The basic principles and practical application of open fracture managements are discussed. The main aims of open fracture treatment are the control of shock as a life saving procedure and prevention of infection of the wound. The complete debridement of the wound is the one way to prevent infection, however, the trouble some problems are soft tissue closure and hardware implant for the fracture fixation. Skin closure including other soft tissues should be made primarily or as soon as possible in behalf of control infection but in secure state of the wound. The implant for the fixation of fracture should be limited for prevention of further infection of the wound. Multiple threaded pins and external fixation such as Hoffmann or Denham fixture are recommended for the open fracture treatment effectively. Systemic administration of properly selected anti-biotics are essential for the control of infection because of the all open fractures are contaminated at the time of injury.

The urinary bladder consists of two functionally different units, the detrusor and the trigone, and receives autonomic innervations. The beta-adrenergic receptors are responsible for relaxation and prevail in the detrusor, while the alpha-adrenergic ones are responsible for contraction and are present predominantly in the trigone. The parasympathetic innervations are responsible for contraction in the entire urinary bladder muscle. The motor innervation of the urinary bladder is usually represented as cholinergic, therefore contraction of the urinary bladder by muscarinic agents or anticholinesterase is easily blocked by atropine. However, contraction of the urinary bladder by parasympathetic nerve stimulation or ganglionic nicotinic agents is highily resistant to blockade by atropine. Concerning these atropine-resistance phenomena, a number of hypotheses have been advanced to rationalize them. These hypotheses are of two types: 1) the postulate that all postganglionic motor transmission in the urinary bladder is cholinergic and atropine-resistance is due to peculiarities of the tissue or of atropine, and 2) the postulate that at least part of the transmission is noncholinergic. Ambache and Zar (1970) tried an experiment on transmission actions of catecholamine, serotonin, histamine, prostaglandin, and adenosine triphosphate(ATP) in noncholinergic transmission of the urinary bladder, however, they insisted that these substances are not true transmitter released from noncholinergic fibers to the bladder. Recently, evidence has been indicated that a purine nucleotide, probably, ATP, is the transmitter released from nonadrenergic, noncholinergic, inhibitory nerves to the gastrointestinal tract or excitatory nerves to the urinary bladder. It has been shown that purine nucleoddes cause contraction of dog, cat, rat, and rabbit urinary bladder. In this study, using the bladder strips of rabbit, cat, dog, and guinea pig, responses of the urinary bladder to purine nucleotides were observed. In addition, the influence of various blocking agents on the responses of the strip to purine nucleotide was investigated. Bladder strips about 1.5cm in length were carefully isolated from dome and trigone of the rabbit, cat, dog, and guinea pig. They were suspended in a muscle chamber containing 100ml of Tyrode solution maintained at a constant temperature of 38℃. The chamber was aerated with 95% oxygen and 5% carbondioxide bubbling through the bathing fluid by means of sintered glass plate at the bottom. The bladder strip was attached to the Grass force displacement transducer and the motility was recorded on a Grass polygraph(Model 7). When a stable motility level of the strip had been reached, several drugs were added to the muscle chamber and the changes of motility of the strip were observed. The results obtained are as follows; 1. ATP or ADP enhanced the spontaneous contraction of detrusor strip of rabbit, cat, dog, and guinea pig, while it unaffected the motility of trigone strip. 2. Contractile response of detrusor strip to ATP or ADP was not blocked by pretreatment with atropine, phenoxybenzamine, propranolol, procaine, procainamide, lidocaine, oxytocin, or prostaglandin F_2α. 3. Contractile response of detrusor strip to ATP or ADP was blocked by pretreatment with quinidine or quinine. From the above results, it is suggested that the detrusor of urinary bladder is innervated by noncholinergic excitatory purinergic receptor which is blocked by quinidine.

A pressure sore is generally considered to be an area of ulceration and necrosis of the skin occurring in any part of the body but usually over an underlying bony prominence which is subject to prolonged or often repeated pressure. Such areas of ulceration are also known as bedsores and decugitus ulcers. In the care of the ulcer, the underlying physical, metabolic and neurovascular etiologic factors are corrected in so far as possible. The purpose of definitive surgery is to remove the ulcer, itscontents, surrounding unsatisfactory tissues, infected bursae and the underlying, often devitalized, bony prominence, en bloc if possible. We had 20 cases of bedsores who were admitted to EWHA hospital during the 2 years from July 1977 to July 1979. Author has been satisfactorily treated by large good padding local flap coverage or split thickness skin graft for the defects following removed of the ulcers, including surrounding scar tissue and underlying bony prominence in Department of Plastic Surgery in EWHA University Hospital, and brief review of references.

The onset and persistence of headache following spinal puncture is a continual problem to physicians who perform this procedure. There is considerable evidence that headaches following spinal puncture result from low cerebrospinal fluid pressure caused by leakage through the puncture in the dural sac. The author has studied the value and consequences of prophylactic autologous epidural blood patch in postlumbar-puncture headaches. Fifty patients undergoing myelography received prophylactic autologous epidural blood patches to prevent postlumbar-puncture headache; the results indicate a significant reduction in the incidence and severity of this problem compared to a control group, without any significant side effects. Based on the results of this study, author believes that epidural blood patch is a safe and effective procedure of prophylaxis and treatment for postlumbar-puncture headache.

Cytochrome P-450 is a terminal oxidase of the hepatic microsomal monooxygenase system associated with the oxidative biotransformation of a varity of lipophilic endogenous and exogenous compounds, and generally is assayed by CO-binding spectro-photometry of dithionite-reduced samples. In well fed normal male rats with or without stress condition, the dffect of antiulcer drug; cimetidine, sulpiride and diazepam on the level of microsomal cytochrome P-450 were determined. Only stress condition produced on significant effect in cytochrome P-450 contents. Administration of cimetidine, sulpiride and diazepam in this condition caused a 44.1%~87.5% increment in cytochrome P-450, diazepam produced the most increase. After diazepam treatment of rats, the peak position of cytochrome P-450 shifted to a longer wave length of 452 nm.

Sodium and potassium are important cations essential to higher animals which regulate the composition of their body fluids. They participate in muscle contraction, stimualtion of nerve, maintenance of osmotic prossure, water metabolism, and maintenance of acid-base balance in blood. This study was designed to determine and report the sodium and potassium contents in Korean foods eaten in our daily lives and to give a help to the diet pattern of the patients who need low-sodium diet. Samples were cereals, legumes, fruits, and vegetables. They were obtained in the open market at the day experimented and the sodium and potassium contents of them were determined with flame photometer(Coleman Model 51).

Teratoma are probably the result of a segregated blastomere which, being totipotent, results in a jumble of tissues. It has also been suggested that they may be displacements of the coccygeal body. However, regardless of their origin they are usually present at birth or shortly there-after and are excised via perineal route. The following case of a sacrococcygeal teratoma is reported because of the histogenesis involved and the excellent result following surgical removal.

The authors describe a case of the brain abscess in the left temporal lobe which was accurately diagnosed by computerized tomography brain scan and complete surgical excision of abscess capsule was accomplis with great success. SUMMARY The case presented by authors was otogenic in origin and diagnosed accurately by the computerized tomographic scan, and total excision of the abscess capsule was performed by two stage operation.