The tracheostomy is increasingly being performed. In most cases, the tracheostomy sites are left to heal by secondary intention, so it leaves a depressed and wide scar that is cosmetically disfigured. Another problem os that the scar is also attached directly to the trachea itself and will move vertically with the trachea during the act of swallowing. Even though the tracheostomy scar is cosmetically acceptable, the mobility and retraction of the scar is a continual nuisance to the patient. We performed a retrospective study on 9 patients who had undergone revision of the depressed thracheostomy scar by the Renner Method from June, 1997 to February, 1999. The method includes transverse fusiform incision of the original scar and excision of the depressed portion of the scar to the level of the trachea itself. To prevent attachment of the skin and trachea, a bilateral subcutaneous flap and muscle flap were simply advanced to the midline and overlapped. Then the rest of scar that was not depressed was deepithelized and flipped to augment the soft tissue volume in the central depressed area. Satisfactory results were achieved in all patients without hematoma, infection, hypertrophic scar, and keloid formation. We believe this simple Renner method is one of the best ways of performing posttracheostomy scar revision.
Cicatrix* ; Cicatrix, Hypertrophic ; Deglutition ; Hematoma ; Humans ; Intention ; Keloid ; Retrospective Studies ; Skin ; Trachea ; Tracheostomy

No abstract available.
Female ; Meigs Syndrome*

We managed 118 patients with benign prostatic hyperplasia by transurethral resection during January 1994 and December 1995 in Eul Ji Medical Center and all patients were operated upon by 2 staff doctors. Among 118 cases, 7 cases with intraoperative complications such as bladder injury or severe prostatic capsule injury and 8 cases with combined neuropathic bladder or chronic urinary retention and 2 cases with urethral stricture were excluded. The average age of 101 cases were 66.4 years old (50-92), and average weight of resected adenoma was 10.0 gm (2-32). We categorized these patients randomly into 2 groups. In group I (n=48), we removed the urethral catheter within 2 days after TURP and in group II (n=53), we removed it after 3 days (mean 4.2 days) following surgery. The average hospital stay postoperatively was4.1 days in group I and 7.4 days in group II. Recatheterization rate was 8.3% (4/48) in group I and 5.6% (3/53) in group II (p>0.05). There was no statistical difference in other complication including failure to void, intraoperative bleeding, urethral stricture, incontinence and TUR syndrome. This study supports early catheter removal after TURP would become an accepted and routine postsurgical practice following uncomplicated TURP.
Adenoma ; Catheters* ; Hemorrhage ; Humans ; Intraoperative Complications ; Length of Stay ; Prospective Studies* ; Prostatic Hyperplasia ; Transurethral Resection of Prostate* ; Urethral Stricture ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Catheters ; Urinary Retention

No abstract available.
Korea* ; Otitis Media* ; Otitis* ; Risk Factors*

The author has reviewed 62 patients with brachial plexus injuries who treated at Department of orthopaedic Surgery, Kyung Hee University Hospital during the period from Dec. 1978 to June 1985. Among these, conservative treatment was performed in 8 patients, 64 cases of 54 patients were treated by 4 types of operation, that is, exploration with neurolysis, neurorraphy, nerve graft and neurotization for restoration of elbow flexion, wrist, finger flexion and shoulder abduction. The patients were followed up more than one year to five years and eight months, average being two yesrs and six months. The whole arm type injury was the most common. The trunk level was the most common. The prognosis of whole arm type was the most severe. And the prognosis of supraclavicular lesion was worse than that of infraclavicular. There were two types of treatment, conservative treatment in 8 patients, operative treatment in 54 patients. By comparing results according to methods of treatment, neurotization with intercostal nerve were useful in avulsion cases of unsatisfactory results following neurolysis, neurorraphy and nerve graft. The operation time of the first three months to six months after injury gave the best chance of success. The result of conservative treatment in all 8 patients was poor.
Arm ; Brachial Plexus ; Elbow ; Fingers ; Humans ; Intercostal Nerves ; Nerve Transfer ; Prognosis ; Shoulder ; Transplants ; Wrist

