Recently there has been decreasing trend of high tibial osteotomy in management of the gonarthrotic patients partly due to recurrence of the symptom and, more importantly, due to the relative success of the total knee joint replacement procedure. But there is still room for the high tibial osteotomy, although it may be 'outdated' procedure, in that younger active patients do well postopera- tively for an enough period of time and that even the older have some gain of pain-relief in early postoperative period. The purpose of this study is to detect the affecting factors of the result of the operation. We reviewed 25 valgus high tibial osteotomies in 23 patients who had medial gonarthrosis and could be followed-up more than 1 year among 32 cases between August 1989 and January 1994. The mean length of follow-up was 30 months(ranged twelve to fifty four months). The results were compared according to modified grading of the HSS score. All cases showed the increase of the score from preop. average 65.2 points to postop. 87.8 points, mainly by the decrease of pain and the increase of functional activity. The severity of degenerative change on the radiographs and the degree of varus seemed to be related with the early clinical results of the operation, but the age was not a major affecting factor. These results could be debatable due to some differences from the others', and long term follow-up would be needed.
Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Osteotomy ; Postoperative Period ; Recurrence

The authors report their experience with 22 cases of intracranial suppuration : 18 with brain abscess and four with subdural empyema. A small series of nine consecutive cases of intracranial suppuraion with one death is presented since Computed Tomographic brain scanning become a routine diagnostic procedure. These patient have been compared to 13 consecutive cases treated without benefit of CT analysis in order to determine the factors responsible for the recently improved prognosis. The mortality rate was 30.8% for al operated patients treated before availability of CT and 22.7% for the patient since advent of CT scan. Among the factors that may have contributed to the improved results for patients diagnosed with CT are : fewer patients with poor preperative clinical status, and a great incidence of total abscess removal. In addition, CT scanning provided more accurate diagnosis and localization of abscess and aided in the rapid detection of postoperative complication.
Abscess ; Brain ; Brain Abscess ; Diagnosis ; Empyema, Subdural ; Humans ; Incidence ; Mortality ; Postoperative Complications ; Prognosis ; Suppuration* ; Tomography, X-Ray Computed

No abstract available.
Humans ; Keratoderma, Palmoplantar ; Pityriasis Rubra Pilaris ; Pityriasis ; Siblings

The purpose of this study is to compare the effects of the femoral attachment points of the graft and knee flexion angles at the time of graft fixation on stability of posterior cruciate ligament reconstruction. We analyzed the posterior stability of the knee on 23 patients(24 knees) with posterior cruciate ligament injury whose posterior cruciate ligament had been reconstructed arthroscopically and followed for minimum 1 year period at Asan Medical Center from May 1992 to June 1994. The patients were divided into the two groups according to femoral attachment points of the graft and knee flexion angles at the time of graft fixation. The distance from the junction of the intercondylar notch with trochlear groove of the femoral attachment points and knee flexion angles were 11mm and 0°-30° in group A and 7mm and 70°-90° in group B, respectively. 11 knees were included in group A and 13 knees in group B. Posterior stability was determined by difference in posterior tibial translation between the injured and the opposite knee with Telos device. In group A, 5 cases were at the range of 0-2mm, 3 cases 3-5 mm, 3 cases 6-10mm. In group B, 10 cases were at the range of 0-2mm and 3 cases 3-5mm, respectively. Differences in posterior tibial translation on average were 3.6mm and 1.7mm in group A and B, respectively. Conclusively, arthroscopic postrior cruciate ligament reconstruction with femoral attachment point at 7mm from the junction of interconlylar notch with trochlear groove and 70°
Chungcheongnam-do ; Humans ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Transplants

BACKGROUND: Proximal humerus fracture is considered to be the third most common fracture for patients aged 65 years or older. Conservative treatment has been known to treat most of humerus fracture. However, fractures with severe displacement or dislocation may require surgical treatment. Intramedullary fibular allograft with a locking plate is frequently used in patients accompanying medial metaphyseal disruption. In this study, author intends to evaluate clinical and imaging results based on patients who underwent surgical treatment using fibular allograft with a locking plate. METHODS: This study is conducted prospectively at Wonju Severance Christian Hospital, targeting patients who previously underwent surgical treatment using open reduction and intramedullary fibular allograft with a locking plate between 2011 and 2015. A total of 26 patients were evaluated on the following: postoperational clinical assessment measuring Constant score, American Shoulder and Elbow Society (ASES) score, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Postoperational imaging assessments are evaluated via measuring the neck-shaft angle. The study subject were Neer classification type 3, 4 proximal humerus fracture cases with disrupted medial hinge and having cortical comminution in the region of the surgical neck. RESULTS: The average period of progression was 22.5 months, and the average age of patients was 72.6 years. At the final follow-up, the average Constant, average ASES, and average DASH scores were 80.1, 78.5, and 20.6 respectively. The average neck-shaft angle was 127.5°. CONCLUSIONS: In conclusion, fibular allograft augmentation with a locking plate showed satisfying results in both clinical and imaging studies.

