No abstract available.
Animals ; Autografts* ; Rats*

Seventeen cases of Kienbock's disease were treated since 1982, and analysed their clinical outcomes to confine the pathogenesis and to make sure the best way to treat them in various stages. It was not related to trauma around wrist joint (35.3%) but significantly closed to ulnar negative variances(64.7%). Ulnar tilt angle was increased definitely upto 28.9° compared with normal value (22°) in ulnar negative variance, but volar tilt angle was within normal limits. The packing with tensor fascia lata or palmaris longus tendon after the complete excision of avascular lunate could not prevent the collapse of carpal bones at long-term follow-up. But the triscaphe fusion was most effective to maintain the normal wrist anatomy, and radial shortening than ulnar lengtherning is thought to be more effective in wrist biomechanics of kienbock's disease with ulnar negative variances.
Carpal Bones ; Clinical Study ; Fascia Lata ; Follow-Up Studies ; Osteonecrosis ; Reference Values ; Tendons ; Wrist ; Wrist Joint

Spinal stenosis is a localized narrowing of spinal canal due to strurctural abnormalities. Its symptoms are obscure, and characterized by chronic, poorly localized, bilateral nerve root compression signs. Computerized tomography(CT) has been accepted as almost an absolute diagnostic method for spinal stenosis after its application in the orthopedic field. During the period of 2 years, from March 1982 to March 1984, 26 cases of spinal stenosis were treated surgically after botlt CT scanning and myelography. We obtained following results about advantage of CT scanning in spinal stenosis. 1. Myelography showed following findings: Hourglass defect 9, Complete block 8, Unilateral focal defect 4, Uniform narrowing 1, Mixed 2, Negative finding 2. Myelographic finding was not specific for spinal stenosis and diagnostic accuracy was inferior to CT. 2. The type of spinal stenosis was identified by CT scan finding. Of 26 cases, 21 cases were degenerative spinal stenosis, of which central stenosis was present in 7 cases, and lateral stenosis was present in all cases. The remaining 5 cases were combined type, and both central and lateral stenosis were present in all cases. 3. The diagnostic accuracy,in localizing the level of stenosis was 61.5% by myelography, and 96.2% by CT scan. CT was especially superior to myelography in the localization of the multi-segmental stenosis. 4. CT gives valuable information about extent and degree of stenosis, especially lateral recess stenosis, thus helping the surgeon to decide on the extent of decompressive lamininectomy preoperatively.
Clothing ; Constriction, Pathologic ; Methods ; Myelography ; Orthopedics ; Radiculopathy ; Spinal Canal ; Spinal Stenosis ; Tomography, X-Ray Computed

Six hundred and fifty one cases of bone tumors diagnosed and operated at Department of Orthopedic Surgery, Seoul National University Hospital, from Jan., 1969 to Apr., 1989. were reviewed and analyzed with respect to the types of tumor, the age and sex distribution of the patients, the location of the lesions and the advances of diagnosis and treatment. 378 benign and 273 malignant bone tumors were identified. Osteochondroma(113 cases, 17.4%) was the most common bone tumor, followed by osteosarcoma(72 cases, 11.1%) and giant cell tumor(50 cases, 7.7%) Second decade was the most common age of bone tumors(216 cases, 33.2%) and male(379 cases, 58%) was more common than female. Femur(222 cases) was the most common site of bone tumors, followed by tibia and vertebra. For simple bone cyst, steroid injection was widely used recently. It was a simple and safe procedure and its results were similar to those of curettage and bone graft. Limb salvage operations were performed for malignant bone tumors increasingly. Neoadjuvant chemotyeraphy and limb salvsge operation using tumor prosthesis were performed in 5 patients of osteosarcoma and their results are so far promising. Of 7 cases of chondrosarcoma, the limb was salvaged by resection arthrodesis or resection arthroplasty. 7 cases of malignant fibrous histiocytoma were treated by radical ablative surgery and/or chemotherapy and radiation, but local recurrence or pulmonary metastasis were detected in all of them. So it was thought to be highly malignant bone tumors.
Arthrodesis ; Arthroplasty ; Bone Cysts ; Chondrosarcoma ; Curettage ; Diagnosis ; Drug Therapy ; Epidemiologic Studies ; Extremities ; Female ; Giant Cells ; Histiocytoma, Malignant Fibrous ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Orthopedics ; Osteosarcoma ; Prostheses and Implants ; Recurrence ; Seoul ; Sex Distribution ; Spine ; Tibia ; Transplants

No abstract available.

