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

Various methods have been described for surgical treatment of recurrent shoulder dislocation. Arthroscopic techniques for stabilizing the shoulder have the theoretical advantage of reduced complication, decreased discomfort, and improved motion. The arthroscopic Bankart procedure was performed in 23 cases at Department of Orthopaedic Surgery, Yonsei University College of Medicine, from January, 1991 to December, 1993. This study is an attempt to evaluate results of arthroscopic Bankart procedure by Caspari's technique. Results of this study were as follows: l. According to the clinical evaluation of Rowe, results were excellent in 18 cases, good in 2 cases, fair in 1 cases and poor in 2 case. The prognosis was related to the size of Hill-Sachs lesion. 2. Complication after treatment included 5 cases of knot problem, 1 case of subluxation, and 2 cases of redislocation. Redislocation was developed in one patient who played ice hockey at 2 months after operation and in one patient who played soccer at 8 months after operation. Subluxation was developed in one patient who had psychologic problem. Among 5 patients who had knot prob- lem, two patients had a operation of removal. In conclusion, Caspari's suture technique in arthroscopic Bankart procedure needs some modification on the insertion point of the guide pin and suturing technique. And arthroscopic Bankart procedure by Caspari's technique offers good cosmetic results, low perioperative morbidity, low complications except knot irritation, and excellent results by the Rowe's criteria for patients with anterior shoulder instability.
Arthroscopy ; Hockey ; Humans ; Prognosis ; Shoulder ; Shoulder Dislocation ; Soccer ; Suture Techniques

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*

No abstract available.
Larynx*

Purpose: To investigate orbital morphology parameters associated with exophthalmos changes in patients undergoing endoscopic orbital decompression to treat thyroid-related orbitopathy. Methods: In total, 33 eyes of 18 patients with thyroid-related orbitopathy who underwent endoscopic orbital decompression were included in this retrospective study. Data were collected before and 6 months after surgery. We performed Hertel exophthalmometry and derived orbital morphology parameters from two-dimensional facial computed tomography records. Parameters associated with exophthalmos reduction on univariate linear regression analysis were subjected to multivariate linear regression analyses. Results: Univariate linear regression showed that the preoperative length of the medial orbital wall (β = 0.179, p = 0.032) and the postoperative distance from the cone apex to the medial wall defect (β = -0.139, p = 0.006) were associated with exophthalmos reduction after endoscopic orbital decompression surgery. Multivariate linear regression of these two parameters showed that the distance from the apex to the medial wall defect was associated with exophthalmos reduction (β = -0.118, p = 0.019). Conclusions The postoperative distance from the cone apex to the medial wall defect was associated with exophthalmos reduction. In patients with thyroid-related orbitopathy, this association should be considered when planning endoscopic orbital decompression.

PURPOSE: To determine whether transpupillary thermotherapy can achieve significant efficacy in maintaining vision without significant adverse effects when used to treat age-related macular degeneration associated with choroidal neovascularization. METHODS: Retrospective chart reviews were made for 33 eyes of 32 patients diagnosed with age-related macular degeneration, and who had received transpupillary thermotherapy due to the development of choroidal neovascularization. Transpupillary thermotherapy was performed 1.4 times on average. RESULTS: Three months after the final therapy, 6 eyes (18%) showed improved vision, 11 eyes (34%) showed no change in vision, and 16 eyes (48%) showed worsening of vision. Of the 21 eyes of 21 patients who were available for optical coherence tomography before and after transpupillary thermotherapy, 19 eyes (90.5%) showed reduced macula thickness, and fundus photographs taken during the latest hospital visit revealed 11 eyes showing fibrosis. CONCLUSIONS: Although it negatively influences subretinal fluid absorption, transpupillary thermotherapy is effective in stabilizing choroidal neovascularization and improving visual accuracy in a short period of time. Thus, further study is warranted.
Absorption ; Choroid* ; Choroidal Neovascularization* ; Fibrosis ; Humans ; Hyperthermia, Induced* ; Macular Degeneration ; Retrospective Studies ; Subretinal Fluid ; Tomography, Optical Coherence

