BACKGROUND: This study investigated and evaluated the clinical outcomes of intra-articular lesions of traumatic anterior shoulder dislocation (TASD) associated with greater tuberosity (GT) fracture of the humerus. METHODS: Subjects included 20 patients who were surgically or non-surgically treated for GT fracture of the humeurs with TASD, and followed-up for at least 2 years. The mean follow-up period was 54.1 months (range, 24–105 months). Of the 20 patients, 12 were treated surgically. Intra-articular lesions were identified randomly on magnetic resonance imaging scans (repeated thrice) by experienced radiologists and orthopedic surgeons. The accompanying intra-articular lesions were left untreated. Clinical outcomes were evaluated by Simple Shoulder Test (SST) and Western Ontario Shoulder Instability index (WOSI) at the last follow-up. RESULTS: Intra-articular lesions were identified in 19 patients: 7 Bankart lesions, 15 humeral avulsion of the glenohumeral ligament lesions, 3 glenoid avulsion of the glenohumeral ligament lesion, and 6 inferior capsular tears. Two or more intra-articular lesions were identified in 6 patients. The mean SST score was 10.9 and the mean WOSI score was 449.3 at the last follow-up. CONCLUSIONS: For GT fracture of the humerus with TASD, a high frequency of diverse intra-articular lesions was identified. There were no incidence of recurrent shoulder dislocations, and good clinical outcomes were obtained without treatment of the intra-articular lesions. We thereby comprehend that although intra-articular lesions may occur in TASD associated with GT fracture of the humeurs, merely treating the GT fracture of the humerus is sufficient.
Follow-Up Studies ; Humans ; Humerus* ; Incidence ; Ligaments ; Magnetic Resonance Imaging ; Ontario ; Orthopedics ; Shoulder Dislocation* ; Shoulder* ; Surgeons ; Tears

No abstract available.

No abstract available.

OBJECTIVE: To evaluate the clinical effect and reproductive outcome of pelviscopic ovarian drilling in infertile patients with polycystic ovarian syndrome resistant to clomiphene citrate. METHODS: Twenty two patients involved in this study were taken pelviscopic ovarian drilling with needle electrocautery. Change of characteristic LH/FSH ratio before and after operative treatment, ovulation and pregnancy success were followed up. Paired t-test was applied for hormonal change (p<0.05). RESULTS: Thirteen of 14 patients (93%) treated only with pelviscopic ovarian drilling showed successful ovulation with or without clomiphene citrate and among these 10 patients (71%) were success in pregnancy and 9 patients delivered full term babies. When including patients who needed other assisted reproductive technique and specific medication of endometriosis 17 of 22 patients (77%) were successfully pregnant and 15 patients (68%) delivered healthy babies. The mean LH/FSH ratio 2.0+/-0.5 before treatment were decreased to 1.26+/-0.37 after treatment (p<0.05). Interestingly, among 22 patients, various degree endometriosis were found during pelviscopy and specific medication with GnRH analogue were followed. CONCLUSION: Pelviscopic ovarian drilling showed successful ovulation rate and effective reproductive outcome in clomiphene-resistant infertile patients with PCO. This surgical technique seems to be an alternative step for the management of clomiphene-resistant infertile patients with PCO and also for the diagnosis of possible high rate of endometriosis in these patents.
Clomiphene* ; Diagnosis ; Electrocoagulation ; Endometriosis ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Needles ; Ovulation ; Polycystic Ovary Syndrome* ; Pregnancy ; Reproductive Techniques, Assisted

A total of 162 patients with invasive cervical cancer was investigated retrospectively with a view to elucidate the efficacy of pretreatment staging procedures of application with intravenous pyelography, cystoscopy, rectosigmoidoscopy. All 72 intravenous pyelograms, 155 sigmoidoscopies, 158 cystoscopies were normal. Of 111 patients with stage Ib who had paraaortic lymph node biopsies, two patients had a positive node(0.02%). Of 51 patients with stage II who had paraaortic lymph node biopsies, five patients had positive paraaortic lymph node(10%). And the accuracy of computed tomography and magnetic resonance imaging in the evaluation of invasive cervical cancer was assessed. In evaluating stage of cervical cancer, clinical staging had an accuracy of 78.9%, compared with 65.7% for CT and 58.9% for MRI. And for detection of parametrial invasion, clincal staging had an accuracy of 85.9%, compared with 85.1% for CT and 78.9% for MRI. Both modalities were comparable in evaluating lymph node metastasis ( 76.1% for CT, 74.4% for MRI ). IVP, cystoscopy and sigmoidoscopy for staging procedure evaluated in this study are unnecessary and should no longer be performed in patients with early stage cervical cancer. In addition, paraaortic lymph node biopsies in the absence of clinically suspicious nodes are not warranted. Compared with CT and MRI, pelvic examination offered improved evaluation of cervical cancer staging, parametrial invasion, but CT and MRI was useful in detecting the pelvic lymph node metastasis which was nearly impossible by clinical evaluation.
Biopsy ; Cystoscopy ; Gynecological Examination ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging* ; Neoplasm Metastasis ; Retrospective Studies ; Sigmoidoscopy ; Urography ; Uterine Cervical Neoplasms

