Eighty four patients with 104 calcaneal fractures which were treated at the dept. of orthopaedic surgery, Inchon Christian Hospital from October, 1979 to September, 1983 were clinically analysed and the results were as follows; 1. 72 patients were male and 12 patients were female. The male were more injuried in the ratio of 6:l. 2. Their ages were ranged from 6 yrs. to 66 yrs. (average; 35.4 yrs.) and the half of the patients were occured at the 3rd and 4th decade. They admitted for average 7.6/7 weeks. 3. The main cause was a fall from a height in 62 patients (73.8%) and its average height was 4.5m. 4. The open fractures were occured in 13 feet (12.5%) and the spine fracture was associated in 16 patient (19%). 5. The 104 cases were classified according to the Rowe and Essex-Lopresti classification. Fractures involving subtalar joint were 74 feet (71.2%) and the Rowes type V were 58 feet(55.8%). 6. The 22 cases were treated by elosed reduction and axial pin fixation, 10 cases were treated by open reduction and the subtalar fusion was done at 2 cases. Others were treated by cast immobilization with or without closed reduction. The satisfactory result was obtained in 64 cases(61.5%). 7. The most common problem after any treatment was persistent foot pain, especially beneath the lateral malleolus.
Calcaneus ; Classification ; Clinical Study ; Female ; Foot ; Fractures, Open ; Humans ; Immobilization ; Incheon ; Male ; Spine ; Subtalar Joint

After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.
Head* ; Humeral Fractures ; Humerus* ; Incidence ; Intra-Articular Fractures ; Surgeons ; Ulnar Nerve*

Leiomyoma is commonly found in the female genital tract, but occurrence in the urinary bladder is very rare with only 235 cases reported in the literature. These tumors have been classified as intravesical (63%), intramural (7%) and extravesical (30%) depending on the direction of the growth. We report a case of intravesical leiomyoma of the urinary bladder in a 36 year-old woman who exhibited dysuria and urinary retention. The gross and microscopical findings of leiomyoma of the bladder are similar to those of the uterus. Immunohistochemical stains for estrogen receptor (ER) and progesterone receptor (PR) revealed diffuse nuclear staining in smooth muscle cells, supporting the hypothesis of hormonal influence in tumorigenesis.
Adult ; Carcinogenesis ; Coloring Agents ; Dysuria ; Estrogens ; Female ; Humans ; Leiomyoma* ; Myocytes, Smooth Muscle ; Receptors, Progesterone ; Urinary Bladder* ; Urinary Retention ; Uterus

We Performed an immunohistochemical study to identify the cellular components and involvement of immune mechanism in proliferative vitreoretinopathy, which is a major cause of delayed filure of retinla surgery. The 17 specimens of periretinal membranes -including vitreal membranes- were surgically obtained during the pars plana vitrectomy. The clinical diagnoses were idiopathic or traumatic retinal detachment (9 eyes), proliferative diabetic retinopathy (6 eyes), and pars plannitis (2 eyes). The labeled streptavidin-biotin immunoperoxidase method was used for immunohistochemical stain. The following antigens were detected in periretinal membranes : cytokeratin in 8 (of 17 cases studied for this antigen), glial fibrillary acidic protein (GFAP) in 9 (of 17), vimentin in 15 (of 17), HLA-DR in 14 (of 17). The macrophages and T lymphocyte expressing CD4 or CD8 markers, were not found in any of the membranes. These results suggest that cellular components of periretinal membranes are consists of retinal pigment epithelial cells, glial cells, and fibroblast. The identification of macrophage and T lymphocytes all met with failure. Also, strong positivity of HLA-DR antigen may indicate involvement of the immune mechanism during the course of proliferative vitreoretinopathy.
Diabetic Retinopathy ; Diagnosis ; Epithelial Cells ; Fibroblasts ; Glial Fibrillary Acidic Protein ; HLA-DR Antigens ; Keratins ; Lymphocytes ; Macrophages ; Membranes ; Neuroglia ; Retinal Detachment ; Retinaldehyde ; T-Lymphocytes ; Vimentin ; Vitrectomy ; Vitreoretinopathy, Proliferative

No abstract available.
Adenocarcinoma* ; Fallopian Tubes* ; Female

In determining the effects of strabismus surgery, it is very important to know where the reattachment site of an extraocular muscle following recession procedure is located. Undercorrections or overcorrections after muscle surgery have been thought to be due to a postoperative positional changes of reattachment site along the surface of the globe. The author performed this experimental study to evaluate the amounts of changes of reattachment site after recession procedure in rabbit with 4 different methods of scleral fixation;direct suture with 6-0 vicryl, hang-back suture, application with Tisseel and Histoacryl. Superior rectus recession was performed in all 40 rabbit eyes, 10 eyes in each group. The distance from limbus to proximal end of recessed superior rectus muscle was measured on day 1, 2, 3, 5 and 7 postoperatively. Further measurements were followed at 2, 3, 4 and 8 weeks after recession procedure. The muscles were found an average of 0.4mm posterior to the intended position in direct suture group and 0.5 mmin hang-back suture group at one week postoperatively. But in the other two groups in which tissue adhesive agents, Tisseel and Histoacryl were used, the amount of displacement of the reattachment site were minimal of within 0.1 mm. From this experimental study, it is suggested that the positional changes of the reattachment site after recession procedure may influence the surgical corrective effects for strabismus.
Enbucrilate ; Fibrin Tissue Adhesive ; Muscles ; Polyglactin 910 ; Strabismus ; Sutures ; Tissue Adhesives

BACKGROUND: Handgrip and cold pressor test may increase the afterload of the heart. And in left ventricular hypertrophy, it is known that mitral flow pattern is affected by decreased left ventricular compliance. We investigated the effects of handgrip and cold pressor test on mitral flow pattern in patients with left ventricular hypertrophy. METHODS: Handgrip and cold pressor test were performed in 12 subjects with left ventricular hypertrophy and in 14 healthy normal subjects. In supine position, blood pressure, heart rate and Doppler echocardiographic parameters(early peak flow velocity : E, atrial peak flow velocity : A) were obtained at rest, 1 and 3 minutes after the onset of tests respectively. RESULTS: In both groups, handgrip and cold pressor test increased blood pressure slightly without a statistical significance. In left ventricular hypertrophy group, there were significant increments in heart rates at 1 minute of handgrip (78+/-12min-1, p<0.001) and cold pressor test(77+/-7min-1, p<0.05) as compared to that at rest (73+/-12min-1). Mitral flow velocities did not show significant change after the tests in control group. A waves after 1 minute of handgrip(85.2+/-18.4cm/sec, p<0.05) and cold pressor test (87.3+/-17.8cm/sec, p<0.001) showed significant increases as compared to that at rest (79.1+/-14.9cm/sec) in left ventricular hypertrophy group whereas E waves did not. CONCLUSION: Although handgrip and cold pressor tests did not affect the mitral flow significantly in control group, each test raised A waves in left ventricular hypertrophy group. These results suggest that increased A waves may be due to a rise in afterload and decreased left ventricular compliance caused by handgrip and cold pressor test in left ventricular hypertrophy group.
Blood Pressure ; Compliance ; Echocardiography ; Heart ; Heart Rate ; Humans ; Hypertrophy, Left Ventricular* ; Supine Position

