No abstract available.
Female ; Hysterectomy, Vaginal*

Pyogenic osteomyelitis is a frequent and difficult disease in treatment in orthopedic surgery. The various manifestation of the disease related to the causative organisms, the sites of involvement, the pathogenesis and the clinical course tend to give a bad prognosis after treatment. This study consists of three hundred and twenty four cases of pyogenic osteomyelitis which are studied at the Department of Orthopedic Surgery, Yonsei University hospital for 7 years and 8 months from January 1973 to August 1979. The results are as follows: 1. The frequency of the disease was highest in 1977 but not significant. 2. Femur and tibia were most frequently involved. (65.4%). 3. Age distribution showed the highest incidence between 6 and 15 years of age. (60.6%) Sex ratio was 2(M):1(F) 4. The causative organism was mostly Staphylococcus. (80.5%) The coagulase(+) Staphylococcus showed the highest sensitivity to cefamezine (88.8%) and the highest resistance to penicillin. (89.7%) 5. The treatment had been carried out case by case with variable methods. Author considered the best method of treatment was early decompression and massive antibiotic therapy in acute osteomyelitis, and saucerization with closed irrigation system in chronic osteomyelitis.
Age Distribution ; Cefazolin ; Decompression ; Femur ; Incidence ; Methods ; Orthopedics ; Osteomyelitis ; Penicillins ; Prognosis ; Sex Ratio ; Staphylococcus ; Tibia

OBJECTIVES: The purpose of this study is to review our experience with spontaneous thalamic hemorrhage. Clinical outcome of patients was brought about by comparing stereotactic aspiration and conservative medical therapy. METHODS: The study consists of seventy-three cases with spontaneous thalamic hemorrhage which were treated from the period of Jan. 1993 to Dec. 1999. Thirty-eighty patients were treated with computed tomography (CT) guided stereotactic aspiration and thirty-five patients were treated conservatively. We compared the factors affecting treatment and the factors are as follows: age and sex, conscious level on admission, hematoma volume, hematoma sites, presence of ventricular penetration. RESULTS: The results in the thirty eight stereotactic aspirated cases for the 6 months from oneset are as follows: good recovery or moderate disability in 43%, severe disability in 32%, vegitative state in 11%, dead in 13% respectively. The clinical result was more favorable in stereotactic aspiration, with 11-30cc hematoma volume, extend to internal capsule of hematoma, poor conscious level on admission than conservative medical therapy. But age and sex, conscious level on admission, presence of ventricular penetration were not influential in the statistical outcome between stereotactic aspiration and conservative medical therapy. CONCLUSION: Treatment modality of spontaneous thalamic hemorrhage is still controversial. But stereotactic aspiration is more recommended for improvement therapeutic results than conservative treatment or open craniotomy in case of 11-30cc hematoma volume, extend to internal capsule of hematoma and poor conscious level on admission.
Craniotomy ; Hematoma* ; Hemorrhage ; Humans ; Internal Capsule

The authors conducted an in-Vivo experimental study using sciatic nerve of 200-300 grammed rats to verify clinical applicability of Silicone cuffing method, by which scar adhesion of repaired nerve in crushed limb is assumed hopefully to be reduced. The following observations were obtainable. 1. Nerve conduction velocity was noted faster in Silicone cuff group than in control group significantly after 6 weeks postoperatively. 2. Adhesion of repaired nerve with surrounding scar tissue was far less present in Silicone cuff group than in control group when observed grossly. 3. The amount of scar formation and axonal degeneration were noted reduced remarkably in Silicone cuff group than in control group after 3 weeks postoperatively. 4. The intraneural vascularity was noted reduced either in Silicone cuff group and in control group, but definitely less reduced in the former than in the latter. Clinical relevance: Above results may be taken as an experimental basis supporting clinical applicability of Silicone cuff wrapping method for neurorraphy in crushed limb.
Animals ; Axons ; Cicatrix ; Extremities ; Methods ; Neural Conduction ; Peripheral Nerves ; Rats ; Sciatic Nerve ; Silicon ; Silicones

This study was condicted to construct a hypothetical model of depression in Korean adolescent women and validate the fit of the model to the empiricla data. The data were collected from 345 high school girls in Seoul, from May 1 to June 30, 1998. The instruments were the Body Mass Index, Physical Satisfaction Scale, Family Adaptatibility and Cohesion Evaluation Scale III, Family Satisfaction Scale, CES-D and School Adaptation Scale. The data were analyzed using descriptive statistics with the pc-SAS program. The Linear Structural Relationship(LISREL) modeling process was used to find the best fit model which would predict the causal relationships among the variables. The overall fit of the hypothetical model to the data was moderate [X2=69.6(df=17, p=.000), GFI=0.95, AGFI=0.90, RMR=0.087, NNFI=0.86, NFI=0.90]. The predictable variables, especially menstrual symptoms, physical symptoms and family function, had a significant direct effect on depression, but school life adaptation did not have a significant direct effect. These variables explained 18.1% of the total variance.
Adolescent* ; Body Mass Index ; Depression* ; Female ; Humans ; Seoul

PURPOSE: The authors applied modified Bilhaut-Cloquet procedure to convergent type of Wassel type IV duplicated thumb. In order to avoid secondary Z-deformity and dysfunction of the reconstructed thumb, the authors modified operative techniques of Bilhaut-Clopuet procedure. METHODS: Fourteen patients received Bilhaut-Cloquet procedures to correct duplicated thumbs from October 2008 to May 2013. Five patients were balanced type and nine patients were unbalanced type. Mean age at the operation was 20.1 month-old (range, 12-52 month-old). Angular deformity, joint stability, range of joint motion and cosmetic outcome were estimated based on Tada score. Postoperative subjective satisfaction score of the parents was evaluated using a 100-points scale. RESULTS: Mean subjective satisfaction score was 75 points at 28 months after the operation. Radiologic study showed bony union of proximal phalangeal bone and stable joint in all patients. Mean range of motion was 20 degrees in interphalangeal joint and 73 degrees in metacarpophalangeal joint. Based on Tada score, the results were good in ten patients (72%), fair in two (14%) and poor in two (14%). Seven patients who were able to follow up for a long term showed no significant difference in length of proximal and distal phalangeal bones compared to the opposite thumb. CONCLUSION: Modified Bilhaut-Cloquet procedure can be applied not only to balanced type of convergent Wassel type IV duplicated thumb, but also to unbalanced type, that focused on functional reconstruction and cosmetic improvement.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints ; Metacarpophalangeal Joint ; Parents ; Range of Motion, Articular ; Thumb*

PURPOSE: The purpose was to evaluate the efficiency of vein repair on flap survival in distally based avulsion flap injury of the hand and forearm. METHODS: Sixteen cases of distally based avulsion flap injury larger than 30 cm2 in size of the hand and forearm in which vein repair was done were enrolled. All had a avulsion injury by rolling machine. To survive the flap, extensive debridement was done to reduce the size of distally based flap injury as little as possible. Thereafter, an average of 1.4 vein were repaired. Postoperatively, hyberbaric oxygen therapy was performed for 2 weeks. The flap survival was assessed at three weeks after operation. RESULTS: When comparing the size of distally based avulsion flap injury and flaps that survived after operation, excellent results were observed in 12 cases, and good results in 4 cases. Additional operation was required including split thickness skin graft in 4 cases. A reverse island fasciocutaneous flap was performed in one case, and elbow joint arthrolysis was performed in another one. CONCLUSION: Treatment of distally based avulsion flap injury of the hand and forearm using vein repair lead to relatively satisfying results in flap survival by allowing earlier motion of the joint, providing favorable functional results.
Debridement ; Elbow Joint ; Forearm* ; Hand* ; Joints ; Oxygen ; Skin ; Transplants ; Veins*

PURPOSE: The purpose of this prospective study is to examine the anatomical variations of the branches of the medial antebrachial cutaneous nerve in Koreans encountered during cubital tunnel surgery. METHODS: Ninety two patients with cubital tunnel syndrome were treated with a standard approach from December 2008 to July 2012. The position of the branches of medial antebrachial cutaneous nerve was evaluated based on the medial humeral epicondyle with the elbows fully extended. RESULTS: At least one medial antebrachial cutaneous nerve branch was found during the surgeries in all patients. The average number of crossing medial antebrachial cutaneous nerve branches per patient was 1.6. Thirty-eight percent of the cases showed that the medial cutaneous nerve branches cross proximal to the medial humeral epicondyle within 1 cm. Eighty-two percent showed that the medial antebrachial cutaneous nerve branches cross distal to the medial humeral epicondyle within 1.9 cm. CONCLUSION: When using standard approach during cubital tunnel surgery, more than one medial forearm cutaneous nerve is found. Therefore, understanding the general position of medial antebrachial cutaneous nerve branches helps avoid iatrogenic damage to this nerve during cubital tunnel surgery.
Cubital Tunnel Syndrome ; Elbow ; Forearm ; Humans ; Prospective Studies

PURPOSE: We present the clinical results and operative method of the immediate eponychium of nail fold set back for lengthening of nails caused by acute fingertip injuries. METHODS: The research was conducted with a total of 172 patients during the period from January 2014 to June 2016. The operation method was performed in a way to fold down the two sides of the nail eponychium and had suture. A survey of the patients' subjective satisfaction was conducted and the relative nail length was compared before and after the operation as well as the nail length of the uninjured contralateral finger. The mean follow-up period was 18.2 weeks. RESULTS: In all cases, the operation time was under 3 minutes. There were no specific complications such as nail eponychium's necrosis or congestion. The new nail did not have any additional deformation. On average, the extended nail length was 3.2 mm. Compared with preoperation, the average extension ratio of the nail length was 48%, even with 75% of nail length recovery in comparison with the uninjured contralateral finger. The subjective self-satisfaction score was 92.5 on average. The satisfaction score was higher for patients who had greater remnant nail length. CONCLUSION: Immediate nail lengthening with the eponychial folding is a simple, safe and useful method with high subjective satisfaction in aesthetics for the patients with acute fingertip injuries.
Esthetics ; Estrogens, Conjugated (USP) ; Fingers* ; Follow-Up Studies ; Humans ; Methods ; Necrosis ; Sutures

Successful treatment of any pathological condition of the shoulder requires an accurate diagnosis. Physical examination represents an integral part of the assessment of shoulder disorders. Pain, loss of strength, decreased range of motion, and instability are the most common symptoms caused by a great variety of different shoulder pathologies. Therefore, a sophisticated clinical approach to the patient with shoulder pathology is essential. A standardized evaluation including a variety of diagnostic tests and clinical assessments improves the diagnostic accuracy by specifically examining one component of the shoulder complex. In most cases a careful physical examination will establish or suggest a diagnosis and special investigative techniques such as imaging procedures can be applied more selectively for confirmation or further evaluation of the pathological entity.
Diagnostic Tests, Routine ; Humans ; Investigative Techniques ; Physical Examination ; Range of Motion, Articular ; Rotator Cuff ; Shoulder