It is not infrequent to observe the reeurrence of the Bakers cyst. Recurrence of the cystic lesions are more frequent in wide based type than in pedicle type due to difficult ,identification and inadequate eradication of the cyst wall. We injected methylene blue into the cyst after aspiration of the fluid. Blue stained wall enables the surgeons to idendify the whole inner surface of the cyst, and lessens the chance of missing a portion of it. We could reduce the recurrence rate near to zero percent after adopting this technique upto now. Broad based type is more prone to recurr and the whole recurred five cases were belong to this type.
Arthroscopy ; Humans ; Knee ; Methylene Blue ; Popliteal Cyst ; Recurrence ; Surgeons

In traumatic knee dislocation, vascular injury is one of the most serious complication. After pertinent management of acute vascular problems, we should take care of the ligamentous injury involving both the ACL and PCL which are the main causes of knee instability, and consequent traumatic degenerative changes. No standard technique of reconstruction has been reported concerning these ligamentous injuries up to now as far as we know. Authors tried a new management which reconstruction was done simultaneously on both the ACL and PCL injuries. Bone-Achilles tendon autograft was used as PCL substitute in all the cases, and which turned out to be a very efficient one for the control of anterior-posterior displasement as well as rotary instability. Bone-patellar tendon-bone autograft or bone-Achilles tendon autograft was good for the reconstruction of the ACL bone-patellar tendon-bone in two cases, bone-Achilles tendon in two cases, and semitendinosus tendon also in two cases. After 6 months of operation, all the patient returned to the previous level of walking without crutches. This management showed outstanding results in terms of knee stability and subjective symptoms.
Achilles Tendon ; Autografts ; Crutches ; Dislocations ; Humans ; Knee Dislocation ; Knee Joint ; Knee ; Ligaments ; Posterior Cruciate Ligament ; Tendons ; Vascular System Injuries ; Walking

One hundred and forty eight cases of tennis elbow were treated by conservative managements firstly such as rest, medication, immobilization, physical therapy and/or local steroid injection, from Jan. 1985 to Jun. 1994 at Department of Orthopaedic Surgery, National Medical Center. Among the 148 cases, 16 cases who failed conservative managements, were treated with Nirschl & Pettrone operation. The results were summarized as follows, 1. Among the 148 cases, 110 cases(74%) were female, and 61 cases(41.2%) were in the age group 41 to 50 years old, and mean age was 42.3 years old. 2. Ninty nine cases were housewives and only 15 cases were related to sports. 3. The conservative results of one hundred and sixteen patients were graded excellent and good; and of thirty two patients, fair and failure. 4. The operative results of seven patients were graded excellent; of three, good; of four, fair; and of two, failed. 5. Recurence was developed in 18 cases(12.2%), and we obtained excellent and good result in 17 cases with both conservative and operative treatment. Above results suggest that the term, tennis elbow is a misnomer because it occurs more commonly in non-athletes such as housewives than in tennis players. So it seems to be an occupational disease rather that sports injury. Now, we propose to eliminate of the term of tennis elbow and to substitude with new terminology that describes the true understanding and therapeutic orientation of it.
Athletic Injuries ; Female ; Humans ; Occupational Diseases ; Restraint, Physical ; Sports ; Tennis Elbow ; Tennis

Although the incidence of leprosy is decreased considerably, the deformity and disability of it is serioues. In the hand, combined median and ulnar nerve affection is most common, and it leads to many problems including opposition dysfunction and claw hand deformity. And opposition dysfunction is most significant disability in the hand function, so its correction or reconstruction is mandatory We performed 20 cases of opponensplasty from Oct. 91 to Apr. 94 at National Medical Center, and analyzed its results according to new assessment criteria invented by authors, and evaluated the efficacy of the operative treatments. The results were as follows: 1. The patients were 9 males and 11 females, average age was 48 years old, and average duration of paralysis was 28 years. The mean follow-up period was 2.8 years. And most common type of nerve affection was combined low median and high ulnar nerves. 2. We performed 18 cases of Burkhalter opponensplasty using extensor indicis proprius and 2 cases of Riordan opponensplasty using ring finger sublimis at the leprosy hands. 3. According to authors assessment criteria for leprosy hand, the result of operative treatment was excellent in two, good in ten, fair in seven, and poor in two patients. So we obtained more than good results in 50% patients. 4. We could obtain good result with Burkhalter opponensplasty in leprosy hand, especially when combined with proper preoperative physical therapy and adjuvant operation for release of contracture and joint stiffness.
Animals ; Congenital Abnormalities ; Contracture ; Female ; Fingers ; Follow-Up Studies ; Hand ; Hand Deformities ; Hoof and Claw ; Humans ; Incidence ; Joints ; Leprosy ; Male ; Paralysis ; Tendon Transfer ; Ulnar Nerve

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare and recently recognized disease of unknown etiology, characterized by remission and exacerbation of multiple bone lesions which radiologically and pathologically have the appearance of hematogenous osteomyelitis. The natural history appears to be slow and spontaneous resolution of the osseous lesions without specific treatment. And antimicrobial agents seem to have no beneficial effect. In proper clinical setting, CRMO should be considered, because recognition of this entity would help us to avoid costly and potentially harmful diagnostic and therapeutic interventions. We report a case of a 48-year-old adult who had chronic recurrent multifocal osteomyelitis.
Adult ; Anti-Infective Agents ; Humans ; Middle Aged ; Natural History ; Osteomyelitis

Altough neurovascular injury following clavicular fracture is significant problems, the incidence is low. Furthermore authors have not be able to find a report which describes subclavian artery injury as a sequela of operative treatment with a screw. We are reporting the case with compression of the subclavian artery by an inadequately long screw, emphasizing the importance of proper technique in implantation.
Incidence ; Subclavian Artery ; Thrombosis

We treated the 90 wrists (83 patients) with de Quervain's disease, and studied retrospectively the factors affecting the result of treatment, and the results of several treatment modalities, compared with published series of this disease. There was significant association between outcome and duration of symptoms before treatment, but age, sex, associated disease, and hand dominance were not associated(chi-square test, p < 0.05). And 75 wrists received single injections of steroid and local anesthetic into the tendon sheaths with complete pain relief in 59 wrists (69%). Furthermore, an additional injection gave pain abatement in 6 wrists. And regardless of treatment method, 95% of the whole patients had satisfactory outcome at a mean of 54 months (minimum follow-up, 45 months). We concluded that injection of steroid is the preferred initial treatment in de Quervain's disease, giving complete and lasting relief in 87% of cases.
De Quervain Disease ; Follow-Up Studies ; Hand ; Humans ; Methods ; Retrospective Studies ; Tendons ; Wrist

In this article, Table 1's data was given incorrectly. Metodopramide should be corrected as Metoclopramide.

BACKGROUND: Because of the common etiologic factor, such as smoking, lung cancer and chronic obstructive Pulmonary disease are often present in the same patient. The preoperative prediction of remaining pulmonary function after the resectional surgery is very important to prevent serious complication and postoperative respiratory failure. 99mTc-MAA perfusion scan has been used for the prediction of postoperative pulmonary function, but it may be inaccurate in case of large V/Q mismatching. We compared 99mTc-DTPA radioaerosol inhalation scan with 99mTc-MAA perfusion scan in predicting postoperative lung function. METHOD: Preoperative inhalation scan and/or perfusion scan were performed and pulmonary function test were performed preoperatively and 2 month after operation. We predicted the postoperative pulmonary functions using the following equations. Postpneumonectomy FEV1=Preop FEV1x% of total function of lung to remain RESULTS: 1) The inhalation scan showed good correlations between measured and predicted FEV1, FVC and FEF25-75%. (correlation coefficiency; 0.94, 0.91, 0.87 respectively). 2) The perfusion scan also showed good correlations between measured and predicted FEV1, FVC and FEF25-75%. (correlation coefficiency; 0.86, 0.72, 0.97 respectively). 3) Among three parameters, FEV1 showed the best correlations in the prediction by lung scans. 4) Comparison between inhalation scan and perfusion scan in predicting pulmonary function did not show any significant differneces except FVC. CONCLUSION: The inhalation scan and perfusion scan are very useful in the prediction of postoperative lung function and don't make a difference in the prediction of pulmonary function although the former showed a better correlation in FVC.
Humans ; Inhalation* ; Lung ; Lung Neoplasms ; Perfusion* ; Pulmonary Disease, Chronic Obstructive ; Respiratory Function Tests ; Respiratory Insufficiency ; Smoke ; Smoking

"The prenatal diagnosis of spine bifida include the combined use of maternal serum alpha-fetoprotein (MSAFP) screening and fetal sonography. Sonographically, spina bifida is characterized by direct signs of the visualization of the spinal defect, and indirect signs of the cranial markers : the lemon sign, the banana sign, and ventriculomegaly. These ultrasonographic signs are more accurate in defining the cranial malformations associated with spina bifida than evaluation of the spine. Recently, three cases of spina bifida which was diagnosed as ""splaying"" of the posterior ossification centers, meningomyelocele sac at the lumbosacral area, lemon sign, banana sign and ventriculomegaly by ultrasonography at 21+2 gestational weeks in a 32 years old nullipara, at 21+2 gestational weeks in a 26 years old nullipara, at 23+6 gestational weeks in a 26 years old multipara were experienced at our department. We present this cases with a brief review of literatures"
Adult ; alpha-Fetoproteins ; Humans ; Mass Screening ; Meningomyelocele ; Musa ; Prenatal Diagnosis ; Spinal Dysraphism* ; Spine ; Ultrasonography