No abstract available.

Radiofrequcy(RF) treatment has a long history, more than hundred years, for the management of chronic intractable pain of various causes. With better understanding of pain mechanism and advancement of technology, along with previous valuable experience, a simpler and safer method of delivering RF thermo coagulation to ideal sites are now available that can be expected to provide more beneficial effects to these patients with chronic disabling pain. This type of treatment will be especially helpful in aged in whom surgery is often contraindicated or highly risky due to medical problems. Here, using up-to-dated, evidence based knowledge and personal experience, authors have tried to introduce briefly the history and basic mechanism of RF technique and various clinical situations where this type of therapy is currently known to be indicated or effective in providing substantial pain relief. In summary, the RF thermocoagulation is proven to be effective way of providing significant pain relief in many chronic refractory pain states with numerous advantages such as minimal invasive, quantitative lesioning with temperature-controlled, well-circumscription of lesions, simplicity and feasibility of procedure, and most of all safety and cost-effectiveness. When it is selected based on careful investigation on type and cause of pain it can be expected to provide relatively long duration of pain relief and also to help to recover functional disabilities from such pain. However, judicious use is warranted because some painful conditions are known to be ineffective or contraindicated from this type of therapy and because there are possible serious complications, although very few. Use of latest technique of pulsed, high-frequency, low-temperatured thermocoagulation will possibly bring hope and new insights in the management of chronic intractable pain of neuropathic in nature. Further research and experience will be required before justifying this type of therapy in appling broader and more challenging situations.
Electrocoagulation ; Hope ; Humans ; Neuralgia ; Pain, Intractable*

Recently the incidence of intertrochanteric factures of the femur has been increasing progressively due to prolongation of average life span and increased activity. Most of intertrochanteric fractures of the femur occur in elderly patients with osteoporotic bone change and general weakness. The goal of treatment is early mobilization with immediate weight bearing to prevent the complications such as deep vein thrombosis, pulmonary embolism, pneumonia or atelectasis, and pressure sore. We have tried to assess the outcome and complications of bipolar hip prostehsis for the femoral intertrochanteric fracture in elderly patients. The twenty octogenarian patients received a bipolar hip prosthesis due to femoral intertrochanteric fractures from January 1989 to December 1994 at the Department of Orthopedic Surgery of Chonbuk National University Hospital. The results were as follows: 1. The average age of patients was 83.5 years and underlying problems are hypertension, cerebral vascular accident, pulmonary problem, diabetes mellitus, and osteoarthritis. 2. By Tronzo classification, Type III was the most common (80%) type. 3. Complications were peroneal nerve palsy, intraoperative femoral shaft fracture, postoperative stem tip fracture, dislocation and shortening. 4. Postoperative ambulation was possible at 2 weeks after surgery. 5. In elderly unstable osteoporosis patient, bipolar hemiarthroplasty can be recommended for the first treatment of intertrochanteric fracture.
Aged ; Aged, 80 and over ; Classification ; Diabetes Mellitus ; Dislocations ; Early Ambulation ; Femur ; Hemiarthroplasty ; Hip ; Hip Fractures ; Hip Prosthesis ; Humans ; Hypertension ; Incidence ; Jeollabuk-do ; Orthopedics ; Osteoarthritis ; Osteoporosis ; Paralysis ; Peroneal Nerve ; Pneumonia ; Pressure Ulcer ; Pulmonary Atelectasis ; Pulmonary Embolism ; Venous Thrombosis ; Walking ; Weight-Bearing

No abstract available.
Humans* ; Korea*

We experienced a case of a primary aortoduodenal fistula, which was successfully diagnosed and repaired. This diagnosis must be considered in cases of gastrointestinal bleeding with an abdominal aortic aneurysm. If the correct diagnosis can be made promptly, surgical repair of the fistula is possible.
Aortic Aneurysm, Abdominal ; Diagnosis ; Fistula* ; Hemorrhage

No abstract available.
Facial Nerve*

In order to observe the differences in fixability and stability of the acetabular cup through the differences in cup size in relation to the size of acetabular reaming, we analyzed 75 cases of porous coated acetabular cup of Harris-Galante type which be followed up more that two years. All cases were divided into two group ; the first group (On line fit :45 cases) used with acetabular cup equal in size to the last reaming size and the second group (Press fit : 30 cases) used with acetabular cup 2mm larger than the last reaming size. For initial stability, all cases were fixed with acetabular screws. Both groups were analyzed for presence of gap, change of acetabular inclination, presence of radiolucent line, degree of displacement of vertical distance, stability and clinical results. The results were as follows; 1. The average Harris hip score was improved from 55.8 points preoperatively to 90.2 points postoperatively in the first group, from 56.9 points to 91.2 points in the second group, Clinical results are excellent in 39 cases, good in 4 cases, fair in 2 cases in the first group, and excellent in 29 cases and good in 1 case in the second group. 2. The gap between the acetabular cup and acetabulum was found initially at 17 zones in the first group but no gap at final follow up. In the second group, the gap was found at 23 zones and finally remained less that 1 mm gap was found at 3 cases in zone B1. 3. No radiologic instability of acetabular cup by Martell evaluation was noted in both 1st and 2nd group. Our data suggests that initial gap between acetabular cup and acetabulum in microporous coated acetabular cup were replaced with new bone and also, radiologic stability and good clinical results could be obtained in the second group used with acetabular cup 2 mm larger than the last reaming size.
Acetabulum ; Arthroplasty, Replacement, Hip ; Clinical Study ; Follow-Up Studies ; Hip

