Authors reviewed and clinically analysed 34 cases of trasometatarsal joint injury treated at the Orthopedic department of Pusan National University Hospital during the period from January 1975 to December 1979, and following results were obtained. 1. The incidence was higher in male and the active age group of 20-40. 2. Among the causes, traffic accidents were 22 cases (64.7%) and crushing injuries in the industrial field were 6 cases (17.6%). 3. Fracure-dislocations were higher than simple dislocation. 4. According to the Wilsons Classifications, the injuries were classified as follows. First stage of supination (51), 11 cases (32.4%): First stage of pronation (P1), 8 cases (23.5%): Plantar-flexion alone (PF), 4 cases (11.8%): Second stage of supination (S2), 3 cases (8.8%): Second stage of pronation (P2), 2 casese (5.9%): And finally direct crushing injuries,were 6 cases (17.6%): 5. Associated injuries were fracture of the metatarsal bone in 15 cases (44.1%), fractures of the tarsal bone in 7 cases (20.6%) and severe soft tissue injuries in 6 cases (17.6%), 6. The operative treatments with early anatomical reduction were obtained better results than conservative treatment. 7. As complications, pain in 31 cases (91.2%), bony deformity in 26 cases (76.5%), motion limitation in 32 cases (94.1%), skin necrosis in 3 cases (8.8%) and traumatic arthritis in 23 cases (67.6%) were observed.
Accidents, Traffic ; Arthritis ; Busan ; Classification ; Clinical Study ; Congenital Abnormalities ; Dislocations ; Humans ; Incidence ; Joints ; Male ; Metatarsal Bones ; Necrosis ; Orthopedics ; Pronation ; Skin ; Soft Tissue Injuries ; Supination ; Tarsal Bones

PURPOSE: To analyze factors related to prognoses of adult osteochondritis dissecans. MATERIALS AND METHODS: 19 cases of osteochondritis dissecans(16 patients) were studied for 9 years(19901998) and mean follow-up was 3 years 5 months(2 years-5 years 6 months). To evaluate factors possibly related to prognoses, age at the onset of symptom and location, size, and degrees of progres-sion of the lesion were compared with final results. RESULTS: Clinical symptoms were improved in all cases, and evaluation with the Huston rating scale for osteochondritis dissecans revealed 2 excellent result, 9 good, 6 fair, 1 poor, and 1 failure. The results for the patients who initially developed symptoms before epiphyseal closure were better than for the patients who developed symptoms after epiphyseal closure, Lesions of non-weight-bearing area showed better results than lesions of weight bearing area. There were no relations between final results and lesions size. The lower stage of pathologic deterioration of the lesion had the better results. CONCLUSION: After arthroscopic treatment for osteochondritis dissecans, clinical results were improved in all cases, but radiologic results showed various results from complete healing to joint space narrowing. Radiologic finding determined final results. Age at the onset of symptoms and location and degrees of progression of the lesion have direct relationship with final results, but because this study for prognosis factor is short term result, long term follow up will be needed.
Adult* ; Fibrinogen ; Follow-Up Studies ; Humans ; Joints ; Knee* ; Osteochondritis Dissecans* ; Osteochondritis* ; Prognosis ; Weight-Bearing

STUDY DESIGN: Analysis was based on radiographic appearance of 57 cases of congenital scoliosis and associated anomaly PURPOSE: The aim of the present study was to assess the incidence, morphology and the associated anomalies of the congenital spinal scoliosis. SUMMARY OF LITERATURE REVIEW: Hemivertebra is the most common type of congenital scoliosis and urogenital, musculoskeletal and cardiac anomalies are strongly associated. MATERIALS AND METHODS: The authors analysed the morphology and the associated anomalies of 57 cases of congenital scoliosis from 1994 to 2000. RESULTS: It was more common in male(32 males and 25 females). The bony anomalies were classified as failure of formation(40cases, 70.2%), failure of segmentation(11cases, 19.3%) and mixed type(6cases, 10.5%). Of the failure of formation, there were 36 cases(63.2%) of hemivertebra, 2 cases of posterior quadrant vertebra and 2 cases of wedge vertebra. We found associated anomalies in 26 patients(45.6%). Associated cardiac anomalies were 2 dextrocardia, ventricular septal defect, atrial septal defect and patent ductus arteriosus. Associated musculoskeletal anomalies were 5 rib fusion, 2 developmental dysplastic hip, 3 Klippel-Feil syndrome, Achondroplasia, Arnold-Chiari malformation, spinal dysraphism with sacral hair patch, cleft palate with congenital anklyloglossia. Associated neurogenic anomalies were 2 cases of syringomyelia and 3 mental retardation. There were unilateral renal agenesis and undescended testicle in urogenital anomalies. CONCLUSIONS: Common type of the congenital scoliosis was hemivertebra(63.2%) caused by the failure of formation(70.2%). Associated anomalies were found in 26 patients(45.6%).
Achondroplasia ; Arnold-Chiari Malformation ; Cleft Palate ; Dextrocardia ; Ductus Arteriosus, Patent ; Hair ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Hip ; Humans ; Incidence ; Intellectual Disability ; Klippel-Feil Syndrome ; Male ; Ribs ; Scoliosis* ; Spinal Dysraphism ; Spine ; Syringomyelia ; Testis

