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

No abstract available.
Knee*

No abstract available.
Hip

No abstract available.
Osteoma, Osteoid* ; Spine*

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

Nowdays steroid injection into the epidural space is increasing gradually by pain clinic physician in order to control of low back and radiculating pain. But, there are a few reports about the effect of methylprednisolone that is injected into the epidural space on the plasma cortisol levels. So we undertook to determine the effect of epidural methylprednisolone acetate(Depomedrol) on the hypothalamus-pituitaryadrenal axis by checking plamsa cortisol levels. 9 patients were given 80 mg of methylprednisolone acetate and 10 ml of 0.25% bupicaine epidurally 3 times of injection at weekly intervals and checked the plasma cortisol levels of 1 hour before and after each injection respectively. The levels of plasma cortisol were also checked at first and 4th week after the last injection. The results are as follows: The baseline plasma cortisol level is 11.21+/-6.38mg%. The plasma cortisol levels of 1 hour before and after 2nd injection are 3.94+/-5.38 and 4.11+/-7.10mg%. The plasma cortisol levels of 1 hour before and after 3rd injection are 2.01+/-1.33 and 2.90+/-4.31mg%. The palsma cortisol level of 1st week after the last injection is 1.76+/-1.03mg%. The plasma cortisol level of 4th week after the last injection is 7.45+/-2.38mg%.
Axis, Cervical Vertebra* ; Epidural Space* ; Humans ; Hydrocortisone ; Low Back Pain ; Methylprednisolone* ; Pain Clinics ; Plasma

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

A fracture of the affected extremity in patients with Klippel–Trenaunay–Weber syndrome can be fatal due to massive bleeding and show poor results. A 42-year-old male presented with an old fracture of the right femoral shaft with metal failure. We planned an operation to remove the previously fixed plate and to perform re-fixation using an intra-medullary nail. Preoperative angiography was performed and the arteriovenous malformations were embolized in order to reduce the risk of bleeding. After angiography, the previously fixed plate was removed.After the operation, a second angiography was performed immediately and the venous malformation was embolized. One week after the first operation, a second operation was performed in order to reduce the fracture and to perform re-fixation using an intramedullary nail. The patient is being followed without major complication over a period of seven years after surgery. We recommend careful planning of preoperative and postoperative angiography and embolization in order to reduce the risk of bleeding in patients with Klippel–Trenaunay–Weber syndrome.

OBJECTIVES: The present study was performed to investigate whether estrogen and progesterone induce the change of vascular tone in endothelium-denuded human uterine artery and vascular reactivity may be mediated by intracelluar calcium modulation through receptor- and voltage-dependent calcium channels. METHODS: The uterine arteries were obtained at the time of hysterectomy from 28 women followed by denudation of endothelium. After confirmation of functional integrity of endothelium-denuded uterine artery, vascular reactivity was measured by using isometric force transducer and recorded by physiograph. Contraction was induced by 10-6 M norepinephrine and 35mM high concentrated potassium chloride solution which activated receptor-dependent calcium channel and voltage-dependent calcium channel, respectively.Thereafter estradiol of 4 different concentrations from 3x10-11M to 3x10-8M was administered. Progesterone was also administered to endothelium-denuded uterine artery which was contracted by 10-6M norepinephrine and high potassium chloride solution. To evaluate the effect of additional progesterone on vascular smooth muscle relaxation effect of estrogen,4 different progesterones in concentrations from 3x10-8M to 3x10-5M were given to vascular smooth muscle which was initially pretreated with norepinephrine followed by relaxation of estradiol. RESULTS: Estradiols from 3x10-11M to 3x10-8M showed in significant dose-dependent vascular relaxation. Progesterones result in significant decrease in vascular contraction in concentration dependent manner. Additional progesterone on estrogenic effects also results in significant decrease in vascular contraction. CONCLUSION: Estradiol may have endothelium independent vasorelaxation effect in human uterine artery. These vasorelaxant effects may be mediated through antagonistic action for receptor-and voltage-dependent calcium channels in vascular smooth muscle. Progesterone also bring about vasorelaxation by same action in endothelium-denuded vascular smooth muscle. On estrogen induced vascular relaxation, progesterone results in additional vasorelaxation.
Calcium ; Calcium Channels ; Endothelium ; Estradiol ; Estrogens* ; Female ; Humans* ; Hysterectomy ; Muscle, Smooth, Vascular ; Norepinephrine ; Potassium Chloride ; Progesterone* ; Relaxation ; Transducers ; Uterine Artery* ; Vasodilation

Alcoholic celiac plexus blocks have been used to relieve intractable upper abdominal cancer pain. Various techniques have been proposed including the use of the X-ray and CT scanner to improve results and to avoid complications. We used the CT scanner and the X-ray fluroscope for 36 cases of alcoholic celiac plexus blocks to determine the depth and position of the needle without previous diagnostic blocks. Good to excellent pain relief occurred in more than 72% of the patients and the advantages of the use of the CT scanner showed that 1) placement of the needle tip is easily established according to the surrounding anatomical structures. 2) the operator can introduce the needle without anxiety. 3) the time required for block are saved.
Alcoholics ; Anxiety ; Celiac Plexus* ; Humans ; Needles