Recently there has been a noted increase in the incidence of traumatic bony gap in long bones due to accidents in industry, high speed traffic accidents and common gunshot accidents. There are several methods to treat traumatic bony gap such as bone graft (autogenous, homogenous and heterogenous), bone transplantation, periosteal osteogenesis and reinplantation of the extruded bone etc. The authors studied 26 patients of traumatic bony gap in the long bones which had been treated by autogenous bone grafting. The results of the clinical observation were as following; 1 The causes were shotgun accidents, vehicle accidennts and explosive accidents. 2 There was bony gap involved in 10 upper extremities and 16. lower extremities. The radius was the most common site in the upper extremity and the femur in the lower extremity. 3. The largest bony gaps were 10.5cm. in the tibia and next were 10.6cm. in ulna and 9.0cm. im humerus. 4. The period of the bony union in these cases was prolonged 1.5~3 times the usual healing period of simple fractures. 5. It was very important to prevent and control infection of the open fractures and to decide the correct time for bone grafting operation after healing of the infected wounds. We did the bone grafting sugery 2 or 3 months later after the infected wounds had been healed. 6 The authors could avoid some complications such as delayed union, shortening of the affected limbs and stiffness of the joints of the affected limbs etc.
Accidents, Traffic ; Bone Transplantation ; Extremities ; Femur ; Fractures, Open ; Humans ; Humerus ; Incidence ; Joints ; Lower Extremity ; Osteogenesis ; Radius ; Tibia ; Transplants ; Ulna ; Upper Extremity ; Wounds and Injuries

No abstract available.
Head*

PURPOSE: We studied the effectiveness and toxicities of 5-fluorouracil+leucovorin, combination chemotherapy in advanced or recurred colo-rectal cancer patients, who didn't have previous chemotherapy and enrolled from August 1993 to July 1998. MATERIALS AND METHODS: All patients were treated with leucovorin followed by 5-fluorouracil for 5 consecutive days every 4 weeks. Among 43 patients who were enrolled, 40 patients received treatment at least 2 courses, and they were evaluable. Male to female ratio was 21 to 19. In serum CEA level, 27 patients were greater than 5 ng/ml and 13 were less than 5 ng/ml. And primary site was colon in 21 patients and rectum in 19 patients. RESULTS: The complete response rate was 7,5% and the partial response rate was 25%. The median survival duration was 14.7 months, the median response duration was 16.0 months, and median time to progression was 7.3 months. In the analysis of response, survival duration, time to progression according to various characteristics of patients, serum CEA level and liver involvement were revealed significant difference in survival duration, time to progression (p=0.0122, 00350 & 0.0202, 0.0123) on univariate analysis, but no significant difference on multivariates. Hematologic and non-hematologic toxicities were mild and tolerable. CONCLUSION: This study indicates that the combination of 5-fluorouracil (370 mg/m) and leucovorin (20 mg/m) is effective and tolerable regimen in advanced or recurred colo-rectal cancer patients without previous chemotherapy.
Colon ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Fluorouracil* ; Humans ; Leucovorin* ; Liver ; Male ; Rectal Neoplasms* ; Rectum

BACKGROUND: If the corrections of the cryptorchid testes are delayed, it may lead the patients to suffer loss of testes or fertility. So we purposed to analyze the present status of correction and the causes of delay and tried to emphasize the needs to educate and inform the ideal age for correction. METHODS: Total 363 cryptorchid patients who visited our hospital in 10 years from January 1987 to December 1996 were divided into 3 groups according to their ages at visit as under 2, 3 to 5 and over 6 years groups. We analyzed the operative findings of the 3 groups, compared the ratio of the over 6 group during the half ten years till 1991 to the same ratio after 1992 and also analyzed the causes of delay in 81 patients for whom the causes of delay could be identified in over 6 years group. RESULTS: The age distributions showed 88 patients(24.2%) of under 2 years group, 118 patients(32.5%) of 3 to 5 years group and 157 patients(43.3%) of over 6 years group. When we compare the former 5 years till 1991 to the latter 5 years after 1992, the number of the patients who underwent orchiopexy under the age of 2 were increased from 34 (19.1%) to 54(29.2%) and those over the age of 6 were decreased from 88(49.4%) to 69 (37.3%) but still in higher proportion. The intraoperative findings showed that the rate of atropic or smaller testes than normal size in over 6 years group(128 testes, 73.1%) were higher than those of under 2 years(10 testes, 9.8%) and 3 to 5 years group(28 testes, 20.2 %). The most common causes of delay in over 6 years group was recommendation by relatives or neighbors(36 patients, 48.1%) and the remainders were advices of doctors other than urologists(27 patients, 33.3%), poor economic status(8 patients, 9.9%) and unawareness of the anomaly(7 patients, 8.6%). CONCLUSIONS: To prevent the loss of testicular function or testis itself in patient with cryptorchidism, the early correction should be performed because the recommended age for the correction tends to be decreased. The public information for the recommended age should be provided and also educational programs for the primary physicians are supposed to be performed.
Age Distribution ; Cryptorchidism ; Fertility ; Humans ; Male ; Orchiopexy ; Testis

