In addition to general charceteristics of tibial fracture, segmental tibial fracture is commonly combined with extensive soft tissue injury, comminution and displacement with poor blood supply in its middle segment. According to recent reports, intramedullary nailing was regarded as the excellent method in the management of this kind of fracture. Twenty-one cases were treated at the department of Orthopaedic Surgery, National Medical Center from January 1980 to December 1987 and following results were obtained; 1. Most common type of fracture was Type I (38.1%). Almost all the fractures were accompanied by open wounds(85.7%) and GIIIB open wounds were 12 cases(57.1%). 2. A verage union time was 31.8 weeks(union rate, 76.2%) and showed marked difference between closed fracture(20.2 weeks) and GIIIB open one(38.6 weeks). 3. Better results were seen in 8 cases of intramedullary nailing(average union time, 24.2 weeks), while all the plating method showed non-union in 3 cases of open wound.
Fracture Fixation, Intramedullary ; Methods ; Soft Tissue Injuries ; Tibia ; Tibial Fractures ; Wounds and Injuries

The present study was undertaken to evaluate the anthelmintic effects of fenbendazole against intestinal nematode; Ascaris lumbricoides, hookworm and Trichuris trichiura, and to compare the efficacy in fenbendazole, oxantel-pyrantel pamoate and placebo by means of double blind method. Out of 114 subjects harbouring Ascaris lumbricoides, hookworm and Trichuris trichiura, 36 cases were treated with single dose of fenbendazole, 38 cases with oxantel-pyrantel pamoate, and the remaining 40 cases had received the placebo. The results were as follows: In the group treated with fenbendazole (30-50 mg/kg), the cure rates were 83.9 percent in 31 subjects with Ascaris lumbricoides and 83.3 percent in 18 subjects with hookworm, and only 28.6 percent in 28 subjects with T. trichiura respectively. In the group treated with a single dose of oxantel-pyrantel pamoate (10 mg/mg), the cure rates were 96.7 percent in 30 subjects with A. lumbricoides, 95.2 percent in 21 subjects with hookworm, and 54.6 percent in 33 subjects with T. trichiura. Egg reduction rate was 85.7 percent in T. trichiura cases. On the other hand, the egg negative conversion rates in placebo group were 9.7, 8.3 and 33.3 percent in Ascaris, Trichuris and hookworm infections respectively. The above results showed that fenbendazole was highly effective against Ascaris and hookworm. However, incomparisom with oxantel-pyrantel pamoate, fenbendazole was less effective in regards of A. lumbricoides, hookworm and T. trichiura infections.
parasitology-helminth-nematoda ; chemotherapy ; Ascaris lumbricoides ; hookworm ; Trichuris trichiura ; fenbendazole ; oxantel-pyrantel pamoate

Osteoma is relatively rare benign tumor of non-inflammatory origin having a circumscribed form, a definite periosteal covering forming a line of cleavage from adjacent structures and showing active participation of osteoblasts. The tumor commonly originates in a nasal accessory sinus or calvaria and may invade the orbit relatively early in its growth, causing ocular disability prior to localizing signs in the smus. We have reported a giant osteoma in an adult having right eye protrusion, pain and interference of eyeball movements. The mass was totally removed by transcranial route successfully with no development of significant complications. The mass was extremely hard, well circumscribed and extended into right frontal, ethmoidal sinuses and orbital cavity.
Adult ; Ethmoid Sinus* ; Humans ; Orbit* ; Osteoblasts ; Osteoma* ; Skull

The authors report a case of glossopharyngeal neuralgia which was successfully treated with intracranial section of the glossopharyngeal and upper two rootlets of the vagus nerves. Despite of the complete section of these nerves, corresponding sensory or motor deficit was not developed. And the histories of this surgery were reviewed.
Glossopharyngeal Nerve Diseases ; Neuralgia* ; Vagus Nerve

Poor R-Wave Progression(PRWP) of precordial leads is frequently encountered electrocardiographic findings of uncertain significance and has simply been deemed as suggestion of anterior myocardial infarction without concrete ground. 217 cases with poor R-Wave Progression have been analyzed on clinical records and results are as follows. 1) PRWP was most frequently found in fifties and sixities, comprising 63.9% of the subjects. 2) Co-existent disease entities with PRWP were classified into three categories, cardiovascular diseases, chronic lung diseases and normal variants. 3) The cardiovascular diseases related with PRWP were mainly hypertensive diseases, comprising 59.8% of cardiovascular diseases, followed by ischemic heart disease, valvular heart disease and cardiomyopathies. 4) PRWP may be an early sign of acute myocardial infarction in a certain part of cases, which was endorsed by typical clinical symptoms and enzyme studies. 5) As the criterion of PRWP, V3R equal to or less than 3 mm was thought more adequate for higher specificity rather than 4 mm.
Cardiomyopathies ; Cardiovascular Diseases ; Electrocardiography ; Heart Valve Diseases ; Lung Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Sensitivity and Specificity

