A clinical study of the tibial fracture was made on patients, total 234 tibias, who were treated at the Department of Orthopedic Surgery, Paik Hospital, Inje Medical College from 1974 to 1979. The results were as follows: 1. The ratio between male and female was 5. 5: 1 and majority was found between 3rd decade and 5th decade. 2. In the shape of fracture, commiuted fracture, transverse fracrure were common in order. 3. The most common cause of these fractures was traffic accident and the ratio between open and closed fracture was 1:2. 4. The most common associated injury was the fibular fracture. 5. More complications ensued in open reduction and internal fixation than in closed reduction. of 50 cases, which were treated by open reduction and internal fixation, delayed union in 32 cases (64%) and infection in 11 cases (22%) resulted. 6. In the treatment of open comminuted tibial fractures with skin and soft tissue loss or marked displacement, Hoffmans external fixation method and pin and resin external fixation method bad good results, Early motion of adjacent joint, easy care of wound and rigid fixation were obtained by it.
Accidents, Traffic ; Clinical Study ; Female ; Fractures, Closed ; Humans ; Joints ; Male ; Methods ; Orthopedics ; Skin ; Tibia ; Tibial Fractures ; Wounds and Injuries

Giant cell tumor of the spine is a rare and potentially malignant condition which presents rather difficult clinical problems in treatment because of their localization and unpredictable clinical course. Authors experienced a case of giant cell tumor involving third lumbar vertebra which was successfully treated by ea bloc resection and anterior interbody fusion of the adjoining vertebrae with iliac bone graft. At eighteen months follow up, there is no evidence of recurrence and solid union of the bone graft was noted.
Follow-Up Studies ; Giant Cell Tumors ; Giant Cells ; Recurrence ; Spine ; Transplants

PURPOSE: To assess the efficacy of ancillary CT findings other than the obstructive lesion per se for the differential diagnosis of extrahepatic biliary obstruction. MATERIALS AND METHODS:CT findings of 49 patients with extrahepatic bile duct obstruction(22 benign and 27 malignant lesions) were assessed with emphasis on the patterns of ductal dilatation, contrast enhancement, and diffuse thickening of the extrahepatic ductal wall. Degree of central and peripheral intrahepratic ductal dilatation was graded by comparing with the adjacent portal radicles and hepatic parenchymal thickeness. RESULTS: Diffuse circumferential thickening and contrast enhancement of the extrahepatic ductal wall were more frequent in benign cases, but only thickening was statistically significant(p < 0.01). Peripheral intrahepatic ducts were more severely dilated by malignant causes(p < 0.01). With the same degrees of extrahepatic and central ductal dilatations, peripheral intrahepatic ducts were more severely dilated in malignant than in benign cases. CONCLUSION: These results may help to interpret the CT findings of extrahepatic biliary obstruction, particularly when the cause of biliary obstruction is uncertain.
Bile Ducts, Extrahepatic ; Diagnosis, Differential ; Dilatation* ; Humans

We present a case of recurrent left atrial myxoma which occurred 7 years and 10 months after initial operation despite resection of originaltumor and adjacent atrial septum. This is the first case report of recurrence in Korea. Among the possible causes of recurrence, regrowth from pretumorous focus seems to be the most suggesting one in this case. Histopathologic findings of recurrent myxoma showed increased cellularity with active proliferation and nuclear hyperchromasia. These findings, together with the rapidity of regrowth, suggest that recurrent myxoma may have 'wilder' behavior. Prolonged postoperative observation is important, even if ample resection was done at the initial operation including atrial septum.
Atrial Septum ; Korea ; Myxoma* ; Recurrence*

BACKGROUND AND OBJECTIVES: Hypothyroidism is a well recognized complication of radiotherapy and surgery in the treatment of head and neck cancer, especially laryngo-hypopharyngeal cancer. Several studies were undertaken to determine the thyroid stimulating hormone (TSH) levels in the population of patients with head and neck cancer, to better characterize clinical factors in the eventual elevated TSH levels. We evaluated the incidence and related factors of hypothyroidism following radiotherapy, surgery and combined treatment for laryngeal and hypopharyngeal cancer. MAERIALS AND METHODS: Forty-four patients who had been treated for laryngeal and hypopharyngeal cancer were divided into three groups according to the types of treatment they received: radiotherapy alone, surgery with partial thyroidectomy, surgery with partial thyroidectomy and postoperative radiotherapy. TSH and free thyroxin (T4) level were examined before and after the treatment. We analyzed the differences according to clinical factors and treatment modalities. RESULTS: The TSH level was higher in hypopharyngeal cancer than in laryngeal cancer (p>0.05). In the advanced stage and during longer follow-up periods, the TSH level were elevated (p<0.05). In patient with combined treatment modalities, the TSH level was higher than in patients who received radiotherapy or surgery alone (p<0.05). CONCLUSION: We concluded that hypothyroidism frequently develops following treatment for laryngeal and hypopharyngeal cancer even when thyroid resection has not been performed. Patient should be evaluated postoperatively and carefully monitored by means of serial thyoid function test.
Follow-Up Studies ; Head and Neck Neoplasms ; Humans ; Hypopharyngeal Neoplasms ; Hypothyroidism* ; Incidence ; Laryngeal Neoplasms ; Radiotherapy ; Thyroid Function Tests ; Thyroid Gland ; Thyroidectomy ; Thyrotropin ; Thyroxine

