The arthrodesis of the hip is the only certain method for eliminating pain and providing stability in young and middle aged adults. The first used arthrodesis in old congenital dislocation was reported by Heusner, Lampugnani, and Alert as early as 1885 according to Nove-Josserand. The various papers published on this operation appear to be concerned mainly with surgical methods and the frequency of bone healing, rather than with loss of function and its causes. The purpose of this study is to evaluate function of the arthrodesed hip especially the relationship between position of the hip and its daily use. The author studied arthrodesis of the hip clinically in 89 cases of arthrodesed patients, admitted to the Orthopedic Department of Severance Hospital during the 14 years from June 1957 until May 1970. The auther also studied 40 cases which confirmed sound bony ankylosis of the hip by X-ray examination. The follow-up included a careful inquiry into the patients ability to use the fixed hip in various functions of daily life. The results are as follows. 1. The average age of the patients at the time of operation was 16.9 years and tuberculosis of the hip was the most common cause 83(93%) of arthrodesis. 2. The most common type of operation in this series was intraarticular arthrodesis 67(75.3%), and the fusion rate was relatively good in intra & extraarticular arthrodesis 20(85.5%). 3. The average length of follow-up was 3.9 years. The average position of the arthrodesed hip was 37.7 degrees of flexion, 9.1 degrees of abduction and neutral rotation. Actual shortening of the leg averaged 3.8cm. 4. The gait was poor in the group which had 5cm shortening of the leg and was in 43 degrees of flexion for the arthrodesed hip. 5. The ability to sit and defecate in the ordinary toilet was satisfactory when there was 39 degrees of flexion or more for the arhrodesed hip. 6. 10 patients (25%) had back pain and 12 patients (30%) had mild scoliosis. Average Ferguson angle was 47.8 degrees and the Line of Weight Thrust showed over 40 degrees. 7. The ideal hip position of arthrodiesis in Koreans was assumed to be under 40 degrees of flexion, some degrees of abduction and no rotation.
Adult ; Ankylosis ; Arthrodesis ; Back Pain ; Dislocations ; Follow-Up Studies ; Gait ; Hip ; Humans ; Leg ; Methods ; Middle Aged ; Orthopedics ; Scoliosis ; Tuberculosis

In recent years, with increased number and higher speed of the automobiles, the incidence of the so-called whiplash injury has been increasing. The author had studied the clinical symptoms and signs, roentgenographic findings, associated injuries and treatment of the sixty four patients who had admitted to the Yonsei Medical Center under the diagnosis of the whiplash injury excluding the patients who had sustained an associated injuries those may cause neurologic symptoms and signs during the period of eight years from January, 1972 to December, 1979. and sumnerized the results as followings. 1. Among the sixty four patients, thirty one (48.4%) were male and thirty three (51.6%) were female. The most prevalent age were third and fourth decades (62.5%). 2. The causes were rear-end collision, falling of a car, front-end collision, falling of an airplane in an air-pocket and sudden deceleration of a car in the order of frequency. 3. The admission period were longest in the cases of falling of a car (13.3 days) and shortest in the cases of sudden deceleration of a car (9.4 days). 4. Fifty one (79.7%) were returned to the general activity in two weeks and fifty seven (89.1%) were out of the hospital in three weeks. 5. On admission. the patients were suffered from the symptoms and signs as followings, headache, limitation of the motion in neck, neckache, paresthesia, dizziness and dysphagia in the order of frequency. 6. Roentgenograms show loss of lordotic curve in twenty eight (43.7%) and prevertebral swelling in seven (10.3%). 7. Thirty six (56.3%) were associated with other injuries as followings; multiple contusion, teeth injuries, scalp laceration. There were thirteen cases (36.1%) of cerebral concussion. 8. In all the cases, we used analgegics and muscle relaxants until the neck pain subsided. We had performed cervical traction, hot packs in selected cases. Twelve (18.8%) needed cervical braces or Thomas collar at discharge.
Accidental Falls ; Aircraft ; Automobiles ; Braces ; Brain Concussion ; Clinical Study ; Contusions ; Deceleration ; Deglutition Disorders ; Diagnosis ; Dizziness ; Female ; Headache ; Humans ; Incidence ; Lacerations ; Male ; Neck ; Neck Pain ; Neurologic Manifestations ; Paresthesia ; Scalp ; Tooth Injuries ; Traction ; Whiplash Injuries

