No abstract available.
Suction* ; Tonsillectomy*

PURPOSE: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. MATERIALS AND METHODS: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's(R) Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS(R) proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. RESULTS: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. CONCLUSION: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.
Breast Neoplasms ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Dislocations ; Female ; Femur* ; Follow-Up Studies ; Fractures, Spontaneous ; Hematoma ; Humans ; Limb Salvage* ; Lung Neoplasms ; Male ; Multiple Myeloma ; Osteosarcoma ; Periprosthetic Fractures ; Prostatic Neoplasms ; Prostheses and Implants* ; Recurrence ; Thyroid Neoplasms ; Walking ; Weights and Measures

No Abstract Available.
Arthroplasty* ; Knee Joint* ; Knee*

Thirty-two consecutive patients with spondylolisthesis associated with displacement in varying degrees were operated by the Steffee procedure. Slippings more than Meyerding Grade III were reduced by modified Schollner technique:destabilization of the slipped segement, local distraction with spinal elevator and completion of reduction with a cork screw force pulling backward. Autogenous bone and Pyrost were added to get solid fusion. The authors reviewed thrity-two cases of symptomatic lumbar spondylolisthesis which were operated since March in 1987 at Kangnam Sacred Heart Hospital, Hallym University and the followings were obtained. 1. There were 17 males and 15 females, and the age of the patients was 44.2 years in average ranging from 19 to 66 years. 2. The types of spondylolisthesis were isthmic defect at 19 levels in 18 cases and degenerative in 14 cases. The level of the lesion was L5-Sl in 17 cases, L4-5 in 15 cases and L2-3 in 1 cases. 3. The clinical symptoms were low back pain, radiating pain, intermittent claudication, and motorsensory deficit in order of incidence. 4. Preoperatively, the degree of slinpping was Meyerding Grade I in 18, Grade III in 12 and Grade Ill in 3 cases. The slipping was reduced to nearly anatomic position in 13 cases and Grade I in 20 cases. The average slipping measured by Taillard method was changed from 23.4% preoperatively to 5% postoperatively. 5. Clinically, the results were judged as excellent in 13(13%) cases, good in 16(50%) cases and fair in 3(9%) cases according to Kim's criteria. 6. Postoperative complications were leg pain in 3 cases and "stress transfer" in 1 cases.
Elevators and Escalators ; Female ; Heart ; Humans ; Incidence ; Intermittent Claudication ; Leg ; Low Back Pain ; Male ; Methods ; Pedicle Screws ; Postoperative Complications ; Spine ; Spondylolisthesis

To demonstrate the stimulation effect on fracture healing by capacitively coupled electrical field, the rabbits' fibulae were fractured and treated with a capacitively coupled electrical signal (10V peak to peak, 60 kiloherz, symmetrical quadriangular wave) that was applied non-invasively over the skin surface overlying the approximate site of the fractured fibulae. Each fibula was evaluated with gross, roentgenographic, histological and mechanical tests after 21 days of the electrical stimulation, and compared to control group statistically. Maximum bending moment, Young's modulus of elasticity and bending stiffness were calculated by 3 point bending test, and the ratios of the fractured to the intact fibulae of the electrically stimulated rabbits were compared to the non-stimulated rabbits statistically. The results revealed that the fractured fibulae exposed to capacitively coupled electrical field showed the higher degree of fracture healing than the non-stimulated fibulae.
Elastic Modulus ; Elasticity ; Electric Stimulation ; Fibula ; Fracture Healing ; Rabbits ; Skin

Purpose: We evaluated the use of three criteria to determine the need for additional treatment of cystic thyroid nodules after their recurrence following ethanol ablation (EA). Methods: In total, 154 patients (male:female=30:124; mean age, 53.4 years; range, 23 to 79 years) with 154 thyroid nodules (49 cystic and 105 predominantly cystic nodules) who presented between January 2014 and August 2017 were enrolled. All patients underwent follow-up ultrasonography (US) 1 month after EA, and were divided into therapeutic success and failure groups. Therapeutic success was defined as the absence of any residual fluid or sufficient volume reduction (≥50%) with improvement of nodule-related symptoms. The therapeutic failure was defined according to three previously suggested criteria for recommending additional treatment: nodules with ≥1 mL of remnant fluid (criterion 1), volume reduction <50% (criterion 2), and demonstration of a solid component with vascularity (criterion 3). Results: Thyroid nodules treated by EA showed significant volume reduction (18.4±21.6 mL to 4.2±6.5 mL [1-month follow-up] to 1.9±3.3 mL [final follow-up], P<0.001) and improvement in clinical problems. Therapeutic failure were 26 patients according to criteria 1, 14 patients according to criteria 2, and 35 patients according to criteria 3. Additional treatment was unnecessary in 81.3%, 70.0%, and 77.8% of patients deemed to need it according to criteria 1, 2, and 3, respectively. Conclusion The choice to perform additional treatment after EA should be made according to a combination of clinical problems and US features. Understanding this concept will be useful in planning further treatment following US-guided EA.

