No abstract available in English.
Torticollis

No abstract available in English.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies

Dislocation of peroneal tendons are caused by forceful domifiexion of the foot accompanied by a powerful contraction of the peroneal muscles. This mechanism of injury tears the superior pemneal retinaculum and allows the tendons to snap anteriorly. It is an important, although infrequent, cause of disability of the ankle. The acute injury can be treated by immobilization in a plaster cast, but when there is chronic recurring dislocation, surgical reconstruction is necessary. Authors experienced two cases of dislocation of pemneal tendons which were treated by use of Sarmiento's and Platzgummer's(modified) operative procedures with good results.
Ankle ; Casts, Surgical ; Dislocations ; Foot ; Immobilization ; Muscles ; Surgical Procedures, Operative ; Tears ; Tendons

We have experienced 11 cases of large bony defect that were treated using microsurgery since 1981. Free vascularized bone transplantation was performed in 8 of them, vascularized bone transposition in 2 cases, and free vascularized joint transplantation in the remaining 1 case. The causes of the large bony defect were primary bone tumor (4 cases), congenital pseudoarthrosis (3 cases), open comminuted fracture (2 cases), sequela of osteomyelitis (1 case), and post-traumatic ankylosis of PIP joint of second finger (1 case). As a donor, fibula was used in 8 cases, iliac crest in 1 case, rib in 1 case and in the remaining 1 case, the second M-P joint of foot was transplanted. In 9 of 11 cases, successful result was obtained and 2 cases were failed because of vascular damage following tibial lengthening in one case and infection on the grafted area in the other one. From the above data and review of articles, following conclusions were obtained. 1. Fibula is thought to be the most appropriate donor for the large bony defect in the extremity, especially in lower extremity, but the donor site must be determined according to the anatomical and physilogical condition of the patient. 2. After mechanical lengthening of the extremity, it is recommened to perform the microvascular surgery after sufficient time for the recovery of vascular damage. But further studies are required for the identification of the change in the vascular tissue following stretching and its recovery time. 3. Progression of the ossification in the epiphysis of transplanted iliac crest was observed and this finding proposed us the idea that the epiphyseal plate injury or leg length discrepancy will be able to be treated with free vascularized epiphyseal plate transplantation and the reconstruction of the destroyed joint of growing children will be possible using free vascularized joint transplantation. 4. As the technique become more popular, the free vascularized bone transplantation is being used for the reconstruction of the extremity more frequently, but it seems to be wise to restrict its indication to cases which are impossible to be treated with more simple methods such as vascularized bone transposition or pedicled bone graft.
Ankylosis ; Bone Transplantation ; Child ; Epiphyses ; Extremities ; Fibula ; Fingers ; Foot ; Fractures, Comminuted ; Growth Plate ; Humans ; Joints ; Leg ; Lower Extremity ; Microsurgery ; Osteomyelitis ; Pseudarthrosis ; Ribs ; Tissue Donors ; Transplants

In Korea, the metallic implant had to be supplied through import channel with many problems. KAIST succeeded in making AISI 316 LVM stainless steel within the criteria of American Society for Testing and Materials. With the animal experiment at preliminary report I, the biocompatibility in the muscle was examined. For biocompatibility test of new material, test in the bone is essential. In this animal experiment using rat tibia, the biocompatibility of the Kirschner wire of KAIST was compared with that of Zimmer. The result was as follows: 1. Tissue reaction of the Kirschner wire of KAIST was minimal to moderate. 2. Corrosion was negligible, and there was no definite difference between the KAIST and Zimmer Kirschner wires. 3. Authors observed the satisfactory biocompatibility of the KAIST Kirschner wite in bone and muscle, and concluded that the Kirschner wire of KAIST can be applied to human body without serious problems.
Animal Experimentation ; Animals ; Bone Wires ; Corrosion ; Human Body ; Korea ; Rats ; Stainless Steel ; Tibia

PURPOSE: Increasing evidence suggests that Randalls plaque contributes to the pathogenesis of urinary stone formation. The purpose of our study is to compare the incidence of the abnormal metabolic stone risk factors between the calcium stone former with papillary calcification and the calcium stone former without papillary calcification on unenhanced spiral computed tomography (CT). MATERIALS AND METHODS: A series of patients with calcium stones (n=49) underwent unenhanced spiral CT and complete metabolic evaluation after they consumed a random diet for 1 month after stone removal. Of the 49 patients, 38 patients showed papillary calcification on unenhanced spiral CT and 11 patients did not. Their blood was evaluated by using a multichannel analysis sequential multichannel autoanalyzer (SMA)-20 and PTH tests. The 24-hour urinary constituents were assayed for calcium, oxalate, citrate, total volume, phosphorus and sodium. We compared the incidence of abnormal metabolic risk factors between the two groups. Statistical analysis was performed by chi-square tests. RESULTS: The incidences of hyperuricemia were 27.3% in the patients without papillary calcification and 31.6% in the patients with papillary calcification. The incidences of hypernatriuria were 18.2% versus 42.1%, the incidences of hypercalciuria were 36.4% versus 26.3%, the incidences of hyperuricosuria were 18.2% versus 18.4%, the incidences of hyperoxaluria were zero versus 28.9%, and the incidences of hypocitraturia were 45.5% versus 44.7%, respectively. The difference between the two groups was statistically significant only for hyperoxaluria (p=0.043). CONCLUSIONS: Hyperoxaluria is the only metabolic risk factor that more frequently occurred in the patients with papillary calcification. Our date suggest that hyperoxaluria may be an important factor in the pathogenesis of papillary calcification.
Calcium ; Citric Acid ; Diet ; Humans ; Hypercalciuria ; Hyperoxaluria ; Hyperuricemia ; Incidence ; Phosphorus ; Risk Factors* ; Sodium ; Tomography, Spiral Computed* ; Urinary Calculi

