BACKGROUND: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. METHODS: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in 20° external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in 20° external rotation view. RESULTS: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was 138°± 4°, and at one-year follow-up, the neck shaft angle was 137°± 5°. There was no significant difference between the preoperative and postoperative values (p=0.105). CONCLUSIONS: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

PURPOSE: To make the guideline for diagnosis and treatment policy of various hepatocytic nodular lesions detected during the imaging diagnosis of cirrhotic liver and to get our own data about hepatocellular carcinoma based on Korean patients. MATERIALS AND METHODS: We retrospectively reviewed 40 confirmed hepatocellular carcinomas foilwed up with CT more than once without any treatment. Total numbers of follow-up were 50. First, we input the data of initial and follow-up diameter visible on CT images and follow-up interval of each mass to the computer, and got the mean growth rate curve and growth curve of hepatocelluiar carcinoma using a program of Quattro-pro, one of the spreadsheet. And then the doubling time was also calculated using Schwarz's formula. RESULTS: According to the growth rate curve, the tumor under 3 cm in diameter showed relatively show growing pattern but the one above 3 cm in diameter showed rapid growing pattern. Mean growth curve also showed rapid turning point around 3 cm. Overall mean doubling time was 82 days(mean +/- SD = 82.3 +/- 56.2): 119 days in the tumors smaller than 30 mm in diameter, 69 days larger than 30 mm in diameter. CONCLUSION: Hepatocellular carcinoma'is relatively slowly growing tumor and shows rapid increase of its growth rate when it is larger than 30 mm in diameter as a turning point. We think that this fact could make an important role to determine the treatment policy of various hepatocytic nodular lesions suspecting hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Diagnosis ; Follow-Up Studies* ; Humans ; Liver ; Retrospective Studies

Fixed pelvic obliquity refers to a composite deformity induced by contractures both above and below the pelvis and the elements of this deformity are frequently interrelated during the period of growth. From the functional standpoint, leg length discrepancy is caused by deformities of the pelvis and lower extremities, such as pelvic obliquity and acetabular dysplasia, as well as by inequality of true limb bone length, and these deformities either aggravate or compensate functional discrepancy. During fhe fourteen years period, from August 1968 to August 1982, at the Department of Orthopaedic Surgery, Seoul National University Hospital, we treated 35 cases of fixed pelvic obliquity and acetabular dysplasia associated with true or functional limb length discrepancy by means of lumbodorsal fasciotomy or pelvic osteotomies such as Salters innominate osteotomy or Steels triple osteotomy, combined, if necessary, with contralateral abductor fasciotomy to gain functional limb length as well as to improve posture and balance. In many cases of residual poliomyelitis, epiphysiodesis was also performed when indicated. These cases were reviewed and following observations were made: 1. Of the 35 cases, residual poliomyelitis with 29 cases (83%) was by far the main cause of leg length discrepancy. Cerebral palsy (2cases), Legg-Perthes disease (2 cases), and fibrous ankylosis secondary to septic hip (2 cases) comprised the remainder. 2. The male-to-female ratio was about equal, being 17 to 18. 3. The average age at the time of operation was 17.9 years, the youngest being 7 years and the oldest being 30 years. The average age at the time of current follow-up was 18.8 years. 67% of those followed was skeletally mature. 4. An average of 1.35cm of bone length was gained radiographically by pelvic osteotomies. Steels triple osteotomy was more effective in gain than Salters innominate osteotomy. 5. An average of 2.43cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy alone. 6. An average of 2.61cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy and combined contralateral Soutters or Campbells fasciotomy. 7. An average of 3.57cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy and combined ipsilateral Steel's triple osteotomy. 8. An average of 1.73cm of functional lengthening when standing was corrected radiographically by ipsilateral Soutter's fasciotomy. 9. When lumbodorsal fasciotomy and Steel's triple osteotomy were combined with contralateral Soutter's or Campbell's fasciotomy, the average radiographic gain in standing length was 3.77cm. 10. Leg length discrepancy in terms of true bone length is conventionally corrected either by epiphysiodesis or bone shortening on the longer limb, or by bone lengthening on the shorter limb. We believe that when leg length discrepancy is associated with fixed pelvic obliquity, frequently aggravating the disability functionally, lumbodorsal fasciotomy and/or pelvic osteotomies on the shorter side and, combined if necessary, Soutters or Campbells fasciotomy on the longer side, can, in many instances, successfully correct or reduce functional limb discrepancy and improve balance, posture and function. Any residual discrepancy, true or functional, may then be corrected by conventional methods.
Acetabulum ; Ankylosis ; Bone Lengthening ; Cerebral Palsy ; Congenital Abnormalities ; Contracture ; Extremities ; Follow-Up Studies ; Hip ; Leg ; Legg-Calve-Perthes Disease ; Lower Extremity ; Osteotomy ; Pelvis ; Poliomyelitis ; Posture ; Seoul ; Socioeconomic Factors ; Steel

