Pathologic fracture occurs in a bone with preexisting stuctual weakness. The author reviewed 30 cases of pathologic fractures in which admission record and X-ray finding was well preserved among 53 cases admitted patients in the department of Orthopaedic Surgery, Seoul National Universty Hospital for 10 years from 1967. The results were as follows: 1.Age & Sex incidence showed even distribution. 2. The most frequent involved site was femur (40%) 3. The underlying etiology was as follows: 2 chronic osteomyelitis 1 homophilia 7 benign tumor 20 malignant tumor 4. metastatic tumor was the most frequent cause in 30 cases. 5. Treatment was as follows: Conservative treatment 4 cases Surgery 21 cases.
Clinical Study ; Femur ; Fractures, Spontaneous ; Humans ; Incidence ; Osteomyelitis ; Seoul

The result of interference with the conductibility of the spinal cord is one of the most disabling and distressing complications of splnal tuberculosis. This fact was recognized as early as in 1779, when Pott published. The antituberculous drugs and improved surgical treatment have made possible a more effective treatment than before and improved the prognosis but not solved all problems completely. The following results were shown by analysis of 63 cases of spinal tuberculosls with neurological symptom experienced in the Department of Orthopedic Surgery, Seoul National University in the past 9.5 years from Jan. 1970 to Jun. 1979. 1. Number of cases In child was 15. (29%). 2. Pulmonary and other tuberculous diseases were manifested in 29 cases (46%). 3. Regions of the spine inovolved were most common In thoracic spine (43 cases), especially lower thoracic spine. 4. There were 49 early and 14 late paraplegia 5. There were 24 complete and 39 incomplete paraplegia. 6. Spastic type was more common than flaccid type. 7. Anterior fusion was done in 55 cases and costotransversectomy in 8. 8. There were 36 cases (57%) of complete recovery and 8 of fallure. 9. The prognosis for recovery from paraplegia appeared to depend on age, duration, type and onset of paraplegia.
Child ; Humans ; Muscle Spasticity ; Orthopedics ; Paraplegia ; Prognosis ; Seoul ; Spinal Cord ; Spine ; Tuberculosis ; Tuberculosis, Spinal

Transcatheter embolization using absolute ethanol is a widely used technic in interventional radiology. Butits mechanism of action and embolization effect on various infusion speed are poorly understood. Authors performedan experimental study in rabbits to doccument the effect of absolute ethanol onvarious infusion rate. The resultsare as follows; 1. In high speed infusion group(>0.1ml/sec. n=13), 11 cases showed peripheral obstruction and 2 cases showed central obstruction. 2. In low speed infusion group(<0.1ml/sec. n=12), 4 cases showed peripheralobstruction and 8 cases showed central obstruction (p<0.02). 3. On follow-up angiography performed 4 weeks later(n=8), no demonstrable significant differences are found between two groups.
Angiography ; Ethanol ; Follow-Up Studies ; Rabbits ; Radiology, Interventional ; Renal Artery

Self expandable metallic stent is a good alternative of percutaneous transhepatic biliary drainage because it can eliminate numerous problems caused by external drainage catheter, such as tube dislodgement, bile leakage and psychotic problems. Authors analyzed initial results of self expandable metallic stents used in the patients with malignant biliary obstruction to evaluate the efficacy of the procedure and to find the technical problems in the procedure. Self expandable metallic stents were inserted in 14 patients: three with recurrent stomach cancer: there with gallbladder cancer: seven with Klatskin tumor: one with common duct cancer. Gianturco type stent was used in 9 cases ans Wallstent was used in 2 cases. In remaining three cases, both Z-stent and Wallstent were used in the same patient. The average period of follow up was 104 days (4-409). In 13 cases, the patency of the bile duct was restored by the stent (technical success: 92.9%). Occlusions of the stent were found in two cases, after two and 13 months, respectively. Causes of failure and stent occlusion were associated duodenal obstruction, tumor overgrowth and shortening of Wallstent. In remaining 11 patients, one patient was lost to follow up an 10 patients did not show recurrent jaundice until death or last follow up. There was no major complication related to the procedure. The insertion of self expandable metallic stent is a safe procedure and call eliminate major disadvantages of PTBD. Overstenting, overlapping land evaluation of associated GI tract obstruction is crucial for obtaining technical success and long-term patency.
Bile ; Bile Ducts ; Catheters ; Drainage ; Duodenal Obstruction ; Follow-Up Studies ; Gallbladder Neoplasms ; Gastrointestinal Tract ; Humans ; Jaundice ; Klatskin Tumor ; Lost to Follow-Up ; Self Expandable Metallic Stents* ; Stents ; Stomach Neoplasms

Self expandable metallic stent is a good alternative of percutaneous transhepatic biliary drainage because it can eliminate numerous problems caused by external drainage catheter, such as tube dislodgement, bile leakage and psychotic problems. Authors analyzed initial results of self expandable metallic stents used in the patients with malignant biliary obstruction to evaluate the efficacy of the procedure and to find the technical problems in the procedure. Self expandable metallic stents were inserted in 14 patients: three with recurrent stomach cancer: there with gallbladder cancer: seven with Klatskin tumor: one with common duct cancer. Gianturco type stent was used in 9 cases ans Wallstent was used in 2 cases. In remaining three cases, both Z-stent and Wallstent were used in the same patient. The average period of follow up was 104 days (4-409). In 13 cases, the patency of the bile duct was restored by the stent (technical success: 92.9%). Occlusions of the stent were found in two cases, after two and 13 months, respectively. Causes of failure and stent occlusion were associated duodenal obstruction, tumor overgrowth and shortening of Wallstent. In remaining 11 patients, one patient was lost to follow up an 10 patients did not show recurrent jaundice until death or last follow up. There was no major complication related to the procedure. The insertion of self expandable metallic stent is a safe procedure and call eliminate major disadvantages of PTBD. Overstenting, overlapping land evaluation of associated GI tract obstruction is crucial for obtaining technical success and long-term patency.
Bile ; Bile Ducts ; Catheters ; Drainage ; Duodenal Obstruction ; Follow-Up Studies ; Gallbladder Neoplasms ; Gastrointestinal Tract ; Humans ; Jaundice ; Klatskin Tumor ; Lost to Follow-Up ; Self Expandable Metallic Stents* ; Stents ; Stomach Neoplasms

