The flexor tendon injuries of the finger are very difficult to treat satisfactorily. Early treatment is desirable, but not always posaible. In addition, joint stiffness and limitation in gliding of the tendon caused by adhesion, make the problem more complex. From 1978 until 1988, 13 patients (14 eases) underwent operations for free tendon graft, and 10 patients (13 eases) for staged tendon graft at the Department of Orthopaedic Surgery, National Medieal Center. They have been followed up for clinical study, and the result was summarized as follows:1. Old flexor tendon injuries were common in the teen and twenties, especially in male. 2. They occurred in the index (10 Cases, 37.0%) and middle (8 cases, 29.6%) fingers most commony, especially zone II (62.9%). 3. The result was evalusted according to the method designed by Strickland and Glovac. In 19 out of 27 cases, satisfactory result (excellent and good) was yielded. 4. In cause, deep laceration by sharp object was better in the result than crushing injury. 5. The interval between the injury and the operation ranged from 1 month through 11 years, averaging 16 months, and is supposed to have little relation to the result. 6. The preoperative state is supposed to have much relation to postoperative result, judging from 100% of satisfactory result in Grade I compared with 40% in Grade V according to Boyes preoperative classification. 7. Little difference is seen in the result between free tendon graft and staged tendon graft. And 5 cases complicated by adhesion, rupture of grafted tendon and wound infection yielded poor result.
Adolescent ; Classification ; Clinical Study ; Fingers ; Hand ; Humans ; Joints ; Lacerations ; Male ; Methods ; Rupture ; Tendon Injuries ; Tendons ; Transplants ; Wound Infection

Injuries of the cervical spine from C3 down to C7 are complex and potentially devastating injuries. The treatment of this condition is complicated and controversial. However, there is an increasing tendency to stabilize unstsble cervical spine injuries surgically with the benefit of good stability of the spine, easy nursing care, early mobilization and rehabilotation. We analysed clinically the 26 patients with unstable lower cervical spine injuries st the department of orthopaedics, National Medical Center from Jan. 1979 to Dec. 1988. The results obtained were as follows:1. The prevalent age distribution was between 20 and 50 years of age(71%), and the ratio between male and female was 6: l. 2. The most common cause of the injury was traffic accident(42%), and the most frequent mechanism of injury was distractive-flexion type(42%). 3. In the overall clinical evaluation, 73% of the patients were judged to have had excellent and good results, and the range of the motion was more limited in the patient who underwent posterior fusion due to wide level of fusion. 4. The patients with distractive-flexion injuries with minimal neurologic deficit were at risk of late instability following conservative treatment, and therefore open reduction and posterior fusion may be advisable. 5. The patients who were given posterior fusion were noted to have a few significant late changes, but the patient with anterior fusion carried a high incidence of progressive kyphotic deformity and persisting, pain. 6. When anterior fusion is used in the patient with posterior instability for the purpose of cord decompression, anterior cervical plate is valuable than the fusion with graft only in view of preventing progressive kyphotic deformity.
Age Distribution ; Congenital Abnormalities ; Decompression ; Early Ambulation ; Female ; Humans ; Incidence ; Male ; Neurologic Manifestations ; Nursing Care ; Spine ; Transplants

Fractures of the distal end of the femur are difficult to manage because of the a wide range of potential complications. In the past, there has been a reluctance toward treatment of fractures of the distal end of femur with internal fixation. Recently, however, a trend toward internal fixation has become evident and good results have been reported by several authors. We analyzed 30 cases of distal femur fracture involving knee joint in the Department of Orthopaedic Surgery in National Medical Center from Jan. 1982 to Dec. 1986. 1. There were 30 cases in 29 patients. And were devided in 23 closed and 7 open fractures. 2. Clinical union were taken from 3 to 5 months in conservative and 2 to 3.5 months in operative treatment. 3. Satisfactory results were 5 cases(64%) in conservstive and 16 cases(73%) in operative treatment. 4. Significant complication were stiffness and infection.
Clinical Study ; Femur ; Fractures, Open ; Humans ; Knee Joint ; Knee

