A clinical analysis on the 33 cases of the collateral ligament injuries of the knee joint was made. Those cases were classified in three groups depend upon the width of the joint space by means of stress-radiogram as one plue (less than 5 mm), two plus(5~10 mm), and three plus(more than 10 mm). Twenty one cases were three plus group and were treated operatively and remaining had conservative treatment. This injury is more prevalent in male with the peak in male with the peak incidence of 21~30 years old age group. The most common site of injury of medial collateral ligament is the mid-portion of the ligament where cross the joint line by the 42.3% on operated cases. The lateral collateral ligament has no specific location of injury but more even on its whole length of femoral or fibullar attachment and mid-portion of the ligament. Results were evaluated in three groups of excellent, good and poor. Six out of 12 cases of conservative treatment and nine out of 21 cases of operative group were excellent in result without joint instability, pain and muscle weakness on walking and flexion was available more than 120 degress. Four cases of conservative treatment group and ten of operative group were good in result with occasional pain on walking, mild degree of instability and range of joint motion between 100 to 120 degrees. Four cases had poor result with pain on walking, marked joint instability and less than 100 degrees of joint motion. Overall result of more than good were 90.5% in operative group and 83.3% in conservative treatment group.
Clinical Study ; Collateral Ligaments ; Humans ; Incidence ; Joint Instability ; Joints ; Knee Joint ; Knee ; Lateral Ligament, Ankle ; Ligaments ; Male ; Muscle Weakness ; Walking

Calcaneus is very important in weight bearing and maintaining the normal contour of the foot. Many diseases can cause the cyst-like destructive changes of the calcaneus. In most cases, histological confirmation and bacteriological examination are necessary for the final diagnosis. In recent years, four cases of the cyst-like destructive lesions of the calcaneus were treated and had satisfactory results. They were confirmed with biopsy and bacterial culture as followings; acute osteomyelitis, chronic osteomyelitis, tuberculous osteomyelitis and simple bone cyst. Operations on the osteomyelitis were curettage with or without sequestrectomy and the simple bone cyst the curettage and bone graft. After operations, proper antibiotics and plaster immobilization followed routinely.
Anti-Bacterial Agents ; Biopsy ; Bone Cysts ; Calcaneus ; Curettage ; Diagnosis ; Foot ; Immobilization ; Osteomyelitis ; Transplants ; Weight-Bearing

A statistical analysis was made on 59 patients of bone tumors who were treated at medical center from March, 1971 to February, 1978. The results were as follows. 1. Thirty nine cases(66%) were benign and twenty cases (34%) were malignant 2. Osteochondroma was the most common benign bone tumor (38.5%) and followed by simple bone cyst(17.9%), enchondroma(10.3%), osteoid osteoma(10.3%) and giant cell tumor(7.7%). 3. The knee joint area was the most common site of osteochondroma(95%) and its peak incidence was in the second decade. 4. Two of three cases of giant cell tumor were recurred at six months and three years after surgical intervention. 5. 11 cases(55%) out of 20 malignant bone tumor were primary tumors of osteogenic sarcoma(9 cases), Ewing's sarcoma(1 case) and multiple myeloma(1 case). Rest of 9 cases(45%) were metastatic bone tumors. 6. The primary organs of the metastatic bone tumor were kidney(2 cases), thyroid and lung(each 1 case), but the 5 cases were undetectable. The most common site of metastasis were spine and pelvis.
Giant Cell Tumors ; Giant Cells ; Humans ; Incidence ; Knee Joint ; Neoplasm Metastasis ; Osteochondroma ; Pelvis ; Spine ; Statistics as Topic ; Thyroid Gland

The case is presented a 49-year-old man had several year history with chronic renal failure with hyperlipidemia due to diabetes mellitus. Treatment of hyperlipidemia was started by oral bezafibrate intake 600 mg per day. Several days later, patient noticed muscle weakness and myalgia. The serum CK, LDH, AST levels were remarkably elevated, myoglobulinuria was also noticed The symptoms of the patient were resolved after the drug was discontinued, thus the diagnosis was established as having bezafibrate induced rhabdomyolysis. On the basis of the above description, bezafibrate may induce muscle damage if dose is excess over the renal capacity. Extreme caution is warranted when the patient is placed on bezafibrate and has renal dysfunction.Strict dose adjustment is necessary in taking account of renal function to avoid muscle damage including rhabdomyolysis.
Bezafibrate ; Diabetes Mellitus ; Diagnosis ; Humans ; Hyperlipidemias ; Kidney Failure, Chronic ; Middle Aged ; Muscle Weakness ; Myalgia ; Rhabdomyolysis

Of the shoulder injuries in trauma, none are more common than those involving the acromioclavicular joint. There are many procedures described for treatment of injuries of the acromioclavicular separation but difficulties continues to be encounted. To know the functional anatomy of this joint and mechanism of injuries makes more proper treatment. We operated the 16 cases of acromioclavicular separation in the Dept of Orthopedic Surgery, Kyung Hee College of Medicine from January 1975 to August 1978. The following results were obtained. 1. This injuries is more prevalent in male with peak incidence in the third and fourth decades. 2. The mechanism of injuries were traffic accident, falling down and the other direct injuries with in orders. 3. The difference of distance between coracoid process and clavicle gives the information of Type II and Type III. 4. The operative procedures in Type II and Type III are good treatment of acromioclavicular separation.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Clavicle ; Humans ; Incidence ; Joints ; Male ; Orthopedics ; Shoulder ; Surgical Procedures, Operative

The diagnostic accuracy of myelography, electromyography, and clinical-neurological findings in 64 patients on whom the presence of herniated intervertebral disc was proved surgically from March, 1974 to February, 1980 in Severance Hospital was discussed and the results of this study was compared with those in comparable studies in the literature. 1. Of the cases in which operation revealed disc herniation or protrusion, the clinical neurological diagnosis was correct in 71.9%, the myelographic diagnosis was coincided in 79.7%, the electromyographic diagnosis was agreed in 73.4%. 2. In the patients which the patellar tendon reflex was weak or absent, operation revealed a herniation between L3 and L4 in 66.7%. The disc herniation bewteen L4 and L5 was noted in 93.0% of patients with weakness of the extensors of the great toe. Of the patients in whom the Achilles tendon reflex was weak or absent, operation revealed a tumbosacral disc herniation in 87.0%. 3. If the myelogram showed lumbar disc changes, these changes were confirmed at operation in the same level in all patients. 4. A disc herniation between L3 and L4 was demonstrated in aH cases of the patients had L4 denervation of the electromyographic findings. The disc herniation between L4 and L5 was seen in 93.0% of them had L5 denervation. A lumbosacral disc herniation was noted in 83.3% of them had 51 denervation. 5. Polyphasic motor units were significant in the absence of diagnosis of the herniated lumbar disc. 6. Signs of denervation in the spinal muscalature but not in the leg muscles were considered significant in patients with diagnostic problems of the lumbar radiculopathy. In summary, it is suggested that electromyography is not superior to the myeolgraphy or the clinicalneurogical examination. But the electromyography aids the surgeon in the dlagnosis of a compression lesion of a specific nerve root.
Achilles Tendon ; Denervation ; Diagnosis ; Electromyography ; Humans ; Intervertebral Disc ; Leg ; Muscles ; Myelography ; Patellar Ligament ; Radiculopathy ; Reflex ; Toes

The most important congenital abnormality of the foot is clubfoot or talipes equinovarus, a deformity easy to diagnose but difficult to correct completely, even in the hands of an experienced orthopaedic surgeon. Furthermore approximately 50% of congenital clubfoot are resistant to non-operative methods such as manipulation and cast correction and consequently, under these circumstances, continuation of non-operative treatment leads to eventual failure, due either to incomplete correction, or recurrence of the deformity. In such resistant clubfoot it is better judgement to perform a relatively minor soft tissue operation at the time for resistance rather than to delay surgical treatment and beforced to perform a major operation at a late date for recurrence. Eighteen patients who presented twenty-five resistant congenital clubfoot abnormalities were followed at our department for 9 years and 4 months from February of 1970 to May of 1979. These were subjected to analysis clinically and radiologically, and the following results were obtained. 1. These patients consisted of: 11 male patients, 7 female patients, 11 single clubfeet and 7 bilateral clubfeet. 2. Age categories at operation were as follows: 6 feet below 1 year old, 8 feet 1 year old, 5 feet 2 years old, 3 feet 3 years old and one each age 4, 5 and 6. 3. Treatment period before operation: 19 clubfeet for 3 months to 6 months, 6 clubfeet for 7 months to 1 year. 4. Operations performed: posterior release-four, medial and posterior release-twelve, medial-plantar and posterior release-three, one stage posteromedial release-four, Evans procedure-one and tibialis anterior to lateral cuneiform-one. 5. Operations performed at an early age showed better results than those performed on older patients. 6. Of all operations performed the one stage posteromedial release with internal fixation showed the best results.
Clubfoot ; Congenital Abnormalities ; Female ; Foot ; Fractures, Open ; Hand ; Humans ; Male ; Recurrence

