We have reviewed 22 cases of acute rupture of the achilles tenden seen at Naticnal Seoul Ho pital during a seven-year peiod (1974.1 to 1980. 12), 17 treated surgically, and 5 treared cons ervatively, The results of a follow-up review are as follows: 1. Males predominated by a ratio of 21: 1. The mean age for the 22 patients was 29.8 years. Fourteen cases (63.6%.) were in the third decade. 2. The sites of rupture were 13 cases(58.4%.) on the left side and the level of rupture was at the tendon itself on 15 Cases (68.2%). 3. The cause of injury was indirect trauma in 14 cases (63.6%) and the most ccmmon mechanim of injury was a sudden push-off of the foot from the plantar flexed position: seven (50%) of 14 cases. 4. Positive Thompson test was noted in 19(86.3%) of 22 cases. 5. The average period of cast immobilization was 6 weeks in surgically treated cases and 10 weeks in conservatively treated cases. 6. The most common complication was wound infection, which developed in three cases(17.6%) postoperatively. One case of re-rupture (20%) developed after conservative treatment.
Follow-Up Studies ; Foot ; Humans ; Immobilization ; Male ; Rupture ; Seoul ; Tendons ; Wound Infection

The purpose of this paper was to report clinical results and complications of high tibial osteotomy with fibular shaft osteotomy for medial unicompartmental osteoarthritis with varus deformity of the knee. Especially, the complications related to fibular shaft osteotomy were surveyed and analysed. Among one hundred and thirty-one cases which underwent high tibial osteotomy from Nov 1993 to May 1999, twenty-five cases underwent it combined with fibular shaft osteotomy and followed up at least more than 2 years. Average follow-up period were 47 months. Hospital for special surgery(HSS) knee score and femorotibial angle from weight bearing anteroposterior roentgenography of the knee were evaluated and measured. HSS knee score was improved from average 69 points preoperatively to 93 points in average at the final follow-up. Femorotibial angle was varus 2.9 degrees in average preoperatively and improved to valgus 8.1 degrees in average postoperatively and valgus 6.6 degrees at the final follow-up. Complications were tender- ness near to fibular shaft osteotomy in 9 cases, superficial peroneal nerve injury in 8 cases, non-union of fibu- lar osteotomy in 7 cases, non-union or delayed union of tibia osteotomy in 3 cases. High tibial osteotomy with fibular shaft osteotomy was a effective procedure in improving clinical results of osteoarthritis of the knee. However care must be taken to avoid complications rel#ated to fibular osteotomy
Congenital Abnormalities ; Follow-Up Studies ; Knee ; Osteoarthritis ; Osteotomy* ; Peroneal Nerve ; Radiography ; Tibia ; Weight-Bearing

PURPOSE: The object of this study was to determine if the low-priced alloy and metal UCLA abutment could be available for manufacturing bar-retained framework of implant prosthesis. MATERIALS AND METHODS: Bar structure was classified into 4 groups, The specimen of group 1 and 2 were based on casting high noble metal alloys and noble metal alloys with gold UCLA abutment. The specimen of group 3 and 4 were based on casting noble metal alloys and base metal alloys with metal UCLA abutment. Cast bar structure was installed in an acrylic resin model and only the screw on the hexed abutment side was tightened to 20 Ncm. On the opposite side, vertical discrepancy was measured with stereo microscope from front, back, and lateral side of the implant-abutment interface. One-way ANOVA was performed to analyze the marginal fit discrepancy. RESULTS: One-way ANOVA test showed significant differences among all groups (P<.05) except for Group 1 and 3. Among them, difference between Group 1 and 2 was noticeable. Measured vertical discrepancies were all below 70 microm except to Group 2. CONCLUSION: Base metal alloy and metal UCLA abutment could be used as an alternative to high-priced gold alloy for implant bar-retained framework.
Alloys

