PURPOSE: To compare the functional and radiographic results of the treatment in unstable intra-articular fractures of distal radius by closed reduction and external fixation versus open reduction and internal fixation. MATERIALS AND METHODS: Forty cases of unstable intra-articular fractures of distal radius were treated either by application of closed reduction and external fixation (CREF) or by open reduction and internal fixation (ORIF) between March 1989 and June 1997. They were followed up for more than one year. To assess the functional results, we used Green and O' Brien' s score system and for the radiographic results, measured volar tilt, radial inclination and radial length. RESULT: In functional results, excellent to good results were obtained in 19 cases (76%) in the CREF group and 10 cases (80%) in the ORIF group, and the average score was 81.4 and 82.8 by the Green and O' Brien' s score system. In radiographic results, mean loss of volar tilt, radial inclination and radial length were 1.4 degree (13.4%), 2.0 degree (9.0%), 1.3 mm (10.3%) in the CREF group and 1.2 degree (10.8%), 1.6 degree (6.1%) and 1.2 mm (11.5%) in the ORIF group on last follow-up radiographs. There was no evidence of statistical difference between two groups in functional and radiographic results (P>0.05). CONCLUSIONS: If an appropriate operative method is selected according to the presence of several properties, including the pattern of fracture, the general condition and activity of patient and the degree of soft tissue injury, the two operative managements are considered useful to restoring articular congruity and alignment and to allow early postoperative range of motion exercise
Follow-Up Studies ; Humans ; Intra-Articular Fractures* ; Radius* ; Range of Motion, Articular ; Soft Tissue Injuries

It was reported that many adverse effects occurred to the growth areas of the adolescent player due to repititous strain. The injuries mainly involved in the shoulder and elbow, and named as little leaguers Shoulder and Little Leaguers: Elbow in boy baseball player. But the stress fracture of olecranon epiphyseal plate was rare and reported in a few cases. We reported a case observed in an adolescent Judo Player.
Adolescent ; Baseball ; Elbow ; Fractures, Stress ; Growth Plate ; Humans ; Male ; Martial Arts ; Olecranon Process ; Shoulder

Partial knee ankylosis is a recognized complication following open operative procedure, trauma and disease processes about the knee. It can result from the formation of intraarticular adhesion and contracture of the capsule as well as the shortening or adhesion of the quadriceps mechanism. Physical therspy and occasionally manipulation under the anesthesia may improve the results, but performed late, these methods will be useless. This is a review of 30 patients who had severe limitation of motion in the knee joint following open operative procedures or trauma about the knee and who were treated by the percutaneous release of adhesions under the arthroscopic control. The following results were obtained; There were 17 males and 13 females, and the age of release ranged from 23 to 69 years old (av. 42.8years old). The interval between arthroscopic adhesiolysis and the last follow-up evaluation ranged from 6 months to 5 years and 7 months(av. 23 months). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from 3 months to 4 years(av. 15 months). The average preoperative knee ROM was 38.8°the postoperative ROM was 121.1°and the average final knee ROM at follow-up was 102.6°So the average loss of ROM was 18.5°The arthroscopic adhesiolysis seems to be applied to the various conditions of the partial knee ankylosis and the results are better than the other surgical procedures when it was performed early enough.
Anesthesia ; Ankylosis ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Male ; Surgical Procedures, Operative

OBJECTIVE: Endometriosis is a disease affecting a large population of women all over the world. A local sterile inflammation occurs in the peritonel cavity of patients with endometriosis. It suggests that immunological events play a major role in the pathogenesis of endometriosis. We have studied the levels of serveral T cell and monocyte derived cytokines, especially IL-6 (promoter of immune response) and IL-10 (inhibitor of immune response), in the peritoneal fluid of patients with endometriosis to characterize the change of immune response that occurs at the site of endometriosis. Method: This study was performed in Hallym university hospital from October, 1997 to October 1998 and enrolled 29 women with gross or microscopic findings of minimal to severe endometriosis in case group, and 28 women without visual evidence of pelvic endometriosis and with benign gynecologic disease in control group. IL-6 and IL-10 levels in the peritoneal fluid were determined using commercial ELISA and compared between endometriosis and controls and between fertile and infertile women with endometriosis and according to the revised American Fertility Society classification. RESULT: IL-6 was higher and IL-10 was lower in the peritoneal fluid of endometriosis group than of control group. Cyclic variations in the IL-6 concentrations were seen in endometriosis group : the concentrations in the secretory phase were significantly higher than those in the proliferative phase. In endometriosis group, IL-6 concentrations of infertile women were higher than fertile women. Both IL-6 and IL-10 in the peritoneal fluid of endomtriosis group did not show significant correlation according to r-AFS stages. CONCLUSION: Increased IL-6 and decreased IL-10 levels in the peritoneal fluid may be related to infertility and pathogenesis in the endometriosis, suggesting that partially contribute to the disturbed immune regulation observed in endometriosis.
Ascitic Fluid* ; Classification ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertility ; Genital Diseases, Female ; Humans ; Infertility ; Inflammation ; Interleukin-10* ; Interleukin-6* ; Monocytes

OBJECTIVE: Our purpose was to investigate the relationship between the levels of IL-6 and tumor necrosis factor-alpha in the peritoneal fluid(PF) of women with and without endometriosis and infertile women. Design: Prospective and case-control study. Setting: University hospital. Patients: Twenty-nine women with laparotomy or laparoscopic findings of minimal to severe endometriosis, and twenty-eight women with no visual evidence of pelvic endometriosis and with benign gynecologic disease. Main Outcome Measures: PF IL-6 and tumor necrosis factor-alpha levels were determined using commercial ELISA. IL-6 and tumor necrosis factor-alpha concentrations were compared among women with and without endometriosis, and with infertile and fertile women, and then also compared according the revised American Fertility Society classification. RESULTS: IL-6 and tumor necrosis factor-alpha concentrations were higher than in the PF of women with endometriosis than in matched normal controls. Cyclic variations in IL-6 concentrations were seen in PF from patients with endometriosis: the concentrations in the secretory phase were significantly higher than those in the proliferative phase. IL-6 concentrations were higher than in the PF among of infertile women than in fertile women. A significant correlation between PF IL-6 and tumor necrosis factor-alpha concentrations and endometriosis stage III and IV was noted. CONCLUSIONS: Increased PF levels of IL-6 and tumor necrosis factor-alpha in patients with endometriosis may be relate to endometriosis-associated infertility and to the pathogenesis of endometriosis suggesting that partially contribute to the disturbed immune regulation observed in patients with endometriosis.
Ascitic Fluid* ; Case-Control Studies ; Classification ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertility ; Genital Diseases, Female ; Humans ; Immunity, Cellular* ; Infertility ; Interleukin-6 ; Laparotomy ; Outcome Assessment (Health Care) ; Prospective Studies ; Tumor Necrosis Factor-alpha

This study was undertaken to investigate the morphologic changes following flushing, preservation and reperfusion procedures in a canine lung allotransplantation model. Donor lungs were flushed with modified Euro-Collins (MEC) solution, low potassium dextran glucose (LPDG) solution or University of Wisconsin (UW) solution, then stored at 10oC for 20 hours. Light microscopic and electron microscopic features of the lungs were examined after flushing, preservation and 2 hours after reperfusion. After flushing light microscopy showed focal mild alveolar collapse and interstitial edema. After preservation the lung tissue showed multiple foci of alveolar collapse, consolidation, and alveolar epithelial cell damage. After reperfusion the lung tissue showed diffuse alveolar collapse, consolidation and many destroyed cellular debris in the alveolar lumina. After flushing electron microscopy showed focal alveolar collapse and mild swelling of type I epithelial cells. After preservation both type I epithelial cells and endothelial cells were swollen and destroyed focally. Some type I epithelial cells were detached from the basal lamina. The endothelial cells showed luminal protrusion of tactile-like structure and vacuoles of the cytoplasm. After reperfusion the lung tissue showed fibrin material in the alveoli, prominent type I epithelial cell swelling with fragmented cytoplasmic debris and marked endothelial cell swelling with vacuoles or tactile-like projections. The alveolar macrophages showed active phagocytosis. After preservation scanning electron microscopic examination of the pulmonary arteries showed multiple patchy areas of swelling or conglomerated lesions in the inner surface of the pulmonary arteries. In conclusion, the ultrastructural changes associated with flushing were mild in severity, the donor lungs were injured during the preservation, and further damage occurred during the reperfusion.
Basement Membrane ; Cytoplasm ; Dextrans ; Edema ; Endothelial Cells ; Epithelial Cells ; Fibrin ; Flushing ; Glucose ; Humans ; Lung Transplantation* ; Lung* ; Macrophages, Alveolar ; Microscopy ; Microscopy, Electron ; Perfusion* ; Phagocytosis ; Phenobarbital ; Potassium ; Pulmonary Artery ; Reperfusion* ; Tissue Donors ; Vacuoles ; Wisconsin

