamethasone ; Ductus Arteriosus* ; Ductus Arteriosus, Patent ; Fluid Therapy ; Gestational Age ; Hemorrhage ; Humans ; Hypotension ; Incidence ; Infant* ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight* ; Mortality ; Pulmonary Edema ; Respiratory Distress Syndrome, Newborn ; Risk Factors* ; Toxemia ; Ventilators, Mechanical ; Weight Loss