To develop a survival prediction model and to use it as a therapeutic guideline a series of 66 cases with ganglio-thalamic hemorrhage accompanying intraventricular hemorrhage were analyzed retrospectively. They were classified into the benign and fatal groups according to their final outcomes. Fourteen indices obtained from the initial CT scans were final outcomes. Fourteen indices obtained from the initial CT scans were subjected to multivariate discriminant analysis. The resultant discriminant function(Z) included the amount of hematoma in the parenchyme(AH), bicaudate cerebroventricular index(BCCI) maximum fourth ventricular width(FVW), and third cerebroventricular ratio(TCR) in an order of decreasing discriminating power and was as follows: Z = -3.2639 + 0.3508 X 10(-1) X AH + 6.8816 X BCCI + 0.1139 X FVW-5.7794 X TCR. This function predicted survivability with accuracy of 84.9% when it was applied to the original subjects. The conclusion is that AH, BCCI, FVW, and TCR are the potent predictors of the survival of patients with ganglio-thalamic hemorrhage accompanying intraventricular hemorrhage.
Hematoma ; Hemorrhage* ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed*

A combined technique for lid retraction, that includes recession of retractors and Mullerectomy with or without spacers was presented, Twenty two procedures on eleven patients were reviewed, Of 22 procedures, 14 were for upper eyelid retraction and 8 for lower eyelid retration. Preserved sclera as a spacer was used on 5 upper eyelids and 6 lower eyelids in selected cases, Eight patients with lid retraction had hyperthyroidism, two patients showed lid retraction due to previous lid or orbital syrgery and one patient revealed lagophthalmos caused by facial palsy, All patients showed excellent cosmetic appearance during the follow-up period of 6 to 32 months (average 15months), but two patients required reoperation with happy results.
Eyelids* ; Facial Paralysis ; Follow-Up Studies ; Humans ; Hyperthyroidism ; Orbit ; Reoperation ; Sclera

The occurrence of the colonic obstruction secondary to colorectal carcinoma (CRC) has been reported in 7~30% of the CRC patients. It is generally believed that obstructive CRC is associated with a poor prognosis with respect to operative mortality and five-year survival. A series of 1064 cases of the CRC treated surgically at Asan Medical Center from June 1989 to December 1996 has been analyzed to compare clinicopathological findings between obstructive and non-obstructive CRC and to evaluate surgical treatment options in obstructive CRC. Complete obstruction was present in 49 cases (4.6%). There were no differences between obstructive and non-obstructive CRC in tumor location, size, Dukes' stage, and differentiation. In forty-nine obstructive CRC cases, primary resections were performed in 29 cases after peri-operative bowel decompression. In this group, right colon cancer was more prevalent than staged operation group (45% vs. 5%, P<0.05) and hospital stay was significantly short (16 days vs. 38 days, P<0.05). Postoperative complication rate was higher in staged operation group (65% vs. 28%, P=0.01). It may be due to stoma related wound complication. In obstructive left colon cancer, there was a significant difference in complication rate between primary resection and staged operation (P<0.05). Overall 5-year survival rate were 66% and 53% in non-obstructive and obstructive group, respectively. Survival rate according to the Dukes' B and C stages did not show statistical differences, either. Conclusively, primary resection is preferred to the obstructive CRC when supportive care, preoperative bowel decompression, and intraoperative colonic irrigation were performed adequately.
Chungcheongnam-do ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms* ; Decompression ; Humans ; Length of Stay ; Mortality ; Postoperative Complications ; Preoperative Care ; Prognosis ; Survival Rate ; Wounds and Injuries