10 cases of tuberculosis of the greater trochanter of the femur were treated at the Department of Orthopedic Surgery, Seoul National University Hospital from Jan. 1964 to Jun. 1971 with following results; 1) Duration of onset was more than 2 years in 7 cases and tuberculous foci of other organ were noted in 4 cases. 2) Bony destruction on the greater trochanter was observed in all cases and marked synovial thickening was combined in 4 cases. 3) Radical curettage or resection of bony focus of the greater trochanter were carried out in all cases with excellent result except 1 case in which reoperation was necessary 4 years later.
Curettage ; Femur ; Orthopedics ; Reoperation ; Seoul ; Tuberculosis

A spontaneous rupture into the sigmoid colon and peritoneal cavity is a most unusual complication for a mature cystic teratoma of the ovary. A 38-year-old woman with acute lower abdominal pain, presenting as peritonitis, visited our hospital. Physical examination revealed tenderness, rebound tenderness, and vague palpable mass in the right lower quadrant of the abdomen. A pelvic computed tomographic scan demonstrated a right ovarian cystic mass with bone and fat tissue, which had ruptured into the sigmiod colon, and peritoneal fluid collection. During a laparotomy, the ovary tumor was found to be densely adherent to the rectosigmoid junctional wall; also a solid element of the ovary tumor containg hair and skin tissue seemed to be in continuity with colonic lumen, and the ovarian wall was ruptured with spillage of purulent exudate into the peritoneal cavity. En bloc resection of the tumor-bearing segment of the sigmoid colon, together with the adherent right ovary and salpinx was carrried out. The diagnosis of a mature teratoma of the ovary was made by histologic examination of a surgical specimen; the tumor had perforated the sigmoid colon wall, had protruded into the bowel lumen, and had ruptured the intraperitoneal cavity due to inflammation its wall.
Abdomen ; Abdominal Pain ; Adult ; Ascitic Fluid ; Colon ; Colon, Sigmoid* ; Diagnosis ; Exudates and Transudates ; Fallopian Tubes ; Female ; Hair ; Humans ; Inflammation ; Laparotomy ; Ovarian Cysts ; Ovary* ; Peritoneal Cavity* ; Peritoneum ; Peritonitis ; Physical Examination ; Rupture* ; Rupture, Spontaneous ; Skin ; Teratoma*

No abstract available.
Heart*

PURPOSE: To evaluate the usefulness of ultrasound-guided nerve blockade in patellar fracture surgery. MATERIALS AND METHODS: Twenty-three patients who underwent metal fixation under ultrasound-guided lower extremity blockade after diagnosis of patellar fracture from July 2011 to June 2012 were enrolled in this study. Under ultrasound guidance, femoral nerve, lateral femoral cutaneous nerve, obturator nerve, and sciatic nerve blockades were performed. For evaluation of anesthesia, interference with overall surgery, such as intraoperative knee pain and tourniquet pain, was checked. Individual anesthetic complications, satisfaction with nerve blocks, and choice of future anesthesia method were investigated. RESULTS: Nineteen patients underwent surgery without any pain and 4 patients with mild pain. Satisfaction was excellent in 17 patients, good in 5, and unsatisfactory in 1. No complications such as infection or nerve injury occurred. In terms of selection of future anesthesia, 22 patients chose a nerve blockade of the lower extremity under ultrasound guidance, and one chose general anesthesia. CONCLUSIONS: Overall, ultrasound-guided nerve block of the lower extremity for patellar fracture surgery showed satisfactory results. Therefore, it could be a useful method to prevent complications associated with general or spinal anesthesia.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal ; Diagnosis ; Femoral Nerve ; Humans ; Knee ; Lower Extremity ; Nerve Block ; Obturator Nerve ; Patella ; Sciatic Nerve ; Tourniquets ; Ultrasonography

We report a 62-year-old woman with a simultaneous occurrence of posterior reversible encephalopathy syndrome (PRES) and Guillain-Barre syndrome (GBS). The simultaneous presence of PRES in GBS is unusual and can easily escape recognition, with potentially serious consequences for the patient. Previous reports showed that the simultaneous or initial manifestation of PRES in GBS is more common in elderly female. The preponderance of female in older age may be due to age and gender related difference in sympathetic nerve activity.
Aged* ; Female ; Guillain-Barre Syndrome* ; Humans ; Middle Aged ; Posterior Leukoencephalopathy Syndrome* ; United Nations

Background: Tibiotalocalcaneal arthrodesis is an established surgical procedure for treating patients with end-stage ankle joint arthritis and subtalar joint arthritis. Although it greatly relives pain, a major drawback is loss of range of motion. Although it is known to restrict an additional subtalar joint compared to tibiotalar arthrodesis, there is a lack of gait analysis studies comparing the two methods. This study aimed to evaluate the differences in kinematics of the foot and ankle joints between tibiotalar and tibiotalocalcaneal arthrodesis. We also compared preoperative and postoperative statuses for each surgical method. Methods: The study included 12 and 9 patients who underwent tibiotalar and tibiotalocalcaneal arthrodesis, respectively, and 40 healthy participants were included in the control group. The DuPont foot model was used to analyze intersegmental foot and ankle kinematics during gait. Results: Compared to controls, both tibiotalar and tibiotalocalcaneal arthrodesis resulted in slow gait speed with reduced stride length, increased step width, and decreased range of sagittal plane motion. Both fusion methods showed similar range of motion in all segments and planes following surgery. Coronal positions showed more supination of the forefoot and pronation of the hindfoot segment after each operation, particularly tibiotalocalcaneal arthrodesis. Gait after tibiotalocalcaneal arthrodesis did not significantly differ from that after tibiotalar arthrodesis, but there was a tendency of more pronation in the hindfoot segment. Conclusions Both fusion methods limited foot and ankle motion in similar ways. Comparing tibiotalar and tibiotalocalcaneal arthrodesis suggests that additionally fusing the subtalar joint does not cause greater movement restriction in patients. Objectively comparing tibiotalar and tibiotalocalcaneal arthrodesis will facilitate further understanding of the effect of tibiotalocalcaneal arthrodesis on movement and the value of subtalar joint motion for improved preoperative counselling.

