Paralytic hand is the ultimate result of permsnent damage of the central nervous system, failure of the functional repair of peripheral nerve injuries and extensive muscular or tendinous defect resulting in the impairment of hand function. There are a lot of controversies in the side of treatment methods in the paralytic hand, and it is very difficult to formulate the most adequate surgical reconstruction for a given pstient. At Depsrtment of Orthopedic Surgery, Seoul National University Hospital, 66 cases oi paralytic hands in 62 patients have been treated surgically with tendon transfers for 7 years from Jan, 1980 to Dec, 1986. 49 case in 46 patients were followed up for more than one year, and surgical method and its results were anslysed. They consist of CNS lesion (17), peripheral nerve lesion(23) and musulotenidinous defect(9). The methods of surgical reconstruction were opponenesplasty(12), standard set extensor reconstruction(9), Green and Bsnks FCU transfer(11), intrinsic reconstruction(7), pronator rerouting(7), adductorplasty (5) and so on. The mean follow-up was 2.2 years, and in 38 cases good or excellent results were obtained.
Central Nervous System ; Follow-Up Studies ; Hand ; Humans ; Methods ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Seoul ; Tendon Transfer

The author analyzed detailed pattern of pelvic bone fracture in 52 cases of posterior urethral injuryassociated with pelvic bone fracture in male. The relationship between fracture and urethral injury was reviewed n38 cases who received retrograde urethrography at the time of injury. The pattern of urethral injury due to pelvicbone fracture was newly classified. The results were as follows; 1. In age distribution, the most common was 5thdecade(26.9%). 2. The most freqent type of pelvic rami fracture was two rami fracture(52%). 3. There was no casewith only the superior ramus fracture, and all cases were associated with inferior ramus fracture with or withoutsuperior ramus fracture. 4. In inferior ramus fracture, the ratio of ischial ramus fracture to pubic ramusfracture was 46.1:17.4. 5. In cases with only the ischial ramus or pubic ramus fracture, unilateral fractureexceeded bilateral fracture(44.2:19.3). 6. The bladder rupture was found in 10 among the total 52 cases, 9 ofwhich were associated with superior ramus fracture, and 8 were extraperitoneal type. 7. The most common type ofurethral injury was Type III(73.7%), and followed by Type II(10.5%), Type I(7.9%), and Type IV(7.9%). 8. Theseresults strongly suggested that the superior ramus frature was related to bladder rupture, and inferior ramusfracture to urethral injury.
Age Distribution ; Humans ; Male ; Pelvic Bones ; Rupture ; Urinary Bladder

Staging of carcinoma of the urinary bladder is important for the choice of therapy and also has prognostic implications. Hitherto the staging has been based upon cystoscopy with bio psy, transurethral resection , and palpation with complementary radiographic examlnations such as cystography, urography, lymphangiography, ultrasound and angiography. However, with all these methods, the staging of bladder carcinomas still uncertain and inferior to CT. Authors analyzed CT staging of bladder cancers and compared with pathologic staging of laparotomy results. The results are as follows: 1. Overall accuracy of CT staging in bladder carcinoma was 72 percent. 2. Overstaging was 20 percent (5/25) and understaging was 8 percent (2/25). 3. All of CT stage B cancers were proven to be stage B, pathologlcally. 4. In 6 cases of CT stagec cancers,only one was correct,3 were overstaged and 2 were understaged. 5. In 7 cases of CT stage D cancers, 5 were correct and 2 were overstaged. 6. CT detected only 2 cases of pelvic Iymph node involvement in 4 of pathologically proven Iymphadenopathy.
Angiography ; Cystoscopy ; Laparotomy ; Lymphography ; Palpation ; Ultrasonography ; Urinary Bladder Neoplasms ; Urinary Bladder ; Urography

Numerous operations have been described to treat the recurrent anterior dislocation of the shoulder, but no one procedure was accepted as the choice of operation. We perforemed 6 Bristow procedures and 5 combined Bankart and Putti-Platt procedures and examined six shoulders by arthroscope from sep. 1989 to Sep. 1992, and we analysed the pathologic feature and the results of them. The average follow-up period was 2.2 years. 1. There were 8 males and 3 females and their average age was 33.7 years. The mean age in initial dislocation was 28 years. 2. The number of recurrent dislocation before operation was 17.9 times and the average duration of the disease was 5.7 years. 3. The pathologic lesions observed in intraoperative field were Hill-Sachs lesion (72.7%), Bankart lesion (90.9%), and the erosion of the glenoid rim (54.5%). On arthroscopic examination of 6 cases, Hill-Sachs lesion was found in 4 cases, Bankart lesion was seen in all of 6 cases, and the erosion of the glenoid rim was observed in 4 cases. 4. The average range of the limitation of external rotation was 17.3 and its significant difference was not observed between 2 operative groups. 5. By Rowes rating sheet, 4 cases of 5 combined Bankart and Putti-Platt operations were excellent and 1 case was good. 6. In conclusion, combined Bankart and Putt-Platt operation was considered as a good surgical procedure in the treatment of recurrent anterior dislocation of the shoulder.
Arthroscopes ; Dislocations ; Female ; Follow-Up Studies ; Humans ; Male ; Shoulder

