No abstract available.
Angiogenesis Inhibitors*

The tibial plateau fracture which involving articular surface of the proximsl tibia is very common in pedestrian injury of the traffic accident and sometimes results in significant disability in knee joint function. The authors analized 40 cases of the tibial plateau fracture treated in our depsrtment during the year 1980 through 1985. The results obtained are as follows : l. 15 cases were treated by conservative methods. 2. 25 cases were treted by operative methods. 3. 33 cases(82.5%) were “Acceptable” group according to Roberts criteria.
Accidents, Traffic ; Knee Joint ; Tibia

Hallux valgus is a complex deformity consisting of more than a 20° valgus angle of the first metatarsophalangeal joint. And more than 9° between the first and second metatarsals as well as bursal hypertrophy over the medial eminance of the first metatarsal head(bunion). Many surgical procedures have been available for treating the hallux valgus complex. Johnson and Coreless have acquired sufficiently good results in modifying the Mitchell osteotomy into the chevron osteotomy. They recommend the chevron osteotomy for the hallux valgus complex with the following patient profile : younger than 50 years old, hallux valgus angle less than 40°, the first-second intermetatarsal angle less than 20°. This procedure consists of 1) medial eminance removal, 2) V-shaped intracapsular osteotomy through the first metatarsal head, 3) lateral displacement of the capsular fragment, 4) removal of the resulting projection of the first metatarsal, and 5) medial capsulorrhaphy. Our results of eleven cases of the hallux valgus deformity which were treated by the chevron osteotomy during the period form July 1985 to Februsary 1988, in the Orthopedic Department of Keimyung University Dongsan Medical Center were as follows. 1. The average age at surgery was 43 years. 2. The average valgus angle was 38° and the first-second intermetatarsal angle was 15° preoperatively. They were correted to 19° and 10° respectively. 3. All cases had complained of severe metatarsalgia preoperatively. 4. The metatarsalgia subsided in all cases, and no avascular necrosis or nonunion was found.
Clinical Study ; Congenital Abnormalities ; Hallux Valgus ; Hallux ; Head ; Humans ; Hypertrophy ; Metatarsal Bones ; Metatarsalgia ; Metatarsophalangeal Joint ; Necrosis ; Orthopedics ; Osteotomy

In 1970, Boutine introduced a alumina ceramic for cemented total hip replacement . A ceramic articulation thought to be superior to metal on polyethylene due to its extremely low coefficient of friction and its potential for resistance to wear. Mechanical failure of ceramic femoral head is rare. We report a case of fracture of ceramic femoral head, which occured after implantation of uncemented total hip replacement.
Aluminum Oxide ; Arthroplasty, Replacement, Hip* ; Ceramics* ; Friction ; Head* ; Polyethylene

Generalized pustular psoriasis is a severe form of paoriasis and is frequently associated with arthritis and nail deformity. We present a case of generalized pustular psoriasis in a 40 year-old man, with nail change, arthritis of both knee and ankle joints, spondylitis, and glomerulonephritis. We found a positive results of HLA A-9, B-27 in this patient. Skin lesions, arthralgia and hematuria improved marked1y by plasmapheresis and application of topical corticostertoid.
Adult ; Ankle Joint ; Arthralgia ; Arthritis* ; Congenital Abnormalities ; Glomerulonephritis* ; Hematuria ; Humans ; Knee ; Plasmapheresis ; Psoriasis* ; Skin ; Spondylitis*

This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1. 1988 to June 30, 1989 and the post-implementation period was from July 1. 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respcetively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased form 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Department of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments (form 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 22. to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased form 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.
Angina Pectoris ; Carbuncle ; Communicable Diseases ; Diabetes Mellitus ; Duodenitis ; Fissure in Ano ; Gastritis ; Humans ; Hypertension ; Insurance ; Internal Medicine ; Outpatients* ; Pediatrics ; Referral and Consultation*

