The tibial plateau fracture is a fracture of the proximal end of the tibia, involving the articular surface and the supporting metaphysis of a major weight bearing joint. This fracture frequently accompanies soft tissue injury such as ligaments and menisci. So it often produces disability of the knee joint. Of the tibial plateau fractures which had been treated by open reductions at Keimyung University Hospital between May 1971 and December 1981, the 28 cases that were followed for 1 year to 3 years have been analysed according to its cause, classification, treatment and result. Open reduction is indicated in anyone with one or more of the following deformities as shown by roentgenograms: a compression greater than 6-8mm and a split greater than 5mm of the condyle. Anatomical considerations and a clinical end result study of the 28 fractures emphasize that the unacceptable results were from comminution of the fracture, associated soft tissue injury, osteoporosis, infection and other conditions that prevent early knee motion. Twenty-two cases (79 per cent) out of Twenty-eight revealed the rating of “ACCEPTABLE” according to Roberts criteria.
Classification ; Clinical Study ; Congenital Abnormalities ; Joints ; Knee ; Knee Joint ; Ligaments ; Osteoporosis ; Soft Tissue Injuries ; Tibia ; Weight-Bearing

Seven cases of traumatic fractured femoral heads with posterior dislocation of the hip were treated at the Keimyung University Hospital between November 1973 and December 1981. All cases were followed from 6 months to 8 years. Five cases were caused by traffic accidents. The other two cases were caused by a landslide. In six cases, at first a closed reduction was performed under general anesthesia and the femoral head was reduced in the acetabulum, but in 5 of the 6 cases head fragments were not reduced. So, after one or more days, open reductions were performed on the remaining 5 cases by internal fixation with iliac bone pegs (two-four). In the remaining one case of the 6, who had a head injury and an intestinal rupture, after the closed reduction, one head fragment was reduced but not anatomically. But because of his poor general condition, conservative treatment was taken. During conservative treatment redislocation and displacement of the head fragment occurred at the 4th week after the closed reduction was done. So this case was also treated by the above method. The 7th case, who has an ipsilateral femoral neck and intertrochanteric fracture, was reduced by primary open reduction. By the classification of the Pipkins, there were 4 cases of Type I and Type II, III and IV each had I case. The post operative X-ray and follow-up study showed that two were classified as excellent, four as good and the one who had the ipsilateral femoral neck and intertrochanteric fracture (Pipkin's Type III) was classified as poor.
Accidents, Traffic ; Acetabulum ; Anesthesia, General ; Classification ; Craniocerebral Trauma ; Dislocations ; Femur Head ; Femur Neck ; Follow-Up Studies ; Head ; Hip ; Landslides ; Methods ; Rupture

Radiographic measurement of cervical spine is very important in cervical spine injury especially those without fracture. Authors measured the retropharyngeal space, retrotracheal space, lordortic curve and sagittal diameter of cervical spinal canal in 148 cases of normal adult male. The results are as follows: 1 . In normal Korean adult male maximum retropharyngeal space is 7mm in C, level and Smm in Cs level. Maximum retrotracheal space is 16mm in C, level. 3. Loss of normal lordotic curve is shown in 21 cases(14.2%), 4. Average sagittal diameter of C, level is 21.27mm-it's the largest of all the cervical spinal cana1s, and that of C, level is 16.15mm-it's the smallest.
Adult ; Humans ; Male ; Spinal Canal ; Spine

42 knees with degenerative arthritis underwent arthroscopic lavage and 7 knees underwent arthroscopic lavage combined with multiple bone drilling in between 1994 and 1995 and followed average 12 months. Clinical evaluation using the hospita1 for specia] surgery knee scores (HSS scores) was done at last follow up and classified into 4 groups: excellent (90-99), good (80-89), fair (70-79) and poor (less than 70). The results were as follows: l. Of the 42 knees of the lavage group, 6 knees (16%) was excellent, 14 knees (33%) good, ]7 knees (40%) fair and 5 (11%) knees poor. Success group (Excellent & Good) were achived in 20 knees (49%). 2. Of 17 knees treated with arthroscopic lavage comhined with multiple bone drillig resulted in excellent in 9 knees (53%), good in 4 knees (23%), fair in 2 knees (12%) and poor in 2 knees (12%). Success group were achived in 13 knees (76%). 1n conclusion, we helieve that multiple bone drilling in conjunction with arthroscopic lavage has more favorable effect on the pain relief for degenerative osteoarthritis of the knee than arthroscopic lavage only.
Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis* ; Therapeutic Irrigation*

