The goal of fracture treatment is to restore the patient to pre-injury function level. But the outcome assessment after orthopedic interventions has usually focused on physician-defined parameters of technical success, such as fracture union, alignment and range of motion rather than patient function and quality of life. However, the correlation among improvements in these parameters and functional status, psychosocial well being is inconsistent and weak in the elderly. Therefore authors assessed the functional status after surgical intervention of hip fractures in the elderly with functional recovery score(FRS). Independence in basic activities of daily living, in instrumental activities of daily living, in mobility, freedom from pain and intact memory were assessed in 133 hip fractures in the elderly. The hip fractures in the elderly resulted in 24.8% loss of function after the first year. The older the age, the more the loss of function after surgery of hip fractures. The more functional loss was observed in female patients and in patients with poor postoperative radiological results, but statistically insignificant (P>0.05). The more functional loss was observed in patients with underlying medical disease preoperatively and it was statistically significant (P<0.05). We recommend the evaluation of functional status in the elderly after hip fractures.
Activities of Daily Living ; Aged* ; Female ; Freedom ; Hip Fractures* ; Hip* ; Humans ; Memory ; Orthopedics ; Quality of Life ; Range of Motion, Articular

We report CT and MR findings in tow cases of primary malignant melanoma of the vagina, one arising from cervicovaginal junction mimicking squamous cell carcinoma of the cervix and the other one recurring at vagina after resection. Two cases of malignant melanoma had high-attenuation on CT and high signal intensity on T1-weighted MR images and enhanced well after gadopentetate dimeglumine administration.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Gadolinium DTPA ; Melanoma* ; Vagina*

We report CT and MR findings in tow cases of primary malignant melanoma of the vagina, one arising from cervicovaginal junction mimicking squamous cell carcinoma of the cervix and the other one recurring at vagina after resection. Two cases of malignant melanoma had high-attenuation on CT and high signal intensity on T1-weighted MR images and enhanced well after gadopentetate dimeglumine administration.
Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Gadolinium DTPA ; Melanoma* ; Vagina*

No abstract available.
Axilla* ; Paget Disease, Extramammary*

STUDY DESIGN: The preoperative and postoperative lateral radiograms and clinical results were analyzed in 22 cases of lumbar spinal stenosis with osteoporosis treated by posterior decompression and posterior lumbar interbody fusion. OBJECTIVES: To assess the efficiency of the cage-instrumented posterior lumbar interbody fusion in lumbar spinal stenosis with osteoporosis. SUMMARY OF LITERATURE REVIEW: Problems in surgical treatment of osteoporotic spinal stenosis were early screw loosening and early reversal to the original deformity because of insufficient mechanical stability in the bone-screw interface, and special strategy is essential for transpedicle screwing to sustain axial and screw cut-up load applied by flexion-extension motion in vivo. MATERIALS AND METHODS: We reviewed 22 cases of lumbar spinal stenosis with osteoporosis(Jikei grade I, II/III) from June 1996 to July 1998 with an average follow up period of 1.4 years. Inclusion criteria was combined segmental instability, deformity, spondylolisthesis and herniated nucleus pulposus with significant disc space narrowing. We asssessed the radiographic results of sagittal angle correction(SAC) of the instrumented segment and disc height restoration(DHR) on the preoperative, postoperative and last follow up lumbar lateral views, and clinical results according to the Kirkaldy-Willis criteria. RESULTS: Postoperative mean SAC gain was 10degree(p<0.05) and mean SAC loss at last follow up was 1.1degree(p>0.05). Postoperative mean DHR gain was 21.3%(p<0.05) and mean SAC loss at last follow up was 3.9%(p>0.05). The clinical result was analyzed as 2 excellent(9.1%), 16 good(72.7%), 4 fair(18.2%) and no poor. There were 2 intraoperative complications of a dural tear and a nerve root injury and 2 postoperative complications of a transient radiculopathy and a pseudoarthrosis. CONCLUSIONS: Cage-instrumented posterior lumbar interbody fusion can be an option for the lumbar spinal stenosis with osteoporosis requiring instrumentation because of instability, deformity or postdiscectomy anterior column deficiency.
Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Intraoperative Complications ; Osteoporosis* ; Postoperative Complications ; Pseudarthrosis ; Radiculopathy ; Spinal Stenosis* ; Spondylolisthesis ; Tears

