The veins of the lower limb are subdivided into deep veins, superficial veins, and comminucating veins. The deep veins accompany the arteries, while the superficial veins course under the superficial fascia just beneath the skin and they have great, small saphenous veins, and their tributaries. The superficial and deep veins are connected by the commincating veins, which are usually located along the intermuscular septum. There are many reports about the venous system of the lower limb in foreign countries but a few in Korea. It is considerably valuable in the vascular surgery of the lower limb and the surgical management of the varicose veins. This study deals with the Korean cadavers, the authors observed the location of the saphenofemoral junction, medial and lateral femoral circumflex veins, and deep femoral veins, and the termination modes between the superficial veins and great saphenous veins and the femoral circumflex veins to the deep femoral veins or femoral veins. The following results were: 1. Any noticeable anomalies of the femoral vein proper were not present. 2. The saphenofemoral junctions were located at 3.78±0.91cm below the inguinal ligaments, 2.22±1.18cm below the pubic tubercles, 3.99±0.99cm lateral to the pubic tubercles. 3. The termination modes of superficial veins to the great saphenous veins around the fossa ovalis were classified into 3 types, Type I: Superficial epigastric vein, superficial iliac circumflex vein, external pudendal vein emptied into the upper end of the great saphenous vein(45.1%). Type II: One or more veins among above mentioned 3 veins emptied into the lateral accessory saphenous vein (48.8%). Type III: One or more veins among above mentioned 3 veins emptied into the medial accessory saphenous vein(4.9%). One cadaver(1.2%) was not belonged to the above classification, in which above mentioned 3 veins were emptied directly into the femoral vein. 4. The termination level of deep femoral veins into the femoral veins was 8.68±1.92cm below the inguinal ligaments, 6.60±1.98cm below the pubic tubercles, 5.28±51.46cm lateral to the pubic tubercles. 5. The termination level of medial femoral circumflex veins into the femoral veins or deep femoral veins was 5.10±1.73cm below the inguinal ligaments, 3.65±1.92cm below the pubic tubercles, 4.62±1.41cm lateral to the pubic tubercles, and the termination level of the lateral femoral circumflex veins into the femoral veins or deep femoral veins was 7.00±1.48cm below the inguinal ligaments, 5. 05±1. 67 cm below the pubic tubercles, 5. 41±1.21 cm, lateral to the pubic tubercles. 6. The termination modes of femoral circumflex veins were classified into 4 types in male cadavers, Type A: Medial and lateral femoral circumflex veins emptied into the femoral vein. Type B: Medial femoral circumflex vein emptied into the femoral vein and lateral femoralcircumflex vein emptied into the deep femoral vein. Type C: Medial femoral circumflex vein emptied into the deep femoral vein and lateral femoral circumflex vein emptied into the femoral vein. Type D: Medial and lateral femoral circumflex veins emptied into the deep femoral vein. In the right sides, type A was 94.1% and type C was 5.9% while in the left sides, type A was 79.4%, type B was 5.9% and type C was 14.7%. 7. The collateral circulations were identified in 67 observations (81.7%) and venous circles were identified in 46 observations (56.1%).
Adult ; Arteries ; Cadaver ; Classification ; Collateral Circulation ; Femoral Vein ; Femur ; Humans ; Korea ; Ligaments ; Lower Extremity ; Male ; Saphenous Vein ; Skin ; Subcutaneous Tissue ; Varicose Veins ; Veins

No abstract available.
Colorectal Neoplasms* ; Humans ; Male*

PURPOSE: Objective measurements of knee of flexor and extensor strength using isokinetic equipment and function after total knee arthroplasty (TKA) were evaluated until postoperative 12 months. MATERIALS AND METHODS: The control group constituted of 15 persons who were of same age and weight without knee problems. Most of the patients (70%) were operated on both knees simultaneously. The patient group consisted of constituted with 20 patients (34 cases). Isokinetic testing (Cybex) of knee flexor and extensor strength of knee and functional evaluation by HSS score was performed preoperatively and at 3, 6, 12 months postoperatively. RESULTS: The peak torque of the knee extensor and flexor muscle in the patient group was decreased by 17-41% compared to the control group. Especially, the peak torque of extensor was more decreased than flexor muscles. At postoperative 12 months, the peak-torque values of hamstring and quadriceps were able to attain the same strength levels of the preoperative knee. According to the grade of the Hospital for Special Surgery knee rating scales by Insall, 28 cases (82 %) in the patient group could obtain good result at postoperative one year. CONCLUSIONS: Exercises to increase the strength of extensor should be emphasized in the rehabilitation programs after TKA
Arthroplasty* ; Exercise ; Humans ; Knee* ; Muscle Strength* ; Muscles ; Rehabilitation ; Torque ; Weights and Measures