OBJECTIVE: The aim of this study was to evaluate the positive rate of squamous cell carcinoma antigen (SCC), carcinoembryonic antigen (CEA), and CA-125 according to clinical stage and histology. We also determine the rate of normalization of SCC after surgical and radiation therapy. RESULTS: In 222 patients with cervical cancer, the pre-treatment positive rate of SCC, CEA, and CA- 125 were 38.7%, 24.3%, and 19.8%, respectively. The positive rate of SCC by clinical stage were 12.9% for stage I, 60.5% for stage II, 88.2% for stage III, and 87.5% for stage IV. The positive rate of CEA by stage were 7.8% for stage I, 36.4% for stage II, 83.3% for stage III, and 75% for stage IV. The positive rate of CA-125 by stage were 5.9% for stage I, 23.3% for stage II, 83.3% for stage III, and 75% for stage IV. The positive rates of SCC, CEA, and CA-125 were significantly increased by clinical stage. According to histology, the positive rate of SCC (39.8%) was more significantly higher than the positive rates of other tumor makers in squamous cell carcinoma of the uterine cervix. The positive rate of CA-125 was higher than the positive rate of other tumor markers in adenocarcinoma and adenosquamous carcinoma of the uterine cervix, but it was not statistically significant difference. CONCLUSION: SCC have been shown to be higher positive rate than any other tumor markers in patients with cervical cancer. The positive rates of SCC, CEA, and CA-125 were significantly increased by clinical stage. Concomitant measurement of SCC, CEA, and CA-125 may be more useful than measurement of SCC alone, and further study was needed.
Adenocarcinoma ; Carcinoembryonic Antigen ; Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Biomarkers, Tumor* ; Uterine Cervical Neoplasms*

PURPOSE: The objective of our study was to compare preoperative "Monitor Templating" with postoperative results for total hip replacement and to investigate the accuracy of "Monitor Templating" that was carried out by monitoring with picture archiving communication system (PACS). MATERIALS AND METHODS: Forty five patients underwent primary cementless total hip replacements. For setting parameters, we located the 10cm rod placed in the medial thigh on anteroposterior view of both hips and in the anterior thigh on Lowenstein lateral view. We measured implant sizes and the predictive value of corrective change in leg length and horizontal offset, by using radiographs magnified 120% of the anteroposterior views of both hips and Lowenstein lateral view of PACS on 27 inch monitor. We examined the correlation between preoperative monitor templating and the actual implant size, postoperative leg length and horizontal offset difference. RESULTS: The preoperative monitor templating showed a high rate of coincidence with the actual implant size, the postoperative leg length, and the horizontal offset difference. The averages in accurate prediction were 98% in the acetabular cup, 98% in the femoral stem, 97% in the postoperative actual difference of leg length, and 97% in the horizontal offset. With regard to leg length discrepancy, the sick limb was on average 4.7 mm shorter and 0.5 mm longer postoperatively than the contralateral limb. The average ratio of horizontal offset of the sick limb to the contralateral limb was 94.6% preoperatively and increased to 97.8% postoperatively. CONCLUSION: Preoperative "Monitor Templating" using PACS images on 26 inch monitor is an easy and effective method for predicting implant size, correcting leg length discrepancy and restoring horizontal offset.
Arthroplasty, Replacement, Hip ; Extremities ; Hip ; Humans ; Leg ; Organothiophosphorus Compounds ; Thigh

