Attempt to treat degenerative arthritis of the knee by surgical means have been limited. Patellectomy or patelloplasty may be done in the presence of symptomatic patellofemoral arthritis; and joint debridement, including removal of loose bodies, large osteophytes, and damaged menisci, is occasionally used. Most patients with degenerative arthritis of the knee bear more of their weight on one tibial condyle than on the other. As the articular cartilage degenerates over the tibial condyle that bears the most weight, the natural varus or valgus deviation increases and a vicious cycle is set up in which increasing deformity creates increasing degenerative change. If weight-bearing and other stresses could be increased on this more normal area and decreased on the involved portion, it would been that pain might be relieved and the useful life-span of the knee joint considerably prolonged. The tibia in degenerative arthritis of the knee has become the preferred site for the osteotomy because of restriction of knee motion. The osteotomy is increasingly performed proximal, rather than distal, to the attachment of the patellar tendon at the tibial tuberosity because healing occurs faster in the cancellous bone of the metaphysis as compared with the cortical bone of the diaphysis, and particularly as the quadriceps extensor mechanism stabilizes the osteotomy. We have had 4 cases of modified high tibial osteotomy in the degenerative arthritis patients by division of proximal tibio-fibular ligament instead of removal of fibular head. And the follow-up resutts are “good” in all cases without any complication.
Arthritis ; Cartilage, Articular ; Child ; Clinical Study ; Congenital Abnormalities ; Debridement ; Diaphyses ; Femur Neck ; Follow-Up Studies ; Head ; Humans ; Joints ; Knee ; Knee Joint ; Ligaments ; Osteoarthritis ; Osteophyte ; Osteotomy ; Patellar Ligament ; Tibia ; Weight-Bearing

Takayasu's arteritis is an arteritis of undetermined etiology, which affects the aorta, the proximal portions of its major branches, and the pulmonary arteries, and causes coarctation, occlusion, or aneurysmal dilatation of the affected vessels. Authors has reported 9 cases in 1973, and another 24 cases in 1977. Thereafter, during next 4 years, authors experienced another 42 cases and obtained some additional results. The results are as follows: 1. Among 75 cases, 10 are male and 65 female patients with sex ratio of 1:6.5, and about 2/3 of total patients are under 30 years of age. 2. Headache, dizziness, absent or weak radial pulse and hypertension are the most common symptoms and signs. 3. Conventional chest roentgenography may be helpful but not specific in diagnosis of Takayasu's arteritis. 4. The aortographic findings are characteristic and pathognomonic in diagnosis of Takayasu's arteritis. In our series, the most common findings are stenosis or occlusion of subclavian artery, diffuse narrowing and aneurysmal dilatation of abdominal aorta and its branches, narrowing with irregular contour of descending thoracic aorta, and renal artery involvement. 5. Involvement of the aorta was classified as extensive type in 38 cases, descending thoracic and abdominal type in 22 cases and arch type in 15 cases. 6. As total aortography in cluding abdominal aorta uncovers evidence of unsuspected involvement of aorta and its branches, it is of paramount importance in the diagnosis of Takayasu's arteritis.
Aneurysm ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic ; Aortography ; Arteritis ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Dizziness ; Female ; Headache ; Humans ; Hypertension ; Male ; Pulmonary Artery ; Radiography ; Renal Artery ; Sex Ratio ; Subclavian Artery ; Takayasu Arteritis* ; Thorax

Forty-three patients with papulo-pustular rosacea with Demodex(D.) folliculorum were treated for 8 weeks on a random basis either with tetracycline 250 mg three times daily or with metronidazole 250 mg three times daily. Both drugs produced an improvement which was greater after 8 weeks than after 4 weeks, but there was no significant difference between them. The number of D. follilculorum after treatment with tetracycline was slightly decreased, but the number of D. folliculorum after treatment with metronidazole was more decreased than the tetracycline group. Metronidazole appears to be a effective drug for the treatment of rosacea with D. folliculorum.
Humans ; Metronidazole* ; Rosacea* ; Tetracycline*

The important prerequisite for treatrnent of onychomycosis is the removal of as rnuch fungus-infected nail material as possible. Nincty-five patients with anychomycosis were treated with using urea preparations under occlusive dressings. The urea preparations were quite successful in maceraing the nail plate from the nail bed, allowing the easy removaI of diseased nails in all cases except one. The urea preparations removed only abnormal nail. Completely normal nail was unaffected. After nail avulsion, 95 patients were treated for 6 months with combination clotrimazole and ketoconazcile(group A), or with clotrimazole only(group B). Of the 38 patients in group A who complcted the treatment, 25(65.8%) were cured 6 months later by clinical and mycological criteria, compared to 20(47.6%) of 42 patieries in group B.
Clotrimazole ; Humans ; Ketoconazole ; Nails, Malformed ; Occlusive Dressings ; Onychomycosis* ; Urea

