No abstract available.

Triple arthrodesis was performed on 167 feet in 153 patients at the Department of Orthopaedic Surgery, Seoul National University Hospital, during the 19 years from July 1957 to March 1976. Review of statistics, technical problems, and complications has led to following conclusions. 1) Of the total of 167 feet, residual poliomyelitis was the most common etiology with 127 feet (76%). 2) The youngest age was 5 years and the oldest 54 years, the 12–17 year group with 84 feet occupying half of the cases. 3) 79 feet (46.7%) had equinovarus deformity and 27 feet had equinocavovarus. 13 feet had no deformities. 4) Hoke's lazy S incision was utilized in 110 feet and Olliers incision in 57 feet. Hokes technique was employed in 118 feet and Lambrinudi's technique or its modification in 44 feet, while in the 5 feet without deformity exeresis alone was performed. Steinmann pins were used in 121 feet for temporary internal fixation and staples were used in 39 feet. 7 feet had no internal fixation. The senior author (D.Y.L.) routinely employs Hoke's incision, Hoke triple arthrodesis and Steinmann pin fixation, while when there is no deformity simple exeresis may be performed. 5) In our opinion, Hoke triple arthrodesis can correct any deformity and is particularly suitable in severely deformed rigid feet, since excision and replacement of the head of the talus affords better exposure and mobilization as well as easier set-up of the foot. 6) Whenever necessary, triple arthrodesis was combined with tendo Achilles lengthening, percutaneous plantar fasciotomy, posterior capsulotomy, medial or posteromedial release, subtalar and midtarsal wedge osteotomy, tibiotalar arthrodesis, supramalleloar osteotomy, and transmetatarsal osteotomy, followed by cast wedging or tendon transfers if indicated. 7) There was no nonunion in our cases. Clinically significant skin necrosis and wound sloughing occurred in 8 feet, gross postoperative infection in 2 feet, secondary osteoarthritis of the ankle in 2 feet, significant residual equinus deformity in 8 fret(in seven tendo Achilles lengthening was not done and in the one with tendo Achilles lengthening the deformity had been extreme and rigid), residual varus deformity in 3 feet, and residual valgus in 1 foot. These major complications occurred mostly in older children and adults, in whom deformities were severe and rigid and extensive surgery was necessary in order to achieve adequate correction. In such feet, correction is extremely difficult and greater risks of a variety of complications demand meticulous attention to technical details and postoperative care.
Adult ; Ankle ; Arthrodesis ; Child ; Clubfoot ; Congenital Abnormalities ; Equinus Deformity ; Foot ; Head ; Humans ; Necrosis ; Osteoarthritis ; Osteotomy ; Poliomyelitis ; Posterior Capsulotomy ; Postoperative Care ; Seoul ; Skin ; Talus ; Tendon Transfer ; Wounds and Injuries

Hereditary sensory neuropathy is a unusual disease which is charcterized by mutilating acropathy with cutaneous sensory loss and complete absence of sensory apparatus. We experienced a case of bereditary sensory neuropathy Type 2.
Hereditary Sensory and Autonomic Neuropathies

Based on clinical, operative and pathological finding in twenty six cases of giant cell tumor, treated by curettage and bone graft in 14 and resection and bone graft in 5 buring 19 years, from 1958 to 1976, following results were obtained. Even in this study, according to others, giant cell tumors were mostly located around the knee in 16 cases. Following up results postoperatively, the overall recurrence rate of giant cell tumor was 38 percent. Especially in curettage and bone graft, it was recurred in 43 percent. Tumor located around the knee and vertebrae showed higher rate of recurrence than those in other sites. Four of the six patients who had an episode of recurrence recurred within the second years, and the other one in the third years after curettage and bone graft. All the two cases who had experienced a second recurrence were resulted in recurrence within second years after curettage and bone graft. Three of six patients treated by curettage and bone graft as secondary treatment had no recurrence.
Curettage ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Humans ; Knee ; Recurrence ; Spine ; Transplants

