Primary tumor of the renal pelvis and ureter is relatively rare disease, but usually malignant. It's prognosis is dependent upon the early detection, accurate diagnosis, procedure for treatment, and tumor grade and stage. Therefore, urologist should endeavor after accurate diagnosis and definitive treatment. A clinical observation was done on the 11 patients with renal pelvic tumor and the 3 patients with ureteral tumor at the Department of Urology, Kyungpook National University Hospital during the period of 4 years from January, 1978 to December, 1981. The results were as follows: 1. There were 9 men and 5 women, giving a ratio of 1.8 to 1. The average age at presentation of the 14 patients was 51.4 years. 2. On excretory urogram, nonvisualization of the kidney was the most prevalent sign in 10 patients. Retrograde pyelogram was done in 11 patients in whom findings of IVP were not sufficient for diagnosis. Renal angi0graphy was done in 9 patients. 3. Urine cytology was positive in 2 of 14 patients. 4. Of the 13 patients treated, 12 were proved to have transitional cell carcinoma, and 1 was leiomyoma. In 3 of the 11 patients with renal pelvic tumor, Concomitant ureteral tumor was present at diagnosis. And in 2 of the 11 patients with renal pelvic tumor developed subsequent urothelial tumors in the ureter and/or bladder after simple nephrectomy. 5. Nephroureterectomy including resection of a bladder cuff was done in 11 patients, and in 2 of these was also performed lymphadenectomy. Simple nephrectomy was done in 2 patients with renal pelvic tumor under the misdiagnosis of renaltuberculosis. 6. Postoperative complications developed in 3 cases, wound infection, pneumothorax, and death, in each case.
Carcinoma, Transitional Cell ; Diagnosis ; Diagnostic Errors ; Female ; Gyeongsangbuk-do ; Humans ; Kidney ; Kidney Pelvis* ; Leiomyoma ; Lymph Node Excision ; Male ; Nephrectomy ; Pneumothorax ; Postoperative Complications ; Prognosis ; Rare Diseases ; Ureter* ; Urinary Bladder ; Urology ; Wound Infection

No abstract available.
Arthroplasty, Replacement, Hip*

The following case report concerns a rare bone metastasis of malignant melanoma occurring in the 4th and 5th lumbar spines and adjacent iliac crests and sacrum. A 42-year-old woman was admitted with a 6 months history of severe lumbago ar right flank pain radiating to right lower extremity. Preoperative X-ray studies revealed stag horn stone in the right renal pelvis as spondylolisthesis of the 5th lumbar spine with bilateral isthmic defects. On physical examinations, dark brown colored nevus was noted at lower lumbar regio which was removed and subjected for biopsy. Surgical exploration demonstrated a melanoma metastasis to have invaded the spine process, lamina and transverse processes of the 5th lumbar spine, adjacent L4 and sacru and iliac crests. Surrounding soft tissues, however, were apparently normal. Postoperatively course of the patient seemed to follow a rapidly terminal clinical cours.
Adult ; Animals ; Biopsy ; Female ; Flank Pain ; Horns ; Humans ; Kidney Pelvis ; Low Back Pain ; Lower Extremity ; Melanoma ; Neoplasm Metastasis ; Nevus ; Physical Examination ; Sacrum ; Spine ; Spondylolisthesis

