We have made a statistical survey on 2441 amputated limbs of 2150 patients who were treated at the Depart- ment of Orthopedic Surgery and who were prescribed the prosthetics at the Prosthetic Center of Veterans Hospital from Mar. 1972 to Feb. 1982. 1. The peak incidence was in the age group from 21 to 30 years with 1546 cases (63.3%). Of 2150 patients only 9 patients were female. 2. The main causes of amputation were trauma with 1901 cases (77.9%), vascular insufficiency with 326 cases (13.4%) and chronic osteomyelitis with 157 cases (6.4%). And the most fre#quent cause of traumatic amputation was explosive injury with 1080 cases (56.8%). 3. Of the 2441 amputated limbs, 1756 cases (71.91°) were at the lower extremity and the most frequent site was below the knee with 1000 cases (57%). 4. Minor limb amputation was performed on 326 cases (13.4%). 5. Multiple limb amputation was performed on 255 patients (11.9%) and of these 12 patients were amputated on 4 extremities. 6. Reoperation was performed on 420 cases (17.2%). It was most prevalent in the lower extremity with 365 cases (86.9%) and their main cause was neuroma with 171 cases (40.7%). The most frequent site was below the knee with 240 cases (57.2%).
Amputation ; Amputation, Traumatic ; Amputees ; Extremities ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Knee ; Lower Extremity ; Neuroma ; Orthopedics ; Osteomyelitis ; Reoperation

Twenty nine cases of segmental tibial fracture were treated at Ewha Womans University Hopital, Department of Orthopedic Surgery, during the period from January, 1970 to December, 1984. The following results were obtained. 1. Most common fracture level was type I, high middle segment, occurred about 12 cases (41.4%). 2. In view of the higher incidence of open fracture (16 cases, 55.1%) and comminuted fracture (22 cases, 75.9%), fracture was caused by high velocity. 3. Various external and internal fixation methods were applied, but higher union rate was seen in the cases of Küntscher nailing and plating with bone graft. 4. Excluding the cases of type V, average union rate was 28.5 weeks and open fracture (ave. 29.6 weeks) required more longer union rate than closed fracture (ave. 26 weeks). 5. Higher rate of complication (21 cases, 72.4%) was noted than other types of tibial fracture. 6. Good result was obtained for treatment of 5 cases of delayed union or non-union by plating and bone graft than any other methods.
Clinical Study ; Female ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Humans ; Incidence ; Orthopedics ; Tibia ; Tibial Fractures ; Transplants

The method of ankle arthrodesis is variable but compression arthrodesis has been widely used because of better results than non-compression arthrodesis. Twenty-one cases of ankle arthrodesis were carried out at department of orthopaedic surgery of Korea Veterans Hospital from January 1980 to June 1986, and were analysed clinically. The results obtained were as follows; l. Among 11 cases of compression arthrodesis, Charnleys method was done in 8 cases and Monofixateur in 3 cases. 2. Among 10 cases of non-compression arthrodesis, Chuinard-Peterson method was done in 7 cases and anterior 'sliding graft in 3 cases. 3. The average duration of immobilization after ankle arthrodesis was 11.7 weeks, and average 4.2 weeks were less needed in the compression arthrodesis than non-compression arthrodesis. 4. The postoperative complications were developed in 8 cases (38%): wound infection in 4 cases,skin necrosis in 3 cases and incisional neuroma in 1 case. 5. Bony union was obtained in 20 cases(95.2%) out of 21 cases at average 15.7 weeks, and in the non-compression arthrodesis and in the cnmpression arthrodesis, respectively, 90% at 17.7 weeks and 100% at 13.9 weeks.
Ankle Joint ; Ankle ; Arthrodesis ; Hospitals, Veterans ; Immobilization ; Korea ; Methods ; Necrosis ; Neuroma ; Postoperative Complications ; Transplants ; Wound Infection