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*

No abstract available.
Endometrial Neoplasms* ; Female

The inverted nipple presents both cosmetic and functional problems and may create psychological trauma in the patients and nutritional deficiency in the new born infants, Histopathologically it is characterized by less fibroconnective tissue beneath the nipple, shortened and fewer functional lactiferous duct, and short dense fibrous tissue beneath it. Many surgical and non-surgical methods have been designed and introduces for correction of the inverted nipple. We experienced 46 inverted nipples in 25 patients at Korea University Guro Hospital. For correction of nipple inversion we used purse-string suture method, Elsahy method, Pitanguy method, and author's method which modified D'Assumpcao technique. Including recurred cases, 44 nipples were operates by author's method, were follow-up for more than one year. Of these, postpartum breast feeding was possible in all evaluated 8 nipples. Undercorrection was identified in 4 nipples, but nipple projection was maintained to some degree. Author's method was effective for correction of the inverted nipple with preservation of lactiferous duct and lew recurrence rate.
Breast Feeding ; Follow-Up Studies ; Humans ; Infant ; Korea ; Malnutrition ; Nipples* ; Postpartum Period ; Recurrence ; Sutures

No abstract available.
Paralysis* ; Tourniquets*

PURPOSE: To evaluate the contrast enhancement patterns and mass detection rate of metastatic adenocarcinoma of the liver in the early and late phase of spiral bolus dynamic CT. MATERIALS AND METHODS: Two-phase spiral bolus dynamic CT of the liver was performed on 34 patients with clinically or pathologically proved metastatic adenocarcinoma of the liver after bolus administration of 120 mL of contrast material intravenously. CT scanning was started at 45 seconds and 6 minutes after I~eginning of injection in 23 patients, and at 35 seconds and 3 minutes in another 11 patients. The enhancement patterns of the tumors were classified into 6 types compared with attenuation of surrounding normal liver parenchyma, as diffusely high, peripherally high, centrally high, mixed, iso, diffusely low. The enhancement patterns of 76 tumors in 34 patients were analysed. RESULTS: In the early phase, peripherally high attenuation was seen in 34(45%) and diffusely low attenuation in 23(30%). In the late phase, diffusely low attenuation was seen in 27(36%) followed by iso and mixed in 14 (18%), in each, and peripherally high in 13(17%). The appearances of enhancement pattern from the early to the late phase were variable. 12(16%) were diffusely low in both phases, 11(14%) were peripherally high in the early phase and diffusely low in the late phase, and 10(13%) were peripherally high in both phases. Number of tumor lesions detected were more in the early phase in 12(35%)patients, and in the late phase in 3(9%) patients. CONCLUSION: Metastatic adenocarcinoma of the liver showed variable enhancement patterns in the early and late phases of spiral bolus dynamic CT, although the most common pattern was peripherally high in early phase, and diffusely low in the late phase. The detection rate of masses was higher in early phase than late. The two-phase spiral bolus dynamic CT should be good method in detection and differential diagnosis of metastatic adenocarcinoma of the liver.
Adenocarcinoma* ; Diagnosis, Differential ; Humans ; Liver* ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

PURPOSE: To evaluate the contrast enhancement patterns and mass detection rate of metastatic adenocarcinoma of the liver in the early and late phase of spiral bolus dynamic CT. MATERIALS AND METHODS: Two-phase spiral bolus dynamic CT of the liver was performed on 34 patients with clinically or pathologically proved metastatic adenocarcinoma of the liver after bolus administration of 120 mL of contrast material intravenously. CT scanning was started at 45 seconds and 6 minutes after I~eginning of injection in 23 patients, and at 35 seconds and 3 minutes in another 11 patients. The enhancement patterns of the tumors were classified into 6 types compared with attenuation of surrounding normal liver parenchyma, as diffusely high, peripherally high, centrally high, mixed, iso, diffusely low. The enhancement patterns of 76 tumors in 34 patients were analysed. RESULTS: In the early phase, peripherally high attenuation was seen in 34(45%) and diffusely low attenuation in 23(30%). In the late phase, diffusely low attenuation was seen in 27(36%) followed by iso and mixed in 14 (18%), in each, and peripherally high in 13(17%). The appearances of enhancement pattern from the early to the late phase were variable. 12(16%) were diffusely low in both phases, 11(14%) were peripherally high in the early phase and diffusely low in the late phase, and 10(13%) were peripherally high in both phases. Number of tumor lesions detected were more in the early phase in 12(35%)patients, and in the late phase in 3(9%) patients. CONCLUSION: Metastatic adenocarcinoma of the liver showed variable enhancement patterns in the early and late phases of spiral bolus dynamic CT, although the most common pattern was peripherally high in early phase, and diffusely low in the late phase. The detection rate of masses was higher in early phase than late. The two-phase spiral bolus dynamic CT should be good method in detection and differential diagnosis of metastatic adenocarcinoma of the liver.
Adenocarcinoma* ; Diagnosis, Differential ; Humans ; Liver* ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed