Fractures of the pateila Is one of the most important subjects considering the increasing number of such patients Much has been written concerning these fractures during last thirty years or more. In this series, we reviewed 78 fractures of the patella, we could follow up from January 1964 to December 1978. Most of the fractures occurred in man, and occurred In third to forth decades. Traffic accident was the most common cause. Twelve cases were open fractures and most of the fractures were comminuted or transverse type. we treated these 78 cases as followings: 1. Total excision, 8 2. Partial excision, 19 3. Open raduction and Internal flxation, 21 (of these, Circumferential wire loop flxation, 13; Magnuson wire loop fixation, 3; Tension band wiring, 5) 4. Conservative treatment, 30. Average follow-up period was 26.6 weeks and average flexion range of knee at the end of the period was 118.2. The end results of Tension band wiring was much better than those of other methods. It Is considered that the range of motion of the knee jolnt after treatment was Influenced by immobilization period. The shorter the period, the better the result.
Accidents, Traffic ; Clinical Study ; Follow-Up Studies ; Fractures, Open ; Humans ; Immobilization ; Knee ; Patella ; Range of Motion, Articular

There has been considerable controversies in the method of the treatment of dislocation of the acromioclavicular joint, especially in grade III injury. It is hard to give a direct firm repair having a short ruptured coracoclavicular ligament. Thats why there are lots of difficulties in the treatment. Therefore, in operative treatment, the authors make use of cotton tape on coracoid process and clavicle as a reconstructive technique, because we have thought a simple fixation of acromioclavicular joint adding to a firm fixation of clavicle and coracoid process is inevitable. From January 1991 to December 1995, twenty-nine cases of grade III acromio-clavicular dislocation were treated by the modified Phemister method with using the cotton tape. Twenty-four patients were followed for an average of fifteen months and the following results were obtained. 1. The clinical results were evaluated by Weitzman criteria after average fifteen months follow up. An excellent result was obtained in 19 cases (79.2%), a good result in 3 cases (12.5%) and a fair result in 2 cases (8.3%), consecutively. 2. Clinical result in patients over 60-year old were bad. 3. The comparison of the coracoclavicular interval ratio before surgery with that after surgery facilitated the evaluation of effectiveness of the coracoclavicular ligament reconstruction. 4. The operative technique is through temporary fixation using K-wires which endows horizontal stability, and it fixes clavicle and coracoid process using cotton tape which endows vertical stability.
Acromioclavicular Joint ; Clavicle ; Dislocations* ; Follow-Up Studies ; Humans ; Ligaments ; Middle Aged

The distribution of transforming growth factor-α (TGF-α) and epidermal growth factor (EGF) in developing mouse embryos of gestational age 8 to 15 days was immunohistochemically (ABC method) studied to investigate the differential expression of these growth factors. Paraffin embedded sections were immunostained with antibodies for TGF-α and EGF. Staining of TGF-α was observed in several organs derived from endoderm, mesoderm and ectoderm in 9-day-old mouse embryos, such as in the heart, optic pit, head mesenchyme, neural tube and primitive gut, and the staining became more intense in 10 to 15-day-old mouse embryos. The staining of EGF was seen in the heart and primitive gut derived from mesoderm and ectoderm respectively, in 9-day-old mouse embryos, but it was observed in other organs as well in 10 to 15-day-old embryos although the intensity was weaker. In the development of heart, immunoreactivity for TGF-α was more intense than EGF, which suggests more active involvement of TGF-α. In the lung, TGF-α staining was observed both in the bronchus and lung bud, whereas EGF staining was seen only the bronchus. In the nervous system, TGF-α was expressed more extensively and more intensively than EGF. In the developing skeletal system, TGF-α staining was stronger and the expression was observed at earlier stage compared with EGF. These results indicate that the activity of TGF-α is more potent than EGF in the development of mouse embryo in general, especially, in the development of mouse heart, nervous system, mesenchyme and skeletal system.
Animals ; Antibodies ; Bronchi ; Ectoderm ; Embryonic Structures* ; Endoderm ; Epidermal Growth Factor* ; Gastrula ; Gestational Age ; Head ; Heart ; Intercellular Signaling Peptides and Proteins ; Lung ; Mesoderm ; Mice* ; Nervous System ; Neural Tube ; Paraffin

