197 spine CTs were performed from 29th, March 1982 to 7th March, 1984. Among them, 39 patients preoperatively diagnosed as herniated nucleus pulposus ar bulging disc with CT and myelography were operated. 43 disc spaces ofdisc disease were analysed in true positive and false negative cases. Finally the accuracy, sensitivity and specifictiy of spine CT and myelography ar calculated. The resuslts are as follows; 1. The CT findings of disc diseases are in order of frequency, asymmetrical obliteration of epidural fat (82%), ventral indentation orcompression on dural sac(72%), focal protrusion of disc(64%), root changs
Constriction, Pathologic ; Humans ; Hypertrophy ; Intervertebral Disc Displacement ; Methods ; Myelography ; Spine ; Vacuum ; Zygapophyseal Joint

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking

Acetabular fractures assume great clinical importance because acetabular is weight bearing joint in the lower extremity. The undisplaced fractures of the acetabulum gave satisfactory results with closed method, but the treatment of displaced fractures have been controversial. A clinical analysis was performed on the 72 patients with displaced acetabular fractures, who had been treated at Soonchunhyang University Hospital from January 1980 to December 1989. The results obtained were as follows. 1. The prevalent age ranged from 21 to 50 years, which comprised 86.1% of all, and the ratio between male and female was 3:l. 2. The most common cause of injury was traffic accident, which comprised 76.4%. 3. According to Letournel's classification, simple fracture was 38 cases (52.8%), associated fracture was 34 cases (47.2%) and hip dislocation was associated in 28 cases (38.9%) and most common was posterior (20.8%). 4. Closed treatment was done in 47 cases and open treatment in 25 cases. 5. Results of open treatment group were better than closed treatment group in both clinical and roentgenographic study. 6. The complication were occured in 14 (29.8%) out of 47 cases of closed treatment group, and 10 (40.0%) out of 25 cases of open treatment group. 7. Not only choice of treatment but also determination of surgical approach require accurate assessment of the fracture pattern in this region of complex bony architecture by careful radilogic analysis.
Accidents, Traffic ; Acetabulum ; Classification ; Female ; Hip Dislocation ; Humans ; Joints ; Lower Extremity ; Male ; Methods ; Weight-Bearing

No abstract available.
Tibial Fractures*

CT has becom increasingly important diagnostic method as the inital examination in the diagnosis of subarachnoid hemorrhage with direct detection of extravasated blood inbasal cistern and cortical sulci. Furthermore, CT provides better and exact visualization of the presence, localization, extent and degree of intracerebral, intraventricular and subdural hemorrhage, infarction, hydrocephalus and rebleeding which may be associated wtih subarachnoid hemorrhage, and also could detect the causative lesions with contrast enhancement inmany cases. The purpose of the paper is to describe the CT findings of subarachonid hemorrhage due to various causes and to evalute the diagnostic accuracy of CT in subarachonoid hemorrhage. Authors analysed a total of 153 cases with subarachnoid hemorrhage confirmed by lumbar puncture at Seoul National University Hospital from March 1979 to April 1981, with special emphasis on CT findings.All of the cases took CT scan and 125 cases of the mangiography. The results are as follows; 1. Most prevalent age group was 4th to 6th decades (78%). The ratio ofmale to female was 1.1:1. 2. Of all 125 with angiography, aneurysm was a major cause (68%). Others were arterio-venous malformation (9.6%), Moya-moya disease(4%) and unknown (18.4%). 3. Of all 153 cases with CT scan,hemorrhage was demonstrated in 98 cases (64.1%); SAH in 72 cases (47.1%), ICH in 65 cases (42.5%), IVH in 34 cases(22.2%) and SDH in 1 case(0.7%). SAH combined with ICH was a major group (34.7%) in SAH. Detecton rate of SAH was68.3% within the first 7 days and 5.8% after 7 days. 4. In aneurysms, SAH was detected in 60 of 85 cases (70.6%);88.1% within the first 7 days and 5.6% after 7 days. Anterior communicating artery was the most common site of theaneurysms(40%), in which detection rate of SAH was 100% within the first 7 days. SAH was combined with ICH in38.3%. 5. On CT, SAH of unilateral Sylvian fissure was pathognomonic for ruptured MCA aneurysm and ICH of corpuscallosum for ACA aneurysm. 6. The detection rate of aneurysm itself on CT was 20%(17/85) and its size was variablefrom 5 to 25mm. 7. Infarction was demonstrated in 9 cases (6%) and there was no significant correlation between infarction and angiospasm, 8. Hydrocephalus was detected in 65% cases(42.5%), and 21 cases (32.3%) were demonstrated within the first 3 days.
Aneurysm ; Angiography ; Arteries ; Diagnosis ; Female ; Hematoma, Subdural ; Hemorrhage ; Humans ; Hydrocephalus ; Infarction ; Methods ; Seoul ; Spinal Puncture ; Subarachnoid Hemorrhage ; Tomography, X-Ray Computed

Renal infarction with ethanol was induced exprimentally in rabbits and selective renal angiography wasperformed to evaluate the effectiveness of ethanol as embolic material. The results were as follows; 1. Completeobstruction of renal artery was produced in all cases within 1 week after injection of absolute ethanol(0.5ml/kg). 2. Incomplete obstruction of renal artery was produced in majority after injection of absolute ethanol(0.2ml/kg) and changed to complete obstruction above half cases with time. 3. Incomplete obstruction of renalartery was produced in minority after injection of 60% ethanol (0.2ml/kg) and complete obstruction of renal arterywas not produced. It was considered that ethanol is an effective agent for complete renal infarction and 0.2 to0,5ml/kg of absolute ethanol is effective dose for complete renal infarction.
Angiography ; Ethanol ; Infarction ; Rabbits ; Renal Artery

