Congenital vertical talus associating tarsal coalition, which is a very anomalous condition and causes severe rigid flat foot, is presented with literary reviews. This case was treated with soft tissue release and triple arthrodesis.
Arthrodesis ; Flatfoot ; Talus

Purpose: To analyze the causes and to prevent dislocations of the hip joint that occur in patients who underwent revisions of total hip arthroplasties by changing only the polyethylene liners and femoral heads, subsequent to primary total hip arthroplasties. Materials and Methods: We evaluated 28 patients who underwent acetabular component revisions of total hip arthroplasties subsequent to primary total hip arthroplasties. The average age of the patients was 55 years old and all 28 patients had operations through the posterolateral approach. In 17 of the cases, the acetabular cups, polyethylene liners, and femoral heads were changed; in 10 cases, just the polyethylene liners and femoral heads were changed; and in 1 case, only the polyethylene liner was changed. Results: We observed 7 cases of hip dislocations that occurred among a total of 28 cases after revisions of total hip arthroplasties. In all 7 cases, the polyethylene liners and femoral heads were changed, but not the acetabular cups. In additional, in all 7 cases of dislocation, the patients were non-compliant and started weight-bearing prematurely after revisions of the total hip arthroplasties Conclusion: We observed new dislocations in the 7 cases in which the polyethylene liners and femoral heads were changed. The main reasons were inadequate soft tissue tension and hip joint laxity. Therefore, it is necessary to increase the neck length, use elevated rim polyethylene liners, readjust the acetabular cups to their optimal positions, and apply hip abduction braces to patients early after revision of total hip arthroplasties in order to lessen the danger of dislocations.
Acetabulum* ; Arthroplasty ; Braces ; Dislocations* ; Head ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Neck ; Polyethylene ; Risk Factors* ; Weight-Bearing

Diastasis of the ankle joint was associated with extensive ligamentous rupture and resulted from external rotation or abduction injuries at the ankle. It might occur without associated fracture but was more frequently seen in cases of bimalleolar fracture in which there was fracture of the medial malleolus or rupture of the deltoid ligament with fracture of the lower third of the fibula. Thirty patients of diastasis of the ankle joint were admitted and treated by internal fixation with screw and bolt from January 1978 to December 1981. The following results were obtained: 1. The main cause of the injuries was falling from a height and the other causes were slipping down and sports injury in order. 2. The most common type by Lauge-Hansen classification was supination-external rotation type (20 cases, 67%). 3. Partial diastasis of the ankle joint or anterior type was 14 cases (47%) and complete diastasis or total type was 16 cases (53%). 4. In all cases, mixed oblique fibular fracture and medial instability were seen. 5. The good results were achieved in 24 patients (80%).
Accidental Falls ; Ankle Fractures ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Fibula ; Humans ; Ligaments ; Rupture

Plain chest films are the most useful modality in diagnosis of primary lung cancer, but it is difficult tointerpret the radiologic findings by histological types. Authors reviewed chest films of 324 cases ofhistologically confirmed primary lung cancer from Jan. 1974 to April 1982 at Seoul National University. The resulsare as follows; 1. Incidence was most common in the 6th decade as 34.4%. Male to female sex ratio was 3.8:1 andthere was no sex difference in Adenocarcinoma. 2. Distrubution of histologic types of primary lung cancer asfollows; Squamous cell Carcinoma 50.6%, Small Cell Carcinoma 22.5% lange Cell Carcinoma 9.3% Bronchegenic adenocaranoma 10.5% Bronchioloalveolar Cell Carcinoma 1.9%. Adenosquamos Carcinoma 0,6%, Carcinoid Tumor 0.3%, AdenoidCystic Carcinoma 0.3%. 3. Radiologic findings by histologic types as follows; a) Squamous cell carcinoma commonlypresent as collapse(51.8%) peripheral mass (40.8%), pneumonitis(37.2%), hilar involvement(34.8%), and in singleabnormality, peripheral mass (44.4%). b) Small cell carcinoma commonly present as hilar involvement(78.1%),mediastinal wideing or mass (53.4%) and in single abnormality, hilar involvement(58.3%). c) Large cell carciomacommonly present as hilar involvement(50%) pneumonia(46.7%), collapse (40%), peripheral mass(36.7%) and in singleabnormality, large peripheral mass (33.3%). d) Bronchogenic Adenocarcinoma commonly present as peripheralmass(44.1%), collapse (41.2%), pleural effusion (35.2%) and in single abnormality, peripheral mass(50%). e)Solitary peripheral mass commonly present as lobulation(48%) and spiculated margin (51%), but no specific findingsby histologic types. Cavitary formation was most common in Squamous cell carcinoma.
Adenocarcinoma ; Carcinoid Tumor ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Female ; Humans ; Incidence ; Lung Neoplasms ; Lung ; Male ; Pleural Effusion ; Seoul ; Sex Characteristics ; Sex Ratio ; Thorax

