BACKGROUND: The blunted tip of a reusable with multiple uses can cause problems with the passing procedure in arthroscopic Bankart repair. This study assessed the advantage of Scorpion with a 70° arthroscope in arthroscopic Bankart repair compared to hook typed suture passer. METHODS: Scorpion in 19 patients, the hook type suture passer (conventional group) in 18 patients were used. All patients underwent the same procedure except for the type of suture passer used. Another different point of the procedure were telescopes and the number of portals used; three arthroscopic portals (posterior, anterorsuperiorlateral, and mid-anterior) and a 30° arthroscope in the conventional group, but two portals and a 70° arthroscope as well as the 30° one in the Scorpion group. The surgery time and the surgical complications including an iatrogenic axillary nerve injury were recorded. RESULTS: The Scorpion group showed a significant decrease in surgery time compared to the conventional group. In contrast to the conventional group, Scorpion provided an easy estimation of the exit of suture passing, no iatrogenic labral injury during the passing procedure with straight movement and the sharp tip of the knife installed. Iatrogenic supraspinatus injuries could be avoided when making an accessory anteosuperiorlateral portal due to the 70° arthroscope. CONCLUSIONS: In arthroscopic Bankart repair, the use of the Scorpion suture passer and a 70° arthroscope can reduce the surgery time, avoid unnecessary supraspinatus injury, and avoid iatrogenic axillary nerve damage through the relatively easy and precise suture passing and saving of the anterosuperior portal.
Arthroscopes* ; Arthroscopy ; Humans ; Scorpions* ; Sutures* ; Telescopes

A clinical review was done on 343 infants and children diagnosed and operated at the Department of Pediatric Surgery in Keimyung University, Dong San Medical Center for congenital gastrointestinal anomalies from January, 1988 to December, 1991. The results are summarized as follows; The most prevalent age group of congenital gastrointestinal anomaly was within first week after birth, and infants within 3months occupied 70% of total, and male to female ratio was 2:1. 2) The moat common lesion of congenital gastrointestinal anomalies was stomach with 87cases (25.4%), followed by anus with 80 cases (23.3%), colon with 63 cases (18.4%) and biliary tract with 38 cases(11.1%). 3) The most common congenital anomaly was congenital hypertophic pyloric stenosis with 87 cases (25.4%), followed by imperforate anus with 70 cases (20.4%), congenital megacolon with 63 cases (18.4%), and prevalent age was 2 week-3month, first week after birth, 1month-3year. 4) The incidence of common congenital gastrointestinal anomalies were mostly higher in male than in female but choledochal cyst was higher in female than in male. 5) Associated anomalies were observed in 14 cases (4%) of total cases, duodenal atresia was seen the highest rate of the associated anomalies and the most common associated anomaly was annular pancreas, followed by Down syndrome, congenital diaphragmatic hernia.
Anal Canal ; Anus, Imperforate ; Biliary Tract ; Child ; Choledochal Cyst ; Colon ; Down Syndrome ; Female ; Hernia, Diaphragmatic ; Hirschsprung Disease ; Humans ; Incidence ; Infant ; Male ; Pancreas ; Parturition ; Pyloric Stenosis ; Stomach

Actinomycosis is an indolent, suppurative infection caused by an anaerobic gram-positive organism (usually actinomyces israelii) which usually causes infection in the face, mediastitum, lung, and abdomen. Primary esophageal actinomycosis which is not related with pulmonary or mediastinal actinomycosis, is very rare, especially in immunocompetent host. A 58-year-old woman has been suffered from dysphagia, odynophagia, and chest pain after insertion of esophageal stent in esophageal acid stricture. She underwent a esophagectomy with esophagogastrostomy for above mentioned symptoms. Pathologic diagnosis was a esophageal actinomycosis.
Abdomen ; Actinomyces ; Actinomycosis* ; Chest Pain ; Constriction, Pathologic ; Deglutition Disorders ; Diagnosis ; Esophagectomy ; Female ; Humans ; Lung ; Middle Aged ; Stents*

No abstract available.
Humans

There is still discussion concerning the methods for treating Tossy type 3 dislocations of the acromioclavicular joint. Since 1995, the authors have treated 10 patients of type 3 dislocations by arthroscope-assisted modified Weaver and Dunn operation with favorable results. The operation consisted of diagnostic shoulder arthroscopy, arthroscopic resection of acromial end of coracoacromial ligament with bone block, excision of distal end of clavicle, bone block transfer of coracoacromial ligament into the medullary canal of clavicle, and augmentation between coracoid process and resected distal end of clavicle with the Mersilene tape. The advantages of this arthroscope-assisted modified Weaver and Dunn operation are as follows: (1) Using the shoulder arthroscope, associated patholgy in the shoulder joint can be found and treated appropriately. (2) Arthroscopic resection of the acromial end of coracoacromial ligament can give the small incision and least damage to the deltoid muscle so that immediate post-operative range of motion exercise can be possible. (3) Bone block transfer of coracoacromial ligament and augmentation between coracoid process and resected clavicular end can prevent displacement of the resected clavicular end.
Acromioclavicular Joint ; Arthroscopes* ; Arthroscopy ; Clavicle ; Deltoid Muscle ; Dislocations* ; Humans ; Ligaments ; Range of Motion, Articular ; Shoulder ; Shoulder Joint