PURPOSE: To recanalize the occlusive lesion of superficial femoral artery at origin site by retrograde approach via popliteal artery. MATERIALS AND METHODS: 15 patients, who were poor surgical candidates due to coronary artery disease and who had severe occlusive lesion of superficial femoral artery close to its origin with good distal runoffs to popliteal artery, were selected. Patients were all~men and range of age were from 53 years to 66 years (mean age:63 years). Range of lesion length were from 15cm to 30cm (mean length:22.4cm). Localization of popliteal artery was done with Doppler stethoscope or "road-map" DSA. The method of recanalization were transluminal endarterectomy catheter (TEC), TEC and angioplasty, thrombolysoangioplasty (TLA). RESULT: Retrograde puncture of popliteal artery were done in 15 patients successfully. TEC & PTA was performed in 9 patients, TEC only in 2 patients, and TLA & PTA in 2 patients. During the follow-up period of 5 months to 2 years reocclusion did not occurr in 10 patients except for 1 patient with poor cardiac output in whom it occured 1 day later. Remained 4 patients were lost in follow up. Any neurologic or vascular complication did not occur. CONCLUSION: Retrograde approach of superficial fernoral artery via popliteal artery in patients with difficult vascular intervention by common method provides a useful, alternative recanalization method.
Angioplasty ; Arteries ; Cardiac Output ; Catheters ; Coronary Artery Disease ; Endarterectomy ; Femoral Artery* ; Follow-Up Studies ; Humans ; Popliteal Artery* ; Punctures ; Stethoscopes

The association between choledochal cysts and pregnancy is unlikely to be etiological, but may rather be an aggravation or precipitation of a preexisting condition. Although choledochal cysts rarely occur in pregnancy, the aim of this study is to elucidate the condition associated with pregnancy because delayed or inappropriate therapy may be catastrophic for both mother and child. Authors reviewed 18 cases of choledochal cyst, of which 2 were aggravated during pregnancy, managed at the Department of Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, during the period from 1990 to 1995. The results were as follows: The ratio of female to male was 2.6:1 which revealed predominance in female and most frequent age group was above sixty years old(33%). In non-pregnant patients, the most common symptoms were abdominal pain(78%) and all pregnant patients had pain, jaundice, nausea and vomiting, and indigestion. Transaminase and bilirubin were elevated in all pregnant patients. In all patients, US(88%, 100%) was the most common preoperative diagnostic study and one case was diagnosed during explo-laparotomy. Pregnant patients have cholecystitis in two cases and nonpregnant patients had cholecystitis(19%), CBD stone(19%), and others. The operative procedures were performed in 9 cases and pregnant patients were operated by cyst excision and Roux-en-Y hepaticojejunostomy in one case, and also Roux-en-Y choledochocystojejunostomy in one case. According to Todani's classification, in non pregnant patients, type I was the most common(63%), in pregnant patients, two cases were type I. Postoperative complications occurred in 3 cases, wound infection(6%) and cholangitis(6%) in non pregnant patients, pleural effusion(6%) in pregnant patients. Two cases of choledochal cyst in pregnancy were 25 years old at 29.4 weeks and 36 years old at 16 weeks into pregnancy.
Adult ; Bilirubin ; Child ; Cholecystitis ; Choledochal Cyst* ; Classification ; Dyspepsia ; Female ; Heart ; Humans ; Jaundice ; Male ; Mothers ; Nausea ; Postoperative Complications ; Preexisting Condition Coverage ; Pregnancy* ; Surgical Procedures, Operative ; Vomiting ; Wounds and Injuries

A case of metastatic alveolar soft part sarcoma is presented with clincal, pathological and radiological features. Alveolar soft part sarcoma is a rare soft-tissue neoplasm that is malignant and invariably fatal. It was first described and named by Christopherson, et al. in 1952. Since 1952 numerous examples of this tumor have been reported and have been studied with the electron microscope, but there is still considerable uncertainty as to the exact histogenesis of the tumor. Most cases occur in young females involving the lower extrimities especially in the right side. The most initial presenting symptom is a slowgrowing painless mass and the principal metastatic sites are the lungs, followed by the brain and skeleton. Cerebral metastasis, in fact, may be the first manifestation of the disease. Treatment is radical surgical excision but radiotherapy and chemotherapy are less effective. We present the reported case of metastatic alveolar soft pat sarcoma with electron microscopic findings.
Brain ; Drug Therapy ; Female ; Humans ; Lung ; Neoplasm Metastasis ; Radiotherapy ; Sarcoma ; Sarcoma, Alveolar Soft Part* ; Skeleton ; Uncertainty