To evaluate historical trend, if any, anesthetic experiences of 23,385 in total performed at the Seoul National University Hospital from Jan. 1965 through Sept, 1972 were analyzed statistically according to age, sex, anesthetic agents and methods. The results are as follows: 1) General anesthesia has been used with increasing frequencies inversely to local anesthesia. 2) More than half the total cases were for the patients in the second or third decade of there ages. 3) The use of halothane has been steadily increasing ever since its introduction into clinical anesthesia in its country. 4) Thiopental has mainly been used for intravenous induction, and succinylcholine for facilitating endotracheal intubation. 5) In almost all cases semiclosed circle absorption system has been employed, and non-rebreathing system has recently been used with increasing favor for pediatric anesthesia.
Absorption ; Anesthesia ; Anesthesia, General ; Anesthesia, Local ; Anesthetics ; Halothane ; Humans ; Intubation, Intratracheal ; Seoul ; Succinylcholine ; Thiopental

Though trichogenic tumors were classified as trichoblastoma, trichoblastic fibroma, trichogenic trichoblastoma and trichogenic myxoma by Headington(1970), their true classification depends upon the epithelial and mesodermal component as well as evidence of their induction. Because of the rarity of hair germ cell tumors their classification is still controversial. In this report, we describe a case of trichogerminoma which is not included in the above classification. The trichogerminoma was first described by Sau et al. in 1992 and characterized by its morphologic pattern of germinal centers and lymphoid follicle-like structures in the nests of trichoblasts. Herein we reporte a tumor which arose on the skin on the back of a 51-year-old man and presented as a sharply circumscribed mass(4.5x2.0x1.5 cm) involving both the dermal and subcutaneous tissues without any epidermal connection. The tumor had many germinal center-like structures in the basaloid trichoblasts. Lobular cell nests were separated by variable amounts of stroma, but no horn cyst were noted. The germinal center-like cells showed early differentiation of hairs, resembling early hair bulbs. Trichogerminoma is considered to be a type of tumor located between trichoblastoma and trichoblastic fibroma.
Male ; Humans ; Cysts

Preoperative angiography is frequently used in the planning of microsurgical reconstruction for identification of vascular abnormality that influence the planning of operation. But, recently 3D CT angiography is considered as new technique that can provide detailed information about vascular anatomy as well as soft and bony tissue without the risks of invasive angiography. 3D CT angiograms were performed in 19 patients before microsurgical reconstruction for the lower extremity and hand between May of 2003 and Oct of 2004. Sixteen of the studies were of the donor site and all of 19 studies were of the recipient site. No complications were found from the 3D CT angiograms. In one case of the bone exposed open wound, the injury of anterior tibial artery was identified and the zone of injury was adequately demonstrated. With the improvement in quality of CT imaging, 3D CT angiograms may provide a favorable alternative to invasive angiography. It is capable of providing high-resolution, three dimensional vascular imaging without the need for arterial puncture and prolonged post-procedure observation. The relation among blood vessels, bones, and soft tissue is well demonstrated in 3D CT angiogram. Also The acquisition time and examination cost were considerably lower in comparison with invasive angiography. In conclusion, this study demonstrates that 3D CT angiography may provide accurate, safe, and cost-effective preoperative imaging. The 3D CT angiography with relatively low morbidity, low cost, ease of image acquisition can have an broader role in microsurgical reconstructive surgery.
Angiography* ; Blood Vessels ; Hand ; Humans ; Lower Extremity ; Punctures ; Tibial Arteries ; Tissue Donors ; Wounds and Injuries

In order to determine the normal range for intraocular pressure(IOP) in the post-LASIK population. We retrospectively reviewed the charts from the first 50 consecutive post-LASIK eyes. 50 eyes were divided into subgroups according to the degree of preoperative myopia, and the amount of ablated corneal thickness, and the diameter of treated optical zone. Preoperative(blaseline) & postoperative intraocular pressures at 1 day, 1 week, 1 month and 3 month were measured with air puff applanation tonometer. Mean postoperative intraocular pressures were compared to the baseline IOP in suvgroups and between inter-suvgroups. Postoperative IOP was decreased significantly in all 3 myopic suvgroups(p<0.05), but there was no pressure difference between inter-surgroups preoperatively(p>0.1) and postoperatively(p<0.3). Also the ablated corneal thickness groups and the treated optical zone groups showed an significant postoperative lowering of IOP(p<0/05) but there was no pressure difference between the subgroups preoperatively and postoperatively. And, in all suvgroups, post-LASIK intraocular pressures were underestimated more than a 30% of vaseline IOP. These results reflect that post LASIK IOP is not a true IOP.
Intraocular Pressure* ; Keratomileusis, Laser In Situ* ; Myopia ; Petrolatum ; Reference Values ; Retrospective Studies

