Dislocation of the metacarpophalangeal joint of the finger is rare except thumb. We experienced a case of volar dislocation of little finger and 2 cases of dorsal dislocation of index finger. The mechanism of injury seems to be direct trauma to the dorsum of hand with the metacarpophalangeal joint acutely flexed in volar dislocation and the dorsal dislocation is forced the metacarpophalangeal joint into hyperextension. In 1957, Kaplan advocated the triple incision, that is release of the volar fibrocartilageous plate, the natatory ligament, and the superficial transverse metacarpal ligament, exposing the operation field through a palmar approach. The recommended treatment for such very rare injury is open reduction through nalmar approach in dorsal dislocation, and dorsal approach in volar dislocation; the single most important element preventing reduction is interposition of the volar plate within the joint space in dorsal dislocation and the obstacles of volar dislocation are entraped dorsal capsule and partial ruptured extensor tendon. In dorsal dislocation, we advocated only half release of volar fibrocartilage for lessor trauma of soft tissue and reduction was made easily after release of 1/2 volar fibrocartilage. We report this rare and interesting cases with review of literature.
Dislocations ; Fibrocartilage ; Fingers ; Hand ; Joints ; Ligaments ; Metacarpophalangeal Joint ; Tendons ; Thumb

2 cases of extensive open tibia fracture and 1 case of infecture of tibia were treated by Papineaus cancellous bone graft at department of orthopedic surgery, Inchon Christian Hospital from Dec. 1982 to Dec. 1984. 1. Bony stability was obtained by pin and resin method in 1 case, and the others were fixed by Hoffmanns external fixator. 2. Wound was healed spontaneously in case 1 and by skin graft in 2 cases. 3. Initial weight bearing started after evidence of radiological union about 12 weeks after bone graft with the supply of long leg brace in 2 cases and one was not supported.
Braces ; External Fixators ; Incheon ; Leg ; Methods ; Orthopedics ; Osteomyelitis ; Skin ; Tibia ; Transplants ; Weight-Bearing ; Wounds and Injuries

BACKGROUND: From 1980s the methamphetamine(phillopon) was suddenly spread to our country and it becomes a serious social problem. Although the proportion of transfusion associated hepatitis C declined after introduction of Anti-HCV assay as screening test of blood donors, the overall prevalence of hepatitis C has remained the same, primarily because of increase of the proportion of hepatitis C patients among intravenous drug abusers. So we studied about prevalence of Anti-HCV, and other viral infectious disease transmission by intravenous drug abuse. METHODS: Total 202 drug abusers who had been admitted to Taegu Medical Center in 1994-1996 were tested for the presence of Anti-HCV. Epidemiologic data and histories related to drug use were obtained, as were serum test for hepatitis B, aminotransferase, HIV. RESULTS: The overall seropositivity of anti-HCV was 79.2%. Patients In HCV positive group were significant old age(34.0 yrs) and had long duration of injection(3.0 yrs) and the number of patient who had elevated aminotransferase level were significantly more than HCV negative group(p<0.05). No significant difference in sex, prevalence of HBs Ag and Anti HBc were observated between HCV positive group and negative group. The prevalence of Anti HBc was 52.1% and HBs Ag was 4.2%, but anyone was not detected for AIDS. CONCLUSIONS: The seropositivity of Anti-HCV in intravenous drug users in Taegu, Korea was 79.2%, comparable to that in Europe and U.S.A. This finding suggest that its time to hurry up for medical and public walfare service personal to concern and education of drug abusers, and inview of preventive medical care the need of general public information and education is pressing.
Blood Donors ; Daegu ; Disease Transmission, Infectious ; Drug Users* ; Education ; Europe ; Hepatitis B ; Hepatitis C ; HIV ; Humans ; Korea ; Mass Screening ; Prevalence ; Social Problems ; Substance Abuse, Intravenous

No abstract available.
Hemosiderosis* ; Humans ; Kidney Failure, Chronic* ; Seizures*

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

BACKGROUND AND OBJECTIVES: Many studies have shown that coronary artery bypass graft (CABG) surgery prolongs the life of patients with left main coronary artery disease (LMCD). Recently, percutaneous coronary intervention (PCI) has been applied to treat LMCD, with good clinical results. However, a significant portion of patients decline any revascularization therapy, so receive medical treatment only. The aim of this study was to evaluate the long term clinical outcome in these patients with LMCD, according to the treatment strategies. SUBJECTS AND MEHTODS: The clinical outcomes of 281 consecutive patients, with significant LMCD, between January 1997 and December 2000, were evaluated. The patients were divided into three groups, according to their initial treatment strategies;1) CABG, 2) PCI and 3) medical treatment. The mean follow-up duration was 37.4+/-14.9 months. RESULTS: The 1- and 3-year survival rates in the CABG group (97.4+/-1.5% and 95.6+/-1.9%) were significantly higher than those of the medical group (89.8+/-3.9% and 76.1+/-5.9%;p=0.03). The survival rates in the PCI group (one year and 3-year survival rate, 98.1+/-1.3% and 93.8+/-2.5%) were similar to those of the CABG group (p=0.93). The incidence of 3-year MACE in the medical group (40.7%) was higher than those of the CABG (10.5%, p<0.001) and PCI groups (20.4%, p=0.007). There was no significant difference between the CABG and PCI groups (p=0.06). CONCLUSION: In patients with LMCD, a CABG remains the standard therapy for prolonging survival and lowering the incidence of MACE. PCI offers similar survival benefits in selected patients. Medical treatment is associated with a significantly higher mortality and MACE. Active revascularization therapy should be the treatment of choice for the patients with LMCD.
Angioplasty ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Disease* ; Follow-Up Studies* ; Humans ; Incidence ; Mortality ; Percutaneous Coronary Intervention ; Survival Rate ; Transplants

No abstract available.
Twins, Conjoined*

No abstract available.
Twins, Conjoined*

The occurrence of atrial fibillation during an electrophysiologic study or catheter ablation in patients with accessory pathways is a common problem and sometimes complicates the localization and ablation procedure of accessory pathways. In patients with sustained atrial fibrillation, it is often time-consuming to terminate atrial fibrillation by drugs or electrical cardioversion. We performed successful radiofrequency catheter ablation in a patient with right-sided accessory pathway during atrial fibrillation requiring repeated electrical cardioversion. The target site was determined by activation mapping and morphology of unipolar electrogram at a site of early ventricular activation.
Atrial Fibrillation* ; Catheter Ablation ; Electric Countershock ; Humans

Percutaenous transhepatic biliary drainage (PTBD) is widely used to control cholangitis, sepsis, or jaundice caused by biliary tree obstruction. The PTBD tract can be used in percutaneous biliary stone extraction in pre-or post-operative state when ERCP is failed or operation is contraindicated. We performed 16 cases of percutaneous transhepatic biliary stone removal. Locations of biliay stones are combined intrahepatic and extrahepatic in 8 cases (50%), only extrahepati in 7 cases (44%), and only intrahepatic in 1 case (6%). The number of stones was single in 6 cases and multiple in 10 cases. Over all success rate was 81% (13/16), 93% (14/15) in extrahepatic stones and 78% (7/9) in intrahepatic stones. In 5 of 6 cases, complete stone removal was impossible due to marked tortuosity of T-tube tract or peripherally located stones, complete removal of biliary stones was achieved via a new PTBD tract. No significant pre-or post-procedure complication was occured. Percutaneous removal of biliary stones via PTBD tract is an effective and safe alternative method in difficult cases in the menagement of biliary tract stones.
Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Drainage ; Jaundice ; Methods ; Sepsis