A case of osteold osteoma was presented because of its rarity in number particularly in localization of tumor, that is, subperiosteal in position. Also we could treat the patient successfully by surgical intervention and the removed specimen preserved beautifully all the character and contour of the tumor grossly and microsoopically.
Humans ; Osteoma ; Osteoma, Osteoid

This is to present 44 cases of hip fractures, of these 28 being fractures of femoral neck and the remainder, intertrochanteric, which were treated at the Department of Orthopedic Surgery, Seoul National University Hospital for four years and 8 months from Jan. 1965 to Aug. 1969. 1. There were 33 males. and 11 females in the series. 26 cases(59.1) were over 51 years of age. 2. The femoral neck fractures were treated by means of Smith Petersen nailing in 16 cases, modified Girdlestone hip arthroplasty in 3 cases, Austin-Moore hip prosthesis in 6 cases and other methods in 3 cases. 3. Modified Girdlestone hip arthroplasty could be a treatment of choice for femoral neck fracture requiring hip arthroplasty for those unsuitable for extensive surgery. 4. The intertrochanteric fractures of femur except for 3 unstable fractures were treated successfully with the Smith-Petersen nail and plate, following anatomical reduction of fracture. In 3 unstable fractures, satisfactory stabilization and internal fixation was obtained by the method of medial displacement of proximal part of distal fragment of fracture.
Arthroplasty ; Clinical Study ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Hip Fractures ; Hip Prosthesis ; Hip ; Humans ; Male ; Methods ; Orthopedics ; Seoul

Subperiosteal Cortical Defect is a symptomless rarefaction of cortical bone which begins most often on the external surface of the medial and posterior cortical walls of the lower end of the femur in children between the ages of 3 and 6 years. The name of Subperiosteal Cortical Defect was first used by Aegerter who differentiated it from non-osteogenic fibroma. The authors found out 5 positive cases of incidental findings among 62 cases of both knee joint X-ray of which 3 was male and 2 was female. Also we experienced 3 cases which necessiat d a correct diagnosis and differential diagnosis. Because this is a common lesion, it frequently accompanies more serious bone conditions, and because this is self-limited disease, treatment is not necessary. It was emphasized that its nature should be understood by all those dealing with bone disease lest it be overdiagnosed and overtreated.
Bone Diseases ; Child ; Diagnosis ; Diagnosis, Differential ; Female ; Femur ; Fibroma ; Humans ; Incidental Findings ; Knee Joint ; Male

Five cases of the spinal tuberculosis with severe kyphosis and paraplegia were treated with radical surgery at the Department of Orthopedic Surgery, Seoul National University Hospital. All the cases were involved at the thoracic spine and kyphosis were ranged 100 through 150 degrees. Severe fixed chest deformity and impaired pulmonary function were observed. By thoracotomy, aorta was seen to be adherent to the surrounding tissue and this was separated from the verterbral lesion with meticulous procedure. The focus was curetted radically exposing spinal cord which was decompressed with anterior transposition. Then the spine was stabilized with anterior interbody fusion. Postoperative intensive pulmonary care and antituberculous therapy are imperative for the good result. Spinal tuberculosi with severe kyphosis and paraplegia could be benefited with the radical surgery by the experienced surgeon.
Aorta ; Congenital Abnormalities ; Kyphosis ; Orthopedics ; Paraplegia ; Seoul ; Spinal Cord ; Spine ; Thoracotomy ; Thorax ; Tuberculosis, Spinal