Renal allograft recipients are at risk for Pneumocystis carinii pneumonia (PCP) within the first year following transplantation and during treatment for graft rejection. We experienced two cases of PCP in renal allograft recipients. The first case was a 39-year-old female who had received renal allograft 7 years before. At the time of traosplantation, she was a carrier of hepatitis B surface (HBs) antigen. After transplantation, she had been received the rnaintenance dose of cyclosporine and oral prednisolone. Three months before adrnission, dosage of prednisolone was increased because of the increased serum creatinine level and gene-ralized edema. A week before admission, syrnptom of exertional dyspnea, dry cough, and fever was developed. Chest X-ray film showed streaky interstitial infiltration in both lung fields and chest CT showed diffuse ground-glass appearance. Rroncho- alveolar lavage revealed positive Grocott's methenamine silver stain for numerous clumps of pneumocystis carinii cysts. Despite the aggressive treatment, she died of respiratory and hepatic failure and GI bleeding. Another case was a 40-year-old male who had received renal allograft S years before. He had been received maintenance immune suppressive therapy with cyclosporine and oral prednisolone. He was admitted for evaluation of hypertension and elevated serum creatinine level. After several days of admission, he complained fever, dry cough and dyspnea. X-ray film showed pneumonic infiltration and the bronchial brushing and washing fluid revealed the Pneumocystis carinii cysts that were stained by methenamine silver. He was treated with the full dose of trimethoprim-sulfamethoxazole and clindamycin. Sacrificing the renal allograft, he recovered from Pneumocystis carinii pneumonia.
Adult ; Allografts* ; Clindamycin ; Cough ; Creatinine ; Cyclosporine ; Dyspnea ; Edema ; Female ; Fever ; Graft Rejection ; Hemorrhage ; Hepatitis B ; Humans ; Hypertension ; Liver Failure ; Lung ; Male ; Methenamine ; Pneumocystis carinii* ; Pneumocystis* ; Pneumonia, Pneumocystis* ; Prednisolone ; Therapeutic Irrigation ; Thorax ; Tomography, X-Ray Computed ; Transplantation ; Trimethoprim, Sulfamethoxazole Drug Combination ; X-Ray Film

A case of neurenteric cyst within the cervical canal is reported. He has been suffered from gradual aggravated quardriparesis since 4 months. On spine C-T scan and cervical myelographic examination, intradural extramedullary mass was detected. And so total laminectomy of C4, C5 and C6 was performed. We could diagnose by the pathological findings.
Laminectomy ; Neural Tube Defects* ; Spinal Canal* ; Spine

PURPOSE: The forehead flap is the workhorse in nasal reconstruction, which provides a similar skin color, texture, structure, and reliability. There are some disadvantages, including donor site morbidities, 2- or 3-stage operations, and postoperative management after initial flap transfer. Furthermore, there has been little attention to the exposed raw surface wound, after the first stage of an operation. This article describes the authors??modification to overcome this problem, using artificial collagen membrane. METHODS: An Artificial collagen membrane is composed of an outer silicone membrane and an inner collagen layer. After a forehead flap elevation, the expected raw surface was covered by an artificial collagen membrane with 5-0 nylon suture. A simple dressing, which had been applied to the site, was changed every 2 or 3 days in an outpatient unit. At 3 weeks postprocedure, a second stage operation was performed. RESULTS: With biosynthetic protection of the raw surface, there were no wound problems, such as infection or flap loss. Thus, the patient was satisfied due to an effortless management of the wound and a reduction in pain. CONCLUSION: The application of an artificial collagen membrane to the raw under-surface of the flap could be a comfortable and a protective choice for this procedure.
Bandages ; Collagen ; Forehead ; Humans ; Membranes ; Membranes, Artificial ; Nose Deformities, Acquired ; Nylons ; Outpatients ; Silicones ; Skin ; Surgical Flaps ; Sutures ; Tissue Donors