Objective: Extramammary Paget’s disease (EMPD) of the vulva is a rare disease which predominantly presents in postmenopausal Caucasian women. As yet, no studies on Asian female patients with EMPD have been performed. This study aimed to identify the clinical features of patients with vulvar EMPD in Korea, and to evaluate the risk factors of recurrence and postoperative complications in surgically treated EMPD. Methods: We retrospectively reviewed 47 patients with vulvar EMPD who underwent wide local excision or radical vulvectomy. The clinical data and surgical and oncological outcomes following surgery were extracted from medical records and analyzed. Univariate and multivariate analyses for predicting recurrence and postoperative complications were performed. Results: 21.3% of patients had complications after surgery, and wound dehiscence was the most common. 14.9% of patients experienced recurrence, and the median interval to recurrence from initial treatment was 69 (range 33–169) months. Vulvar lesions larger than 40 mm was the independent risk factor of postoperative complications (odds ratio [OR]=7.259; 95% confidence interval [CI]=1.545–34.100; p=0.012). Surgical margin status was not associated with recurrence in surgically treated vulvar EMPD patients (OR=0.83; 95% CI=0.16–4.19; p=1.000). Conclusion Positive surgical margin is a frequent finding in the patients with vulvar EMPD, but disease recurrence is not related with surgical margin status. Since EMPD is a slow growing tumor, a surveillance period longer than 5 years is required.

BACKGROUND/AIMS: Pegylated interferon (peginterferon) and ribavirin combination therapy is less effective and associated with a higher frequency of serious complications in chronic hepatitis C patients with cirrhosis than in noncirrhotic patients. This study evaluated the efficacy and tolerability of peginterferon and ribavirin treatment in patients with hepatitis C virus (HCV)-related cirrhosis. METHODS: Eighty-six patients with clinically diagnosed liver cirrhosis were treated with either peginterferon alpha-2a (n=51) or peginterferon alpha-2b (n=35) plus ribavirin. The sustained virologic response (SVR) and adverse effects were analyzed retrospectively. RESULTS: Of the 86 patients (55 males), 48 patients (55.8%) had HCV genotype 1 infection and 38 (44.2%) had genotype non-1 infection. The overall SVR rate was 34.9% (30/86), and the rates of SVR in the genotype 1 and non-1 patients were 20.8% (10/48) and 52.6% (20/38), respectively. The multivariate analysis revealed that having HCV genotype 1 (P=0.003) and high baseline viral load (>8.0x10(5) IU/mL, P=0.012) were the independent predictive factors for SVR failure. In 20.9% (18/86) of the patients, treatment was not completed due to adverse events (27.8%), loss to follow-up (50.0%), and other reasons (22.2%). CONCLUSIONS: Peginterferon and ribavirin combination therapy was relatively effective and feasible for clinically diagnosed HCV patients, especially in those with genotype non-1 infection and low baseline viral load.
Adult ; Aged ; Antiviral Agents/*therapeutic use ; Drug Therapy, Combination ; Female ; Genotype ; Hepacivirus/*genetics ; Hepatitis C, Chronic/complications/*drug therapy/virology ; Humans ; Interferon-alpha/*therapeutic use ; Liver Cirrhosis/*diagnosis/etiology/virology ; Male ; Middle Aged ; Polyethylene Glycols/*therapeutic use ; RNA, Viral/blood ; Recombinant Proteins/therapeutic use ; Retrospective Studies ; Ribavirin/*therapeutic use ; Viral Load

BACKGROUND: Defects of the cheek present a reconstructive challenge because of the visibility of the site, as well as the limited local tissue supply. In addition, the cheek abuts several structures with expressive function, such as the eye, mouth, and surrounding facial musculature. This report describes a system of classifying cheek defects according to tumor size and location and present corresponding reconstruction techniques used to accomplish three-dimensional restoration of all missing components and adequate texture matching. METHODS: From 2008 to 2013, 27 patients with cheek defects resulting from skin cancer excision were treated. According to the size of the defect, location on the cheek, and relationships to adjacent structures and existing skin tension lines, different surgical methods were applied. RESULTS: The procedures used for cheek reconstruction included direct closure, Limberg flap, V-Y advancement flap, slide-swing flap, cheek rotation flap, and full-thickness skin graft. All flaps healed well without major complications, and no cancer recurrence was detected during follow-up. CONCLUSIONS: The anatomic classification of skin cancers and surgical protocols described in this report is simple and appropriate for reconstruction involving the cheek. Wide excision of skin cancer and appropriate, relatively easy-to-perform flaps based on this classification system can successfully produce safe and aesthetically-pleasing surgical outcomes.
Cheek* ; Classification ; Esthetics ; Follow-Up Studies ; Humans ; Mouth ; Reconstructive Surgical Procedures ; Recurrence ; Skin Neoplasms* ; Skin* ; Surgical Flaps ; Transplants