Background: Endoscopic forehead lift effectively corrects brow ptosis, and is less invasive and has fewer complications than classic forehead lift. Therefore, endoscopic procedures are often used instead of making a coronal incision. However, very few studies have investigated changes in the height of the hairline and documented exact values regarding the extent of forehead elongation after these procedures. Therefore, we conducted this study to determine the degree to which the height of the forehead changes after endoscopic forehead lift. Methods: Patients’ medical records were retrospectively analyzed and measurements of clinical photography were made to investigate changes in the height of the forehead after the procedure. Subjects were divided into an experimental group (n=33) and an age-matched control group (n=33) for analysis; the experimental group comprised those who underwent endoscopic forehead lift from January 2015 to March 2018, and the control group comprised those who underwent upper blepharoplasty without forehead rejuvenation from July 2009 to September 2017. Results: The changes between the preoperative and postoperative height of the forehead in the experimental group were not statistically significant (right, P=0.163; left, P=0.256; midline, P=0.545). However, the changes in the height of the forehead in the control group were statistically significant on the right side (P=0.026) and left side (P=0.028), but not at the midline (P=0.244). Conclusions We investigated the extent of forehead elongation that occurred in cases of endoscopic forehead lift and verified that significant forehead height changes did not occur after endoscopic forehead lift.

Airway perforation is a rare but potentially fatal complication following laser surgery. A 66 years old man was admitted for surgery of tracheal stenosis. He had undergone 2 prior anesthesia for similar surgery and had diabetes mellitus due to chronic steroid therapy. 2 hours after surgery, tracheal perforation lead to pneumomediastinum, tension pneumothorax and perforation of innominate artery with potential risk to injury, which lies in the close proximity to perforation site of trachea. Arterial wall was so weak and fragile that it was difficult to repair the ruptured site. During the procedure, hemorrhage persisted and cardiac arrest developed. Immediate CPR(cardiopulmonary resuscitation) with internal cardiac massage was done but the patient did not recover. We believe that in patient with history of multiple operations, chronic steroid therapy and diabetes mellitus, the vascular structure of thin and fragile should be approached with greater caution when using CO2 laser during surgery.
Aged ; Anesthesia ; Brachiocephalic Trunk ; Diabetes Mellitus ; Granulation Tissue* ; Heart Arrest ; Heart Massage ; Hemorrhage ; Humans ; Laser Therapy ; Lasers, Gas* ; Mediastinal Emphysema ; Metabolism ; Pneumothorax ; Trachea ; Tracheal Stenosis

This paper reports our experiences in laparoscopically assisted surgical staging (LASS) to manage the patients with early-stage endometrial cancer. From March 1996 to March 1999, we performed LASS in 6 patients with clincal stage I adenocarcinoma of the endometrium. We performed laparoscopic-assisted vaginal hysterectomy (LAVH) with bilateral salpingo-oophorectomy (BSO) and intraoperative frozen-section (IFS) diagnosis. The depth of myometrial invasion, tumor differentiation, histologic types, cervical invasion, and adnexal involvement were determined by IFS diagnosis. Laparoscopic pelvic and/or para-aortic lymphadenectomies were performed based on the grade of the tumor and depth of myometrial invasion. One patient was discovered to have tumor metastases in pelvic peritoneum and uterosacral ligaments, and underwent only para-aortic lymphadenectomy for determining field of radiation therapy. 2 out of 5 patients only underwent LAVH with BSO and peroitoneal washing cytology. Three other patients underwent LAVH with BSO, peritoneal washing cytology and pelvic lymphadenectomy because they were identified by IFS diagnosis as intermediate risk group for nodal metastasis. The mean age of the patients was 46.4 years. Total length of the operation time ranged from 100 minutes to 305 minutes and the mean was 187.5 minutes. The mean hemoglobin decrement after the surgery was 0.9 gm/dl. No one recieved blood transfusion. The average number of pelvic and para-aortic lymph nodes removed were 16.7 and 18, respectively. After the surgery, the patients passed gas after an average of 2.0 days and urinated urine after an average of 3.8 days. No one had complication after LASS. Based on our experiences, LASS might be an alternative to the traditional surgical approach in patients with early-stage endometrial carcinoma.
Adenocarcinoma ; Blood Transfusion ; Diagnosis ; Endometrial Neoplasms* ; Endometrium ; Female ; Humans ; Hysterectomy, Vaginal ; Ligaments ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Peritoneum