Discoid semilunar cartilage is an abnormality in which the meniscus is discoid rather than semilunar, and first reported by Young of Glasgow in 1889. 13 cases of discoid semilunar cartilages which were experienced at the Department of Orthopedic Surgery, College of medicine, Seoul National University from Jan. 1956 till Aug. 1972 are reported with review of literature. 1) The incidence was remarkable higher in the male than in the female as 11 versus 2, and higher in the age group of second decade (Average 16.4 year old). 2) Most common site was lateral meniscus, and bilateral discoid meniscus were 3 cases. 3) 3 cases out of 13 cases had complicated rupture of semilunar cartilage, and one case had cyst of the meniscus. 4) Meniscectomy were performed in all cases with successful outcome.
Female ; Humans ; Incidence ; Male ; Menisci, Tibial ; Orthopedics ; Rupture ; Seoul

PURPOSE: To evaluate the diagnostic efficacy and complications of ultrasound-guided percutaneous renal biopsy using automatic biopsy gun in patients with pediatric diffuse renal disease. MATERIALS and METHODS: Using an 18G automatic biopsy gun, biopsies were performed on 97 pediatric patients with clinically suspicious diffuse renal disease. The acquired tissue specimens were analyzed by photomicroscopy, immunofluorescence, and electron microscopy to support the diagnosis. In the 97 biopsies, the success of the histologic diagnosis, number of glomeruli, and complication rates were retrospectively evaluated by analyzing the variable exams and clinical records. RESULTS: Adequate tissue for histologic diagnosis was obtained in 91 of 97 biopsies (94%) and the mean number of glomeruli was 9.6. Complications such as minute pain, gross hematuria, and small perirenal hematoma presented in 22 of the 97 biopsies (23%), all of which either improved within 5-72 hours or did not need specific treatment. CONCLUSION: Ultrasound-guided percutaneous renal biopsy using 18G automatic biopsy gun is an effective and safe method for the histologic diagnosis of pediatric diffuse renal disease without any major complication.
Biopsy* ; Diagnosis ; Fluorescent Antibody Technique ; Hematoma ; Hematuria ; Humans ; Microscopy, Electron ; Retrospective Studies

PURPOSE: Because cryptorchid testes are known to undergo histopathologic changes affecting development, maturation, and tertility, early surgical correction is usually recommended. However there are differing opinions concerning whether retractile testes are affected by similar changes and also whether there is a need for surgical treatment. We aimed to assess the histopathologic changes in retractile testis by studying the changes in testes artificially placed back in the abdomen after they have descended to scrotum in experimental rat models. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 3 groups; a control group(controls), prepubertal ascent group (P) in which testis were placed back intraabdominally by bilateral inguinal canal obstruction at 6 weeks, a neonatal group(N) in which intraabdminal testis was induced by bilateral inguinal canal obstruction at birth. The relative weight of the testis, morphology of the seminiferous tubules including Leydig cells, tubular degeneration phase(TDP), spermatogonia per tubules(S/T), and Sertoli cell index (SCI) of these three groups were analyzed and compared. RESULTS: The relative weight of testis was significantly decreased in the group of N(0.0016+/-0.001) and P(0.0015+/-0.0002) compared to controls(0.0037+/-0.0002) (p<0.05). The S/T value was also decreased in P(2.05+/-18.2) and N(73.2+/-32.4) when compared to controls (360.2+/-21.3). Similar changes were observed in SCI of both P(64.5+/-6.4) and N (91.2+/-14.2) when compared to controls (227.9+/-31.1). Only minority of N and P showed higher TDP values. However, although statistically insignificant, TDP was increased in both P and N when compared to controls. The Leydig cells in N and P showed cellular distortion and hypertrophy. CONCLUSIONS: This study demonstrate that prepubertal ascent, similar to that of innate cryptorchid testis, also can induce histopathologic changes such as changes in testicular seminiferous tubule, decrease in the S/T value and decrease in SCI value. Our findings supports that hypothesis that retractile testis may cause histological damage thus surgical correction may also be warranted similar to in case of genuine cryptorchism.
Abdomen* ; Animals ; Cryptorchidism ; Humans ; Hypertrophy ; Inguinal Canal ; Leydig Cells ; Male ; Models, Animal ; Models, Theoretical ; Parturition ; Rats* ; Rats, Sprague-Dawley ; Scrotum ; Seminiferous Tubules ; Spermatogonia ; Testis*

