Although osteltis fibrosa cystica was the clinical manifestation originally recognized as a feature of the primary hyperparathyroidism, its frequency in diagnosed cases currently has decreased. Affected patients are now being detected in earlier stages of the disease. We have experienced a case of primary hyperparathyroldism with the typical bony changes and the pathologic, subtrochanteric fracture of left femur. We have treated the fracture with Zickel nalling and parathyroidectomy was performed. Four months after the removal of parathyoid adenoma the fractured femur healed well.
Adenoma ; Femur ; Fractures, Spontaneous ; Humans ; Hyperparathyroidism, Primary ; Parathyroidectomy

More than 100 surgical methods were described as the treatment of recurrent patella dislocation. These can be divided into two categories, the proximal, dynamic reconstruction and the distal, static reconstruction. We treated a case of recurrent patella dislocation with a new method, using gracilis. The tendon of gracilis was dissected and cut at the point about 7cm proximal to the insertion. A 'H' shaped slot was made subperiosteally in the anterior surface of patella. The both ends of cut gracilis tendon were imbedded into the 'H' shaped slot of patella and sutured. So the gracilis tendon could act as a static and dynamic stabilizer. The result was excellent at 1 year follow up.
Dislocations ; Follow-Up Studies ; Methods ; Patella ; Tendons

Limb salvage operation in primary malignant bone tumors is increasing recently, according to the improvement of diagnostic methods, surgical technique and adjuvant chemotherapy. The purpose of this study is to obtain the interim results of survival rate and the functional grade of the limb in primary malignant bone tumors treated by limb salvage operation. Between 1985 to 1993, 63 primary malignant bone tumors treated by limb salvage operations. Tumor prosthesis arthroplasty was performed in 49 patients, resection arthrodesis in 9 patients, and IM nailing with cement molding in 5 patients. Autoclave autograft was combined in 2 patients. Adjuvant chemotherapy and postoperative radiotherapy were performed in selected patients. The average follow-up period was 50 months(ranged 12 months to 116 months). In the cases of osteosarcoma, estimated survival rate was 61.9% based on Kaplan-Meier survival plot. In the parosteal sarcoma, the survival rate was 87.5% and 80% in chondrosarcoma patients. According to functional grading by Enneking, 66% was excellent, 20% was good, 11% was fair and one patients was poor. Complications occurred in 16 patients:wound infection was developed in 6 patients, local recurrence in 4, peroneal nerve palsy in 2 patients and femoral stem loosening in 2 patients. Fracture in resection arthrodesis and pulmonary metastasis were also occurred. Reoperation was performed in 10 patients at average 31 months after initial operation. Revision tumor persthesis arthroplasty was performed in one patient due to local recurrence and in 2 patients due to femoral stem loosening. Three amputations were done due to recurrence of tumor. IM nailing with cement molding was performed in one patient due to deep infection and repeated arthrodesis was done in a fracture patients. Scheduled custom-made tumor prosthesis arthroplasty was performed within a year in 2 patients treated with IM nailing with cement molding. In conclusion, with the careful preoperative assessment, adjuvant chemotherapy and skillful surgical technique, limb salvage operation would provide the primary malignant bone tumor patients for longer survival and better quality of life.
Amputation ; Arthrodesis ; Arthroplasty ; Autografts ; Chemotherapy, Adjuvant ; Chondrosarcoma ; Extremities ; Follow-Up Studies ; Fungi ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Osteosarcoma ; Paralysis ; Peroneal Nerve ; Prostheses and Implants ; Quality of Life ; Radiotherapy ; Recurrence ; Reoperation ; Sarcoma ; Survival Rate

Parameters of the left ventricular performance were evaluated by echocardiographic examination in 66 normal subjects. Effects of pulse rate, systemic arterial pressure, peripheral resistance and left ventricular end-diastolic dimension on the parameters were also observed. Normal value(mean+/-SD) of fractional shortening was 34.0+/-5.2%, ejection fraction 0.71+/-0.07, mean rate of circumferential fiber shortening 1.15+/-0.19 circ/sec, mean posterior wall velocity 4.05+/-0.70cm/sec, maximal posterior wall velocity 6.31+/-1.26cm/sec, mean normalized posterior wall velocity 0.82+/-0.14/sec, and maximal normalized posterior wall velocity 1.28+/-0.24/sec. There were negative correlations of peripheral resistance to fractional shortening, ejection fraction and mean rate of circumferential fiber shortening. Pulse rate and left ventricular end-diastolic dimension did not have significant effects on these parameters. Mean and maximal posterior wall velocity had negative correlations to peripheral resistance and positive correlations to left ventricular end-diastolic dimension. But mean and maximal normalized posterior wall velocity had no correlations to any of them.
Arterial Pressure ; Echocardiography* ; Heart Rate ; Vascular Resistance

It has been known that the obesity is one of the predisposing factors of the primary degenerative arthritis of knee. And nowadays, it seems that the number of obese person increases gradually in Korea. The authors studied 50 cases of the degenerative arthritis of knee clinically and statistically, compared with 50 cases of the control group, in the Department of Orthopedic Surgery, Seoul National University Hoispital from Jan. to Aug. 1981. The results were as follows: l. Among the degenerative arthritis of knee, the ratio of male: female was 1:9, and the age group with the highest frequency was the 5th. decade (48%). 2. Thirty-two cases (64%) was obese in the degenerative arthritis group, and 7 cases (14%) was obese in the control group. 3. The incidence of obesity in the degenerative arthritis group was 13.5 times higher than that in the control group, and it was highly significant statistically.
Causality ; Female ; Humans ; Incidence ; Knee ; Korea ; Male ; Obesity ; Orthopedics ; Osteoarthritis ; Seoul

No abstract available in English.
Plasmacytoma

No abstract available in English.
Orthopedics

No abstract available.

Advances in multimodal treatment using radiation and chemotherapy, more sophicated diagnostic, radiologic methods, and newer reconstructive surgical techniques have led to aggressive surgical treatment of chondrosarcoma of the pelvis. Recently, good results have been reported in even high grade chondrosarcoma of the pelvis with surgery with/without adjuvant therapy. From January 1984 to June 1992, ten patients with chondrosarcoma of the pelvis were treated. Their average age was 40(18 to 55). Location of the lesion were ilium(5), periacetabular lesion(1), ischiopubic region(1) and sacrum(3). Nine cases were conventional type and one was dedifferentiated type. Surgical resection was done for nine patients, with which radical margin in one, wide margin in four, marginal margin in one and intralesional margin in three. Postoperative radiotherapy(6000-7000cGy during 6-7week) was done for five patients of having wide(1), marginal(1) or intralesional(3) surgical margin. One patient took radiotherapy only after biopsy. The average follow-up period was 2 years and 9 months(1 year to 6 years 1 month). Six patients wer continuously disease free(CDF) or disease free(DF). One patient is alive with disease(AWD). Three patients died of disease(DOD). With Kaplan-Meier's method, 5-year actuarial survival rate for total 10 cases was 60%, for operated group(9 cases) 66.7% and for operated conventional group(8 cases) 80%. With wider resection margin, better survival could be achieved.
Biopsy ; Chondrosarcoma ; Combined Modality Therapy ; Drug Therapy ; Follow-Up Studies ; Humans ; Methods ; Pelvis ; Radiotherapy ; Survival Rate

No abstract available.
Female ; HELLP Syndrome* ; Pregnancy