Elective neck dissection for the clinically node-negative neck is targeted to diagnose and eradicate the occult lymph node metastasis. However, this elective neck dissection gives unnecessary risk of complication and morbidity. Therefore, the extent of the elective neck dissection tends to be reduced to minimize the postoperative morbidity. The sentinel lymph node biopsy has been developed for this purpose. Sentinel lymph node is the first lymph node that gets lymphatic drainage from the tumor. Evaluation of this sentinel lymph node enables the prediction of the presence of occult lymph node metastasis. If the biopsy of the sentinel lymph node shows no metastasis, additional neck dissection can be avoided, which reduces the postoperative morbidity. There have been clinical studies on the sentinel lymph node biopsy for the head and neck squamous cell carcinoma, in which the diagnostic accuracy has been reported to be 95-100%. We started sentinel lymph node biopsy for the clinically node-negative, early-staged oral cavity cancer in December 2002. From 2002 to 2004, we evaluated its diagnostic accuracy. The positive predictive value and the negative predictive value were 100% and 98.5%, respectively. We currently determine the elective neck dissection according to the result of the sentinel lymph node biopsy.
Biopsy ; Carcinoma, Squamous Cell ; Drainage ; Head ; Lymph Nodes ; Mouth* ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Sentinel Lymph Node Biopsy*

A questionnaire on a variety of ophthalmic topics was made up and sent to 150 members of the Korean Society of Cataract and Refractive Surgery-[KSCRS] in May, 1996. Forty percent [60/150] responded within the deadline in June, 1996. As the contents of the questionnaire were almost identical to the ones prepared in the USA [1994, 1995] and in Japan [1994], the answer to the questionnaire could be compared with those gathered from the USA and Japan. Over half of the respondents [57%] were in their forties. The average number of operations done per month was 26. Cataract operation accounted for over 60% of the total operations in 34% of KSCRS members. And more than 76% of the cataract operation were done using phacoemulsification technique in 31% of the respondents. There were no difference in the preferred method of local anesthesia for the cataract surgery in Korea compare to the USA or Japan. And there was less likelihood of using peribulbar anesthesia and no suture technique in Korea compared to the USA. Sixty-one percent of the Korean ophthalmic surgeon implanted the intraocular lenses even before the patients were younger than 20 years old whereas, 82% of ophthalmic surgeon in Japan did only when the patients were older than 20 years of age. For radial keratotomy as a means of correcting myopia, 91% of the Korean respondents were not performing the procedure any more, while 45% of the American respondents abandoned it. Fifty four percent of the Korean respondents and 46% of the American respondents have been doing excimer laser photorefractive keratectomy. There was no statistical difference between the two. From the answers to the qustionnaire, we found that our results did not differ significantly from those of the USA or Japan and we believe that these results reflect the present trends of cataract and refractive surgeries in Korea.
Anesthesia ; Anesthesia, Local ; Cataract* ; Surveys and Questionnaires ; Humans ; Japan ; Keratotomy, Radial ; Korea ; Lasers, Excimer ; Lenses, Intraocular ; Myopia ; Phacoemulsification ; Photorefractive Keratectomy ; Refractive Surgical Procedures* ; Suture Techniques ; Young Adult

Congenital onychodysplasia of the index fingers(COIF) is a rare condition of the nails, characterized by the following : (1) congenital occurrence, (2) unilateral or bilateral index finger involvement, (3) variability in nail appearance such as anonychia, micronychia, and polyonychia, (4) possible hereditary involvement, and (5) frequently associated bone anomalies. A 7-week-old male baby with an atrial septal defect presented with micronychia of the left index finger. Roentgenogram of both hands revealed a bone defect of the left 2nd distal phalanx. To our knowledge, distal phalangeal bone defect has not been previously described in this disease. We report a case of COIF with atrial septal defect.
Fingers* ; Hand ; Heart Septal Defects, Atrial ; Humans ; Male