Ipsilateral fracture of the femur and tibia is also called “floating knee”. And it is well known that its treatment is difficult and functional result is poor in most cases because it has often comminuted, open fracture with severe soft tissue injuries. Authors reviewed 20 cases in 18 patients which were treated from September 1989 to March 1993. All were followed for more than one year. The results were as follows: 1. Among 20 cases of femoral fracture, 15 cases were treated with internal fixation and others with external fixation and among 18 cases of tibial fracture(2 amputations excluded), internal and external fixation were equal in number. 2. The bony union time was shorter in the intramedullary nailing than the plate and screws, and external fixations. 3. The end result was better in Group I(internal fixation for both fracture) than Group II (one or both fractures were treated with external fixator) because the femur had less severe comminution, and soft tissue injuries. 4. There were many complications in Group II than Group I, That is, wound infections, delayed union or non-unions. There were 11 operations for the treatment of complications,.
Amputation ; Clinical Study ; Femoral Fractures ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Open ; Humans ; Soft Tissue Injuries ; Tibia ; Wound Infection

Patients who had posterior synechiae associated with uveitis,IOL mplantation, vitrectomy, underwent Nd-YAG synechiolysis had been treated with topical corticosteroids and surgical iridectomy. Even minimal dilatation of the pupil by Nd YAG synechiolysis enable the patient to read and the surgeon to postpone cataract surgery and evaluate optic disc or fundus. Also, pupil block may be treated by detaching the synechiae.18 Patients (20 eyes) with posterior synechiae underwent Nd-YAG synechiolysis at Kangnam St.Mary's Hospital from November 1997 to August 1998. An average of 17.14 +/-6.43mJ laser were used. The average prelaser pupil size was 3.78 +/-0.98 mm ;postlaser, 5.13 +/-1.27 mm.This change was statistically significant (p<0.01). Microhyphema and pigment dispersion developed in 4 eyes. However,no significant long-term complications occurred, and there were no obvious lenticular damage and pupil abnormality. Because this laser treatment is relatively safe and offers some possibility of visual improvement, we recom-mend Nd-YAG synechiolysis,but only if performed by an experienced laser microsurgeon.
Adrenal Cortex Hormones ; Cataract ; Dilatation ; Humans ; Iridectomy ; Lasers, Solid-State ; Pupil ; Vitrectomy

In patients with the sequele of poliomyelitis, pyogenic or tuberculous arthritis, or trauma, flexion contracture of the knee could be developed and many difficult problems would be met in treating them. Ilizarov suggested the method of gradual correction of deformities of bone after corticotomy-osteo- clasis, combined with gradual elongation of the shortened soft tissues, and the flexion contracture of knee & limb length discrepancy could be corrected simultaneously or sequentially following a sigle operative procedure. The authors have treated 25 patients with flexion contracture of the knee joint by the principle of Ilizarov treatment at the Sang Gye Paik Hospital between September 1991 and March 1994, The average preoperative flexion contracture of the knee joint, 25° (range, 10°
Arthritis ; Congenital Abnormalities ; Contracture ; Extremities ; Fractures, Stress ; Hip Joint ; Humans ; Ilizarov Technique ; Knee Joint ; Knee ; Leg ; Methods ; Osteotomy ; Poliomyelitis ; Surgical Procedures, Operative ; Tibia

A total of 4757 apparently healthy aged persons over 65 years of age was surveyed for geriatric hypertension. A single blood pressure measurement was taken in the sitting position. Mean systolic blood pressure rose significantly with age in female but didn't in male and mean diastolic blood pressure didn't change with age in both sex. The prevalence of pure systolic hypertension, i.e., a systolic blood pressure greater than or equal to 160 mmhg and a diastolic blood pressure less than 95mmhg, increased with age. The prevalence was slighty lower for female than it was for male, being 7.0% for female and 8.0% for male. The prevalence of classical hypertension-defined as diastolic blood pressure greater than or equal to 95mmhg - was 42.7% for female and 48.2% for male and it rose with age in female. The prevalence of both pure systolic and classical hypertension was 49.7% for female and 56.1% for male.
Blood Pressure ; Epidemiologic Studies* ; Female ; Humans ; Hypertension* ; Korea* ; Male ; Prevalence

PURPOSE: To evaluate the CT findings of bronchial abnormalities in patients with endobronchial metastasis from extrapulmonary tumors, and to correlate these with the bronchoscopic findings. MATERIALS AND METHODS: The authors retrospectively reviewed the CT and bronchoscopic findings of 17 patients (M:F=9:8; mean age, 56 years) with histologically proven endobronchial metastasis from extrapulmonary primary tumors. Carcinoma of the uterine cervix (n = 5) was the most common primary site for endo-bronchial metastasis. CT findings of bronchial abnormalities with associated peribronchial and lung parenchymal lesions were analyzed and compared with the bronchoscopic findings. RESULTS: Among the 17 patients, 20 sites of bronchial abnormalities were visualized bronchoscopically. CT findings of bronchial abnormalities were smooth narrowing (n = 11), occlusion (n = 3), intraluminal mass (n= 4), and normal (n = 2). Peribronchial lesions(lymph node enlargement or parenchymal mass) were found in 12 cases. Bronchoscopy revealed bronchial narrowing due to a mucosal nodule or intraluminal polypoid mass in 16 cases, and total obstruction of the bronchus in four. With regard to the identification of bronchial abnormalities, the findings of CT and of bronchoscopy agreed in 17 cases and disagreed in three. While bronchoscopy was advantageous for detecting early mucosal abnormality, CT effectively evaluated the extent of a lesion beyond the stenosis or bronchial obstruction. CT was also useful for predicting the causes of bronchial abnormalities. CONCLUSION: CT is relatively accurate in evaluating bronchial abnormalities, and in patients with endo-bronchial metastases may be used as a complementary procedure to bronchoscopy for evaluating the extent of the lesion.
Bronchi ; Bronchoscopy ; Cervix Uteri ; Constriction, Pathologic ; Female ; Humans ; Lung ; Neoplasm Metastasis* ; Retrospective Studies

No abstract available.