Fifty four patients who received closed hemorrhoidectomy were randomized into two parallel groups and treated with Venitol(R)(a micronized flavonoidic fraction containing diosmin 450 mg and hesperidin 50 mg) (group 1) or placebo (group 2). Venitol(R) was administered at the dosage of three toblets b.i.d. the first four days and two tablets b.i.d following three days. Postoperative analgesia and laxative prescription as well as hospital stay were same in two groups. Though there is no difference of symptoms at D1, improvement of symptoms of complications was greater in group 1 than in group 2 at D18. The clinical severity of postoperative spot-bleeding, pain and anal discharge diminished in both groups but to a greater extent in group 1 (P<0.005). There was no side-effects in using Venitol(R). In summary, Venitol(R) is effective in reducing complications after hemorrhoidectomy.
Analgesia ; Diosmin ; Hemorrhage ; Hemorrhoidectomy* ; Hesperidin ; Humans ; Length of Stay ; Prescriptions ; Prospective Studies* ; Tablets

PURPOSE: To evaluate intrahepatic nodular lesions detected on CTAP but not on conventional contrast CT in regard to its relationship with satellite nodules or borderline malignancies. MATERIALS AND METHODS: From June 1991 to March 1994, CTAP was undertaken in 132 cases with confirmed hepatocellular carcinoma(HCC), of which 35 cases having 82 lesions were suitable for analysis(excluding the cases which had no follow-up studies, showed segmental abnormal portal perfusion, no additional lesions and, or inumerable lesions). The CTAP findings were compared with those on artery dominant imaging studies (angiography, DSA, bolus dynamic CT, arterial CT, Lipiodol CT) taken during the same period(to confirm the presence of lesions) and the findings on follow-up imaging studies(to assess the developemerit of malignancy). RESULTS: Arterial vascularity was identified in 35 of 82 lesions(42.7%) on arterial dominant imaging studies. Developement into malignancy was identified on follow-up imaging studies in 25 of remained 47 lesions(53.2%). CONCLUSION: The total positive predictive value of nodules on CTAP was 73.2%(35+25/82), but the predictive value for HCC by follow-up only was 53.2%. Given'the difficulties in detecting intranodular arterial flow and the short follow-up duration in many patients, the actual positive value might be higher.
Arteries ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Perfusion

PURPOSE: To evaluate intrahepatic nodular lesions detected on CTAP but not on conventional contrast CT in regard to its relationship with satellite nodules or borderline malignancies. MATERIALS AND METHODS: From June 1991 to March 1994, CTAP was undertaken in 132 cases with confirmed hepatocellular carcinoma(HCC), of which 35 cases having 82 lesions were suitable for analysis(excluding the cases which had no follow-up studies, showed segmental abnormal portal perfusion, no additional lesions and, or inumerable lesions). The CTAP findings were compared with those on artery dominant imaging studies (angiography, DSA, bolus dynamic CT, arterial CT, Lipiodol CT) taken during the same period(to confirm the presence of lesions) and the findings on follow-up imaging studies(to assess the developemerit of malignancy). RESULTS: Arterial vascularity was identified in 35 of 82 lesions(42.7%) on arterial dominant imaging studies. Developement into malignancy was identified on follow-up imaging studies in 25 of remained 47 lesions(53.2%). CONCLUSION: The total positive predictive value of nodules on CTAP was 73.2%(35+25/82), but the predictive value for HCC by follow-up only was 53.2%. Given'the difficulties in detecting intranodular arterial flow and the short follow-up duration in many patients, the actual positive value might be higher.
Arteries ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Perfusion

No abstract available.
Female ; Mammals* ; Ovulation* ; Rupture*

No abstract available.
Animals ; Immunohistochemistry* ; Neurons* ; Rats* ; Substantia Nigra*

In the treatment of dislocations and subluxations of the hip in the older children, whether congenital or paralytic, orthopedic surgeons are blessed with a wide variety of commonly used surgical procedures; namely, Salters innominate osteotomy, acetabtloplasties, Pembertons pericapsular osteotomy, shelf operations, Chiaris pelvic displacement osteotomy. and Colonnas capsular arthroplasty. However, with increasing age and soft tissue contractures,these procedures become ineffective, leaving a wide range of age between older children and young adults subject to uncertain or unfavarable prognosis. Steels triple osteotomy (1973) is aimed at coverig this age group, when displacement or in nominate osteotomy is either technically infeasible or likely to fail. It consists of an open reduction with or without soft tissue release and skeletal traction, redirection of the acetabulum to cover the femoral head by osteotonmies of the pelvis that has lost its young cartilagenous resiliency, and preservation and physiological remodelling of the articular cartilage of the acetabulum. We performed Steels osteotomy on a 21-years-old female with a severe paralytic subluxation of the hip associated with pelvic obliquity and paralytized both lower extremities. One and a half year follow-up result was satisfactory with a stable and congruous joint despite paralysis and with the patient walking for the first time in her life.
Acetabulum ; Adult ; Arthroplasty ; Cartilage, Articular ; Child ; Dislocations ; Female ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Lower Extremity ; Orthopedics ; Osteotomy ; Paralysis ; Pelvic Bones ; Pelvis ; Prognosis ; Steel ; Surgeons ; Traction ; Walking ; Young Adult

Slipped femoral capital epiphysis is a rare entity in Korea and only three cases have been reported so far1,2,3). One of our cases was a unilateral mild chronic slip in a 14 year old boy with Frohlich body type. It was treated by gentle closed reduction followed by knowles' pin fixation. The other case, a 20 year old female, presented chondrolysis of the left hip. Scrutinization of roentgenograms revealed typical features of an unrecognized slipped femoral capital epiphysis. It was treated by Wagner resurfacing replacement arthroplasty.
Arthroplasty, Replacement ; Epiphyses ; Female ; Hip ; Humans ; Korea ; Male ; Somatotypes