In femorsl neck fracture, viability of the femoral head depends on the revascularization of the femoral head. The purpose of this study is to observe the effect of early fixation and anatomical reduction by measuring the Tc-99m-MDP uptake ratio of the femoral head in experimental animsls. Femoral neck region of 20 mature rabbits were osteotomized completely and divided into 2 groups ; each group consisted of 10 rsbbits. Group 1 had two Kirschner wire fixation after osteotomy and anatomic reduction. Group 2 had no fixation after osteotomy. The uptake ratio of Tc-99m-MDP of the femoral head in each group were measured st the intervals of 24 hours, 48 hours, 1 week, 2 weeks, 3 weeks, and 4 weeks, respectively. The results obtained were as follows ; 1. In experimental group 1, the mean uptake ratio of the femoral head was 0.72±0.13 at 1 day after operation, increased to a level of 1.44±0.14 at 1 week, increased to a maximal value of 2. 90±0.36 at 3 weeks and decreased to a level of 1.10+0.12 at 4 weeks. 2. In experimental group 2, the mean uptake ratio of the femoral head was 0.70±0.10 at 1 day, 0.64±0.13 at 1 week, decreased to a maximal value of 0.33±0.05 at 3 weeks and 0.47±0.05 at 4 weeks, showing decreased level below 1.0. The results suggest that early anatomicsl reduction and rigid fixation of femoral neck fracture is helpful for revascularization of the femoral head and prevention of non union.
Femoral Neck Fractures ; Femur Neck ; Head ; Neck ; Osteotomy ; Rabbits

Interlocking nailing technique has many advantages in the fracture treatment. Such as the prevention of infection and devitalization by closed technique, stable intramedullary osteosynthesis, bone grafting effect of reaming debris, and early restoration of loading and function, comparing to the conventional intramedullary nailing. However, we met many problems during the operative procedure due to deficient concept and technique. We have checked the possible problems during and after the procedure of interlocking nailing for the tibia or femur fractures in 69 cases. 1. Sixty nine cases were consisted by 26 cases of femur fractures and 43 cases of tibia fractures. 2. The inadequate implant length was the most common error in the implant selection (4 cases in femur, 6 cases in tibia). 3. A new fragment was made in 12 patients(17%) during surgery, more commonly in the femur (9 cases), especially medial side and distal to the fracture line. 4. Bone shortening, angulation deformity or rotational deformity, caused by incomplete reduction, were developed more commonly in the tibia than in the femur. 5. Post-operative deep infection were developed in 2 cases(3%). 6. Delayed or non-union were developed in 18 cases(28%), who were followed for more than 3 months. 7. Circumferential wiring or bone grafting using semiclosed technique is thought to be useful to prevent delayed or nonunion when there is a wide gap between fractured fragments pre-operatively.
Bone Transplantation ; Congenital Abnormalities ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Surgical Procedures, Operative ; Tibia

We Performed an epidemiologic survey for strabismus among primary school-children in order to investigate the number of strabismus from March 1995 to February 1996. Cover-uncover test and prism cover test were used. The results were as follows:1. Out of 9054 1st grade primary school-children examined, 322(3.56%) were found as strabismus. 2. 322 cases of strabismus include 262(81.4%)exodeviation and 60(18.6%) esodeviation. 3. Alternating type and monocular type strabismus have no difference both in exotropia and esotrapia. 4. In exotropia and esotropia, no sexual predilection was found. 5. Most portion of deviation angle distribute between 11 to 20 prism diopter. 6. The difference of number of strabismus between big cities and small cities was statistically insignificant(p>0.05).
Epidemiology ; Esotropia ; Exotropia ; Korea* ; Strabismus*

No abstract available.
Tibia*

The purpose of this study is to evaluate the short-term results of the reconstruction of acetabular bone defect radiographically. Twenty three reconstruction with bone graft and non-cemented porous hemispherical cup and one reconstruction with bone graft and cemented polyethylene cup that had been performed in 24 patients from 1991 at Wonkwang University Hospital and had followed more than one year were included in this study. Osseous union, resorption of the graft, the amount of the migration and angle change of the acetabular components and radiolucency were checked on plain X-ray. 9 morselized grafts for contained defect showed 100% union within 6 months, without severe resorption and loosening. Of the 15 structural grafts, 11 minor column or shelf grafts showed 100% union and remodeling, and one case of radiolucency around the cup. There were two collapses of the structural graft and one migration of the cup which suggest the failure among the 4 major column grafts. For the above 3 failed cases, non-cemented porous hemispherical cups were used. In conclusion, bone graft for reconstruction of the deficient acetabular bone stock seems to be suc- cessful, but the use of cement and the delay of weight bearing should be considered for the major column graft.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Humans ; Polyethylene ; Transplants* ; Weight-Bearing

There were 21 cases of tibial pilon fractures in total: type I-2 cases, type II-14 cases, type III-5 cases according to Rued's classification. In type I and II, ring fixators were applied to tibia and foot and closed reduction was performed monitoring the quality of the reduction with an image intensifier. When the quality of the reduction was questionable, we rechecked it using arthroscopy and if neces- sary, the reduction was readjusted. Instead of using plate and screws, we used olive stop wires to achieve stable fixation. In type III, a limited open reduction was performed in the place of arthroscopy. Approximately at the eighth week after operation, we removed the fixation of calcaneus, metatarsal and foot mounting. Between 16 and 28 weeks, we removed the foot mounting after achieving bony union in all cases except one case(20 cases). In the follow-up cases of 2 years and more, we obtained the fine functional results of 15 good, 4 fair and 2 poor cases. Fewer major complications were observed except 8 cases of pin tract infection(grade 1) and 1 case of reduction loss. Using ring fixators and arthroscopy, we had fewer surgical complications.
Arthroscopy ; Calcaneus ; Classification ; Follow-Up Studies ; Foot ; Metatarsal Bones ; Olea ; Tibia