Because most of modern peoples are busy with many their task according to specialization and complexity of society, it is impportant to determine optimal and comfortable time of colonoscopy. So this study was designed to compare efficacy of colonic cleansing and patient acceptance according to the time of colonoseopy. Among 140 peoples who underwent colonoscoyy in Busan St. Benedict Hospital between March 1995 to August 1995, two groups of 70 peoples were randomly assigned to undergo colonoscopy either at A.M. or ~P.M. The results were as follows: 1) In view of efficacy rate of colonic cleansing, the group at P.M, was superior to the group at A.M.. 2) In view of patients acceptance and side effects, the group at P.M. showed better acceptance and less side effects than the group at A.M.. In conclusion, this study showed that the colonoscopy at P.M. is better than at A.M., especially when patient is poor systemic condition or low acceptance to colonoscopic cleansing preparation. However, it may be also acceptable undergoing colonoscopy at A.M. if patient condition is good and patient is busy with his task.
Busan ; Colon* ; Colonoscopy* ; Humans ; Prospective Studies*

Ectopic opening of the common bile duct (CBD) in the duodenal bulb is not an incidental finding, but a pathologic condition that can be associated with clinical entities, such as recurrent duodenal ulcer, choledocholithiasis. or cholangitis. We report a case of ectopic CBD with hematemesis in a 61 year-old male patient. Esophagogastroduodenoscopy showed several active ulcers with a fresh blood clot at the duodenal bulb, which had a mucosal deformity and a small opening with suspicious drainage of bile, and the second part of the duodenum had no papilla-like structure. MRCP showed a trident-like pancreatobiliary tree. The biliary tree was visualized via a suspicious ectopic opening of the bile duct at the duodenal bulb. The distal CBD looked hook-shaped and had no filling defect. We report a unique case of ectopic opening of the CBD in the duodenal bulb, which presented as hematemesis.
Bile ; Bile Ducts ; Biliary Tract ; Cholangitis ; Choledocholithiasis ; Common Bile Duct ; Congenital Abnormalities ; Drainage ; Duodenal Ulcer ; Duodenum ; Endoscopy, Digestive System ; Hematemesis ; Humans ; Incidental Findings ; Male ; Ulcer

BACKGROUND: Patent foramen ovale (PFO) is increasingly being recognized in stroke patients. The capability of transcranial Doppler (TCD) to detect a PFO has been established. We studied the frequency of PFO in patients with ischemic stroke. METHODS: Eighty-nine patients with ischemic stroke (62 men, mean age: 56.5) consecutively underwent a contrast-enhanced TCD with monitoring of the bilateral middle cerebral arteries (MCA). The contrast solution, which consisted of 8 ml of normal saline, 1 ml of air, and 0.2 ml of patient's blood, was injected twice during normal breathing and the Valsalva maneuver. High intensity transient signals (HITS) were counted for 30 seconds after the injection. RESULTS: Patent foramen ovale was detected in 19 patients (21%). The mean age was similar in those with (55 years) and those without (57 years) PFO. Patent foramen ovale was more frequent among men (26%) than women (11%). There were no differences in the frequency of PFO among stroke subtypes (large artery atherosclerosis, 18%; small artery occlusion, 27%; cardioembolic, 27%; undetermined cause, 11%). CONCLUSIONS: Patent foramen ovale is common in patients with ischemic stroke of all subtypes.
Arteries ; Atherosclerosis ; Female ; Foramen Ovale, Patent* ; Humans ; Incidence* ; Male ; Middle Cerebral Artery ; Respiration ; Stroke* ; Valsalva Maneuver

BACKGROUND/AIMS: Recent guidelines strongly recommend that the interval of surveillance colonoscopy be determined according to the risk stratification obtained at index colonoscopy. However, because of the differences in perception of the classification of colorectal intraepithelial neoplasia between Asian and Western countries, there is some confusion about surveillance colonoscopy. The aim of the present study was to evaluate the clinicopathological characteristics and the interval of surveillance colonoscopy between patients with high-grade dysplasia/carcinoma in situ and those with intramucosal carcinoma. METHODS: From January 2003 to June 2010, 727 patients were included from 8 tertiary centers. Four hundred fifteen patients (57.1%) had high-grade dysplasia/carcinoma in situ (group A), and 312 (43.9%) had intramucosal carcinoma (group B). Clinicopathological data were reviewed retrospectively. RESULTS: Group A had a significantly more frequent family history of colorectal cancer (3.1% vs. 0.6%, P<0.001), smaller polyp size (12 mm vs. 15 mm, P=0.001), and more proximal location (31.1% vs. 21.8%, P=0.005) than did group B. Among 727 patients, surveillance colonoscopy was performed within 6 months in 55.8% of patients and within 12 months in 77.8%. Group B had a significantly shorter interval of surveillance colonoscopy than did group A (P<0.001). There was no difference in detection of advanced neoplasia at surveillance colonoscopy between the 2 groups (6.6% vs. 5.4%, P=0.638). CONCLUSIONS: The recommended interval of surveillance colonoscopy is not followed in Korea. More education about post-polypectomy surveillance guidelines is required.
Asian Continental Ancestry Group ; Carcinoma in Situ ; Colonic Polyps ; Colonoscopy* ; Colorectal Neoplasms ; Humans ; Korea* ; Polyps