The endoscopic variceal ligation(EVL) has been adopted as a new treatment for acute hemorrhage from esophageal varices that ranks the highest mortality rate in upper gastrointestinal tract bleedings. This treatment method has good effects for the urgent treatment and eradication of varices from acute variceal bleeding in repeated sessions. We enrolled 34 patients with an acute or chronic variceal bleeding episode at the time of admission in this study from Apr. 8, 1992 to June. 2, 1994. Among 34 patients, there were 31 males and 3 females, at ages between 45-66(mean: 52 years). The incidence of symptoms on admission was 10 in tarry stool, 9 in hematemesis 8 in ascites, 4 in hepatic encephalopathy and 3 in nonspecific symptoms. Varices were eradicated or reduced to grade I in 30(88.2%) of the 34 patients by 4-25 bands (mean: 10.8 bands) in 1-7 EVL sessions(mean: 3.1 sessions). After EVL, there are complicated by active bleeding in 3 patients, dysphagia in 3 patienta and transient chest discomfort in 5 patients but subsided during 24 hours. These results indicated that EVL is a safe method for treatment of bleeding from esophageal varices.
Ascites ; Deglutition Disorders ; Esophageal and Gastric Varices* ; Female ; Hematemesis ; Hemorrhage* ; Hepatic Encephalopathy ; Humans ; Incidence ; Ligation* ; Male ; Mortality ; Thorax ; Upper Gastrointestinal Tract ; Varicose Veins

No Abstract Available.
Sutures* ; Tibia*

The clinical study on recurrent dislocation of the shoulder was performed on fourteen cases who were treated by Putti-Platt operation from July 1967 to November 1968. The cases studied were treated at the 17th Army Hospital in Kwang-ju and U.S. 121st Evacuation Hospital in Bu-pyung. Ages in initial dislocation were varied from 11 to 25 with an average of 18 years. Five cases of them were recurred over ten times prior to operation. On radiological findings, Hill-Sachs lesion has been revelaed in 57.1%. On pathological finding, Bankart lesion was seen in 78.5% and detachment of the glenoid labrum with capsular separation in 28.6%. No recurrence has been encountered in this s ries, and average rarige of abduction was gained upto 165 and external rotation 30°.
Clinical Study ; Dislocations ; Gwangju ; Hospitals, Military ; Recurrence ; Shoulder

The technique of the arthroscopic total meniscectomy of discoid meniscus is very difficult. Ikeuchi(1982) reported a technique of arthroscopic total meniscectomy of the lateral discoid meniscus by removal of 2/3 of the anterior part of the meniscus first and then by morselization. The purpose of this paper is to report a technique of arthroscopic total meniscectomy of the lateral discoid meniscus as a whole. During the period from October 1982 to October 1984, we had 12 experiences of arthroscopic total meniscectomy of the discoid meniscus and found good results, that is, little postoperative pain, short period of hospitalization and early restoration of joint motion without physical therapy. Complications are 3 cases of symptomless slight lateral instability and 4 cases of hemarthrosis.
Arthroscopy ; Hemarthrosis ; Hospitalization ; Joints ; Knee ; Pain, Postoperative

Intracompartmental pressure of leg was measured by the slit catheter technique in one hundred fifty compartments of one hundred cases; fifty were from healthy young male adults, the others were from tibial fractured patients during three years from March 1983 to Fobruary 1986. The results were as follows; 1. Slit-catheter technique was found as a accurate method for continuous pressure monitoring. 2. The range of normal pressure was from zero to six millimeters of mercury(1.45mmHg±0.85). 3. Tissue pressure was 0–15mmHg(4.03mmHg±1.83) in unaffected side of fractured patients, 4–35mmHg(14.65mmHg±2.05) in affected side of fractured patients.
Adult ; Catheters ; Clinical Study ; Humans ; Leg ; Male ; Methods

The PCL is the strongest ligament in the knee joint. And it gives the posterior stability to the knee joint and act on rotation of knee joint. The many authors reported the surgical approaches for PCL. But none of them was satisfactory for exposure for PCL. Authors report the approach for repair and reconstruction on PCL injury The purpose of this report is to get the more satisfactory exposure of operation field for anatomical repair of injuried PCL. 1. PCL injury combined with MCL injury. a) MCL injury at its femoral attachment area. Detach the injuried MCL from femoral attachment completely, continue with anteromedial incision, and can observe both femoral and tibial attachment of PCL and ACL. b) MCL injury at its tibial attachment area. Retract the injuried MCL, medial meniscus, joint capsule superiorly, and through between medial meniscus and tibial proximal protion, also can observe the tivial attachment of PCL. 2. Isolated PCL injury. a) at tibial attachment(avulsion fracture) Through posterior approach or straight anteromedial approach, incised the posteromedial joint capsule, and can observed the tibial attachment of PCL. b) at substance level. Detach the MCL from its femoral attachment with bone-block and apply the knee valgus force. And can observe the entire length of PCL. Also reinforce the repaired site of PCL by reconstruction using a semitendinosus tendon.
Joint Capsule ; Knee Joint ; Knee ; Ligaments ; Menisci, Tibial ; Posterior Cruciate Ligament ; Tendons