The use of a cast-brace in the treatment of tibial fractures was first applied by the authors since 1964 in an attempt to prevent stiffness of the knee resulted from prolonged cast immobilization. The authors attempts on all 43 cases throughout the experimental period were proved satisfactory, among which, however, only a few case showed unwanted result such as delayed union in the early clinical experience.
Immobilization ; Knee ; Lower Extremity ; Tibial Fractures

No abstract available.
Aneurysm* ; Carotid Artery, Internal* ; Epistaxis*

A case of Maffucis syndrome is presented with a brief review of literature because of its rarity. An attempt was made for reconstructive surgery for the deformities involving right hand with rewarding result.
Congenital Abnormalities ; Hand ; Reward

A case of aneurysmal bone cyst is reported in a 23 years old male, who complained of pain and tenderness on the right lateral aspect of thigh, This case had been treated with radical curettage and autogenous bone graft, but eight months later the radiological evidence of recurrence was present. So he was reoperated and he has been recovered relatively gradually, Roensgenograms of 7 montbs duration after reoperation showed abundent new bone formtion and no evidence of recurrence.
Aneurysm ; Bone Cysts ; Curettage ; Femur ; Humans ; Male ; Neck ; Recurrence ; Reoperation ; Thigh ; Transplants

Ewing's Sarcoma is a rapidly growing malignant neoplasm that arises from primitive cells of the bone marrow in young persons. This case, a seventeen year-old male, complained of pain and swelling on the both knee. He had been treated under the impression of osteomyelitis at several local clinics. Clinically, malaise and high fever were continued during admission period. Microspically it was confirmed as Ewing's Sarcoma and then he was discharged. Presently he is under the radiation therapy.
Bone Marrow ; Fever ; Humans ; Knee ; Male ; Osteomyelitis ; Sarcoma, Ewing

During the past 11 years period from April, 1961 to March, 1972 171 cases of electrical burn patients were treated at Orthopedic Department of Han-Il Hospital. The author reviewed and discussed our clinical experience of electrical thermal injuries. Clinical analysis of these 171 cases of electrical burn patients was carried out and summarized as follows; 1) The majority of the patients ranged two to three decades of life(68.4%); The youngest 1 year old and oldest 53 years of age. Male were involved significantly more than female, the incidence being 163 cases (95.3%) and 8 cases. 2) Seasonal distribution showed more than about two third with 114 cases for rainy summer times and Autumn from May to October. 3) Among 171 cases of electrical burn patients, 131 patients (54.2%) were under 5% of body surface and 15 patients (11.3%) were over 20% of body surface. 4) In the regional distribution of burn wound, the upper extremity were 157(92.3%), 73(42.9%) in lower extremity, and 49 (28.9%) in other region. 5) Occupational distribution; The electrical line man and electrician were seen 136 cases (80%) which is two third of 171 patients, labor 12 cases(7%), 10 cases (5.9%) in painters, 8 cases (4.6%) in company employee and industrialist, 5 cases (2.9%) in house-wife, and 4 cases (2.4%) in motor man. 6) The most frequently early complication at electric burn of 171 cases were gastrointestinal symptom 111 cases (65%), fracture 18 cases (10.5%), head injuries (intracranial bleeding and basal bone fracture of skull) 15 cases (6.4%), spinal cord injury and kidney rupture 1 cases (0.6%), hemorrhage 2 cases (1.2%), and other 8 cases (4%). 7) The predominating organisms cultured out of burn wounds of 26 cases were staphylococcus aureus 9 (34.7%), pseudomonas auerginosa 5 (19.2%), E. coli 3 (11.5%), staphylococcus albus 1(4%), β-hemolytic streptococcus 1 (4%), and no growth were 7 (26.9%). 8) The type of current and the voltage in 102 cases among the 171 cases of electric burn patients was clear. Injury of the 99 cases out of the 102 cases were by indirect current and the 3 was by direct current. In 99 cases by indirect current, electric burn in accordance with high tension current in voltage was 81 cases (79.4%), low tension current injuries 18 cases (17.6%). 9) At the admission, laboratory findings of the electric burn patients showed hemoconcentration and leukocytosis. 10) Early excision of the necrotic tissue and skin grafting was performed in 94 times. The results was excellent in 71 times. 11) Among 171 cases of electric burn patients, later complication were seen 47 cases (27.4%), which is 25 cases (14.3%) in amputation, 8 cases in cicatrical contraction, 4 cases in serum hepatitis, 4 cases in paralysis, 2 cases in osteomyelitis, 2 cases in ankylosis of knee joint, 2 cases in drop foot, 1 case in anal stricture, and 1 case in cataract. 12) The overall motality in this series was 8% (14cases) and the most frerent cause of the death was due to head injury (9 cases) at the time of electrical burn injuries.
Amputation ; Ankylosis ; Burns ; Burns, Electric ; Cataract ; Constriction, Pathologic ; Craniocerebral Trauma ; Female ; Foot ; Fractures, Bone ; Hemorrhage ; Hepatitis ; Humans ; Incidence ; Kidney ; Knee Joint ; Leukocytosis ; Lower Extremity ; Male ; Orthopedics ; Osteomyelitis ; Paralysis ; Pseudomonas ; Rupture ; Seasons ; Skin Transplantation ; Spinal Cord Injuries ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Upper Extremity ; Wounds and Injuries

