No Abstract Available.
Mass Screening*

No abstract available.

The Duodenal diverticulum is the rare cause of the common bile duct obstruction. We experienced a case of the diverticulum of the second portion of duodenum in a 59-year-old male, who complained recurrent attacks of right upper abdominal pain and fever since 16 months prior to admission. Duodenoscopic finding and UGI study revealed a typical duodenal diverticulum just side to the papilla of Vater. Diverticulectomy and cholecystectomy was performed and after than, he has been free front above mentioned symptoms. We reported a case of duodenal diverticulum which caused recurrent common bile duct obstruction.
Abdominal Pain ; Cholecystectomy ; Common Bile Duct* ; Diverticulum* ; Duodenum ; Fever ; Humans ; Male ; Middle Aged

The types of the synovial plicae were classified according to the classification of Kim and Choe(1997). The purpose of this study was to evaluate the diagnostic ability of MRI for synovial plicae. We retrospectively reviewed the MR findings of the knee in 95 cases of 91 patients. In all 95 cases, findings of arthroscopy and MR images were available. MRI was performed with a 1.5 Tesla Magnetom(Siemens) using a round surface coil. Pulse sequence were Tl weighted image(TR 650ms /TE 20ms) and T2 weighted image(TR 2000ms/TE 70ms). MR images could not show the infrapatella plicae and lateral plicae clearly, but some suprapatellar plicae were shown in T2 weighted MR images (37.5% of hole type, 80% of complete type, 26% of medial type). In 20(22%) of the 90 cases with medial patella plicae proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on T2 weighted MR images. These 20 cases included 3 of fenestra type, 9 of wide shelf type and 8 of medial shelf type. The low intensity band seen on T2-weighted MR images and its anatomical relation to the medial femoral condyle are helpful in diagnosing the presence of medial shelf type and wide shelf type of medial plicae.
Arthroscopy* ; Classification ; Femur ; Humans ; Knee* ; Magnetic Resonance Imaging* ; Patella ; Retrospective Studies

Two patients with flexor paralysis of the elbow due to brachial plexus injury and three patients with flexor paralysis of the wrist and fingers due to Volkmann's contracture were treated by transplantation of the gracilis muscle which was detached at both ends and transferred to replace the biceps and long finger flexors, preserving its long and lax neurovascular pedicle. At eleven to fifteen months after operation, the strength and flexion of the elbow were satisfactory and the additional cosmetic effect was obtained. This method should be performed only after a complete study of the patient's general functional needs and the condition of the affected arm, forearm and hand.
Arm ; Brachial Plexus ; Contracture ; Elbow ; Fingers ; Forearm ; Hand ; Humans ; Methods ; Paralysis ; Wrist

Dislocations of the toes are comparatively rare. The majority of the these injuries occur in the great toe at the metatarsophalangeal joint. Dislocations of the interphalangeal joint of the great toes are extremely unusual, especially interphalangeal dislocation of the grcat toe with interposition of a sesamoid bone is extremely rare. Authors wishes to report two cases of interphalangeal dislocation of the great toe with interposition of the interphalangeal sesamoid.
Dislocations ; Joints ; Metatarsophalangeal Joint ; Sesamoid Bones ; Toes

It is well known that the early diagnosis and treatment are very important for the patient with ankle instability to provide a favorable occupational function through the whole life. Therefore, to evaluate the result of treatment of lateral ankle instability, we analyzed the 10 cases with 3.1 years follow-up period who were treated at the Orthpaedic department, National police Hospital, from January, 1980 to December, 1986. The results were as follows : l. Among the 10 patients, 4 patients were female, 6 patients were male and all patients were required operative procedures. 2. The aversge age was 21.3 years ranging from 18 years to 24 years and average follow-up period was 3.1 yesrs ranging from 6 months to 7 years. 3. In occupstional distribution, volley ball players were 4 patients, soccer players were 2, combat police were 3, student was 1 snd athletes were 6 patients (60%) among the 10 patients. 4. In the method of treatment, surgical treatment by Evans or Watson-Jones reconstructive procedure was used for 10 pstients. 5. The results of treatment were Excellent in 6 patients (60%), Good in 2 (20%) and Poor in 2(20%) by author's rating system. 6. The most common complication was the degenerative arthritis.
Ankle ; Athletes ; Early Diagnosis ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Osteoarthritis ; Police ; Soccer ; Surgical Procedures, Operative

