In the past several years, total hip replacement arthroplasty has become an established procedure in the management of painful arthritic hips in older adults. It is still gaining an increasing popularity as experience has accumulated and indications broadened. The authors reviewed the first 47 total hip replacement arthroplasties in 41 patients performed at the Department of Orthopedic Surgery, Seoul National Univerity Hospital, during the period of 4 years and 8 months, from April 1972 to November 1976. The longest follow-up was 4 years and 8 months and the shortest 1 month, the average being 2 years and 1 month. The youngest age was 17 years and the oldest 71 years, the average being 41 years. There were 26 males and 15 females. The underlying etiology was as follows: primary osteoarthritis 4 hips, avascular necrosis 12 hips, septic hip residua 18 hips (pyogenic 11 hips, tuberculosis 7 hips), rheumatoid arthritis 3 hips, failed previous operation 3 hips (failed endoprosthesis 2 hips, failed total hip replacement 1 hip), secondary osteoarthritis 5 hips (congenital dislocation 4 hips, Legg-Perthes disease 1 hip), and nonunion of femoral neck 2 hips. Following types of prosthesis were used; Sbarbaro 3, Charnley 8 (including custom-made extralong, narrow stem and extra-small stem prostheses), Muller 22, and Trapezoidal-28 14. The results were evaluated by the methods of Harris and d'Aubigne, both preoperatively and postoperatively, In the average, Harris' score improved from 57 to 92 (gains of 35) and the d'Aubigne rating from 10.4 to 16.8 (gains of 6.2) following operations.
Adult ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Dislocations ; Female ; Femur Neck ; Follow-Up Studies ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Male ; Necrosis ; Orthopedics ; Osteoarthritis ; Prostheses and Implants ; Seoul ; Tuberculosis

Our experience with recurrent dislocation of the patella on ten knees in eight patients seen at Seoul National University Hospital during the last 2 years and eight months is reported. Five were female and three male. The age ranged from seven to 27 years. In four of the patients the onset was attributable to a definite history of trauma, while in one patient the dislocation was considered due to developmental anomalies and in another it was clearly congenital Still another patient had a progressively short limb due to premature closure of the distal femoral epiphysis with accompanying flexion-valgus deformity of the knee, presumably caused by an unrecognized infection during early childhood One adolescent girl had bilateral knock knees. The knock knees were treated successfully by supracondylar osteotomy and one post-traumatic knee by classical Roux-Goldthwait procedure with equally excellent result, The rest were treated by Greens vastus medialis transfer with division of the iliotibial band or reefing of the medial joint capsule when necessary. In one knee dislocation recurred, probably due to avulsion of the transferred vastus, and two knees had residual subluxation and limitation of flexion. The results on the remaining seven knees were excellent.
Adolescent ; Congenital Abnormalities ; Dislocations ; Epiphyses ; Extremities ; Female ; Genu Valgum ; Humans ; Joint Capsule ; Knee Dislocation ; Knee ; Male ; Osteotomy ; Patella ; Quadriceps Muscle ; Seoul

A rare case of mesothelial/monocytic incidental cardiac excrescences (cardiac MICE) is described in the aspect of pathological interest. This cardiac lesion is pathologically characterized by exuberant proliferation of mixed mesothelia and monocytes and might be misdiagnosed as metastatic carcinoma, rhabdomyosarcoma, and histiocytoid hemangioma, if the disease is not in the minds of pathologists. The reactive nodular hyperplasia due to irritation to mesothelia by various causes is a most prevailing pathogenetic mechanism. About 20 cases have been reported in the worldwide literature. A 67-year-old female patient presented with cough and dyspnea for 2 months, without any history of previous cardiac operation. 2D echocardiography of the heart revealed moderate amount of pericardial effusion with posterior wall thickening. Under the impression of metastatic malignancy, pericardiostomy was performed. Grossly, the tissue was dark hemorrhagic and friable and the histologic sections revealed the solid tumor-like proliferation of round to polygonal histiocytic cells admixed with small cuboidal mesothelial cells which formed strips and tubular arrays. They were found within the fibrinous network and there were scattered empty vacuolar spaces. Immunohistochemical staining confirmed their biphasic nature with the CD68 positivity of the histiocytes and the cytokeratin positivity of the cuboidal cells. Factor VIII positivity was not detected in any cell components. The lesion was considered the monocytic and mesothelial proliferation of reactive nature, so-called cardiac MICE in the pericardial cavity. We report a typical case of so-called MICE first in the Korean literature.
Aged ; Animals ; Cellular Structures ; Cough ; Dyspnea ; Echocardiography ; Factor VIII ; Female ; Fibrin ; Heart ; Hemangioma ; Histiocytes ; Humans ; Hyperplasia ; Keratins ; Mice ; Monocytes ; Pericardial Effusion ; Pericardial Window Techniques ; Rhabdomyosarcoma

