30 cases of distal femur fracture were treated with cast-brace for 2 years and 6 months from Feb., 1977 till July, 1979 at the department of Orthopaedic Surgery, Presbyterian Medical Center, in Jeon Ju. The results were obtained as follows: 1. In 9 cases, cast-brace were applied initially and other 21 cases were treated with cast-brace secondarily after operation. 2. 20 cases were male and 10 cases were female. 3. 12 cases were on mid 1/3 fracture and 18 cases were distal 1/3 fracture involving 2 condylar fractures. 4. The average duration of fracture healing was 14.7 weeks in the cases with cast-brace which is compared with 20.7 weeks of hip-spica cast control group. 5. A.G.F. of knee joint was 80–115 degree at removal of cast-brace, otherwise merely 50–65 degree at dlscarding of hip-spica cast. 6. There were no complication such as nonunion or delayed union in the cases with cast-brace.
Braces ; Female ; Femur ; Fracture Healing ; Humans ; Jeollabuk-do ; Knee Joint ; Male ; Protestantism

No abstract available.
Hearing Loss, Sensorineural*

PURPOSE: The aim of this study is to compare the shock wave lithotripsy (SWL) with the rigid ureteroscopic stone removal (URS) in order to establish the efficacy in treating upper ureteral stones according to the stone size. MATERIALS AND METHODS: We reviewed 328 patients who have been treated for upper ureteral stones between January 1999 and December 2002. 227 patients were treated with SWL, and 101 patients were treated with URS. We analyzed the success rates of the stone removal, reasons for failure, and complication rates of each procedure. RESULTS: The overall success rate of the URS was 93.1%. In terms of stone size, the success rates were 94.5% (<10mm) and 91.3% (>10mm), respectively. With the SWL treatments, the overall success rates after the first, second, and third sessions were 59%, 78%, and 92.5%, respectively. According to the stone size, the success rates were 96.5% (<10mm) and 85.7% (>10mm) after third sessions, respectively. The success rate was significantly affected by the size of the stone in the SWL group, but this was not the case with the URS group. The associated complication rates of URS and SWL were 11% and 7%, respectively. CONCLUSIONS: In this study, URS was relatively more efficacious than SWL when the stone was larger than 10 mm. The proper selection of patients for in situ SWL or URS would improve the results of the initial treatment.
Humans ; Lithotripsy* ; Shock* ; Ureter* ; Ureteral Calculi ; Ureteroscopy

PURPOSE: To evaluate CT features of metastatic ureteral tumors. MATERIALS AND METHODS: CT findings in 16 patients with ureteral metastases were evaluated retrospectively ;there were eight cases of bilateral ureteral involvement. Primary tumors metastatic to the ureter were advanced gastric cancer (n=13), breast cancer (n=l), colon cancer (n=l), or adenocarcinoma of unknown primary (n=l). We analysed CT findings with regard to the site of ureteral obstruction, configuration of obstructed sites of ureter, presence or absence of periureteral soft tissue density, and status in other organs. RESULTS: Among 24 ureters involved, ureteral wail thickening was noted in 15, periureteral soft tissue density in 13. Small nodular enhancing lesions less than lcm, within the retroperitoneal space around the involved ureters were noted in seven patients, and four of them were multiple lesions. CONCLUSION: Among various primary tumors, gastric cancer was the most common cause of ureteral metastasis. The common CT findings of ureteral metastases were thickening of ureteral wall, periureteral soft tissue density, and small periureteral enhancing nodular lesions. The constellation of these CT findings may be helpful in making the diagnosis of ureteral metastases.
Adenocarcinoma ; Breast Neoplasms ; Colonic Neoplasms ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Retroperitoneal Space ; Retrospective Studies ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction

63 cases of meningitis in children were reviewed to study correlation between brain CT findings and clinical course. We divided 63 cases into 3 groups according to clinical course, that is , Group I :Healed without significant sequelae. Group II: Discharged with sequelae such as neurologic deficit or complicated clinical course. Group III : Expired or considered to be expired after hopeless discharge. The CT finding were retrospectively analyzed and compared with each clinical group. We drawed several conclusions as follows; 1. The wrost prognostic CT finding is dirty basal cisternal enhancement. (Group I only 5%, Group II 50%, Group III 45%).2. Focal brain parenchymal lesion, especially multiple, such as granuloma and infarct shows unfavorable clinical outcome, that is, high rate of Group III and evident neurologic deficit, in contrast to only 7% of Group I. 3. In 7 cases of which CT finding is only hydrocephalus, the prognosis is rather favorable, that is, 57% were Group I, 43% were improved after V-P shunt (Group II) and no Group III. But hydrocephalus with dirty disternal enhancement results in grave prognosis, that is, Group I only 8%, Grouop II 54%, Group III 38%, With regard to overall hydrocephalus, predilectron for good or bad prognosis can't be mentioned. 4. No prognostic difference were noted between presence and absence of periventricular low desnity in hydrocephalus. 5. CSF pressure of hydrocephalus ismostly high (over 20cm H20). but normal pressure hydrocephalus were noted in 24%. CSF pressure of normal ventriclesize is mostly under 18cm H2O) but high pressure were noted in 18% of the nomral sized venticle (most of them shows intracranial space occupying lesion such as granuloma, acute infarct, subdural effusion, etc). 6. Most of diffuse braine swelling, diffuse brain atrophy and subdural effusion result in Group I, that is, favorable clinical outcome. 7. Normal CT findings ar found in 29%, of which 61% belong to Group I and 31% to Group II.
Atrophy ; Brain ; Child ; Granuloma ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure ; Meningitis ; Neurologic Manifestations ; Prognosis ; Retrospective Studies ; Subdural Effusion

A total of 188 cases of primary bone tumor was reviewed and analyzed clinically and pathologically at the Department of Orthopaedic Surgery, Presbyterian Medical Center, Jeonju, Korea during the 10 years period from January, 1970 to December, 1979. The results were obtained as follows: 1. 58 cases were benign and 130 cases were malignant. 2. Osteochondroma was the most common benign bone tumor and followed by giant cell tumor, simple bone cyst, osteoma and fibrous dysplasia. 3. Giant cell tumor was 15 cases, which were divided pathologically into benign(Grade I & II) 8 cases and malignant (Grade III) 7 cases. and treated by curretage, curettage & bone graft, arthrodesis, irradiation and amputation. 4. The most common primary malignant bone tumor was osteosarcoma, and it was followed by chondrosarcoma, fibrosarcoma and multiple myeloma. 5. Osteosarcoma was 60 cases and it occured commoly around knee joint area. 6. Treatment of primary malignant bone tumor contained of amputation, chemotherapy and irradiation.
Amputation ; Arthrodesis ; Bone Cysts ; Chondrosarcoma ; Curettage ; Drug Therapy ; Fibrosarcoma ; Giant Cell Tumors ; Jeollabuk-do ; Knee Joint ; Korea ; Multiple Myeloma ; Osteochondroma ; Osteoma ; Osteosarcoma ; Protestantism ; Transplants

The hindfoot in the human body is known to play an important function for weight bearng, shock absorption and locomotion. The defect of hindfoot presents serious problems of the leg length discrepancy and weight bearing. Therefore, it is essential to reconstruct the defect of hindfoot. Up to date, many surgical modalities from a skin graft to the innervated osteocutaneous flap have been developed, but a completely satisfactory method of reconstruction has not been found. The ideal reconstructive method should provide sufficient padding tissue and sensibility. In the Department of Orthopaedic Surgery, capital Armed Forces General Hospital, two cases of hindfoot defect due to explosion were reconstructed by the midplantar fasciocutaneous flap with free iliac bone graft. The results of our procedure were very acceptable one year after the operations.
Absorption ; Arm ; Explosions ; Hospitals, General ; Human Body ; Leg ; Locomotion ; Methods ; Shock ; Skin ; Transplants ; Weight-Bearing ; Wounds and Injuries

