Low back pain and sciatica is one of the most frequent and troublesome problem in the orthopedic field. A study of the effectivity and reliability of the anterior interbody fusion with autoiliac bone graft for the spondylogenic and Discogenic back pain was done on 166 patients who had been hospitalized from January 1978 to December 1984. The approach to the lesion was retroperitoneal with anterior approach. The anterior interbody fusion was performed by using one block or two block from autoiliac bone. The status of the spine fusion after operation was decided by the plane roentgenogram or clinical sign, and the tomogram or dynamogram in some case. We analysed 116 patients having anterior fusionto study whether fusion rate has any relation with the number of the grafted bone, preoperative diagnosis and the level of fusion. At 9 months after operation, the clinical result was assesed and was compared between the group of the preoperative diagnosis. The following results were obtained from analysis of the cases studied. 1. The fusion rate for the grafted bone was 92.2%. There was no difference in fusion rates between the group of patients operated using one block and two-block. 2. The fate of the grafted bone could be categorized into 5 different types. 3. In patients with spondylolisthesis or spondylolysis, there was high incidence of non union.Also in terms of the vertebral level, the fusin between the L5-Sl showed high incidence of non union. 4. High fusion rate was obtained by using back brace without cast immobilization. The average duration of brace wearing was 6.6 months. 5. Overall clinical results were as follows:excellent or good 64.6%, fair 31.9%, poor 3.5%,and spondylolisthesis showed better clinical results than other diseases. 6. Post sympathectomy symptoms were noticed in 12 patients after operation and there were no permanent genitourinary problem.
Arthrodesis ; Back Pain ; Braces ; Diagnosis ; Equidae ; Humans ; Immobilization ; Incidence ; Low Back Pain ; Orthopedics ; Receptors, CXCR4 ; Sciatica ; Spine ; Spondylolisthesis ; Spondylolysis ; Sympathectomy ; Transplants

Birth injury is defined as any condition that affects the fetus adversely during the labor or delivery. These traumatic injuries are subdivided further into those that from hypoxia and mechanical factors. We analyzed 57 patients of birth trauma including fractures, nerve injuries and head injuries during the delivery at Severance Hospital from Jan. 1980. to Dec. 1985 and 24 patients which were transfered from other hospital after delivery and the following results were obtained. 1. The rates of birth trauma in our hospital were 0.36% including clavicle fractures 0.27%,femoral fractures 0.006%, brachial plexus injuries 0.031%, skull fractures 0.025% and intracranial hemorrhage 0.025%. 2. The site of clavicle fractures were all middle one third, and 71.4% of cases were displaced. 3. Five cases of brachial plexus injuries were found, and each type was Erb's palsy 3 cases, Klumpke's palsy 1 case and whole arm palsy 1 case. Three cases were recovered completely and 2 cases were recovered partially. 4. Methods of delivery were as followed; normal delivery 50.6%, breech delivery 3.7%, forcep 7.5%, vacuum 21.0%, and Cesarian section 17.2%. 5. The primipara was 65.4% of the patients of birth trauma. 6. There was no statistical significances in the birth weight, head circumferences, and chest circumferences of the patients comparing to the normal infants.
Anoxia ; Arm ; Birth Injuries ; Birth Weight ; Brachial Plexus ; Brachial Plexus Neuropathies ; Clavicle ; Craniocerebral Trauma ; Fetus ; Head ; Humans ; Infant ; Intracranial Hemorrhages ; Paralysis ; Parturition ; Skull Fractures ; Surgical Instruments ; Thorax ; Vacuum

