OBJECTIVE: To compare the clinical outcomes of intrauterine insemination (IUI) according to the catheter used. MATERIALS AND METHOD: From March 1998 to September 1998, total 95 infertile patients were included in this study. Patients were randomly allocated to TomCat group (n = 39) and Mackler group (n = 56) according to the catheter for insemination. The controlled ovarian hyperstimulation (COH) using luteal long protocol of gonadotropin releasing hormone agonist (GnRH-a) was used in all patients. Statistical analysis was performed using Student's t-test, Fisher's exact test, and x2 test as appropriate. Statistical significance was defined as p < 0.05. RESULTS: The total dose and duration of exogeneous gonadotropin required were similar between the two groups. There were also no significant differences in serum estradiol (E2) level, endometrial thickness and texture on the day of hCG administration between the two groups. However, the percentage of uterine souding due to failure of initial approach was significantly higher in TomCat group compared to Mackler group (23.1% vs. 0%, p < 0.01). The percentage of bleeding after IUI in TomCat group seemed to be higher than that in Mackler group (15.4% vs. 3.6%, p = 0.06), although there was no statistically significant difference between the two groups. There was also no significant difference in the clinical pregnancy rate per patient between the two groups. CONCLUSION: These results suggested that using Mackler catheter might be effective for IUI, especially for the patients with cervical factor infertility.
Catheters* ; Estradiol ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Hemorrhage ; Humans ; Infertility ; Insemination* ; Pregnancy Rate

No abstract available.
Leprosy*

No abstract available in English.
Ankle ; Foot

The knee joint is the largest weight bearing joint. Knee joint fractures involve the articular surface and damage the surrounding soft tissues, and permanent deformities, especially joint stiffness, instability of the knee joint, post-traumatic arthritis, etc, may ensue following treatment. Many authors have recommended various methods of treatment for these fractures, This study is to present 77 cases of knee joint fractures which were treated at Severance Hospital from January 1965 to December 1974. The results of clinical study were as follows: 1. The causes of injury were traffic accident(75.3%), falling(15.6%) and direct blow(9.1%). 2. There were 63 males and 14 females in the series, 3. Age span was generally 10~40 Years. 4. Among the 77 cases, 42 were femoral condylar fractures, 28 were tibial condylar fractures, and 7 were tibial spine fractures. 5. In femoral condylar fractures, 27 cases were treated by conservative method and 13 cases underwent open reduction, and the clinical end results were satisfactory in 79.2% by conservative method and 54.5% by operative treatment. 6. In tibial condylar fractures, 14 cases were treated by conservative method and 12 cases by operation. Satisfactory results were obtained in 66.7% by conservative treatment and in 72.7% by operation.
Arthritis ; Clinical Study ; Congenital Abnormalities ; Female ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Methods ; Spine ; Weight-Bearing