Lichen planus is rare in Korea and localized lichen planus on the lip without other skin lesions is even rarer. A 77-year-old man has oozing and crusting patches und somewhat ulceration surrounded by whitish reticular elements on violaceous base on both lips with burning sensation and pain. A 63-year-old man has well demarcated violaceous white reticular patches on the lower lip, buccal mucosa, glans penis and coronal sulcus. Clinical and histopathological studies of two cases showed typical features of lichen planus. They were treated with systemic and topical corticosteroids and showed much improvement.
Adrenal Cortex Hormones ; Aged ; Burns ; Humans ; Korea ; Lichen Planus* ; Lichens* ; Lip* ; Male ; Middle Aged ; Mouth Mucosa ; Penis ; Sensation ; Skin ; Ulcer

No abstract available.
Animals ; Arteries* ; Rats*

Percutaneous transhepatic biliary drainage was successfully made 20 times on 17 patients of obstructivejaundice for recent 1 year since June 1981 at department of radiology in Seoul National University Hospital. Thecauses of obstructive jaundice was CBD Ca in 13 cases, metastasis in 2 cases, pancreatic cancer in 1 case and CBDstone in 1 case. Percutaneous transhepatic biliary drainage is a relatively easy, safe and effective method whichcan be done after PTC by radiologist. It is expected that percutaneous transhepatic biliary drainage should bedone as an essential procedure for transient or permanent palliation of obstructive jaundice.
Drainage ; Humans ; Jaundice, Obstructive ; Methods ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Seoul

Two cases report on osteogenesis imperfecta tarda and review of literature has been made. The rare genetic disorder, osteogenesis imperfecta tarda is familiar to most orthopedic surgeons because of management of fracture and skeletal deformities, espicially bowing of long bone. Its clinical manifestations are known as bony fragility, blue sclera and deafness less frequently ligamentous laxity but its etiological factor is obscure; The basic defect is thought to involvement some abnormality of collagen. Recently the bony weakness caused by increased bony turnover rate. One case of osteogenesis imberrfecta tarda in 8 year old male was belonged to tarda type 1. (Falvo-classification), who could not walk due to marked anterolateral bowing of right tibia and the another to tarda type II. in 13 year old male with fresh fracture of right femoral shaft. The former was performed corrective multible osteotomy, realignment and intramedullary rod fixation for correction of bowing deformity of right tibia, and the later was managed the fracture of right femoral shaft with Russels traction and hip spica cast. The result of reported therapeutic mesure was good.
Collagen ; Congenital Abnormalities ; Deafness ; Fibrinogen ; Hip ; Humans ; Ligaments ; Male ; Orthopedics ; Osteogenesis Imperfecta ; Osteogenesis ; Osteotomy ; Sclera ; Surgeons ; Tibia ; Traction

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking

STUDY DESIGN: A retrospective analysis of the patients who had cauda equina syndrome caused by a herniated lumbar disc. OBJECTIVES: To assess the clinical debates concerning the diagnosis, treatment, and results of treatment. SUMMARY OF LITERATURE REVIEW: This syndrome has been considered as an absolute indication of surgical treatment in the herniated lumbar disc and poor prognosis after surgery were reported. Although there are debates on the timing of surgery, early recognition early surgical treatment are recommended for a better results of treatment. MATERIALS AND METHODS: 23 consecutive patients having a cauda equina syndrome caused by herniated lumbar disc were reviewed retrospectively. They were 14 males and 9 females having ages of 41.6 in average. The incidence of this syndrome was 3.8% of the patients who had surgical treatment of herniated lumbar disc. RESULTS: All patients had bladder dysfunction in addition to the low back pain and radicular pain in the leg, but five patient did not recognize their urinary retention which were shaded by severe leg pain. A surgical treatment were performed for all patients at 6.8 days in average after onset of the bladder dysfunction. At follow-up of 3 years and 3 months in average after surgery, 20 patients(86.9%) had satisfactory resolution of the low back pain and leg pain, and all patients had complete recovery of motor weakness except one patients who had residual foot drop. Bladder function recovered satisfactorily in 18 patients (78.3%), but 4 patients had some difficulty of urination and one patient needed a sphinterotomy for urination. CONCLUSIONS: The cauda equine syndrome in herniated lumbar disc was often not recognized early and a poor result of treatment was not rare, particularly in the patients who had acute onset and severe bladder dysfunction. So, early diagnosis and active surgical treatment are recommended for a better results of treatment.
Cauda Equina* ; Diagnosis ; Early Diagnosis ; Female ; Follow-Up Studies ; Foot ; Humans ; Incidence ; Leg ; Low Back Pain ; Male ; Polyradiculopathy* ; Prognosis ; Retrospective Studies ; Urinary Bladder ; Urinary Retention ; Urination