Twenty patients with congenital aortic stenosis excluding valvular stenosis were studied beween April 1980 and April 1984 at Seoul National University Hospital. The clinical and radiologic findings with the emphasis on the cineangiographies were analyzed separately according to the type of aortic stenosis as subaortic and supravalvular aortic stenosis. The summaries of the analysis are as follows: 1. Among the 20 cases, 12 cases were subaorticstenosis and 8 cases were supravalvular stenosis. 2. The anatomic types of subaoritc stenosis were the discrete membranous type (8 cases), the fibromuscular type (2 cases) and the tunnel type (2 cases). 3. The obstruction of subaoritic types was usually severe, and the median left ventricular to aortic systolic pressure gradient was 60mmHg, and associated cardiac defects were found in 10 cases (84%), an incidence greater than that reported in mostother large series. 4. The anatomic types of 8 cases of supravalvular aortic stenosis were mainly focal type (7cases ) and 1 case of diffuse hypoplastic type. 5. The median left ventricular to aortic systolic pressure gradient of supravalvular stenosis was 75mmHg, and associated anomalies were seen in 6 cases(75%) with 3 cases of suspected mental retardation and facial abnormalities without definite hypercalcemia. 6. For accurate diagnosis of congenital aortic stenosis, retrograde left ventricular angiograms obtainend in axial pojections are of crucial importance in demonstration of anatomic types of stenosis and associated anomalies. And supravalvular aortic injection is sometimes helpful to outline the anatomy of the valve and to evaluate the degree of aortic regurgitation.
Aortic Stenosis, Supravalvular ; Aortic Valve Insufficiency ; Aortic Valve Stenosis ; Blood Pressure ; Cineangiography ; Constriction, Pathologic ; Diagnosis ; Humans ; Hypercalcemia ; Incidence ; Intellectual Disability ; Seoul

A statistical analysis was made on the 102 patients of hand injuries and their treatments. The rate of hand injury increases steadily due to the development of industrial activities and traffic accident. The hand has much more delicate functions to be performed and its structural characters should be fully understood to manage them properly. The most important point and to be emphasized is the proper coverage (resurfacing) of the wound as early as possible to avoid infection. For this purpose, early debridement and irrigation of the wound are important previous to the resurfacing. The statistical analysis is concluded as follows: 1. The peak incidence of hand injury was in the age group of 11-20 years (34.3%) and most of all were male in 89.2%. 2. There was no difference rate of dominant side and was almost equal affection of both side. 3. Industrial accident was the main cause and the most cammon type were crushing injuries with open fracture (43.1%). 4. Most of the patient were able to get the chance of early medical care in arriving hospital within six hours in 69.6%. 5. The most common digit of injury was middle finger (25.1%) and 59.8% was monodight involvement. 6. As the final result, the 28.6% (57 out of 199) of finger was amputed at the time of injury or for the purpose of treatment. The most common level of amputation were distal and middle phalanx with the rate of 29.8% each. 7. 46.8% of hand injuries were able to close primarily after debridement including 16.2% with bony amputation. 8. Various complications of hand injuries were observed in 36 case and one of most common complication was the infection in 21 cases (58.3%). About a half (52.4%) of infection were caused by pseudomonas.
Accidents, Occupational ; Accidents, Traffic ; Amputation ; Clinical Study ; Debridement ; Fingers ; Fractures, Open ; Hand Injuries ; Hand ; Humans ; Incidence ; Male ; Pseudomonas ; Wounds and Injuries

It is generally accepted that the integrity of posterior cruciate ligament plays a major role in knee stability. The rotatory movement is around a point to the back of center of joint where the posterior cruciate ligament lies, and it is a structure which is just as important as the other ligaments. Methods of reconstruction have been described, using semitendinosus tendon, gracilis tendon, popliteus tendon, patellar tendon, iliotibial band, and medial meniscus. We have successfully used the semitendinosus tendon in two patients who sustained neglected rupture of posterior cruciate ligament.
Humans ; Joints ; Knee ; Ligaments ; Menisci, Tibial ; Patellar Ligament ; Posterior Cruciate Ligament ; Rupture ; Tendons

The "flosting knee" is the term applied to the flail knee joint segment resulting from a fracture of the shaft of adiacent metanhysis of the ipsilateralfemur and tibia. The various methods of treatment of the "floating knee" were adapted by many authors according to degree of the comminution, degree of the soft tissue injury, general condition state of the fracture. Authors experienced the floating knee in 52 cases on 51 patients who were treated at Soon Chun Hyang University Hospital in the period of 4 years and 5 months from January 1985 to June 1989 and among them, 45 cases were treated by operative method and 7 cases by conservative methods at least one of the femur and tibia, The results were as follews;1. Floating Knee occured six times more in male and the peak age was third and fourth decades. 2. The most common cause of fractures was traffie aecident and there was difficulty in diagnosis of ligamentous disruption of the ipsilateral knee. 3. The common fracture site were middle one third and the most common fracture shape was comminuted in both femur and tibia. 4. A good or excellent functional result was aohieved in treated with open reduction and rigid fixation of both fracture and there were no significant difference in group of the internal fixation of both femur and tibia. 5. Intramedullary nailing on the femur and plate fixation on the tibia provided rigid fixation of fracture and the it made possible early joint motion exercise and ambulation and the average healing time of fracuture was much shortened. 6. The most common concomitant injury were soft tissue injury and delayed or nonuion and osteomyelitis were developed more frequently in the plate and screw fixation group of the open fracture.
Clinical Study ; Diagnosis ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Open ; Humans ; Joints ; Knee ; Knee Joint ; Ligaments ; Male ; Methods ; Osteomyelitis ; Soft Tissue Injuries ; Tibia ; Walking