Fractures involving joints and about the joints provide complex problems with small comminuted fractures, surrounding soft tissue injuries and articular cartilage damage. Various problems are also encountered on the weight bearing surface, especially on the convex side of the distal Femur. Even though many auther had recommended kinds of management upto now, operative methods are more suggested in order to get good results regarding with the accurate anatomical reduction, rigid internal fixation and early joint motion. The clinical analysis of rnanagements of 20 cases of distai femoral fracture demonstrate that seperate dual incision-bilateral or right angle plane-to originate fracture site, and anatomical reduction & rigid internal fixation, early non-weight bearing ROM exercise of joint were sometimes mandatory to treat the displaced, comminuted fracture.
Cartilage, Articular ; Femoral Fractures ; Femur ; Fractures, Comminuted ; Joints ; Soft Tissue Injuries ; Weight-Bearing

No abstract available.
Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

BACKGROUND: The importance of serum lipids & lipoprotein as risk factors in the development and potentiation of atherosclerotic coronary artery disease(CAD) is now supported by the epidemiological and population studies. Lp(a) is composed of LDL particle and apo(a) is considered to have not only atherogenic but also antifibrinolytic activities. The purpose of this study was to evaluate lipoprotein and Lp(a) as risk factor of CAD, and to study the relationship between Lp(a) and other lipids in the patients with CAD. METHODS: We determined plasma level of lipids(Total cholesterol, HDL-C, Triglyceride, LDL-C)and apolipoprotein(apo A, apo B) and Lp(a) in the 315 patients with coronary artery disease and 106 control patients confirmed by coronary angiography. Serum Lp(a) was measured by ELISA and other lipid profiles by conventional methods. RESULTS: The ratio of male(61 vs 44%) and the prevalence of hypertension(44 vs 17%), diabetes(16 vs 3%) and smoking(48 vs 32%) were higher in patients with CAD compared with control group. Total cholesterol(187+/-52 vs 173.2+/-36ml/dl) and LDL-C(114+/-43 vs 97.2+/-35ml/dl)were significantly higher(p<0.05) and the HDL-C(40+/-12 vs 49+/-12ml/dl) and Apo Al/Apo B ratio(1.3+/-1 vs 1.6+/-1) were significantly lower in the patients with CAD(p<0.01). The level of Lp(a) of the CAD group was significantly higher than that of the control group(27+/-22 vs 15+/-15ml.dl, p<0.01). Also Lp(a) concentration in the younger than 60 year old was higher than those of elderly patient(29+/-23 vs 26+/-22mg/dl, p<0.01). However, there were no sexual difference and Lp(a) showed a low correlation coefficient(r=0.02-0.14)with other lipid profiles in both groups. CONCLUSIONS: These results suggest that the derangement of serum lipids are strongly associated with CAD and the measurement of serum lipids and apolipoproteins are able to predict the risk of CAD. Also, Lp(a) is an independent risk factor for the development of CAD.
Aged ; Apolipoproteins ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Lipoprotein(a)* ; Lipoproteins ; Middle Aged ; Plasma ; Prevalence ; Risk Factors ; Triglycerides

BACKGROUND AND OBJECTIVES: Correction of deviated nose is considered one of the most difficult and serious surgical operations in rhinoplasty. The correction of bony deviation, in particular, requires osteotomy. Although there are individual differences in the shapes or features of bony deviations of each patient, the techniques of osteotomy are limited. Therefore, for proper correction of bony deviation, it is necessary to set up a precise pre-surgical plan. SUBJECTS AND METHOD: We categorized 187 patients with bony deviated nose into 5 types based on the analysis of preoperative nasal bone 3D computer tomography, and studied surgical method for each type. RESULTS: Of 187 patients, 92 (49%) patients are categorized into type I, 62 (36%) patients into type II, 12 (6%) patients into type III, 2 (1%) patients into type IVa, 7 (4%) patients into type IVb and 7 (4%) patients into type V. Only did eight patients (5%) undergo revision surgery due to unsuccessful outcomes. Major complications like infection, abscess, arteriovenous fistula, epiphora, and saddle deformation did not occur at all. CONCLUSION: Preoperative planning under the analysis and categorization using 3D CT is considered helpful for the precise and individualized surgery in corrective rhinoplasty.
Abscess ; Arteriovenous Fistula ; Humans ; Individuality ; Lacrimal Apparatus Diseases ; Nasal Bone* ; Nose* ; Osteotomy* ; Rhinoplasty

BACKGROUND: Xanthelasma palpebrarum does not regress spontaneously, its appearance is often seen as cosmetically disturbing. Treatment of xanthelasma palpebrarum may prove difficult due to its delicate location at the periorbit and sometimes its extensive dimension. Treatments include excision, electrodesiccation, chemical cautery and laser surgery. OBJECTIVE: This study was designed to evaluate the effect of a CO2 laser for the treatment of xanthelasma palpebrarum. METHODS: Twenty patients with a total of 56 xanthelasma lesions, were treated with a CO2 laser. The Follow-up period of observation was between 12 and 84 months. RESULTS: All lesions could be removed completely with a single laser treatment. Only transient pigmental change (hypopigmentation 1/20, hyperpigmentation 1/20) was observed without scarring. 8 patients developed a recurrence of xanthelasma. CONCLUSION: The CO2 laser represents an effective means for treating xanthelasma, but recurrence is common.
Cautery ; Cicatrix ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Korea* ; Laser Therapy ; Lasers, Gas* ; Recurrence

Meckel's diverticulum is an embryologic derivative of the omphalomesenteric duct and the most commonly encountered congenital anomaly of the gastrointestinal tract, affecting 1% to 2% of the general population. Although this prevalence is relatively low, Meckel's diverticulum is occasionally encountered as an incidental identification during abdominal exploration and can be associated with several life-threatening disease states, such as massive intestinal bleeding, intestinal obstruction, or on rare occasion, perforation. The management of a Meckel's diverticulum found incidentally on laparotomy is controversial because the rate of complications developing from the diverticulum remains uncertain. The data in this report are based on 18 cases of Meckel's diverticulum which were treated at the Department of Surgery, InJe University Sanggye Paik Hospital, during the 7 years between January 1990 and December 1996. The results are as follows: 1) The overall sex ratio of males to females was 5 : 1 and in the symptomatic group, the ratio was 6 : 1. 2) Ninety percent of the patients were under 40 years of age, and 56% were under 10. 3) The diverticula were located from 20 cm to 100 cm proximal to the ileocecal valve, and the average range was 53 cm from the ileocecal valve. Fifteen cases were located at the antimesenteric border, and 3 cases at the mesenteric border of the ileum. 4) The lengths of the diverticula ranged from 1cm to 6cm, and the diameters ranged from 0.5 cm to 4.5 cm. 5) Appendicitis and intestinal obstruction were the most frequent preoperative diagnoses in the symptomatic group. 6) The common complications were intestinal obstruction and inflammation. 7) Heterotopic tissues were found in three patients and all of them were ectopic gastric mucosa. 8) The treatment was a diverticulectomy or a segmental resection of the involved bowel. 9) Postoperative complications were found in three of the asymptomatic group: two early intestinal obstructions and one wound infection.
Appendicitis ; Choristoma ; Diagnosis ; Diverticulum ; Female ; Gastric Mucosa ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileocecal Valve ; Ileum ; Inflammation ; Intestinal Obstruction ; Laparotomy ; Male ; Meckel Diverticulum* ; Postoperative Complications ; Prevalence ; Sex Ratio ; Vitelline Duct ; Wound Infection

OBJECTIVE: The purpose of this study was to assess memory dysfunction in patients with mild and moderate traumatic brain injury (TBI) with and without frontal lobe injury (FLI). METHODS: The subjects were 110 TBI patients, who had recovered from the acute clinical phase, and comprised 20 (18.2%) mild TBI (MTBI) patients with FLI, 16 (14.5%) MTBI patients without FLI, 51 (46.4%) moderate TBI (MOTBI) patients with FLI and 23 (20.9%) MTBI patients without FLI. All patients were administrated the Korean version of the Memory Assessment Scale (K-MAS). RESULTS: Almost all the Summary Scale scores on the K-MAS failed to show any differences between TBI patients with and without FLI, but differences did emerge by types at severities. TBI patients with FLI showed higher Global Memory ability than TBI patients without FLI if their TBI was only mild, but when their TBI was more severe, this finding was reversed, and TBI patients with FLI showed lower Verbal and Global Memory abilities than TBI patients without FLI. CONCLUSION: Different kinds of assessment tools are needed for the measurement of memory abilities in TBI patients with FLI, and that the selection of the appropriate tool depends on the severity of the TBI.
Brain ; Brain Injuries ; Frontal Lobe ; Humans ; Memory

OBJECTIVES: To assess the clinical efficacy and safety of Hyruan(sodium hyaluronate) in patients with osteoarthritis of the knee. METHODS: A 12-week open study of Hyruan was conducted in 48 patients with osteoarthritis(OA) of the knee. Hyruan was injected into knee joints weekly for 5 weeks. Clinical evaluations were performed using visual analog scale(VAS) for pain, Lequesne's index, tenderness and swollen joint counts weekly for the first 5 weeks and then monthly up to 3 months post-injection. RESULTS: Significant improvements in VAS, Lequesne's index, tenderness and swollen joint counts were noted from the first week and maintained until the end of 3 month follow-up period. At 3 months post-injection, 68.8% of patients had >20mm reduction in the VAS. The patients with Kellgren stage lIl showed significant response in VAS and Lequesne's index as patients with Kellgren stage I and II. The clinical improvement after treatment was slower in patients(n=16) with late(>5 years) OA than in patients(n=32) with early(<5 years) OA, but it was statistically significant in either groups, compared to baseline. There were no severe adverse reactions to Hyruan therapy and laboratory examinations revealed no evidence of toxicity. CONCLUSION: Hyruan has been shown to be effective and safe in the treatment of patients with osteoarthritis of the knee.
Follow-Up Studies ; Humans ; Hyaluronic Acid ; Joints ; Knee Joint ; Knee* ; Osteoarthritis*

OBJECTIVES: This study was conducted to investigate factors influencing physical activities of daily living in the elderly with cognitive impairment. METHODS: The Barthel activities of daily living, modified Blessed Dementia Rating Scale, Korean version of mini-mental state examination, and Motoricity Index were administered to 45 elderly people whose corrected MMSEK scores were 24 or less. They were inhabitants in an institution in Taegu. RESULTS: Of the aforementioned S variables, the Motoricity Index could account far 42% of the variance of the Barthel activities of daily living. If the modified Blessed Dementia Rating Scale score was included in the multiple regression, the accountable portion of the Barthel activities of daily living variance increased by 6% only. CONCLUSION: Motor function of the limbs and severity of dementia may be the most important variables in the physical activities of daily living of the elderly with cognitive impairment.
Activities of Daily Living ; Aged* ; Cognition ; Daegu ; Dementia ; Extremities ; Humans ; Motor Activity*

Subclavian vein injuries occasionally occur as a sequela of penetrating trauma or vascular access, but have rarely been reported to occur after clavicle fracture. The subclavian vessels are mainly enclosed by the subclavius muscle, the first rib, and the costocoracoid ligament. Therefore, in such cases, subclavian vein injury is rare because of the strcutures surrounding the subclavian vessels. Nevertheless, subclavian vein injuries occasionally show thrombotic manifestations, and thrombosis of the upper limbs constitutes 1–4% of cases of total deep vein thrombosis. Furthermore, to the best of the authors' knowledge, although vessel injuries have been reported after clavicle or rib fractures and nerve injuries to regions such as the brachial plexus, no case involving delayed presentation of isolated subclavian vein stenosis after clavicle fracture due to blunt trauma has yet been reported.