Between Jan. 1971 and Dec. 1985, 102 consecutive patients underwent total cystectomy and urinary diversion for primary carcinoma of the bladder. Among the patients, planned radiation therapy (2,000 rad. for 5 days) followed by operation was done in 18 patients, therapeutic dose of radiation was given postoperatively in 8 patients and 76 patients underwent operation only The postoperative mortality rate was 3.9%. Early complications occurred in 30% of the 102 patients and included wound infection, urine leak, bowel obstruction and medical complication. An increased late complication incidence was noted among 26 patients receiving pre- or postoperative radiation (50%) compared with those not receiving radiation (32%). Staging errors by CT scanning occurred in 37% of patients, overstaging in 8 (33%) and understaging in 1 (4%). Survival was evaluated in 45 patients and the overall 5-yesr survival rate for patients with transitional cell carcinoma was 38%.
Carcinoma, Transitional Cell ; Cystectomy* ; Humans ; Incidence ; Mortality ; Survival Rate ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion ; Wound Infection

No abstract available.
Hepatitis B Surface Antigens* ; Interferons* ; Lymphocytes*

Treatment of femoral shaft fractures in children is varying according to age. Satisfactory results have been obtained with longitudinal skin traction, split Russell traction, ordinary Russell traction, 90-90 skeletal traction, and immediate application of a spica cast(2,4,6,11,15). Most authors use one or more techinques routinely. It is safe and convenient to use single treatment protocol to treat all fractures of same type, Distal femoral skeletal traction with the knee and hip flexed 90 degrees and with the thigh hanging free, using the trunk as counter traction, has been used routinely for femoral shaft fractures in children(age 4-12). We reviewed 30 cases of femoral shaft fractures in children treated with 90-90 skeletal traction. 1. The average age of the patients was 6.8 years(range, 4-12 years), and almost all were caused by pedestrian injury. 2. The average time of traction was 48 days(range, 28-75), and 12 cases(40%) were treated without spica cast application. 3. Four among 30 cases developed angular deformity exceeding acceptable range(15° in AP view, 20° in lateral view), and three of them were proximal third fractures. 4. The older the patient, the longer the duration of limited activity and the more tendency of angular deformity. 5. 90-90 skeletal traction is easy, safe and convenient to treat all femoral shaft fractures of the children between four and ten years old.
Child ; Clinical Protocols ; Congenital Abnormalities ; Hip ; Humans ; Knee ; Skin ; Thigh ; Traction

One hundred and twenty patients with symptomatic lumbar disc herniation were treated with automated percutaneous lumbar discectomy(APLD) from June 1988 to October 1989 in Seoul National University Hospital. Among them, 95 patients were followed up for more than 6 months. Number of male patients was 58 and female 37. Age ranged from 15 to 57 years with average 28 years. L4-L5 was the most commomly involved level comprising 80%, and 2 level involvement was 9%. Average duration of procedure was 38 minutes, and average amount of tissue aspirated was 5.2 grams and average hospital stay was 2.4 days. The average follw up was 10.8 months. Eighty seven percent of patients were satisfactory and 13% unsatisfactory and there was no major complication. There was no significant disc space narrowing in all the cases and the size of herniation revealed no significant change in all the patients, even the patient had a satisfactory result. APLD was compared with chemonucleolysis performed during 1988 in terms of clinical results, disc space narrowing on plain films and herniation size change on follw up CT. Chemonucleolysis also had satisfactory result in 89% with reduction of herniation size in 41% but induced significant disc space narrowing in 84%. Authors experienced some special cases, which are generally considered poor indication for percutaneous discectomy. Those were degenerative, calcified and possibly ruptured discs. Satisfactory results were obtained in 10 of 14 these patients.
Diskectomy ; Diskectomy, Percutaneous ; Female ; Humans ; Intervertebral Disc Chemolysis ; Length of Stay ; Male ; Seoul

No abstract available.
Diagnosis* ; Magnetic Resonance Imaging* ; Spinal Stenosis*

Corneal ulcerations are divided into two morphologic types: central and marginal. Marginal corneal ulcerations are characterized by focal, muItifocal, multifocal or diffuse ulcerative, infiltrative, or vascular involvement of the peripheral cornea, and the exact pathogenesis of these ulcerations is not clearly understood but infectious, toxic or autoimmune factors may be involved. The authors treated one peripheral corneal ulcer patient, no respond to steroid and antibiotic therapy, with lamellar keratoplasty and had a good result.
Cornea ; Corneal Transplantation* ; Corneal Ulcer* ; Humans ; Ulcer

