The studies about tibial spine fracture were less frequently reported, especially in its sdult type, had different opinions according to authors. Meyers and McKeever described it had frequedntly occured as isolated injury without associated ligamentous injury of the same knee in children and mainly caused by bicycle accident. They had classified it by three different types according to the shape of it, managed conservatively type I, II,IIIA, and recommanded simple suturing with absorbable materials as operative method. But, in our cases it had frequently occured in adult and combined with ligamentous injury at the same knee including ACL and MCL. Also, it had frequently been caused by major trauma such as traffic accident. Previous method of management including simple stainless steel wiring had scored poor results in these complicated fractures. The author reviewed 24 cases of the tibial spine fracture treated at the Department of Orthopaedic Surgery, National Medical Center from June, 1980, to June, 1988, and the following results were obtained. 1. The most common causes of the injury were traffic accident (12 cases) and associated with rupture of medial collateral ligament in 7 cases. 2. The fracture was classified as four different types according to its pattern and comminution and most commen types were III and IV, scored 8 cases and 7 cases irrespectively. 3. Initially, closed sreduction and cast immobilization was performed in 15 cases, of which 8 cases had poor results with non-union of the fracture and instability. 4. Simple stainless steel wiring in 2 cases scored poor results and distal advancement of ACL with double wiring revealed good results in these cases. 5. One case of type II fracture had persistently positive anterior drawer sign and subjective instability and needed distal advancement of ACL and double wiring. 6. Distal advancement of ACL and double wiring was performed in 6 cases of which 4 cases revealed excellent results and 2 cases did good ones.
Accidents, Traffic ; Adult ; Child ; Classification ; Collateral Ligaments ; Humans ; Immobilization ; Knee ; Ligaments ; Methods ; Rupture ; Spine ; Stainless Steel

No abstract available.
Neurilemmoma* ; Neurofibromatosis 1*

PURPOSE: This study attempted to assess the treatment outcomes after microsurgical varicocelectomy in non-obstructive azoospermic patients and correlate the surgical outcomes with the histopathological patterns of their testes. MATERIALS AND METHODS: Fourteen non-obstructive azoospermic men who underwent testicular biopsy and varicocelectomy, between September 2001 and December 2002, were reviewed. Varicocelectomy was unilaterally and bilaterally performed in 12 and 2 patients, respectively, using an inguinal approach with a microsurgical technique. Postoperative semen analyses were performed in each patient four months after the varicocelectomy. RESULTS: In the testicular histology, hypospermatogenesis was identified in three, maturation arrest in five and Sertoli-cell-only syndrome in six of the subjects. After a mean follow-up of 7.4 months, motile sperm in the ejaculate was identified in 6(43%) of the non-obstructive azoospermic patients. These included 2 in hypospermatogenesis, 3 in maturation arrest and 1 in Sertoli-cell-only syndrome, in terms of their histopathology. These six had improvements in their sperm concentration and motility, which were 0.45x10(6)/ml and 51.3%, respectively. However, of these six, with motile sperm after varicocelectomy, 1 with maturation arrest and 1 with Sertoli-cell-only syndrome returned to their previous azoospermic state on their second postoperative semen analyses. A pregnancy was achieved by natural intercourse for 1 of the men(7.1%) with hypospermatogenesis. CONCLUSIONS: Microsurgical varicocelectomy offers non-obstructive azoospermic patients the chance to have sperm in their ejaculate, and therefore, the possibility of natural pregnancy. Microsurgical varicocelectomy may be considered with the initial treatment modality in selective non- obstructive azoospermic patients with varicocele prior to intervention with assisted reproductive technology.
Azoospermia ; Biopsy ; Follow-Up Studies ; Humans ; Male ; Oligospermia ; Pregnancy ; Reproductive Techniques, Assisted ; Semen Analysis ; Spermatozoa ; Testis ; Varicocele

No abstract available.

