The increased incidence of the trochanteric fracture of the femur was accompanied by the development of the vehicle and the prolongation of the average life-span. Recently it has been also increased in an active person from thirties to forties. 87 cases of the trochanteric fracture of the femur in 86 patients who have been admitted and treated at the Department of Orthopedic Surgery of Hanyang University Hospital during 8 years and 10 months, from May, 1972 to February, 1981, were reviewed. The results of this study were as follows: 1. The trochanteric fracture of the femur was more common in male and was frequent in a person who was from thirties to forties and who had vigorous social activity. 2. An injury from traffic accident was the most common cause of the fracture from thirties to forties and an injury from slip down was most common in seventies. 3. The unstable fracture which was classified by Evans' classification, Boyd and Griffin Type II Fx. and Tronzo Type III Fx. were most common in the intertrochanteric fracture and the Fielding Type II Fx. was most common in the subtrochanteric fracture of the femur. 4. Other injuries were accompanied by the trochanteric fracture of the femur in 38 patients (44.2%) and the pelvic bone fracture was the most common associated injury in these patients. 5. The weight bearing was allowed earlier in the patient who had been given the surgical Tx. than in the patient who had been given the conservative Tx. 6. In adults, there was no significant differences in the duration to achieve the bony union between the conservative treatment and surgical treatment performed. 7. We considered that the diminution of the probable complications by early weight bearing after accurate open reduction in accordance with the Type of the Fx. followed by secure internal fixation with devices is an ideal method of the Tx.
Accidents, Traffic ; Adult ; Classification ; Clinical Study ; Femur ; Hip Fractures ; Humans ; Incidence ; Male ; Methods ; Orthopedics ; Pelvic Bones ; Weight-Bearing

3 cases of orbital tumors were presented, which were confined respectively as papillary adenocarcinoma, pseudotumor and mixed tumor in the histopathological findings. CASE 1: Papillary adenocarcinoma had been noticed in the left eye of a 66-year-old woman from about 4 months previously. Visual acuity was 0(O.D.), 0.3(1.2)(O.S.) and left eye ball was almost protruded out of the orbit. There was a coin-lesion, which was considered metastatic lesion from the eye, in the right upper lung field. Evisceration of the orbit which was almostly destroyed was performed successfully. No incidence of recurrence can be disclosed untill now, 16 months after surgery, and lost in follow up. CASE 2: Pseudotumor was developed in the left eye of a 33-year-old male. Visual acuity was 0.06(O.S), 1.2(O.D.). Severe choked disc and optic nerve atrophy were showed. Exophthalmometry: 24mm(0.5.), 18mm(0.D.). It was necessitated evisceration of the orbit because of the tumor was placed in the almost entire orbital space. Follow up study were impossibJe. CASE 3: In the left eye of a 51-year-old woman, mixed tumor had been developed from about 8 years previously. Visual acuity was 1.0(O.S.) and F.L.P.(O.D.), exophthalmometry: 13mm(O.U.). Surgical removal was successful and lost in follow up.
Adenocarcinoma, Papillary ; Adult ; Aged ; Atrophy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lung ; Male ; Middle Aged ; Optic Nerve ; Orbit* ; Recurrence ; Visual Acuity

3 cases of orbital tumors were presented, which were confined respectively as papillary adenocarcinoma, pseudotumor and mixed tumor in the histopathological findings. CASE 1: Papillary adenocarcinoma had been noticed in the left eye of a 66-year-old woman from about 4 months previously. Visual acuity was 0(O.D.), 0.3(1.2)(O.S.) and left eye ball was almost protruded out of the orbit. There was a coin-lesion, which was considered metastatic lesion from the eye, in the right upper lung field. Evisceration of the orbit which was almostly destroyed was performed successfully. No incidence of recurrence can be disclosed untill now, 16 months after surgery, and lost in follow up. CASE 2: Pseudotumor was developed in the left eye of a 33-year-old male. Visual acuity was 0.06(O.S), 1.2(O.D.). Severe choked disc and optic nerve atrophy were showed. Exophthalmometry: 24mm(0.5.), 18mm(0.D.). It was necessitated evisceration of the orbit because of the tumor was placed in the almost entire orbital space. Follow up study were impossibJe. CASE 3: In the left eye of a 51-year-old woman, mixed tumor had been developed from about 8 years previously. Visual acuity was 1.0(O.S.) and F.L.P.(O.D.), exophthalmometry: 13mm(O.U.). Surgical removal was successful and lost in follow up.
Adenocarcinoma, Papillary ; Adult ; Aged ; Atrophy ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lung ; Male ; Middle Aged ; Optic Nerve ; Orbit* ; Recurrence ; Visual Acuity