Plaster of Paris is an effective ancillary treatment in the surgery of infected cavities in bone. It is well tolerated and spontaneously absorbed over the period of weeks to months, being replaced by bone of normal architecture. When the antibiotics incorporated into plaster of Paris, the antibiotics are capable of prolonged local release in bactericidal concentrations. Therefore it is proposed that antibiotics loaded plaster of Paris might be a simple adjuvant technique after good surgical debridement for the treatment of bone infection. The authors carried out an experiment to study the effect of plaster of Paris containing antibiotics for a prevention of experimental osteomyelitis, using 45 rats, which were divided into 3 groups. In the Group 1, a defect was made at the proximal metaphysis of the tibia, inoculated by Staphylococcus aureus sensitive to Cephradine and Tobramycin and then filled with plaster of Paris pellet. In the Group 2, a defect was filled with Cephradine loaded plaster of Paris pellet. In the Group 3, a defect was filled with Tobramycin loaded plaster of Paris pellet. Then we observed the healing process of the bone defect in the point of view of the gross findings, radiologic findings and histologic findings at 4th, 8th and 12th week after operation. The results of this study were as follows:l. In the control Group;all 30 cases were infected. 2. In the Group 2;only 4 of 30 cases were infected. 3. In the Group 3;all 30 cases were not infected. 4. The plaster of Paris filled into the defect was absorbed continuously and stimulated the new bone formation.
Animals ; Anti-Bacterial Agents ; Calcium Sulfate ; Cephradine ; Debridement ; Osteogenesis ; Osteomyelitis ; Rats ; Staphylococcus aureus ; Tibia ; Tobramycin

We studied the degenerative changes of acetabulum, examining the acetabular articular cartilage at weight bearing dome area from the hips of 25 avascular necrosis of femoral head cases. Histological- histochemical studies demonstrated 4 mild, 19 moderate and 2 severe grade of degenerative arthritic change. This has confirm that even in early stage of avascular necrosis of femoral head, there are degenerative arthritis in acetabular cartilage. This may influence the prognosis of bipolar hemiarthro- plasty in avascular necrosis of femoral head patient.
Acetabulum ; Cartilage ; Cartilage, Articular ; Head ; Hip ; Humans ; Necrosis ; Osteoarthritis ; Prognosis ; Weight-Bearing

The purpose of this study is to evaluate the influence of the extent of involvement in the results of cementless THA in patients with idiopathic AVN of the femoral head. We reviewed 70 hips (52 patients) who had undergone cementless THA for idiopathic AVN of the femoral head. Anatomic femoral components were used in 43 hips and Harris Galante porous prosthesis were employed in 27 cases. The hips were classified according to International Classification (Association Research Circulation Osseous). The length of the follow-up period ranged from 3 to 5 years (average 53.5 months). Preoperative and postoperative clinical documentation and radiographs were evaluated. Statistical analysis was performed on the results of three analysis groups (Group A, comparison of results among Stage IIIA, IIIB, IIIC, and IV; Group B, between stage III and IV; Group C, between IIIA+IIIB and IIIC + IV). Of the 70 hips in the present study, there were 47 hips in stage III (IIIA, 15; IIIB, 19; IIIC, 13) and 23 hips in stage IV. The average postoperative Harris hip score at the time of study was 91.5 (Analysis Group C, p=.009). Femoral subsidence of more than 5 mm occurred in 5 hips (7.1%). Two hips were in Stage IIIC and three hips were in Stage IV (Group C, p=.024). The hips lower than -10 on Engh's index were present in one hip in Stage IIIC and three hips in Stage IV (Group C, p=.011). This study demonstrated that the clinical and radiological results of cementless THA were poor when the extent of involvement was greater or in the case of late stage subjects, particularly those above IIIC (p<05), with avascular necrosis of the femoral head.
Arthroplasty, Replacement, Hip* ; Classification ; Follow-Up Studies ; Head* ; Hip ; Humans ; Necrosis* ; Prostheses and Implants

Although traumatic bowing of one or both bones of the forearm in children following acute trauma was reported by some authors, traumatic bowing of the ulna with dislocation of the radial head was described by only a few reports. We experienced one case of traumatic bowing of ulna associated with dislocation of the radial head and it was managed with open reduction of the dislocation of radial head and closed management of the bowing of the ulna. The result 1 year 10 months after treatment was very good, so we report this a case with related literatures.
Child ; Dislocations ; Forearm ; Head ; Humans ; Ulna

