In recent years, the rate of the spine fracture tends to be on the increase year by year as rate of traffic and industrial accidents are increased. 111 patients with paralysis caused by thoracic, thoracolumbar, lumbar spine injuries were evaluated from January, 1979 to December, 1988 in our study. 1. In patients with paralysis caused by thoracic, thoracolumbar, lumbar spine injuries, most common site of injuries was “thoracolumbar junction” (47.7%) and most common cause was “fall down” (48.7% ). 2. “Burst fracture” was most common type of injuries which were classified by 3-column concept according to Denis & McAfee(52.3%) 3. In early 1980's the operation was performed with Harrington rod, anterior decompression & AIF, posterior decompression & PIF and from 1984, mainly Luque sublaminar wiring, and in 1988, SSI was commonly used. 4. There was no difference in neural recovery between conservative and operative treatments. 5. There was statistic significance in the incidence of complications between conservative and operative treatments(p <0.05). 6. The more severe neurologic damage at injury, the higher incidence in complication(p<0.05). Therefore, although there was no significant difference in neural recovery between conservative and operative treatments in the care of paralysed patients caused by thoracic, thoracolumbar, lumbar spine injuries, rigid internal fixation and rapid mobilization can be recommended for decreasing complications by prologed bed rest and active rehabilitation.
Accidents, Occupational ; Bed Rest ; Decompression ; Humans ; Incidence ; Paralysis ; Rehabilitation ; Spine

Osteonecrosis (Avascular necrosis) of the bone is a known complication of systemic corticosteroid therapy and may he dose related. It also has been associated less commonly with nonsteroida1 chemotherapy. Nonetheless, avascular necrosis of bone has heen reported infrequently in children who have received antileukemia regimens including prednisone. We report our experience with one adolescent girl with acute lymphocytic leukernia (ALL) who developed hoth femoral condylar osteonecrosis presenting bone pain after aggressive chemotherapy that including high cumulative dosage of corticosteroid as well as other antileukemia agents. We performed arthroscopic surgery with debridement, multiple drilling and screw fixation to the lesion sites. Eight months after operation, she was free of pain with full range of both knee movements. We got good resuit according to Hughston criteria.
Adolescent ; Arthroscopy ; Child ; Debridement ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Humans ; Knee* ; Osteonecrosis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Prednisone

Tibial tunnel placement during endoscopic anterior cruciate ligament (ACL) reconstruction has received increased emphasis in the recent literature. Tibial tunnel length is a factor that affect graft fixation, potential impingement, and graft abrasion. Appropriate tunnel length is a critical tecpnical consideration. A tunnel that is too long may make distal fixation and femoral tunnel placement difficult... A tunnel that is too short results in graft extrusion, necessitating supplemental fixation techniques. This grafl-tunnel mismatch can be avoided if fhe sum of the tibial tunnel length plus the intraarticular distance of ACL is equal to or greater than the graft tendon length plus 20mm (the minimum interference fixation possible when using the smallest available 20 mm long interference screw). Authors published an article to determine the reiationship between the length of patellar tendon and that of anterior cruciate ligament, to calculate the tibial tunnel length through the dissection of 19 cadaveric knees (ACL length (mm)=0.73 X Patellar tendon length-2.69 (p Anterior Cruciate Ligament ; Cadaver ; Humans ; Knee ; Patellar Ligament ; Tendons ; Transplants

No abstract available.
Colorectal Neoplasms*

Acute generalized exanthematous pustulosis(AGEP) is a disease entity caused mostly by drugs or viral infections. Clinically it manifests as generalized erythema, erythema multiforme and amicrobial pustules with fever. Histologically, AGEP is composed of neutrophilic subcorneal and spongiform pustules. A 70-year-old female, with no personal or family history of psoriasis, was given medication including diltiazem for hypertension. Fourteen days after taking the medications, pustular eruptions appeared on the face and rapidly spread to the trunk and limbs. A Laboratory examination revealed neutrophilic leukocytosis and an elevated erythrocyte sedimentation rate. The skin biopsy showed subcorneal and spongiform pustules. We report here a case of AGEP probably due to diltiazem.
Acute Generalized Exanthematous Pustulosis* ; Aged ; Biopsy ; Blood Sedimentation ; Diltiazem ; Erythema ; Erythema Multiforme ; Extremities ; Female ; Fever ; Humans ; Hypertension ; Leukocytosis ; Neutrophils ; Psoriasis ; Skin

If the treatment of acetabular fractures are not satisfactory, there will be serious complication such as traumatic arthritis or avascular necrosis of the femoral head. There is much continuing discussion as to where conservative or surgical treatment should be used. The authors experienced 41 cases of acetabular fractures, that wrere treated at the Department of Orthopaedic surgery, Maryknoll Hospital from January 1981 to September 1987. The results of 29 cases who were followed over a 1 year period are as follows:1. According to Letournel's classification, the most common type of elementray fracture was posterior wall(24.1%) and a T- shsped fracture was 10.3 % and both column fractures were 10.3%. 2. Complications were traumatic arthritis(14 cases), superficial infection(5 cases), ectopic ossification(5 cases), osteomyelitis(1 case), AVN of the femoral head(1 case), and iartrogenic femoral shaft fracture(1 case). 3. According to matta's assessment, satisfactory results of conservative treatment were 38% clinically and 38% radiologically, and by surgical treatment, 73% clinically and 64% radiologically. 4. Surgical treatment in acetabular fractures, such as an anatomical reduction and rigid fixation fixation followed by early joint motion were improved the result and decresed the rate of traumatic arthritis.
Acetabulum ; Arthritis ; Classification ; Head ; Joints ; Necrosis

Arthroscopically assisted anterior cruciate ligament(ACL) reconsturction provide a technique with less morbidity, less pin, less sacr, lower ris k of sepsis. The magnification offered by arthroscopic visualization also provide a clearer view, more precise location of anatomical landmarks, and the ability to place the graft in the exact anatomic sites. However, in order to accomplish all these goals, the surgeon must possess a high level of psychomotor skills, which take time and practice to develop. Wile this learning curve is being completed, there are occasion when complications will occur, and, realistically these may be difficult to avoid. The purpose of this study is to evaluate author's cases in which complication occurred during the endoscopic one-incision ACL reconstruction using the patellar tendon and to offer some tips on how to avoid them and how to salvage the situation if they do occur. We reviewed 22 complications (11 patients) out of 40 ACL reconstructions performed between May 1994 and December 1995. The complications were divergence(6), graft-tunnel mismatch(5), too anterior tibial tunnel(3), too anterior femoral tunnel(2), too posterior femoral tunnel(2), rotation of screw around the graft(2), guide pin breakage(1), bone plug retraction into the joint(1). It is suggested that arthroscopist should constantly try to avoid the intraoperative complications of arthroscopically assisted ACL reconstruction and follow the precautions and preventive measures recommended.
Intraoperative Complications ; Knee ; Learning Curve ; Patellar Ligament ; Sepsis ; Transplants

Many types of meniscal anomalies were reported. Authors found a double-layered lateral meniscus, with one meniscus overlying another. The 39-year old male patient had torn medial and lateral menisci. We performed partial medial and lateral meniscectomy, and incidentally found that lateral meniscus was double-layered. It was characteristic that the upper small accessory meniscus was firmly connected from the posterior horn to middle segments of the lower main meniscus along its peripheral edge. We left it alone. The symptoms were gone, So, it was thought that this anomaly was not related to the patient's symptoms.
Animals ; Horns ; Humans ; Male ; Menisci, Tibial

Divergent placement of the femoral interference screw has been described as a major pitfall in single incision endoscopic reconstruction of the anterior cruciate ligament. This study reviews the radiographic results in 30 consecutive endoscopic single-incision ACL reconstructions using interference screw fixation to find a method to reduce the divergent femoral screw fixation. We measured the angles which were determined by a line through axis of femoral bone block and axis of interference screw in anteroposterior and lateral view of knee(APD/LD),through axis of femoral tunnel and axis of tibial tunnel in the full extension-anteroposterior view(AFT),through the longitudinal axis of distal femoral shaft and axis of femoral tunnel in the anteroposterior and lateral view(APFT/LFT). Average LD(4.96+/-62degrees) was significantly larger than average APD(1.303+/-13degrees) (P=0.008). Significant correlation was present between APD and APFT(g=-0.3882, P=0.034), between LD and LFT(gamma=0.6933, P=0.000) and other variables had no significant correlation. The femoral divergence in the anteroposterior plane occurred in the case with small angle between longitudinal axis of femoral shaft and that of femoral tunnel, and vice versa in lateral plane. During drilling of femoral tunnel, more than 90 flexion causes LFT to increase and the risk of femoral divergence increases. Therefore, in the anteroposterior plane, angle between femoral tunnel and longitudinal axis of femoral shaft shoud be made as large as possible and flexion of knee should not be more than 90 during drilling of femoral tunnel.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Axis, Cervical Vertebra ; Knee ; Patellar Ligament*

The authors report a xase of primary non-gestational choriocarcinoma(PNGCO) of the ovary in a prepubertal female patient and reviewed. It is an extremely rere disease of which incidence is one in 369 million. Major clinical symptom is abdominal pain, precociois puberty and it can be misdiagneosed as ectopic pergnancy. Distinction from gestational choriocarcinoma(GCO) of the ovary is important because of the worse prognosis of PNGCO. But no distinctive ultrastructural or immunohistochemical differences are found between PNGCO and GCO. Most acceptable treatment modality is an aggressive surgical therapy and systemic chemotherapy, but its progrosis is poor.
Abdominal Pain ; Adolescent ; Choriocarcinoma, Non-gestational* ; Drug Therapy ; Female ; Humans ; Incidence ; Ovary* ; Prognosis ; Puberty