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Pelvic Bones*

Microsurgical compoeite tissue transplantation to date has contributed to reconstructive surgery by expediting transfer of large blocks of tissue. We have performed the first successful transplantation of microneurovascular tendocutaneous free flap from the dorsum foot to the defect of dorsum hand including extensor tendons. We considered the free flap with extensor tendons from the dorsum foot was the best donor site for functional recovery of the defect of dorsum hand. Two cases of tendocutaneous free flap transplantation were performed at the Department of Orthopedic Surgery of Hanyang University Hospital, and satisfactory results were obtained.
Foot ; Free Tissue Flaps ; Hand ; Humans ; Orthopedics ; Tendons ; Tissue Donors ; Tissue Transplantation ; Transplants

OBJECTIVE: To evaluate the effects of piroxicam patch(Trast) in rheumatoid arthritis patients with knee joint pain and swelling and to determine the concentration of plasma and synovial fluid following patch application. METHODS: Twenty-two patients with rheumatoid arthritis participated in a double-blind, placebo-controlled study. The patients were instructed to apply piroxicam or placebo patch at one knee and re-apply it every other day for 2 weeks. They had washout period for 2 weeks and then applied the other patch for 2 weeks at the same joint. The patients recorded knee joint pain using visual analog scale. Knee joint swelling and tenderness were assessed before and after application of piroxicam and placebo patch. Complete blood count, AST, ALT, BUN, creatinine, joint fluid analysis were also done. Piroxicam concentration in plasma and synovial fluid were measured by high performance liquid chromatography(HPLC) after 2 weeks of piroxicam patch application. RESULTS: Knee joint pain improved significantly after the application of piroxicam patch for 2 weeks(visual analog scale, 56. 2+5. 9m vs 48. 2+5. 7mm, p=0. 03 by Wilcoxon signed rank test). There was no significant change in white cell count of synovial fluid, peripheral blood cell count, chemistry, C-reactive protein and erythrocyte sedimentation rate. In terms of adverse effects, mild gastrointesti nal disturbance(8/21 cases, 38%) and local side effects such as pruritus and ery thema(3/21 cases, 14%) were developed, which were insignificant compared with control groups(30%, 15% respectively). Piroxicam concentrations in plasma and synovial fluid after the application of piroxicam patch were 0. 129+0. 04ug/ ml (mean+SE) and 0. 644+0. 202ug/ml respectively. CONCLUSIONS: Piroxicam patch is a safe and effective therapeutic modality for knee joint pain in patients with rheumatoid arthritis. Mild adverse effects such as gastrointestinal disturbance and local side effects were noted. Piroxicam concentration was higher in synovial fluid than in plasma following the application of piroxicam patch.
Arthritis, Rheumatoid* ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Cell Count ; Chemistry ; Creatinine ; Humans ; Joints ; Knee ; Knee Joint ; Piroxicam ; Plasma ; Pruritus ; Synovial Fluid ; Visual Analog Scale