Pyogenic arthritis remain a difficult problem, despite the availability of a wide range of powerful modernantibiotics. Early and correct diagnosis is imperative to assure the prompt initiation of an effective therapeuticregimen and the prevent of late sequela. Careful clinical, laboratory and roentgenological analysis arefundamental to early and precise diagnosis. Therefore, plain roentgenogram shold not be overlooked. A radiologicaland clinical observation was made in 51 cases of pyogenic arthritis admittted to Chosun University Hospital duringthe period from January 1976 to Dec. 1983 and following results were obtained. 1. Among the 51 cases, 36 cases(70.6%) were male and 15 cases(29.4%) were females. The most prevalent age was 5 to 9 (27.6%). 2. Symptom durationless than 5 days was in 21 cases (41.2%) and more than 31 days was in 6 cases (11.7%). 3. The most common symptomon admission was pain around the involved joint and others are limitation of motion, swelling, tenderness, fever,local heating and erythema. 4. The underlying causes were composed of unknown in 21 cases(41.2%), trauma in 18cases(35.3%), infections focus in 8 cases (15.7%) and iatrogenic reasone 4 cases(7.8%) 5. The msot commonlyaffected joint was hip joint (45.1%). The other affected sites in order of frequency were knee, ankle, shoulder,S-I and elbow joint. In infants and children, hip and knee joint are commonly affected; In adults, knee joint ismost commonly affected. 6. In laboratory findings, the number of W.B.C and E.S.R were increased in 56.9%. Symptomduration more than 31 days in 5 cases were increased E.S,R only. Causative microorganism was isolated in 31 cases;the most common microorganism was Staphylococcus auterus in 22 cases. Others are B-hemolytic Streptococcus,Enterobacteriaceae species and Pseudomonas aeruginosa. 7. In 26 cases(50.9%) of the patients, roentgenographicfinding was negative. The most common radiological findig was soft tissue swelling and the others are include inorder of frequency: joint space widening, small erosions in articular cortex, subchondral osteoporosis. The comonradiological findings of symptom duration more than 31 days in 6 cases were lost of entire cortex, ankylosis andjoint space narrwoing.
Adult ; Ankle ; Ankylosis ; Arthritis ; Child ; Diagnosis ; Elbow Joint ; Erythema ; Female ; Heating ; Hip ; Hip Joint ; Hot Temperature ; Humans ; Infant ; Joints ; Knee ; Knee Joint ; Male ; Osteoporosis ; Pseudomonas aeruginosa ; Staphylococcus

Many unsolved probIems still remain in these in management of trochanteric fracture of hip, especially unstable type of trochanteric fracture. Among many cases of the trochanteric fracture treated during period from Jan. 1963 to July, 1973 at Busan National University Hospital, six patient has severe sequelae such as coxa vara deformity, shortening of the affected limb and ankylosis of the hip joint, which were analyzed clinically and results obtained were as follow. 1. It is the most important factor that the medial and the posterior cortex is good alignment in reduction with internal fixation and maintainance of unstable trochanteric fracture. 2. It is dangerous for the unstable type of trochanteric fracture to be reducted and maintained with only screws or plates. Jewett nail is more effective than the S-P nail and Thornton plate in internal fixation of unstable type of trochanteric franture. 3. The posterior fragments can hardly be found in A-P view but easily in lateral view 4. In cases that had not good alignments between posterior fragments the distaI fragment displaced medially and migration of the naiI, distraction of the pIate, malunion have developed in spite of prolonged immobilization in cast. 5. In one case that the severe coxa vara deformity have been developed. we performed the transverse osteotomy & fixed with Blount-V-blade plate like device. The result was good but the shortening of the limb could not prevent.
Ankylosis ; Busan ; Congenital Abnormalities ; Coxa Vara ; Extremities ; Femur ; Hip Joint ; Hip ; Humans ; Immobilization ; Osteotomy

