No abstract available.
Temporal Bone*

The anterior cruciate ligament(ACL) is one of the most important structure for maintenance of the sta- bility of the knee joint. Chronic instability as a result of insufficiency can lead to functional disability, pain, meniscal tears, and degenerative change in articular cartilage. The incidence of injuries of this liga- ment is increasing tendency due to development of vehicle system, industrial system and sports activities. Different authors have recommended both operative and nonoperative treatment for anterior cruciate ligament injuries. Variable methods for functional recovery of anterior cruciate ligament were introduced and argued about ideal method. As arthroscopic techniques improve, surgeons are more inclined to rec- ommend surgical treatment. The methods of repair of acute rupture of the anterior cruciate ligament through the arthrotomy tech- nique have been used widely, but the arthroscopic repair is a relatively new technique. This arthroscopic technique is idealy applicable for rupture at femoral and tibial attachment site. A arthroscopic repair of anterior cruciate ligament was performed with use of the arthroscopy, in 15 consecutive, selected anterior cruciate ligaments that were ruptured at femoral or tibial attachment site, and within 2 weeks after injury. The 15 patients were followed for a minimum of one year(mean, eighteen months; maximum, thirty-eight months). The mean age of the 15 patients at the operation was thirty years(range, seventeen to forty-eight years). The results of arthroscopic repair of anterior cruciate ligament in 15 cases were satisfactory, and as fol- lows. l. All of the 15 cases, the laxity of repaired anterior cruciate ligaments were decreased. 2. The average Lysholm Knee Score Scale was increased from 16 points preoperatively to 89 points postoperatively. Five of the patients(33%) were rated as excellent, and ten patients(67%) were rated as good. 3. The range of motion of the repaired knee joints were from Oo to 135o that results were achieved at postoperative 6 months.
Anterior Cruciate Ligament* ; Arthroscopy ; Cartilage, Articular ; Humans ; Incidence ; Knee ; Knee Joint ; Range of Motion, Articular ; Rupture* ; Sports

No abstract available.
Fractures, Open* ; Tibia*

Interlocking intramedullary nailing has many advantages for long bone fracture. However, we can meet many problems during the operative procedure. Among the patients who were treated with interlocking intramedullary nailing from March, 1990 to December, 1991, forty-eight patients(49 cases) of femur and tibia fracture who were followed up more than twelve months(average 14months: 12months 18months) were included in this study. 1) Forty-nine cases consisted of 20 cases(41%) of femur fracture and 29 cases(59%) of tibia fracture. 2) Two cases of proximal protrusion were developed because of inadequate implant length. 3) Operative complications were encountered with 3 cases of new fracture line, 1 case of new fragmentation, 1 case of reduction loss, 2 cases of failure of proximal targeting, 3 cases of failure of distal targeting, 2 cases of distraction of fracture site more than 3 mm, 1 case of sciatic nerve injury due to excessive traction and 1 case of tibial inlet error. 4) Postoperative complications were encountered with 1 case of distal targeting screw failure, 4 cases of infection and 8 cases of delayed union. 5) According to the result, sufficient planning and confirmations(preoperatively, intraoperatively and postoperatively) can diminish the complications. And then the interlocking intramedullary nailing will be useful method in the case of long bone fracture when the operator has extensive experiences.
Bays ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Humans ; Methods ; Postoperative Complications ; Sciatic Nerve ; Surgical Procedures, Operative ; Tibia ; Traction

The benign teratoma is usually slow growing tumor, but we expirienced a case of primary huge mediastinal benign teratoma that had grown very rapidly, maximally during 3 years. The 14-year-old female patient was admitted to our hospital because of abnormal chest X-ray that showed 10x10cm sized well definded mass with multiple calcificactions. but the mass was not present in chest X-ray perfomed on 3 years prior to admission. Under the diagnosis of teratoma, complete surgical resection was done by the left thoracotomy. The result of pathology was benign teratoma.
Adolescent ; Diagnosis ; Female ; Humans ; Mediastinal Neoplasms ; Pathology ; Teratoma* ; Thoracotomy ; Thorax

PURPOSE: To report a case of proptosis occurring during a Valsalva maneuver in a neurofibromatosis patient with an arachnoid cyst. CASE SUMMARY: A 42-year-old man diagnosed with type I neurofibromatosis visited our hospital with a 20-year history of enophthalmos in the left eye. The patient also complained of exophthalmos during the abdominal straining. On exophthalmometry, a 4 mm enophthalmos was found. The patient also presented with a limited motion to the superior and lateral direction. There was an ocular pulsation corresponding to the heart rate. During the Valsalva maneuver, a marked exophthalmos of the left eye occurred. The patient had light brown spots on the skin of the face and body trunk. Following an orbital computed tomography (CT), defects of the left sphenoid bone were present. Posteriorly, an arachnoid cyst was found; however, there was a lack of varix. The archnoid cyst was also observed to expand into the orbit during the Valsalva maneuver and forward the globe. CONCLUSIONS: To date, cases of proptosis occurring during a Valsalva maneuver by causes other than orbital varix are rare. Herein, the authors report a case with a review of literature.
Adult ; Arachnoid ; Enophthalmos ; Exophthalmos ; Eye ; Heart Rate ; Humans ; Light ; Neurofibromatoses ; Orbit ; Skin ; Sphenoid Bone ; Sprains and Strains ; Valsalva Maneuver ; Varicose Veins

STUDY DESIGN: Retrospective study. PURPOSE: This study was conducted to compare vertebral body height restoration rate in rheumatoid arthritis (RA) patients who had undergone percutaneous balloon kyphoplasty (KP) with that of control group who had matched age, sex, body mass index, and bone mineral density. OVERVIEW OF LITERATURE: There is no report on result of KP in RA patients. METHODS: Postoperative height restoration rate of RA group consisting of 15 patients (18 vertebral bodies) who had undergone KP due to osteoporotic vertebral compression fracture with a 30% or higher vertebral compression rate between May 2005 and January 2013 were compared to control group consisting of 38 patients (39 vertebral bodies) who had matched age, sex, body mass index, and bone mineral density. RESULTS: No statically significant difference in age (p=0.846), sex (p=0.366), body mass index (p=0.826), bone mineral density (p=0.349), time to surgery (p=0.528), polymethylmethacrylate injection time (p=0.298), or amount (p=0.830) was found between the RA group and the control group. However, preoperative compression rate in the RA group was significantly (p=0.025) higher compared to that in the control group. In addition, postoperative height restoration rate showed significant correlation with the RA group (p=0.008). Although higher incidence of recollapse occurred in the RA group compared to that in the control group, the difference was not statistically significant (p=0.305). CONCLUSIONS: Compared to the control group, RA patients showed higher compression rate and higher vertebral restoration rate after KP, indirectly indicating weaker bone quality in patients with RA. Higher incidence of recollapse occurred in the RA group compared to that in the control group, although it was not statistically significant.
Arthritis, Rheumatoid ; Body Height ; Body Mass Index ; Bone Density ; Fractures, Compression* ; Humans ; Incidence ; Kyphoplasty* ; Polymethyl Methacrylate ; Retrospective Studies

PURPOSE: This case-control study was designed to investigate the possible association of the metabolic syndrome(MS) with benign prostatic hyperplasia(BPH) in healthy males. MATERIALS AND METHODS: We reviewed the data of 702 men who had a general health check-up without significant evidence of disease. The database for health check-ups included demographic, anthropometric, serum-related and prostate-related data. The presence of the MS was determined according to the NCEP-ATPIII criteria. We compared prostate- related data between the MS and the non-MS group. Testing for linear trends and logistic regression were performed to determine whether the presence of the MS was associated with an increased risk for BPH. RESULTS: The MS was identified in 166 men(23.6%). There was an increased prevalence of both the MS and BPH along with increasing age. There was a tendency for the total prostate volume and the PSA to increase along with the an increasing number of factors related to the metabolic syndrome. In a comparison between the MS and non-MS group, there were no differences in the prostate-related variables. However, subgroup analysis in men less than 50 showed significant differences in the PSA, total volume and calculated annual growth rate. In addition, only in this group was the presence of the MS a significant risk factor for BPH(odd ratio; OR=2.21, 95% confidence interval; CI 1.28-4.75). CONCLUSIONS: The results of this study showed a weak but significant relationship between the MS and BPH, especially in men less than 50. Further longitudinal studies with a larger patient population are required to confirm our findings.
Case-Control Studies ; Humans ; Logistic Models ; Male ; Mass Screening* ; Prevalence ; Prostate ; Prostatic Hyperplasia* ; Risk Factors

BACKGROUND: Clonidine, an 2-adrenergic agonist, shows the analgesic effect and potentiates the analgesic effect of opioid. However, when it is injected with bolus technique, it reveals the short duration of inadequate analgesia and induces hypotension, bradycardia or sedation. We examined the analgesic and side effects of clonidine administered by continuous epidural infusion over 24 hrs, following epidural morphine injection. METHODS: Sixty parturients, scheduled for elective cesarean section under epidural anesthesia were randomly allocated into three groups. They received an infusion of saline alone (group 1, n= 20), clonidine 20 g/hr (group 2, n= 20), or 40 g/hr (group 3, n= 20) respectively, following epidural morphine 3 mg injection at the end of operation. The total doses and number of request for supplemental analgesic, blood pressure, heart rate, and degree of sedation were measured during 24 hrs. RESULTS: There were significant differences in pain relief between clonidine groups and group 1. The total doses and number of patient's request for supplemental analgesic in clonidine groups, compared to group 1 were significantly decreased (p<0.05), but no significant differences between the two clonidine groups. The diastolic pressure of group 3 was significantly lower than that of group 1 over 24 hrs, and that of group 2 at 18 hr, 24 hr (p<0.05). However, there was no severe hypotension, bradycardia or sedation in the three groups. CONCLUSION: Clonidine administered by continuous epidural infusion over 24 hrs enhances the analgesic effect of epidural morphine, and the infusion of clonidine with 20 g/hr rather than 40 g/hr shows minimal changes of blood pressure. Therefore, administration of epidural clonidine (20 g/hr) following epidural morphine may be considered as a regimen for pain management after cesarean section.
Analgesia* ; Anesthesia, Epidural ; Blood Pressure ; Bradycardia ; Cesarean Section* ; Clonidine* ; Female ; Heart Rate ; Hypotension ; Morphine ; Pain Management ; Pregnancy

PURPOSE: To report the anatomic and visual results of vitrectomy without scleral buckling in rhegmatogenous retinal detachment. METHODS: Primary vitrectomy without scleral buckling for the treatment rhegmatogenous retinal detachment was done in 41 eyes (41 patients) and followed up for a mean period of 21.5 months(range 6~65 months). Indications of primary vitrectomy were uncertain preoperative breaks, the presence of large breaks, the presence of breaks near equator, multiple breaks, proliferative vitreoretinopathy not related to breaks and presence of inferior vitreous hemorrhage. RESULTS: The anatomic success rate after a single operation was 90.2%. Visual acuity was improved or stable in 37 eyes (90.2%). Progression of lens opacity (35.7%) and formation of epiretinal membrane (12.2%) constituted the major complications after primary vitrectomy. CONCLUSIONS: Primary vitrectomy without scleral buckling can be a safe, effective method to repair primary rhegmatogenous retinal detachments in selective cases.
Cataract ; Epiretinal Membrane ; Retinal Detachment* ; Retinaldehyde* ; Scleral Buckling ; Visual Acuity ; Vitrectomy* ; Vitreoretinopathy, Proliferative ; Vitreous Hemorrhage