BACKGROUND: Burns remain a common public problem among children and often cause severe injuries, resulting in physical and mental problems for the patients. Children constitute a risk group because of their natural curiosity, their mode of reaction, their impulsiveness and lack of experience in risk assessment. PURPOSE: The objects of this study were to characterize pediatric burn injuries and to understand their clinical outcomes in Korea. METHODS: we analyzed the records of the 1401 pediatric burn patients (age 0~15 years old) out of the 4423 burn patients, who have been admitted to the Burn Center, Hangang Sacred Heart Hospital, Hallym University for 5 years (1991~1995). RESULTS: Males were more affected than females; 58.1% were males and 41.9% were females. Most thermal injuries in children occur in the age group younger than 5 years (82%); especially 66.9% of pediatric burn patients were under the age of 3. Scalding burns accounted for 72.5%, and flame burns fors 18.1%. Most pediatric burns occurred in urban areas. The most common activities related to pediatic burn injuries were food preparation and food consumption, which accounted for 57.5% of all burn injuries. In 66% of the cases, the extent of the burned surface was under 10%. In 77.8% of the cases, the depth of the burn wound was 2nd degree. In 63.9% of the cases, the duration of hospitalization was 3 weeks or less. The incidence of wound infection was 14.8%, and 50% of the infections were caused by Pseudomonas aerusinosa. The major complications were wound infection (30.9%), hypertrophic scarring (21.4%) and irritant dermatitis (20.3%). The mortality rate in a series of 1,401 pediatric patients was 2.6%. The main causes of death were sepsis, burn shock, ARDS and air way obstruction. When 51~70% of the surface area was burned the mortality was 25%, when over 70% of the surface area was burned the mortality was 81.3%. SPCCULATION: The successful way to prevent pediatric burn is to reduce the risk to children by effective intervention.
Burn Units ; Burns* ; Cause of Death ; Child ; Cicatrix, Hypertrophic ; Dermatitis, Irritant ; Exploratory Behavior ; Female ; Heart ; Hospitalization ; Humans ; Incidence ; Korea ; Male ; Mortality ; Pseudomonas ; Risk Assessment ; Sepsis ; Shock ; Wound Infection ; Wounds and Injuries

The authors experience 3 cases of angiographically occult vascular malformation(AVOM) of the brain during the last 3 months in 1990. All cases were diagnosis of either operative or pathological finding and were associated with intracerebral hemorrhage. The authors recommend that surgery should be considered even to those angiographically negative intracerebral hemorrhage cases, once clinical features are highly suggestive of AOVM. Surgery can be an effective and define therapy for these entities, which are prone to cause recurrent hemorrhage and persistent neural deficits.
Brain* ; Cerebral Hemorrhage ; Diagnosis ; Hemorrhage ; Magnetic Resonance Imaging ; Vascular Malformations*

No abstract available.
Fistula*

Intracranial metastasis of hepatocellular carcinoma have been rarely reported, even in the Orient and Africa where this carcinoma is one of the relatively common malignancies. Hepatocellular carcinomas usually spread to regional lymph nodes around the porta hepatis via lymphatics. But venous metastasis of this cacinoma can occur via intrahepatic vein. The lungs are the most common distant metastatic sites followed by stomach, bones, and adrenals. Recently, we experienced a case of intracranial metastasis of hepatocellular carcinoma associated with epidural hematoma. Although the epidural hematoma and the metastatic tumor mass were totally removed, the patient died of liver complications on the 9th day of postoperative care. The clinical and radiological details of this case are presented here with a brief review of the literature.
Africa ; Carcinoma, Hepatocellular* ; Hematoma* ; Humans ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis* ; Postoperative Care ; Stomach ; Veins