The purpose of this study was to analyse the various patterns of calcification demonstrated in the anteriorand lateral neck roentgenograms of 213 unselected patients with thyroid enlargement. The patterns of thyroidcalcifications were correlated with clinical, surgical and histological findings. The results were as follows: 1.Of 213 cases of thyroid enlargement, 180 cases were benign and 168 cases were female. 2. The calcification ratewas high in the chronic thyroid enlargement. 3. The incidence of calcification was 30.2% in the malignancy and17.2% in the benign disease. There was no clacification in the Hashimoto's disease. 4. The nodular calcificationwas demonstrated in the both benign and malignant disease but curvilinear calcifiation was predominantly seen inbenign disease.
Female ; Hashimoto Disease ; Humans ; Incidence ; Neck ; Thyroid Gland

OBJECTIVE: The purpose of this study was to evaluate the feasibility of vaginal hysterectomy on contraindicated cases. MATERIAL AND METHODS: We examined the medical records of 154 patients who underwent vaginal hysterectomy and 139 patients who underwent abdominal hysterectomy from March 1999 to March 2002. Among vaginal hysterectomy group, 77 patients (Group I) were found to have more than one contraindication for vaginal hysterectomy such as large uterus (>280 g), nulliparous or no previous vaginal delivery, and previous pelvic laparotomy. Remaining 77 patients (Group II) had no contraindications for vaginal hysterectomy. These two groups were compared with 139 abdominal hysterectomy patients (Group III) regarding preoperative surgical indication, uterus size, operative time, bleeding volume, hospital stay, pain duration and postoperative complications. RESULTS: 1. The Group II patients were older than the other groups (Group I 45.9 years; Group II 53.4 years; Group III 45.9 years) and had history of higher parity by vaginal delivery (Group I 2.5; Group II 3.5; Group III 2.1). 2. The most common indication of hysterectomy was myoma in Group I (59.7%) and Group III (71.9%) and uterine prolapse in Group II (41.6%). 3. The average bleeding volume during the operation was greater in Group III (308.6 ml) than Group I (123.4 ml) and Group II (116.2 ml)(p<0.01). 4. The operative time was longer in Group III (105.4 min) than the other groups (P<0.01). 5. Hospital stay was shorter in Group I (7.6 days) and II (7.6 days) than Group III (8.8 days)(P<0.01). 6. The pain duration was shorter in Group I (1.53 days) and Group II (1.59 days) than in Group III (2.23 days)(P<0.01). 7. The incidence of postoperative major and minor complications was significantly higher in Group III (38.8%) than the other groups (Group I 24.6%; Group II 19.5%)(P<0.01). CONCLUSION: The vaginal hysterectomy is still safe and effective procedure for the patients who have contraindications such as a large uterus, nulliparity or no previous vaginal delivery and previous laparotomy except the cases with immobility of uterus by severe pelvic adhesion.
Female ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Incidence ; Laparotomy ; Length of Stay ; Medical Records ; Myoma ; Operative Time ; Parity ; Postoperative Complications ; Uterine Prolapse ; Uterus

Avulsion injury of the flexor digitorum profundus (FDP) tendon from the distal phalanx is considered as a rare injury. We report a patient who sustained a FDP tendon rupture insertion on her fifth finger as a result of a closed, hyperextension with no accompanying laceration or predisposing pathologic condition. Preoperative ultrasonography showed complete rupture of FDP and the gap between the tendon ends. According to the classification by Leddy and Pacter, this case is type II. The reconstruction of flexor tendon using pull-out suture and tie-over button. We are reporting a case with brief review of literatures.
Classification ; Fingers ; Humans ; Lacerations ; Rupture* ; Sutures ; Tendon Injuries ; Tendons ; Ultrasonography

PURPOSE: The purpose of this study is to evaluate the clinical results of locking compression plate (LCP) fixation for olecranon fractures with proximal ulna comminution. MATERIALS AND METHODS: We review 10 cases of olecranon fractures with proximal ulna comminution treated with LCPs from August 2011 to August 2013. Follow-up period was from 12 months to 18 months. Mean age was 63.1 years (35-84 years). According to the Mayo classification, there were eight type IIB, and two type IIIB fractures. We used Mayo classification. Clinical evaluation was performed based on radiographic union of olecranon and measurements of range of motion at last follow-up. Disability of the arm, shoulder and hand (DASH) score and Mayo elbow performance score (MEPS) were used for evaluation of functional recovery. RESULTS: All patients had bone union. According to the MEPS, nine of ten patients had a good or excellent outcome. The mean DASH score was 18.6. All cases started postoperative range of motion (ROM) within 14 days. Elbow ROM was more than 110degrees in all cases except one. Mean radiological bony union time was 4.2 months (2.5-6.0 months) postoperatively. Complication was hardware irritation in three patients. CONCLUSION: Internal fixation using LCP for olecranon fractures with proximal ulna comminution can be a good treatment option which obtains good clinical results and enables early ROM.
Arm ; Classification ; Elbow ; Follow-Up Studies ; Hand ; Humans ; Olecranon Process* ; Range of Motion, Articular ; Shoulder ; Ulna*