A 66-year-old female patient had a firm, non-tender, dome shaped mass on the scalp. The lesion had enlarged slowly for 2 years, and measured about 4 × 6 cm. The histologic finding of the skin biopsy specimen demonstrated an infiltration of immature plasma cells in the dermis, which express monoclonal cytoplasmic lambda light chain by immunohistochemical stainings, and staging work-up after the biopsy revealed no evidence of disease in other foci. The mass on the scalp was treated successfully by radiation therapy, with the diagnosis of primary cutaneous plasmacytoma.
Aged ; Biopsy ; Cytoplasm ; Dermis ; Diagnosis ; Female ; Humans ; Plasma Cells ; Plasmacytoma* ; Scalp ; Skin

No abstract available.
Ankylosis ; Fascia ; Temporal Muscle ; Temporomandibular Joint

Magnetic resonance imaging(MRI) is accepted as a useful tool for the diagnosis of injury of the knee recently. The anterior cruciate ligament tear is accompanied by the damage of the osseous and soft tissue of the knee. The occult osseous lesion is found on magnetic resonance imaging as bone density change that is not found on the simple radiograph. From Jan. 1992 to Apr. 1994, magnetic resonance imaging was performed on 44 patients with acute anterior cruciate ligament tears. MRI was done within 6 weeks of the index anterior cruciate ligament injury. The criteria of decreased signal intensity on the Tl weighted image and increased signal intensity on the T2 weighted image was applied for the incidence assessment of the occult osseous lesion. After arthroscopy with or without ACL reconstruction, follow-up simple radiograph was checked every 3 months. Occult osseous lesions were documented in 32(73%) of the 44 patients. Of the 32 patients with bony lesion, 81% had lesions of the lateral compartment. Lateral femoral condyle was involved in 15 cases(46.9%), and lateral tibial plateau in 22 cases (68.8%). Follow-up X-ray revealed no joint deperession in all of the 32 patients with the occult osseous lesion. This result suggests that there is a high correlation between the occult osseous lesion of lateral compartment of the knee on magnetic resonance imaging and anterior cruciate ligament tear. The presence of the occult osseous lesion in the patient with acute anterior cruciate ligament tear did not affect rehabilitation and weight bearing.
Anterior Cruciate Ligament ; Arthroscopy ; Bone Density ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Knee ; Magnetic Resonance Imaging ; Rehabilitation ; Tears ; Weight-Bearing

Cybex evaluation of muscle strength was performed on 15 patients with chronic anterior cruciate ligament tears following arthroscopic reconstruction using central one-third patella tendon autograft. Cybex testing was done preoperatively and at 3, 6, 9, and 12 months postoperatively. Peak torque and total work of the quadriceps and hamstrings at the angular velocity of 60 degree/sec and 180 degree/sec were measured and analyzed. The results were as follows: l. At the angular velocity of 60 degree/sec, the muscle strength of the quadriceps showed 45.4% deficit in peak torque and 50.9% deficit in total work compared to the contralateral normal knee preoperatively, 48.2% and 49.0% deficit respectively at 3 months after operation, 40.3% and 37.7% deficit at 6 months, 30.6% and 32.5% deficit at 9 months and 23.4% and 24.7% deficit at 1 year after operation. 2. At the angular velocity of 60 degree/sec, the muscle strenggth of the hamstrings showed 32.3% deficit in peak torque and 42.9% deficit in total work compared to the contralateral normal knee preoperatively, 39.3% and 42.4% deficit respectively at 3 months after operation, 27.3% and 32.3% deficit at 6 months, 21.2% and 22.3% deficit at 9 months and 17.9% and 18.4% deficit at 1 year after operation. 3. At the angular velocity of 180 degree/sec, the muscle strength of the quadriceps showed 38.4% deficit in peak torque and 42.0% deficit in total work compared to the contralateral normal knee preoperatively, 41.1% and 47.54% deficit respectively at 3 months after operation, 34.4% and 33.7% deficit at 6 months, 28.5% and 28.6% deficit at 9 months and 21.0% and 22.1% at 1 year after operation. 4. At the angular velocity of 180 degree/sec, the muscle strength of the hamstrings showed 26.9% deficit in peak torque and 31.8% deficit in total work compared to the contralateral normal knee preoperatively, 41.2% and 45.2% deficit respectively at 3 months after operation, 32.3% and 36.0% deficit at 6 months, 21.4% and 25.1% deficit at 9 months and 16.1% and 15.7% at 1 year after operation.
Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Autografts ; Humans ; Knee ; Muscle Strength ; Patellar Ligament ; Tears ; Torque

No abstract available.
Radiculopathy*