No abstract available.
Adenocarcinoma, Papillary*

STUDY DESIGN: The lumbar segmental motions were analysed in asymptomatic volunteers. OBJECTIVES: To obtain normative data on flexibility and Graf's instability degree in sagittal plan of the normal lumbar spine. SUMMARY OF LITERATURE REVIEW: Although several clinical and radiological measurement tech niques are available, little is known about the normal range of lumbar spine motion. As a consequence, the diagnostic evaluation of radiographs are frequently based on subject opinions rather than object reality. MATERIALS AND METHODS: The authors have checked lumbar flexion-extension Yiews of 95asymptomatic volunteers who were divided into 5 groups by the age, and then their flexibility and Graf's instability degree were calculated by Graf's method with using Graf/Bar Mark II(digitalizing table) and personal computer program(RachisR). Evaluation of the sexual difference and comparison of the difference of each age group in spine level were done RESULTS: 1. There were significant differences in flexibility among age groups(p<0.05) and highest flexibility was observed in group 1 (age: 15-19yrs) and 15-19 segment 2. Flexibility was not different between male and female(p>0.05). 3. Graf's instability degree was not different among 5 age groups(p>0.05), and between male and female(p>0.05). 4. The mean Craf's instability degree was below 8o in L2-3, L3-4, and L4-5 segment, but above 8 in L5-S1 segment(male: 11.62+/-9.27 , female. 11.11+/-8.70). CONCLUSIONS: Although we observed small subjects, these results are the basic steps toward more objective and careful interpretation of flexibilty and Graf's instability degree.
Female ; Humans ; Male ; Microcomputers ; Pliability* ; Reference Values ; Spine ; Volunteers

Crypt glandular infection theory is accepted as an explanation of anal fistula's major cause. However, the pathogenesis of an anal fistula in Crohn's disease is different from that of a conventional anal fistula because a Crohn's anal fistula is caused by ulceration which, in turn, is caused by transmural inflammation of the rectal wall due to Crohn's disease. The difficulty with operating on anal fistulas in Crohn's disease lies in the fact that healing of the wound is inhibited because of continuous inflammation of the anorectal tissue due to Crohn's disease. Hence, there is a high possibility of incontinence due to sphincter muscle injury. Especially, because almost all Crohn's disease patients have frequent defecation and diarrhea, the patients will suffer more if incontinence occurs. Nowadays, even with increased understanding of the etiology of Crohn's disease, new medications, and aggressive surgical approaches, the result of treatment is still not satisfactory. Recently, since Korean eating habits have changed to include more western-style food in the diet, inflammatory bowel disease, such as Crohn's disease, is expected to increase. Consequently, the number of cases of anal fistulas in Crohn's disease is also expected to increase. The authors reviewed 20 confirmed cases of anal fistulas in Crohn's disease, which were treated from January 1993 to December 1995 at Song-Do Colorectal Hospital. The results are as follows: 1) Anal fistulas in Crohn's disease were present in 20(0.6%) of the 3378 cases of anal fistulas treated during the time period considered. 2) The male to female ratio for these 20 cases was 2: 1, and the most Prevalent age group was the 3rd decade, followed by the 2nd decade, the 4th decade, and the 5th decade in that order. 3) Three cases of anal fistulas whose origins could be explained by crypt glandular infection theory and which did not involve the rectum healed, although the healing was delayed. 4) Seventeen cases of anal fistulas whose origins could not be explained by crypt glandular infection theory and which involved the rectum did not heal after the operation. he results of the study show that anal fistulas whose origins can be explanined by crypt glandular infection theory and which do not involve the rectum can be cured by conventional fistula surgery. However, perirectal fistulas whose origins can not be explained by crypt glandular infection theory and which involve the rectum do not heal. Because there is the possibility of incontinence after a conventional operation, it is suggested that, in the cases of perirectal fistulas in Crohn's disease, better results, although not completely satisfactory, can be obtained by long-term seton drainage and diversion colostomy.
Colostomy ; Crohn Disease* ; Defecation ; Diarrhea ; Diet ; Drainage ; Eating ; Female ; Fistula ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Male ; Rectal Fistula* ; Rectum ; Ulcer ; Wounds and Injuries