Pseudo-Bartter syndrome is a rare medical disease of the kidney characterized by normal blood pressure, hypokalemic metabolic alkalosis, hyperreninemia and hyperaldosteronism with drug history of diuretics. We report US, CT and MRI findings of a patient with clinically proved pseudo-Bartter syndrome. The patient was a 37-year-old woman with a history of long term ingestion of the diuretics(furosemide) for 20 years. Renal US revealed hyperechoic renal medulla at both kidneys. The resistive index(RI), calculated from the duplex doppler waveform is 0.61. Unenhanced CT revealed faint high attenuation along the medulla. Tl-weighted MRI revealed indistinct corticomedullary differentiation.
Adult ; Alkalosis ; Blood Pressure ; Diuretics ; Eating ; Female ; Humans ; Hyperaldosteronism ; Kidney ; Magnetic Resonance Imaging

After the discovery of penicillin by Fleming, a great improvement in the treatment of osteomyelitis was obtained and the mortality rate in the acute stage was markedly decreased. But, because of abuse of the antibiotics and resulting resistant organisms to antibiotics, the incidence of acute hematogenous osteomyelitis tends to increase recently. During the period of 6 years extending from 1979 to 1984, we have treated 45 cases of acute hematogenous osteomyelitis in children and clinical analysis was made about the causes of the development of chronic osteomyelitis with particular emphasis on the time interval from onset to treatment, and on the operative methods in the surgical treatments. The following results were obtained; 1. The incidence in males was 1.5 times greater than females. 2. Age incidence showed that it was most prevalent in the age group of 6 to 15 with 66.2% of the total cases. 3. The most common sites of the involvement was femur and tibia in orders. 4. Most of cases showed pain, local tenderness, pyrexia, loss of motion, swelling, and heat of the involved limbs. 5. Among the causative organisms, staphylococcus aureus was most prevalent one. 6. Cephalosporin, methicillin, gentamicin showed the highest sensitivity while penicillin showed marked resistancy (80%). 7. Time interval from onset to treatment was persistently an important factor in the development of chronicity. 8. Bone fenestration was the best method in the surgical treatments of acute hematogenous osteomyelitis in children. 9. Early diagnosis, adequate antibiotics, and early surgical decompression and drainage (esp. bone fenestration) were considered to be the essential part of management of acute hematogenous osteomyelitis in preventing its chronicity.
Anti-Bacterial Agents ; Child ; Decompression, Surgical ; Drainage ; Early Diagnosis ; Extremities ; Female ; Femur ; Fever ; Gentamicins ; Hot Temperature ; Humans ; Incidence ; Male ; Methicillin ; Methods ; Mortality ; Osteomyelitis ; Penicillins ; Staphylococcus aureus ; Tibia

Congenital synostosis of the proximal ends of the radius and ulna is a rare malformation which often completely prevents pronation and supination of the forearm. The evidence for a genetic etiology is provided by noting its presence in a Klinefelter's syndrome and its positive familial history. Two cases of congenital radioulnar synostosis occurred in brothers have been experienced and are to be reported with review of references.
Forearm ; Humans ; Klinefelter Syndrome ; Pronation ; Radius ; Siblings ; Supination ; Synostosis ; Ulna

Various kinds of spinal instrumentation have been developed for treatment of spinal disorders which are associated with instability. Recently, newly designed devices using pedicle screw were developed with advantages of short segment fixation and firm internal fixation. This is a retrospective clinical and roentgenographic study to evaluate the effectiveness of Cotrel 1. Of the 27 cases, spinal stenosis were 11, spondylolisthesis were 8, spondylolysis were 4, burst fracture were 2, metastatic bone tumor was 1, and failed back syndrome was 1 case. 2. Result of clinical evaluation by Hanley's criteria at last follow up were excellent in 7(27%), Good in 15(58% ), fair in 4(15%). (1 case of metastatic bone tumor was excluded). 3. In the cases of spondylolisthesis, we tried to reduce the displacement in 2 cases of Meyerding Grade II, and 1 case was reduced and 1 case was not reduced. In the cases of of Meyerding Grade I, no further displacement was developed. 4. The complications were observed in 10(37%)cases. A) Generalized complications were 2 cases of hematoma, 3 cases of superficial infection of wound, and 1 case of nerve root irritation. B) Failure in instrmentation were 1 case of screw breakage, 1 case of complete loss of fixation between screw and rod, and 2 cases of partial loss of fixation. 5. To prevent above mentioned complications in fixation of the instrument, the following factors are recommended: 1) Selection of the adequate length of rod. 2) Fixation of the additional implant such as security bolt when instability between screw and rod is predictable. 3) Selection of the closed head screw in the fixation of proximally sided screw if possible. 6. Cotrel-Dubousset instrument has many advantages such as rigid internal fixation, anatomical reduction, and good maintenance and also effective in reduction and maintenance of spondylolisthesis and in wide posterior decompression of spinal stenosis, but for prevention of some complications, precise use of instrument and good application of surgical technique will be needed.
Decompression ; Follow-Up Studies ; Head ; Hematoma ; Internal Fixators ; Pedicle Screws ; Retrospective Studies ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Spondylolysis ; Wounds and Injuries