PURPOSE: Combined androgen blockade(CAB) is often used in the management of advanced adenocarcinoma of the prostate. Recent case reports indicated that hypogonadism from CAB therapy is associated with osteoporosis and related fracture. The effect of CAB on bone mineral density(BMD) has not been adequately studied in men with prostate cancer. In this study, the possibility, frequency and severity of osteoporosis following CAB in prostate cancer patient was investigated. MATERIALS AND METHODS: A total of 19 men with advanced prostate cancer receiving CAB were evaluated for the presence of osteoporosis defined as bone mass 2.5 standard deviation below peak bone mass of young normal men(T-score). The BMB of the femoral neck and lumbar spine were measured. The BMD was then compared to the age-matched control value and reported as the Z-score. BMD measurements were compared to duration of CAB and Gleason score. RESULTS: Osteoporosis occurred in 10 of 15 patients in lumbar spine, and 4 of 18 patients in femoral neck. Osteoporosis was unrelated to the type of the CAB(orchiectomy, or LHRH-agonist). CAB caused a decrease in mean BMD of lumbar spine and femoral neck. There is a negative linear relation between mean BMD and duration of CAB(lumber spine; R2=0.059, Y=-2.368-0.016X, p>0.05, femoral neck; R2=0.089, Y=-1.923-0.020x, p>0.05). There is a statistically significant negative linear relationship between Gleason score and mean T-score of femoral neck(lumbar spine; R2=0.391, Y=-0.08-0.371X, p<0.05, femoral neck; R2=0.517, Y=0.855-0.450x, p<0.005). CONCLUSIONS: Our study provide evidence for acceleration of osteoporosis among men whose prostate cancers were treated with CAB. This study indicates a need for bone mineral density determination at the onset of CAB and at periodic intervals there after to begin appropriate therapy, undefined at this point, for prevention of osteoporosis and its complications aggravated by this therapy.
Acceleration ; Adenocarcinoma ; Bone Density ; Femur Neck ; Humans ; Hypogonadism ; Male ; Neoplasm Grading ; Osteoporosis* ; Prostate* ; Prostatic Neoplasms* ; Spine

OBJECTIVES: AGUS often reflects an immediate cervical cancer precursor such as a HSIL mimicking an endocervical glandular lesion. In this study, we attempted to assess the clinical significance of a cytologic diagnosis of atypical glandular cells of undetermined significance (AGUS) and determine the usefulness of the human papillomavirus (HPV) DNA testing as the triage strategies in evaluating AGUS. METHODS: Between 1994 and 1998, 67,730 Papanicolaou smears were evaluated at Kangnam and Uijongbu St Mary's Hospital. There were 87 (0.13%) cases of AGUS smears during that time. Colposcopy was performed on all women, and HPV DNA testing was performed on 11 persons. RESULTS: Mean age of these patients was 45.8 years. Histologic diagnosis of AGUS were kolocytosis and CIN-I in 6 (6.9%), CIS in one, endometrial hyperplasia in 2 (2.3%), endometrial adenocarcinoma in 7 (8.0%), cervical adenocarcinoma in 14 (16.1%) and cervical squamous cell carcinoma in 2 (2.3%) cases. Endometriosis was 8.9% under 46 years old and none in over 46. CIN was 8.9% and 7.2%, respectively. Cervical adenocarcinoma was 6.7% under 46 and 19.1% over 46. Endometrial cancer was 4.4% and 11.9%, respectively. The risk of cervical cancer and endometrial cancer was high in the AGUS with Adenocarcinoma ; Carcinoma, Squamous Cell ; Colposcopy ; Diagnosis ; DNA* ; Endometrial Hyperplasia ; Endometrial Neoplasms ; Endometriosis ; Female ; Human Papillomavirus DNA Tests ; Humans ; Middle Aged ; Papanicolaou Test ; Triage ; Uterine Cervical Neoplasms

Mature cystic teratomas of the fallopian tube are unusual, being almost incidentally identified. Here we describe a case of mature cystic teratoma arising in the fallopian tube, in a 44-year-old female. The mass was found during a regular checkup without complication. Microscopically, components from each germ layer were identified.
Adult ; Fallopian Tubes ; Female ; Germ Layers ; Humans ; Teratoma

PURPOSE: Bone graft is essential for successful spinal fusion. So, we clinically assessed the effect of uniting grafted autologous bone. MATERIALS AND METHODS: Retrospective analysis is performed on 46 patients who had grade I or II, one segmental, degenerative spondyloiisthesis according to Meyerding classification and treated operatively by posterolateral fusion with posterior decompression and autologous iliac bone graft from January 1991 to June 1996. We got the data from simple anteroposterior, lateral, flexion- extension X-ray film at preoperative, postoperative and last follow-up period, and from clinical results at last OPD follow-up according to Kirkaldy-Willis criteria. We compared the union of grafted autologous bone with clinical results using X2-test. We also compared preoperative spinal instability, with/without instrumentation and intraoperative reduction with the union of grafted autologous bane and clinical results. RESULTS: There was high significant correlation (P=0.000) between the union of grafted autologous bone and clinical results statistically, CONCLUSIONS: This results suggest that the union of grafted autologous bone was an important factor in determing clinical results.
Classification ; Decompression ; Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Fusion ; Spondylolisthesis* ; Transplants* ; X-Ray Film