Percutaneous nephrostomy for relief of obstruction and functional preservation of the kidney was effectivelyperformed 19 times in 14 patients for recent 1 year since July 1982 at Departement of Radiology in Seoul NationalUniversity Hospital. The etiologies of the total 14 obstructive uropathies were metastatic cervix cancer in 6-cases, metastatic rectal cancer in 2 cases, and metastatic bladder cancer, malignant mixed mesodermal tumor operimetrium, pyonephrosis, bilateral staghorn stone, UVJ obstruction of undertermined cause, congenital UPJobstruction in 1 case respectively. Percutaneous nephrostomy was done bilaterally in 1 case of congenital UPJobstruction and unilaterally in 13 cases. We used ultrasound as puncture guide in 13 cases and CT in 1 case. Majorcomplication was absent, but minor complications occured in 4 patients; gross hematuria persisting 24 hours (1case), catheter dislodgment after several seeks (2 cases ) and luminal narrowing after 3 months(1 case).Satisfactory outcomes were made in 13 patients except 1 patient who succumbed one day after the procedure due topreexisting severe sepsis. The procedure proved to be safe and effective alternative to operative nephrostomy insome patients with urinary obstruction.
Catheters ; Hematuria ; Humans ; Kidney ; Mesoderm ; Nephrostomy, Percutaneous ; Phenobarbital ; Punctures ; Pyonephrosis ; Rectal Neoplasms ; Seoul ; Sepsis ; Ultrasonography ; Urinary Bladder Neoplasms ; Uterine Cervical Neoplasms

While effectiveness of ultrasound in diagnosis of stone in gallbladder and common bile duct has been wellestablished, role of ultrasound in detection of intrahepatic bile duct stone has rarely been described. However,in ultrasonographic diagnosis of common bile duct and gall bladder stone, evaluation of intrahepatic bile duct isessential to decrease the incidence of residual stone because about 5-8% of common bile duct and/or gall bladderstone also have stone in intrahepatic bile duct. We studied 27 cases of intrahepatic bile duct stone diagnosedwith ultrasound for recent 14 months from Sep. 1983 to Nov.1984 at Department of Radiology, Seoul NationalUniversity, and analysed ultrasonographic findings of the stones. The results were as follows: 1. In 27 cases outof total 35 cases(77.1%), intrahepatic duct stones were confirmed by operation, postoperative T-tubecholangiography, ERCP. PTC, and CT; in 4 cases(11.4%), there were no stone in hepatic duct; and in 4 cases (11.4%)intrahepatic ducts were not completely evaluated because of incomplete studies. 2. 17 cases of 27cases with provenintrahepatic duct stones had also common bie duct and/or gall bladder stones(63%). 3. Ultrasound showed echogenicmaterial (from due to mass) in 27 cases(100%), posterior shadowing in 26 cases(96%), and ductal dilatation in 23cases(85%). 4.Intrahepatic stones tend to be apeared as mass-like echogenecity, with the increase in size, numberand degree of agregation of stones.
Bile Ducts, Intrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Diagnosis ; Dilatation ; Gallbladder ; Hepatic Duct, Common ; Incidence ; Seoul ; Shadowing (Histology) ; Ultrasonography ; Urinary Bladder ; Urinary Bladder Calculi

