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

All clinical studies reported in the literature have indicated that non-operative treatment is the treatment of choice for the diaphyseal fractures of the clavicle. It has also been suggested by some that open reduction may contribute the development of nonunion. From 1985 to 1989, 23 of 133 diaphyseal fractures of the clavicle were treated by open reduction and internal fixation with the intramedullary pinning with or without cerclage wiring, or prebent plate and screw fixation with supplementary iliac bone graft in each instance. All fractures healed without any complication such as the infection, pin migration, other fixation failure, neurovascular accident, and pseudarthrosis. Based on our experience and review of the literature, we concluded that the indications for open reduction and internal fixation should be: 1. The patient's inability to tolerate prolonged immobilization or recumbency in multiple injury. 2. Widely distracted or displaced fractures in adults. 3. Comminution with one or more large butterfly fragments. 4. Neuro-vascular compromise due to displacement and impingement of the bone fragment. 5. Symptomatic delayed union or nonunion. 6. Refracture. And early operative treatment is safe, reliable and provide excellent results comparable to the conservative treatments.
Adult ; Butterflies ; Clavicle ; Humans ; Immobilization ; Multiple Trauma ; Pseudarthrosis ; Transplants

In anterior dislocations of shoulder complicated by fracture of greater tuberosity, the prognosis of shoulder after reduction of dislocation depends upon associated injury of the rotator cuff. Early recognition and repair are thought to be essential if better functions is to be obtained. Among 40 patients with 41 dislocations, 28 cases with fracture of greater tuberosity were managed and treated at the Department of Orthopaedic Surgery, Hangang Sacredheart Hospital, Hallym University, from January, 1985 to December, 1988. The results obtained from this study were as follows: l. Among 40 patients with 41 cases of fracture-dislocation, 27 patients with 28 cases(68.3%) were complicated by fracture of greater tuberosity. Most of these were by traffic accident and occurred at the age of 40s and 50s. 2. According to the Depalma's classifcation, the most common type was type 2(15 cases, 53.5%). 3. Open reduction with repair of cuff was done in 2 cases of type 2 and 4 cases of type 3. 4. Rotator cuff injury was confirmed in eight operatively treated cases and in 3 cases by arthrography and ultrasonography. 5. Five operatively treated cases of fracture-dislocation with rotator cuff injury showed improved function especially in abduction. Therefore in anterior disloations with fracture of greater tuberosity, careful evaluation of anatomic reduction state of fragment after reduction and accompanying rotator cuff injury is necessary. If the fragment retracts under the acromion or still shows displacement more than 8-10mm after reduction, we may assume that a tear of rotator cuff is present and open reduction of fracture with repair of rotator cuff is essential for the better function of the shoulder.
Accidents, Traffic ; Acromion ; Arthrography ; Dislocations ; Humans ; Prognosis ; Rotator Cuff ; Shoulder ; Tears ; Ultrasonography

In children, the supracondylar fractures of the humerus are common in elbow region, and often associated with various complications and problems in treatment (ie,Volkmann's ischemic contracture, cubitus valgus or varus deformity, rotational deformity). The results of reduction can be measured by Baumann's angle, carrying angle, trochlea-capitellum angle, and displacement of distal radial styloid process on radiological study. So we have made experiments on the process which various three dimensional displacements reflected into two dimensional Baumann's angle and humerocapitellar angle. And we investigated the process of rotation, through various radiological studies by means of molded models of humerus. The results were as follows:l. In experiments, AP & lateral X-ray studies showed no change in rotation of proximal segment of fracture with fixed distal segment of fracture. 2. On the other hand, AP & lateral X-ray showed significant change, in rotation of proximal fracture segment with distal segment of fracture. 3. Supracondylar rotation angle(S.R.A.)depicted as the ratio of the length of proximal fracture width minus that of the distal fracture width in lateral view, to the length of distal fracture width in AP view minus that of the distal fracture width in lateral view. 4. According to the modified Mitchell result, S.R.A. to the result of treatment was average 7.6 degree in excellent group, 15.2 degree in good group and 29.3 degree in unsatisfactory group.
Child ; Congenital Abnormalities ; Elbow ; Fungi ; Hand ; Humans ; Humerus ; Ischemic Contracture