Between Jan. 1983 and Dec. 1990, 17 Patients with distal anterior cerebral artery(DACA) aneurysms were admitted to our institute and underwent microsurgical neck clipping of their aneurysms. This group comprised 3.7% of the 437 aneurysms managed surgically during this period. There were 11 females and 6 males. The mean age was 48.5 years. Most of DACA aneurysms were located at the genu portion of the anterior cerebral artery. Three cases were at the proximal protion of A2 close to the anterior communicating artery. Two cases were at the dista pericallosal artery and distal callosomarginal artery. Eight patients had additional vascular anomalies documented by angiography such as multiple aneurysms, azygos DACA and duplication of DACA. Direct neck clipping was possible in all cases through the interhemispheric approach or the frontotemporal approach according to the location. For the interhemispheric apporach preoperative evaluation of the exact location and direction of the aneurysms on the angiogram was important for operative planning. The surgical outcome was good or excellent without any neurological deficits in 17 of the cases. Operative management, clinical features and incidence of vascular anomalies associated with DACA aneurysms are discussed.
Aneurysm ; Angiography ; Anterior Cerebral Artery* ; Arteries ; Female ; Humans ; Incidence ; Intracranial Aneurysm* ; Male ; Neck

OBJECTIVE: It is generally accepted that ectopic pregnancy (EP) may adversely affected on the female fertility. However, it is not fully understood how it influences on the future fertility after treatment of an EP, so we intended to evaluate its effects, METHODS: This study was undertaken on 473 patients with clinically and pathologically proven diagnosis of ectopic pregnancies at the Department of Obstetrics and Gynecology, Anam Hospital, Kroea University Medical College hom Jan. 1, 1989 to Aug. 31, 1996. RESULTS: The incidence of ectopic pregnancy was 1 in 19.6 deliveries (5.1%). The overall spontaneous conception rate after treatment of ectopic pregnancy was 67.4%, and among them, the rate of intrauterine pregnancy (IUP) and repeat ectopic pregnancy (rEP) was 56.3% and 11.1% respectively. The occurrance rate of infertiity after treatment of EP was 32.6%. The mean time to IUP after treatment of EP was 16.5 months, and 79.0% of all IUP were conceived within 2 years after treatment. The mean time to repeat ectopic pregnancy was 15.9 months. With increasing maternal age, IUP rate was decreased and rEP rate was increased but they were statistically not signiTicant. Repeat EP rate was also increased in multiparous women but it was also statistically not significant. Overall PR (IUP and rEP) was decreased in women who have organic lesions (adhesions, endometriosis, PID etc.) in pelvic cavity(p=0.003). Patients who were treated with conservative surgery achieved a lower conception rate without statistical significance and it may be due to low cases. CONCLUSION: Future fertility rate was not significantly altered by EP itself, but rather affected by patient's age, organic lesions and previous history of pelvic surgery. Recently, the advent of assisted reproductive technology and its associated techniques improved the female fertility in women with such a problem.
Birth Rate ; Diagnosis ; Endometriosis ; Female ; Fertility* ; Fertilization ; Gynecology ; Humans ; Incidence ; Maternal Age ; Obstetrics ; Pregnancy ; Pregnancy, Ectopic* ; Reproductive Techniques, Assisted