The therapeutic responsibles of the inductive preoperative chemotherapy on the breast cancer were variable and we examined relations between age, chemotherapeutic regimens, size of tumor, mammographic and sonographic findings, hormoal factors in tumor mass and responsibles of the inductive chemotherapy in 44 cases of good responders among 101 cases of breast cancer patient underwent preoperative inducuive chemotherapy in 44 cases of good responders among 101 cases of breast cancer patient underwent preoperative inductive Chemotherapy at Chungnam National University Hospital, from Jan. 1993 to Dec. 1997. The results of the study were obtained as follows: 1) The premanopause women were 29 patients (28.7%), postmanopause women were 15 patient (48.4%) and the response was good in postmanopause women than premanopause women (p=0.06). 2) The good responders were underwent underwent MMM regimen (46.3%) compare with FAC regimen (38.2%)(p=0.07). 3) The result was good in smaller maximum diameter of initial tumor mass than larger one. There were 86.7% of responders in less than 2cm of tumor size, 42.6% in 2-4cm and 20.2% in more than 4 cm(p=0.001). 4) The relations between degree of marginations, density, microcalcification, spiculation on mammography and sonography and responsibles of inductive chemotherapy were no significant one.
Breast Neoplasms* ; Breast* ; Chungcheongnam-do ; Drug Therapy* ; Female ; Humans ; Mammography ; Ultrasonography

PURPOSE: We explored the prognostic significance of obesity for the surgical and hormonal treatment of prostate cancer in correlation with the other prognostic factors such as Gleason's sum, the clinicopathologic stage, and the pre- and post treatment prostate specific antigen (PSA) changes. MATERIALS AND METHODS: A retrospective review was performed on 132 consecutive patients who had received androgen deprivation therapy (ADT) (108 patients) or radical prostatectomy (24 patients) under the diagnosis of prostate cancer via transrectal prostatic biopsy from July 1993 to May 2003 in our hospital. Obesity was evaluated in terms of the body mass index (BMI), and the patients were categorized into four groups according to the National Institute of Health (NIH) classification. The relationship between the BMI and the other prognostic factors were statistically analyzed by One-way ANOVA test and the Spearman correlation coefficient. RESULTS: There were no significant associations between the BMI and any of the measured clinical and pathological parameters except for the time to hormone failure and biochemical recurrence. In the ADI group, the mean time to hormone failure was significantly longer in case of the low BMI group compared to the normal and overweight groups (p<0.006). Sperman's correlation analysis showed a significant inverse correlation between the BMI and the PSA free survival after radical prostatectomy. CONCLUSIONS: These findings showed that the BMI is closely related to the failure to hormone treatment after ADI and the BMI was also related to the biological failures after radical prostatectomy.
Biopsy ; Body Mass Index ; Classification ; Diagnosis ; Humans ; Obesity* ; Overweight ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy* ; Prostatic Neoplasms* ; Recurrence ; Retrospective Studies

There are several rnethods to correct the tibial bony defect including resection, cement filling, autograft or allograft and metal augmentation. The purpose of this study is to find the adequate treatment method of tibia bony defect through analysis of the result with above methods. From Sep. 1993 to Dec. 1997, the authors analyzed 93 cases of tibial medial bony defect corrected by overresection of lateral condyle, allograft and metal wedge or block among 358 cases of primary total knee arthroplasty(TKA) operated at Asan Medical Center. All cases were devided into four groups according to the treatment method; group A(31 cases) with overresection of lateral condyle, group B(37 cases) with metal wedge, group C(21 cases) with metal block and group D(4 cases) with allograft. The mean follow up period was 23.6 months(12 56 months). The results were as follows, 1. There were no definite statistical difference between group A, B, C and D in HSS knee score, ROM, correction of deformity. But in group D, there is one case of loss of the correction. 2. Loosening of the implant was not noted, but 17 cases of mild bony resorption was found just beneath the implant. It was particularly prominent in group B(9 cases) than group A(5 cases) and C(3 cases). 3. Among 4 cases of allograft, one has developed collapse of allograft. 4. 3 cases of deep infection developed only in group C, which were followed by revision TKA. Although further follow up study should be carried out, we concluded that resection of lateral tibial condyle, allograft, metal augmentation is a good substitute to the correction of the tibial bony defect in primary TKA.
Allografts ; Autografts ; Chungcheongnam-do ; Congenital Abnormalities ; Follow-Up Studies ; Knee ; Tibia