Fifty-seven cases of non-union examined and treated at Department of Orthopedic Surgery, Seoul National University Hospital during the period of 1968 to 1979 were observed and analysed. The results were summarized as follows: 1. Of the 57 cases,there were 43 male and 14 female patients. This result showed marked predominence of male over female patients. 2. Non-unions most commonly occured between 21 and 40 of age. 3. The causes of the fractures consisted of 22 traffic accidents, 20 fallings, 7 machinery injuries, 6 direct blows, and 2 chronic osteomyelitis. 4. Of the 57 cases, there were 20 open fractures and 37 closed fractures. 5. The sites of nonunion were lower extremities in 41 cases and upper extremities in 16 cases. The femur, 31 cases, was most commonly involved. 6. The mean duration from fracture to diagnosis of non-union was 14.8 months. 7. Prior to admission to this hospital, one received no treatment at all, 23 were treated conservatively, and the remaining 33 treated operatively. 8. Probable causes of the nonunions were unsatisfactory immobilization in 26 cases, operative complications in-24, infections in 3, interpositions of the soft tissues in 3, and separations of fragments in 1. 9. All patients received surgical operations, which were successful in 87.7%.
Accidents, Traffic ; Diagnosis ; Female ; Femur ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Lower Extremity ; Male ; Orthopedics ; Osteomyelitis ; Seoul ; Upper Extremity

The authors analyzed 28 cases with hypertensive cerebellar hemorrhage, diagnosed by computerized tomography(CT), between 1987 and 1990, in Chonbuk National University Hospital. The authors assessed the relationship of outcome to the CT appearance of the quadrigeminal cistern, which in some cases was obliterated by rostral displacement of the vermis resulting from the cerebellar mass. Obliteration of the quadrigeminal cisterns was classified on the CT scans into three grades:Normal(Grade I), Compressed(Grade II), or Absent(Grade III). There were 7 cases with Grade I, 9 with Grade II, and 12 with Grade II cisterns. Of the 28 cases, 6(85%) of those with Grade I, 7(78%) of those with Grade II, and none of those with Grade III cisterns respectively returned to their previous activities at 6 months or more after onset. A Grade I cisterns predicted a good outcome whether the hematoma was evacuated or not, as long as obstructive hydrocephalus, if present, was relieved early. However, a Grade II cistern was not predictive of a good outcome unless the hematoma was evacuated within 48 hours after onset of the hemorrhage. A Grade III cisterns predicted an unfavorable outcome. Taken together, these results strongly suggest that the CT grade of quadrigeminal cistern obliteration may be an indicator of outcome and may be useful in selecting treatment for patients with cerebellar hemorrhage.
Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Jeollabuk-do ; Tomography, X-Ray Computed

The authors analyzed 28 cases with hypertensive cerebellar hemorrhage, diagnosed by computerized tomography(CT), between 1987 and 1990, in Chonbuk National University Hospital. The authors assessed the relationship of outcome to the CT appearance of the quadrigeminal cistern, which in some cases was obliterated by rostral displacement of the vermis resulting from the cerebellar mass. Obliteration of the quadrigeminal cisterns was classified on the CT scans into three grades:Normal(Grade I), Compressed(Grade II), or Absent(Grade III). There were 7 cases with Grade I, 9 with Grade II, and 12 with Grade II cisterns. Of the 28 cases, 6(85%) of those with Grade I, 7(78%) of those with Grade II, and none of those with Grade III cisterns respectively returned to their previous activities at 6 months or more after onset. A Grade I cisterns predicted a good outcome whether the hematoma was evacuated or not, as long as obstructive hydrocephalus, if present, was relieved early. However, a Grade II cistern was not predictive of a good outcome unless the hematoma was evacuated within 48 hours after onset of the hemorrhage. A Grade III cisterns predicted an unfavorable outcome. Taken together, these results strongly suggest that the CT grade of quadrigeminal cistern obliteration may be an indicator of outcome and may be useful in selecting treatment for patients with cerebellar hemorrhage.
Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypertension ; Jeollabuk-do ; Tomography, X-Ray Computed

Pelvic inflammatory disease can induce tubo-ovarian abscess, peritonitis, perihepatitis as sequelae. It can result in an associated hydroureteronephrosis or ureteral obstruction. We experienced a case of ureteral obstruction with urinoma in a 22-year old woman who had tubo-ovarian abscess, presented with fever, chills and left flank pain. She was treated with ureteroureterostomy and urinoma excision.
Abscess* ; Chills ; Female ; Fever ; Flank Pain ; Humans ; Pelvic Inflammatory Disease ; Peritonitis ; Ureter* ; Ureteral Obstruction* ; Urinoma* ; Young Adult

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*

PURPOSE: To investigate the effects of varying the time of Mitomycin-C (MMC) subconjunctival injection before, during and after operation. METHOD: We divided rabbits into 3 groups according to injection time. Subconjunctival injections of 0.01% MMC 0.05 ml were given to the preoperative group at 6, 12 and 24 hours before operation, and to the postoperative group at 6, 12 and 24 hours after operation. The control group was given the injections during operation. Bleb formation and histologic analyses were studied for 4 weeks after operation. RESULTS For gross findings, the blebs of the preoperative and control groups were seen on the fourth day and completely formed at one week after operation, and were larger than those of the postoperative group. On the other hand, the blebs of the postoperative group were seen to have poor formation, displaying hypervascularity on the fourth day and disappearing one week after operation. For histologic findings, the proliferation of collagen fibers and the undifferentiation of fibroblasts observed in the preoperative and control groups were almost identical. But, the proliferation of collagen fibers and well-differentiated fibroblasts were seen to increase in the postoperative group, so aqueous flow was obstructed at week 3. CONCLUSIONS: Subconjunctival injections within 24 hours before or during glaucoma filtration surgery were better for bleb formation and preservation than those administerd after surgery.
Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Filtration* ; Glaucoma* ; Hand ; Mitomycin* ; Rabbits*

PURPOSE : 99mTc DMSA renal scan have been widely used not only for the evaluation of renal scars but also for the diagnosis of acute pyelonephritis. Recent studies have shown SPECT images have higher accuracy than the planar images with some controversy. We evaluated the availability of the SPECT images adding to planar images for the diagnosis of acute pyelonephritis(APN) and renal scar in children with urinary tract infection (UTI). METHODS : 130 children with UTI (260 kidney units) and 22 follow-up children (44 kidney units) were included between January 1, 1997 and July 31, 1999 at Ewha University Mokdong Hospital. Planar Anterior and posterior images and SPECT axial and coronal images of 99mTc DMSA renal scan were obtained with Starcam 4000-i U.S.A. GE at 3 hours after 99mTc DMSA I.V. injection. The data were analyzed by Chi square test after Yates's correction. RESULTS : The detection rate of the acute pyelonephritis by SPECT images was 12.3% higher than that of planar images (47.7% vs 35.4%) by the patient and 6.9% higher also (31.9% vs 25.4%) by the kidney unit. 18 kidney units with negative planar images had focal defect in 10 kidney units (3.8%) and multifocal defect in 8 kidney units (3.1%) on SPECT images, but 1 kidney unit with positive planar image had negative SPECT image. SPECT images were superior to the planar images in 17.3%, identical in 82.3% and inferior in 0.4% to planar image. The detection rate of the renal scars by SPECT images was 13.7% higher than planar images by the patient (68.2% vs 54.5%) and 6.8% higher also (43.2% vs 36.4%) by the kidney unit. SPECT images were superior to the planar images in 17.3% and identical in 82.3% to planar image. CONCLUSION : SPECT images had shown higher detection rate and better image than planar images for the diagnosis of the acute pyelonephritis and the evaluation of the renal scars.
Child* ; Cicatrix ; Diagnosis ; Follow-Up Studies ; Humans ; Kidney ; Pyelonephritis ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid* ; Tomography, Emission-Computed, Single-Photon* ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: There are several methods for the reconstruction of partial urethral defect. Split-thickness skin graft, full-thickness skin graft, prepuce flap and free flap are those. Despite partial success using these methods, most results are unsatisfactory due to frequent complications such as postoperative infection, fistula formation, hair growth and stricture. There has been several pioneering experiments in this field using autogenous vein graft, but the results of this procedures were controversial. Therefore, this study was designed to illustrate the possibility of using vein graft for the reconstruction of partial urethral defect. MATERIALS AND METHODS: Two different types of vein graft method were performed in total 20 New Zealand White rabbits with partial urethral defect. Firstly, for the patch graft group, 1x cm rectangular vein graft was sutured at defective area of the same size. Secondly, for the tubed graft group, vein graft segment of 1 cm long was replaced at segmental urethral defect of the same length. Histologic study was performed at 3 and 8 weeks postoperatively in each group. And retrograde urethrogram was checked at eight weeks postoperatively. RESULTS: On histologic study, the process of transitional cell epithelial replacement within grafted vein was uniformly observed in both experimental group at three week postoperatively. At eight weeks postoperatively, the epithelial replacement was almost complete and histologically undistinguishable. In the retrograde urethrogram performed on the day of the 8th week postoperatively, in patch graft group, contrast material was well advanced to the bladder and showed no stricture, and two of five rabbits of tubed graft group showed mild stricture with luminal patency at the graft site. CONCLUSIONS: Natural urethral epithelium was restored in grafted venous segment irrespective of type of graft. Mild stricture was observed in 40% of tubed graft group while complete reconstruction was possible in patch graft group.
Constriction, Pathologic ; Epithelium ; Fistula ; Free Tissue Flaps ; Hair ; Phenobarbital ; Rabbits* ; Skin ; Transplants* ; Urethra ; Urinary Bladder ; Veins*