Platelet-derived growth factor(PDGF) is known to accelerate soft tissue fracture and periodontal bone healing, but little information is available for characterizing the healing of articualr cartilage. This study was designed to demonstrate the regeneration potential of pasteurized autogeneous osteochondral graft when PDFG was applied locally in vivo. Eighteen rabbits in two groups were used in the experiment. The free osteochondral fragment(1x1x1 cm) were taken from distal femur. The fragment were pasteurized in 65degrees C for 5 minutes. In experimental group(group II), the fragment were soaked in 0.25 mg/ml of recombinant human PDGF mixed 5 ml normal saline and reimplanted to the resected site, and followed with local administration of 0.25 mg/ml PDGF to knee joint. In control group(group I), the pasteurized fragment were reimplanted in the resected site without any treatments. The histologic characteristics of the transplanted autografts for three rabbits in each group were observed at 3, 5 and 7 weeks postoperatively. The results were as follows; Group II revealed the more favorable regeneration of articular cartilage, less arthritic changes and more mature arrangement of chondrocytes than group I. Even thought the cartilage is avascular and the regeneration capacity of pasteurized cartilage is severely limited, the regeneration of grafted articular cartilage is thought to be accellerated by increased newly formed blood vessels and soft tissues due to the diffusion of PDGF on grafted cartilage, and probably also by differentiation of mesenchymal cells in the initial stage of experiment. The results of this study suggest that local administration of PDGF could be used for the treatment of posttraumatic or degenerative arthritis and various cartilage damages.
Autografts ; Blood Vessels ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Diffusion ; Femur ; Humans ; Knee Joint ; Osteoarthritis ; Platelet-Derived Growth Factor* ; Rabbits* ; Regeneration* ; Transplants*

Spinal disc surgery has been the most common cause of iatrogenic disc infection, resulting in pyogenic spondylitis. The diagnosis is usually difficult because of the infrequency of occurrence of pyogenic spondylitis. If three or more vertebrae are involved, the diagnosis of osteomyelitis is unlikely to be correct. Especially involvement of multiple non-contiguous vertebrae indicates metastatic tumor. Therefore, we report a rare case of latent multiple non-contiguous pyogenic spondylitis following spinal surgery. The actual cause of infection in this case is unknown. CT guide biopsy may be needed to rule-out tuberculosis spondylitis and metastatic tumor in such case of multiple spinal involvement. In conclusion, the possibility of latent spinal infection must be considered even though surgery had been done several years ago.
Biopsy ; Diagnosis ; Osteomyelitis ; Spine ; Spondylitis* ; Tuberculosis

Discoid medial meniscus was first reported in l930 by Watson-Jones. Discoid medial menisci are very rarely reported although the presence of discoid lateral menisci are not uncommon. From Jan. 1989 to Dec. 1994, we have experienced five cases who had discoid medial menisci with pain due to substance tear following knee injury in arthroscopy. There were three complete type anct two incomplete type. Out of flve cases, longitudinal tea1 and bucket-handle type tear were two, respectively. The remained one was a compound tear.
Arthroscopy ; Knee Injuries ; Menisci, Tibial*

Operations on the inner aspect of the pelvis are often necessary for irreducible fracture of the ilium, irreducible fracture of superior and medial portion of the acetabulum, tumors and infections involving iliac fossa, and fracture-dislocation and infection of the sacro-iliac joint. Until now Letournel and Judet's ilioinguinal and iliofemoral approaches provided access to anterior column of the pelvis by elevating muscle layer on inner aspect of the pelvis. We used modified iliofemoral approach using ASIS(anterior superior iliac spine) osteotomy to gain better access to anterior column, the pelvlc brim, and in some occasions as far as anterior sacroiliac joint while avoiding injury to the structures in the inguinal ligament and lateral femoral cutaneous nerve and reported six cases treated with this approach. In conclusion, a modified iliofemoral approach using ASIS osteotomy is a useful approach which can obtain an excellent exposure in the inner pelvis.
Acetabulum ; Ilium ; Joints ; Ligaments ; Osteotomy ; Pelvis ; Sacroiliac Joint

Osteoid osteoma is a relatively common benign tumor that most commonly affect the cortex of the long bone, Adolescent and young adult males are most frequently affected. It causes aching pain that worsens at night and commonly is relieved by aspirin. The typical radiographic appearance is a lucent nidus with surrounding dense cortical thickening. If the lesion is located in intra-articular cancellous bone, an osteoid osteoma may present with clinical findings that are more indicative of an inflammatory synovitis, and with atypical radiographic findings such as lack of both surrounding sclerosis and a lucent nidus. Therefore intra-articular osteoid osteoma may pose a diagnostic difficulty. Recently, we experienced 3 cases of intra-articular osteoid osteoma(2 humeral haed, 1 femoral head) and present them in detail.
Adolescent ; Aspirin ; Humans ; Male ; Osteoma, Osteoid ; Sclerosis ; Synovitis ; Young Adult