PURPOSE: Augmentation enterocystoplasty is a valuable technique, as a surgical repertoire, for urologists treating a myriad of conditions that cause either a small anatomic or functional bladder capacity. A variety of surgical techniques for augmentation cystoplasty have been developed. The clinical availability of augmentation cystoplasty was evaluated using a Goodwin's ileal cup-patched bladder in patients with a small capacity, high pressure, poorly compliant and unstable bladder. MATERIALS AND METHODS: At our institute, 21 patients, with a neurogenic bladder, have undergone augmentation cystoplasty using a Goodwin's ileal cup-patched bladder, since July 1999. The mean age at operation and follow-up period were 32 years and 11 months, respectively. 9 patients had various degrees of vesicoureteral reflux. The preoperative assessments included urinalysis, urine culture, renal function tests, voiding cystourethrography and urodynamic evaluation. RESULTS: The mean bladder capacity increased from 170cc preoperatively to 438cc postoperatively. The mean maximal end-filling intravesical pressure decreased from 55cmH2O to 22cmH2O, with a significant increase in bladder compliance. There were no significant complications that required surgical revision. CONCLUSIONS: Augmentation cystoplasty using a Goodwin's ileal cup-patched bladder offers a high success rate, with low complications, in selected patients with neurogenic bladder dysfunction.
Compliance ; Follow-Up Studies ; Humans ; Reoperation ; Urinalysis ; Urinary Bladder* ; Urinary Bladder, Neurogenic ; Urodynamics ; Vesico-Ureteral Reflux

PURPOSE: Animal and clinical experiments have recently shown that TUEIP resulted in a reduction of the prostate volume and an increase of the lumen of the prostatic urethra. We assessed the clinical efficacy of TUEIP for BPH. MATERIALS AND METHODS: Between February 2001 and December 2001, 27 patients diagnosed with BPH, and had undergone surgical management, were evaluated. With endoscopic injection set, 99% alcohol was injected into the inferior portion of the bladder neck and around the verumontanum, depending on the individual endoscopic findings. Pre-operatively, immediately after removal of the Foley catheter and at 3 months post-operatively, all the patients were evaluated with uroflowmetry and PVR, with 15 patients receiving transrectal ultrasound at 3 months post-operatively. RESULTS: The pre-operative Qmax was 8.1ml/sec, which increased to 11.8ml/sec (p<0.05) after removal of the Foley catheter, and was further increased to 13.0ml/sec (p<0.05) at 3 months post-operatively. The pre-operative PVR was 14.2ml, which increased to 15.8ml and 16.5ml after removal of the Foley catheter and at 3 months post- operatively, respectively. The pre-operative prostate volume was 39.7cc, which was reduced to 25.9cc (p<0.05) at 3 months post-operatively. There was no systematic adverse effect from alcohol absorption. CONCLUSIONS: TUEIP is considered as an effective alternative treatment of symptomatic bladder outlet obstruction caused by BPH, showing a significant increase in Qmax and reduction of the prostate volume.
Absorption ; Animals ; Catheters ; Ethanol* ; Humans ; Neck ; Prostate* ; Prostatic Hyperplasia* ; Ultrasonography ; Urethra ; Urinary Bladder ; Urinary Bladder Neck Obstruction

This statistical analysis of 4,709 legal autopsies performed in Korea in 2012 was conducted to obtain primary data about and related variables. The analysis revealed the following: 1. Of the total number of deaths, men accounted for and women, 26.8%. Evidently, the number of deaths among men was more than twice that among women. 2. With respect to mode of death, 54.8% were recorded as unnatural deaths, 39.2% were natural deaths, and 6.0% had unknown causes. Of the 2,581 unnatural deaths, 44.8% were accidental deaths; 27.2%, suicidal; 17.5%, homicidal; and 10.3%, undetermined. 3. Of the total number of unnatural deaths, 43.0% were trauma-related deaths, for which falling down was the leading cause, accounting for 33.5% cases. Asphyxiation was accounted for 17.2%, among which the predominant cause was hanging (55.3%). Moreover, 12.5% of deaths were due to drowning; 11.5%, poisoning; 11.2%, thermal injuries; 2.7%, complications in medical procedures; and 0.3%, electrocution, starvation, or neglect. 4. Among 1,847 natural deaths, heart diseases accounted for 50.2% and vascular diseases accounted for 16.7%. 5. There were 207 cases of deaths among children under the age of 10, of which 94 were unnatural and 49 were homicidal deaths. Of all cases, 9.2% had an unknown cause of death, and of these 67.6%, were putrefied or skeletonized bodies.
Autopsy* ; Cause of Death ; Child ; Drowning ; Female ; Heart Diseases ; Humans ; Korea* ; Male ; Poisoning ; Skeleton ; Starvation ; Vascular Diseases

