The treatment of acetabular fractures is composed of operative and conservative methods, however, they are still controversial. Generally, because the acetabular fracture involves the joint surface and one sequalae such as post-traumatic arthritis can follow treatment, therefore an accurate reduction and postoperative early mobilization to obtain the prevenation of joint stiffness and arthritis are required. In order to achieve these purposes, we have studied and done a comparative survey between conservative and operative treatment on 55 patients with acetabular fractures, who were treated at our department from Jan. 1982 to Dec. 1988. Results were obtained as follows. 1. The prevalent age was the third decade and the cause of injury was traffic accidents in the majority. 2. The most common type of fracture was a posterior wall by Letournel classification. 3. Satisfactory results of operative treatment were 76% and conservative treatment 47%. 4. The complications were post-traumatic arthritis, ectopic ossification, peroneal nerve palsy and skin infection. 5. In the majority of displaced acetabular fractures, ORIF was recommended.
Accidents, Traffic ; Acetabulum ; Arthritis ; Classification ; Early Ambulation ; Humans ; Joints ; Ossification, Heterotopic ; Paralysis ; Peroneal Nerve ; Skin

Simple posterior hip dislocations requiring open reduction is very few and reported approximately 3% of all posterior hip dislocations and we have little comments of the various causes preventing or blocking a concentric reduction following traumatic posterior hip dislocation. In a review of eleven cases of posterior dislocation requiring open reduction, we divided two groups, one is a failed closed reduction group, the other is a nonconcentric reduction group. A concentric reduction was prevented from an inverted limbus or an osteocartilagenous loose body from acetabulum or femoral head.
Acetabulum ; Dislocations ; Head ; Hip Dislocation ; Hip

Keratosis punctata of the palmar creases (KPPC) is rare skin condition characterized by punctiform hyperkeratotic pits confined to the palmar and digital creases. Although this condition has been regarded as a variant of classical punctate keratoses, there are some differences between classical punctate keratosis and KPPC. We herein report a case of KPPC in a 22-year-old man who had numerous, tiny, hyperkeratotic pits limited to the palmar creases of both hands with typical histologic findings.
Hand ; Humans ; Keratosis* ; Skin ; Young Adult

Lentigo maligna melanoma(LMM) is the least common type of melanoma. LMM is almost exclusively located on sun-exposed skin of the head and neck. We describe a case of lentigo maligna melanoma evolved from lentigo maligna in 82-year-old man. Five years ago, the patient developed a brownish pigmented lesion on the left cheek. The lesion progressed slowly, and several months ago, a black pigmented patch was developed in the periphery of the brownish pigmented patch. Histopathologic examination of the lesions revealed findings consistent with lentigo maligna and lentigo maligna melanoma.
Aged, 80 and over ; Cheek ; Head ; Humans ; Hutchinson's Melanotic Freckle* ; Lentigo* ; Melanoma* ; Neck ; Skin

Synovial chondromatosis is a rare monoarticular disorder which often involves the knee, hip and the elbow but the shoulders are less frequently affected. The diagnosis depends on the important radiographic and operative findings as well as histopathological criteria. We have experienced the synovial chondromatosis developed in the left shoulder of a 37 year-old male who was diagnosed by CT scan, axillary angiography and microscopic findings and treated at Chonbuk National University Hospital.
Angiography ; Chondromatosis, Synovial ; Diagnosis ; Elbow ; Hip ; Humans ; Jeollabuk-do ; Knee ; Male ; Shoulder ; Tomography, X-Ray Computed

PURPOSE: We report a case of presumed noninfectious endophthalmitis following intravitreal triamcinolone acetonide injection. METHODS: A 63-year-old female patient was treated with intravitreal triamcinolone acetonide for diabetic macular edema in her right eye. Two days after the injection, the patient complained of decreased visual acuity but didn't visit the hospital until five days after the injection. Visual acuity had dropped to hand motion, and the slit lamp examination showed 3+ cells and hypopyon in the anterior chamber. In the vitreous there was a dense haze completely obscuring the view of the fundus. RESULTS: The position of the hypopyon was gravity dependent and shifted with changes in the patient's head position. Vitreous taps and culture were performed followed by the intravitreal injection of vancomycin and ceftazidime. The anterior chamber had cleared and hypopyon resolved completely eight days after the original injection, but the diffuse vitreous haze remained. The vitreous haze resolved slowly over four weeks and visual acuity recovered to baseline vision. CONCLUSIONS: In the presence of inflammation signs after intravitreal triamcinolone acetonide injection, the differentiation of infectious endophthalmitis from noninfectious endophthalmitis is mandatory. The pseudohypopyon was distinguishable from an infective or inflammatory hypopyon by its shifting position, which was dependent upon the patient's head position. Close observation and differential diagnosis are needed to avoid unnecessary surgical intervention.
Anterior Chamber ; Ceftazidime ; Diagnosis, Differential ; Endophthalmitis* ; Female ; Gravitation ; Hand ; Head ; Humans ; Inflammation ; Intravitreal Injections* ; Macular Edema ; Middle Aged ; Triamcinolone Acetonide* ; Triamcinolone* ; Vancomycin ; Visual Acuity

Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

Ureteroscopic removal of the stone is now popular for the management of the lower ureteral stone. A clinical study was performed on our 75 patients with lower ureteral stone treated with ureteroscopy. Of the 75 stone manipulations 62 (83%) were immediately successful and the final success rate including spontaneous delivery of stone or fragment after the procedure was 87 percents (65 cases). Of 57 smaller calculi than 1 cm (radiographic largest diameter) 50 (88%) were removed successfully. Mean duration of postoperative hospitalization was 5.6 days. There were no interrelations between the success rate and anesthetic methods. Significant complications during or after procedure were not identified. We conclude that ureteroscopic removal of stones under direct vision can be done safely and be the first choice of procedure for the lower ureteral stones.
Calculi ; Clinical Study ; Hospitalization ; Humans ; Ureter* ; Ureteroscopy

Kasabach-Merritt syndrome is the association of thrombocytopenia, disorder of coagulation, spontaneous bleeding and enlargement of a hemangima or extensive hemangiomatosis, which can be often life threatening. We experienced a three years-old girl with suddenly enlarging hemangioma of right cheek, complicated by severe thrombocytopenia, consumptive coagulopathy and hemorrhagic cystitis. Generalized petechia and ecchymosis were noted on the overlying skin of hemangioma, trunk and extremities. But the study of MRI and angiography, hypevascular was located within the right masseter muscle extending to temporalis muscle and anterior to parotid gland. So selective embolization with PVA (polyvinyl alcohol) was performed through the distal branch of internal maxillary artery and facial artery. She was medicated with oral corticosterioid for 3 weeks. After embolizationn, blood flow to hemangioma and facial swelling were markedly decreased. Patient was followed up for 7 years and she showed normal contour of face and no bleeding diathesis.
Angiography ; Arteries ; Cheek ; Cystitis ; Disease Susceptibility ; Ecchymosis ; Extremities ; Female ; Hemangioma ; Hemorrhage ; Hemorrhagic Disorders* ; Humans ; Kasabach-Merritt Syndrome* ; Magnetic Resonance Imaging ; Masseter Muscle ; Maxillary Artery ; Parotid Gland ; Skin ; Thrombocytopenia

We performed erotic stimulation that in 63 patients with erectile dysfunction in order to investigate erectile responses to visual sexual stimulation in patients with psychogenic and organic impotence and to elucidate valuable parameters for differential diagnosis between psychogenic and organic impotence. After the test using polygraph system and erotic film, subjective sexual drive in each patient was evaluated as grade I (poor), grade II (moderate), grade III (good). Following parameters were statistically analyzed : degree of maximal rigidity, degree of maximal tumescence, T -up phase (time taking place from the beginning of the erection to maximal level). The T-max phase (time taking place for the plateau phase of maximal erection). The results obtained were summarized as follows. Regardless of sexual drive of each patient, psychogenic impotence group showed better maximal rigidity and shorter T-up phase of rigidity than organic impotence group (p<0.05}. Of patients with psychogenic impotence, good sexual drive group showed better maximal rigidity and maximal tumescence than poor sexual drive group (p<0.06). Psychogenic impotence group showing good sexual drive revealed much better maximal rigidity and shorter T-up phase of rigidity than organic impotence group with same degree of sexual drive (p<0.05). These results indicate erotic stimulation test is highly valuable method for differential diagnosis between psychogenic and organic impotence, especially when the patient shows sexual drive in moderate or good degree. And it is suggested that maximal rigidigity and T-up phase of erection parameters in erotic stimulation test provide high validity for the differention.
Diagnosis, Differential ; Erectile Dysfunction* ; Humans ; Male