PURPOSE: The proximal femoral fractures in children are rare but the complications are grave. The importance of this fracture is related to the frequency of complications. So authors evaluated the result of early surgical treatment of proximal femoral fracture. MATERIALS AND METHODS: From February 1993 to June 1997, authors have treated 8 cases of displaced proximal femoral fractures in children follow up, more than a year. We classified fracture type by Delbet's, and functional results by Ratcliff's. Internal fixation was done with smooth steinmann pins or small caliber cannulated screws. RESULTS: According to the Delbet's classification, the cases of type II, III, IV were 2, 5, 1. The average age was 7.3 years and boys were predominant (7 cases). Seven cases were treated by immediate anatomical reduction and internal fixation and one was delayed. The mean operation time was 52.7 minutes, duration of hip spica cast was 5.8 weeks and the time of union was 10.9 weeks in average. The mean time to partial weight bearing and full weight bearing were 10.3 and 13.9 weeks. The fixation devices were removed at 24.3 weeks in average. All cases were excellent. CONCLUSION: We suggest that immediate anatomical reduction and internal fixation is the one of the best way to reduce the frequency and severity of the complication of proximal femoral fractures and can expect good functional results in children.
Child ; Classification ; Femoral Fractures* ; Follow-Up Studies ; Hip ; Humans ; Pediatrics* ; Weight-Bearing

No abstract available.
Keratosis, Seborrheic* ; Poroma* ; Scalp*

A spontaneous spinal epidural hematoma (SSEH) is a rare disease that accompanies severe axial pain in the spine with various levels of paralysis depending on the location of the hematoma. A SSEH is mainly caused by a coagulating disorder or anticoagulants medication, while certain cases relate this disease with spinal inflammatory conditions. The early diagnosis of a SSEH is important for its treatment. Most cases with neurologic symptoms can be treated with an immediate laminectomy and decompression. If the neurologic symptom improves within 12 hours, a conservative treatment is effective; however few cases have been reported. We report this case with a review of the relevant literature.
Anticoagulants ; Decompression ; Early Diagnosis ; Hematoma ; Hematoma, Epidural, Spinal ; Laminectomy ; Neurologic Manifestations ; Paralysis ; Polymethacrylic Acids ; Rare Diseases ; Spine

Torture is an extreme life stressor which increases the risk of serious psychological and physical sequelae of victims. Despite Geneva declaration, Amnesty International reports that torture remains as human rights issue in many sites of the world. Even in Korean peninsula, torture is a serions human rights issue. This paper is a critical review on torture; to describe its methods and effects, the assessment of psychological and physical sequelae, and its treatment. Torture also affects survivor's family. The more prolonged, repeated, and unpredictable the experience of torture is, the more serious psychiatric consequences are likely. Psychological responses and sequelae include not only symptoms of Posttraumatic Stress Disorder (PTSD), but also depression, personality changes, somatoform disorders and others. Diagnositic terms such as complex PTSD or torture syndrome have been used to denote the complexity of torture trauma. Treatment is a combination of pharmacotherapy, cognitive-behavioural therapy, guidance for of socialre readaptation. Ensuring safety and trust between survivors and medical staffs is important. Torture prevention is to expose the facts particularly health data to the public, and collaborate with international organizations fighting against torture. Preventive interventions is linked to a change in the underlying socio-political causes and to the creation of necessary conditions for human rights and development at the level of society.
Depression ; Drug Therapy ; Human Rights ; Humans ; Medical Staff ; Somatoform Disorders ; Stress Disorders, Post-Traumatic ; Survivors ; Torture*

No abstract available.
Adult ; Fingers ; Humans