The carpal scaphoid is the commonest of the carpal bones to be fractured, and this injury is the commonest to befall the wrist of working man. There is still some disaggrement as to the optimum treatment and as to how long immobilization should be maintained. The twenty seven cases of the carpal scaphoid were treated at department of orthopaedic surgery, Maryknoll Hospital. They were analyzed in regared to the clinical and radiological aspects. The results were summarized as follows. l. Of 27 cases 24 cases were in the age group 20 to 39, and all cases were male patients. 2. In 17 cases, the fracture was found in right side. 3. In 19 cases (70.4%), the fracture was found on the middle 1/3 of the carpal scaphoid and in 18 cases(66.8%), the fracture line was transverse. 4. The union rate of fracture was 100% in the distal 1/3 fracture, 89.5% in the middle 1/3 fracture and 66.3% in the proximal fracture. The average period of immobilization were 10.3, 14.9 and 15.3 weeks respectively. 5. By Maudsley's assessment, the end result was good in all cases of the distal 1/3 fracture, 84.2% in the middle 1/3 fracture and 66.7% in the proximal 1/3 fracture. 6. Traumatic arthritis developed in 3 cases, avascular ncerosis in 7 cases, nonunion in 4 cases.
Arthritis ; Carpal Bones ; Humans ; Immobilization ; Male ; Wrist

Management of bladder tumors depends upon early detection and adequate follow-up. Urine Cytology plays an increasingly important and prominent role in the multidisciplinary approach to this problem. Herein we review our experience with urine cytology in the diagnosis and follow-up of bladder cancer at Department of Urology, College of Medicine, Yonsei University from 1981 to 1985. 1. A total of 478 cytologic evaluations were performed in the 198 patients. 2. The overall incidence of positive cytology was 49.2%. 3. The incidence of positive cytology in the presence of biopsy proven bladder tumor was 71.1%. 4.The incidence of positive cytology after TUR followed by adriamycin instillation was 72.2% at diagnosis, 41.7% after 3 months, 31.0% after 6 months, 33.3% after 9 months and 36.8% after 12 months. 5. The Number of cases with negative cytology after TUR and adriamycin instillation was 11 cases after 3 months, 7 cases after 6 months, 2 cases after 9 months and 1 case after 12 months. 6. Of the 5 patients having recurred tumor, there was 4 patients who constantly class IV, and 1 patient who had conversion from class I or II to class IV.
Biopsy ; Diagnosis ; Doxorubicin ; Follow-Up Studies ; Humans ; Incidence ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology

Nutcracker syndrome is a rare disease caused by the compression of the renal vein between the aorta and superior mesenteric artery. It is known to cause of venous hypertension, peripelvic and periureteral varicosities. Clinical manifestations include varicocele, hematuria, and flank or abdominal pain. Surgical correction is needed in nutcracker syndrome cases with severe or recurrent hematuria and abdominal or flank pain. Reanastomosis of the renal vein at 5cm below the original insertion site at the inferior vena cava is the one of the most common corrective methods and the transabdominal approach is usually employed. This disease usually appears in healthy young people and in order to decrease postoperative complications such as intestinal obstruction and bowel adhesion by avoiding unnecessary intraperitoneal manipulation, the authors used the extraperitoneal approach through a flank incision. We report because, in selected cases, we consider that this extraperitoneal approach is one of the alternative methods for the usual transperitoneal approach.
Abdominal Pain ; Aorta ; Flank Pain ; Hematuria ; Hypertension ; Intestinal Obstruction ; Mesenteric Artery, Superior ; Postoperative Complications ; Rare Diseases ; Renal Veins ; Varicocele ; Vena Cava, Inferior

No abstract available.
Neck* ; Talus*

No abstract available.