No abstract available.
Pseudohypoparathyroidism*

No abstract available.
Tonsillectomy*

There are many difficult problems of reduction and its maintaining in the treatment of unstable intertrochanteric fractures. Especially, in cases of elderly patients with marked osteoporosis, prolonged immobilization brings more serious complication. In order to solve these problems, in cases of unstable intertrochanteric fractures with large lesser trochanteric fragment, we have carried out anatomical reduction and rigid internal fixation with compression hip screw and additional transfixation screw on posteromedial fragment. The unstable fractures have been convrted into the stable fractures by transfixation screw. We analyzed the 1 1cases with additional transfixation screw and they showed good results in one year follow up.
Aged ; Femoral Fractures ; Femur ; Follow-Up Studies ; Hip Fractures ; Hip ; Humans ; Immobilization ; Osteoporosis

We have treated the open tibia shaft fractures, especially Gustilo type II, with unreamed interlocking intramedullary nail. In cases combined with soft tissue damage around fracture site, maintaining rigid internal fixation and preserving endoosteal blood supply is important in union of fracture and soft tissue healing. We have analyzed 18 cases of Gustilo type II open tibial shaft fractures managed with intramedullary nailing without reaming since 1991, the follow-up period was average 22 months. Most of the fractures were the result of moderate to high-energy trauma. In all 18 cases, nails were inserted via closed method. Static interlocking nailing was used in all cases. In 16 cases, union of the fracture was achieved from 16 to 25 weeks(average 23 weeks). In the other 2 cases, union was achieved in 7 months. There was no serious postoperative complication except one skin infection with skin defect managed by skin flap and one failure of the interlocking screw. These results are comparable with those obtained from other forms of fixation, including immobilization with a cast, reamed intramedullary nailing, and external fixation.
Follow-Up Studies ; Fracture Fixation, Intramedullary ; Immobilization ; Methods ; Postoperative Complications ; Skin ; Tibia

No abstract available.
Diagnosis, Differential*

An external thrombotic hemorrhoid is a very painful disease with a high incidence rate. The chief complaints encountered by the surgeon are protrusion and pain. However, because the spontaneous healing rate is very high, there is no consensus on whether conservative management or surgery is a more effective treatment policy. In an attempt to resolve this problem, we performed a clinical analysis of fifty patients with external thrombotic hemorrhoids who were treated by conservative management at Song-Do Colorectal Hospital from October 1996 to December 1996. We recorded the time required for the protrusion and the pain to disappear and performed manometry to check the sphincter pressure and tissue pathology to determine the pathogenesis of the external thrombotic hemorrhoid. The results are as follows: 1) Based on pathology, the cause of the external thrombotic hemorrhoids was venous thrombosis due to venous stasis, not a hematoma due to venous rupture. 2) Manometry showed that the resting sphincter pressure and the squeezing sphincter pressure for the patients with external thrombotic hemorrhoids was higher than those of the control group, which was the reason for the venous stasis. In conclusion, because an external thrombotic hemorrhoid is just a thrombosis due to venous stasis, the thrombosis can be improved by using methods such as a warm sitz bath and analgesics to decrease the sphincter pressure. Hence, conservative management should be the preferred treatment in almost all cases.
Analgesics ; Baths ; Consensus ; Hematoma ; Hemorrhoids ; Humans ; Incidence ; Manometry ; Pathology ; Rupture ; Thrombosis ; Venous Thrombosis

A double-blind trial of the efficacy of propranolol hydrochloride a new beta adrenergic blocking agent, in the prophylactic treatment of angina pectoris was conducted in 9 patients. Through the trial period of 8 weeks to more than 26 weeks, the patients received propranolol and placebo for equal period. Following are the results. 1. The effective dose of propranolol hydrochloride in the prophylactic treatment of angina pectoris was 80 mg to 120 mg per day. 2. The effectiveness of propranolol hydrochloride was manifested by a reduction in frequency of pain to 40.7%, in nitroglycerin comsumption to 38.8% and by an increase in exercise tolerance. 3. Obseved side effects were transient nausea, vomiting and bradycardia, which were improved with reduction in drug dosage. 4. Further clinical and experimental information may be necessary in order to assess the long-term effects of propranolol hydrochloride.
Angina Pectoris* ; Bradycardia ; Exercise Tolerance ; Humans ; Nausea ; Nitroglycerin ; Propranolol* ; Vomiting