Tumors involving the proximal humerus confront the surgeon with the problem of both eradicating the osseous lesions and restoring shoulder joint function. This problem is magnified because of the biomechanical complexity of the shoulder, its anatomic configuration, and its inherent lack of stabillity. With the increased interest in limb-sparing resection for lesions in the area, efforts are being made to improve the reconstructive techniques. These include leaving a flail shoulder, an being made to improve the reconstructive techniques. These include leaving a flail shoulder, an arthrodesis using intercalery graft between the scapula and the remaining humerus, or if the glenoid is preserved, an arthroplasy. From January 1984 to December 1993, 23 patients with a malignant or locally aggressive bone tumor in the proximal humerus were treated by limb-sparing surgery in Seoul National University Hospital. Histologic diagnosis included osteosarcoma(6), chondrosarcoma(2), Ewing's sarcoma(1), metastatic bone tumor(11), and recurred giant cell tumor(3). Options for reconstruction following limb-sparing resection in our cases were 10 prosthetic arthroplasties, 3 arthrodeses with an living fibula graft, and 10 arthroplasties with intramedullary nailing and cementization. We performed a retrospective analysis in view of tumor eradication and performance status with modified functional evaluation system of Musculoskeletal tumor Society. In 7 cases(74%), good or fair performance status was acquired with average 3.6 years follow-up(6 months-11 years). Each option for reconstruction resulted in relatively good outcome but rather better result was acquired in giant cell tumor and chondrosarcoma. Estimated survival rates by Kaplan-Meier's method, 5 year survival rate was 81% in primary malignant bone tumors(12), 76% in stage Ⅱ B malignancies(5) with 4 years and 4 months follow-up. There was no regional recurrence in primary malignant bone tumors but there were three cases in which distant pulmonary metastases were found in follow-up. Complicationss were one soft tissue infection, two nonunions in arthrodesis with a living fibula graft and one dislodgement of prosthesis in prosthetic arthroplasty. In summary, each option for limb-sparing surgery in malignant bone tumor of proximal humerus might result in rather satisfactory outcome in performance and survival rate when effective preoperative and postoperative chemotherapy were performed in adequately selected cases.
Arthrodesis ; Arthroplasty ; Chondrosarcoma ; Diagnosis ; Drug Therapy ; Extremities ; Fibula ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Giant Cell Tumors ; Giant Cells ; Humans ; Humerus ; Methods ; Neoplasm Metastasis ; Prostheses and Implants ; Recurrence ; Retrospective Studies ; Scapula ; Seoul ; Shoulder ; Shoulder Joint ; Soft Tissue Infections ; Survival Rate ; Transplants

No abstract available.

No abstract available.
Adrenalectomy*

No abstract available.
Carcinoma, Transitional Cell* ; Urinary Bladder*

No abstract available.
Carcinoma, Transitional Cell* ; Urinary Bladder*

There have been several reports that total knee arthroplasty(TKA) was most likely to survive successfully if the coronal tibiofemoral angle was close to 7 degree of valgus, the accepted normal. In order to know whether the postoperative coronal tibiofemoral angle influences the result of total knee arthroplasty, we examined the 152 TKA cases in 106 patients which had been performed at Department of Orthopaedic Surgery, Seoul National University Hospital from Jan. 1987 to Dec. 1991. In our series the average follow-up period was 31 months(range, 13 months to 75 months). Coronal tibiofemoral angles of all cases were checked on weight bearing anteroposterior plain X-rays and were divided into three groups(less than valgus 2° ; valgus 3° to 7° ; greater than valgus 8°). All cases were analyzed on the knee score of Hospital for Special Surgery and the American Knee Society total knee arthroplasty roentgenographic evaluation and scoring system and the cases with radiolucent lines wider than 2mm were checked. Three groups were analyzed comparatively with statistical means(Wilcoxon signed rank test, X² test). There were no significant differences in the clinical results of total knee arthroplasty according to the postoperative coronal tibiofemoral angle. Lateral subluxation of the patella occurred more frequently when the postoperative coronal tibiofemoral angle was above valgus 8°. In the tibial components of group lesser than valgus 2°, the frequency of radiolucent lines wider than 2mm was higher than those of other groups, but its significance should be examined through long term follow-up.
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Patella ; Seoul ; Weight-Bearing

Although long-term studies of total knee arthroplasty(TKA) have confirmed reliable relief of pain and maintenance of function, survivorship at nine to ten years has been inconsistent with late component loosening being the most frequent mode of failure. Tibial component failure has been more frequent than failure of the femoral or patellar component in most TKA series. Encouraged by the early results of porous-ingrowh femoral and patellar components, and aware of retrieval studies showing poor bone ingrowth into tibial components, the “hybrid” method of fixation with an uncemented femoral component and a cemented tibial component, has been introduced and incorporated the potential advantages of both traditional fixation techniques. Between January 1987 and December 1991, forty-five “hybrid” TKAs(group I) were performed in degenerative arthritis and evaluated retrospectively in comparison with the results of nineteen noncemented porous-coated TKAs(group II) in degenerative arthritis. The average follow-up period was 31 months(range, 14 to 60 months) in group I and 26 months(range, 13 to 63 months) in group II. Using the knee rating scale of the Hospital for Special Surgery and the American Knee Society Roentgenographic Evaluation and Scoring System, clinical and radiological comparative study between two groups was performed. Pain scores, range of motion and HSS knee scores improved in both groups, but there was no significant difference between group I and group II(p>0.05). In both groups, the scores of radiolucent lines were significantly higher in zone 1 and 4 of A-P roentgenograph of the tibial component than in other zones(p < 0.05). The tibiofemoral angle was corrected from varus 2.7° to valgus 5.8° in group I and from varus 3.4° to valgus 4.6° in group II. There was no significant differences in component position and scores of radiolucnet lines between group I and group II. In conclusion, there were no significant differences in clinical and radiological results between the “hybrid” and the cementless groups. Results of this study suggest that both the hybrid fixation and the comentless techniques can reliably provide satisfactory clinical and radiological results in properly selected degenerative arthritis patients. But the final outcomes of this study need further evaluation through long term follow-up.
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Methods ; Osteoarthritis ; Range of Motion, Articular ; Retrospective Studies ; Survival Rate

The incidence of atherosclerosis in Korea seems to be much increased due to diet change after national development. The pathogenesis of atherosclerosis is not clarified and there are many hypothesis but the most recent and reliable hypothesis is the ratio of HDL-cholesterol per total cholesterol. Under the basis of this hypothesis there have been much trials to administer the agents which has effect on lipid metabolism, so we tried pantethine on 30 patients who visited Han-Yang University Hospital Internal medicine Department, and the result as follows; 1) The mean age of study population was 50.1 years of age, mean body weight was 62kg, and mean height was 160.8cm. male was 17, and female 10. 2) The associated disease of study population was <19 with> cardiovascular disease, in 19, gastrointestinal disease 3, obesity in 1 and others in 4. 3) The undesirable effect of the drug was found on 3 patients; that is, constipation on 1 patient, dizziness on 1 patient, and skin eruption on 1 patient. 4) The mean serum lipids before and after pantethine administration(levels) are as following table. In conclusion, it seems that the effect of the drug which decreases the serum lipids is mild at initial but more increasing as the time goes by and constant, and we experience little side reaction except mild dizziness, constipation and skin eruption.
Atherosclerosis ; Body Weight ; Cardiovascular Diseases ; Cholesterol* ; Constipation ; Diet ; Dizziness ; Female ; Gastrointestinal Diseases ; Humans ; Incidence ; Internal Medicine ; Korea ; Lipid Metabolism ; Male ; Obesity ; Skin ; Triglycerides*

No abstract available.
Bone Plates* ; Tibia*

No abstract available.