Use of ESWL has made many changes in the treatment of urinary trat stones. However, the treatment of the stone below the iliac crest was not possible owing to the arrangement of the apparatus and the location of the stone within the bony pelvis. For solving the problem, we selected 5 patients having mid ureteral stone. They were placed in prone position and administered shockwave from 500 times to 2600 times. The result was 3 patients had no residual stone and 2 patients showed decreased size of stones in follow-up examinations. All the patients showed no specific complication. The ESWL is able to disintegrate mid ureteral stone by using the change of patient`s position and avoiding the shield of bone around the stone.
Follow-Up Studies ; Humans ; Pelvis ; Prone Position ; Ureter*

Conventional laparoscopic surgery requires definite leaming curve, and must be converted to an open procedure in the event of a large vessel injury. The usage of carbon dioxide gas for securing operative field is generally accepted, but such field rapidly disappears when air pressure decreases. To overcome these shortcomings without sacrificing advantages of excellent cosmetic results and reduced wound pain of laparoscopy without using the gas insufflation, various urologic operations utilizing incisions 2 to 5 cm long were made without cutting abdominal musculature with the help of specially designed retractors and video systems used in conventional laparoscopic surgery. It can be performed in familiar anatomical settings and all the surgical skills of open procedures can be utilized. We have performed 3 living donor nephrectomies, 6 simple nephrectomies, 2 partial nephrectomies, 9 pyeloplasties, 16 ureterolithotomies, 1 ureteroureterostomy, and 2 renal cyst marsupializations. Mean operative time and hospital stay were 185 minutes and 7 days for living donor nephrectomies, 150 minutes and 6.7 days for simple nephrectomies, 255 minutes and 7.5 days for partial nephrectomies, 130 minutes and 4.8 days for pyeloplasties, 85 minutes and 4.1 days for ureterolithotomies, 90 minutes and 5 days for ureteroureterostomy, and 75 minutes and 5.5 days for renal cyst marsupializations, respectively. Immediate wound pain was severe probably due to intense traction of abdominal musculature, but the recovery of such pain was remarkably rapid. No postoperative wound paresthesia was seen and early discharge was possible. In conclusion, the gasless retroperitoneoscopically assisted surgery can take advantage of both conventional open and laparoscopic surgery, and it can be a valid option to conventional open surgery for any surgical procedures in retroperitoneum, including kidney, ureter, and bladder.
Air Pressure ; Carbon Dioxide ; Humans ; Insufflation ; Kidney ; Laparoscopy ; Length of Stay ; Living Donors ; Nephrectomy ; Operative Time ; Paresthesia ; Traction ; Ureter ; Urinary Bladder ; Wounds and Injuries

No abstract available.
Ankle*

The distal one-third fractures of tibia have much difficulty in treatment due to enumerous complications such as skin necrosis, angular deformity and delayed union. As for using Ender nails in distal tibial fractures, the stability of fixation can be strengthened with fanning of the nails in distal fragments and using more than 3 nails and 1cm longer nail. Twenty-two patients having distal tibial fractures, were carried out Ender nailing at Department of Orthopaedic Surgery, Maryknoll Hospital from May 1989 to September 1992. The results were as follows; 1. The distal end of fracture line was situated from 3cm to 9cm above plafond, and the mean duration of radiological bony union was 14.9 weeks except one case of nonunion. 2. Mild angulation developed in two cases and complications such as nonunion, superficial infection and backing out of nail were noted, but it did not affect the results.
Congenital Abnormalities ; Humans ; Necrosis ; Skin ; Tibia ; Tibial Fractures

In 1974, bipolar hip prosthesis was developed by Giliberty and Bateman to reduce the problems of unipolar prosthesis, including acetabular wear and acetabular protrusion, but the indications for it are still controversial. From July, 1988, to February, 1991, at Pusan maryknoll hospital, 37 hips in 33 patients of femoral neck fracture (25 hips) and avascular necrosis (12 hips) with relatively normal acetabular articular cartilage were treated with bipolar hip prosthetic replacement. The thirty-seven cases were reviewed for more than 3 years(range, 3 years to 4 years 8 months: average, 3 years 10 months), and assessed in terms of acetabular migration and function. The authors compared the datas of the femoral neck fracture with those of the avascular necrosis of femoral head. There was no statistical difference between two groups in function. But the acetabular migration of bipolar hip prosthesis used in femoral neck fracture was lesser than that of avascular necrosis of femoral head, and the serial acetabular migration disclosed gradual decrease. The authors concluded that the results of bipolar endoprosthesis used in femoral neck fracture was superior than those of avascular necrosis of femoral head with relatively normal acetabular articular cartilage.
Acetabulum ; Busan ; Cartilage, Articular ; Femoral Neck Fractures ; Femur Neck ; Head ; Hip ; Hip Prosthesis ; Humans ; Necrosis ; Prostheses and Implants