Purpose: The purpose of this study was to evaluate the clinical and radiological results of total hip arthroplasty using a proximal modular femoral stem in patients who had secondary coxarthrosis associated with a deformed femur. Materials and Methods: Forty-two patients (45 hips) with secondary coxarthrosis were evaluated after primary total hip arthroplasty using an S-ROM proximal modular femoral stem, between January 2001 and March 2004. The average follow-up was 44 months (range, 24 to 60 months). The mean age of the patients was 48.5 years old and there was a predominance of female patients (65.5%). The preoperative diagnoses included 26 cases of developmental dysplasia of the hip, 13 cases of sequalae of LCP, 2 cases of epiphyseal dysplasia, 3 cases of sequalae of pyogenic arthritis, and 1 case of congenital coxa vara. Results: The average Harris hip score improved from 52.2 points to 85.5 points. All the femoral stems demosntrated stable fixation, which included 37 cases by bony ingrowth and 8 cases by stable fibrous ingrowth. Neither osteolysis nor progressive radiolucent lines around the femoral stems were found at the latest follow-up. Postoperative complications included: 2 cases of hip dislocations, 1 case of periprosthetic fracture, 1 case of infected cup loosening, and 1 case of sciatic nerve palsy. Overall, forty-one hips (91.9%) exhibited excellent or good clinical results at the most recent follow-up. Conclusion: For advanced secondary coxarthrosis, total hip arthroplasty with use of a proximal modular femoral stem yielded good mid-term results based on clinical and radiological criteria.
Arthritis ; Arthroplasty, Replacement, Hip* ; Coxa Vara ; Diagnosis ; Female ; Femur* ; Follow-Up Studies ; Hip Dislocation ; Hip* ; Humans ; Osteoarthritis, Hip* ; Osteolysis ; Periprosthetic Fractures ; Postoperative Complications ; Sciatic Neuropathy

We made a randomized prospective comparison of the compression hip screw and the Gamma nail for the internal fixation of 60 intertrochanteric fractures to compare perioperative details and to analyze radiographic and clinical results in elderly patients. The operation time for Gamma nail group was shorter than for CHS group and also the intraoperative blood loss was lower in the Gamma nail group. And the Gamma nail enabled earlier ambulation. We found no significant difference of the union time and the sliding length of lag screw between two groups. The decrease of neck shaft angle in the Gamma nail group was significantly smaller than the CHS group. There was no significant mechanical complication in the Gamma nail group such as a fracture of the femoral shaft or fixation failure. We obtained satisfactory results on treatment of elderly patients with intertrochanteric fracture of femur using Gamma nail. So we consider that in the treatment of intertrochanteric fractures of geriatric patients, the Gamma nail would be more efficient than the CHS.
Aged ; Femur ; Hip Fractures ; Hip ; Humans ; Neck ; Prospective Studies ; Walking

The author tried to get result after clinical and radiological studies with 27 patients(35 hip joints) who have been operated non-cemented bipolar hemiarthroplasty or total hip replacement arthroplasty with using Anatomic hip prosthesis(Zimmer, Inc.; Warsaw, IN) femoral stem and who could be followed for the period of more than two years(average 30 months) at the INHA University Hospital, Dept. of Orthopaedic Surgery from the Feb, 1990 through the Dec, 1992. Average sequential Harris hip rating were maintained between 90 and 98 point during the follow- up interval. The Harris hip score was statistically significant in the degree of the initial fixation, degree of the thigh pain and degree of the limping but there was no difference significantly in degree of the final femoral componet fixation. Pain in the thigh was recorded at the yearly examinations from the first to the last follow-up. After one year, there were marked thigh pain in 2.9 per cent but in last follow-up there were no marked painful thigh. The limp was detacted 5.7 per cent after one year and last follow-up. Radiographs demonstrated that the fixation of the femoral componet was by bone ingrowth in 60 per cent of the hip, by stable fibrous fixation in 40 per cent, according to the criteria of Engh et al. The evaluated device was an early-generation prosthesis that was designed for insertion without the use of cement. Further study in necessary to determin the long-term durability of the prosthesis.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hemiarthroplasty ; Hip Prosthesis ; Hip ; Prostheses and Implants ; Thigh

Ossifying fibroma is one of a group of fibro-osseous lesion which arises typically within the jaw bone and only rarely affects the long bones. In 1966, Kempson described two patients with ossifying fibroma of the tibia, noting its unique, aggressive local behavior. This rare lesion resembles monostotic fibrous dysplasia, but can be differentiated from it on histologic and clinical ground. Histologically, ossifying fibroma is characterized by osteoblasstic rimming spicules of bone within a fibrous stroma with evidence of the lamella transformation of bone, and clinically by, frequent recurrence and aggressive progression of the lesion. We experieced three cases of ossifying fibroma, two cases in the tibia and one case in the fibula. In case 1, recurrence was developed after local curettage and bone graft, so reoperation was performed at 11 months after the first opecation. The 2nd case was healed after wide curettage and free vascularized fibula graft, and the 3rd case being followed up after segmental resection of the fibula.
Curettage ; Fibroma ; Fibroma, Ossifying ; Fibrous Dysplasia, Monostotic ; Fibula ; Humans ; Jaw ; Recurrence ; Reoperation ; Tibia ; Transplants

