The tibial plateau fracture which involving articular surface of the proximsl tibia is very common in pedestrian injury of the traffic accident and sometimes results in significant disability in knee joint function. The authors analized 40 cases of the tibial plateau fracture treated in our depsrtment during the year 1980 through 1985. The results obtained are as follows : l. 15 cases were treated by conservative methods. 2. 25 cases were treted by operative methods. 3. 33 cases(82.5%) were “Acceptable” group according to Roberts criteria.
Accidents, Traffic ; Knee Joint ; Tibia

Bronchioloalveolar carcinoma may present with a variety of radiographic and clinical appearances. The authors reviewed the radiographs of 17 patients with pathologically proven bronchioloalveolar carcinoma, retrospectively. Seven cases were of the localized form. Among the seven five showed a localized mass and two showed localized consolidation. Ten cases were of the diffuse form. Among the ten, three showed diffuse nodules, two showed diffuse consolidation, and five showed a combined pattern of nodules and consolidations. Progression of disease was observed in 9 patients. In these cases, localized forms progressed to a diffuse forms and nodular patterns progressed to a consolidation pattern. Seven cases of the diffuse form were given antituberculous medications on hospital admission. In summary, bronchioloalveolar carcinoma has varied radiographic patterns, and often mimicks other pulmonary diseases such as pulmonary tuberculosis.
Adenocarcinoma, Bronchiolo-Alveolar* ; Humans ; Lung Diseases ; Retrospective Studies ; Tuberculosis, Pulmonary

It would be naive to assume that any operative procedure is the solution to the problem of sacral pressure sore in the field of the orthopaedic surgery. The procedures outlined here involve the creation of compound myocutaneous flaps of the gluteus maximus muscle, skin, and the subcutaneous tissue. The myocutaneous flap us- ing the gluteus maximus muscle is a vascular flap instead of a random flap, with better blood supply for healing and advantage of an increased amount of cushion effect. We present an alternative method which will provide satisfactory and substantial soft tissue coverage in sscral pressure sores.
Methods ; Myocutaneous Flap ; Pressure Ulcer ; Skin ; Subcutaneous Tissue ; Surgical Procedures, Operative

This paper was prepared to determine the effects of degree of initial angulation and the method of treatment toward the end results, and also to report cases of twenty-one children with a radial neck lowed up more than 12 months. The results are as follows: 1. An average follow up period was 34 months, and were ranged from 12 months to 70 months. 2. Displacement patterns of fracture were angulation in 5 cases, partial translocation in 11cases, and total displacement in 5 cases, and translocated fracture was most frequent. According to the degree of angulation, in 10 cases angulation was minor(below 30 degrees), in 8 cases moderate(30–60 degrees), and in 3 cases severe (above 60 degrees). 3. One case was treated by simple cast immobilization, 9 cases were treated by gentle closed reduction, 3 cases were by percutaneus pin reduction with K-wire, 7 cases were by open reduction and K-wires fixation, and 1 case was by closed reduction and incorporating cast immobilization. 4. The results of 20 cases were excellent in range of motion without specific complication. Without considering about the method of treatment, when angulation was severe, more time was required for recovery(Wilcoxon 2-simple test P < 0.02). When the degree of angulation was less than 60 degree, the functional recovery was faster with closed reduction than with open reduction, but with the angulation more 60 degree, there was no significant difference(Spearman correlation coefficient=0.599, P value < 0.05). In conclusion, the severity of initial displacement and the method of treatment were considered to be factors that could affect the recovery time.
Child ; Follow-Up Studies ; Humans ; Immobilization ; Methods ; Neck ; Range of Motion, Articular

Total hip replacement for adults with severe acetabular dysplasia presents a difficult problem because deficient bone stock and soft tissue contractures usually prevent sitting at the normal anatomic level. The rationales of high hip center are due to high failure rate of bulk structural weight bearing graft, good short-term result of hemispherical cementless acetabular component in revision surgery, high hip center but not lateral which does not adversely affect the biomechanics of the hip, and intimate apposition with viable host bone. We represented the short-term results of 21 total hip replacements with proximal placement of the acetabular cup than the anatomical position that is normally used. The mean duration of follow up was 18 months(range, 12-58 months) and the mean age of the patient was fifty-one years(range, thirty to sixty-seven years). Most of these hips had a major deficiency or defect of the acetabular bone stock. They had an aver- age Harris hip score of 47 points preoperatively and 90 points postoperatively. Roentgenographic measurements showed that the mean change in the height of the center of the hip postoperatively was only +6.6 millimeters and the mean change of horizontal location of them was 10 millimeters medial to the preoperative position. Postoperative complications included calcar fracture(1 case), trochanteric bursitis(1 case), postop- erative dislocation(1 case) and one case of radiological loosening of the acetabular component. The center of the hip in THR is not a crucial parameter with regard to the long-term stability of acetabular component, so our recommendation is to place the acetabular component at a more proximal but not lateral position if strong bone stock is available. But future studies of high hip center need to address femoral component longevity.
Acetabulum ; Adult ; Arthroplasty, Replacement, Hip ; Contracture ; Femur ; Follow-Up Studies ; Hip Joint ; Hip ; Humans ; Longevity ; Osteoarthritis ; Postoperative Complications ; Transplants ; Weight-Bearing

