We have recently experienced a rare case of abdominal aortic injury caused by shearing force falling from 8 meter height in upright position. The patient was 43 year old and sustained Ll, L2, L5, compression fractures and both distal tibia and fibula comminuted fractures involving ankle joints. 2 years and 2 months later, marked stenosis of the distal abdominal aorta was found together with clinical manifestations of ischemia of both legs. Aorto-femoral bypass on both sides has completely relieved the symptoms.
Accidental Falls ; Ankle Joint ; Aorta, Abdominal ; Constriction, Pathologic ; Fibula ; Fractures, Comminuted ; Fractures, Compression ; Humans ; Ischemia ; Leg ; Tibia

Tibial Plateau fracture is relatively common injury which often produce major disability, and their treatment has been in controversy. Recent studies suggest that early knee motion and perhaps better surgical techniques have improved clinical end results. Protection from weight bearing and length of immobilization have varied among authors and variable treatment methods. Thirty-eight tibial plateau fractures treated at Kangnam Sacred Heart Hospital from March in 1984 to December in 1988 were analized and the followings were obtained. l. Of 38 patients, 29 patients were male and 9 female. 2. The most common associated injury was an ipsilateral fibular fracture. 3. Average duration of immobilization was 4 to 6 weeks in conservative treatment and 2 to 4 weeks in operative treatment. 4. We started partial weight bearing in 24 patients within 6 weeks and full weight bearing in 28 patients between 8 and 12 weeks, and good end results were obtained.
Clinical Study ; Female ; Heart ; Humans ; Immobilization ; Knee ; Male ; Weight-Bearing

Nine patients with ipsilateral tibial shaft fractures and knee ligament injuries were retrospectively reviewed to determine the methods of the diagnosis and the results of the treatment. The incidence of this combined injuries was 5% in one hundred and eighty two tibial shaft fractures. The injuries of posterior cruciate ligament were combined most freqently. Five of nine patients were open fractures. Bone union was obtained in all cases and the mean duration of bone union was 22.5 weeks. Athroscopy and stress X-ray for the cruciate ligament were helpful to diagnose this combined injures. The ligament injuries were surgically managed in eight and conservatively in one. Better results were obtained when this combined injuries were operated early, but four of nine patients were disabled. The results suggest that the examination of the knee is necessary to document ligamentous injuries that occur with tibial shaft fractures.
Diagnosis ; Fractures, Open ; Humans ; Incidence ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Retrospective Studies

No abstract available.
Humans* ; Knee* ; Synovial Fluid*

No abstract available.
Ciprofloxacin* ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus*

Arachnoid cyst of the velum interpositum is unusual and causes symptoms similar to those seen with a third ventricular mass. This report describes a case in which the arachnoid cyst occupied the cistern of the velum interpositum and was coincident with multiple cranial neuropathies. The patient was treated by endoscopic fenestration of the cyst. The surgery resulted in decreased in the size of the cyst but aggravation of cranial neuropathies. The patient underwent methylprednisolone pulse therapy and intravenous immunoglobulin administration under the impression of the multiple cranial neuropathies and recovered completely 3 months later. The authors conclude that combined neurological disease that needs medical treatment should be differentiated and priority of the treatment should be determined carefully if arachnoid cyst is associated with unrelated or ambiguous neurological symptoms and signs. Careful considerations of cause and effect may avoid an unnecessary surgical manipulation
Arachnoid* ; Cranial Nerve Diseases* ; Humans ; Immunoglobulins ; Methylprednisolone

Lymphomatous involvement of the gallbladder is rarely identified and manifests mostly as a local involvement of disseminated disease. There have been reported only about 20 primary malignant lymphomas of the gallbladder without involvement of other sites. A 63-year-old woman presented with jaundice, epigastric pain, and weight olss of two months duration. There was no systemic lymphadenopathy elsewhere. Abdominal computed tomograph revealed a focal thickening of the gallbladder wall. The removed gallbladder contained a well circumscribed, 5x3 cm-sized, slightly elevated firm area with accentuated mucosal papillary excrescences near the neck protion. The lesion involved whole thickness of the wall, and was made up of diffuse atypical lymphoid cell infiltrates of variable size accompanying plasmacytoid differentiation in areas. Some large tumor cells were pleomorphic and contained prominent nucleoli. To our knowledge, this is the first case of primary malignant lymphoma of the gallbladder in Korean literature.
Female ; Humans

