Various methods for the treatment of fracture of the femur neck including total hip arthroplasty have been developed and performed, but it is still called the ""unsolved fracture"" in certain situations. The role of bipolar hemiarthroplasty as primary treatment of fracture of the femur neck, however, continues to be controversial. The authors reviewed and analysed 38 cases of cementless bipolar hemiarthroplasty in patients between the ages of 51 and 69 at the Department of Orthopaedic Surgery, Chosun University, during the period from January, 1989 to December, 1994. The purposes of the study were to analyse the clinical and radiological results and to detect the motions of bipolar cup. At the average 38 months follow up, 31 (81.6%) of the patients were satisfied by Lunceford methods. But, 24 (63.2%) of the patients suffered from inguinal area pain and discomfort while they resumed their normal Korean life-styles. As time elapsed, the amount of the outer bearing motion was more than that of the inner bearing motion. the acetabular erosion were present in 2 patients.
Acetabulum ; Arthroplasty, Replacement, Hip ; Femoral Neck Fractures ; Femur Neck* ; Follow-Up Studies ; Hemiarthroplasty* ; Humans

The ankle is an important joint supporting the entire musculoskeletal system during standing and walking. Current opinion has emphasized necessity of anatomical reduction and rigid internal fixation for a displaced or unstable fracture of the ankle. The purpose of this study was to evaluate the correlation of the adequate surgical operative methods and postoperative care with prognosis. The authors analysed 104 cases of ankle fracture, treated operatively in Department of Orthopedic Surgery of Dae-Han Hospital from January 1991 to December 1994, followed up more than one year. The results were as follows: 1. According to the classification of Lauge-Hansen and Danis-Weber, the most common type was supination-external rotation and type B, respectively. 2. The most common cause of injury was slip down and the others were traffic accident, fall down and direct trauma. 3. According to the criteria of Meyer, the result of treatment was good or excellent in 94 cases (90.4%) radiologically and in 91 cases (87.5%) clinically. 4. The complications were 5 cases of traumatic arthritis, 3 cases of malunion, 2 cases of non-union and 1 case of infection. 5. The early ROM exercise after accurate reduction and rigid internal fixation was very important in treatment of fracture of the ankle.
Accidents, Traffic ; Ankle Fractures ; Ankle* ; Arthritis ; Classification ; Joints ; Musculoskeletal System ; Orthopedics ; Postoperative Care ; Prognosis ; Walking

Endoscopic injection sclerotheraphy(EIS) was an effective method for treatment of bleeding esophageal varices. However, it might be associated with some undesirable complications. Endoscopic variceal ligation(EVL) is a recently developed method for control of active variceal bleeding and eradicating esophageal varices with similar efficacy and minimal risk of complications compare to EIS. We performed EVL in 40 patients who had recently bled from esophageal varices. Total 198 variceal ligations were performed during 64 separate EVL session. Control rate of acute bleeding was 90%(36 of 40patients) and 4 patients died after EVL because of failure of bleeding control. Rebleeding following initiation of EVL occured in 5 patients-three patients were successfully controlled by EVL, one patient was controlled but eradication was impossible and one patient died. Varices were eradicated or reduced to grade I in 31(86.1%) of 36 survivors by 1-9 ligation(mean 5.0) in l-4 EVL sessions(mean 1.6). After EVL, there were mild complications-mild substernal discomfort in 4 patients, mild dysphagia in 2 patients and fever in 2 patients. These results suggest that EVL is a safe and effective method for treatment of bleeding and eradication of esophageal varices with less complication.
Deglutition Disorders ; Esophageal and Gastric Varices* ; Fever ; Hemorrhage* ; Humans ; Ligation* ; Survivors ; Varicose Veins

Interference with visual pathways is usually not caused by intracranial aneurysms. Aneurysms of the anterior communicating artery rarely produce visual symptoms and signs in spite of their proximity to the visual pathways. The reason may be that these aneurysms rupture and present with subarachnoid hemorrhage before becoming large enough to exert significant pressure on the chiasm or optic nerves. The visual symptoms would be presented as visual field defect or impaired vision. These can be explained as the result of direct compression of the optic pathways, ischemic changes in the visual pathways caused by severe vasospasm after subarachnoid hemorrhage, or intraocular pathology such as retinal hemorrhage. 2 cases of anterior communicating artery aneurysms associated with visual symptoms are presented with a brief review of literatures.
Aneurysm ; Arteries ; Intracranial Aneurysm* ; Optic Nerve ; Pathology ; Retinal Hemorrhage ; Rupture ; Subarachnoid Hemorrhage ; Visual Fields ; Visual Pathways

Advanced techniques of nasal endoscopy made it possible to approach the optic nerve, pituitary gland, and anterior skull base transnasally. Epidural or brain abscess caused by ascending infection through the defect of the fovea ethmoidalis can be drained with reduced morbidity by endoscopic sinus surgery. Recently we have experienced a brain abscess that was managed by endoscopic transnasal drainage successfully.
Brain Abscess* ; Brain* ; Drainage* ; Endoscopy ; Optic Nerve ; Pituitary Gland ; Skull Base