No Abstract Available.
Knee* ; Synovitis, Pigmented Villonodular*

A total of 420 cases of tumors of bone and cartilage were seen and treated at our department during the 19 years period from January, 1957 to November, 1975, This studies reviewed and analysed clinically, radiologically and pathologically. One hundred fifty-three cases (36.4%) were benign tumors. These included osteochondroma-54 cases (35.3%), benign giant cell tumor-18 cases (11.8%), enchondroma and osteoma-15 cases (9.8%) each, fibrous dysplasia-14 cases (9.2%), solitary bone cyst-13 cases (8.5%), osteoid osteoma-11 cases (7.2%),aneurysmal bone cyst and non-ossifying fibroma-5 cases (3.2%) each, chondroblastoma-2 cases (1.3%), and chondromyxoid fibroma 1 case (0.6%). Two hundred sixty-seven cases (63.6%) were malignant tumors. Among these cases, one hundred forty-nine cases (55. 9%) were metastatic bone tumors and one hundred eighteen were primary malignant bone tumors. The latter included osteogenic sarcoma 54 cases (46.0%), chondrosarcoma-19 cases (16.1%), reticulum cell sarcoma-9 cases (7.6%), multiple myeloma and malignant giant cell tumor-8 cases (6.7%) each, Ewings sarcoma-7 cases (6.0%), fibrosarcoma-5 cases (4.2%), juxtacortical osteogenic sarcoma and liposarcoma-3 cases (2.5%) each, and lymphosarcoma 2 cases (1.7%). a greated incidence of malignant tumors. The result led us to conclude that; 1. In this study of bone tumors, the ratio between benign and malignant tumors was around 1: 1. 7, a greater incidence of malignant tumors. 2. Osteochondroma was the most frequently encountered benign bone tumor (35.3%), and followed by benign giant cell tumor (11.8%). 3. Excluding metastatic bone tumor, osteogenic sarcoma was the most frequently encountered malignant bone tumor (46.0%), and followed by chondrosarcoma (16.1%). 4. The most common site of solitary osteochondroma was around knee joint including the distal femur and the proximal tibia in 15 cases (45.5%). The peak age incidence was in the second decade of life and 43 cases were solitary and 11 cases were multiple lesion. 5. In 15 cases of enchondroma, 10 cases were solitary and 5 cases were multiple lesions. The common site was phalanges of the hand. 6. Giant cell tumor was 26 eases and to be divided into pathologically Grade I & II 18 cases (69%) and Grade III 8 cases (31%). 7. The average age of giant cell tumor was 33.8 years with the peak incidence in the third and forth decade of life. 8. The common sites of giant cell tunior were the distal femur in 8 cases and proximal tibial in 4 cases and distal radius in 6 cases. More than half of these series, the tumor occurred around the knee. 9. The sex distribution of chondrosarcoma showed 4 times of the male predominence. The 2 cases of secondary chondrosarcoma arose from osteochondroma and multiple osteochondromatosis. 10. The average age of osteogenic sarcoma was 25. 5 years with the peak incidence in the second decade of life. 11. The sex distribution of osteogenic sarcoma 42 males (77.8%) and 12 females (22.2%), a male predominance. 12. The common sites of osteogenic sarcoma were distal femur and the proximal tibia and proximal humerus in 42 cases (77.8%). 13. In metastatic bone tumor, male was predominent; 90 males (60.4%) and 59 females (39.6%), and common primary site of cancer included stomach (13.4%), lung (12.8%), breast (6.0%), liver (4.7%) and female genital organ (4.7%). 14. The most common sites of metastatic tumor to bone was spine in 46.3%, and followed by pelvis, ribs, femur and skull.
Bone Cysts ; Breast ; Cartilage ; Chondroma ; Chondrosarcoma ; Exostoses, Multiple Hereditary ; Female ; Femur ; Fibroma ; Genitalia ; Giant Cell Tumors ; Giant Cells ; Hand ; Humans ; Humerus ; Incidence ; Knee ; Knee Joint ; Liver ; Lung ; Lymphoma, Non-Hodgkin ; Male ; Multiple Myeloma ; Osteochondroma ; Osteosarcoma ; Pelvis ; Radius ; Reticulum ; Ribs ; Sex Distribution ; Skull ; Spine ; Stomach ; Tibia

Calcaneus is more frequently fractured than any other tarsal bones. Because of complex contour of calcaneus, it is difficult to evaluate the type of fracture exactyly. Futhermore fractures involving subtalar joint give rise to chronic pain and functional incapacity. Many different methods have been tried for treatment, but there was no aggrement of its methods and results. From January 1981 to December 1986, calcaneal fractures of 62 cases in 52 patients were analyzed and the results obtained from this study were as follows :l. Of 52 patients, 41 patients were male and 11 female. 2. The cause of fractures was a falling down in 38 patients (76%), traffic accident in 8 patients (15%) and direct blow in 6 patients (12%) 3. According to Rowe;s classfication, Type I fracture was in 5 cases, Type II in 6 cases, Type lll in 5 cases, Type IV in 12 cases and Type V in 34 cases (55%). Of these Type V fracture, tongue type was in 21 cases and joint depression type in 13 cases. 4. The treatment was as follows : cast immobilization in 33 cases, closed reduction and pin fixation in 24 cases and open reduction in 5 cases. 5. The functional result was satisfactory in 44 cases (71%). The result was better in fractures not involving subtalar joint and among type V fractures, the result was better in fractures of tongue type treated with open reduction. 6. So, we recommended compressive bandage and early mobilization for fractures without displacement, axial fixation for tongue type fractures and open reduction for joint depression type fracture.
Accidental Falls ; Accidents, Traffic ; Bandages ; Calcaneus ; Chronic Pain ; Depression ; Early Ambulation ; Female ; Humans ; Immobilization ; Joints ; Male ; Subtalar Joint ; Tarsal Bones ; Tongue