No abstract available.
Spine*

Femoral neck fracture has given marked attention to the orthopaedic surgeon due to complications, such as avascular necrosis of femoral head, non-union and degenerative arthritis, moveover common in older age group since early part of the 20th century. It is one of disabling and unsolved problems, so various techniques and implants were introduced and applied. Percutaneous Knowles pinning is one of simple, safe and reasonably effective method in treating femoral neck fracture, provided it is performed correctly. Nineteen cases of femoral neck fracture treated with precutaneous Knowles pinning at the Department of Orthopaedic Surgery, National Medical Center were analyzed and following result were obtained. l. Among the 19 cases, 13 cases were female and 6 cases were male, and high incidence was noted in older age group. 2. The amout of bleeding during operation was less than 100ml and the operative time was less than one and half hour under the local anesthesia in majority. 3. Good result was obtained in the group of operation less than 3 days after initial injury compared to more than 3 days group. 4. There was high complication rate in poor group than acceptable group according to Garden alignment index and we could predict the end result by aid of alignment index. 5. There was no cast immobilization in case of stable reduction, good fixation and good Rapport. 6. Bony union was established within 4.7 months in non-displaced fracture and 7.3 months in displaced fracture in average. 7. There were 1 case of avascular necrosis. 3 cases of non-union and 2 cases of degenerative osteoarthritis and poor results were correlated with Garden stage.
Agriculture ; Anesthesia, Local ; Female ; Femoral Neck Fractures ; Femur Neck ; Femur ; Head ; Hemorrhage ; Humans ; Immobilization ; Incidence ; Male ; Methods ; Necrosis ; Operative Time ; Osteoarthritis

Tentative diagnosis of meniscal pathology is very helpful for the successful operative management including arthroscopy. Conventional arthrography has long been used to meet this purpose, but it has some limitations due to complex views and some difficulties in imaging the whole anatomical structures. Recent diagnostic advancement produced post-arthrographic HRCT and MRI for the compensation of these problems of conventional arthrography. Arthrography and post-arthrographic HRCT has been carried out on 49 knees in 43 patients. 38 knees among them could be confirmed by arthroscopy and following results were obtained. 1. Diagnostic accuracies of post-arthrographic HRCT for medial and lateral meniscal injuries of knee were 94.7% and 92.1% repectively. 2. Shape, contour of torn meniscus and the relationships between the torn fragments were better demonstrated with HRCT. 3. Horizontal tear could also be suspected by HRCT. 4. Peripheral detachment could be differentiated with synovial recess on the HRCT, especially in the reformat view, but was more clearly visible in arthrography. 5. Arthrography and HRCT can be used as a good complementary study for the evaluation of meniscal injuries.
Arthrography ; Arthroscopy ; Compensation and Redress ; Diagnosis ; Humans ; Knee ; Magnetic Resonance Imaging ; Pathology ; Tears

Rectus sheath hematoma of the abdominal wall is a well-recognized, but uncommon condition, caused by a tear in an epigastric vessel and characterized by sudden onset of severe abdominal pain and palpable mass. In most cases, a precipitating cause can be demonstrated. Causes include external trauma, strenuous activities, coughing, lifting, sneezing, vomiting, straining while urinating or defecating, golfing, pregnancy and the puerperium, anticoagulation therapy, infection, chronic diesase, arteriosclerosis, hypertension, prior paracentesis or laparotomy, inadequate hemostasis or excessive retraction in surgery, and idiopathy. Unfortunately, the correct diagnosis often is missed, and the hematoma is found only during an exploratory laparotomy. Treatment should be conservative in most instances. Although the mortality rate for patients with rectus sheath hematoma is low, the condition may be fatal if the volume of the hemorrhage is large and if treatment is delayed. Hence, it should be included in the differential diagnosis of any patient who presents to the emergency department with acute onset of abdominal pain. Our purpose is to familiarlize emergency physicians with the pathophysiology, the diagnosis, and the treatment of rectus sheath hematoma. We describe a patient with fatal rectus sheath hematoma presenting to the emergency department and give a review of the literature.
Abdominal Pain ; Abdominal Wall ; Arteriosclerosis ; Cough ; Diagnosis ; Diagnosis, Differential ; Emergencies ; Emergency Service, Hospital ; Golf ; Hematoma* ; Hemorrhage ; Hemostasis ; Humans ; Hypertension ; Hypovolemia* ; Laparotomy ; Lifting ; Mortality ; Paracentesis ; Postpartum Period ; Pregnancy ; Shock* ; Sneezing ; Vomiting

Vestibular neurectomy is known as an effective procedure in the management of intractable peripheral vertigo from Meniere's disease and other episodic peripheral vertigo disorders. Various approaches have been developed for selectively sectioning the vestibular nerve, in order to preserve hearing and avoid facial nerve injury. Vestibular neurectomy is performed in two patients with Meniere's disease to control intractable episodic vertigo through retrolabyrinthine approach. Vertigo was improved with preserving their hearing. We report the surgical technique and advantages of retrolabyrinthine vestibular neurectomy in the treatment of vertigo.
Facial Nerve Injuries ; Hearing ; Humans ; Meniere Disease ; Vertigo* ; Vestibular Nerve

The use of artificial skins for full thickness wounds is an accepted technique, but unfortunately the take rate is low and the aesthetical result is not acceptable. The freeze-drying treatment of allogenic tissues can destroy cells with preserving the structural organization of extracellular matrices, permitting allogenic transplantation. In this study we investigated a new method to process the allogenic skin for transplantable allogenic dermis and this dermis was evaluated in a full thickness wound model. The results are as followings; 1. After treatment with NaCl and SDS solution and then with freeze-drying method, the allogenic dermis shows acellular dermal matrix with preserved normal extracellular matrix. 2. This allogenic dermis became completely incorporated into the wound without evidence of rejection or replacement by scar tissue. 3. The take rate of thin autografts overlying the allogenic dermis that were applied simultaneously was comparable to take rate of autograft alone. 4. The reduction in secondary contraction by allogenic dermis treated wounds was significant. 5. After grafting with cultured keratinocytes, the degree of epithelial coverage was 70% at 2 weeks. In conclusion, the allogenic dermis processed with our method displayed lack of antigenicity, and rapid revascularization. This allogenic dermis can permit simultaneous engraftment of an overlying STSG or cultured kerationocytes, reduce secondary contraction and improve cosmesis of full thickness wounds.
Acellular Dermis ; Autografts ; Cicatrix ; Dermis* ; Extracellular Matrix ; Keratinocytes ; Skin ; Skin, Artificial ; Transplants ; Wounds and Injuries*

No abstract available.
Fallopian Tubes* ; Female

A 19-year-old man had a good neurologic recovery from a severe hypothermia(19 degrees C) and a prolonged coma following active infernal rewarming. From inhaling hydrocarbons, he was left unconscious on the cold floor for 24 hours. As soon as the patient was brought into the emergency medical center, he was early evaluated arid treated aggressively. ECG showed Osborn(J) wave on all leads. The temperature o( patient was increased by 2-3 degrees C per hour through active external rewarming (by heating blankets and warm bag) and active infernal rewarming (by airway rewarming, warmed IV fluids, gastrointestinal tract irrigation, and bladder irrigation). The temperature reached 36 degrees C after 6 hours. Active infernal rewarming provides rapid core rewarming with the additional benefit of circulatory support during the period of cardiac instability.
Coma ; Electrocardiography ; Emergencies ; Gastrointestinal Tract ; Heating ; Hot Temperature ; Humans ; Hydrocarbons* ; Hypothermia* ; Inhalation ; Rewarming ; Unconsciousness* ; Urinary Bladder ; Young Adult

No abstract available.
Debridement* ; Knee* ; Osteoarthritis* ; Osteotomy*

No abstract available.
Intervertebral Disc* ; Zygapophyseal Joint*