BACKGROUND: Non-small cell lung cancer is one of the most frequent cause of death due to cancer in men, and its incidence among women is rapidly increasing. Although there has been a recent surge of interest in combined modality therapy for stage III non-small cell lung cancer(NSCLC), the optimal treatment is still not well established. Thoracic irradiation has long been the gold standard for locally advanced unresectable NSCLC. However, although conventional radiotherapy(XRT) can palliate symptom and improve local control of disease, it huts at most only a modest effect on survival. Recently, cisplatin(cia-diamminedichloroplatinum ) has been reported to enhance the cell-killing effect of radiation For patients with unresectable NSCLC, cisplatin-based concurrent chemoradiotherapy(CCRT) had the advantage of therapeutic response over XRT alone and therapeutic side effect more commonly occurred in CCRT group in EORTC(European Organization for Research and Treatment of Cancer) and other trials. Objectives : We compared therapeutic response, compliance, and side effects between CCRT and XRT in patients with advanced NSCLC. Patients and METHOD: Thirty patients with biopsy-proven inoperable NSCLC were randomized to one of two treatment arms. Arm A consisted of XRT, radiotherapy for 4~6 weeks(1.8 Gy given 20~33 times, in five fractions a week), and arm B consisted of CCRT, radiotherapy for 2 weeks(3 Gy given 10 times, in five fractions a week), followed by 3 week rest period and then radiotherapy 2 more weeks(2.5 Gy given 10 timed in five fractions a week), combined with 6mg cisplatin per square meter, given daily before radiotherapy. We evaluate therapeutic response, compliance, change of performance status, side effects, and radiation pneumonitis by using the author's made scoring system. RESULTS: There was no significant difference in therapeutic response and compliance. But there was a significantly lower laboratory complication and radiation pneumonitis in CCRT group (p<0.05). There's significant negative correlation between stage and therapeutic response score in both groups(R=0.353, p<0.05). In both groups, patients with squamous cell carcinoma had a tendency to higher therapeutic response score than those with adenocarcinoma. CONCLUSION: There was. no difference between CCRT and XRT in respect to therapeutic response and compliance. But CCRT had a advantage of decreased side effects.
Adenocarcinoma ; Arm ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Cause of Death ; Chemoradiotherapy* ; Cisplatin ; Combined Modality Therapy ; Compliance ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Male ; Radiation Pneumonitis ; Radiotherapy*

PURPOSE: Clinical and radiologic results of femur intertrochanteric fractures treated with ITST nail in elderly patients with osteoporosis were analysized to evaluate the efficacy and complication of ITST nailing. MATERIALS AND METHODS: 32 patients who were treated with ITST nail due to femur intertrochanteric fracture and were followed up for more than 1 year were analysed. According to Evans classification, 11 cases were stable fractures and 21 cases were unstable fractures. Clinically, ambulatory function was compared and radiologically, BMD of healthy leg was checked with analysis of postoperative bone union and complication. RESULTS: In ambulatory function comparison before and after the operation, there were 9 cases of good, 17 cases of moderate and 6 cases of poor. Considering social activity after the operation, 7 cases showed normal ambulation, 9 cases showed ambulatory with one cane, 5 cases showed two cane ambulation and 11 cases showed dependent ambulation. In radiologic evaluation, T-score of ward triangle in healthy femoral neck showed BMD of -3.12. In 20 cases, bone union was observed within 3 months. The patients with low BMD result had poor outcome. There were 2 cases of intraoperative proximal femur fracture, 3 cases of nonunion and 4 cases of death within 1 year. CONCLUSION: In elderly patients with intertrochanteric fracture, ITST nailing is relatively efficient treatment. However, in pateint with severe osteoporosis (T-score<-3.0) and unstable fracture pattern, arthroplasty should be considered due to relatively high complicaton rate.
Aged ; Arthroplasty ; Canes ; Classification ; Dependent Ambulation ; Femur ; Femur Neck ; Hip Fractures ; Humans ; Leg ; Osteoporosis ; Walking

Primary tracheal tumors, especially lipoma, are very rare. Symptoms of tracheal tumor mimic common upper airway diseases. It is important that they may initially be misdiagnosi4 to bronchial asthma, chronic bronchitis, resulting in a delay in diagnosis. We report a case of tracheal lipoma who was found 6 months after first noticing symptoms including dyspnea, foreign body sensation, successfully removed by bronchoscopic polypectomy.
Asthma ; Bronchitis, Chronic ; Diagnosis ; Dyspnea ; Foreign Bodies ; Lipoma* ; Sensation ; Trachea

