No abstract available.

No abstract available.
Anesthesia, Epidural* ; Radiculopathy*

Most proximal humeral fractures respond satisfactory to simple conservative treatment. But operative treatment is recornmended in the cases that poor results are anticipated by prolonged immobilization, or because of the severe displacement and comminution. After Neer. in 1970, emphasized the need for operative treatment in displaced proximal humeral fractures, many papers reported better results with the operative management. Twenty five cases of displaced fractures and fracture dislocations of the proximal humerus treated at the department of orthopaedic surgery, Keimyung University with open reduction and internal fixation were analyzed clinically and radiologically. The following results were obtained. 1. The prevalent age distribution was the second snd third decades(average 42.6 years) and ratio of male and female was 2.1: 1. 2. In 10 of the 25 cases, wire loop was used for internal fixation, and the result was satisfactory in 8 cases. However, the disadvantage was difficulty in wire removal after bony union because the loop was buried in the callus or cortex. 3. Over-all results were excellent or satisfactory in 64% of 25 cases. There were 4 excellent and 1 satisfsctory in 5 cases of type Il fracture, 7 excellent, 2 satisfactory and 3 unsatisfactory in 12 cases of type III fracture, 1 excellent and 4 unsatisfactory in 5 cases of type 1V fracture, and 1 excellent, 1 unsatisfactory and 1 failure in 3 cases of fracture dislocation. 4. In 6 patients with four part lesions treated with open reduction and internal fixation and followed up for an average of 23 months(from 18 months to 3 years and 2 months), only one case of fracture dislocation revealed avascular necrosis with resorption of the head.
Age Distribution ; Bony Callus ; Dislocations ; Female ; Head ; Humans ; Humerus ; Immobilization ; Male ; Necrosis ; Shoulder Fractures

We present here, a case of pemphigus erythematosus developed in a 31-year-old woman, who had been suffering from repeated episode, of remission and exacerbation with several erythematous, and somewhat oozing patche accompanying a mild pruritus or her face, upper part of the back and anterior chest. In serological studies, she had antinuclear antiboc@lies at. a titer of 1:160. Histopathological finding showed subcorneal bullae. Immunofluorescent study revealed IgG and C, deposition in the intercellular space of the epidermis and along the de rmoepidermal junction.
Adult ; Epidermis ; Extracellular Space ; Female ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin G ; Pemphigus* ; Pruritus ; Thorax

The growth changes in position of upper and lower jaws, incisal inclination in relation to anterior cranial base have been described. Twenty five males was studied quantitavely by means of serial cephalometric reontgenogram from seven to thirteen years of age. The findings seem to warrant the following conclusions: 1. Growth change in anteropaterior of upper and lower jaws to the anterior cranial base showed very littel change before eleven years of age but axial inclination of incisal teeth tended to become labiaization in relation to the anterior cranial base. 2. After eleven years of age, there wasn¥t nearly labialization of incisal teeth but jaw prognathism occurred a little in relation to the anterior cranial base.
Humans ; Incisor* ; Jaw* ; Male ; Prognathism ; Skull Base ; Tooth

The most frequently reported neurological complication of a wasp sting is ischemic stroke. We treated a patient with wasp sting with unusual complications. A 52-year-old man was hospitalized for anaphylactic shock after multiple wasp stings. Although the patient recovered consciousness after 2 days, he had global aphasia and right hemiparesis. Brain magnetic resonance imaging and angiography revealed high-intensity signals in the left basal ganglia and cerebral cortex and stenosis of the left middle cerebral artery. After 2 days, the middle cerebral artery stenosis improved. After 5 days, diffusion-weighted imaging showed an enlarged lesion in the left frontal cortex. The infarct in this case was due to a predominantly unilateral vasoconstrictive hypoxic brain injury from wasp stings.
Brain Injuries

Peripheral nerve injury occurs mostly in company with tendon and muscle injuries, fractures, or dislocations. Because of the disabilities and socioeconomic loss caused by such injuries, much attention must be paid to the initial treatment, and later to the reconstruction and rehabilitation. At department of Orthopedic Surgery, Seoul National University Hospital, 336 patients of nerve lesion were treated from Jan, 1980 to Dec, 1988. Among them 128 patients were nerve compression syndrome (carpal tunnel 52 patients, cubital tunnel 40 patients, thoracic outlet 16 patients, others 20 patients), and 50 patients were brachial plexus injury, and 168 cases were peripheral nerve injury. 50 patients of the peripheral nerve injury were treated with reconstruction and 118 patients were treatred with neurorrhaphy, nerve graft, and neurolysis. Of the 118 patients, 94 patients were followed up for more than one year, and the results of neurorrhaphy, nerve graft and neurolysis were analyzed. In 46 patients (73.0%) of the patients treated with neurorrhaphy, 7 patients (58.3%) with nerve graft, and 15 patients (78.9%) with neurolysis, good or excellent results were obtained.
Brachial Plexus ; Dislocations ; Humans ; Nerve Compression Syndromes ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rehabilitation ; Seoul ; Tendons ; Transplants

Rheumatoid arthritis is a chronic inflammatory systemic disease of young or middle aged adults, characterized by destructive and proliferative changes in the synovial membrane, periarticular structures, skeletal muscle and perineural sheath. Eventually, the joints are destroyed, ankylosed and deformed. Therfore, the aim of treatment is to keep the inflammatory process at a minimum, thereby preserving the joint motion, maintaining the health of muscle supplying motor power about the joint and preventing secondary joint stiffness and deformity. Surgical treatment in rheumatoid arthritis has progressed and there have been advances in the relief of pain and increase in the range of motion. Among them the results of total knee arthroplasty (TKA) have improved steadily during the past decade due to refinements in design, fixation, and surgical technique. At orthopedic department of seoul national university hospital, we performed 31 total knee replacement in 18 patients who had suffered from rheumatoid arthritis during the period from Aug. 1982 to Dec. 1988. Following results were obtained. 1. Knee score increased from 37.8 to 76.9. 2. Tibio-femoral angle was corrected from 0.9° valgus to 5.3° valgus. 3. Conplications were peroneal nerve palsy in 3 knees, instability in 1 knee, tuberculous arthritis in 1 knee. 4. In 25 out of 31 knees, good functional results were obtained.
Adult ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Congenital Abnormalities ; Humans ; Joints ; Knee ; Middle Aged ; Muscle, Skeletal ; Orthopedics ; Paralysis ; Peroneal Nerve ; Range of Motion, Articular ; Seoul ; Synovial Membrane

Rotator cuff injury and impingement syndrome have been thought to be related to the structure of acromion, such as subacromial distance, acromial type, acromial spur and acromial angle. Evaluation was done in 90 normal shoulders without impingement or rotator cuff injury, using shoulder X-ray series, composed of AP view, impingement view, and arch view. As results, 52(52.8%) of them had subacromial spur by the impingement views. The spur size was 12.4+/-4.5 mm and increased with age without statistical significance(p>0.05). The subacromial distance was 11.1+/-2.2 mm in AP view and 10.4+/-1.9 mm in arch view without statistical difference for age and sex(p>0.05). Among 90 normal shoulders, the acromion was quite often curved Type II, 51.1%, type I, 22.2%, and type III 26.7%. Mean acromial angle was 29.1 degrees in arch view and increased with age(p<0.05). Mean acromial tilt was 31.8 degrees without significant difference for age and sex(p>0.05). These results suggest their clinical relevance to the impingement syndrome and the rotator cuff injury.
Acromion ; Rotator Cuff ; Shoulder*

No abstract available.
Chronic Pain* ; Electroacupuncture* ; Needles* ; Syringes*