Purpose: We report a case of iatrogenic Horner’s syndrome developing after robot-assisted transaxillary total thyroidectomy.Case summary: A 31-year-old female with right-eye ptosis was referred to our clinic. Three weeks prior, she had undergone robot-assisted total thyroidectomy via the right transaxillary approach to treat right-side thyroid cancer. On ocular examination, the palpebral fissure widths were 5.0 mm in the right lid and 8.0 mm in the left lid, the marginal reflex distances 1, 1.0 mm in the right lid and 4.0 mm in the left lid, and the levator muscle function of both eyes normal. In a dark room, the pupil diameter was 2.5 mm in the right eye and 4.0 mm in the left eye. She did not complain of facial anhidrosis. Thirty minutes after instillation of 0.5% (w/v) apraclonidine into the right eye, the right palpebral fissure width increased from 5.0 to 8.0 mm, and the pupil size from 2.5 to 4.0 mm in the dark. Conclusions Horner’s syndrome can develop after robot-assisted transaxillary total thyroidectomy; patients should be counselled in this regard.

PURPOSE: To evaluate the effectiveness of a combined procedure of peeling the internal limiting membrane with vitrectomy in diabetic macular edema. METHODS: This study comprised 16 eyes of 16 patients hospitalized during a 1-year period. They were randomized to either a vitrectomy group (10 eyes in 10 patients) or to a combined procedure group (6 eyes in 6 patients). Preoperative and postoperative macular center thickness, best corrected visual acuity and postoperative complications 4 months postoperative were investigated. RESULTS: There were no statistically significant differences in the mean values of preoperative and postoperative best corrected visual acuity (logMAR) between the two groups. The mean values of preoperative and postoperative macular center thickness in the vitrectomy group were respectively 509.50+/-36.77 and 332.60+/-91.73; while in the combined procedure group, they were 516.17+/-55.43 and 333.83+/-51.64. Again, there were no statistically significant differences between the two groups. At the 4-month follow-up, decreased visual acuity was found in 3 eyes of the vitrectomy group and in 2 eyes of the combined procedure group. Vitreous hemorrhage (3 eyes) and tractional retinal detachment (1 eye) were found in the vitrectomy group and vitreous hemorrhage (2 eyes) was diagnosed in the combined group. CONCLUSIONS: In our study, vitrectomy with peeling of the internal limiting membrane was not more effective than vitrectomy alone in decreasing macular edema or in improving best corrected visual acuity. Additional studies of the combined procedure are needed to verify this result.
Follow-Up Studies ; Humans ; Macular Edema* ; Membranes ; Postoperative Complications ; Retinal Detachment ; Traction ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

To evaluate the change in valvular morphology and occurence and severity of mitral regurgitation produced by PMV, 45 patients(33 women and 12 men,mean age 38+/-10 years) were studied using two-dimensional(2-D) and Doppler echocaediography before and 1-2 days after this procedure. Mitral valve area after PMV increased in all patients, from 0.9+/-0.2 to 1.8+/-0.4cm2(P<0.0001). In valve area estimation, the correlation between Gorlin`s method and 2-Dechocardiography was better(r=0.61, p<0.0001) than that between Gorlin`s method and Doppler pressure halftime(r=0.38, P<0.01) before valvuloplasty, but after the procedure Gorlin`s and 2-D image valve area correlated less well(r=0.33, P<0.05) than Gorlin`s-Doppler pressure halftime correlation(r=0.46, P<0.002). Before PMV, 37 patients had no mitral regurgutation, 7 had grade 1 and 1 had grade 2 mitral regurgutation. After PMV, new mitral regurgutation occurred in 14 patients, increased in severity in 5 patients and so mitral regurgutation newly developed or increased in severity in 19(42%) patients. There were no differences between the patients with and those without an increase in mitral regurgutation after PMV, in age, sex, caediac rhythm, initial mitral valve area, increase in mitral valve area and fluoroscopic calcification. However, morphologic characteristics especially mobility(P<0.01) and thickening(P<0.05) of mitral leaflets were better pressured, and EBDA/BSA(effective balloon dilating area/body surface area) was significantly smaller(P<0.02) in patients without an increase in mitral regurgutation. Thus, an increase in mitral regurgutation after PMV might be related to the features of valve morphology especially and thickand EBDA/BSA.
Female ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis