Supracondylar fractures of the femur following total knee arthroplasty are rare complication with reported rates ranging from 0.3% to 2.5%. Union of the fracture in proper alignment, without disruption of prosthetic component fixation and with maintenance of 90 of knee motion, is impotant in treatment of this type of fracture. Modalties of treatment are conservative or operative methods and operative treatment are open reduction 4 internal fixation, intramedullary nailing, revision arthroplasty using a prosthesis with a long stem and closed reduction and external fixation, but there are controversies in the method of treatment. Between Apr. 1989 and Jul. 1994, 10 patients were treated for supracondylar fracture of the ipsilaterai femur following total knee atthroplasty and 2 cases of them had arthrop]asty at other hospital. Average age of patients was 53 years (29-68 years), nine patients were women and one was man. The preoperative diagnosis was rheumatoid arthritis in four, degenerative osteoaithritis in three, posttraumatic osteoarthritis in one and tuberculosis sequelae of the knee in two. In nine cases mechanism of injury were slip down and in one was fall down. The interval hetween arthroplasty and fracture was an average of 22 months (9-79months). Two cases we.re treated with closed reduction and cast immobilization, one case was treated with open eduction and in1ernal fixation and seven patients of' ten cases were treated with closed intramedullay Ender nailing. The average foIlow-up period after fracture was 25 months (3 - 74months). We evaluated the results as the range of motion, bony union at simple radiograph and Knee Rating Score of Hospital for Special Surgery at last follow up. Eight cases of supracondylar fracture occuned among 350 patients, 514 cases of total knee arthroplasty which were operated at Kyung Hee Univcrsity Hospital between Apr. 1989 and Jul. 1994 and incidence was 1.6%. At the last follow up, all 10 cases achieved bony union and 7 cases using Ender naiIing achieved clinical bony union which enabled patients to do weight-bearing without pain at postoperative 6-8 weeks and radiological union was achieved at postoperative 12 weeks. Range of motion were average 105 degrees (80 J.20 degrees) hefore fracture and 86 degrees (6S 120 degrees) at the last follow up and HSS Knee rating score were average 80.3 points (59 94 points) before fracture and average 78.8 points (66-89 points) at the last follow up. At 7 cases using Ender nailing, range of motion were average 106 degrees (90 11S degrees) hefore fracture and 91 degrees (6S-105 degrees) at last follow up and HSS Knee rating score were average 80.6 points (59-94 points) before fracture and average 80.3 points (72-89 poiints) at the last follow up. Closed iintramedullary Ender nailing is a gecommendable operative method in the treatment of supracondylar fracture following total knee arthroplasty considering to good bony union, satisfactory functional result, easy operative technique and less postoperative complication.
Arthritis, Rheumatoid ; Arthroplasty* ; Diagnosis ; Female ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Incidence ; Knee* ; Osteoarthritis ; Postoperative Complications ; Prostheses and Implants ; Range of Motion, Articular ; Tuberculosis ; Weight-Bearing

Posterior instability of the shoulder is far less common than anterior or multidirectional instability. There is still controversy in the diagnosis and treatment of recurrent posterior instability, and many treatment protocols have been advocated. However the failure rate as high as 50% was reported. The purpose of this study is to introduce characteristic physical findings of posterior instability, to present our operative techniques, and to report the efficacy of a superior shift of the postero-inferior capsule in the treatment of recurrent posterior instability. From June 1995 to September 1996, five patients, six shoulders underwent postero-inferior capsular shift for posterior instahility and were evaluated at an average of 17 months(ranged from 9 to 26 months) after operation. The average age was 22.4 years. Preoperatively, mean scores of pain, stability and function according to American Shoulder and Elbow Society (ASES) scoring system were 21, 9, and 16 points respectively and mean overall ASES score was 46 points. After surgery, the average range of motion was 175 of forward elevation and 74 of external rotation and internai rotation in back was up to the sixth thoracic level. Postoperative mean scores of pain, stability and function were 29, 34 and 25 points respectively and mean overall ASES score was 88.5 points. No patient had a recurrence of posterior instability. All patients had satisfactory results with significant improvement in stability and function except one case who had multidirectional instability that mainly involved the posterior component
Clinical Protocols ; Diagnosis ; Elbow ; Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

Epidermoid cysts occur rarely on the palms and soles, where hair is not present. These cysts have long been assumed to arise from traumatic implantation of epidermal fragment, but the pathogenesis is still controversial. Recently, with microscopic findings, immunohistochemical features, and molecular studies, the epidermoid cysts of the sole may be induced by the human papillomavirus. We report two cases of epidermoid cysts of the sole with the discussion of the pathogenesis.
Epidermal Cyst* ; Hair ; Humans*

CT has revolutionized the evaluation and management of patients with head injuries. CT is noninvasive and rapidly provides accurate information regarding the presence, extent and nature of intracranial lesions resulting from trauma. We have reviewed the CT scans of 114 patients, who got head injury with confirmed to skull fracture in plain film. The result were as follows; 1. Of all cases, traffic accident was the most frequent cause and in children fall down was more than 50%. 2. Compound linear fracture was the most frequent type fractures in plain skull film. 3. Of all 114 case, epidural hematoma was 16%, subdural hematoma was 18.4%, intracerebral hematoma was14.4%, subdural hygroma was 2.4%, normal finding was 50%. 4. Mortality rate was 13.2%. 5. Fracture was detected by CT about 28.9%, depression fracture was more easily detected in CT. 6. Incidence rate of countercoup lesion was14.0% and mortality rate was higher than same site lesion, 7. The shape of epidural hematoma was biconvex in 75%, planoconvex in 25%. 8. The shape of subdural hematoma was crescentic shape 82.6%, biconvex shape 8.7%, planoconvex shape 8.7%.
Accidents, Traffic ; Brain ; Child ; Craniocerebral Trauma ; Depression ; Head ; Hematoma ; Hematoma, Subdural ; Humans ; Incidence ; Mortality ; Skull Fractures ; Skull ; Subdural Effusion ; Tomography, X-Ray Computed