OBJECTIVE: The prevalence of multifetal pregnancies has increased up to 30% as a result of the introduction of ovulation inducing agents for assisted reproductive teclmology(ART). An exttemely poor pognosis could be expected for viable pregnancies in multifetal gestation. So, to decrease the consequence of multiple pregnancies and prevent complications, especially premature baby irreversibly damaged, selective fetal reduction to the smaller number of fetuses should be considered in an early gestational period. METHODS: From May 1994 to Apr 1998, transvaginal selective fetal reduction in 13 pati including 9 triplet, 3 quadruplet and 1 quintuplet. Of the 13 patients, 4 were obtained by controlled ovarian hyperstimulation with intrauterine insemination (COH with IUI), 6 were by IVF-ET, 2 wae by controlled ovarian hyperstimulation with natural contact and 1 was by natural conception. Selective fetal reduction using intracardiac KC1 injection and aspiration of amniotic fluid carried out in 8-11 weeks of gestation. RESULTS: After procedures, 8 patients were remained as twin pregnancies, 5 patients as singleton pregnancies and 1 of the remaining twin embryos vanished after procedure. There have been 7 sets of twin delivery including 1 stillbirth and 3 singleton delivery. 1 cases are ongoing state. All of the singleton delivery were completed after 37 weeks of gestation. Of the twin delivery, 2 cases were delivered after 37 weeks of gestation, 2 cases in 35-37 weeks, and 3 cases before 35 weeks of gestation. Unfortunately, 1 stillbirth occurred in 20 weeks of gestation and 2 cases of singleton were aborted. As 3 losses(2 singleton, 1 twin) occurred, the delayed fetal loss rate in this selective fetal reduction was 25.0%(3/12). There was no fetal anomaly related to the procedure. CONCLUSION: Selective fetal reduction in multifetal pregnancies is a rather safe procedure and it may improve the outcome of multiple pregnancies.
Amniotic Fluid ; Embryonic Structures ; Female ; Fertilization ; Fetus ; Humans ; Insemination ; Ovulation ; Pregnancy Reduction, Multifetal* ; Pregnancy* ; Pregnancy, Multiple ; Pregnancy, Twin ; Prevalence ; Quadruplets ; Quintuplets ; Reproductive Techniques, Assisted* ; Stillbirth ; Triplets

OBJECTIVE: Quantitative analysis of both apoptosis and proliferation should provide important insight into tumor biology. The aim of this study is to clarify the significance of apoptosis in the progression of uterine cervical neoplasia, including cervical intraepithelial neoplasia, and microinvasive and invasive squamous cell carcinoma categories. in relation to cell proliferation. METHODS:: Forty five cases of cervical intraepithelial neopasia. 10 of microinvasive carcinoma, and 10 of invasive squamous cell carcinoma were examined using formalin fixed and paraffin embedded samples. The TdT mediated dUTP-biotin nick end labelling(TUNEL) method for apoptotic cells, and Ki-67 and Topo-II immunojhistochemistry for proliferating activity were performed. RESULTS: Apoptotic and proliferative indices, calculated by counting positive nuclei among 1,000 nuclei of cancer cells, should significant positive correlation with histological malignancy grading in CIN and tumor cell invasion into stroma, and showed also significant positive correlation between them. CONCLUSION: These findings suggest that apoptosis in cervical neoplasia may be closely related to tumor cell differentiation and progression.
Apoptosis* ; Biology ; Carcinoma, Squamous Cell ; Cell Differentiation ; Cell Proliferation ; Cervical Intraepithelial Neoplasia ; Cervix Uteri* ; Female ; Formaldehyde ; Paraffin