It has been well known that the incidence of delayed or nonunion of tibial shaft fracture is high and in order to improve methods of treatment and to get satisfactory final results in these fractures, it is important to find out as early as possible whether the fracture is healing normally or not. The fracture healing is closely related to the circulatory conditions at the fracture site, however, in contrast to animal experiments it is impossible to visualize directly the circulatory conditions at the fracture site. There have been many efforts to visualize indirectly these vascular re-establishments through angiography. Kaski(1974) reported a paper concerning osteomedullography of tibial fracture with phlebocompression and noticed 5 types of veins related to the process of healing. We performed 54 cases of osteomedullography in 41 tibial fracture at 3 months after treatment and the following results were obtained: 1. The sinusoidal vein in the proximal fragment was observed most frequently and the next were intra-osseous crossing vein, periosteal callus vein, ascending branch of main efferent vein, and periosteal veins of proximal fragment in decreasig frequency. 2. The rate of positive finding in osteomedullography at 3 months after treatment was lower, and periosteal callus veins were observed more frequently in the group treated with only cast immobilization than in the group treated with plate and screws. 3. In the group treated with compression plate and screws, osteomedullographs were positive in all 3 cases within 3 months after operation and sinusoidal veins in the proximal fragment were visualized in all cases, however periosteal callus vein was not visualized at all. 4. After bone graft, the differentiation of periosteal callus from grafted bone was not easy in plain X-ray film, but osteomedullography was very useful in these cases. Positive findings were noticed in 2~3 months in all cases following bone graft. 5. The authors found that the ideal time of performing osteomedullography was 3 months following treatment. If found to be negative after 4 months following treatment, bone graft was necessary.
Angiography ; Animal Experimentation ; Bony Callus ; Fracture Healing ; Immobilization ; Incidence ; Tibial Fractures ; Transplants ; Veins ; X-Ray Film

In military training, the knee joint is more susceptible to trauma than any other joint in the body. Chronic knee instability is a difficult problem for both the patient and the orthopaedic surgeon who must correct the disability. To achieve the best possible result, the surgeon must first make the correct diagnosis and be aware of the type or types of instability that exist. There may be associated instability in a rotatory plane as described by Slocum and Larson, and the surgeon must examine carefully for this. Various surgical techniques have been used in the past to repair the knee static stabilizers such as ligaments and capsule. Since the introduction of the dynamic concept of rotatory instability and the need for muscular reinforcement of static repair, most orthopaedists have attempted to back up their reapirs with various types of dynamic stabilization such as the pes anserinus transfer and advancement of semimembranosus. 39 cases of medial instability of the knee joint were analysed clinically in the department of orthopaedic surgery of Busan Armed Froce General Hospital from Feb. 1977 to Feb. 1980 and following results were obtained. 1. All of the cases were military personnels, most of them were privates and P.F.C. showed most frequent incidence in 19 cases (49%). 2. Sports injury was a main causes of the knee instability. 3. The highest incidence in severity of the lesion was grade III in 21 cases (54%). 4. Among 39 cases of ligamentous injuries of medial side, rupture of collateral ligament alone were 30 cases, and mixed injuries with cruciate were 9 cases. 5. The pes transfer was performed in all of the cases with acute medial collateral rupture, and even in the cases with instability after primary repair, good results were obtained by carrying out dynamic muscle or tendon transfer. 6. In some cases, the patient did not feel much discomfort for the remaining static instability in valgus stress test after dynamic reconstruction. This was thought to be overcome by dynamic force during use of the leg. 7. For the purpose to prevent further stretching of repaired ligaments, derotation brace were recommended in 5 cases of dynamic reconstructive surgery.
Arm ; Athletic Injuries ; Braces ; Busan ; Clinical Study ; Collateral Ligaments ; Diagnosis ; Exercise Test ; Hospitals, General ; Humans ; Incidence ; Joints ; Knee ; Knee Joint ; Leg ; Ligaments ; Military Personnel ; Rupture ; Tendon Transfer

A Case of multifocal reticulum cell sarcoma in a 61 year old male is reported. The patient had multiple foci of sarcomatous lesion in the olecranon of the right ulna, medial candyle of the left tibia and in both ankle joints. His initial complaints on admission were pain and swelling in his both ankles and the right elbow of three months duration. Biopsy was carried out on his right ankle joint and diagnosis of reticulum cell sarcoma was made. Surgical excision of the right olecranon and below Knee amputation of the right lower extremity were performed. Following the surgical intervention, Cobalt 60 irradiation therapy was given for 20 days with total amount of 4,000 rads. The follow-up study three months after surgery revealed much improvement and no evidence of recurrence.
Amputation ; Ankle ; Ankle Joint ; Biopsy ; Cobalt ; Diagnosis ; Elbow ; Follow-Up Studies ; Humans ; Knee ; Lower Extremity ; Lymphoma, Non-Hodgkin ; Male ; Olecranon Process ; Recurrence ; Reticulum ; Tibia ; Ulna

The author reviewed eighteen congenitally dislocated hips in Kyung Hee University Hospital during the three and a half year period (rom September, 1973 to March, 1977. The following observations were made. 1. The average age of the patients at the first visit was 17.9 months. 2. All 16 patients were female. 3. There were 2 bilateral dislocations and 14 unilateral dislocations. 4. Left side was dislocated in 12 hips snd right side in 6 hips. 5. Limping was the chief complaint in 12(75%) of the patients. 6. Arthrogram gave valuable information as to make correct diagnosis and treatment. 7. Twelve hips were successfully treated by closed methods and 6 hips required operative treatment. 8. Following reduction, cast immobilization was continued for an average of 5 months in the conservative series. 9. In the conservative series, the acetabular index decreased from 33.4 degree before treatment to 28.1 degree immediately after removal of cast. 10. The results were good or excellent in all except for 2 cases of avascular necrosis and 1 case of redislocation.
Acetabulum ; Diagnosis ; Dislocations ; Female ; Hip ; Humans ; Immobilization ; Necrosis