We experienced a complication of brachial plexus palsy secondary to operative position during thoracoscopic thoracic sympathectomies. His general health was excellent and no previous histories vulnerable to peripheral nerve systems were observed. The thoracic sympathectomies were done under general anesthesia. The patient was placed left lateral position with his right arm abduced 150o on padded arm board. An operation was lasted 2 hours and 30 minutes at this position because of severe right apical lung adhesion. The controlateral side was performed same procedure and lasted 20 minutes. After the patient recovered from the anesthesia, the patient had a complete paralysis of right arm. There was also slightly diminished sensation to pinprick on the arm and hand. Neurologic examination and EMG study revealed brachial plexus palsy. Nerve blocks and physiotherapy were performed to treat brachial plexus injuries. His motor functions were improved day by day and he was discharged with a complete range of motion against gravity on 14th. postoperation day. However, there were loss of muscle powers against some resistances and tingling sensations of fingertips. Two months later, he was recovered completely and there was no residual disabilities.
Anesthesia ; Anesthesia, General ; Arm ; Brachial Plexus* ; Gravitation ; Hand ; Humans ; Lung ; Nerve Block ; Neurologic Examination ; Paralysis* ; Peripheral Nerves ; Range of Motion, Articular ; Sensation ; Sympathectomy*

No abstract available.

OBJECTIVES: We propose here a classification system for external auditory canal cholesteatoma (EACC). We classified the EACC by the computed tomography findings and clinical findings of the patients, and we evaluated the EACC characteristics by the proposed staging system. METHODS: Stage classification was done according to the results of temporal bone computed tomography and the clinical findings of the patients. Stage I indicates that the EACC lesion is limited to the external auditory canal. Stage II indicates that the EACC lesion invades the tympanic membrane and middle ear. Stage III indicates that the EACC lesion creates a defect of the external auditory canal and it involves the air cells in the mastoid bone. Stage IV indicates that the EACC lesion is beyond the temporal bone. Between 1996 and 2006, 29 patients with EACC and who underwent surgery were prospectively collected. This study was comprised of 16 males and 13 females with a mean age of 22.8+/-15.0 yr. We reviewed the characteristics and results of surgery by our proposed staging system. RESULTS: A total of 29 patients who underwent operation due to EACC were classified by this system, and the number of stage I, II, III, and IV cases was 14, 3, 10, and 2, respectively. Symptoms such as otorrhea, hearing impairment and otalgia occurred in 12, 17, and 17 cases, respectively. The most common wall invaded by EACC was the inferior wall. The number of cases that had a spontaneous, congenital, post-traumatic, post-inflammatory or tumorous origin was 14, 9, 2, 2, and 1, respectively. Cholesteatoma recurred in 2 patients after surgery. Both cases were stage 1 and both were caused by congenital disease. There were 3 cases with meatal stenosis after surgery, and their primary disease was congenital. CONCLUSION: This proposed staging is simple and easily applicable for use when deciding the treatment plan for patients with EACC.
Cholesteatoma ; Constriction, Pathologic ; Ear Canal ; Ear, Middle ; Earache ; Female ; Hearing Loss ; Humans ; Male ; Mastoid ; Prospective Studies ; Temporal Bone ; Tympanic Membrane

Rabbit eyes were irradiated with neodymium-yttrium-aluminum-garnet(Nd-YAG) laser and the changes of prostaglandin E and protein levels in aqueous humor were measured. Intraocular pressure and pupil diameter were also determined in the same rabbits. Prostaglandin E and protein in aqueous humor were increase depending upon the number of laser lesion. Increase of intraocular pressure and decrease of pupil diameter occurred at similar dose range of laser irradiation. Tesponse of iris to the photodisruption was rapid. Changes in prostaglandin and protein contents and pupil diameter were already prominent at 15 min after the laser irradiation. Indomethacin pretreatment abolished most of tese responses, suggesting that acute reactions following photodisruption were largely dependent on prostaglandin synthesis in iris tissure.
Aqueous Humor* ; Indomethacin* ; Intraocular Pressure ; Iris* ; Lasers, Solid-State* ; Pupil ; Rabbits