PURPOSE: The purpose of this study is to evaluate outcome of variable-angle volar locking plate for treatment of distal radius fractures. MATERIALS AND METHODS: We retrospectively analyzed the results in 45 cases treated by variable-angle volar locking plate. We evaluated the clinical results according to the Mayo wrist performance scoring system and radiographic results. RESULTS: All cases had bony union. The mean Mayo wrist performance scoring system was 84.8. Between preoperative and immediate postoperative radiographic measurement, the mean radial length improved from 8.4 to 11.8 mm, radial inclination from 14.2degrees to 22.4degrees, volar tilt from -4.5degrees to 9.6degrees, and intraarticular step-off from 1.8 to 0.3 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured 0.8 mm, radial inclination 0.4degrees, and volar tilt 0.9degrees (p>0.05). All cases showed bone union with no evidence of malunion, nonunion, or metal failure. CONCLUSION: Treatment of distal radius fractures using variable angle volar locking plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.
Follow-Up Studies ; Radius Fractures ; Radius* ; Retrospective Studies ; Wrist

OBJECTIVE: We studied the effects of the age factor in pregnant women who are over the age of 35 on pregnancy, parturition and verified its usefulness in the future managements of the old aged pregnancy. METHODS: Out of 2,526 mothers who delivered in Dongguk university hospital from April 2000 to June 2003, we selected 183 mothers who aged more than 35 years as a study group, and 150 mothers aged between 25 and 29 years as a control group. We then statistically evaluated and analyzed the two groups. RESULTS: Study group consumed up to 7.24%. Placenta previa, male birth delivery, abnormal presentation, low birth weight, iron deficiency anemia and preterm labor was noted more in the study group. Likewise, preterm delivery, pregnancy induced hypertension and cesarean section rates were significantly high in the study group. CONCLUSION: Pregnancy in old age is currently a rising trend. Whlie they might have the tendency to show prenatal complications, neonatal complication and difficult decision making in delivery method, early detection and treatment of presumable complications by adequate antenatal care and appropriate selection of delivery method can reduce the section rates and obtain relatively successful pregnancy outcome.
Age Factors ; Anemia, Iron-Deficiency ; Cesarean Section ; Decision Making ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Mothers ; Obstetric Labor, Premature ; Parturition ; Placenta Previa ; Pregnancy Outcome ; Pregnancy* ; Pregnant Women*

PURPOSE: The purpose of this study is to evaluate the radiographic and clinical results of patella fractures using a circumferential wiring combined with tension band wiring. MATERIALS AND METHODS: Between January 2005 and June 2012, 22 (male 14, female 8) patients with patella fracture treated with circumferential wiring combined with tension band wiring were analyzed retrospectively. The mean age of patients was 51 years (range, 28 to 72 years). Controlled passive range of motion exercise was started at three weeks from the postoperative day. The patients were evaluated using radiographs, clinical examination, and Levack's scoring system. RESULTS: All fractures healed and mean time elapsed for union was 11.5 weeks (range, 10 to 14 weeks). Complete union without displacement and full range of motion was achieved in all cases. Clinical results according to Levack's scoring system were excellent in 20 cases and good in two cases. We found broken wire in one case. In this case, results of clinical evaluation after reoperation were good. CONCLUSION: Circumferential wiring combined with tension band wiring is appropriate for patella fractures.
Female ; Humans ; Patella* ; Range of Motion, Articular ; Reoperation ; Retrospective Studies

BACKGROUND: This study was performed to investigate the clinical usefulness of acute normovolemic hemodilution to reduce homologous transfusion in revision total hip arthroplasty. To avoid complications of homologous transfusion, many methods are being used in patients who undergo an operation, and autologous transfusion is the most popular modality. METHODS: Fifty-five patients operated on for revision THRA were reviewed. In the hemodilution group (n = 21), 2-4 units of autologous blood were procured immediately after anesthetic induction while Ringer's lactate and 6% Haes-steril were infused to maintain normovolemia. Differences in the amounts of transfusions and postoperative drainage were compared. Statistical analyses were performed by using the Student's t-test. RESULTS: No significant differences were observed between groups in terms of preoperative hematocrit and hematocrit at postoperative 7 days. However, in the homologous transfusion group, 10.1 +/- 3.2 units of RBC products were used in 34 patients. In the autologous transfusion group, 7.5 +/- 2.6 units of RBC products were transfused in 21 patients. And this difference in RBC produce usage was significantly different (P < 0.05). The amount of postoperative wound drainage in the two groups was comparable. CONCLUSIONS: ANH could reduce the reqirement for homologous transfusion in revision total hip arthroplasty.
Arthroplasty, Replacement, Hip* ; Blood Transfusion* ; Blood Transfusion, Autologous ; Drainage ; Hematocrit ; Hemodilution ; Humans ; Hydroxyethyl Starch Derivatives ; Lactic Acid ; Wounds and Injuries

Isolated avulsion of the lesser tuberosity of the humerus is a rare injury. The mechanism of injury is the avulsion of the lesser tuberosity from forced contractions of the subscapularis muscle when the arm is forced into an externally rotated position on shoulder abduction. Authors report a case for isolated avulsion of the lesser tuberosity of the humerus which was treated with open reduction and transosseous suture fixation, as well as a view of the literature.
Arm ; Humerus* ; Muscles ; Shoulder ; Sutures

Benign fibrous hitiocytoma of the infrapatella fat pad is very rare. It has usually do not induced a pain or a symptom because it was located deep tissue. So it was very difficult to be diagnosed. We experienced a case of deep benign fibrous histiocytoma in a 53-year-old woman. It was diagnosed by MRI. Diagnostic arthroscopic procedure was performed and the lesion was completely resected by open excision. We report a rare case of benign fibrous hitiocytoma presenting as an intra-articular tumor in the joint causing pain and limitation of movement.
Adipose Tissue ; Female ; Histiocytoma, Benign Fibrous ; Humans ; Joints ; Knee