The patient was a 35 year old woman complaining of non tender erythematous nodule on the left nipple for 2 years. Histopathologic findings showed focal acanthosis and extension of epithelium into some of the superficial ductal structures. In the dermis, the tubules were lined by a peripheral layer of cuboidal cells and a inner layer of columnar cells. The papillary projections of the luminal cells into the lumen also were shown. In the upper dermis, we could find the keratin cysta. She was treated with a simple excision of the nipple and subareolar tissue.
Adult ; Dermis ; Epithelium ; Female ; Humans ; Nipples* ; Phenobarbital

No abstract available.
Animals ; Magnetic Resonance Spectroscopy* ; Rats* ; Skin*

Photographic standards in plastic surgery is an important problem that has been stressed in the discipline over the past several years. Clinical photographs should always be taken with the same camera lens, lens setting, lighting, film, and patient position to ensure reproducibility and to enable valid pre- and postoperative comparisons. However, no photographic standards in plastic surgery were established in Korean Society of Plastic and Reconstructive Surgeons. We analyzed that inappropriate photographs in the total publishing photographs were counted on the Journals of the Korean Society of Plastic and Reconstructive Surgeons from 1995 to 2000. The causes of inappropriate photographs were categorized as six groups. We found three characteristics from photograph published on this journals. First, the ratio of inappropriate photographs were not decreased for recent six years - 30.6% in 1995 and 29,7% in 2000. The mean proportion of poorly qualifying photographs in total photos was 29.3% during six years. Second, the subject malposition due to incorrect anatomic landmark and technical errors were 34.8%., 20.0%, respectively. The markedly different size of pre-and postoperative subject, inappropriate orientation of camera (horizontally or vertically), inadequate patient preparation, others were 15.3%, 14.9%, 7.9%, 7.1% in order. Third, the most patient identity in this publication was recognizable regardless of patient consent(1673/1761, 95.0%). In our conclusion, first, the ease photographic standards for plastic surgeon in Korea was guided in our study. Second, we thought that the ease of using digital photography may be able to correct the inappropriate photographs due to technical errors of amateur. Third, we proposed that new format of permission for patient photographic authorization and release will be needed because of prevention against sue for invasion of privacy or release of identity in Korea.
Anatomic Landmarks ; Humans ; Informed Consent ; Korea ; Photography ; Privacy ; Publications ; Surgery, Plastic*

No abstract available.
Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia*

A few patients with Parkinson's disease (PD) crave large amounts of levodopa therapy far beyond those needed to alleviate their symptoms, even in the state of overdose complication. Such harmful pattern of compulsive dopaminergic drug use is called as dopamine dysregulation syndrome (DDS). We report a chronic stage PD patient presenting with high fever and altered mentality, who had the DDS as well as the Parkinsonism hyperpyrexia syndrome (PHS).
Dopamine* ; Fever ; Humans ; Levodopa ; Parkinson Disease ; Parkinsonian Disorders*

OBJECTIVE: Atrophy and a high T2 signal of the hippocampus are known to be the principal MR imaging findings of hippocampal sclerosis. The purpose of this study was to determine whether or not individual MRI findings correlate with surgical outcome in patients with this condition. MATERIALS AND METHODS: Preoperative MR imaging findings in 57 consecutive patients with pathologically-proven hippocampal sclerosis who underwent anterior temporal lobectomy and were followed-up for 24 months or more were retrospectively reviewed, and the results were compared with the postsurgical out-come (Engel classification). The MR images included routine sagittal T1-weighted and axial T2-weighted spin-echo images, and oblique coronal T1-weighted 3D gradient-echo and T2-weighted 2D fast spin-echo images obtained on either a 1.5 T or 1.0 T unit. The images were visually evaluated by two neuroradiologists blinded to the outcome; their focus was the presence or absence of atrophy and a high T2 hippocampal signal. RESULTS: Hippocampal atrophy was seen in 96% of cases (55/57) [100% (53/53) of the good outcome group (Engel class I and II), and 50% (2/4) of the poor outcome group (class III and IV)]. A high T2 hippocampal signal was seen in 61% of cases (35/57) [62% (33/53) of the good outcome group and 50% (2/4) of the poor outcome group]. All 35 patients with a high T2 signal had hippocampal atrophy. `Normal' hippocampus, as revealed by MR imaging, occurred in 4% of patients (2/57), both of whom showed a poor outcome (Engel class III). The presence or absence of hippocampal atrophy correlated well with surgical outcome (p<0.01). High T2 signal intensity did not, however, significantly correlate with surgical outcome (p>0.05). CONCLUSION: Compared with a high T2 hippocampal signal, hippocampal atrophy is more common and correlates better with surgical outcome. For the prediction of this, it thus appears to be the more useful indicator.
Adult ; Atrophy ; Female ; Hippocampus/*pathology/*surgery ; Human ; *Magnetic Resonance Imaging ; Male ; Middle Age ; Predictive Value of Tests ; Retrospective Studies ; Sclerosis ; Support, Non-U.S. Gov't ; Treatment Outcome