No abstract available.
Humans ; Teicoplanin*

A brain abscess recurred after complete removal of encapsulated mass on the quite same spot three months later. 23-year-old woman was admitted to our hospital because of headache and vomiting for 3 months. On admission, she was mentally alert but the bilateral optic discs were markedly blurred. Left carotid angiogram and Conray ventriculogram suggested a large space-occupying lesion. At the time of operation, a large mass was removed with slightest occipital damage to the brain. On selection of the extirpated mass, thick purulent liquid came out. After operation, her neurological deficits were markedly improved except the equivocal hemiparesthesia of the right extremity. Postoperative course was quite uneventful and she was discharged. After 3 months postoperatively, she was re-admitted with recurrence of the trouble. She was comatose at this time. Pupillary light reflex was abolished. Pathologic reflexes were positive. The angiography and brain scan revealed recurrence of abscess on the just same area. Puncture for aspiration was immediately performed. Purulent materials were drained about 40ml. After abscess cavity was irrigated with physiologic saline solution, instillation of penicillin and micropaque was done within cavity. After several repeated puncture and aspiration her conditions were dramatically improved. Again, she became almost asymptomatic and was discharged days later her second admission. The results are as following ; 1. Primary focus of bacterial spreading to the brain was not found on both occasions. 2. Pathogenesis of both occasions was not clear. 3. At time of first operation, evidence of local inflammation was not found. 4. Local process and other induration was not found. These were confirmed with the operation and brain scanning. 5. Recurred brain abscess was newly developed. It seems to be hematogenous spreading in anywhere else.
Abscess ; Angiography ; Brain Abscess* ; Brain* ; Coma ; Extremities ; Female ; Headache ; Humans ; Inflammation ; Penicillins ; Punctures ; Recurrence ; Reflex ; Sodium Chloride ; Vomiting ; Young Adult

PURPOSE: There is no scientific basis for an immunization policy for children with renal disease who have increased risk of infection in Korea. As an initial step in approaching this problem, this survey of pediatric nephrologists was undertaken to determine the current recommendations of practicing pediatric nephrologists. METHODS: Questionnaires were sent to the members of Korean Society of Pediatric Nephrology via mail and E-mail. The questionnaire was designed to obtain information about the immunization practice of basic vaccination schedule for nephrotic syndrome, the side effects after vaccination and the immunization practice about recommended vaccines for children with renal disease. RESULTS: Questionnaires were sent to 56 pediatric nephrologists. 35 replies were received (response rate: 62.5%). Almost of the respondents (82.8%) reported practicing at university hospital. All respondents reported modified vaccination schedule. 65.7% of the respondents immunized nephrotic children with live vaccines some time later after discontinuation of corticosteroids treatment and 57.1% of respondents immunized them with killed vaccines during medication of low doses of corticosteroids. Respondents experienced relapse of nephrotic syndrome after vaccination are nine, lack of vaccine efficacy are three and infection by organisms of live vaccines are two. 71.4% of respondents reported vaccinating children with renal disease for hepatitis B, pneumococcus and influenza during medication of low doses of corticosteroids. But There is few difference of the rates of respondents vaccinating them for Hemophilus influenzae type b between during medication of low doses of corticosteroids and after discontinuation of corticosteroids treatment (45.7% vs 42.9%). Almost of respondents reported vaccinating renal failure children without immunosuppression for hepatitis B, pneumococcus, influenza and H. influenzae type b (54.3-77.1%). CONCLUSION: Pediatric nephrologists practiced modifying vaccination schedules for children with renal disease in Korea and there was variation according to the progression of disease and the doses of corticosteroids. It is necessary to establish the immunization guideline for children with renal disease through the prospective studies.
Adrenal Cortex Hormones ; Appointments and Schedules ; Child* ; Surveys and Questionnaires ; Electronic Mail ; Haemophilus influenzae type b ; Hepatitis B ; Humans ; Immunization* ; Immunosuppression ; Influenza, Human ; Korea ; Nephrology* ; Nephrotic Syndrome ; Postal Service ; Surveys and Questionnaires ; Recurrence ; Renal Insufficiency ; Streptococcus pneumoniae ; Vaccination ; Vaccines ; Vaccines, Inactivated