No abstract available.
Arthroplasty, Replacement, Hip*

No abstract available.
Porokeratosis

Intrathecal administration of morphine for pain relief became popular since Pert, et al (1973) reported the opioid receptors in spinal cord. It is obvious now morphine bas prolonged and profound analgesic effect with few compl-ications but the leant dose which produces sufficient analgsia with insignificant complication is still controversial. The dosage of intrathecal morphine used for postoperative analgesia has varied from 0.1 mg to 2 mg, but significantly low dosage was required br direct intrathecal route than by epidural one to reach the appropriate analgesic CSF concentration. We selected 60 Patients (50 for cesarean section, 10 for total hysterectomy) and divided into 3groups to compare the effects respectively. Group l : 20 patients receiving 0.05mg of intrathecal morphine, Group ll : 20 patients receiving 0.1 mg of intrathecal morphine, Group lll : 20 Patients receiving 0.2 mg of intrathecal morphine The results are as follows ; 1) The analgesic effects of group l and ll were good and similiar, but 2 of group l and 1 of group ll required a single supplementary intramuscular demerol 6 hours after intrathecal morphine injection. The quality of analgesia was judged to be better in group lll than in group I and ll. 2) The duration of analgesia of group lll was a little longer than group I and ll, which showed similar duration. 3) The side effects of group l, ll and lll were similar, but pruritus was noted twice as much in group in lll than in group l and ll.
Analgesia ; Cesarean Section ; Female ; Humans ; Meperidine ; Morphine* ; Pregnancy ; Pruritus ; Receptors, Opioid ; Spinal Cord

We performed surgery for correction of abnormal head turn in 10 patients with congenital nystagmus. For 3 patients with a head turn of 30 degrees, a 40% augmented modified kestenbaum operation was performed. For 4 patients with a head turn of 45 degrees, a 40% augmented modified kestenbaum operation combined with a 3 - 4 mm recession of conjunctival and subconjunctival tissues was performed. Finally, for 3 patients with a head turn of 60 degrees, a 60% augmented modified kestenbaum procedure combined with a 3 - 4 mm recession of conjunctival and subconjunctival tissues was performed. At the final follow-up visit(averaging 5.9 months), 7 patients showed complete corrections of previous head turn and 3 patients showed a small residual head turn of less than 10 degrees to the same side of the preoperative head turn. The average amount of correction we obtained from the surgery described above were 26.7, 42.5 and 56.7 degrees for the patients who had had a preoperative head turn of 30, 45 and 60 degrees respectively. Among the 10 patients, 4 showed no change in corrected visual acuity, but 6 showed increased corrected visual acuity by over 1 Snellen line. From the above results, we concluded that if recession procedure of the conjunctival and subconjunctival tissues was combined with augmented modified Kestenbaum procedure, its effect for correction of abnormal head turn in a patient with congenital nystagmus could be enhanced.
Follow-Up Studies ; Head* ; Humans ; Nystagmus, Congenital* ; Visual Acuity

Since the introduction of epidural corticoateroid injections for the management of sciaticall, luintosacral radiculopathy has become one of the most common pain problems enco-untered by anesthesiologists. In order to function effectively, anesthesiologiats should be able to: 1) recognize those syndromes which may respond to nerve block: 2) understand the pathophysiology of the conditions being treated and 3) be familiar with alternate ther-apeutic pathways for patientg not responding to merre b1ock. There are many etiologic factors of low back pain and lumbosacral radiculopathy. Particularly, Nerve root compression caused by a protruding disc, a osteophyte or tumors are usually responsible for pain. Neural inflammation, therefore, is considered to play a major role in pain production.The use of local anesthetics in mixture with steroids is believed to break down neural inflammation. Steroids and local anesthetics were injected lumbar or caudal epidmal to 106 patients for the purpose of relieving low back pain and lumbosacral radiculopathy. The resu1ts are as follows : Excellent Pain relieved group : 27 Patients (25.5%) Good Pain relieved group: 49 Patients(46.1%) Fair pain relieved group : IS patients(14.2%) Not effective group : 15 Patients (14.2%).
Anesthetics, Local ; Humans ; Inflammation ; Low Back Pain ; Nerve Block ; Osteophyte ; Pain Management* ; Radiculopathy ; Steroids