The myoclonic epilepsies of infancy and early childhood pose the most difficult problems in the diagnosis and classification of epilepsies because they are often confused with the Lennox-Gastaut syndrome sharing a number of common features. However, their correct differentiation is easily justifiable because some of the myoclonic epilepsies of early childhood have better prognosis than the Lennox-Gastaut syndrome. We experienced and treated a 4-year-old boy who had normal intellectual function but frequent myoclonic and generalized clinic-tonic-clinic seizures, which were successfully controlled by anti-epileptic drugs. Hence we report a case with brief review of literatures.
Child, Preschool ; Classification ; Diagnosis ; Epilepsies, Myoclonic* ; Epilepsy ; Humans ; Male ; Prognosis ; Seizures

PURPOSE: Improvement in the prognosis of multiple primary malignant neoplasm may be attained by early discovery and awareness of the secondary tumor. This study aimed to determine the characteristics of multiple primary neoplasms involving the urinary tract in Korea. MATERIALS AND METHODS: Of 1,406 patients treated for urologic cancers, 76 patients with multiple primary neoplasms also involving other than the genitourinary system were analyzed. We studied the occurrence rate and distribution of tumors. RESULTS: Of the 76 cases, 33 cases were synchronous and 43 cases were metachronous. Average time interval between the diagnosis of first and second tumor was 48 months. Tumors of the gastrointestinal tract, particularly stomach cancer, among non-urologic cancers and tumors of the bladder among urologic cancers were predominantly involved followed by renal and prostate tumors. However, renal tumor was the most common urologic tumor in synchronous cancers. Eighty-one percent of the metachronous urinary tumors occurred as second tumors. CONCLUSIONS: Our present findings show that the occurrence of multiple primary neoplasms involving the urinary tract is not rare and that the incidence of organ involvement is different from the western countries.
Diagnosis ; Gastrointestinal Tract ; Humans ; Incidence ; Korea ; Neoplasms, Multiple Primary ; Prognosis ; Prostate ; Stomach Neoplasms ; Urinary Bladder ; Urinary Tract* ; Urogenital System ; Urologic Neoplasms

PURPOSE: There is still much controversy about the prognosis of breast cancer developed in young women compared with old women. We performed this study to evaluate the pragnosis of the breast cancer in young women. MATERIALS AND METHODS: From 1985 to 1994, 1189 women received opetaticms for breast cancers at Severance Hospital. The study group included patients less than 36 years old who had unilateral, invasive and primary operable breast eancers (N=158). The control groups included patients between 36 and 50 years old (N=518) and those between 51 and 65 years old (N=269) who had the same conditions as the study group. The 5-year survival and 5-year disease-free survival rate for three groups were compared using Kaplan-Meier method and Log-rank method. To evaluate the age as an independent prognostic factor in premenopausal women Coxs proportional hazard model was used. RESULT: The overall 5-year survival rate and 5-year disease-free survival rate ot the study group were significantly lower than those of control groups (p<0.05). There was no significant difference in 5-year survival and S-year disease free survival between the two control groups. The Coxs propotional hazard model analysis revealed that the stage is the most important prognostic factor and the age was also an independent prognostic factor. CONCLUSION: The prognosis of breast cancer less than 36 year old was poorer than that of 36-51 year old and 51-65 year old, suggesting that the age may be an independent prognostic factor in premenopausal women. More aggessive adjuvant treatment is required for breast cancer patients less than 36 year old of age.
Adult ; Aged ; Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Female ; Humans ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Survival Rate