MEN type 1 is characterized primarily by the presence of functioning and nonfunctioning tumors or hyperplasia of the pituitary gland, parathyroid glands, and pancreatic islet cells. Pancreatic islet tumors in MEN type 1 produce different kinds of hormone which were pancreatic polypeptide, gastrin, glucagon, insulin and so on. To date, ten cases had been reported in Korea. We report another case with MEN type 1 having prolatin-secreating pituitary adenoma, parathyroid hyperplasia and insulinoma. A 36-year-old woman was admitted because of long-standing amenorrhea and recently diagnosed osteoporosis. Otherwise, she had been in good health except experiencing one episode of loss of consciousness after skipped meal. The blood chemistries were normal except hypercalcemia and hypophosphatemia. Hormonal studies revealed elevated levels of intact PTH and prolactin and decreased value of estradiol with low LH and FSH. The neck CT revealed 1 cm-sized nodule at posterior portion of right thyroid gland and 99mTc-sestamibi sintigraphy showed a increased uptake in left lower and right lower parathyroid glands. The sella MRI showed 0.7 cm-sized enhanced lesion in the left pituitary gland. The ratio of immunoreactive insulin to glucose was elevated and 3-4 pancreatic masses of variable size were identified by endoscopic ultrasonography and angiography. Subtotal parathyroidectomy and pyrolus-preserving pancreaticoduodenectomy with spleen-preserving distal pancreatectomy was done. Postoperative she had been doing well with normocalcemia and normoglycemia. Transsphenoidal adenonectomy was done 5 months later. Histologic examination of removed tissues revealed a single insulinoma, prathyroid hyperplasia and prolactin-secreating pituitary adenoma.
Adult ; Amenorrhea* ; Angiography ; Endosonography ; Estradiol ; Female ; Gastrins ; Glucagon ; Glucose ; Humans ; Hypercalcemia ; Hyperplasia ; Hypophosphatemia ; Insulin ; Insulinoma ; Islets of Langerhans ; Korea ; Magnetic Resonance Imaging ; Male ; Meals ; Multiple Endocrine Neoplasia Type 1* ; Multiple Endocrine Neoplasia* ; Neck ; Osteoporosis* ; Pancreatectomy ; Pancreatic Polypeptide ; Pancreaticoduodenectomy ; Parathyroid Glands ; Parathyroidectomy ; Pituitary Gland ; Pituitary Neoplasms ; Prolactin ; Technetium Tc 99m Sestamibi ; Thyroid Gland ; Unconsciousness

The author reviewed the effectiveness of triple procedure in terms of the visual acuity and the intraocular pressure control after 6 months follow up of twenty-four consecutive glaucoma patients who was treated with triple procedure: trabeculectomy with simultaneous lens extraction and intraocular lens implanation. At 6 months after operation, the mean intraocular pressure was 7.0mmHg lower than the preoperative level, and the kind of glaucoma medication was decreased from 2.1 to 0.6. The visual acuity improved in 67% at two months and 93% at six months after operation, respectively. The several complications such as hyphema, shallow anterior chamber with wound leaking, posterior capsular opacity and uncontrolled intraocular pressure were appeared. Effectiveness of triple procedure in terms of intraocular pressure control and visual acuity improvement seems to be similar to that of the operation done separately.
Anterior Chamber ; Cataract ; Follow-Up Studies ; Glaucoma* ; Humans ; Hyphema ; Intraocular Pressure ; Lenses, Intraocular ; Trabeculectomy ; Visual Acuity ; Wounds and Injuries

PURPOSE: To evaluate the efficacy and safety of the inferior conjunctival transposition flap for primary pterygium surgery. METHODS: This study reviewed 59 eyes in 59 patients with primary pterygium who were treated with pterygium excision and an inferior conjunctival transposition flap. The inferior conjunctival flap was obtained from lower bulbar conjunctiva and was secured with 8-0 vicryl. Patients were followed-up on the third day after surgery and then at 1, 2, 4 and 12 weeks postoperatively. RESULTS: The mean patient age was 55.6 (ranging from 34 to 74) years. The mean follow-up period was 24.9 (ranging from 12 to 46) months. During the follow-up period, the pterygium recurred in one (1.7%) of the 59 eyes. There were no severe complications except for mild congestion and hemorrhage of the conjunctival flap. CONCLUSIONS: Inferior conjunctival transposition flap technique may be considered as a safe and effective method that reduces complications and recurrences after primary pterygium excision.
Conjunctiva ; Estrogens, Conjugated (USP) ; Eye ; Follow-Up Studies ; Hemorrhage ; Humans ; Polyglactin 910 ; Pterygium ; Recurrence

We herein describe a case of a 55-year-old healthy woman with localized primary thymic amyloidosis presented as a mediastinal mass, found incidentally by chest radiography. Computed tomography revealed a 4.1 cm soft tissue lesion with nodular calcification in the left anterior mediastinum. The resected specimen was a well-defined lobulating mass with calcification. Microscopically, the mass was consisted of amorphous eosinophilc hyalinized substances involving the thymus and intrathymic lymph nodes. These eosinophilic substances showed apple-green bi-refringence under polarized light after staining with Congo red. In immunohistochemical study, they were positive for kappa and lambda light chains and negative for amyloid A. There was no evidence of systemic amyloidosis in clinical investigations. A final diagnosis of localized primary thymic amyloidosis was made.
Amyloid ; Amyloidosis ; Congo Red ; Eosinophils ; Female ; Humans ; Hyalin ; Light ; Lymph Nodes ; Mediastinum ; Middle Aged ; Thorax ; Thymoma ; Thymus Gland