No abstract available.
Ambulatory Care Facilities* ; Humans ; Low Back Pain* ; Outpatients*

No abstract available.
Urinary Bladder Neoplasms* ; Urinary Bladder*

Between Jan. 1971 and Dec. 1985, 102 consecutive patients underwent total cystectomy and urinary diversion for primary carcinoma of the bladder. Among the patients, planned radiation therapy (2,000 rad. for 5 days) followed by operation was done in 18 patients, therapeutic dose of radiation was given postoperatively in 8 patients and 76 patients underwent operation only The postoperative mortality rate was 3.9%. Early complications occurred in 30% of the 102 patients and included wound infection, urine leak, bowel obstruction and medical complication. An increased late complication incidence was noted among 26 patients receiving pre- or postoperative radiation (50%) compared with those not receiving radiation (32%). Staging errors by CT scanning occurred in 37% of patients, overstaging in 8 (33%) and understaging in 1 (4%). Survival was evaluated in 45 patients and the overall 5-yesr survival rate for patients with transitional cell carcinoma was 38%.
Carcinoma, Transitional Cell ; Cystectomy* ; Humans ; Incidence ; Mortality ; Survival Rate ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion ; Wound Infection

Cervical spinal stenosis can be diagnosed indirectly by measuring the anteroposterior diameter or Pavlovs ratio in simple cervical spinal radiographs. The purposes of this study were to assess the trasverse areas of the spinal canal,the dural tube and the spinal cord of the cervical spine of normal adults by magnetic resonance imaging (MRI), and to find the possible correlationship among the MRI results. T1-weighted MR images of the cervical spine of 100 normal adults were evaluated by measuring the transverse areas of the three structures in the axial plane. The maximal transverse areas of the spinal cord was 84.5mm2 at C5 and the minimal transverse areas of the dural tube and spinal canal were 153.6mm2 and 232.4mm2 at C6, respectively. The transvere areas of the spinal canal correlated better with the dural tube areas than with the spinal cord areas. The areas of the spinal canal, the dural tube and the spinal cord in MRI correlated better with the sagittal diameter than with the Pavlov's ratio in simple lateral radiographs.
Adult* ; Humans ; Magnetic Resonance Imaging* ; Spinal Canal* ; Spinal Cord* ; Spinal Stenosis ; Spine

To evaluate the usefulness of dynamic ultrasonography in documenting treatment efficacy and expecting prognosis in developmental dysplasia of the hip (DDH), 49 DDH hips in 32 patients, who had serial dynamic ultrasonographic examinations by Harcke's method during Pavlik harness treatment, were studied as for the progression of ultrasound findings. Grafs alpha and beta angle were measured in coronal flexion view of dynamic ultrasonography. Among 49 hips, on follow-up radiographs, 44 hips showed normal hip development and 5 hips showed dysplasia. In 44 normal hips, 43 hips had alpha angle of more than 50 degrees and stability on dynamic sonogram at the time of weaning of harness. In contrast, all five hips with residual dysplasia exhibited instability on dynamic stress with comparable alpha angle to that of normal hips. This finding suggests that when the hip matures beyond "delayed ossification"(alpha angle more than 50 degrees) with stability on dynamic sonogram, normal hip development can be expected. But if the hip is continuously unstable, regardless of alpha angle, there can be a possibility of residual dysplasia.
Follow-Up Studies ; Hip ; Humans ; Methods ; Prognosis ; Treatment Outcome ; Ultrasonography ; Weaning

The authors have reviewed 63 resistant clubfeet of 40 patients who were treated by modified Turco's operstion at the Department of Orthopaedic Surgery, Seoul National University Hospital during the eight years period from July, 1979 to June, 1987. The procedure performed by the senior author(D.Y.L.) is essentially similar to Turco's original technique, but with the following modifications :(a) A curvilinear skin incision instead of Turco's straight oblique incision. (b) Aponeurotic tenotomy of the abductor hallucis. (c) Medial capsulotomies of the first metatarso-medial cuneiform joint, medial cuneiformnavicular joint and release of the medial extension of the tibialis anterior insertion. (d) Z-plastic lengtening of the tibialis posterior tendon instead of tenotomy (e) Plantar fasciotomy The average age at the time of operation was 23.4 months, the youngest being 4 months and the oldest being 6 year and 7 months. The follow-up period was minimum 12 months and maximum 6 years, the average being 27.4 months. The cases were analysed radiologically and clinically, and following observations were made. l. AP and lateral talocalcaneal angles were corrected satiafactorily in 60 feet(95%) and 59 feet(94%), respectively. The Talocalcaneal indices were corrected satisfactorily to over 40 in 60 feet(95%). 2. The talo-first metatarsal angles, which reflect adduction of the fore-foot, were corrected satisfactorily to within +10°in 55 feet(87%). 3. Good and fair results were obtained in 54 feet(86%) in the radiological evaluation. 4. Adduction deformity of the forefoot was responsible in most cases of radiologically unsatisfactory results. 5. Among 40 feet of 26 pstients who were evaluated clinically by the Wynne-Davis method, 33 feet were rated good and 7 feet were rated fair. No poor results were found clinically. 6. Senior author's modification of additional forefoot medial release is an important addition to Turco's original technique and effectively reduced unsatisfacotory results.
Clubfoot ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Humans ; Joints ; Metatarsal Bones ; Methods ; Seoul ; Skin ; Tendons ; Tenotomy

Recently, continuous epidural catheter insertion is common practice not only in anesthesia but also in pain clinic. Meningitis is rare but serious complication of epidural analgesia. Acute bacterial meningitis occurred in a 82-year-old female patient with thoracic herpes zoster after continuous thoracic epidural analgeia. An MRI of thoracic region did not show an epidural abscess or granulation tissue. Gram stain and culture of the epidural catheter tip and the CSF yielded Staphylococcus aureus. Immediate treatment with antibiotics and supportive therapy was instituted and then the patient discharged without neurologic sequalae.
Aged, 80 and over ; Analgesia, Epidural* ; Anesthesia ; Anti-Bacterial Agents ; Catheters ; Epidural Abscess ; Female ; Granulation Tissue ; Herpes Zoster ; Humans ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Bacterial* ; Pain Clinics ; Staphylococcus aureus

No abstract available.
Bacillus* ; Humans ; Urinary Bladder Neoplasms* ; Urinary Bladder*

A clinical observation on the vesicovaginal repair was done on24 cases admitted to the Dep. of Urology, Keimyung University Hospital, during the period from 1971 through 1981. Vesicovaginal fistula can be surgically repaired via vaginal route or transvesical extraperitoneal or transperitoneal technique and the following results were obtained. 1. Overall success rate of vesicovaginal fistula repair was 71% and that of simplified transperitoneal transvesical approach was higher than conventional method (88%). 2. Excision of the fistulas were facilitated by continuing traction on the Foley catheter, vaginal insertion of assistant`s finger and sand bag application below hip. 3. Preoperative infection with scar tissue, short duration, large sized fistula, inadequate exposure and dissection of bladder from vagina turned out to be main factors of the operative failure. 4. Wide exposure with tension free closure of well-vascularized peritoneal flaps and the judicious interposition of pedicled omentum have produced the most encouraging results and supravesical diversion by ileal or colonic conduit can be avoided. 5. Previous attempts for surgical repair seemed to have relation with success rate.
Catheters ; Cicatrix ; Colon ; Fingers ; Fistula ; Hip ; Omentum ; Silicon Dioxide ; Traction ; Urinary Bladder ; Urology ; Vagina ; Vesicovaginal Fistula*

No abstract available.
Pregnancy*