PURPOSE: Laparoscopic surgery has been generalized for the treatment of localized renal cell carcinoma(RCC). Recently, laparoscopic radical nephrectomy for an RCC over the pT2 stage has gained rapid momentum as an effective surgery for treatment. We evaluated the possibility of the use of laparoscopic surgery for a large RCC, using the surgical results according to tumor size. MATERIALS AND METHODS: Between June 2003 and June 2007, a total of 46 patients that under underwent a laparoscopic radical nephrectomy for RCC were divided into three groups according to tumor size: group 1 (n=16, tumor size 7cm). The surgical outcomes and perioperative morbidities were evaluated retrospectively, and were compared for each group. RESULTS: The transfusion rate for group 3 patients was higher than for the other groups(group 1: 0%, group 2: 13.3%, group 3: 26,7%). However, the mean operative time(group 1: 154.3 minutes, group 2: 158.4 minutes, group 3: 197.9 minutes), postoperative initiative time to ambulate(group 1: 1.88 days, group 2: 2.00 days, group 3: 1.87 days) postoperative initiative time to diet(group 1: 1.38 days, group 2: 1.53 days, group 3: 1.53 days), total hospital stay(group 1: 7.94 days, group 2: 8.47 days, group 3: 8.20 days) and complication rate(group 1: 12.5%, group 2: 13.3%, group 3: 13.3%) were similar for patients in the three groups. Pathological results indicated that all cases showed a renal cell carcinoma with a negative surgical margin. CONCLUSIONS:There were no differences in the operative and postoperative results of the performance of laparoscopic radical nephrectomy according to tumor size, except for the transfusion rate. If the use of the technique and experience accumulate, laparoscopic radical nephrectomy will be feasible for all localized RCC regardless of tumor size.

Background. Ultimate goal for the treatment of the deformities in the lower extremities is to minimize the energy requirement and conserve the energy on walking and daily living. The normal energy saving mechanism is usually broken down in the patients with the deformities in the lower extremity, and they need more energy consumption. This is the reason why they feel fatigue frequently. It is well known that the deformity in the lower extremity cause excessive energy consumption. Objectives. There is no report that compared the energy consumption according to the deformities of the lower extremity. When we decide the priority of the treatment in cases of multiple deformities, it will be important to understand the energy demand according to each deformity. Therefore, it is the purpose of this study that assess the energy consumption according to the various types of lower extremity deformities. Method. We induced the multiple deformities in ten normal adults with the brace artificially. The induced deformities are as follows: Equinus deformity; mild (10degrees), moderate (20degrees), severe (30degrees), Knee flexion deformity; mild (10degrees), moderate (20degrees), severe (30degrees), Hip flexion deformity; mild (10degrees), moderate (20degrees), severe (30degrees). For the control group, same braces were applied without any deformity. Oxygen consumption was measured for the energy consumption with the Oxygen Consumption Meter (Morgan Oxylog II, Morgan Ltd. England). Heart rate was checked with the Telemonitor (Dynascope, Fukuda Ltd, Japan). We evaluated the inspired volume, oxygen rate, oxygen cost, and heart rate in each group and compared the data among the groups. Result. Energy consumption was higher in the hip deformity group, in the knee deformity group, and in the ankle deformity group in that order. Conclusion. When there are concomitant deformities in hip, knee and ankle, the priority of treatment may be hip, knee and ankle, in that order in terms of energy consumption.
Adult ; Ankle ; Braces ; Congenital Abnormalities* ; Equinus Deformity ; Fatigue ; Heart Rate ; Hip ; Humans ; Joints* ; Knee ; Lower Extremity* ; Oxygen ; Oxygen Consumption ; Walking