Toxic shock syndrome (TSS) is a rare but life-threatening illness that is mainly caused by toxigenic strains of Staphylococcus aureus. Although TSS is classically known to be associated with tampon use, the number of TSS cases with non-menstrual causes such as skin and soft tissue infection has been increasing. Tattooing can result in several complications such as localized and systemic infections, inflammatory skin eruptions and neoplasms. We recently experienced a 26-year-old man diagnosed with typical TSS following tattooing. He complained of fever, chills and erythematous rash at tattoo site. Subsequently, the patient developed sign of shock. The skin cultures on the tattoo site were positive for methicillin-sensitive Staphylococcus aureus. The patient was successfully treated with vasopressor infusion and intravenous antibiotics and was discharged without complications. On discharge from the hospital 7 days later, desquamations on the tattoo site, fingers and toes were observed.
Adult ; Anti-Bacterial Agents ; Chills ; Exanthema ; Fever ; Fingers ; Humans ; Shock ; Shock, Septic* ; Skin ; Soft Tissue Infections ; Staphylococcus aureus ; Tattooing* ; Toes

No abstract available.
Bone Density* ; Estrogens* ; Female ; Humans

A total of 33 patients with infective endocarditis were observed in the Guro and Hye Hwa Hospitals of Korea University Between September, 1981 and Feb, 1987. Among thses patients four patients presented with heart murmur and heart failure and had vegetation like findings observed on the two dimensional echocardiography. But these patients did not have any fever or leukocytosis in the peripheral blood and the repeated blood cultures were negative. They showed the immunologic phenomena of infective endocarditis such as microscopic hematuria in 4 patients, rheumatoid factor in 3 patients, false positive VDRL in one patient. The serum complement was decreased in 2 patients in whom it was checked. We report these 4 patients because we think these patients might be in the clinical stage in which the infecting organism is spontaneously cleared but the immunologic sequelae are remained.
Complement System Proteins ; Echocardiography ; Endocarditis* ; Fever ; Heart Failure ; Heart Murmurs ; Hematuria ; Humans ; Korea ; Leukocytosis ; Rheumatoid Factor

Intradural extramedullary tuberculoma of the spinal cord (IETSC) is an uncommon disease which can occurs secondary to tuberculous meningitis. A 31-year-old woman was diagnosed as tuberculous meningitis after mental disorientation. Her mentality was recovered after antituberculous therapy. After 7 months of antituberculous therapy, paraplegia has developed. Magnetic resonance imaging (MRI) revealed a mass lesion between the T1 and T12 spinal levels with arachnoid thickening which results in the development of tuberculoma. She received surgical resection of IETSC followed by antituberculous therapy and neurological function has been improved. The two years after surgical treatment, spinal MRI showed syringomyelia between T1 to L1. But, her neurological outcome was not aggravated.
Adult ; Arachnoid ; Female ; Humans ; Magnetic Resonance Imaging ; Paraplegia ; Spinal Cord* ; Syringomyelia ; Tuberculoma* ; Tuberculosis, Meningeal*

PURPOSE: To determine whether there is a relationship between abnormal temporomandibular joint radiographic findings and age or gender in a sample of preorthodontic patients. MATERIALS AND METHODS: Individualized corrected sagittal tomographs of 188 temporomandibular joints in 94 preorthodontic patients, aged 11 to 29 years, were taken and viewed by an observer blinded to clinical records. The study population was divided into 2 aged groups (11-15 years and 16-29 years) for comparative purposes. Temporomandibular joint radiographic findings were classified as normal or abnormal. RESULTS: There was no difference in ratio of abnormal to normal findings between the both aged groups. The frequency of osseous abnormalities was similar with that of abnormalities of condylar position. Abnormalities in CP and JS were most frequent in all aged groups. CONCLUSION: There is no significant difference between ages or genders for temporomandibular joint radiographic abnormalities.
Humans ; Orthodontics ; Temporomandibular Joint*

Background: Hypertension results from an impaired baroreceptor reflex and enhanced sympathetic activity. The prevalence of hypertension differs among ethnicities and is more frequent in South Asians than in Caucasians, suggesting that baseline autonomic nervous system functions and their regulation may also differ among ethnic groups. In most studies, the reference values for clinical autonomic function tests are obtained from heterogeneous ethnic populations, or ethnic factors are not considered in the study design. Obtaining reference data in a homogenous ethnic group and comparing them within various ethnic groups could be helpful to detect ethnic differences in autonomic functions. The aim of this study was to identify normative reference values for standard autonomic reflex measurements in a homogeneous Korean population. Methods: A total of 181 healthy Korean volunteers (age, 20–74 years) underwent standard autonomic function tests: heart rate difference during deep breathing, Valsalva maneuver, and the quantitative sudomotor axon-reflex test. Mean and 5th and 95th percentile values were obtained for each age group. We also analyzed factors (age, sex, and body mass index) that can influence autonomic functions. Results: The heart rate difference during deep breathing and expiratory-inspiratory ratio were higher in males than in females and were inversely related to age. The Valsalva ratio was inversely related to age. Males had higher sweat volumes at all body areas evaluated than those of females, and only forearm sweat volume was significantly different between the age groups. Conclusions: Cardiovagal function was affected by age and sex in Koreans. Sudomotor function was affected by sex, and only forearm sweat volume was affected by age and sex. These results represent preliminary normative clinical autonomic data in a Korean population comprised of a single ethnicity
Hypertension