BACKGROUND: Blood pressure (BP) control is the most-established method for the prevention of chronic kidney disease (CKD) progression. However, the ideal BP target for CKD patients is still under debate. METHODS: We performed a survey of regular registered members of the Korean Society of Nephrology to determine physician perceptions of BP control in patients with CKD. In addition, we evaluated the target BP achievement rate using data from the APrODiTe-2 study. RESULTS: Two-thirds of physicians considered the target BP for CKD to be < 130/85 mmHg. The systolic BP (SBP) thresholds for diabetic CKD, proteinuria ≥ 300 mg/day, 30 ≤ glomerular filtration rate (GFR) < 60 mL/min/1.73 m2, age < 60 years, and the presence of atherosclerotic (ASO) complications were significantly lower than the SBP thresholds of the opposite parameters. The three major hurdles to controlling BP were non-compliance with lifestyle modification and medications, and self-report of well-controlled home BP. Most physicians prescribed home and ambulatory BP monitoring to less than 50% of their patients. The target BP achievement rates using the SBP thresholds in this survey were as follows: non-diabetic (69.3%); diabetic (29.5%); proteinuria < 300 mg/day (72.3%); proteinuria > 300 mg/day (33.7%); GFR ≥ 60 (76.4%); GFR < 30 (47.8%); no evidence of ASO (67.8%); and the presence of ASO (42.9%). CONCLUSION: The target BP was lower in patients with higher cerebro-cardiovascular risks. These patient groups also showed lower target BP achievement rates. We also found a relatively lower application and clinical reflection rate of home or ambulatory BP monitoring.
Blood Pressure* ; Glomerular Filtration Rate ; Humans ; Life Style ; Methods ; Nephrology ; Proteinuria ; Renal Insufficiency, Chronic*

Carcinoma ex pleomorphic adenoma is transformed at the incidence of 1-20% in pleomorphic adenoma and frequently recurred. It accounts for 10% of all malignant salivary tumors and its average age of occurrence is 60s. It will present in a large, long-standing pleomorphic adenoma or in one that was previously treated but has recurred. According to cell composition in malignant cell carcinoma, and clear cell adenocarcinoma. Most (75%) occur in parotid gland, while about 20% occur in the minor gland of the oral mucosa. The metastasis rate to regional lymph node is about 25%, and to distant organs about 33% and the 5-year survival rates are 40%. Though the treatment of the carcinoma ex pleomorphic adenoma is not established, it is treated ideally with and extensive resection, neck dissection, postoperative radiotherapy, and chemotherapy. When occurred in parotid gland, facial paralysis is reported. With a review of literatures, we report a case of carcinoma ex pleomorphic adenoma which operated with total parotidectomy and supraomohyoid neck dissection.
Adenocarcinoma, Clear Cell ; Adenoma, Pleomorphic ; Incidence ; Lymph Nodes ; Mouth Mucosa ; Neck Dissection ; Neoplasm Metastasis ; Parotid Gland ; Survival Rate

Malignant melanoma is a highly malignant form of cutaneous cancer derived from melanocytes. The lesion frequently metastasizes to the lymph nodes, lung, liver and bone. However, an endobronchial metastasis and a primary malignant melanoma of the lung are quite rare. We report a case of an unknown primary malignant melanoma with a pulmonary and endobronchial metastasis in a 34 years old male. He complained of coughing and black-colored sputum. Abnormal skin and mucosal lesions were not found during a physical examination. A chest X-ray revealed multiple nodular masses in both lung fields. A flexible bronchoscopy showed two yellowish small nodules at the entry of left lower bronchus. Vimentin, the S-100 protein, and HMB-45 stain positive melanoma cells were detected at the bronchoscopic biopsy specimen.
Biopsy ; Neoplasm Metastasis

Malignant melanoma is a highly malignant form of cutaneous cancer derived from melanocytes. The lesion frequently metastasizes to the lymph nodes, lung, liver and bone. However, an endobronchial metastasis and a primary malignant melanoma of the lung are quite rare. We report a case of an unknown primary malignant melanoma with a pulmonary and endobronchial metastasis in a 34 years old male. He complained of coughing and black-colored sputum. Abnormal skin and mucosal lesions were not found during a physical examination. A chest X-ray revealed multiple nodular masses in both lung fields. A flexible bronchoscopy showed two yellowish small nodules at the entry of left lower bronchus. Vimentin, the S-100 protein, and HMB-45 stain positive melanoma cells were detected at the bronchoscopic biopsy specimen.
Biopsy ; Neoplasm Metastasis