BACKGROUND: Endoprosthetic reconstruction is widely applied for pathological fractures of the proximal humerus; however, functional impairment is usually unsatisfactory. The aims of the current study are to evaluate the reliability of interlocking intramedullary (IM) nailing with cement augmentation as a fixation method in proximal humeral lesions and to assess functional outcomes. METHODS: We reviewed 32 patients with pathological fractures of the proximal humerus who underwent interlocking IM nailing and cement augmentation. Functional scores and pain relief were assessed as outcomes. RESULTS: The mean follow-up period was 14.2 months. The mean Musculoskeletal Tumor Society functional score and Karnofsky performance status scale score were 27.7 and 75.6, respectively. Improvement of pain assessed using the visual analogue scale was 6.2 on average. Thirty-one patients (97%) experienced no pain after surgery. The mean ranges of forward flexion and abduction were 115° and 112.6°, respectively. All patients achieved stability and had no local recurrence without failure of fixation until the last follow-up. CONCLUSIONS: Proximal interlocking IM nailing with cement augmentation appears to be a reliable treatment option for pathological or impending fractures of the proximal humerus in selected patients with metastatic tumors, even with extensive bone destruction.
Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Fractures, Spontaneous* ; Humans ; Humerus* ; Karnofsky Performance Status ; Methods ; Neoplasm Metastasis ; Recurrence

BACKGROUND: Improvements in catheter equipments and increasing experience of the operators have brought about a broadening of the indications and applications of percutaneous transluminal coronary angioplasty(PTCA). In particular, coronary angioplasty has been employed in total occlusions.We evaluated the initial success rate and safety of PTCA total occulsive coronary artery disease. METHODS: To assess the success rate and safety of PTCA total coronary artery occlusion, the data of 24 patients(male 19, female 5, mean age 55+/-9 years), in whom PTCA for total occlusion were performed, were examined. RESULTS: Primary success rate of procedure was 66.7%(16 out of 24 lesions).The success rate according to the duration of total occlusions was 8 out of 11(72.7%) with occlusions<4 weeks duration and 3 out of 7(42.9%) with occlusions>4 weeks duration(p=0.07). There was no difference in success rate according to vassel dilate(left anterior descending 75.0%, right coronary 44.4%) and length of occluded lesion(0.93%+/-0.47%cm, p=0.35). Eight procedural failures included inability to cross the lesion with a guide wire in 6 and inability to dilate the lesion in 2, but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Even though the recanalization of occluded coronary arteries has a lower initial success rate than angioplasty for stenotic arteries, PTCA in total occlusion can be performed as a safe and effective therapeutic modality in selective patients.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arteries ; Catheters ; Coronary Artery Disease ; Coronary Vessels* ; Death ; Emergencies ; Female ; Humans

BACKGROUND: Indications and applications of percutaneous transluminal coronary angioplasty(PTCA) have been broaden recent years. We evaluated the initial success rate and safety of PTCA in mulitiple lesions and vessels. METHODS: To assess the success rate and safety of PTCA In mulitiple lesions and vessels, the data of 60 lesions from 28 patients(male 23, female 5, mean age 56+/-12 years), in whom PTCA for multiple lesions and vessels were performed, were examined. Initial results and complications were compared in 37 lesions undergoing multivessel and 23 lesions undergoing multilesion PTCA. RESULTS: Overall primary success rate of procedure was 82%(49 out of 60 lesions). Angioplasty was attempted in mean 2.1 stenotic lesions per patient. Primary success rate per lesion was 84%(31 of 37) among those who underwent multivessel and 78%(18 of 23) among those who underwent multilesion PTCA(p>0.05). Success rate according to the combination of dilated vessels was 85.7%(12 of 14) in left anterior descending(LAD) and left circumflex(LCX), 83.3%(10 of 12) in LAD and right coronary artery(RCA), 100.0%(4 of 4) in LAD and diagonal branch, RCA and LCX in 75.0%(3 of 4), and 66.7%(2 of 3) in LAD, LCX and diagonal branch. Eleven failures(18.3%) included inability to pass the guide wire cross the lesion or inability to locate the balloon catheter in 5(8,3%), abrupt closure in 2(3,3%), coronary spasm in 1(1.7%) and major branch occlusion in 3(5.0%), but there was no emergency coronary bypass surgery or cardiac death. CONCLUSION: Coronary angioplasty in selected patients with multivessel and multilesion coronary artery disease might be useful and have relatively good initial results, but the long-term efficacies with other forms of treatment must be evaluated prospectively.
Angioplasty* ; Catheters ; Coronary Artery Disease ; Death ; Emergencies ; Female ; Humans ; Spasm