No abstract available.
Histiocytosis*

Trochanteric fractures frequently occur in the elderly patients and complications such as pneumonia, thromboembolic disease, decubitus ulcer, and urinary tract infection are common. The principle in the treatment of an elderly patient wlth trochanteric fractures have swung from traction to internal fixation due to such complications. Since the introduction of the Smith-Petersen nail, numerous internal fixation devices such as I-beam nail, Thornton plate, Jewett nail, and Holt nail have been developed. Recently compression hip screw is popular because of rigid internal fixation. Also many surgeons such as Evans, Dimon and Hughston, Sarmiento, and Boyd and Anderson have attempted to provide stable fixation of fracture by altering the position of fracture fragments. This report is based on 104 cases of trochanteric fractures who were seen and treated at our orthopedic department during the 13 years period from January, 1965 to December, 1978. The study includes clinical and radiologic observation on our series of trochanteric fractures. The results were summarized as follows: 1. Of 104 cases of trochanteric fractures 79 cases occurred in man, 25 cases in woman and each mean age was 51 years in man, 62 years in woman. 2. The most common cause of fracture was due to traffic accident. 3. Among 104 cases, 73 were treated with open reduction and internal fixation, and 31 were treated conservatively. 4. Of fixation devices, Jewett nails were used in 40 cases, Temple University nails in 9 cases, Mclaughlin nail plates in 5 cases, Moore blade plates in 4 cases, Blount blade plates in 3 cases, Thornton nail plates in 2 cases, Neufeld nail plate in 1 case, Richard compression sliding screw plates in 2 cases, plate and screws in 3 cases, Kuntscher nail in 2 cases, and screws in 2 cases. 5. Of 92 cases of trochanterir fractures, 27 cases were stable fracture and 65 cases were unstable fracture. The method of medial displacement of proximal part of distal fragment in 2 cases with unstable fracture and anatomic reduction in 90 cases with stable and unstable fracture were achieved. 6. The average time to fracture union was 16.6 weeks roentgenologically. There was no significant difference in the union rate between the method of treatment. 7. The average time to weight bearing was 11.8 weeks in operative treatment and 18.3 weeks in conservative treatment. 8. Complicatlon after internal flxation were reduced by early ambulation. 9. The method of medial displacement of proximal part of distal fragment of fracture was achieved in 2 cases of unstable fractures, and obtained satisfactory fracture healing, but had disadvantages such as some limitation of motion of the affected hip, shortening of affected extremlty. 10. Satisfactory result was obtained in 95.5% out of operatlve treatment, and 84% out of non-operative treatment. 11. From a consideration of those series, it was concluded that operative treatment of trochanteric fractures offered the advantages of improved function, economy of hospital beds, less complication, and comfort and early ambulatlon of the patient.
Accidents, Traffic ; Aged ; Clinical Study ; Early Ambulation ; Female ; Femur ; Fracture Healing ; Hip ; Hip Fractures ; Humans ; Internal Fixators ; Methods ; Orthopedics ; Pneumonia ; Pressure Ulcer ; Surgeons ; Traction ; Urinary Tract Infections ; Weight-Bearing

Many kinds of operations have been devised to treat Kienböck's disease with variable results. But no one have mentioned about the advantage of early motion in distraction to prevent the fibro-osseous ankylosis and carpal collapse. Two cases with Kienböck's disease were treated by the complete excision of the lunate and replacement of it with pronator quadratus muscle pedicled rectangular bone graft. Once these procedures were accomplished, the distraction-motion devices were used to maintain the joint surfaces separated at predetermined distances while kinematically normal joint motion was gradually restored. Although the experience is limited to two cases, the final results seem to be very promising.
Ankylosis ; Arthroplasty ; Joints ; Transplants

Cystic hygroma is a rare, endothelial lined cystic lesion of lymphatic origin which is encountered most often in children, usually at birth or early in life. The tumor is usually found in the neck and axilla. It is a soft, nontender, semifluctuant freely movable tumor of varying size filled with lymphatic fluid. The mass is sometimes pedunculated and is uaually multilocular, althouh it may be monolocular. The cystic hygroma of the right axilla and the upper arm, in a 4 month-old female infant, is presented with a review of the literature.
Arm ; Axilla ; Child ; Female ; Humans ; Infant ; Lymphangioma, Cystic ; Neck ; Parturition

OBJECTIVE: To compare the clinical outcomes of intrauterine insemination (IUI) according to the catheter used. MATERIALS AND METHOD: From March 1998 to September 1998, total 95 infertile patients were included in this study. Patients were randomly allocated to TomCat group (n = 39) and Mackler group (n = 56) according to the catheter for insemination. The controlled ovarian hyperstimulation (COH) using luteal long protocol of gonadotropin releasing hormone agonist (GnRH-a) was used in all patients. Statistical analysis was performed using Student's t-test, Fisher's exact test, and x2 test as appropriate. Statistical significance was defined as p < 0.05. RESULTS: The total dose and duration of exogeneous gonadotropin required were similar between the two groups. There were also no significant differences in serum estradiol (E2) level, endometrial thickness and texture on the day of hCG administration between the two groups. However, the percentage of uterine souding due to failure of initial approach was significantly higher in TomCat group compared to Mackler group (23.1% vs. 0%, p < 0.01). The percentage of bleeding after IUI in TomCat group seemed to be higher than that in Mackler group (15.4% vs. 3.6%, p = 0.06), although there was no statistically significant difference between the two groups. There was also no significant difference in the clinical pregnancy rate per patient between the two groups. CONCLUSION: These results suggested that using Mackler catheter might be effective for IUI, especially for the patients with cervical factor infertility.
Catheters* ; Estradiol ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hemorrhage ; Humans ; Infertility ; Insemination* ; Pregnancy Rate

A total of 72 cases of internal biliary drainage procedure has been done percutaneously at Departement ofRadilogy, Seoul Natinal Universtiy Hospital for recent 4 and half years since August 1981. Five different types ofinternal drainage including endoprosthesis were applied to various conditions with different obstruction levels.The different method of procedure in each type of internal drainage was described and the results were analysed.1. Among the clinical diagnosis in 72 cases, carcinoma of bile duct was in 37 cases as the most frequent one. Thenext was pancreas head carcinoma in 16 cases, followed by metastatic carcinoma and other disease. 2. Type Iinternal drainage, classical internal and external type with distal end in duodenum, was applied in 43 cases asthe most comon one. Type II, modification of type I with distal end in CBD, was applied in 17 cases. Type III,endoprosthesis distal end into duodenum, was applied in 7 cases. Type IV, endoprosthesis just across theobstruction in bile duct, was applied in 2 cases, Type V, combined type of any internal drainage with externaldrainage, was applied in 3 cases. 3. According to various obstruction level, prefered type could be selected. Forproximal obstruction type II and IV were preferred and for distal obstruction type III was chosen. However, type Icould be applied in any situation. 4. Early complication occurred in 9 cases(12.5%). Clinical imporvement withdecrease in bilirubin level was observed 17 of 21 cases in which follow-up data was available over 2 months. 5.Though the experience with those 72 cases it is recommended that appropriate type of internal biliary drainageshould be selected according to prognosis, obstruction level and clinical findings of each patient.
Bile Ducts ; Bilirubin ; Diagnosis ; Drainage ; Duodenum ; Follow-Up Studies ; Head ; Humans ; Methods ; Pancreas ; Prognosis ; Seoul

PURPOSE: The differentiation between renal cell carcinoma(RCC) and transitional cell carcinoma(TCC) is important due to the different methods of treatment and prognosis. But occasionally it is difficult to draw a distinction between the two diseases when renal parenchyme and renal collecting systems are invaded simultaneously. MATERIAL AND METHOD: We reviewed CT scans of 37 cases of renal cell carcinoma and 12 cases of transitional cell carcinoma which showed involvement of renal parenchyma and renal sinus fat on CT. Retrospective analysis was performed by 3 abdominal radiologists. Check points were renalcontour bulging or reniform shape, location of mass center, intact parenchyme overlying the tumor, cystic change, calcification, LN metastasis, vessel invasion, and perirenal extention. RESULT:There were renal contour bulging due to the tumor mass in 33 out of 37 cases of renal cellcarcinima, wherea and nine of 12 cases of transitional cell carcinoma maintained the reniform appearance. This is significant statiscal difference between the two(p<0.005). Center of all TCCs were located in the renal sinus, and 24 out of 35 cases of RCC were located in the cortex(p<0.005). Thirty-six out of 37 cases of RCC lost the overlying parenchyma, whereas 4 out of 9 cases of well enhanced TCC had intact overlying parenchyma(p<0.005) RCC showed uptic change within the tumor mags in 31 cases which was significanity higher than the 4 cases in TCC(p<0.05). CONCLUSION: CT findings of renal cell carcinoma are contour bulging, peripheral location, obliteration of parenchyma, and cystic change. Findings of transitional cell carcinoma are reniform appearance, central location within the kidney, intact overlying parenchyma, and rare cystic change.
Carcinoma, Renal Cell* ; Carcinoma, Transitional Cell* ; Kidney ; Neoplasm Metastasis ; Pelvis* ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Goiter*

No abstract available.
Female ; Lymphoma* ; Ovary*

No abstract available.
Mandible* ; Spine*