The Ilizarov technique for gradual distraction osteogenesis was developed in the 1950s. A correctly performed osteotomy is essential to the success of distraction osteogenesis and prepares for limb lengthening. Between Sept. of 1991 and 1994, thirty-four patients were treated by Ilizarov technique at St. Benedict Hosp. and Gang-Dong Hosp.. And then assigned to two separate groups : a corticotomy group (group A) and osteotomy group (group B; osteotomy with Gigli saw or osteotomy with multiple drill holes and osteotome). The regenerate segments were evaluated weekly for the first six weeks after operation. After the initial six-week evaluation period, observations of these segments were continued through a series of monthly radiographs. Distraction began on postoperative day seven in group A and on day eleven in group B; and continued at a rate of 1 mm/day and a frequency of 4 times/day. Group A displayed new bone formation earlier than group B: group A's mean was 16.5 ± 4.9 days, while B's mean was 25.3 ± 4.6 days. The first bridging callus occurred earlier in group A than it did in group B: A's mean was time of 36.7 ± 9.9 days, while B's mean was 44.0 ± 7.9 days. There was no significant difference between groups A & B in terms of first cortical formation : A's mean was 86.9 ± 24.0 days, and B's mean was 100.6 ± 25.2 days. There was no significant difference between groups A & B in terms of the bone healing index : A's mean was 41.6 ± 13.5 days and B's mean was 41.15 ± 8.10 days.
Bony Callus ; Extremities ; Humans ; Ilizarov Technique ; Methods ; Osteogenesis ; Osteogenesis, Distraction ; Osteotomy

The present study was performed to compare maternal and perinatal outcomes in triplet and twin pregnancies with the result of ART(Assisted Reproductive Technology). Each pregnancy of 18 triplet pregnancies with 18 weeks or more was matched for maternal age, EDC(estimated date of confinement), parity, history of preterm delivery, indication of ART with two sets of twin pregnancies. Triplet pregnancies had a significantly shorter gestational age at delivery than twin pregnancies(30.4 versus 34.6 weeks), and a significantly lower mean birth weight(1,514 versus 2,286g). The mean hospital stay was significantly longer in triplets(22.3 versus 10.1 days). The incidences of 5 min Apgar score less than 7, neonatal deaths were significantly more often in triplets than twins; 18(33.3%) vs 6(8.3%), 15(27.8%) vs 7(9.72%), respectively. There were significant differences in the incidence of neonatal complications such as respiratory distress syndrome; 14(25.9%) vs 7(9.72%), ventilatory support; 18(33.3%) vs 5(6.9%), neonatal seizure; 9(16.7%) vs 0, btween the two groups. However, there were no significant differences between the groups in maternal complications or neonatal morbidity such as congenital malformations or hyperbilirubinemia, intraventricular hemorrhage, or bronchopulmonary dysplasia. We suggest that counseling patient regarding the anticipated perinatal outcomes of triplet pregnancies with the result of ART should be conducted with our data.
Apgar Score ; Bronchopulmonary Dysplasia ; Counseling ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hyperbilirubinemia ; Incidence ; Infant, Newborn ; Length of Stay ; Maternal Age ; Parity ; Parturition ; Pregnancy ; Pregnancy, Triplet ; Pregnancy, Twin* ; Reproductive Techniques, Assisted* ; Seizures ; Triplets*

PURPOSE: To evaluate the radiologic characteristics of axillary lymph nodes which are found on mediolateral oblique(MLO) view of mammography and to assess their clinical significance. MATERIALS AND METHODS: We retrospectively evaluated 119 cases axillary lymph nodes on MLO view of 410 cases of mammography in 205 patients regarding the size, bilaterality, number, grade of density, presence of central lucency, calcification of lymph nodes and presence of associated parenchymal pathologic lesions in breast. RESULTS: Axillary lymph nodes on MLO view were demonstrated in 119 (29%) among 410 cases. Axillary lymph nodes(112 cases) in cases without breast parenchymal lesions or with benign breast lesions showed; unilaterality in 68 cases(61%), smaller than 1.5cm in 100 cases(89%), lower density than breast parenchyma in 99 cases(88%), presence of central lucency in 99 cases(88%) and calcification in 3 cases(2.7%). Axillary lymph nodes(7 cases)in cases with breast cancer showed small size of less than 1.5cm in 4 cases(57%), absence of central lucency in 7 cases(100%) and iso-to higher density than breast parenchyma in 7 c&ses(100%). CONCLUSION: Axillary lymph nodes noted on MLO view of mammography, more than 1.5cm in diameter, absence of central lucency and iso to higher density than breast parenchyma could be suggested as clinically significant.
Breast ; Breast Neoplasms ; Humans ; Lymph Nodes* ; Mammography ; Retrospective Studies