One hundred and four cases of the ankle fracture have been treated and managed in the Department of Orthopaedic Surgery, Catholic Medical College Hospital. During the period from January, 1968 to December, 1971. 104 patients were analyzed clinically and the results obtained were as follow. 1. The causes of ankle fractures were mostly due to traffic accident 49.9% and direct blow 30.7%. 2. The incidence of trauma was in the young man, most frequent in the 3rd decaed. 3. In classification of Lauge-Hansen, the type of pronation-external rotation is most common type in this series and the stage III of pronation-external rotation is more common than other stages. 4. The average duration of cast immobilization is 8.8 weeks after closed reduction performed but duration of cast immobilization is shorter after open reduction of cast immobilization. 5. Anatomical reduction was obtained in 64 patients 61.5% with good objective clinical results in 54 patients 51.9% 6. The quality of clinical results depends mostly on the accuracy of the reduction, to a lesser extent on the degree of initial displacements, and least on the type of fracture.
Accidents, Traffic ; Ankle Fractures ; Ankle ; Classification ; Humans ; Immobilization ; Incidence

No abstract available.
Popliteal Artery

Fundus perimetry is the device that provides visualization of the fundus and the precise localization of the stimuli on it. With the increasing importance of the direct fundus perimetry for certain focal retinal morphologic abnormalities, the scanning laser ophthalmoscope[SLO]has been utilized as a system to eliminate some of the classic technical problems in fundus perimetry. The aim of this study was to evaluate the normal light sensitivity values for microperimetryusing SLO system. Thirty eyes of thirty normal subjects were examined in 60 degrees image field using stimuli of variable intensity. The maximal retinal distance point which responded to stimulus was recorded, point which responded to stimulus was recorded, and the distance[millimeter]from the fovea was calculated by the Bennett formula. The maximum distance from the fovea at the given stimulus intensity was measured as follows :0.7596 +/-0.5262millimeter at 28decibel, 2.2050 +/-0.5878millimeter at 26decibel, 3.0571 +/-0.7151millimeter at 24decibel, 4.3690 +/-1.0973millimeter at 22decibel, and 5.6557 +/-1.3458millimeter at 20decibel. In conclusion, we were able to establish the normal range of light sensitivity in Microperimery examination. It may serve as the baseline for subsequent study of retinal pathology and functional evaluation as well as its treatment.
Ophthalmoscopes* ; Pathology ; Photophobia ; Reference Values* ; Retinaldehyde ; Visual Field Tests

There has been no report about hereditary and clinical features of retinitis pigmentosa (RP) in Koreans. To evaluate these, data were collected from 365 RP patients including age, gender, visual acuity (VA), spherical equivalent (SE) of refractive errors, funduscopic findings, color vision test, visual field score (VFS) obtained from Goldmann perimetry, and the inheritance patterns from pedigrees. Simplex RP was the most common inheritance pattern (61.9%); followed by autosomal recessive RP (17.3%), autosomal dominant RP (12.1%) and X-linked recessive RP (8.8%). Myopia was the most common refractive errors (77.5%) including 16.1% of high myopia. The most common cataract type was posterior subcapsular cataract (25.8%). Observed retinal findings included changes of retinal pigment epithelium (88.8%), bony spicule-like pigmentation (79.7%), attenuation of retinal vessel (76.2%), waxy disc pallor (12.6%), golden ring around optic disc (2.2%), epiretinal membrane (0.8%) and cystoid macular edema (0.5%). Corrected VA and refractive errors did not show any significant difference between the inheritance patterns. VFS was significantly worse in autosomal recessive RP than in autosomal dominant RP. Color vision defect was noted in 66.1% on Hardy-Rand-Rittlers color vision test. In conclusion, Korean RP patients have the indigenous hereditary and clinical features as well as the ordinary ones.