OBJECTIVE: The objective of this study was to estimate the reproductive outcome of young women with early-stage cervical cancer who underwent fertility-sparing laparoscopic radical trachelectomy (LRT). METHODS: We performed a retrospective review of the medical records of patients with early-stage cervical cancer who underwent LRT. Clinicopathological data were obtained from patient medical records, and reproductive outcome data were obtained from patient medical records and telephone interviews. RESULTS: Fifty-five patients who underwent successful LRT were included in this study. The median age of patients was 32 years (range, 22 to 40 years), and the median follow-up time after LRT was 37 months (range, 3 to 105 months). Menstruation resumed in all patients after LRT, with fifty patients (90.9%) and five patients (9.1%) reporting regular and irregular menstruation, respectively. Six patients (10.9%) presented with cervical stenosis, which was manifested by regular but decreased menstrual flow and newly-developed dysmenorrhea. These patients underwent cervical cannulation and dilatation. Eighteen patients (32.7%) attempted to conceive, with six out of 18 patients receiving fertility treatments. Fourteen pregnancies (i.e., four missed abortions, six preterm births and four full-term births) occurred in 10 patients after LRT. Nine out of 10 patients gave birth to 10 healthy babies. The pregnancy rate after LRT was 55.6% (10/18). The spontaneous abortion rate and live birth rate were 28.6% (4/14) and 71.4% (10/14), respectively. The preterm birth rate was 60% (6/10). CONCLUSION: Pregnancy and live birth rates after LRT were promising; however, the preterm birth rate was relatively high. Cervical stenosis also occurred in a small percentage of patients.
Abortion, Missed ; Abortion, Spontaneous ; Catheterization ; Constriction, Pathologic ; Dilatation ; Dysmenorrhea ; Female ; Fertility ; Follow-Up Studies ; Humans ; Interviews as Topic ; Live Birth ; Medical Records ; Menstruation ; Parturition ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Premature Birth ; Retrospective Studies ; Uterine Cervical Neoplasms*

PURPOSE: Sudoriferous cyst usually occurs on the face, and especially on the ear and scalp as a solitary cystic mass. It is derived from the sweat glands of Moll and results from the obstruction of excretory ducts with the retention of fluid. In the eyelid, it is usually seen as small and firm vesicle arising at the eyelid margin. If it rarely occurs on the orbit, it develops from orbital ectopic epithelial cells predetermined to form glands of Moll. We experienced a case of sudoriferous cyst on eyelid which was adhered to levator aponeurosis and it disappeared when patient closed eyes. METHODS: A 55-year-old women suffered palpable mass on left upper eyelid without pain that had been present for 25 years. Orbital computed tomographic finding showed a oval mass(2.1x0.6x0.6cm size) inside upper eyelid and it invaded the orbit. The mass was completely excised under general anesthesia and histopathological examination was followed. RESULTS: Cystic mass was purple color and it was located in superiorly to tarsal plate. The mass was adhered to levator aponeurosis and levator palpabrae superioris muscle between the fat layer of post-orbital septum and the Whitnall ligament. The mass was completely excised without injury of aponeurosis and muscle. Microscopically, the lesion was a solitary cyst lined by two layers of cuboidal epithelial cells and innermost cells displaying eosinophilic cytoplasm with apical expansions. CONCLUSION: Sudoriferous cyst usually occurs on eyelid margin. But in this case, cystic mass occurred on upper eyelid and disappeared when patient closed the eyes because it was partially adhered to levator aponeurosis and levator palpebrae superioris muscle. Therefore, if sudoriferous cyst occurs on eyelid, it is necessary to excised the mass carefully.
Anesthesia, General ; Bone Cysts ; Cytoplasm ; Ear ; Eosinophils ; Epithelial Cells ; Eye ; Eyelids ; Female ; Humans ; Ligaments ; Middle Aged ; Muscles ; Orbit ; Retention (Psychology) ; Scalp ; Sweat Glands