BACKGROUND: This study investigates the prevalance of HBV precore mutant in chronic B hepatitis patients and whether HBV precore mutants affect hepatic inflammation and response to interferon alfa. METHODS: HBV DNA in liver tissue from 48 chronic hepatitis patients was amplified by polymerase chain reaction. The HBV precore mutants were detected by direct sequencing of amplified PCR products. Thirty-three HBeAg-positive patients (Group 1: wild- type, Group 2: mixed) were received 3-6 MU INF three times a week for 4-6 months. We did follow-ups for at least six months(mean : Group 1-11.3, Group 2- 13.7 months). A complete responder was defined as persistent(>6 months) normalization of transaminase and loss of HBeAg and/or seroconversion. RESULTS: The HBV precore mutants were found in 15 cases(31.2%) among 48 patients: 7 cases(21.2%) in 33 HBeAg-positive patients and 8 cases(53.3%) in 15 HBeAg-negative patients. The HBV precore mutants were more frequently found in HBeAg-negative patients(p= 0.043). Differences in severity of hepatic pathology were not observed in the wild-type versus mutant-type chronic hepatitis B patients(p =1.00). Initial response rate was not significantly different between two Groups(p= 0.228), but complete response rate had a lower tendency in Group 2 (p=0.073). CONCLUSION: There is a tendency for HBV precore mutants to be less responsive to INF therapy than wild type. Therefore the patients with chronic hepatitis B should be treated as early as possible in natural history of their liver disease before the emergence of HBV precore mutants.
DNA ; Follow-Up Studies ; Hepatitis ; Hepatitis B e Antigens* ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Inflammation ; Interferon-alpha ; Interferons* ; Liver Diseases ; Liver* ; Natural History ; Pathology ; Polymerase Chain Reaction

PURPOSE: To evaluate the result of treatment of proximal femoral shaft fracture with limited open reduction and intramedullary nailing. MATERIALS AND METHODS: Fifteen patients who had limited open reduction and intramedullary nailing due to proximal femoral shaft fracture for follow-up for more than 12 months were selected between March 2001 and December 2005. The clinical and radiologic results were analyzed. Winquist-Hansen classification and OTA/AO classification were used. RESULTS: Thirteen cases achieved bone union and 2 cases showed delayed union. The mean bone union period was 21.3 weeks (14~32). There was no postoperative infection. Nonunion was observed in 2 cases of which bone union was acquired with the exchange of intramedullary nail and bone graft in one case and with the additional plate fixation and bone graft in the other case. CONCLUSION: Treating proximal femoral shaft fracture with limited open reduction and intramedullary nailing seems to be a technique to manage proximal femoral shaft fracture that has combined fracture or ipsilateral femoral fracture or is unable to acquire acceptable reduction with closed reduction.
Femoral Fractures ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Humans ; Nails ; Transplants

PURPOSE: The aim of this study was to investigate the usefulness of mortise angle and fibular length measured in radiologic findings in predicting the ankle stability. MATERIALS AND METHODS: One hundred cases fifty cases were randomly selected volunteers with normal ankle function and the other fifty cases were randomly selected patients whose ankle were treated in our hospital and who were followed for over 1 years with good results. A specific experimental fixture were made to get the even AP and lateral view and objective stress view. RESULTS: The mortise angle and fibular length was not statistically significant to the degree of talar tilt angle under valgus or varus stress and that of displacement under anterior or posterior stress. CONCLUSION: The mortise angle and fibular length was not the objective predicting factors on the ankle stability. Maintenance of constrained talus in dynamic status is most important factors in determining the ankle stability.
Ankle* ; Humans ; Talus ; Volunteers

This study evaluated the influence of application time of self-etching primers on microtensile bond strength (microTBS) to dentin using three self-etching primer adhesive systems. Dentin surfaces were exposed from forty-eight human molars. They were conditioned with three self-etching primers (Clearfil SE Bond [SE], Unifil Bond [UF], Tyrian SPE + One Step Plus [TY]) and different primining times (10s, 20s, 30s and 40s). Composite resins were bonded to dentin surfaces and specimens were made. microTBS was tested and statistically compared using by one-way ANOVA and Tukey's Test The results of this study presented that priming time for 10s in SE and UF groups and for 30s and 40s in TY group was highly decreased microTBS to dentin.
Adhesives ; Composite Resins ; Dentin* ; Humans ; Molar

ProSeal(TM) laryngeal mask airway (PLMA) was developed to be more effective especially with glottic airway sealing and is suppose to be an improved device over the classic laryngeal mask airway (cLMA). The PLMA's cuff is bulkier, softer, and more pliable than the cLMA. We reviewed a case were a patient had hand surgery under general anesthesia using the PLMA. After having the hand surgery, the patient suffered from dyspnea and had difficulty with their respirations at a supine position. The problems with dyspnea and respiration after surgery resulted because of difficulties from inserting PLMA No.5 into the patient. We suspect from this case that the problems in dyspnea and respiration were due to the folded cuff and incomplete placement of the PLMA, which resulted in lacerations of the mucosa in the soft palate of the patient. In this paper, we considered the probable causes for lacerations of the mucosa in the soft palate and reviewed all of the relevant literature, especially about the proper placement of the PLMA.
Anesthesia, General ; Dyspnea ; Hand ; Humans ; Lacerations ; Laryngeal Masks ; Mucous Membrane ; Palate, Soft ; Respiration ; Supine Position