Fractures of the tibial condyles, involving as they do weight-bearing articular surfaces and important soft tissues such as collateral ligaments, cruciate ligaments and semilunar cartilages present a variety of problems in treatment and prognosis. Apley, Slee, and others maintained the opinion that most fractures of the tibial condyles could be managed conservatively. On the other hand, Rombold, Schatzker, and others seemed to consider closed treatment to be virtually a form of therapeutic nihilism and adviced open reduction. But recently most authors agree that the method of treatment has to be selected in each individual case, and recommend anatomical reduction of the fracture as possible and early knee motion. During 7 years period from January 1974 to July 1981, of the tibial condylar fractures treated at the department of orthopaedic surgery, Han Gang Shim Hospital, 41 cases that could be followed have been analysed according to the cause, classification, method of treatment and result. The following results were obtained from the analysis of 41 tibial condylar fractures. l. Of the 41 cases, 34 (83%) were male and 7 (17%) were female. 2. Of the 41 cases, 32 (78%) were due to traffic accident, 25 pedestrian, 7 occupant, 8 (20%) were due to fall from height. 3. Of the 41 cases, 31 (76%) were associated with other injuries. 4. Of the 41 cases, 30 were treated by conservative method with functionally acceptable result in 22 cases (73%) and 11 were treated by open reduction with functionally acceptable result in 9 cases (82%). 5. According to the Hohl and Luck's criteria, acceptable functional result was obtained in 31 (76%) cases.
Accidents, Traffic ; Classification ; Clinical Study ; Collateral Ligaments ; Female ; Hand ; Humans ; Knee ; Ligaments ; Male ; Menisci, Tibial ; Methods ; Prognosis ; Weight-Bearing

The occurrence of carcinoma in a congenital uterine anomaly is uncommon. Indeed, malignancy of the uterine fundus with congenital uterine anomaly is quite rare, with fewer than 50 cases reported in the world liturature. Many patients go through life without the knowledge of their presence, and they are discovered at autopsy. Early diagnosis and proper management is necessary to decrease the high mortality. We present a case of endometrial carcinoma in a single horn of a bicornuate uterus.
Animals ; Autopsy ; Early Diagnosis ; Endometrial Neoplasms* ; Female ; Horns* ; Humans ; Mortality ; Uterus*

BACKGROUND AND OBJECTIVES: Spontaneous progression of severe congestive heart failure is structurally characterized by cellular degeneration and multiple foci of myocardial cell death. The cardiac troponin I (cTnI), one of the subunits of the troponin regulatory complex, binds to actin and inhibits interaction between actin and myosin. cTnI is uniquely expressed in the adult human myocardium, and an increase in its circulating levels is highly indicative of myocardial injury. In this study, we addressed the usefulness of cTnI as a sensitive and specific molecular marker for severity in patients with congestive heart failure. MethodscTnI, creatinin kinase-MB (CK-MB), and myoglobin were assessed in 59 patients with severe congestive heart failure diagnosed by the echo-cardiography and gated equilibrium blood pool heart scan. Also we assesed cTnI, creatinin kinase-MB (CK-MB), and myoglobin in 25 persons without cardiac disease in echocardiography. RESULTS: 1) The cTnI con-centration was 89.6+/-69.3 pg/mL in patients with congestive heart failure and its level was greater than that of the control group (22.4+/-17.1, p=0.001). 2) The cTnI level differed significantly according to left ventricular ejection fraction (EF), 117.3+/-73.8 pg/mL in patients with EF\<40% (28 patients), 66.3+/-44.5 pg/mL in patients with EF> or =40% (31 patients), 22.4+/-17.1 pg/mL in the control group (25 persons) (p=0.001). CONCLUSION: cTnI was useful as a specific and sensitive serum molecular marker in patients of congestive heart failure. And its level reflected the severity of congestive heart failure.
Actins ; Adult ; Cell Death ; Echocardiography ; Equidae ; Estrogens, Conjugated (USP)* ; Heart ; Heart Diseases ; Heart Failure* ; Humans ; Myocardium ; Myoglobin ; Myosins ; Stroke Volume ; Troponin I* ; Troponin*

We developed a cardiac cell model to explain the phenomenon of mechano-electric feedback (MEF), based on the experimental data with rat atrial myocytes. It incorporated the activity of ion channels, pumps, exchangers, and changes of intracellular ion concentration. Changes in membrane excitability and Ca2+ transients could then be calculated. In the model, the major ion channels responsible for the stretch-induced changes in electrical activity were the stretch-activated channels (SACs). The relationship between the extent of stretch and activation of SACs was formulated based on the experimental findings. Then, the effects of mechanical stretch on the electrical activity were reproduced. The shape of the action potential (AP) was significantly changed by stretch in the model simulation. The duration was decreased at initial fast phase of repolarization (AP duration at 20% repolarization level from 3.7 to 2.5 ms) and increased at late slow phase of repolarization (AP duration at 90% repolarization level from 62 to 178 ms). The resting potential was depolarized from -75 to -61 mV. This mathematical model of SACs may quantitatively predict changes in cardiomyocytes by mechanical stretch.
Action Potentials ; Animals ; Ion Channels ; Membrane Potentials ; Membranes ; Models, Theoretical ; Muscle Cells* ; Myocytes, Cardiac ; Rats*