The aim of percutaneous transhepatic biliary drainage(PTBD) is to decrease serum bilirubin level and promoteliver function in patient with biliary tract disease, especially obstruction by malignant disese. But somepatients showed persistent high serum bilirubin level or higher than pre-PTBD level. Percutaneous transhepaticbiliary drainage was performed in 341 patients of obstructive jaundice for 5 years from July, 1981 to July, 1986at departement of radiology, Seoul Natinal University Hospital. Follow up check of the serum bilibrubin level waspossible in 188 patients. Among them the authors analysed 32 patients who showed persistent high serum bilirubinlevel after PTBD. The results were as follows: 1. The male to female ratio was 3.4:1 and the age ranged from 33 to 75. 2. The causes of obstructive jaundice included 30 malignant diseases and 2 benign diseases. Malignant diseasewere 16 cases of bile duct carcinoma, 7 cases of pancreatic cancer and 7 cases of matastasis from stomach, colonand uterine cervix. Benign disease were 1 cases of common hepatic duct stone and 1 case of intrahepatic ductstones. 3. The msot common level of obstruction was trifurcation in 17 cases. 4. The most common indication ofPTBD was palliative drainage of obstruciton secondary to malignant tumor in 28 cases. 5. Change of serujmbilirubin level ratio(post-PTBD level) was 1.28, 1.22, 1.38, 1.51 in serial period of 1–3 days, 4–6 days, 1–2 week 2–3 week after PTBD. 6. Causes of persistent high serum bilirubin level after PTBD were 12 cases of partialdrainage of intrahepatic bile, 13 cases of hepatic dysfunction including 9 cases of metastatic nodule, 2 cases ofbiliary cirrhosis, 2 cases of multiple liver abscess, and 7 cases of poor function of cather including 4 cases ofhemobilia, 1 case of multiple intrahepatic stones, pyobilia and intraheptic Clonorchis sinensis.
Bile ; Bile Ducts ; Biliary Tract Diseases ; Bilirubin ; Cervix Uteri ; Clonorchis sinensis ; Drainage ; Female ; Fibrosis ; Follow-Up Studies ; Hepatic Duct, Common ; Humans ; Jaundice, Obstructive ; Liver Abscess ; Male ; Pancreatic Neoplasms ; Seoul ; Stomach

Spinal hematomas are a rare but serious complication that is typically observed in the epidural space. Spinal subdural hematomas are a dangerous clinical situation because of their potential to cause significant compression of the neural elements and can be mistaken easily for spinal epidural hematomas. This paper reports a case of a severe whole lumbar subdural hematoma after a simple epidural injection that was treated with surgical decompression with excellent clinical results.

Among 334 thoracolumbar spinal injury patients who were admitted to this hospital from June 1972 to June, 1982, 66 patients with fracture and fracture dislocation of thoraco-lumbar spine which were defined as unstable clinically and radiologically were treated with surgical measures. The ratio between male and female was 7.3:1, the majority was found in third and fourth decade (46 cases, 69%), and the most common cause of injury was falling from a height (38 cases, 58%). The most common site of the injury was lumbar spine (29 cases, 44%) and the most common mechanism of injury was flexion-rotation (29 cases, 44%). Our surgical measures were Harrington rod instrumentation with either anterior or posterior fusion (25 cases, 38%), posterior wiring and fusion (14 cases, 21%), anterior decompression and anterior fusion (14 cases, 21%), posterior fusion (4 cases, 6%), anterior fusion and posterior fusion (3 cases, 5%) and etc. The average correction of displacement was 65% and the average correction of kyphotic deformity was 50%. The most remarkable correction was found at the cases of Harrington rod instrumentation (71%, 74%). Neurological deficit had already developed in 43 cases(65%) prior to operation, and the recovery was observed in 18 cases(42%). Most excellent recovery of neural deficit was found also at the cases of Harrington rod instrumentation (11 cases, 52%). We have analysed the results of these treatment and obtained following conclusions. 1. For the unstable fracture and fracture-dislocation of thoraco-lumbar spine with or without neural involvement, immediate surgical treatments were valuable to expect restoration of anatomical reduction and promotion of every possible recovery of neural function with spinal stability and fewest complication. 2. Fixation with Harrington rod instrumentation appears to provide better reduction and stability with neural improvement than other methods, and therefore early undertaking of rehabilitation activities is possible. 3. For the patients who are seriously compromised or require anterior decompression, immediate posterior reduction and fixation with Harrington rod instrumentation followed anterior decompression and anterior fusion of the involved segments at the eariest feasible time, we feel, is the treatment of choice.
Accidental Falls ; Clinical Study ; Congenital Abnormalities ; Decompression ; Dislocations ; Female ; Humans ; Male ; Mortuary Practice ; Rehabilitation ; Spinal Injuries ; Spine