BACKGROUND: Pulmonary complications including pneumonia and pulmonary edema frequently develop in critically ill surgical patients. Lung ultrasound (LUS) is increasingly used as a powerful diagnostic tool for pulmonary complications. The purpose of this study was to report how LUS is used in a surgical intensive care unit (ICU). METHODS: This study retrospectively reviewed the medical records of 67 patients who underwent LUS in surgical ICU between May 2016 and December 2016. RESULTS: The indication for LUS included hypoxemia (n = 44, 65.7%), abnormal chest radiographs without hypoxemia (n = 17, 25.4%), fever without both hypoxemia and abnormal chest radiographs (n = 4, 6.0%), and difficult weaning (n = 2, 3.0%). Among 67 patients, 55 patients were diagnosed with pulmonary edema (n = 27, 41.8%), pneumonia (n = 20, 29.9%), diffuse interstitial pattern with anterior consolidation (n = 6, 10.9%), pneumothorax with effusion (n = 1, 1.5%), and diaphragm dysfunction (n = 1, 1.5%), respectively, via LUS. LUS results did not indicate lung complications for 12 patients. Based on the location of space opacification on the chest radiographs, among 45 patients with bilateral abnormality and normal findings, three (6.7%) and two (4.4%) patients were finally diagnosed with pneumonia and atelectasis, respectively. Furthermore, among 34 patients with unilateral abnormality and normal findings, two patients (5.9%) were finally diagnosed with pulmonary edema. There were 27 patients who were initially diagnosed with pulmonary edema via LUS. This diagnosis was later confirmed by other tests. There were 20 patients who were initially diagnosed with pneumonia via LUS. Among them, 16 and 4 patients were finally diagnosed with pneumonia and atelectasis, respectively. CONCLUSIONS: LUS is useful to detect pulmonary complications including pulmonary edema and pneumonia in surgically ill patients.
Anoxia ; Critical Care* ; Critical Illness ; Diagnosis ; Diaphragm ; Fever ; Humans ; Lung* ; Medical Records ; Pneumonia ; Pneumothorax ; Pulmonary Atelectasis ; Pulmonary Edema ; Radiography, Thoracic ; Retrospective Studies ; Ultrasonography* ; Weaning

No abstract available.
Hemolytic-Uremic Syndrome*

No abstract available.
Child* ; Humans ; Reye Syndrome*

We analyzed 57 patients with tuberculous nonfunctioning kidneys, which were diagnosed pathologically or bacteriologically at Seoul National University, from October 1981 to December 1989. The patients were divided into 3 groups according to the treatment ; Group 1 : 12 patients, only chemotherapy for more than 12 months ; Group 2 :32, nephrectomy and chemotherapy for more than 6 months ; Group 3 . 13, nephrectomy and chemotherapy only for 3 months. As a standard antituberculous regimen, isoniazid, rifampin, and ethambutol were used, and pyrazinamide was added in 15 patients. The follow-up tests were urinalysis, urine AFB smear and culture, and intravenous pyelography. The duration of the follow-up was 6 to 1O8 months, with a mean of 23.3 months. There was no evidence of recurrence in any patient among the 3 groups. Two postoperative complications (hematoma and fistula formation) occurred in 45 nephrectomized patients. Pathologic examination of the resected kidneys revealed findings compatible with tuberculosis in all patients of Groups 2 and 3. Coexisting cortical adenomas were found incidentally in 2 patients. Final diagnoses of the other 2 patients were hydronephrosis and chronic pyelonephritis without any evidence of tuberculosis, although these 2 patients were excluded in this study. Severe drug toxicity occurred in 7 patients that belonged to Groups 1 and 2. In conclusion, early nephrectomy for accurate diagnosis and removal of infective foci was the justifiable initial procedure, and this should be followed by postoperative antituberculous chemotherapy for the shortest acceptable period in tuberculous nonfunctioning kidneys. In highly selective cases where the lesion is completely localized in one kidney, we can consider early nephrectomy and a 3-month course of chemotherapy as one treatment modality.
Adenoma ; Diagnosis ; Drug Therapy ; Drug-Related Side Effects and Adverse Reactions ; Ethambutol ; Fistula ; Follow-Up Studies ; Humans ; Hydronephrosis ; Isoniazid ; Kidney* ; Nephrectomy ; Postoperative Complications ; Pyelonephritis ; Pyrazinamide ; Recurrence ; Rifampin ; Seoul ; Tuberculosis ; Urinalysis ; Urography

No abstract available.
Catheters* ; Heart Defects, Congenital*