PURPOSE: Serum aspartate aminotransferase (AST) is an enzyme widly used in the diagnosis of acute liver disease. It is also highly sensitive in cases of myocardial infarction and muscular injury. This study is designed to ascertain the utility of AST for diagnosis in emergency room. METHODS: From July 2001 to September 2002, 98 patients with AST greater than ten times (400 U/L) the normal range were identified by the biochemistry laboratory in the Emergency Medical Center of Chonnam National University Hospital. The patients 'clinical records were studied to determine the diagnosis, the clinical course, the physical finding on arrival, the past history, other serological and imaging studies, etc. RESULTS: The most common cause of elevated AST level was hepatic in origin (74 cases, 75.5%). Other causes were soft tissue injury (13 cases, 13.3%) and myocardial infarction (11 cases, 11.2%). In group with hepatic causes for raised AST, 21 (28.3%) patients had pancreaticobiliary desease, 20 (27.0%) patients were in conditions producing hepatic ischemia, 18 (24.3%) patients had hepatocellular desease, 6 (8.1%) patients had traumatic liver injury, and 4 (5.4%) patients had malignancy. The hepatic ischemia was caused by sepsis (6 cases, 30.0%), heart failure (6 cases, 30.0%), hypoxia (5 cases, 25.0%), and prolonged hypotension (3 cases, 15.0%). CONCLUSION: The main cause of a notably increased serum AST level is known to be hepatocellular disease, but this study for emergency patients revealed that other causes, such as hepatic ischemia, traumatic liver injury, and muscular disease, were also remarkable. When the level of serum AST is abnormally high, the clinician must consider not only hepatocellular disease but also prolonged hypotension, circulatory collapse, hypoxia, traumatic liver injury, etc.
Anoxia ; Aspartate Aminotransferases ; Biochemistry ; Diagnosis ; Emergencies* ; Emergency Service, Hospital ; Heart Failure ; Humans ; Hypotension ; Ischemia ; Jeollanam-do ; Liver ; Liver Diseases ; Muscular Diseases ; Myocardial Infarction ; Reference Values ; Sepsis ; Shock ; Soft Tissue Injuries

In generalized amyloidosis, involvement of heart is not rare, but development fo severe conduction distubance in cardiac amyloidosis is a rare presentation in a clinical situation. We report the first case in Korea of cardiac amyloidosis with complete atrioventricular block, which was confirmed by endomyocardial biopsy. A 59-year-old woman was admitted due to drowsy mentality. We observed a severe atrioventricular conduction disturbance on the electrocardiogram and a marked hypertrophied ventricular wall and a granular sparkling appearance within the wall, a characteristic feature in cardiac infiltration of amyloidosis, on the echocardiography. Endomyocardial biopsy was performed and revealed extensive deposition of amorphous eosinophilic materials within the cardiac muscle cells. Polarizing illumination after Congo-red staining showed typical green birefrigence. We performed a insertion of permanent pacemaker(VVI type) for the treatment of complete atrioventricular block.
Amyloidosis* ; Atrioventricular Block* ; Biopsy ; Echocardiography ; Electrocardiography ; Eosinophils ; Female ; Heart ; Humans ; Korea ; Lighting ; Middle Aged ; Myocytes, Cardiac

OBJECTIVE: This research is a basic investigation of collecting experts' opinions for constructing the national cancer expert network. The objective of this research is to evaluate present situation and to use it for the planning of future korean cancer network in the cancer-related area. METHODS: We analyzed the need of the network and degree of information demand for constructing the network from Clinicians and Basic researchers(n=376) who answered themselves 'cancer expert'. The questionnaire consists of 9 questions and it was analyzed by using frequence, t-test and Chi-square. RESULTS: 53.7 percents of respondents answered they are already recognized cancer expert network and 93.5 percents of respondents answered that they need the network. Among the services that would be served by the network, the demand of cancer statistics, development and evaluation of cancer policy, and cancer clinical trials were listed in the high priorities. And recognized societies included in the high priorities were Korean Cancer Study Group, Korean Cancer Association, Korean Association for the Study of Lung Cancer. CONCLUSION: We are going to develop a database and network for the experts to generate, evaluate and verify cancer-related information based on evidence-based cancer information infrastructure. Hence, this research will be contributed to provide fundamental data for activating cancer-related research through joint studies with experts.
Surveys and Questionnaires ; Joints ; Lung Neoplasms