In recent years the rate of the spine Injury tends to be on the increase year by year as the rate of traffic and industrial accidents are increased. During industrial, sports and automobile accidents are occurred, the various forces were exerted by the mechanism, “flexion, extension, flexlon-rotation, vertlcal compression and shearing.” These exercise their effects on the vertebral bodies, the neural arches and intervertebral disc and the contents of the spinal cord, depending on direction and intensity of the trauma, and the posture and muscular attitude existent at the movement. Once the neurological Iesion has been diagnosised and the type of vertebral injury has been established and particularly after a decision has been made as to whether the spinal injury is stable or unstable, a rational method of treatment can be decised upon: Our treatment consists of providing the best condition for recovery from the spine injury, preventlng further neurologlcal damage in the unstable area, achieving stable bone and llgament heallng ln satisfactory position, preventing metabolic compllcations from being fatal, mobllizing the patient early, and rehabilitating to provide maximum fuctlonal independence with the remaining-muscle power avallablc to the cord injury patient. One hundred and fifty seven spine fracture and dislocation patients were clinically observed and evaluated from Jan. 1972 to Dec. 1978 in our study. The result of this study may be summerized as follows: 1. Out of the patients, there were 135 male and 22 female cases. The ratio between male and female was 6.1:1. The majority (84.7%) of the spine injuries was found in the age of 20 to 50 years. Fifty-two percent of the cases was caused by industrial accidents. 2. The most common site of the lesion occurred between T-11 and L-2 vertebrae (71.8%). 3. In cervical injury, fracture dislocation type was most common (50%), and especially, pure dislocation by extension mechanism was 12.5% but in thoracolumbar iniury, simple anterior wedge compression fracture was most common (66.6%) and there were no pure dislocations just like cervical spine injury cases. 4. Fifty seven cases of the total were complicated by paraplegia, of which 62.5% in cervical region and 31.6% in thoracolumbar region were noticed. The most frequent type of the injury in which paraplegia developed was the fracture dislocation (73.8%) and the most common site of the lesion was between the T-12 and the L-2 vertebrae. 5. Open reduction was performed in 9 cases out of 24 cervical spine injury patients and in 41 cases out of 133 thoracolumbar injury patients. 6. Prognosis of neurologic recovery in initially complete lesion was poor, regardness of treatment. In the cervical lesion cases there were no patients who were recovered. But in the other sites about 10.5% of initially complete lesion showed partial neural recovery comparing to 62.5% of initially incomplete lesions. 7. Progressive deformity is often noted as a complication of spine fracture or dislocation when solid fusion fails to develop. The increment of kyphosis after treatment is as follows: Simple wedge fracture
Accidents, Occupational ; Automobiles ; Catheterization ; Catheters ; Clinical Study ; Congenital Abnormalities ; Diagnosis ; Dislocations ; Female ; Fractures, Compression ; Humans ; Intervertebral Disc ; Kyphosis ; Laminectomy ; Male ; Methods ; Paraplegia ; Posture ; Prognosis ; Spinal Cord ; Spinal Injuries ; Spine ; Sports ; Urinary Bladder

Malformations of the hand in newborn infants are comparatively uncommon, and the forms which these malformations assume are extremely varied, some being so bizzare as to almost defy description. The etiology of congenital anomalies of the hand has not been conclusively established, but at the present time the most acceptable theories are those of maldevelopment due to teratogens or of mutations which are subsequently inhereted. This paper is based upon our own series of 99 anomalies in 93 patients who were hospitalized and treated at Severance Hospital during the period between 1965 and 1979 and the following results were obtained. 1. There were 56 males and 37 females in 93 patients and the ratio between male and female was 1.5: 1. 2. Right hands were involved in 49 patients, left hands were in 33 patients, and both hands were in 11 patients. 3. The most common type of anomalies were polydactylism (60.6%), next were syndactylism (24.3%), and the following anomalies were found; congenital finger deficiency, congenital constriction band, camptodactyly, cleft hand, congenital clasped thumb, and symphalangism. 4. 33 associated congenital anomalies were found in 27 patients, in which, anomalies of the foot were most common. 5. Prenatal history such as drug ingestion, eclampsia or difficult labor, and prematurity were found, but no genetic or familial history could be obtainable. 6. Treatment was stressed upon the function of hand rather than cosmetic appearance.
Clinical Study ; Constriction ; Eating ; Eclampsia ; Female ; Fingers ; Foot ; Hand ; Humans ; Infant, Newborn ; Male ; Polydactyly ; Pregnancy ; Teratogens ; Thumb