Six cases of lunate dislocation were treated in the departments of orthopaedic surgery, Hangang Sacred Heart Hospital and Kangnam Sacred Heart Hospital, Hallym College during the period from March 1, 1978 to August 31, 1982. The results were as follows; l. Among the total 6 cases, two cases had lunate dislocation only and the other four had associated injuries of the same wrist joints. 2. Marupulative reduction was successful in only one case. Five cases were treated by open reduction, and for four of them internal fixation was tried. 3. Postoperative roentgenograms showed acceptable reductions in all cases except one which redislocation occurred. This case showed lunate dorsiflexion instability and was treated with extensor carpi radialis longus tenodesis. 4. The cases with pure lunate dislocation yielded better functional recovery than those with associated carpal injuries.
Dislocations ; Heart ; Tenodesis ; Wrist Joint

Various kinds of bone cements mixed with antibiotics have been widely used for treatment and prevention of infections, especially combined with bone defects. But bone cements have some disadvantages in that they are rather expensive and capable of incurring some complications such ss fibrosis of surrounding soft tissue or local erosion of bone, and furthermore, they must be removed after infection is controlled for bone graft to fill up the defects because they do not have properties of osteoconduction or osteoinduction. So we have come to the idea of using theoretically advantageous plaster of paris to take place of bone cements, and performed in-vitro experiment upon the effectiveness of plaster of paris pellets containing antibiotics, then obtained good results comparable to those from many experimental studies using bone cements. By this, we think that it would be possible in the future to treat and prevent infections supervening bone defects with plaster of paris mixed up with antibiotics. The results are as follows : 1. Sustained release of large amount of antibiotics from plaster of paris enough to exert inhibitory activity on abcterial growth, and there was a direct relationship between concentrations of eluted antibiotics and diameters of inhibitory zones. 2. Tobramycin was capable of inhibiting the growth of S. aureus, E. coli, and Ps. aeruginosa for 7 days at maximum. 3. Cephradine inhibited the growth of S. aureus and E. coli but did not affect that of Ps. aeruginosa. 4. The maximum antibacterial activity wss reached within first 24 hours from the start of elution of antibiotics from plaster of paris.
Anti-Bacterial Agents ; Bone Cements ; Bone Regeneration ; Calcium Sulfate ; Cephradine ; Fibrosis ; Tobramycin ; Transplants

Although several histopathological changes have been developed in frozen shoulder, frozen shoulder is mostly accompanied by the changes of the rotator cuff which has the most important function in movement and has a role in stabilizing the shoulder joint. The changes of the rotator cuff in frozen shoulder have not been reported in Korea yet, but Simon reported that there was an attenuation of the rotator cuff in frozn shoulder. Accordingly, we observed the changes of the rotator cuff in frozen shoulder by ultrasonography, which has no rsdiation exposure and is non-invasive. The authors practiced the shoulder ultrasonography on 36 patients with a pain and limitation of motion in shoulder at the Dept. of Orthopedic Surgery, Hangang Sacred Heart Hospital, Hallym University, from March in 1988 to August in 1988. The results are as follows ;1) Ultrasonography is thought to contribute a great deal in detection of the changes of the rotator cuff, especially of the thickness of the rotstor cuff. 2) Among 36 patients, the thickness of the rotator cuff of 35 patients was 6.494+1.008 mm (M+SD) in the affected shoulder and 6.475+1.052 mm(M+SD) in the unaffected shoulder. In only one pstient, the thickness of the rotator cuff was 1.68+0.58 mm(M+SD) in the affected shoulder and 553+1.16mm(M+SD) in the unaffected shoulder. Theres no significant change in the thickness of the rotator cuff measured by ultrasonography in frozen shoulder. 3) Ultrasonography is an excellent diagnostic method in detecting the rupture of the rotator cuff in frozen shoulder.
Bursitis ; Heart ; Humans ; Korea ; Methods ; Orthopedics ; Rotator Cuff ; Rupture ; Shoulder ; Shoulder Joint ; Ultrasonography