BACKGROUND AND OBJECTIVES: Pure pontine infarct is defined as an infarct limited to the pons without the evidence of any other brainstem infarct. This study was designed to assess the etiology, lesion topography, and clinical characteristics of pure pontine infarcts. METHODS: Sixty-six patients with pure pontine infarcts, shown on magnetic resonance imaging, were divided into three groups(Group I(n=32) : unilateral lesion reaching the ventral surface of the pons(>1.5cm in size), Group II(n=27) : single or multiple lesions, separated from the surface(<1.5cm), Group III(n=7) : bilateral extensive lesion reaching the ventral surface). Clinical characteristics including the risk factors and the symptomotology were evaluated. Conventional or magnetic resonance angiography was performed in 37 patients(Group I ; 18/32, Group II ; 14/27, Group III ; 5/7). RESULTS: Pontine lesions in Group I(number of lesions = 36) were located longitudinally in the upper (8/36, 22.2%), middle(11/36, 30.6%), and lower(17/36, 47.2%) pons. Thirty-seven patients, in whom angiography was performed, were classified etiologically in each groups. In Group I, fourteen patients had basilar artery branch disease and four had large artery disease. In Group II, all had small artery disease. In Group III, three patients had large artery disease and two had basilar artery branch disease. The most frequent risk factor in pure pontine infarct was hypertension in all three groups. CONCLUSION: The lower region of pons is the most vulnerable site of pure pontine infarct. Basilar artery branch disease was the most common cause of the pure pontine infarct(43.2%). Small artery disease occupied 37.8% and large artery disease(18.9%) was less common.
Angiography ; Arteries ; Basilar Artery ; Brain Stem ; Humans ; Hypertension ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Pons ; Risk Factors

We expierienced five cases of bilateral inferior vena cava for recent one year. We evaluated the CT findings of the cases and of dilated veins located in the left retroperitoneum (seven left gonadal, seven inferior mesenteric, and two left ascending lumber veins)in the viewpoints of the size, location and relation with the surrounding structures. Bilateral inferior vena cava (IVC) may be asymmetric and the left IYC may be smaller than other retroperitoneal veins with a round contour. The left lYC was located anterior to the spinal body and corresponded with contralateral vena cava in the anteroposterior plane. The gonadal vein was located anterior or anterolateral side of the psoas and always crossed the ureter. Most of the inferior mesenteric vein showed similar location to the opposite site of the vena cava in the anterolateral side of the psoas muscle, medial to the left ureter without crossing. The left ascending lumbar vein was similarly located to the left vena cava but dilated in a short segment. It is required to trace the vessel upward and downward and observe its continuity for correct differentiation. If it is impossible, some differential points suggested in the results of our study will be helpful for distinguishing them.
Gonads ; Mesenteric Veins ; Psoas Muscles ; Ureter ; Veins* ; Vena Cava, Inferior

Many investigators were interested in the pathogenesis and the relationship between microscopical features and clinical behavior of hydatidiform mole. Trophoblastic cells in the trophoblastic disease were intensively examined histologically, ultrastructurally, immunohistochemically, and with hormone assay method, etc. But ultrastructural study on the stroma of hydatidiform mole was scarcely reported. In this paper, hydatidiform mole was examined at light and electron microscopic levels, with emphasis on the stroma. The results were as follows: 1) Hydropic degeneration of H-mole is more severe in the center of stroma and is not related with the degree of trophoblastic proliferation. Hofbauer cell and vascular structure are extremely rarely observed in the periphery of stroma which has relatively preserved cellular components. 2) Basement membrane is sometimes separated from trophoblastic layer. Degenerated cells in the stroma contain vacuoles, autophagosomes, and lipid droplets. Collagen is abundant in the loose interstitium. Hofbauer cells have no lysosome or phagosome. Vascular lumen is patient and endothelial cells are degenerated. From the above results, H-mole may be produced due to abnormal changes of trophoblasts and stromal changes may be a secondary process, so called autolysis. Hofbauer cells are not engaged in the stromal degeneration and may be different from usual tissue macrophages.