The effect of Atenolol on the blood pressure were studied in 31 cases of essential hypertension and on the effect of plasma renin activity in 8 cases. There were 8 cases of male with age 49.5(42-70) and 23 cases of female with age 49(35-71) years. 27 cases of 31 cases were untreated hypertensive patients and 4 cases were refractory to hypotensive drugs of diuretics and vasodilators. The Atenolol 50mg once-daily was given to all patients orally for 3 weeks. The blood pressure, heart rate, ECG and symptoms were checked in one week interval. In 8 cases, the plasma renin activity was measured by Dainabot Kit before and after one week medication. The results were as follows: 1. In 27 cases of untreated hypertension, the control blood pressure was 182.9/11.4mmHg in average. The blood pressure decreased in average by 18.3/11mmHg in one week, 23.7/15.9mmHg in two week and 21.5/10.5mmHg in three week. The heart rate also decreased by 7.4/min. in one week, 14.9/min. in two week and 7.8/min. in three week. These data showed considerable reduction of blood pressure and heart rate with 50mg Atenolol once-daily. 2. The basal plasma renin activity after one week medication was reduced by 46% in 8 cases and this data showed considerable reduction regardless control level of basal plasma renin activity. 3. There were considerable blood pressure reduction by adding Atenolol 50mg once-daily to diuretics and vasodilator to which patient's blood pressures were refractory. 4. There was no orthostatic hypotension or serious side effect by Atenolol medication.
Atenolol ; Blood Pressure* ; Diuretics ; Electrocardiography ; Female ; Heart Rate ; Humans ; Hypertension* ; Hypotension, Orthostatic ; Male ; Plasma* ; Renin* ; Vasodilator Agents

The Peutz-Jeghers syndrome is a familial disesse charaeterized by mucocutaneaus pigmentation, gastrointestinal polyposis, and transmission of autosomal dominant trait. This syndrome is clinically important becuase of the coreplieation caused by the polyp, leading to abdominal pain, gastrointestinal bleeding, and intussusception. Authors experienced a case of Peutz-Jeghers syndrome admitted to Walace Memorial Baptist Hospital who was complained of recurrent abdominal pain, melanin pigmentation of lips, oral mucosa, and digits. UGI series, small bowel series, colon cnema, gastrofiberscopy, and colonoseopy revealed multiyle intestinal polyps. Pathologic findings on endoseopic polypectomy showed hamartomatous polyp.
Abdominal Pain ; Colon ; Hemorrhage ; Intestinal Polyps ; Intussusception* ; Lip ; Melanins ; Mouth Mucosa ; Peutz-Jeghers Syndrome ; Pigmentation ; Polyps ; Protestantism

BACKGROUND: South Korea is rapidly being an aging-society and the demand of long-term care insurance services for elderly patients is rising. In addition, because the elderly taking multiple medicines, the adherence is lowered and the adverse events are easily occurred. Therefore, many are interested in introducing the geriatric pharmacy specialist to manage this situation. PURPOSE: By applying a similar program such as the geriatric pharmacy specialist working in nursing home, we conducted this study to evaluate the potential contribution to both the health insurance services and financial savings for the elderly patients. METHODS: We conducted a trial in an elderly nursing home to collaborate between doctor and pharmacist making a checklist for improving medication adherence and establish a consultation system. Also we applied a smart phone application in the pharmaceutical care processes. RESULTS: Thereby completing the drug therapy related checklist apply to nursing facilities in South Korea. And we got a performance that improves medication adherence when used in the clinical practice settings. CONCLUSION: By introducing a training program of pharmacy care managers and geriatric professionals such as the United States and Japan, we revealed the elderly nursing home residents and vulnerable elderly people living alone were improved the medication adherence and it will contributed to the health and quality of life of the patients.
Aged* ; Checklist ; Drug Therapy ; Education ; Humans ; Income ; Insurance, Health ; Insurance, Long-Term Care ; Japan ; Korea ; Long-Term Care ; Medication Adherence* ; Nursing Homes* ; Nursing* ; Pharmaceutical Services ; Pharmacists ; Pharmacy ; Quality of Life ; Specialization ; United States ; Smartphone

No abstract available.
Fistula* ; Pyriform Sinus* ; Thyroiditis, Suppurative*