Thirty-two consecutive patients with spondylolisthesis associated with displacement in varying degrees were operated by the Steffee procedure. Slippings more than Meyerding Grade III were reduced by modified Schollner technique:destabilization of the slipped segement, local distraction with spinal elevator and completion of reduction with a cork screw force pulling backward. Autogenous bone and Pyrost were added to get solid fusion. The authors reviewed thrity-two cases of symptomatic lumbar spondylolisthesis which were operated since March in 1987 at Kangnam Sacred Heart Hospital, Hallym University and the followings were obtained. 1. There were 17 males and 15 females, and the age of the patients was 44.2 years in average ranging from 19 to 66 years. 2. The types of spondylolisthesis were isthmic defect at 19 levels in 18 cases and degenerative in 14 cases. The level of the lesion was L5-Sl in 17 cases, L4-5 in 15 cases and L2-3 in 1 cases. 3. The clinical symptoms were low back pain, radiating pain, intermittent claudication, and motorsensory deficit in order of incidence. 4. Preoperatively, the degree of slinpping was Meyerding Grade I in 18, Grade III in 12 and Grade Ill in 3 cases. The slipping was reduced to nearly anatomic position in 13 cases and Grade I in 20 cases. The average slipping measured by Taillard method was changed from 23.4% preoperatively to 5% postoperatively. 5. Clinically, the results were judged as excellent in 13(13%) cases, good in 16(50%) cases and fair in 3(9%) cases according to Kim's criteria. 6. Postoperative complications were leg pain in 3 cases and "stress transfer" in 1 cases.
Elevators and Escalators ; Female ; Heart ; Humans ; Incidence ; Intermittent Claudication ; Leg ; Low Back Pain ; Male ; Methods ; Pedicle Screws ; Postoperative Complications ; Spine ; Spondylolisthesis

The purpose of this study was to improve bone formation and shorten the period involved in distraction osteogenesis using sodium fluoride (NaF). This has been used in managing osteoporosis for several decades. This study was carried out on 40 New Zealand white rabbits. Twenty animals were used for a control group (no medication) and 20 for the experimental group. NaF 1 mg/kg/day was administered to each experimental animal via drinking water beginning 4 weeks prior to surgery and continued until sacrifice for examination. A distraction device was applied to the left mandible along a plane perpendicular to the direction of osteotomy. After a 5-day latent period, the mandibles were lengthened at 1 mm per 24 hours for 10 days. Five rabbits from each group were sacrificed on the 1st day, 2nd week, 4th week and 8th week of the consolidation period. After lengthening, all the rabbits developed a severe cross-bite. By the 4th week, cortical continuity was seen. Bone densities at the site of bony lengthening were measured by quantitative computer tomography (QCT) and dual X-ray absorptiometry (DXA). The results were as follows: the measurements of the experimental group were significantly higher than of the control group by the 1st day of the consolidation period (p>0.05) and insignificantly higher after the 2nd week. Histologically, in the experimental group, there were more osteoblasts, increased and thickened trabeculae and more mature lamellar bones than in the control group. This study showed that osteogenesis of the experimental group was significantly higher during and immediately after distraction. Our study suggested that the use of NaF could improve bone formation and decrease the period of distraction osteogenesis if a safe dose and method of fluoride administration can be determined for growing humans.
Absorptiometry, Photon ; Animals ; Bone Density ; Drinking Water ; Fluorides ; Humans ; Mandible* ; Osteoblasts ; Osteogenesis ; Osteogenesis, Distraction* ; Osteoporosis ; Osteotomy ; Rabbits* ; Sodium Fluoride* ; Sodium*

No abstract available.
Diabetes Mellitus* ; Humans ; Neutrophils* ; Superoxides*