PURPOSE: Imaging studies for the diagnosis of breast cancer such as ultrasonography or mammography, play an essential role; however, it is well known that they have some limitations; the low specificity of ultrasonography and the low sensitivity of mammography, especially in the dense breasts of Korean women. Recently, 99mTc-MIBI scintimammography was introduced for the detection of breast cancer, and showed acceptable results in its diagnostic accuracy. In this study, the clinical usefulness of 99mTc-MIBI scintimammography was evaluated for the determination of a better imaging study for the diagnosis of breast cancer. METHODS: This study included 75 patients with breast masses, and 3 imaging studies were performed; mammography, ultrasonography and 99mTc-MIBI scintimammography and the results compared on the basis of the pathological reports from core needle or excisional biopsies of the patients. RESULTS: From the pathological reports of 75 patients, 45 cases were confirmed as malignant and 30 as benign diseases. Based on the pathological reports, the sensitivities of mammography, ultrasonography and 99mTc-MIBI scintimammiography were 62.2, 88.9, and 86.7%, and the specificites of 3 imaging studies were 90.0, 76.7, and 90.3% respectively. The positive predictive values were 90.3, 85.1, and 92.9% and the negative predictive values were 61.4, 82.1, and 81.8%, respectively. 99mTc-MIBI mammoscintigraphy showed a comparable sensitivity to ultra-sonography, and a similar specificity to mammography, in the diagnosis of breast cancer. CONCLUSION: Clinically, as a primary imaging tool, 99mTc-MIBI mammoscintigraphy showed acceptable results in the diagnosis of breast cancer. Considering the weak points of ultrasonography and mammography, 99mTc-MIBI mammoscintigraphy would be a very useful tool in the diagnosis of breast cancer.
Biopsy ; Breast Neoplasms* ; Breast* ; Diagnosis* ; Female ; Humans ; Mammography ; Needles ; Sensitivity and Specificity ; Ultrasonography

No abstract available in English.
Tuberculosis, Spinal

No abstract available in English.
Clinical Study ; Spine ; Tuberculosis ; Tuberculosis, Spinal

PURPOSE: Although has become increasingly acceptable to perform total thyroidectomy for bilateral and multiple benign nodules, diffuse toxic goiter, and thyroid cancers, surgeons continue to debate whether the potential benefits outweigh the potential complications of this procedure. The aim of this study was to evaluate the safety, effectiveness and complications of total thyroidectomy for malignant and benign thyroid diseases. METHODS: The medical records from 332 patients who had undergone total thyroidectomy for malignant and benign diseases between January 1990 and December 1999 at St. Mary's Hospital and St. Vincent's Hospital were reviewed retrospectively. RESULTS: Of the 332 patients, 121 had had benign disease and 211 had had carcinomas. Female patients were predominate, being 6.4 times the number of males. The incidence rate by age peaked in the 4th decade for patients. Masses of below 2 cm in diameter were the second most common size (30.8%) and 2 to 5 cm occupied more than half (51%). Of the 211 thyroid carcinomas, histologic types were papillary in 185 patients (87.7%), follicular in 21 (10%), anaplastic in 3 (1.5%), medullary in 1 (0.5%) and lymphoma in 1 (0.5%). Of the 121 benign disease, 71 (58.7%) were benign multiple nodular goiters, 23 (19%) toxic diffuse goiter, and there were 18 cases (14.9%) of Hashimoto thyroiditis and 9 (7.4%) of adenomatous goiter. Among the 211 patients who underwent total thyroidectomy for thyroid malignancy, anterior compartment lymph node dissection was performed in 53 patients (25.1%). Modified radical neck dissection was done in 31 cases, due to suspicions of local lymph node invasion during the operation. Radical neck dissection was done in 10 cases with palpable cervical nodes. The most common complication was early postoperative hypocalcemia 108 (32.5%), most of which was transient and sixty-three percent of which was symptomatic. It usually persisted less than 7 days, and the difference in incidence of post-operative hypocalcemia between benign disease and malignancy was not significant. The other complications were hoarseness (13%), bleeding (3%) and the recurrent laryngeal nerve injury (1.5%). CONCLUSION: Total thyroidectomy can be performed without additional risk compared with subtotal thyroidectomy for bilateral benign and malignant thyroid diseases, if done meticulously.
Female ; Goiter ; Goiter, Nodular ; Hashimoto Disease ; Hemorrhage ; Hoarseness ; Humans ; Hypocalcemia ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Lymphoma ; Male ; Medical Records ; Neck Dissection ; Recurrent Laryngeal Nerve Injuries ; Retrospective Studies ; Surgeons ; Thyroid Diseases ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy*