No abstract available.
Chancre ; Lip

No abstract available.

Intertrochanteric fractures are common in older age group. Recently better implant design and surgical technique have improved clinical results. But still many patients suffer from high morbidity and mortality, because of accompanying osteoporosis and various senile diseases. From January 1991 to June 1994, we treated 54 patients older than 70 years with intertrochanteric fractures of femur. Among them, 23 patients were followed up at our hospital and the other patients were informed from police station. Lost follow up was ten patients and final follow up were 44 patients. Mortality was analyzed for the detection of causative factors, such as age, sex, associated medical problems. type of fracture, degree of osteoporosis, type of operation, internal between injury and operation and duration of admission. The results were as follows; 1. 26 patients survived and 18 patients died(Mortality rate :40.9%) 2. 10 patients died within 1 year(Mortality rate :22.7%) 3. Mortality was related to associated medical problems, interval between in jury and operation and type of fracture, which were statistically significant(P < 0.05).
Aged ; Femur ; Follow-Up Studies ; Hip Fractures ; Humans ; Mortality ; Osteoporosis ; Police

No abstract available.
Hand

PURPOSE: This study was accomplished to evaluate the clinical & radiological results of cementless total hip arthroplasty using a fully hydroxyapatite-coated femoral stem after follow up of at least, 2 years. MATERIALS AND METHODS: Thirty one hips in 28 patients, who underwent primary total hip arthroplasty using a fully hydroxyapatite-coated femoral stem between september 2007 and May 2009, were followed up for more than 2 years after surgery. The average age of patients was 67 years old, and the average duration of follow up was 35 months. Preoperative diagnosis was 17 cases of osteonecrosis and 10 cases of femoral neck fracture. Clinical evaluation was done by Harris hip score (HHS). Radiological evaluation was done in terms of stability of components, subsidence of femoral stem and occurrence of osteolysis. RESULTS: The average of HHS improved from 34.3 preoperatively to 82.6 at final follow-up. Radiologically, fixation by bony ingrowth was 23 cases(74%) and fibrous ingrowth was 8 cases(26%). Subsidence was within 2-4 mm and occurred within 6 weeks in all 5 cases. There were 4 cases of intra-operative femoral fracture, 1 case of superficial infection. CONCLUSION: Short-term clinical and radiological results of cementless total hip arthroplasty using a fully hydroxyapatite-coated femoral stem were not good enough. Radiologically, bony ingrowth were no more than 74%. Therefore, longer-term follow up would be necessary.
Arthroplasty ; Durapatite ; Femoral Fractures ; Femoral Neck Fractures ; Follow-Up Studies ; Hip ; Humans ; Osteonecrosis

OBJECTIVE: Symptomatic epidural fluid collection (EFC) arising as a complication of cranioplasty is underestimated and poorly described. The purpose of this study was to investigate the risk factors for development of symptomatic EFC after cranioplasty following traumatic brain injury (TBI). METHODS: From January 2010 to December 2014, 82 cranioplasties following decompressive hemicraniectomy for TBI were performed by a single surgeon. Of these 82 patients, 17 were excluded from this study due to complications including postoperative hematoma, hydrocephalus, or infection. Sixty-five patients were divided into 2 groups based on whether they had developed symptomatic EFC: 13 patients required an evacuation operation due to symptomatic EFC after cranioplasty (Group I), and 52 obtained good outcome without development of symptomatic EFC (Group II). We compared the 2 groups to identify the risk factors for symptomatic EFC according to sex, age, initial diagnosis, timing of cranioplasty, cerebrospinal fluid (CSF) leakage during cranioplasty, size of bone flap, and bone material. RESULTS: A large bone flap and CSF leakage during cranioplasty were identified as the statistically significant risk factors (p<0.05) for development of symptomatic EFC. In Group I, 11 patients were treated successfully with 5 L catheter drainage, but 2 patients showed recurrent EFC, eventually necessitating bone flap removal. CONCLUSION: A larger skull defect and intraoperative CSF leakage are proposed to be the significant risk factors for development of symptomatic EFC. Careful attention to avoid CSF leakage during cranioplasty is needed to minimize the occurrence of EFC, especially in cases featuring a large cranial defect.
Brain Injuries* ; Catheters ; Cerebrospinal Fluid ; Decompressive Craniectomy* ; Diagnosis ; Drainage ; Hematoma ; Humans ; Hydrocephalus ; Risk Factors ; Skull

PURPOSE: The purpose of this study was to retrospectively evaluate the survival of periodontally hopeless teeth that were intentionally extracted and replanted after a delay and to compare the radiographic characteristics of the survival group with those of the failure group. METHODS: The clinical and radiographic data from patients who underwent delayed intentional replantation between March 2000 and July 2010 were reviewed. Twenty-seven periodontally hopeless teeth were extracted and preserved in medium supplemented with antibiotics for 10-14 days. The teeth were then repositioned in the partially healed extraction socket and followed for 3 to 21 months. The radiographic parameters were analyzed using a paired t test and the cumulative survival rate was analyzed using Kaplan-Meier analysis. RESULTS: Seven replanted teeth failed and the overall cumulative survival rate was 66.4%. In the survival group, the amount of bone loss was reduced from 68.45% to 34.66% three months after replantation. There was radiologic and clinical evidence of ankylosis with 5 teeth. However, no root resorption was found throughout the follow-up period. In the failure group, bone formation occurred from the bottom of the socket. However, a remarkable radiolucent line along the root of a replanted tooth existed. The line lengthened and thickened as time passed. Finally, in each case of failure, the tooth was extracted due to signs of inflammation and increased mobility. CONCLUSIONS: Delayed intentional replantation has many advantages compared to immediate intentional replantation and could serve as an alternative treatment for periodontally involved hopeless teeth. However, techniques for maintaining the vitality of periodontal structures on the tooth surface should be developed for improved and predictable results.
Alveolar Bone Loss ; Ankylosis ; Anti-Bacterial Agents ; Bone Remodeling ; Follow-Up Studies ; Humans ; Inflammation ; Intention ; Kaplan-Meier Estimate ; Osteogenesis ; Periodontal Diseases ; Replantation* ; Retrospective Studies* ; Root Resorption ; Survival Rate ; Tooth Replantation ; Tooth*

Infected nonunion of the long bone, while less common today than in the past, continues to challenge orthopaedic surgeons. Various treatment methods including current techniques of internal fixation, bone graft, electrical stimulation and external fixation have been tried, but results are not always satisfactory. Authors reported successful treatment of infected nonunion by rigid internal fixation with one plate and autogenous bone graft in previous volumes 1989. Recently we adopted dual plate method, by which we overcame a greater amount of bone defect and obtained more rigid internal fixation. We have treated 14 cases of infected nonunion with this method from Oct. 1992 to Oct. 1994, and the results are as follows; 1. Tibia fractures were 9 cases, and femur fractures were 5 cases. 2. Six cases showed large bone defect. The average bone defect was 4.5cm in length and we could overcome it by Dual plate method and autogenous bone graft. 3. Six cases which showed large bone defect were united in average 5 months. 4. In remaining 8 cases, union was obtained in average 3 months.
Electric Stimulation ; Femur ; Tibia ; Transplants

Pincer nail deformity is characterized by excessive curvature and distortion of the nail in the transverse dimension, and particularly at the distal part of the nail plate. This deformity leads to pinching off and loss of soft tissue in the affected digit, causing severe pain. Many treatment methods have been proposed; however, an effective long-term method preserving the nail matrix has not yet been established. We present here a case of pincer nail in the left thumb in a 49-year-old woman who was treated successfully with dermal grafting under the nail bed. We describe the surgical method and the treatment results. To the best of our knowledge, this is the first report in the Korean medical literature on the use of dermal grafting for the treatment of pincer nail deformity.
Congenital Abnormalities ; Female ; Humans ; Middle Aged ; Nails ; Thumb ; Transplants

BACKGROUND: Tuberculosis is the most frequent opportunistic infection in HIV-infected patients in Korea. We examined the incidence and risk factors for tuberculosis in HIV-infected patients. METHODS: We reviewed the medical records of 143 HIV-infected patients between January 1988 and June 1997 at the Seoul National University Hospita The incidence of tuberculosis was determined by the number of new tuberculosis per 100 patients divided by a total duration of follow-up (cases/100 person- years). The incidence of tuberculosis was analyzed with respect to CD4+ lymphocyte count, status of tuberculin skin reaction, and status of delayed hypersensitivity skin reaction. RESULTS: The total duration of follow-up was 229.6 person-years. During follow-up, 22 patients developed tuberculosis [9.6 cases per 100 person-years (95% CI, 6.0 to 14.5)]. The incidence of tuberculosis according to sex and transmission route showed no significant difference. Tuberculosis occurred more frequently in patients with minimum CD4+ T lympho-cyte counts of less than 200 cells/mm3 (14.2 cases/100 person-years) than in those with higher T lymphocyte counts (3.9 cases/100 person-years) [relative risk, 4.02 (95% CI 1.32 to 12.5), P=0.009]. The incidence of tuberculosis was higher among tuberculin- positive patients [17.0 cases/100 person-years (95% CI, 9.0 to 29.0)] than among tuberculin-negative [8.0 cases/100 person-years (95% CI, 3.2 to 16.6)], but the difference was not statistically significant [relative risk, 2.35 (95% CI, 0.88 to 6.26, P=0.078)]. The rate of tuberculosis in patients with negative delayed hypersensitivity test was not significantly different from that in patients with positive results (P=0.510). CONCLUSION: The incidence of tuberculosis was 9.6 cases per 100 person-years. CD4+ lymphocyte count (<200 cells/mm3) was the most useful predictor for the development of tuberculosis in HIV patients in Korea.
Follow-Up Studies ; HIV ; Humans* ; Hypersensitivity, Delayed ; Incidence* ; Korea* ; Lymphocyte Count ; Medical Records ; Opportunistic Infections ; Risk Factors* ; Seoul ; Skin ; Tuberculin ; Tuberculosis*