Osteochondritis dissecans of the capitellum is a condition which causes pain and limitation of motion in the elbow joint. Conservative management can be done in the early stage, but operative method is indicated when conservative treatment failed or loose bodies causing symptoms developed. The authors experienced 20 cases of osteochondritis dissecans of the capitellum, which received satisfatory surgical treatment, such as 1) removal of loose body, 2) removal of loose body, curettage, and multiple drilling, 3) curettage and multiple drilling at the Department of Orthopedic Surgery, National Police Hospital, from January, 1985 to August 1989. Following results were obtained. 1. The occupations were baseball players in 5 cases (25%), gymnast in 4 csses (20%), tennis player in 1 case (5 %), which implicates repetitive trauma or excessive use of the elbow joint as a cause of osteochondritis dissecans of the capitellum. 2. The main symptoms were pain in all cases(100%), limitation of range of moiton(70%), locking(25%), swelling of the joint, and clicks on range of motion in decreasing order. 3. Of the 20 cases, removal of loose bodies was performed in 13 cases(65%), removal of loose bodies, curettage, and multiple drilling in 4 cases (20%), and curettage and multiple drilling in the remaining 3 cases (15%), And follow-up results were excellent in 16 cases (80%), good in 3 cases (15%), and moderate in 1 case (5%). So, we concluded that the above surgical measurements are good enough to give satisfactory results for osteochondritis dissecans of the capitellum.
Baseball ; Curettage ; Elbow Joint ; Follow-Up Studies ; Humans ; Joints ; Methods ; Occupations ; Orthopedics ; Osteochondritis Dissecans ; Osteochondritis ; Police ; Range of Motion, Articular ; Tennis

In the endoscopic one-incision anterior cruciate ligament(ACL) reconstruction, placing the graft's tendon-bone interface flush with the intraarticular femoral tunnel results in frequent distal graft protrusion. On the contrary, we occasionally found that the intraarticular posterior cruciate ligament(PCL) length was longer than patellar tendon length and had a great difficulty in performing the endoscopic one-incision technique of PCL reconstruction. The purpose of this study is to get a certain guideline in the endoscopic one-incision technique of cruciate ligament reconstruction by measuring intraarticular distance of ACL, PCL and patellar tendon and by measuring distance between the insertion of pes anserinus and medial tibial plateau in 19 cadaveric knees. The results were as follows; 1. The average patellar tendon length was 36.2±4.7mm(range 24.7-45.0). 2. The average ACL length was 23.7±3.9mm(range 16.5-30.3). 3. The average PCL length was 32.7±3.8mm(range 25.4-41.0). 4. The average distance between the insertion of pes anserinus and medial tibial plateau was 38.3±5.4mm(range 27.2-53.6). Clinical Relevance: Since Korean patellar tendon is shorter than Caucasian's and intraarticular distance of ACL is same as Caucasian's, graft-tunnel mismatch doesn't seem to be a major problem with the accurate technique of the endoscopic one-incision ACL reconstruction in Korean patients. It is possible to interfere with the pes anserinus if the length of the tibial tunnel is needed more than 44.8 mm, It is very difficult to perform an endoscopic one-incision PCL reconstruction if the length of patellar tendon is less than 35mm because intraarticular distance of PCL is sometimes longer than patellar tendon in such cases.
Adult ; Cadaver ; Humans ; Knee ; Ligaments ; Patellar Ligament ; Transplants

PURPOSE: To evaluate the glaucoma discrimination ability of visual field index (VFI), a new perimetric index of Humphrey field analyzer II, in glaucoma patients with central and peripheral visual field defects (VFD). METHODS: Humphrey visual field test and OCT were performed in 204 glaucomatous eyes and 70 healthy eyes. The associations of VFI with mean deviation (MD), pattern standard deviation (PSD), and average retinal nerve fiber layer thickness (RNFLT) were analyzed using Pearson's correlation. The diagnostic abilities of the parameters were analyzed using the areas under the receiver operating characteristic curves (AUROC). The AUROC were compared between MD-matched patients with central VFD (at least one point with p < 1% within the central most 16 points of 30-2 SITA standard automated visual field) and peripheral VFD (VFD beyond the central most 16 points of 30-2 SITA standard automated visual field). RESULTS: The associations between analyzed parameters and VFI were statistically significant. The MD, RNFLT, age, intraocular pressure, and central cornea thickness were not different between the two groups (p > 0.05). The AUROC value of VFI was greater than those of the MD and average RNFLT but was not different from that of PSD (p = 0.332) in the central VFD group. However, there were no significant differences between AUROC value of VFI and those of other parameters in the peripheral VFD group (all, p > 0.05). CONCLUSIONS: The results from the present study suggest that VFI may be more useful than MD in diagnosing glaucoma, especially in patients with central VFD.
Cornea ; Discrimination (Psychology) ; Eye ; Glaucoma ; Humans ; Intraocular Pressure ; Nerve Fibers ; Retinaldehyde ; ROC Curve ; Visual Field Tests ; Visual Fields