No abstract available.
Hip

A large mass as a sign of an infection is rare, and it might convince a physician that it had the appearance of a malignancy. The patient in this case visited our clinics after attending several hospitals, with a mass that had the appearance of a malignancy, based on the severe destructive findings observed on plain radiographs. We report the first documented case of a patient with a large mass (12×7×20 cm) and a low-grade infection, which developed at the proximal thigh after a hip arthroplasty. It is important to realize that an infection accompanied by a large mass, can mimic a highly destructive malignant lesion on plain radiographs.
Arthroplasty* ; Hip* ; Humans ; Thigh*

The spine fracture of osteoporotic patients is considered as meaningful since it occurs prior to other life-threatening fractures (for example; fracture of proximal of femur). The purpose of this study were to analyze the relationship between BMD and spine fracture in patients who complained of back pain without any obvious trauma history. We studied the cases of one hundred thirty patients above an age of sixty years, whose visited the Department of Orthopaedic Surgery at Kosin University Medical Center, from March 1995 to April 1996. Both simple X-ray and Dual Energy X-ray Absorptiometry (DEXA) were checked in old patients. The following results were obtained. 1. The BMD of spine fracture group with the osteoporosis (mean; -3.66 standard deviation (SD)) was significantly lower than the nonfracture group (mean; -2.38 standard deviation (SD)) (P = 0.0000). 2. According that the BMD Z-score is decreased, the proportion of spine fracture is increased significantly (above-1.0SD; 16.67%, -1.0SD~ -2.0SD; 16.67%, -2.0SD~ -3.0SD; 37.83%, - 3.0SD~ 4.0SD; 51.61%, below -4.0SD; 61.54% (P = 0.000)). 3. The probability of developing the spine fracture based on above -2.0 standard deviation (SD) was 2.8 times in -2.0SD~ -3.0SD (P = 0.044), 5.3 times in -3.0SD~ -4.0SD (P = 0.004), and 7.9 times below -4.0SD (P = 0.001). We recommended more intensive treatment to the osteoporotic patients below -2.0 SD in BMD Z- score.
Absorptiometry, Photon ; Academic Medical Centers ; Back Pain ; Humans ; Middle Aged* ; Osteoporosis ; Spine*

The authors experienced a case of basosquamous cell carcinoma occuring in the eyelid, which was confirmed by the biopsy. Histological findings showed the infiltrating nests of malignant squamous cell with nests of basal cell infiltrating into the dermis. A huge ulcerating, infected lesion with irregular indurating border involved the entire lid and extended onto the orbital margin and nose with the nasolacrimal duct exposed. Because of the unusual case, it was felt that literatures review would be instructive.
Biopsy ; Dermis ; Eyelids* ; Nasolacrimal Duct ; Nose ; Orbit ; Ulcer

Authors experienced an unusual case of malunited trans-epiphyseal fracture of the proximal femur in a 2 year-old girl. She was treated at a private clinic by closed reduction and cast immobilization, which subsequently resulted in malunion and capital subluxation. Because of subsequent failure of remodelling of the subluxated malunited fracture for two years, corrective femoral varisation and internal rotation osteotomy was done to reduce the subluxated femoral head. Postoperatively congrous reduction was obtained and gradual remodelling of the malunited fracture took place during 5 and a half years follow-up period.
Child ; Female ; Femur ; Follow-Up Studies ; Fractures, Malunited ; Head ; Hip ; Humans ; Immobilization ; Osteotomy

PURPOSE: To evaluate the diagnosis and treatment of femoral osteolysis. CONTENTS: Osteolysis developed from biologic interaction by wear debris, is one of the common and important complications, which is the most influencing factor of the durability of artificial joint. However, it is difficult to diagnose and treat femoral osteolysis early, because there are no symptoms until a serious bone loss occurs. For the accurate treatment and the early diagnosis of femoral osteolysis, we evaluated the clinical and radiological findings, and also evaluated the medical and surgical managements. CONCLUSION: From the improvement of the quality and design of artificial joint, femoral osteolysis is reducing these days. However, it still remains a problem, so consistent effort are required to reduce it.
Early Diagnosis ; Femur ; Hip ; Joints ; Osteolysis

No abstract available.
Colonialism* ; Leprosy*

No abstract available.
Hernia, Diaphragmatic*

PURPOSE: The survival rate according to the methods of treatment was significantly higher in the osteosarcoma patients in which limb salvage operation with neoadjuvant chemotheraphy. The purpose of this study is to analyze the results of treatment in the Stage IIB osteosarcoma patients who treated with modified T10 protocol. MATERIALS AND METHODS: From Jun. 1990 to Oct. 1997, thirty eight cases of Enneking's stage IIB osteosarcoma in extremities, were treated with neoadjuvant chemotherapy by modified T10 protocol of Rosen. Their mean age was 22 years old (8 months to 55 years). And average duration of follow up is 29 months(10 manths to 88 months). The preoperative chemotherapy consisted of high dose methotrexate(HDMTX)(above 12 years old: 8 g/m2, below 12 years old: 12 g/m2), adriamycin(ADR)(30 mg/m2/day x 2), intraarterial cisplatin(CDDP)(100 mg/m2) or ifosfamide (IFO)(1.8 g/m2/day x5). The preoperative tailoring was performed according to the radiologic response after chemotherapy. If the patient revealed good response, we continued the chemotherapy next one more cycle and if not, stoped the chemotherapy or changed the cisplatin to ifosfamide. The postoperative chemotherapy consisted of HDMTX, adriamycin, ifosfamide or cisplatin with 4 cycles. According to the pathologic response to the pre-operative chemotherapy, we use HDMTX, ADR, CDDP in good response group and HDMTX, ADR, IFO in poor response group respectively. RESULTS: On the latest follow up, 27 patients were continuous disease free(CDF 27/38), 4 patients were alive with disease(AWD) and 6 patients were died of disease(DOD) and I case was died of bone marrow and hepatic failure due to complication of chemotherapy. According to Kaplan-Meier's plot, the overall 5 years survival rate was 73.6%, and continuous disease free 5 years survival rate being 64%. The comparison of continuous disease free survival rates between good radiologic response group and poor response group showed 73% and 55%. The continuous disease free survival rates according to the pathologic response in good response group and poor were 90 % and 55%. During the chemotherapy, the most serious complications were leukocytopenia and bone marrow failure. These were controled by granulocyte colony stimulating factor(G-CSF) and leukotrophic agent. Other minor complications were nausea, vomiting, headache and extrapyramidal symptom, which were easily managed by simple conservative measure. CONCLUSION: It was obtained that the overall 5 years survival rate was 73.6%, and continuous disease free 5years survival rate being 64% with modified T10 protocol.
Bone Marrow ; Child ; Cisplatin ; Disease-Free Survival ; Doxorubicin ; Drug Therapy* ; Extremities ; Follow-Up Studies ; Granulocytes ; Headache ; Humans ; Ifosfamide ; Leukopenia ; Limb Salvage ; Liver Failure ; Nausea ; Osteosarcoma ; Survival Rate* ; Vomiting ; Young Adult

For several centuries, orthopaedic surgeons have been given the task of managing the pain, limp, and gait disturbance that develop in association with various trauma and diseases of the hip joint. Progress has been made in development of surgical methods for the hip joint, and a recent concept was determined by introduction of the 'Clean Air Operating Enclosure' system and 'low frictional arthroplasty' in total hip arthroplasty (THA) by John Charnley, in 1960. THA has been performed as an exclusive method for hip joint reconstruction. We report on understanding of the current status from the past, present, and future trends with an introduction of the prior method of THA and a discussion of the history.
Arthroplasty ; Friction ; Gait ; Hip ; Hip Joint ; Tacrine