Dissecting aortic aneurysm is an emergency condition which requires prompt diagnosis and management. From January 1992 to December 1996, 54 patients were admitted to our department. Patients were categorized according to the Stanford classification of aortic dissection and investigation of the clinical records utilized the retrospective method. Male constituted the majority, according for 38(70.4%) of the total number of patients, whereas females accounted for 16(29.6%). Mean age was 52.1+/-2.2 years old (range:25~82). Clinical findings included chest pain in 46 cases(85.2%), renal failure in 11(20.4%), aortic insufficiency in 10(18.5%) and stroke in 9(16.7%). Predisposing factors were hypertension in 48 cases(88.9%), Marfan's syndrome in 5(9.3%) and diabetes mellitus in 1(1.8%). 21 patients(type A:12, type B:9) underwent surgical treatment. There were three(2 in type A and 1 in type B) deaths in the surgical treatment group and nine(5 in type A and 4 in type B) deaths in the medical treatment group. These results reflect our current policy in the management of dissecting aortic aneurysm.
Aortic Aneurysm* ; Causality ; Chest Pain ; Classification ; Diabetes Mellitus ; Diagnosis ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Hypertension ; Male ; Marfan Syndrome ; Renal Insufficiency ; Retrospective Studies ; Stroke

Many difficult problems are encountered in the treatrnent of infected nonunion of long bone. To solve these difficult fractures, authors adopted an active approach-thorough debridement of the infected and necrotic soft tissue and bone, rigid internal fixation with autogenous cancellous bone graft and opening of the wound to ensure continuous drainage until union of the fracture. Authors treated 28 cases of infected nonunions with this method from Mar. 1980 to Feb. 1989, and the results are as follows ;1. Femur(54%) and tibia(43%) were most frequently involved sites. 2. Most of the cases(86%) were treated by rigid internal fixation and cancellous bone graft. 3. In most cases(64%), infection was controlled spontaneously by the time of bony union, but in 5 cases which showed persistent drainage, implant removal controlled the problem, and residual soft tissue and bony defect were solved by Papineau's technique or musculocutaneous flap. 4. Revision was required in 5 cases(18%) because of insercure fixation. 5. Union could be obtained in average 4.8 months, and infection could be controlled in all except 1 case.
Debridement ; Drainage ; Methods ; Myocutaneous Flap ; Transplants ; Wounds and Injuries

Ninety cases of meniscus injury were treated by arthroscopic meniscetomy between March, 1988 and March, 1992. Eighty four cases were treated by arthroscopic partial, 5 cases by subtotal, and 1 case by total meniscectomy. All cases were followed up for more than 1 year. The results were as follows. 1. The ratio of male to female was 57 to 31, and that of right to left was 52 to 38. 2. There were 41 cases of medial meniscus and 49 cases of lateral meniscus. Longitudinal tears were 35 cases (39%), oblique tears were 20 cases (22%), horizontal tears were 15 cases (17%), and radial tears were 9 cases (10%). There was no difference in the shape of tear between medial and lateral meniscus. 4. The most common associated injury was anterior cruciate ligament tear. 5. The Tapper and Hoover scale was used to record the clinical results, and satisfatory results (exellent and good)were in 86% of cases.
Anterior Cruciate Ligament ; Clinical Study ; Female ; Humans ; Knee ; Male ; Menisci, Tibial ; Tears

BACKGROUND: Trauma is the third leading cause of death, irrespective of age, and the leading cause of death in persons under 40 years of age. Computed tomography (CT) is an effective technique in the initial emergent evaluation of the abdomen and head following blunt trauma. Most chest indies are not seen on conventional chest radiography, or may be underestimated. But routine use of CT in the initial emergent evaluation of chest trauma is controversial. CT, however, has been shown to be useful in the diagnosis of unsuspected chest injuries and in directing therapeutic interventions. This review discusses the efficacy of emergent CT in patients with blunt trauma on the chest. METHODS: To evaluate the efficacy of CT of the thorax, a retrospective study comparing early thoracic CT scanning with initial chest roentgenogram(CXR) was carried out on 121 patients with blunt trauma on the chest. The interval between CXR and CT was less than 1 hour. RESULTS: Among 121 patients, 42 patients had normal initial chest roentgenogram in whom 19 patients showed normal CT findings. Sensitivities of diagnosing pneumothorax and pleural effusion by CXR were low (49.3%and 45.1%respectively), whereas 65.7% (44/67) of patients had thoracostomy only by CXR. CONCLUSIONS : Although sometimes abused in patients with chest trauma, CT of the thorax is an effective method of detecting thoracic injuries and provides accurate information regarding their pattern and extent in the initial emergent diagnosis.
Abdomen ; Cause of Death ; Diagnosis ; Emergencies* ; Head ; Humans ; Pleural Effusion ; Pneumothorax ; Radiography ; Retrospective Studies ; Thoracic Injuries ; Thoracostomy ; Thorax* ; Tomography, X-Ray Computed

No abstract available.
Leptospira interrogans* ; Leptospira*

No Abstract Available.
Epinephrine* ; Lidocaine*

No abstract available.
Kallmann Syndrome*

No abstract available.
Arthroplasty* ; Knee*

No abstract available.
Humerus*

Calcaneus was the most commonly involved bone among the tarsal bone fractures. Although various methods have been practiced in treating calcaneal fractures, controversy exists between conservative and operative ones. Also there have been many complications such as persistent pain and limitation of motion on subtalar joint which compromised final result. The purpose of this study is that open reduction of the subtalar joint, especially posterior facet joint, could reduce the complications. Twenty seven cases of displaced intra-articular fracture of calcaneus were treated with open reduction, internal fixation, and cancellous bone graft from 1984 to 1989 at the Department of Orthopedic surgery, Kang-Nam General Hospital Public Corporation. Seventeen cases were analysed with more than one year follow-up and summarized as follow:1. All of the cases were the type IV and V on the basis of Rowe's classification. 2. The lateral approach was used in all cases. 3. The pre-operative Bohler's angle was from −30°to 15°(average −1.4°). The postoperative Bohler's angle was from 15°to 40°(average 24.5°), which was increased significantly. 4. Based on Rowe's grading, excellent and good results were obtained 13 cases. 5. Among 3 cases of fair result, arthritis of the subtalar joint occurred in 2 cases and peroneal spasm in one. In one case of poor result, postoperative infection occurred. 6. It was thought that open reduction of the posterior facet joint of calcaneus could restore the congruity of subtalar joint near to normal, and contributed to a large extent to the decrease of foot pain commonly developed after calcaneal fracture.
Arthritis ; Calcaneus ; Classification ; Follow-Up Studies ; Foot ; Hospitals, General ; Intra-Articular Fractures ; Orthopedics ; Spasm ; Subtalar Joint ; Tarsal Bones ; Transplants ; Zygapophyseal Joint