Most proximal humeral fractures respond satisfactory to simple conservative treatment. But operative treatment is recornmended in the cases that poor results are anticipated by prolonged immobilization, or because of the severe displacement and comminution. After Neer. in 1970, emphasized the need for operative treatment in displaced proximal humeral fractures, many papers reported better results with the operative management. Twenty five cases of displaced fractures and fracture dislocations of the proximal humerus treated at the department of orthopaedic surgery, Keimyung University with open reduction and internal fixation were analyzed clinically and radiologically. The following results were obtained. 1. The prevalent age distribution was the second snd third decades(average 42.6 years) and ratio of male and female was 2.1: 1. 2. In 10 of the 25 cases, wire loop was used for internal fixation, and the result was satisfactory in 8 cases. However, the disadvantage was difficulty in wire removal after bony union because the loop was buried in the callus or cortex. 3. Over-all results were excellent or satisfactory in 64% of 25 cases. There were 4 excellent and 1 satisfsctory in 5 cases of type Il fracture, 7 excellent, 2 satisfactory and 3 unsatisfactory in 12 cases of type III fracture, 1 excellent and 4 unsatisfactory in 5 cases of type 1V fracture, and 1 excellent, 1 unsatisfactory and 1 failure in 3 cases of fracture dislocation. 4. In 6 patients with four part lesions treated with open reduction and internal fixation and followed up for an average of 23 months(from 18 months to 3 years and 2 months), only one case of fracture dislocation revealed avascular necrosis with resorption of the head.
Age Distribution ; Bony Callus ; Dislocations ; Female ; Head ; Humans ; Humerus ; Immobilization ; Male ; Necrosis ; Shoulder Fractures

This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongjuu-city Health center, Seongju-Gun Health center and Koryong-Gun Health center in Kyongsangbuk-Do, from June 10 to october 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6 %), easy to get referral permission in health centers(27.l%), and very difficult to get referral permission in local clinics(l6.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested speciality is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.
Connective Tissue ; General Practitioners ; Gyeongsangbuk-do ; Hospitals, General ; Humans ; Musculoskeletal System ; Nervous System ; Orthopedics ; Parasitic Diseases ; Surveys and Questionnaires ; Referral and Consultation* ; Specialization*

Rotatory Instability of the permitting abnormal external totation of the tibia on the femur is the result af forced abduction of the flexed knee and external rotation of the tibia. The basic lesion is a tear in the medlal capsular ligament. The authors have reported clinical study in 40 patients with medial collateral ligament injuries who were treated by operative methods in the Orthopedic Department at the Taegu Presbyterian Hospital from January 1973 to Octdber 1979. of 40 patients, pes anserinus transplantation was performed on 15 patients and direct repair on 25 patients. The results are as followings: 1. All the patients were seen with a complete rupture of the medial collateral ligament and of these 45% had rupture of the femoral attachement. 2. Exellent to good result were more often obtained in recent injuries of less than 2 weeks rather than those in older Injuries. 3. Exellent to good result were more often obtained in the groups of Pes Anserinus tranplantation than the groups of direct repair. 4. In all cases of groups of pes anserinus transplantation, permanent sensory palsy af the patellar branches of the saphenous nerve was present due to the location of the surgical incision.
Clinical Study ; Collateral Ligaments ; Daegu ; Femur ; Humans ; Knee Joint ; Knee ; Ligaments ; Orthopedics ; Paralysis ; Protestantism ; Rupture ; Tears ; Tibia

Synovial chondromatosis is an uncommon benign lesion characterized by multiple cartilagenous and osteocartilagenous nodules of the synovium and loose bodies. The affection is monoarticular and most commonly involves the knee and has an unknown etiology. Of the five cases of synovial chondromatosis experienced by the authors, both knee joints were involved in a case, two the elbow joint, and one the proximal phalanx of the left middle finger. The diagnosis of synovial chondromatosis was made by the histopathological findings of the excised masses.
Chondromatosis, Synovial ; Diagnosis ; Elbow Joint ; Fingers ; Knee ; Knee Joint ; Synovial Membrane