We have studied the angiograms before and after arteriorrhaphy, which were performed on 20 cases at Busan National University Hospital. Among the cases, 15 were on upper extremity and 5 on lower extremity. The results obtained were as follows; 1. 8 cases among 19 on which angiogram were checked after arteriorrhaphy revealed the obstructive findings distal to injured vessels. 2. Necrosis did not occur following arteriorrhaphy for brachial artery, radial artery and ulnar artery and ulnar artery ruptures. On a cases of anterior tibial artery rupture, an A-K amputation was done due to progressive tissue necrosis. 3. Collateral circulations were very important pathway after brachial artery rupture and increased collateral circulations were showed on angiograms. 4. Localized thrombosis and hypertrophic vascular changes were found in 3 cases of re-exploration because of the obstruction after initial surgery.
Amputation ; Brachial Artery ; Busan ; Clinical Study ; Collateral Circulation ; Extremities ; Lower Extremity ; Necrosis ; Radial Artery ; Rupture ; Thrombosis ; Tibial Arteries ; Ulnar Artery ; Upper Extremity ; Vascular System Injuries

Pigmented villonodular synovitis (PVNS) is a relatively rare condition. The disorder almost always involves a single joint and the knee is most commonly affected. We report on three cases of localized PVNS that involved the patella fat pad and synovium. Diagnostic and therapeutic arthroscopies were performed, and typical findings of localized PVNS were found. Complete resection of the lesions were performed arthroscopically. Arthroscopy can be used as an effective diagnostic and therapeutic tool for identification and resection of intraarticular localized PVNS of the knee.
Adipose Tissue ; Arthroscopy ; Joints ; Knee* ; Patella ; Synovial Membrane ; Synovitis, Pigmented Villonodular*

Bronchiectasis means a permanent abnormal dilatation of one or more large bronchi owing to destruction of theelastic and muscular components of the bronchial wall. Radiological study is the most importat and mandatory procedure. Especially bronchography is essential for the definitive diagnosis of bronchiectasis and for theprecise delineation of the type and extent of the disease. The radiological and clinical findings of 48 cases ofbronchiectasis diagnosed by bronchography and treated at Chosun University Hospital during the 5 years fromJanuary 1980 to Dec. 1984 were analyzed retrospectively. The results were as follows; 1. Among the 48 cases, 34cases(70.8%) were male and 14 cases(29.2%) were female. Peak incidence was in second decade. 2. Chronic cough,productive sputum and hemoptysis are main symptoms and others are chest pain, dyspnea and recurrent bouts ofpneumonia. The most common physical sign is persistent moist rales over the involved area in 23 cases(47.9%).Others are no sign in 17 cases(35.4%), wheezing in 11 cases(22.9%) and digit clubbing in 3 cases(6.3%). 3. Thepresumed causes were composed of not known in 30 cases(62.5%) and complications of measles in 7 cases(14.6%),pertusis in 5 cases(10.4%) and pneumonia in 4 cases(8.3%). Two cases were Kartagener's syndrom and unilateralhyperlucent lung. 4. Plain chest roentgenographic findings were abnormal in 42 cases(87.5%) but normal in 6cases(12.5%). The most common radiological findings was accentuation of lung markings in 36 cases(85.7%) theothers are include in order of frequency; pneumonic infiltration, linear radiolucencies, cystic radiolucencies,decreased affected lung volume air-fluid level and pleural thickening. 5. Bilateral bronchiectasis was demonstrated in 11 cases(22.9%) and the disease was much more often involved left lung than right. The mostcommonly involved lobe is left lower lobe, and the most common site of involvement was the posterior basal segmentof the lower lobe. The type of bronchiectasis is cylindrical in 22 cases(45.8%), varicose in 11 cases(22.9%),saccular in 9 cases(18.8%) and mixed type in 6 cases(12.5%)
Bronchi ; Bronchiectasis ; Bronchography ; Chest Pain ; Diagnosis ; Dilatation ; Dyspnea ; Female ; Hemoptysis ; Humans ; Incidence ; Lung ; Male ; Measles ; Pneumonia ; Respiratory Sounds ; Retrospective Studies ; Sputum ; Thorax