Fanconi syndrome is a generalized functional disorder of the proximal tubule of the kidney and is characterized by aminoaciduria, glycosuria, hyperphosphaturia, dehydration, rickets, and growth failure. Nephrocalcinosis and hypercalciuria are rare manifestations of Fanconi syndrome. There is no case report of Fanconi syndrome complicated with nephrocalcinosis and hypercalciuria in Korea. A 6-year-old boy presented with genu valgum and waddling gaits for about 3 years. There was no family history of renal disease and his physical examination was normal except for genu valgum and corrected cleft lip and palate. Laboratory investigations showed generalized aminoaciduria, glycosuria, hyperphosphaturia, hypercalciuria, and low-molecular weight proteinuria including beta2-microglobulin. Serum 25-OH vitamin D3 was within the normal range, and 1,25-(OH)2 vitamin D3 was elevated. Bilateral renal medullary hyperechogenicity was demonstrated by ultrasonography. Analysis of the CLCN5 gene revealed no mutation. Here we describe a boy with Fanconi syndrome complicated with nephrocalcinosis and discuss the differential diagnosis.
Child ; Cholecalciferol ; Cleft Lip ; Dehydration ; Diagnosis, Differential ; Fanconi Syndrome* ; Gait ; Genu Valgum ; Glycosuria ; Humans ; Hypercalciuria ; Hypophosphatemia, Familial ; Kidney ; Korea ; Male ; Nephrocalcinosis* ; Palate ; Physical Examination ; Proteinuria ; Reference Values ; Rickets ; Ultrasonography

This paper presents the results of a survey for the causes of sensori-neural hearing impairment in Korea. The subjects were 1,676 children of total 2,928 enrolled in 16 Deaf Schools; two schools in each area of Seoul, busan, Kyoungbook, Kyoungna, Kyounggi and Chunbug, and each one in Chungnam, Chungbug, Chunnam and Jaeju. The data were collected by questionnaire with 28 items distributed to their parents. The filling in the check lists were performed by their class teacher, interviewer, for 18 months from September, 1975 to February, 1976. The questionable or missed problems were reaffirmed. The results obtained were as follows. Most of the reasons, 78.5% were acquired characters that could be developed during pregnant period, the time of delivery and the time of after birth. The pure hereditary reasons except the cases complexed with one or two were only 11.3%. Those who could not be defined with any reasons were 10.2%. Among the acquired causes, 5.8% of total subjects were developed for pregnance; 3.3%, during delivery; and 69.7%, after birth. In the pregnant period, the drug intoxications were 2.4% of total subjects, several diseases such as influenza, bleeding, surgical operation, venereal disease and rubella etc. were about one percent, and the accompanied with some symptoms of pregnancy intoxication and traumatic events were 2.4%. During time, the cases with delayed rhythmical pain were 16 persons, the immaturities were 11, the asphyxial cases were nine, the errors of forceps delivery were seven, the cases of low body weight inspite of full term were our, the cases with cesarian section were three, the head injuries were two, and the accompanied with three kinds of above reasons were three. During after birth, the cases with acute communicable diseases were 35.4% of total subjects, the fever unknown origin were 16.1%, the chronic otitis media were 3.7%, the meningitis were 3.5%, the gastric and nutritional diseases were 3.5%, the drug intoxications were 4.8%, the blood diseases were 0.3% and the other causes were 2.2%. Here by acute communicable diseases, some importances were measle, 10.1% of total subjects; meningitis, 7.3%; convulsion with some reasons, 4.9%; poliomyelitis. 3.2%; encephalitis, 2.4%; and mumps, rubella, pertusis, scarlet fever, and small pox were somewhat played a role in. Among 59 cases with brain diseases, 53 were concussion by the accidents, such as traffic and falling or sliping down etc., the cerebral paralysis and hydrocephalus were two, respectively. And the blood diseases were severe newjaundice in all five cases. If we were summarized with the above mentioned, most of the hearing impairments were introduced by the combined reasons with familial or hereditary factors and the acquired, than by a simple disease. Among the congenital or hereditary hearing impairments classified to now a day, we suppose that the many cases with the acquired causes during pregnancy, delivery and after birth were complexed. Subsequently, the maternal and child health should be more and more developed in our country, also.
Body Weight ; Brain Diseases ; Busan ; Child Health ; Child* ; Chungcheongnam-do ; Communicable Diseases ; Craniocerebral Trauma ; Encephalitis ; Fever ; Hearing Loss* ; Hearing* ; Hematologic Diseases ; Hemorrhage ; Humans ; Hydrocephalus ; Influenza, Human ; Korea ; Meningitis ; Mumps ; Otitis Media ; Paralysis ; Parents ; Parturition ; Poliomyelitis ; Pregnancy ; Surveys and Questionnaires ; Rubella ; Scarlet Fever ; Seizures ; Seoul ; Sexually Transmitted Diseases ; Surgical Instruments