No abstract available.
Female ; Humans ; Pregnant Women*

OBJECTIVE: To determine whether hysterectomy by the vaginal route is safe and feasible in patients with previous pelvic operation. METHODS: A retrospective study of the records of Hallym University Hospistal patients who underwent vaginal hysterectomy performed by the senior author. Between January 1990 and January 1997, 212 patients who had previous pelvic operation were studied with special reference to operative difficulties, previous operation type, intraoperative complications, surgical time, hospital stay. RESULTS: 1. Patients characteristics was that ; The average age was 44.5+/-6.6 years old, the average parity was 2.3 , the average stay of hospitalization was 7.5+/-0.89 days, the frequency of Morcellation was in 24.5%, the average surgical time including associated procedure was 82+/-16.2 minutes, the average uterine weight was 164+/-85.1gm. 2. The most common previous pelvic operation was cesarean section(95 cases). 3. The most common indication was uterine myoma(51.9%). 4. Surgical technique used to gain access to the pouch of Douglas was done anteriorly; 52 patients of previous cesarean section(24.5%) and 112 patients of others operation(52.8%) were easily opened by blunt dissection, 43 patients of previous cesarean section(20.3%) and 5 patients of others operation(2.4%) were required sharp dissection. posterioly ; 190 patients(89.6%) were easily opened by blunt dissection, 22 patients(10.4%) were required sharp dissection. 5. Significant complications were bladder injury(1 case) , postoperative transfusion due to bleeding(6 cases). No cases of postoperative laparotomy was done and other minor compications were fever(15 cases), bladder retention(11 cases), others. CONCLUSIONS: It was possible to perform vaginal hysterectomy safely in patients with previous pelvic operation. Vaginal hysterectomy remains the method of choice for removal of the uterus of the previous pelvic operations in the absence of other contraindications.
Cesarean Section ; Female ; Hospitalization ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Intraoperative Complications ; Laparotomy ; Length of Stay ; Operative Time ; Parity ; Pregnancy ; Retrospective Studies ; Urinary Bladder ; Uterus

The soleal line in 115 (left; 61, right; 54) cases of tibiae was studied morphometrically by the method of Mysorekar and Nandedkar. 1. The soleal line showed a uniform character throughout in 26 cases and a mixed characters in 89 cases. The bones showing uniform character were seen generally as a lineal line or wide line. 2. The soleal line having mixed characters divided into three parts. In the upper and middle thirds, the major type of line was wide line. In the lower third, the line was commonly seen as a lineal line. In about 12% of the bones examined the line was seen as a groove, particularly in the middle and lower thirds. 3. The soleal line commenced 1-2cm below the fibular facet In about 61% of cases. 4. The length of the soleal line was 10.5cm, and the ratio to that of the tibia was about 30%. The results of this study provide the characters of the soleal tne of the tibia in Korean. The soleal line, unlike the textbook description, generally shows mixed characters of a line.
Methods ; Tibia*

With the current widespread use of obstetric ultrasonography, increasing cases of congenital malformations have been demonstrated antenatally. Both pulmonary sequestration and congenital cystic adenomatoid malformation of the lung (CCAM) are two infrequent congenital pulmonary diseases. The combination of these entities is rare. In the review of literature, this abnormality is so rare that only 80 cases were reported worldwide. To our knowledge, there has been no report that this combined malformation is located transdiaphragmatically. We report the first case of transdiaphragmatic extralobar pulmonary sequestration (ELS) associated with CCAM which was diagnosed by prenatal ultrasonography at 24 weeks gestational age.
Bronchopulmonary Sequestration* ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Gestational Age ; Lung Diseases ; Lung* ; Ultrasonography ; Ultrasonography, Prenatal