No abstract available.
Gestational Age* ; Intracranial Hemorrhages*

In adenomatous polyposis coli there are many colonic and extracolonic manifestations, and various combinations of these induce different clinical presentations and syndromes. We experienced a unique case of adenomatous polyposis of the large intestine and stomach in a 39-year-old man. In the colon, small cell neuroendocrine carcinoma rather than adenocarcinoma had developed, which did not contain adenomatous or carcinomatous foci. The adenomatous polyps in the colon were all small and sessile with no cancerous or precancerous change two years after the resection of the symptomatic gastric adenomas, even though the gastric adenomas were larger and showed dysplastic change. We think this case is another variant of adenomatous polyposis syndrome.
Adenocarcinoma ; Adenoma

The posterior cruciate ligament is the primary static restraint to posterior translation of the tibia and provides proprioception within the knee. The goals of treatment in the injuries of PCL are restoration of normal tibiofemoral stability and reduction of long term osteoarthrosis of the knee. The purpose of this study is to cornpare functional outcome, muscle power, and posterior stability between conservative treatment and reconstruction with autogenous RPTB augmented with Kennedy LAD in PCL injuries. Twenty-seven patients with PCL rupture who have been treated from November 1990 to May 1996 were reviewed. The patiens were divided into conservative group and reconstruction group. Conservative treatment was done in 15 patients and reconstruction by autogenous bone patellar tendon bone with Kennedy LAD was performed in 12 patients. All patients were evaluated with posterior stress x-ray films, KT-2000 knee ligament arthrometer, Cybex 340 isokinetic dynamometer, subjective Cincinnati symptom rating scale and Lysholm knee score, complication. The results were as follows; 1. Mild and moderate posterior instability was remained in spite of BPTB graft and need more stable fixation technique and vigorous rehabilitation program. 2. At the angular velocity of 90 degree/sec and 180 degree/sec, the muscle strenth of quadriceps was decreased after PCL injury in both group in the test of Cybex 340 isokinetic exercises. The power of hamstrings were not changed after PCL injuries. 3. Average Lysholm knee score was 89 points in reconstruction group and 78 points in conservative group and average Cincinnati symptom-rating scale was 8.4 points in reconstruction group and 7.1 points in conservative group. More satisfied functional results and subjective symptoms were revealed in the reconstruction group and statiscal significancy (p<0.05) was showed when comparing conservative group with reconstruction poup. 4. Good clinical results did not always coincidence with lesser posterior instability and clinical results were influenced by associated injury of the knee. The more combined ligament injury of the knee, the worse clinical results.
Exercise ; Humans ; Knee ; Ligaments ; Osteoarthritis ; Patellar Ligament ; Posterior Cruciate Ligament ; Proprioception ; Rehabilitation ; Rupture ; Tibia ; Transplants ; X-Ray Film

Rupture of Achilles tendon was first reported by Pare, 1575 and thereafter the cause and the diagnostic and therapeutic methods of the ruptured tendon have been described by many workers. Rupture of the Achilles tendon is often wrongly diagnosed and inadequately treated by the doctor who first sees it, with consequent problems of treatment and prognosis. In this paper 24 patients(25 cases)
Achilles Tendon ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Prognosis ; Rupture ; Tendons

The coexistence of extraadrenal pheochromocytoma and renal artery stenosis is extremely rare. The mechanisms of renal artery stenosis with pheochromocytoma include direct compression of the tumor mass on the renal artery and catecholamine-induced vasospasm, fibromuscular hyperplasia, and fibrous adhesion. We report a rare case of renal artery stenosis caused by extraadrenal pheochromocytoma in a 29- year-old female. She was admitted to the hospital because of palpitation and headache. She had been treated for hypertension for 2 years. On admission, her plasma epinephrine and norepinephrine levels were elevated as were her plasma renin activity, urinary vanillylmandelic acid (VMA) and metanephrine levels. Through the use of abdominal computed tomography, 131I-MIBG scan, and renal arteriography, a mass was found in the hilus of the left kidney which affected left renal artery stenosis. Surgical removal of the mass and left kidney restored the catecholamine excretion, plasma renin activity, and blood pressure to normal. Electronmicroscopic examination of the mass confirmed the pheochromocytoma.
Angiography ; Blood Pressure ; Epinephrine ; Female ; Headache ; Humans ; Hyperplasia ; Hypertension ; Kidney ; Metanephrine ; Norepinephrine ; Pheochromocytoma* ; Plasma ; Renal Artery Obstruction* ; Renal Artery* ; Renin ; Vanilmandelic Acid