PURPOSE: To compare the effect of triamcinolone acetonide injection between intravitreal injection alone group and intravitreal injection in combintaion with posterior subtenon injection group in diabetic macular edema. METHODS: Twenty-nine eyes of 29 patients with diabetic macular edema were randomly classified into two groups. Intravitreal injection of triamcinolone acetonide 4 mg was administered to 15 eyes and posterior subtenon injection of triamcinolone acetonide 20 mg in combination with intravitreal injection was administered to 14 eyes. Best corrected visual acuity (BCVA), macular thickness measured by optical coherence tomography were assessed 1, 3, 6, and 12 months after the procedure. RESULTS: Baseline BCVA and macular thickness showed no differences between two groups. BCVA and macular thickness 1, 3, and 6 months after the procedure revealed significant improvement, but no significant differences between two groups were observed. CONCLUSIONS: Intravitreal injection of triamcinolone acetonide alone and intravitreal inejction in combination with posterior subtenon injection were equally effective, but had no significant differences.
Humans ; Intravitreal Injections ; Macular Edema* ; Tomography, Optical Coherence ; Triamcinolone Acetonide ; Triamcinolone* ; Visual Acuity

23 eyes of 23 patients who underwent conventional vitreoretinal surgery with high specific gravity perfluorocarbon liquid, perfluorophenanthrene, for complicated retinal detachment were evaluated retrospectively. Preoperative vitreoretinal findings showed grade C2 PVR in 4 eyes and C3 in 1 eye and C4 in 10 eyes and C5 in 8 eyes. As a result, 17 eyes(74%) showed anatomical success, completely reattached in 15 eyes, partially reattached in 2 eyes, and 12 eyes(52%) showed functional success (corrected visual acuity 5/200 or better). Follow-up period was over 6 months in all cases. Postoperative complications includes keratopathy in 6 eyes, hypotony in 5 eyes, cataract in 2 eyes, transient vitreous hemorrhage in 1 eye, acute increased IOP in 1 eye, posterior synechiae in 1 eye, cystoid macular edema in 1 eye, and pupillary membrane in 1 eye. Consequently, perfluorophenanthrene can be used beneficially in yield of surgical field and mechanical stabilization of retina in complicated retinal detachment surgery.
Cataract ; Follow-Up Studies ; Humans ; Macular Edema ; Membranes ; Postoperative Complications ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Retrospective Studies ; Specific Gravity ; Visual Acuity ; Vitreoretinal Surgery ; Vitreous Hemorrhage

Early treatment to facilitate the muscular blood flow can avert myonephropathic metabolic syndrome (MNMS) and major amputation for patients suffering with acute limb ischemia. Delayed reperfusion or microemboli in the small vessels can aggreviate: ischemic changes and lead to irreversible muscle necrosis. Amnion is an excellent biological dressing, and we tried using it to treat anterior compartment muscle necrosis (ACMN). The amnions were aseptically collected from caesarean sections. Additional betadine (1 : 3 solution) and vaseline-soaked gauzes were applied over the amnion as a daily biologic wet dressing. The amnion was replaced every three days. Finally, split skin grafting was performed on the healthy granulation tissue. We treated two patients who happened to have shin muscle necrosis. A 65-year-old man with a femoro-femoral arterial bypass showed graft thrombosis. Thirteen days after performing balloon angioplasty with stent insertion in the right femoral artery, new emboli were found in the stent and in the left popliteal artery. There was an attack of myocardial infarction the next day after embolectomy. The severe MNMS and ACMN at the right shin occurred after cardiopulmonary resuscitation. The dry gangrene was excised 3 months later, and this was followed by a skin graft 4 months later. An 81-year-old woman with atrial fibrillation showed left common femoral arterial obstruction and ACMN on the left shin during the management of congestive heart failure. The dry gangrene was excised 2 months later, and this was followed by a skin graft 3 months later. The amnion dressing shows promises for providing healthy granulation tissue for split skin grafts when treating muscle necrosis of the leg. Biologic dressing with using amnion is an option for limb salvage in the case of muscle necrosis that is caused by acute limb ischemia, although the treatment takes a long time.
Aged ; Aged, 80 and over ; Amnion* ; Amputation ; Angioplasty, Balloon ; Atrial Fibrillation ; Bandages* ; Biological Dressings ; Cardiopulmonary Resuscitation ; Cesarean Section ; Embolectomy ; Extremities* ; Female ; Femoral Artery ; Gangrene ; Granulation Tissue ; Heart Failure ; Humans ; Ischemia* ; Leg ; Limb Salvage ; Lower Extremity* ; Myocardial Infarction ; Necrosis* ; Popliteal Artery ; Povidone-Iodine ; Pregnancy ; Reperfusion ; Skin ; Skin Transplantation ; Stents ; Thrombosis ; Transplants

PURPOSE: Various methods of scleral fixation for the cases of posterior chamber intraocular lens (PCL) dislocation or subluxation into the vitreous cavity had been developed, and in the recent year a modification of internal scleral fixation using a hollow-bore needle has been introduced. The authors endeavored to evaluate clinical usefulness of the method. METHODS: The study was conducted for four cases of PCL dislocation or subluxation. A 10-0 polypropylene suture was threaded up the internal shaft of a 30 G straight needle and retrieved. The needle containing this suture was then inserted through the bed of the partial-thickness scleral flap 1.5 mm posterior to the limbus. The loop of suture was hooked with haphic of PCL. After the needle was retracted, the haptic was captured and the suture was tied to the sclera. The same maneuver was performed for the haptic in the opposite side. RESULTS: Except for pars plana vitrectomy, time taken for the above procedure was 10~15 minutes. Postoperatively induced astigmatism of all 4 cases were less than 3 diopters on the second postoperative day. No specific complication associated with this procedure was noted. IOL remained stable without tilting or rotation 18 months after procedure. CONCLUSIONS: This modified internal scleral fixation technique must be a convenient and effective procedure for repositioning posteriorly dislocated PCL.
Astigmatism ; Dislocations* ; Lenses, Intraocular* ; Needles* ; Polypropylenes ; Sclera ; Sutures ; Vitrectomy

After the performance of 100 coronary cineangiographies in 100 paitents who were adminitted to Soonchunhyang University Hospital under the diagnosis of ischemic heart disease from July 1986 to October 1987, we observed the coronary collateral circulation and measured the ejection fraction, circumferential fiber shortening, left ventricular end-diastolic pressure and pulmonary artery wedge pressure in 52 paitents who had 50% or more stenosis in one or more coroanry arteries. The results were as follow : 1) The collaterall circulation was observed in 16 patients(30.8%) of the 52 patients and it was developed mainly(87.5) in patients with 90% or more coronary artery stenosis. In patients with stenosis of less than 90%, however, collateral circulation was observed rarely(12.5%). 2) The left ventricular wall motion abnormality was severe in the group without collateral circulation. 3) The collteral circulation was most frequently developed in patients with severe right coronary artery stenosis and most of the routes were supplied from contralateral coronary arteries. 4) There was no significant difference in ejection fraction, circumferential fiber shortening, left ventricular end-diastoic pressure and pulmonary artery wedge pressure between the 2 groups with and without coronary artery collateral circulation.
Arteries ; Cineangiography ; Collateral Circulation* ; Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; Coronary Vessels ; Diagnosis ; Humans ; Myocardial Ischemia ; Pulmonary Wedge Pressure ; Ventricular Function, Left*

To difine the relation between plasma atrial natriuertic peptide (ANP) levels and hemodynamic changes, we measured plasma concentration of atrial natriuertic peptide in 19 patients with heart disease undergoing cardiac catherization and in 15 normal subjects. The following results were obtained; 1) There were significantly increased plasma levels of atrial natriuertic peptide in patients with elevated mean pulmonary arterial wedge pressure. 2) A significant step-up in atrial natriuertic peptide concentration was seen between the femoral venous and right atrial plasma (P<0.01) and between the right atrial and pulmonary arterial plasma (P<0.05). 3) Peripheral venous atrial natriuretic peptide levels were significantly correlated with mean pulmonary arterial pressure and pulmonary wedge pressure (r=0.05, r=0.65, P<0.05). 4) Plasma atrial natriuretic peptide levels in pulmonary artery were significantly correlated with mean pulmonary arterial pressure (P<0.05).
Arterial Pressure ; Heart Diseases* ; Heart* ; Hemodynamics* ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure