30 cases of distal femur fracture were treated with cast-brace for 2 years and 6 months from Feb., 1977 till July, 1979 at the department of Orthopaedic Surgery, Presbyterian Medical Center, in Jeon Ju. The results were obtained as follows: 1. In 9 cases, cast-brace were applied initially and other 21 cases were treated with cast-brace secondarily after operation. 2. 20 cases were male and 10 cases were female. 3. 12 cases were on mid 1/3 fracture and 18 cases were distal 1/3 fracture involving 2 condylar fractures. 4. The average duration of fracture healing was 14.7 weeks in the cases with cast-brace which is compared with 20.7 weeks of hip-spica cast control group. 5. A.G.F. of knee joint was 80–115 degree at removal of cast-brace, otherwise merely 50–65 degree at dlscarding of hip-spica cast. 6. There were no complication such as nonunion or delayed union in the cases with cast-brace.
Braces ; Female ; Femur ; Fracture Healing ; Humans ; Jeollabuk-do ; Knee Joint ; Male ; Protestantism

A total of 188 cases of primary bone tumor was reviewed and analyzed clinically and pathologically at the Department of Orthopaedic Surgery, Presbyterian Medical Center, Jeonju, Korea during the 10 years period from January, 1970 to December, 1979. The results were obtained as follows: 1. 58 cases were benign and 130 cases were malignant. 2. Osteochondroma was the most common benign bone tumor and followed by giant cell tumor, simple bone cyst, osteoma and fibrous dysplasia. 3. Giant cell tumor was 15 cases, which were divided pathologically into benign(Grade I & II) 8 cases and malignant (Grade III) 7 cases. and treated by curretage, curettage & bone graft, arthrodesis, irradiation and amputation. 4. The most common primary malignant bone tumor was osteosarcoma, and it was followed by chondrosarcoma, fibrosarcoma and multiple myeloma. 5. Osteosarcoma was 60 cases and it occured commoly around knee joint area. 6. Treatment of primary malignant bone tumor contained of amputation, chemotherapy and irradiation.
Amputation ; Arthrodesis ; Bone Cysts ; Chondrosarcoma ; Curettage ; Drug Therapy ; Fibrosarcoma ; Giant Cell Tumors ; Jeollabuk-do ; Knee Joint ; Korea ; Multiple Myeloma ; Osteochondroma ; Osteoma ; Osteosarcoma ; Protestantism ; Transplants

BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

Conjoined twins occur when there is imcomplete fission of the inner cell mass later at approximately 13 to 15 days after fertilization. The earlist case in the literat.ure appears to be that of the Biddenden Maids who were born in England in 1100. since then over two hundred cases of successful separation were reported on literature. And also successful separation cases were reported by Seung et al.(1991) in Korea. Conjoined twins occur between one in 50,000 to 100,000 births but real incidence is one in 200,000 because two thirds are stillbirth or died immediately after birth. The conjoined twins are not associated with maternal age, race or family history and 70 % of them are females. We experienced a case of conjoined twins with omphalopagus and performed surgical separation. A brief review of related literatures was done.
Animals ; Continental Population Groups ; England ; Female ; Fertilization ; Humans ; Incidence ; Korea ; Maternal Age ; Murine Acquired Immunodeficiency Syndrome ; Parturition ; Stillbirth ; Twins, Conjoined*

PURPOSE: To report clinical appearances and the outcomes of patients treated for wrist laceration with suicidal intent. MATERIALS AND METHODS: Between March 2005 and February 2008, patients with wrist laceration were treated at our center. Among them, 14 patients with suicidal intent were reviewed retrospectively. They were 8 females and 6 males with a mean age of 33 years at the time of treatment. The side of injured wrist, injured structures, suicidal instrument, the time of injury, a suicidal motive, drug or alcohol abuse or not, indication of combined psychiatric disease, the duration of postoperative treatment, and the results of treatment were analyzed. RESULTS: The injured wrist was the left one in 13 cases (93%), and knife wounds in 11 cases (79%) was the most frequent mechanism of injury. An average of 4.6 structures were injured including 3.5 tendons, 0.57 nerves and 0.5 arteries. The most frequently injured structures were the palmaris longus (71%), FCU (50%), FCR (43%), FDS 3 (36%), FDS 2, median nerve, and ulnar artery (each 29%). Simultaneous injury of both median and ulnar nerves occurred in 3 cases (21%), and simultaneous injury of both radial and ulnar artery occurred in 1 case (7%). The injury time was the night in 12 cases (86%), and the most frequent suicidal motive was human relations such as lover or spouse in 12 cases (86%). In 9 cases (64%), the injured were in a drunken state, 3 cases (21%) had been treated for a psychiatric disease at the time of the injury. The durations of postoperative treatment were an average of 5 days of admission and 1 day follow up. Only 1 case results could be evaluated. CONCLUSIONS: Patient's poor compliance in wrist laceration with suicidal intent should be expected and these characteristics may affect the management plan.
Alcoholism ; Arteries ; Compliance ; Female ; Follow-Up Studies ; Humans ; Lacerations ; Male ; Median Nerve ; Retrospective Studies ; Spouses ; Suicide ; Tendons ; Ulnar Artery ; Ulnar Nerve ; Wrist

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

PURPOSE: Arterialized venous flap is useful for reconstruction of the traumatic soft tissue defect in fingers, but insufficient circulation of the traumatic fingers makes surgeons annoying to use the flap. We have grafted flaps in 7 fingers with insufficient vascular bed hoping to expanded the category of the flap. MATERIALS AND METHODS: Arterialized venous flap have transplanted in 7 fingers from March 2008 through February 2010 and followed up for 4 to 16 months(average 7.2 months). They were all male with a mean age at the time of surgery was 33. The main injury was crushing in 4 degloving, contact burn and saw injury was I respectively. Time interval from injury to flap transplantation was average 3.1. weeks(3 days to 6 weeks). Designed flap size ranges from 8 cm x 3.5 cm to 4 cm x 3 cm. Vessel type of flap was one artery with two veins were 5 cases and one artey with one vein 2. Flap type was cutaneous in 3, tendocutaneous 2, neurotendocutaneous 1 and neurocutaneous 1. The circulation state of recipient site was avascular in 2 cases, insufficiency 3 and tip avascular 2. RESULTS: Arterialized venous flap was complete survived in 2 cases, partial necrosis(less than 10%) 3 and failed in 2. CONCLUSION: An arterialized venous free flap could be a useful procedure for reconstruction in soft tissue or combined defect of the finger despite an avascular or insufficient vascular beds if the recipient beds were free from infection.
Arteries ; Burns ; Fingers ; Free Tissue Flaps ; Glycosaminoglycans ; Humans ; Male ; Transplants ; Veins

An intestinal obstruction is a common cause of acute abdominal diseases which need emergency measures. Sigmoid volvulus is one of rare causes of colonic obstruction and occupies 2~3% of its causes in Korea. Volvulus requires a prompt diagnosis and decompression in order to prevent its progression to strangulation and gangrene. Although 90% of sigmoid volvulus can be diagnosed just by plain abdominal x-ray, computed tomography or barium enema can be done for more accurate diagnoses. For the successful treatment, accurate early examination, endoscopic reduction and surgical colonic resection are required. Endoscopic reduction has low mortality but is liable to recur, whereas emergency colonic resection has little recurrence rate but a high mortality. We experienced a case of a sigmoid volvulus in a 55-year-old male who companied of sudden abdominal pain. After diagnosed as sigmoid volvulus through plain abdominal x-ray and abdominal computed tomography, endoscopic reduction was done in the early period of development, and the sigmoid resection was performed after 7 days. We report our experience with a review of the literature regarding the diagnosis and treatment of sigmoid volvulus.
Abdominal Pain ; Barium ; Colon* ; Colon, Sigmoid* ; Decompression ; Diagnosis ; Emergencies* ; Enema ; Gangrene ; Humans ; Intestinal Obstruction ; Intestinal Volvulus* ; Korea ; Male ; Middle Aged ; Mortality ; Recurrence

BACKGROUND: Left ventricular hypertrophy is major cardiovascular risk factor for sudden death, acute myocardial infarction and congestive heart failure. Antihypertensive treatment able to normalize blood pressure and regression of left ventricular mass would also favorabley affect coronary flow reserve and cardiovascular mortality. OBJECT: This study was designed to explore changes of left venrtricular mass, echocardiographic datas such as interventricular septal thickness in diastole, posterior wall thickness in diastole, left ventricular end diastolic dimension, relative wall thickness, mainmorphologic change of LV, and diastolic function after antihypertensive treatment. METHODS: From May 1988 to Agust 1997, in 41 patients(14 men, 27 women) with estaiblished essential hypertension aged 35 to 78(mean 56+/-13) year were studied. We obtained the basal echocardiography and follow up echocardiography after treatment. RESULT: The results were as followings: 1) Baseline blood pressure was 157/92mmHg and fell to 137/81mmHg(p<0.001), and LV mass were reduced from 133.9g/mg2 to 132.9g/m2 without statistical significance. 2) Most of the patients(48.8%) were remained increased LV mass and only 12% of the patients were revert to normal LV mass. 3) Most of the patients remained same LV morphology after antihypertensive treatment. 4) Normalization of LV diastolic dysfunction was not observed after antihypertensive treatment. CONCLUSION: Most of the patients were remained increased LV mass, same morphology, and relaxation abnormality of LV after antihypertensive treatments. For analysis of our result, follow up studies are needed about regression of LV mass, remodeling of LV, diastolic function after antihypertensive treatment.
Blood Pressure ; Death, Sudden ; Diastole ; Echocardiography ; Follow-Up Studies ; Heart Failure ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Male ; Mortality ; Myocardial Infarction ; Relaxation ; Risk Factors

The pathophysiology, clinical presentation and prognosis of left ventricular obstruction present an important cardiological problem. Various anatomical and functional abnormality can cause this phenomenon. Rarely, left ventricular outflow obstruction can result after mitral valve surgery. We experienced a case of left ventricular outflow obdtruction 13 years after mitral valve replavement. The diagnosis was made using two-dimensinal Doppler echocardiography and confirmed by cardiac catheterization. The pressure gradient across the left ventricular outflow obstruction was 96mmHg. A second mitral valve replacement was performed. Because severe fibrosis, pannis around the prosthetic mitral valve and a subaortic web were detected during the operation, the subaortic web was removes.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography, Doppler ; Fibrosis ; Mitral Valve* ; Prognosis ; Ventricular Outflow Obstruction*