A total of 200 cases of metastatic bone tumors was treated at the Yonsei Medical Center during the 5 years period from January 1976 to December 1980. The results of clinical radiological and pathologic analysis are as followings. 1. Among 200 cases of metastatic bone tumors, common site of cancer comprised the lung (30.5%), breast (15.0%), uterus (8.5%), stomach (6.4%), thyroid (3.5%), liver (3.5%), kidney (3.5%), nasopharynx (3.0%), and prostate (2.0%). In male, common primary sites of cancer were lung, stomach, kidney, oropharynx in decreasing order of incidence and in female, breast, uterus and lung. 2. In metastatic bone tumors, 75.5% were observed in the age group between 41 and 70 year of age, and average age was 53.1 years. 3. The sex distribution was 107 males (53.1%) and 93 females (46.5%). 4. The bones affected most frequently in this series were as followings; In only 9 cases (4.5%), metastasis to bone distal to the elbows and knees occurred. 5. Clinical features in this series were classified according to various conditions. Bone pain noticed on 163 cases (81.5%), fatigue on 152 cases (76.0%) and weight loss on 128 cases (64.0%). 6. Pathologic fractures occurred on 22 cases (11.0%); among them, 13 cases on the femur, 5 cases on the vertebrae, and 1 case on the acetabulum, humerus, rib and clavicle respectively. 7. Hematologically, serum calcium and phosphorus was noticed within normal limits. Serum alkaline phosphatase was slightly elevated and serum acid phosphatase was elevated in all cases of prostatic carcinoma. Serum albumin/ globuline ratio was slightly reversed (3.4/3.5mg%). 8. Radiologically, 86 cases were osteolytic, 10 cases were osteoblastic and 44 cases were mixed type. False negative on X-ray examination with positive finding of scan with 99mTc-MDP were found in 17 cases (27.4%). 9. All cases was treated by various methods; among this series, radiation and chemotherapy performed in 57 cases, radiation in 49 cases, chemotherapy in 14 cases, hormone therapy in 16 cases and radioisotope therapy in 5 cases. For 22 pathologic fractures, conservative treatment was performed in 9 cases, open reduction and internal fixation in 13 cases, open reduction and internal fixation with acrylic cement in 5 cases.
Acetabulum ; Acid Phosphatase ; Alkaline Phosphatase ; Breast ; Calcium ; Clavicle ; Drug Therapy ; Elbow ; Fatigue ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Humerus ; Incidence ; Kidney ; Knee ; Liver ; Lung ; Male ; Nasopharynx ; Neoplasm Metastasis ; Oropharynx ; Osteoblasts ; Phosphorus ; Prostate ; Ribs ; Sex Distribution ; Spine ; Stomach ; Technetium Tc 99m Medronate ; Thyroid Gland ; Uterus ; Weight Loss

Cubitus varus deformity caused usually by malunion in supracondylar fracture or epiphyseal injuries of the elbow joint, but the other causes of cubitus varus deformity have not been reported. 7 cases of cubitus varus deformity were found among the patients in Sam Yook Childrens Rehabilitation Center in Oct. 1981 all of whom used crutches in order to ambulate due to late sequele of poliomyelitis. The results were as follows. l. After long-term crutch walking, cubitus varus deformity and bowing around the proximal forearm were seen among the patients who mis-used the crutches. 2. Gross carrying angle was greater than radiographic carrying angle and it caused by hypertrophy of the extensor muscle group in forearm and bowing around the proximal forearm. 3. Etiologic factors of the cubitus varus deformity were considered to be improper measurement of the crutches, degree of paralysis of lower extremity and duration of the crutch walking, etc. 4. The mechanism of this deformity could be explained biomechanically by the abnormal axial loading onto the elbow following long-term crutch walking. 5. The correct measurement of the crutches and proper flexion of the elbow during crutch walking were stressed.
Child ; Congenital Abnormalities ; Crutches ; Elbow ; Elbow Joint ; Forearm ; Humans ; Hypertrophy ; Lower Extremity ; Paralysis ; Poliomyelitis ; Rehabilitation Centers ; Walking

No abstract available.
Tibia*

Peripheral nerve injury occurs mostly in company with tendon and muscle injuries, fractures, or dislocations. Because of the disabilities and socioeconomic loss caused by such injuries, much attention must be paid to the initial treatment, and later to the reconstruction and rehabilitation. At department of Orthopedic Surgery, Seoul National University Hospital, 336 patients of nerve lesion were treated from Jan, 1980 to Dec, 1988. Among them 128 patients were nerve compression syndrome (carpal tunnel 52 patients, cubital tunnel 40 patients, thoracic outlet 16 patients, others 20 patients), and 50 patients were brachial plexus injury, and 168 cases were peripheral nerve injury. 50 patients of the peripheral nerve injury were treated with reconstruction and 118 patients were treatred with neurorrhaphy, nerve graft, and neurolysis. Of the 118 patients, 94 patients were followed up for more than one year, and the results of neurorrhaphy, nerve graft and neurolysis were analyzed. In 46 patients (73.0%) of the patients treated with neurorrhaphy, 7 patients (58.3%) with nerve graft, and 15 patients (78.9%) with neurolysis, good or excellent results were obtained.
Brachial Plexus ; Dislocations ; Humans ; Nerve Compression Syndromes ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rehabilitation ; Seoul ; Tendons ; Transplants