PURPOSE: The forehead flap is the workhorse in nasal reconstruction, which provides a similar skin color, texture, structure, and reliability. There are some disadvantages, including donor site morbidities, 2- or 3-stage operations, and postoperative management after initial flap transfer. Furthermore, there has been little attention to the exposed raw surface wound, after the first stage of an operation. This article describes the authors??modification to overcome this problem, using artificial collagen membrane. METHODS: An Artificial collagen membrane is composed of an outer silicone membrane and an inner collagen layer. After a forehead flap elevation, the expected raw surface was covered by an artificial collagen membrane with 5-0 nylon suture. A simple dressing, which had been applied to the site, was changed every 2 or 3 days in an outpatient unit. At 3 weeks postprocedure, a second stage operation was performed. RESULTS: With biosynthetic protection of the raw surface, there were no wound problems, such as infection or flap loss. Thus, the patient was satisfied due to an effortless management of the wound and a reduction in pain. CONCLUSION: The application of an artificial collagen membrane to the raw under-surface of the flap could be a comfortable and a protective choice for this procedure.
Bandages ; Collagen ; Forehead ; Humans ; Membranes ; Membranes, Artificial ; Nose Deformities, Acquired ; Nylons ; Outpatients ; Silicones ; Skin ; Surgical Flaps ; Sutures ; Tissue Donors

PURPOSE: To evaluate the radiologic findings of carotid-vertebrobasilar anastomosis and associated anomalies. MATERIALS AND METHODS: Thirteen patients with fourteen cases of carotid-vertebrobasilar anastomosis collectedfrom January 1992 to December 1997 were reviewed. Clinical diagnosis refered for cerebral angiography werecerebral infarction(n=3), intracranial hemorrhage(n=2), subarachnoid hemorrhage(n=1), brain tumor(n=3),arteriovenous malformation(n=3) and trigeminal neuralgia(n=1). Cerebral angiograms and clinical symptoms wereretrospectively analyzed. RESULTS: The fourteen carotid-vertebrobasilar anastomsis consisted of eleven cases ofpersistent trigeminal artery and three cases of type I proatantal intersegmental artery. Persistent trigeminalarteries were associated with anterior communicating artery aneurysm(n=1), posterior fossa arteriovenousmalformation(n=2) and persistent trigeminal artery variant(n=5). Type I proatantal intersegmental arteries wereassociated with hypoplastic vertebral arteries(n=2) : only proximal segment in one, and proximal and distalsegments in one case. Only one patient had clinical symptom related to the carotid-vertebrobasilar anastomosiswhich was trigeminal neuralgia. CONCLUSION: Knowledge of the anatomical and radiologic findings ofcarotid-vertebrobasilar anastomosis and associated anomalies will aid in the accurate diagnosis of neurovasculardisease and prevent possible complications during surgical and interventional procedures.
Arteries ; Brain ; Cerebral Angiography ; Diagnosis ; Humans ; Trigeminal Neuralgia

PURPOSE: Placement of an arteriovenous fistula (AVF) before initiation of chronic hemodialysis (HD) is recommended to avoid the use of a dialysis catheter. However, many patients use temporary catheter at the start of HD for many reasons. We conducted a study to examine the reasons for use of temporary catheter instead of AVF at initial HD therapy. METHODS: We investigated 61 chronic renal failure (CRF) patients who started HD from January 2001 to August 2004 at Daegu Fatima Hospital. Fourty one of them used temporary catheter (catheter group) and 20 used AVF (AVF group) at initial HD. The causes of CRF, clinical presentation at initial HD, reasons that required start of HD and reasons for use of temporary catheter were investigated. RESULTS: The reasons that required start of HD were dyspnea (23), uremic symptoms (11), severe edema (4) and metabolic abnormalities (3) in catheter group and uremic symptoms (8), progression of CRF with minimal uremic symptoms (8) in AVF group. Those causes of unpreparedness of AVF in catheter group were delayed referral (12), rapid progression of CRF (12), unawareness of CRF (10), and noncompliance (7). The systolic and diastolic blood pressure were higher in catheter group than AVF group (171.3+/-33.5 vs 146.0+/-18.0 mmHg, 94.0+/-18.5 vs 80.6+/-10.8 mmHg, respectively). Serum albumin level was lower (3.0+/-0.6 vs 3.4+/-0.7 g/dL) and serum phosphorus level was higher (6.8+/-1.9 vs 5.7+/-1.7 mg/dL) in catheter group. CONCLUSION: To avoid temporary vascular catheter, early diagnosis of CRF, early referral to nephrologist and preparation of AVF is essential.
Arteriovenous Fistula* ; Blood Pressure ; Catheters* ; Daegu ; Dialysis ; Dyspnea ; Early Diagnosis ; Edema ; Humans ; Kidney Failure, Chronic ; Phosphorus ; Referral and Consultation ; Renal Dialysis* ; Serum Albumin ; Vascular Access Devices