Biliary ascariasis is a rare complication of intestinal ascaris infestation. Retrograde migration of the adult worm through the papilla of Vater causes biliary colic, and may give rise to pancreatic and biliary obstruction, choledocholithiasis, cholecystitis, cholangitis, hemobilia, and if the worm lodges in intrahepatic bile ducts, to liver absceases. In the past, treatment of biliary ascariasis has usually involved the direct removal of ascaris throagh a surgical choledochatomy and subsequent saline lavage of the common duct through an indwelling T tube. Recently, the worm in the bile duct can be seen by ERCP and it can be removed during the endoscopic procedure. A 55-year-old woman with intermittent colicky right upper quadrant abdominal pain was admitted to out hospital. Abdominai sonogram disclosed an echogenic structure within a mildly dilated common bile duct and a high ehogenic structure with acoustic shadowing in the distal common bile duct(CBD), which suggests a CBD stone. ERCP after obtaining the sonogram revealed a thick, long, linear, smooth filling defect in the CBD with a distal CBD stone. A distal CBD stone was removed by sphinctetotomy and lithotripsy, then we directly extracted ascaris with a tripod forcep without any complication.
Abdominal Pain ; Acoustics ; Adult ; Ascariasis* ; Ascaris ; Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystitis ; Choledocholithiasis ; Colic ; Common Bile Duct* ; Female ; Hemobilia ; Humans ; Lithotripsy ; Liver ; Middle Aged ; Shadowing (Histology) ; Surgical Instruments ; Therapeutic Irrigation

It is Known that ocular tuberculosis occurs as a consequence of active infection from hematogenous spread or a hypersensitivity reaction to circtlating tuberculoproteins. The common findings of ocular tuberculosis are uveitis and choroidal tuberculoma. Paralleling the decrease of pulmonary tuberculosis and improvemem of differential diagnostic metnods, there has been a dramatic decline in the number of diagnosed cases of ocular tuberculosis. In a 65-year-old female a choroidal tumor was diagn03ed at our hospital a year ago Thereafter, she has been medicated with antituberculotic agents for brain tuberculosis in the other hospital. Recently she returned to our clinic cOffiJlaining of aggravated ocular symptom. The right vision was no light perception Enucleation of her right eye was perfomed under the impression of malignant tumor of choroid with secondary glaucoma. Pathologic findings of enucleated eyeball revealed the nature of tuberculoma; so, we report it with a review of literature.
Aged ; Brain ; Choroid* ; Female ; Glaucoma ; Humans ; Hypersensitivity ; Tuberculoma* ; Tuberculosis ; Tuberculosis, Ocular ; Tuberculosis, Pulmonary ; Uveitis

It is Known that ocular tuberculosis occurs as a consequence of active infection from hematogenous spread or a hypersensitivity reaction to circtlating tuberculoproteins. The common findings of ocular tuberculosis are uveitis and choroidal tuberculoma. Paralleling the decrease of pulmonary tuberculosis and improvemem of differential diagnostic metnods, there has been a dramatic decline in the number of diagnosed cases of ocular tuberculosis. In a 65-year-old female a choroidal tumor was diagn03ed at our hospital a year ago Thereafter, she has been medicated with antituberculotic agents for brain tuberculosis in the other hospital. Recently she returned to our clinic cOffiJlaining of aggravated ocular symptom. The right vision was no light perception Enucleation of her right eye was perfomed under the impression of malignant tumor of choroid with secondary glaucoma. Pathologic findings of enucleated eyeball revealed the nature of tuberculoma; so, we report it with a review of literature.
Aged ; Brain ; Choroid* ; Female ; Glaucoma ; Humans ; Hypersensitivity ; Tuberculoma* ; Tuberculosis ; Tuberculosis, Ocular ; Tuberculosis, Pulmonary ; Uveitis