Obesity-Hypoventilation syndrome (OHS) is characterized by morbid obesity, hypoxia, and hypercapnea during wakefulness without parechymal lung disease or severe obstructive sleep apnea. A woman was admitted because of mental deterioration and diagnosed as OHS on the basis of obesity and hypoventilation, while awake, after ruling out other causes. By bilevel positive airway pressure (BiPAP) therapy, hypercapnea and hypoxia were resolved. We report that BiPAP can be an effective treatment for severe hypercapnea and hypoxia in OHS, which obviate the need for invasive endotracheal intubation.
Anoxia ; Female ; Humans ; Hypoventilation ; Intubation, Intratracheal ; Lung Diseases ; Obesity ; Obesity Hypoventilation Syndrome* ; Obesity, Morbid ; Sleep Apnea, Obstructive ; Wakefulness

BACKGROUND: Exercise induced ST-segment depression in patients after coronary angioplasty is frequently observed but the mechanism responsible for exercise induced myocardial ischemia early after successful coronary angioplasty is poorly understoodd. The object of this study is to investigate potential determinants of this phenomenon by analizing the clinical, exercise testing, and angiographic characteristics in patients with exercise induced ST-segment depression. METHODS: The study group comprised 13 patients with exercise induced ST-segment depression(Positive group,M:12, mean age:59+/-9year) and 26 patients without exercise induced ST-segment depression(Negative group, M; 22, mean age; 55+/-13 year) after succeessful coronary angioplasty in single vessel disease. We compared preangioplasty clinical, angiographic, and hemodynamic variables in group with positive and negative results on exercise testing after successful PTCA. RESULTS: 1) Clinical characteristics: The initial diagnosis were acute myocardial infarction in 5, unstable angina in 8 patients at positive group, and 16 and 10 patients at negative group, respectively. There were no significant different in initial diagnosis, risk factor for coronary artery disease, and medication used before exercise test at between two groups. 2) Cornary angiography and PTCA: The maximal ballooning size were significantly smaller in positive group than negative group(2.7+/-0.5 vs 3.1+/-0.4mm, 2.9+/-0.4mm, vs 3.2+/-0.4mm, respectively(p<0.05) but there were no significantly different in ejection fraction, end-diastolic volume, end-systolic volume before PTCA. degree of stenosis of lesion before and after PTCA, total ballooning time, balloon pressure, lesion site and infarction relation of lesion at between two groups. 3) Exercise test: The mean time from angioplasty to the performance of exercise testing were 9.5+/-4.0 days in positive group and 6.1+/-4.5 days in negative group. The mean depression of ST-segment was 1.5+/-0.5mm and was predominantly noted in lateral leads(V4-6)(9/13:69%). There were no significantly different in total exercise time, rate-pressure product, and metabolic equivalents-exercise time at positive and negative group. But positive results at follow up exercise test were significantly higher in positive group(p<0.05). CONCLUSION: There were no definite determinating factors for exercise induced ST-segment depression early after successful coronary angioplasty by analizing the clinical, angiographic, and exercise testing variables. The pathophysiologic mechanism of this findding remain to be elucidated, especially for association of microvascular functional alternation.
Angina, Unstable ; Angiography ; Angioplasty* ; Constriction, Pathologic ; Coronary Artery Disease ; Depression* ; Diagnosis ; Exercise Test ; Follow-Up Studies ; Hemodynamics ; Humans ; Infarction ; Myocardial Infarction ; Myocardial Ischemia ; Risk Factors

Spindle cell carcinoma of the esophagus containing both carcinomatous and sarcomatous elements is rare, accounting for approximately 1- 2% of all esophageal neoplasms. Terms used to describe this lesion include carcinosarcoma, pseudosarcoma, polypoid carcinoma, pseudosarcomatous squamous cell carcinoma and spindle cell variant of squamous cell carcinoma. Spindle cell carcinomas were originally classified as carcinosarcomas or pseu- dosarcomas, depending on the morphology and bilologic behavior of the particular lesian. However, pseudosarcoma and carcinosarcoma appear to be the same pathologic entity with varying degrees of anaplastic spindle cell metaplasia of the carcinomatous portion of the tumor. Thus, these lesions have been clsssified together as spindle cell carcinomas. A 59 year-old man who experienced weight loss for 4 months was hospitalized as a result of suffering from dysphagia for 2 months. A diffuse bulky protruding mass with superficial ulceration and easy friability on 25 to 35 cm from the incisors, which invaded the right intermediate bronchus and involved the right paratracheal and subcarnial lymph nodes, were obsetved in esophagogram, endoscopy and chest CT. Pathologic finding, including immunoreactivity to cytokeratin and vimentin, was consistent with spindle cell carcinoma. We report a case of spindle cell carcinoma of the esophagus.
Bronchi ; Carcinoma, Squamous Cell ; Carcinosarcoma ; Deglutition Disorders ; Endoscopy ; Esophageal Neoplasms ; Esophagus* ; Humans ; Incisor ; Keratins ; Lymph Nodes ; Metaplasia ; Middle Aged ; Tomography, X-Ray Computed ; Ulcer ; Vimentin ; Weight Loss