No abstract available.
Progeria*

No abstract available.
Child* ; Humans ; Thyroid Gland* ; Thyroid Neoplasms*

No abstract available.
Tricuspid Atresia*

Initial success with total hip arthroplasty on those severely crippled, painful hips in elderly people has prompted its application to a broad variety of conditions; namely, primary and secondary osteoarthritis, rheumatoid arthritis, avascular necrosis of the femoral head, and failed arthroplasties. Some have attempted it on previously arthrodesed hips, while others have successfully treated failed Girdlestone by total hip arthroplasty. To date, however, total hip arthroplasty remains essentially a procedure for older people. It has been greatly emphasized that total hip arthroplasty on 29 cases of residual hips secondary to pyogenic or tuberculous infection occurred during childhood. All were young adults ranging from 17 to 56 years of age, with a mean age of 32. 1 years. None of the hips had active infection at time of operation, although in 2 cases biopsy, at the arthroplasty, revealed chronic granulomatous inflammation. The hips had bony or fibrous ankylosis,or pseudarthrosis with dislocation, and presented marked flexion deformity, bony hypoplasia, limb shortening, and muscle atrophy. In 6 cases, arthroplasty was preceded by preliminary anterior soft tissue release and osteotomy of the ankylosis, followed by skeletal traction. In one case, anterior release through a separate incision was carried out on the same setting prior to arthroplasty. Lateral approach with trochanteric osteotomy was routinely employed, except in two in which the hip was approached posteriorly without trochanteric osteotomy. Trapezoidal-28 prosthesis was used in 17 cases, 5 of which were of short neck, thin stem sized, 7 of which were of medium neck small stem sized. Muller prosthesis was used in 8 cases, 7 of which were of standard neck standard stem sized. One small straight stem Charnley prosthesis failed and was later replaced by a custom-made Charnley stem prosthesis. Two offset bore ovoid cup and Charnley extra-small stem were used. In addition to routine preoperative, intraoperative, and postoperative antibiotics, Kanamycin was mixed to cement routinely. There was no postoperative wound infection. In two cases with presumably healed tuberculosis, infection recurred after arthroplasty. In all the remaning hips, painless serviceable function was restored, especially in view of diverse range of motion in orientals. In the oriental life style, the importance of a mobile hip cannot be overstressed.
Aged ; Ankylosis ; Anti-Bacterial Agents ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Biopsy ; Congenital Abnormalities ; Dislocations ; Extremities ; Femur ; Head ; Hip ; Humans ; Inflammation ; Kanamycin ; Life Style ; Muscular Atrophy ; Neck ; Necrosis ; Osteoarthritis ; Osteotomy ; Prostheses and Implants ; Pseudarthrosis ; Range of Motion, Articular ; Surgical Wound Infection ; Traction ; Tuberculosis ; Young Adult

The results of the treatment upon total 132 cases of ankle and foot fractures treated during the period from January 1969 to August 1978 at the Department of Orthopaedic Surgery, National Medical Center have been analysed and reported in this paper. 1. Sex ratio between male and female was 3.7:1. 68 cases (51.5%) cases out of 132 cases were in the age groups of 2nd and 3rd decades. remarkably higher than any other group. 2. 85 cases out of 132 cases were closed fractures and 47 cases were open fractures, but the incidence of the open fracture in higher in the fractures below the metatarsal bones and multiple fractures. 3. 59 cases out of 132 cases were ankle fractures 34 tarsal bone fractures 14 metatarsal bone fractures, 8 phalangeal bone fractures and 20 multiple fractures Accordingly, the incidence of the ankle fracture is higher than other fractures. 4. Ankle fracture was classified in 4 types according to the fracture mechanism (Lauge-Hansen classification). 20 cases out of 59 cases were pronation-abduction type, 15 cases were pronation-external rotation type, 14 cases were supination adduction type and 9 cases were supination-external rotation type. 15 cases out of 59 cases of the ankle fractures were treated by tension band compression internal fixation. The result of this method was much better than other methods. 5. 25 cases out of 35 cases of calcaneal fracture involved subtalar joint according to Rowe classification. 12 cases out of 25 cases of calcaneal fracture involved subtalar joint were Tongue type-C. In the treatment, no relation between restoration tuber angle or Gissane angle and the incidence of complication was obtained. 6. The incidence of the complication, such as secondary oateoarthritis, non union. malunion, occurred higher in the open and multiple fractures than closed and single fractures.
Ankle Fractures ; Ankle ; Classification ; Female ; Foot ; Fractures, Bone ; Fractures, Closed ; Fractures, Multiple ; Fractures, Open ; Humans ; Incidence ; Male ; Metatarsal Bones ; Methods ; Sex Ratio ; Subtalar Joint ; Supination ; Tarsal Bones ; Tongue

Subluxation of hip is a disease commonly experienced in orthopaedic field, which is classified into primary subluxation and secondary subluxation. Generally, secondary subluxation of the hip in children who once suffered from infected hips, Legg-Calve-Perths disease and also as sequellae of incompletely treated congenital dislocation of the hip can be often seen in Korea. Especially in Korea, subluxation of the hip with some destruction of the affected femoral head frequently arose from late complication of the tuberculous or septic hip in children. But, no definite treatment for the condition was established and no satisfactory results were obtained with various operative methods. Authors experienced satisfactory result by combining the intertrochanteric varus osteotomy and administration of crystalline glucosamine sulphate (Viatril, Rotta pharmaceuticals, Italy) in subluxated burnt-out tuberculous hip of 6 years old male.
Child ; Crystallins ; Dislocations ; Glucosamine ; Head ; Hip ; Humans ; Korea ; Male ; Osteotomy ; Tuberculosis

Rupture of muscle, either complete or incomplete, is a fairly frequent occurence. It may be caused by direct or indirect violence, and occurs either in normal or diseased muscle. Undoubtedly if any of the aching and painful muscles resulting from trauma is examined, a considerable number of partial ruptures would be found which is often overlooked or wrongly diagnosed as a strain, hematoma, myositis and neuralgia etc. We had the opportunity to examine the 15 patients with ruptured muscles. Our survey is presented in this paper.
Clinical Study ; Hematoma ; Humans ; Muscles ; Myositis ; Neuralgia ; Rupture ; Violence