Malignant thymoma is usually manifested as a mediastinal mass. Occasiomally, these tumors may be associated with a variety of systemic syndromes, such as myasthenia gravis, pure red cell aplasia or hypogammaglobulinemia. However, it is generally accepted that thymomas rarely metastasize and the frequency of extrathoracic metastasis has been reported as 1 to 15%. In general, nuclear changes of tumor cells such as enlarged size, irregular shape and altered textures are determining feactors in the assessment of the grade of malignancy. We experienced a case of malignant thymoma of anterior mediastinum in a 35-year-old woman. After 3 years, she developed recurrent malignant thymoma in the right supraclavicular area, diagnosed by aspiration biopsy cytology.
Adult ; Agammaglobulinemia ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Female ; Humans ; Mediastinum ; Myasthenia Gravis ; Neoplasm Metastasis ; Red-Cell Aplasia, Pure ; Thymoma*

BACKGROUND: Several studies have shown that the presence of cerebrovascular lesions may play an important role for determining the severity of the clinical symptoms of dementia. But no study to date has explored the clinical effect of cerebrovascular disease in Parkinson's disease with dementia (PDD), although cerebrovascular disease is common causes of dementia in elderly population. Therefore we conducted this study to evaluate the relationship between silent cerebrovascular lesions and cognitive decline in PDD. METHODS: Only 27 patients with PDD were chosen; 17 patients had PDD with silent cerebral ischemic lesions (PDDI) and 10 patients had PDD without silent cerebral ischemic lesions (pure PDD). These subjects received the global cognitive function testing and were all evaluated with detailed neuropsychological tests including attention, memory, language, and also the visuospatial and frontal function. RESULTS: There were no significant differences between pure PDD and PDDI group on general cognitive functions tests. Regard to mean time duration of suffering from Parkinson motor symptoms and motor function scale, pure PDD group showed more long duration than PDDI group but there was no significant difference between two groups. Furthermore, there were not any significant differences between the two groups on detailed neuropsychological tests. CONCLUSIONS: We concluded that silent cerebrovascular lesions do not contribute to neuropsychological severity of PDD, although vascular disease is a common cause of cognitive impairment in the elderly. Thus the results of the present study suggest that factors other than cerebrovascular disease contribute to severity of PDD.
Aged ; Cognition ; Dementia ; Humans ; Memory ; Neuropsychological Tests ; Parkinson Disease ; Stress, Psychological ; Vascular Diseases

OBJECTIVES: Achalasia is primary esophageal motility disorder characterized by aperistalsis in body and incomplete lower esophageal sphincter(LES) relaxation. The aim of this study was to evaluate the parameters of successful balloon dilatation predicting long term outcome METHODS: 17 patients with primary esophageal achalasia from March 1995 to December 1996 were included in this study. 5 patients were performed re-balloon dilatation due to recurrence of symptoms. We used Rigiflex Achalasia Balloon with diameter of 30 and 35mm and balloon is dilated for 1 minute at a 5 minute interval. Esophageal manometry and scintigraphy before and after 1 month of balloon dilation were compared between groups with good long term results and relapsed RESULTS: 1) After balloon dilatation, LES pressure, basal esophageal pressure and retention rate were significantly decreased 2) After 6 months of dilatation, 12 patients were successfully treated and 5 patients were recurred 3) No significant pre-dilatation parameters were found to predict the recurrence 4) After 1 month of dilatation, patients with recurrence of symptoms showed significant higher LES pressure and retention rate 5) 2 patients showed recovery of the peristasis, and in these patients, amplitude of esophageal body contraction of pre- and post-balloon dilatation were significantly high CONCLUSION: After 1 month of dilatation, LES pressure and retention rate can predict the outcome after balloon dilatation and high amplitude of esophageal body contraction predict recovery of peristalsis and long term good result
Dilatation ; Esophageal Achalasia* ; Esophageal Motility Disorders ; Humans ; Manometry ; Peristalsis* ; Radionuclide Imaging ; Recurrence ; Relaxation

When a patient complains of gastrointestinal symptoms such as nausea, vomiting, and upper abdominal pain after ingestion of a substance such as a corrosive agent and certain drugs which can cause mucosal injury to the esophagus and stomach, we always keep in mind gastrointestinal injury and should perform an endoscopic procedure promptly and use the appropriate treatment. It is well known that common corrosive agents which can cause gastrointestinal injury are acidic and alkaline chemicals, and the common causative drug for gastrointestinal injury is NSAID. However, it is not well known that consuming hot food and drinks can cause gastrointestinal injury also. Up to now, there have only been a few case reports of esophageal mucosal injury due to the consumption of hot food and drinks. Gastric mucosal injury after ingesting hot food and drinks is rare and has not been reported often. So here, we report a case of gastric mucosal injury after ingesting a hot liquid diet via gastric feeding tube.
Abdominal Pain ; Diet ; Eating ; Enteral Nutrition ; Esophagus ; Hot Temperature ; Humans ; Nausea ; Stomach ; Vomiting