OBJECTIVES: The most often perfomed major operation in gynecology is hysterectomy.Our purpose was to compare the indications, charateristics and outcomes of patients undergoing total abdominal hysterectomy and total vaginal hysterectomy and to help to establish guidelines to determine the route of hysterectomy. METHOD: The hospital charts of 400 women who underwent elective inpatient hysterectomy at Kyung-Hee University hospital from January 1994 to January 1999, were abstracted retrospectively. Data were collected regarding patients, age, parity, preoperative indications, the route of hysterectomy, uterine weight, operative and postoperative complications and the length of stay. The operative indications were benign uterine disease except from uterine prolapse. Bisection or combined morcellation were used in most cases to obtain reduction in uterine size. RESULT: Patients in whom the vaginal route was successful included 18% of those with uterine weights exceeding 280gm. There was statistically significant difference for uterine weight, operative time, bleeding amount, the length of stay in two camparative group. 4% of vaginal hysterectomy and 7% of total abdominal hysterectomy has documented operative complications. CONCLUSIONS: Vaginal hysterectomy is safe operation with few intraoperative and postoperative complications without notable blood loss. Vaginal hysterectomy allow one to shorten the operating time and allows early postoperative discharge of some patients from hospital. Skilled performance of vaginal hysterectomy is worth greater attention and should be used more often in gynecological study.
Female ; Gynecology ; Hemorrhage ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal ; Inpatients ; Length of Stay ; Operative Time ; Parity ; Postoperative Complications ; Retrospective Studies ; Statistics as Topic* ; Uterine Diseases ; Uterine Prolapse ; Weights and Measures

Ovarian cancer has the highest mortality rate among gynecologic malignancies in developed countries. Most women present with advanced disease and require a combination of surgery and chemotherapy. One patient presented with recurrent ovarian cancer was initially treated with taxol and platinum-based compounds. Although response to these agents occurred, tumor progression was evident by elevated CA 125 levels and CT findings after a period of 4 months. This patient was then treated with topotecan and exhibited a response and stopped therapy. Topotecan exhibited activity in this patient with ovarian cancer resistent to both platinum and paclitaxel. We report a case of advanced ovarian cancer which was treated with topotecan after taxol-cisplatin treatment failed.
Developed Countries ; Drug Therapy ; Female ; Humans ; Mortality ; Ovarian Neoplasms* ; Paclitaxel ; Platinum ; Topotecan*

No abstract available.
Fallopian Tubes* ; Female

Since calcification or ossification of the posterior longitudinal ligament of the spine was first described inJapan in 1960 by Tsukimoto, Terayama used the term of OPLL(Ossification of Posterior Longitudinal Ligament) in1964 and mainly reported in Japanese. But recently, the incidence of the OPLL has been reported increasing amongthe non-Japanese. Because of the OPLL may be associated wtih severe neurologic symptoms, which need to havesurgical decompression, exact diagnosis and analysis are necessary. The OPLL can be diagnosed by simple spine,conventional tomography, myelography and CT. Authors analysed radiologic findings of the OPLL in 8 patients, whowere diagnosed by simple spine. Conventional tomography, myelography and CT, and then performed spinal operation,at Hanyang University Hospital from March 1980 to June 1983. The results were as followings; 1. The age range wasbetween 45 and 63 years and most prevalent age was 6th decades(63%). 2. All of the patients were male. 3. All ofthe OPLL occurred in the cervical spine and predominant at the level of C3,4 (48%). 4. The most common length ofthe OPLL was 2 vertebral level. 5. Except one, which was discontinuous at the level of disc space, all of the OPLLwere continuous in length. 6. 7 of 8 OPLL were located in the midline, but one was in right. 7. The OPLL seemed tocorrelate with spondylotic changes. 8. Of all diagnostic procedure, CT provided better and exact visualization ofthe lesion with axial scan and sagittal reconstruction.
Asian Continental Ancestry Group ; Decompression ; Diagnosis ; Humans ; Incidence ; Longitudinal Ligaments ; Male ; Myelography ; Neurologic Manifestations ; Spine

No abstract available.
Cell Line* ; Gonadotropin-Releasing Hormone* ; Medroxyprogesterone Acetate* ; Medroxyprogesterone* ; Tamoxifen*