In literatures, most of the studies of severe hyponatremia during or following its treatment has been concentrated with special references to the rate of correction and its neurologic outcomes. But, there is relatively few ones analyzing the diverse clinical manifestations of neurologic symptorns or complications during the course of treating severe hyponatremia. We experienced a catastrophic course related to hyponatremia in a 51 year woman with severe rheumatoid arthritis, who underwent knee joint replacement, and this case revealed the initial transient neurologic recovery for 3 days by the initial rapid correction of hyponatremia, then followed by delayed deterioration of osmotic demyelination syndrome leading to locked-in syndrome. Reported cases with similar clinical course (biphasic course) in the world lituratures were reviewed with special interests in the initial maximum rate of correction of hyponatremia and radiologic findings. This review suggests that clinicians treating the patients with severe symptomatic hyponatremia should be aware of the possibility of delayed neurologic sequelae despite the recovery of neurologic status as well as the degree of hyponatremia in the early treatment course of hyponatremia.
Arthritis, Rheumatoid ; Demyelinating Diseases* ; Female ; Humans ; Hyponatremia ; Knee Joint ; Quadriplegia

PURPOSE: To determine the MRI features which distinguish complete and partial tear of the anterior cruciate ligament (ACL) and to thus improve MRI interpretation. MATERIALS AND METHODS: In 80 patients, we analyzed MR findings of direct and indirect signs of ACL tear (complete tear, 61 cases, partial tear, 19 cases) confirmed by arthroscopy or surgery, and compared the relative incidence of each sign in cases of complete and partial tear. RESULTS: Direct and indirect signs were found in 61 (100%) and 60 cases (98.4%), respectively, in complete tears, but in 16 (84.2%) and 15 cases (78.9%), respectively, in partial tears. Poor visualization, discontinuity and hyperintensity were seen in all complete tears but in only nine case (47.4%) of partial tear. A wavy or abnormal contour was seen in 53 cases (86.9%) of complete tear and 14 (73.7%) of partial tear. A wavy contour without other direct signs was seen in only five cases (26.3%) of partial tear. Three cases (15.8%) of partial tear showed normal MR finding. Indirect signs, i. e. abnormal ACL angle, abnormal ACL-Blumensaat line angle, abnormal posterior cruciate ligament (PCL) line, abnormal PCL angle, PCL buckling, anterior displacement of tibia, posterior displacement of lateral meniscus, bone bruise, Segond fracture, tear of collateral ligaments, PCL, and tear of meniscus were commoner in complete than in partial tears. Two cases of O'Donoghue's triad and two of popliteus injury were seen only in complete tears. CONCLUSION: Direct and indirect signs of ACL tear were more commonly noted in complete than in partial tears. The latter showed MR features varying from normal to almost complete tear. We suggest that a wavy contour other direct signs is indicative of a partial tear, and that O'Donoghue's triad and popliteus muscle injury are indirect signs of a complete tear.
Anterior Cruciate Ligament* ; Arthroscopy ; Collateral Ligaments ; Contusions ; Humans ; Incidence ; Magnetic Resonance Imaging ; Menisci, Tibial ; Posterior Cruciate Ligament ; Tibia

BACKGROUND AND OBJECTIVES: E-cadherin and catenins (alpha, beta, gamma, p120cat) are important epithelial adhesion molecules in normal epithelial cells. Loss of E-cadherin-catenin adhesion is an important step in the progression of epithelial cancers such as tongue cancer. E-cadherin and catenins expression in carcinoma of human tongue was evaluated in relation to their clinicopathological features and prognostic values. SUBJECTS AND METHOD: Thirty-nine specimens of tongue squamous cell carcinoma were examined in this study. These patients were all treated by primary surgery without prior radiotherapy or chemotherapy. The specimens of formalin-fixed and paraffin-embedded tumor tissues were investigated by immunohistochemical analysis using E-cadherin and catenin (alpha, beta, gamma, p120cat) monoclonal antibodies. RESULTS: The expressions of E-cadherin, alpha-catenin, beta-catenin, gamma-catenin and p120cat in cell membranes were reduced or absent in 71.8%, 74.4%, 76.9%, 59.0% and 82.1% of the tumors examined, respectively. The reduced expressions of alpha-catenin and gamma-catenin in the cell membranes was cor-related with tumore differentiation (p=0.018, p=0.004, respectively). There were significant correlations between E-cadherin and expressions of the four cantenins in the cell membranes of tongue cancer. There were no correlations between beta-catenin and p120cat expression in the cytoplasm, cell nucleus and clinicopathological features. There was significant correlation between E-cadherin expression and Kaplan-Meier survival curves. CONCLUSION: These results suggest that E-cadherin and catenins (alpha, beta, gamma, p120cat) can be used as prognostic markers of human tongue squamous cell carninoma. The result of beta-catenin and p120cat absence in the nucleus suggests that Wnt/Wingless signaling or Kaiso transcription did not occur in the human tongue squamous cell carcinoma.
alpha Catenin ; Antibodies, Monoclonal ; beta Catenin ; Cadherins* ; Carcinoma, Squamous Cell ; Catenins ; Cell Membrane ; Cell Nucleus ; Cytoplasm ; Drug Therapy ; Epithelial Cells ; gamma Catenin ; Humans ; Kaplan-Meier Estimate ; Prognosis ; Radiotherapy ; Tongue Neoplasms* ; Tongue*

Anesthesia, General ; Animals ; Azaperone ; Durapatite ; Humans ; Osteoblasts ; Osteogenesis ; Polyethylenes ; Polypropylenes ; Seeds ; Swine