PURPOSE: Planning target volume (PTV) for tumors in abdomen or thorax includes enough margin for breathing-related movement of tumor volumes during treatment. Depending on the location of the tumor, the magnitude of PTV margin extends from 10 mm to 30 mm, which increases substantial volume of the irradiated normal tissue hence, resulting in increase of normal tissue complication probability (NTCP). We developed a simple and handy method which can reduce PTV margins in patients with liver tumors, respiratory motion reduction device (RRD). MATERIALS AND METHODS: For 10 liver cancer patients, the data of internal organ motion were obtained by examining the diaphragm motion under fluoroscope. It was tested for both supine and prone position. A RRD was made using MeV-Green and Styrofoam panels and then applied to the patients. By analyzing the diaphragm movement from patients with RRD, the magnitude of PTV margin was determined and dose volume histogram (DVH) was computed using AcQ-Plan, a treatment planning software. Dose to normal tissue between patients with RRD and without RRD was analyzed by comparing the fraction of the normal liver receiving to 50% of the isocenter dose. DVH and NTCP for normal liver and adjacent organs were also evaluated. RESULTS: When patients breathed freely, average movement of diaphragm was 12+/-1.9 mm in prone position in contrast to 16+/-1.9 mm in supine position. In prone position, difference in diaphragm movement with and without RRD was 3+/-0.9 mm and 12 mm, respectively, showing that PTV margins could be reduced to as much as 9 mm. With RRD, volume of the irradiated normal liver reduced up to 22.7% in DVH analysis. CONCLUSION: Internal organ motion due to breathing can be reduced using RRD, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.
Abdomen ; Carcinoma, Hepatocellular* ; Diaphragm ; Humans ; Liver ; Liver Neoplasms ; Prone Position ; Respiration ; Supine Position ; Thorax

The purpose of this study was to collect the informations on the current status and the needs of the physically disabled elderlies in the rural community along with the prevalence rate of these population. One study group for the study of disability status evaluation was 139 physically disabled elderlies living in the main island of Kangwha, and the other group for the study on prevalence of disability was 542 elderlies living in Songhae myun. The prevalence of physical disability was 6.5% in Songhae myun. The neurologic disorder was the most frequent diagnosis among the physically disabled elderlies followed by the musculoskeletal disorder. The time for the medical service delivery was delayed; 45.3% of the subjects received medical service more than one month after the onset of disability. Only 18.0% of the disabled elderlies received the public disability service, and 15.8% of the subjects was waiting for further service. The most common need from the subjects was the medical service, followed by the service from the institution such as a nursing home and the financial support. Registration rate of the disabled was very low(7.7%). There were only three physical therapists for the rehabilitation services in studies areas. This study revealed that the public concepts for the disability and the rehabiltation service were inadequate. We hope that this basic data can be used for the planning of rehabilitation services in this community.
Aged ; Diagnosis ; Disabled Persons* ; Financial Support ; Hope ; Humans ; Nervous System Diseases ; Nursing Homes ; Physical Therapists ; Prevalence ; Rehabilitation ; Rural Population

Duodenal perforations caused by biliary prostheses are uncommon, but they are potentially life threatening and require immediate treatment. Here we describe an unusual case of duodenal perforation induced by a plastic biliary stent. It masqueraded as a case of cholecystitis and combined systemic upset with a localized peritonitis and fever. Primary endoscopic closure by hemoclips was difficult due to the position of the lateral wall and the complexity of aligning the perforation with the endoscope. To approximate the perforated hole and adherent hemoclips, glue injection and sprayings were successfully performed under cap-fitted endoscopy. The patient recovered without additional complications.
Adhesives ; Cholecystitis ; Endoscopes ; Endoscopy ; Fever ; Fibrin ; Fibrin Tissue Adhesive ; Humans ; Intestinal Perforation ; Peritonitis ; Plastics ; Prostheses and Implants ; Stents

There are various causes of acute pancreatitis, and accurately determining the etiology is pivotal for selecting appropriate management. Other hidden causes, such as congenital anomaly, should be considered in patients with recurrent abdominal pain or unexplained recurrent pancreatitis. A santorinicele is a focal cystic dilatation of the terminal dorsal pancreatic duct, and this is usually associated with pancreas divisum and it is a risk factor for acute pancreatitis due to the accompanying relative stenosis of the minor papilla. We present here the case of a patient who was treated for acute pancreatitis that was presumably was caused by either Rifampin or Brucellosis, and the patient recovered with conservative management. However, we eventually diagnosed pancreas divisum with santorinicele by performing MRCP and ERCP after the pancreatitis had relapsed. We report here on a case of successful endoscopic treatment for pancreas divisum with santorinicele as a cause of recurrent pancreatitis, and this was initially confused with drug or infection related pancreatitis.
Abdominal Pain ; Brucellosis ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Dilatation ; Humans ; Pancreas ; Pancreatic Ducts ; Pancreatitis ; Rifampin ; Risk Factors

PURPOSE: Massive pulmonary hemorrhage(MPH) within the first five days after birth is a major cause of early death in extremely low birth weight(ELBW) infants. The objective of this study was to determine risk factors for MPH in ELBW infants. METHODS: Data were retrospectively collected from 115 ELBW infants admitted to Seoul National University Bundang Hospital between January 2007 and September 2012. MPH was defined as the presence of hemorrhagic fluid in the trachea accompanied by acute respiratory failure within the first five days after birth. Initial echocardiography and cranial ultrasonography were performed in all subjects before MPH. Clinical characteristics of ELBW infants with and without MPH were compared and the risk factors for MPH were investigated. RESULTS: MPH occurred at 54+/-30 h after birth and was more frequent in ELBW infants with lower gestational age and lesser birth weight. Older maternal age was also associated with MPH. The presence of patent ductus arteriosus diagnosed using initial echocardiography was not significantly associated with MPH. The presence of intraventricular hemorrhage diagnosed using serial cranial ultrasonography was significantly associated with MPH. Logistic regression analysis indicated that among the variables that preceded MPH, only lower gestational age was independently associated with MPH. CONCLUSION: Lower gestational age was found to be a risk factor for MPH within the first five days after birth in ELBW infants.
Birth Weight ; Ductus Arteriosus, Patent ; Echocardiography ; Gestational Age ; Hemorrhage* ; Humans ; Infant* ; Infant, Extremely Low Birth Weight ; Infant, Low Birth Weight* ; Infant, Newborn ; Logistic Models ; Maternal Age ; Parturition* ; Respiratory Insufficiency ; Retrospective Studies ; Risk Factors* ; Seoul ; Trachea ; Ultrasonography

STUDY DESIGN: A retrospective clinical and radiographic review. OBJECTIVES: The purpose of this study is to suggest the indications and more ideal objective amount of corrections of for upper and lower curves. SUMMARY OF LITERATURE REVIEW: There are many controversies exist about the diagnosis and treatment of double thoracic scoliosis yet. MATERIALS AND METHODS: Thirty-nine double thoracic scoliosis patients with left shoulder elevation and/or positive T1 tilt and an upper curve of 25 degrees or more were divided into two groups. Group I (24 patients) underwent fusion on both curves, and Group II (15 patients), on the lower curve alone. Cobb angles, T1 tilt, left first rib elevation (represents trapezial prominence), and shoulder level difference were measured from standing on pre- and post-operative standing films. The correction ratio [Upper curve correction(%)/Lower curve correction(%)] was used to represent describe how much the upper curve was had been corrected compared to versus the lower curve. RESULTS: T1 tilt did not correlate well with left shoulder elevation, but correlated with left first rib elevation. In Group I, T1 tilt and left first rib elevation improved significantly after fusion of the upper curve, whereas these were aggravated in Group II. In Group I, most of the patients with the a correction ratio of more than 0.8, showed balanced shoulder levels finally. CONCLUSIONS: In double thoracic scoliosis patients, T1 tilt and left first rib elevation should be considered in addition to not only left shoulder elevation and the rigidity of upper curve, but also the T1 tilt and left first rib elevation should be considered as the indication of the extension of fusion to upper curve. The amount of upper curve correction should be more than at least 80% of that of the lower curve for a balanced correction in the treatment of double thoracic scoliosis.
Diagnosis ; Humans ; Retrospective Studies ; Ribs* ; Scoliosis* ; Shoulder