Various kinds of bone cements mixed with antibiotics have been widely used for treatment and prevention of infections, especially combined with bone defects. But bone cements have some disadvantages in that they are rather expensive and capable of incurring some complications such ss fibrosis of surrounding soft tissue or local erosion of bone, and furthermore, they must be removed after infection is controlled for bone graft to fill up the defects because they do not have properties of osteoconduction or osteoinduction. So we have come to the idea of using theoretically advantageous plaster of paris to take place of bone cements, and performed in-vitro experiment upon the effectiveness of plaster of paris pellets containing antibiotics, then obtained good results comparable to those from many experimental studies using bone cements. By this, we think that it would be possible in the future to treat and prevent infections supervening bone defects with plaster of paris mixed up with antibiotics. The results are as follows : 1. Sustained release of large amount of antibiotics from plaster of paris enough to exert inhibitory activity on abcterial growth, and there was a direct relationship between concentrations of eluted antibiotics and diameters of inhibitory zones. 2. Tobramycin was capable of inhibiting the growth of S. aureus, E. coli, and Ps. aeruginosa for 7 days at maximum. 3. Cephradine inhibited the growth of S. aureus and E. coli but did not affect that of Ps. aeruginosa. 4. The maximum antibacterial activity wss reached within first 24 hours from the start of elution of antibiotics from plaster of paris.
Anti-Bacterial Agents ; Bone Cements ; Bone Regeneration ; Calcium Sulfate ; Cephradine ; Fibrosis ; Tobramycin ; Transplants

Authors reviewed about scoliosis the chest films of 325 congenitalheart diseasepatients who visited Seoul National University Hospital during the period of Jan. 1986 to Dec. 1987 to find out the incidence of scoliosis in congenital heart disease patients and to define the nature of scoliosis associated with congenital heart disease and came to following conclusions. 1. When curvatures of 10 degrees or more on chest P-A was classified as scoliosis, the incidence of scoliosis was 14.4%. It was more than 6 times the prevalence of scoliosis of 2. 3% in general population in Korea. 2. There was no difference in the incidence of scoliosis between the cyanotic and acyanotic heart diseases (P < 0.05). 3. There was no difference in the incidence of scoliosis between individual heart diseases (P < 0.05). 4. The scoliosis associated with congenital heart diseases showed a relative male preponderance. The male to female ratio of scoliosis was 1: 2.1 in patients with congenital heart disease while male to female ratio of idiopathic scoliosis in in general populationwas 1: 8.7 in Korea. 5. The curve pattern of scoliosis associated with congenital heart disease was predominantly right sided, comprising 74.5%. There was no difference of curve pattern between the scoliosis associated with congenital heart disease and the scoliosis in the general population. 6. The curve pattern of scoliosis was influenced neither by the side of the aortic arch nor the thoracotomy incision.
Aorta, Thoracic ; Female ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Incidence ; Korea ; Male ; Prevalence ; Scoliosis ; Seoul ; Thoracotomy ; Thorax

This study was performed to analyze the clinical, radiological results of 70 patients with isthmic spondylolisthesis and 30 patients with degenerative spondylolisthesis who were underwent with wide decompression, reduction with transpedicular screw system and posterolateral fusion from Mar. 1990 to Dec. 1995. In this study we excluded posterior lumbar interbody fusion, circumferential fusion or decompression method for sondylolisthesis. The mean follow up duration was 29 months. The most common level was L5-Sl in isthmic group (36 patients, 51%), and L4-5 in degenerative group (23 patients, 77%). The clinical result were analyzed according to Kirkaldy-Willis criteria. The satisfactory result were obtained 90% in each group. Screw failure occured in unstable level with severe slip angle, so anterior column support may be recommended in this group. Pedicle screw fixation and wide decompression augmented with posterolateral bone graft is a satisfactory alternative method for degenerative and isthmic spondylolisthesis.
Decompression ; Follow-Up Studies ; Humans ; Spondylolisthesis* ; Transplants

No abstract available.
Kyphosis*