PURPOSE: To describe the clinical manifestations, diagnosis, and treatments in the patients with delayed diagnosis after foreign body injury. MATERIALS AND METHODS: Seventeen patients with foreign body injury, who had delayed diagnosis more than two months, from January 2000 to August 2008, were enrolled in the present study. The clinical manifestation, materials, locations of foreign bodies, and diagnostic methods were assessed in this study. In addition, we investigated the treatment in the all patients. RESULTS: The interval between injury and removal surgery varied from two months to 16 years. The most common clinical manifestations were foreign body sensation and tenderness (13/17). Glasses (9/17), woods (3/17), needles (2/17), and pencil leads (2/17) were the common foreign bodies. In addition, the most common location of foreign body was palm (7/17), followed by finger (4/17) and wrist (3/17). In the major portion of patients (13/17), the diagnosis was made by simple roentgenogram at the time of presentation. Ultrasonogram (US) or magnetic resonance imaging (MRI) was performed in the residual four radiolucent foreign bodies. In the all 17 patients, surgical removal was performed. CONCLUSIONS: A doctor should perform the scrupulous history taking and physical examination when diagnosing injury by foreign body. In patients with history of prior surgical treatment due to laceration or penetration by foreign body, active examination, radiological diagnosis including roentgenogram, US, and MRI, and surgical removal are recommended.
Delayed Diagnosis ; Eyeglasses ; Fingers ; Foreign Bodies ; Glass ; Humans ; Lacerations ; Magnetic Resonance Imaging ; Needles ; Physical Examination ; Sensation ; Upper Extremity ; Wood ; Wrist

PURPOSE: Retrospective studies were carried out to evaluate the usufulness of CT in differentiating benign or malignant intrahepatic duct(IHD) dilatation due to extrahepatic duct(EHD) obstruction. MATERIALS AND METHODS: Among 75 cases of IHD dilatation, 35 cases(47%) which did not show causative lesion on CT were classified into central or peripheral type according to the extent of the dilatation and into pruned or beaded form according to its pattern. We considered central type or pruned form as a benign feature while peripheral type or beaded from as a malignant feature. Predictions of benignancy or malignancy were made according to the pattern and the extent of IHD dilatation. In all 75 cases, maximum caliber of IHD at portal vein bifurcation were examined. RESULTS: In regard to the classification of the extent, 80% (28 out of the 35 cases:11 of 15 cases of benignancy and 17 of 20 cases of malignancy) of our prediction was correct. As to the classification of the pattern, similar results(82% correct prediction) were obtained(14 out of 17 cases):ln 15 cases of benignancy, we observed six cases of pruning and 1 case of beading. Among the 20 cases of malignancy, two cases of pruning and eight cases of beading of IHD dilatation were observed. Mean diameters of IHD at portal vein bifurcation were 10.1ram in benignancy and 15.1mm in malignancy.(Diameters less than 11mm was suggestive of benignancy(alpha =0.05). CONCLUSION: Evaluation of the extent, the pattern, and the degree of IHD dilatation is necessary in differential diagnosis of benignancy and malignancy of EHD obstruction. We conclude that CT is a useful tool for this purpose of differential diagnosis of the benignancy and the malignancy of extrahepatic biliary obstruction.
Classification ; Diagnosis, Differential ; Dilatation* ; Portal Vein ; Retrospective Studies ; Tomography, X-Ray Computed*

PURPOSE: To give a help in the interpretation of cardiac cine-MR examination, the extent, shape, and timing of appearance of signal void regions near atrioventricular(A-V) valve prospectively evaluated in the healthy population. MATERIALS AND METHODS: Using an axial gradient-echo technique with small flip angle, repetition time(TR) of 36 msec and echo time(TE) of 22 msec, 20 volunteers without known valvular abnormalities undertook cardiac cine-MR imaging including atrioventricualr valve areas. RESULTS: Transient signal void was observed within the atrium near the tricuspid(13/20 = 65%) and mitral valves(9/20 = 45%), respectively, which is so called "physiologic atrioventricular valvular insufficiency". Eight subjects revealed the signal void areas near both tricuspid and mitral valves but, 5 subjects didnot show any evidences of physiologic insufficiency. This physiologic condition does not extend more than lcm proximal to A-V valve plane and is generally observed only during early systole. Its morphology is semilunar or triangular configuration with the base to the valve plane in most cases of normal tricuspid insufficiency and small globular appearance in most cases of normal mitral insufficiency. CONCLUSION: Awareness of normal signal void areas near the A-V valve and their characteristics is critical in the interpretation of cardiac cine MR examinations and maybe helpfal in the study of the normal cardiac physiology.
Magnetic Resonance Imaging* ; Mitral Valve ; Mitral Valve Insufficiency ; Physiology ; Prospective Studies ; Systole ; Volunteers