The ideal breast reduction should create beautiful breasts with limited scars. Unfortunately, no surgeon has ever been able to produce such a result. Most recent breast reduction techniques tend to produce minimal breast scars and avoid the classic inverted-T incision. The vertical mammaplasty can be used in mild to moderate cases of breast reduction, producing consistently good, stable results with limited scars. This technique uses adjustable preoperative markings, an upper pedicle for the areola, and a central breast reduction with limited skin undermining. The shape of the breast is created by suturing of the gland and does not rely on the skin. The adjunctive use of liposuction in fatty breasts can be considered safe and efficient. We have performed reduction mammaplasty using the vertical mammaplasty technique in 12 patients. Overall number and extent of complications were small, and patient satisfaction was high for this procedures. The advantages of vertical mammaplasty technique compared with other methods are as follows ; 1. The markings are adjustable to nearly all patients. 2. Stable contours are produced because the gland is strongly sutured. 3. Few postoperative complications occur. 4. Limited scars(only vertical scars) are created 5. The procedure is easy to learn and perform.
Breast ; Cicatrix ; Female ; Humans ; Lipectomy ; Mammaplasty* ; Patient Satisfaction ; Postoperative Complications ; Skin

Since 1981 there have been many clinical and experimental reports of venous skin flap, which was nourished solely by venous blood, or by arteria1 blood flowing through the venous network. But, the mechanism of survival has not been completely understood. Unfortunately, partial flap necrosis and unstable postoperative recovery course make surgeons hesitant in choosing the venous flap. In order to increase the survival of a venous flap, surgical delay procedure or increasing the number of draining veins have been successfully tried. Historically, tissue expansion has the same effect on skin vascularity as delaying the area The increase in the caliber of the blood vessels and adequate neovascularization of the expanded tissue can increase the size and vascularity of the flap while allowing primary closure of the donor defect. In order to investigate the survival pattern of expanded arterialized venous flap, the author conducted the following study. The arterialized venous flaps were divided into control and two experimental groups. The conventional nonexpanded arterialized venous flap of 5x5 cm in size was used as control group On experimental group I, preoperative tissue expansion was performed during 3 weeks, and then arterialized venous flap with the same size was made. On experimental group II, expanded arterialized venous flap with 10x10 cm in size was made. The mean survival rate of control, experimental group I and II was 81.2%, 98.8% and 99.1%, respectively. The angiogram of expanded flap showed dilatation of the vessels and neovascularization with tortuous vessels to the peripheral area of the flap. In conclusion, the survival of expanded arterialized venous flap was superior than that of conventional arterialized venous flap. The expanded venous flaps appear to be useful in producing large flaps, in decreasing marginal necrosis of the flap as well as minimizing donor defect.
Blood Vessels ; Dilatation ; Humans ; Necrosis ; Skin ; Surgical Flaps ; Survival Rate ; Tissue Donors ; Tissue Expansion ; Veins

A clinical investigation of the patients with pustulosis palmaris et plantaris (PPP) was made on 36 patients who were seen at the Department of Dermatology, Seoul National University Hospital, from January 1986 through June 1987. The results were summarized as follows : 1. In this series of 36 patients, 14 patients(38.9%) were male and 22 patients (61.1%) were female. Females are more subject to the affection than males. 2. The mean age of onset in male was 30.6 years and in female it was 38.4 years, indicating a earlier onset in male. The peak age of incidence in male was between 20 and 29 years and in female, between 40 and 49 years. 3. The sites of involvement were mostly bilateral hands and feet. 4. the season of the year did not influence the severity of the skin lesions in 68.9%. 5. Nine patients(28.1%) had psoriasis-like skin lesions and 14 patients(43.1%) had nail changes out of 32 patients with PPP. 6. No direct relationship could be found between pustular eruptions and focal infections, such as tonsilitis, otitis, dental abscess and sinusitis. 7. Remmission of the pustular eruptions could be achieved in 5 out of 10 patients treated with etretinate and in 4 out of 11 patients treated with ketoconazole for more than 4 weeks' treatment
Abscess ; Acitretin ; Age of Onset ; Dermatology ; Etretinate ; Female ; Focal Infection ; Foot ; Hand ; Humans ; Incidence ; Ketoconazole ; Male ; Otitis ; Palatine Tonsil ; Psoriasis* ; Seasons ; Seoul ; Sinusitis ; Skin

The incidence of the tuberculous osteomyelitis of bone and joint has been decreasing due to improvements in nutrition and medical treatment. However the resurgence of tuberculosis is observed with more frequency as an opportunistic infection. In Korea the incidence of the tuberculosis has been decreasing with rapid economic development, but it is still one of the common pathological conditions involving bone and joint. Tuberculos osteomyelitis confined only to the long bones without involving joints is very rare. The accurate diagnosis of the turberculos osteomyelitis of long bone is difficult, because of the low incidence, long duration and nonspecific radiological findings. We reviewed retrospectively a total of 521 consecutive bone and joint tuberculosis from March 1985 to December 1994. Thirty-eight cases were involved only long bones without inflicting joints. The mean duration of follow up was 16 months. The disease was most frequent in the third decade. Femur(45%) and metaphysic(79%) were the most commonly involved site of the tuberculous osteomyelitis of the long bone. Significant delay in the diagnosis and the initation of the treatment would have been avoided if the biopsy had been performed early. It was looked like that longer symptom duration, higher ESR, associated with pulmonary tuberculosis and inappropriate treatment resulted in recurrence. But when compared with primarily cured cases, these factors did not affect the recurrence statistically. In conclusion, the better results and prevention of the recurrence were observed in cases with early diagnosis, complete removal of the lesion and continuous antituberculous medication.
Biopsy ; Diagnosis ; Early Diagnosis ; Economic Development ; Follow-Up Studies ; Incidence ; Joints ; Korea ; Opportunistic Infections ; Osteomyelitis ; Recurrence ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Osteoarticular ; Tuberculosis, Pulmonary

No abstract available.
Echocardiography, Transesophageal*