PURPOSE: Patients with bladder pain syndrome/interstitial cystitis (BPS/IC) can have pain as a main symptom and overactive bladder (OAB) symptoms that are directly or indirectly related to a major mechanism that causes pain. The primary purpose of this study is firstly to identify the prevalence rate of OAB symptoms in patients with BPS/IC, secondly to identify changes in OAB symptoms after low-dose triple therapy, and thirdly to build a theoretical foundation to improve quality of life for patients. METHODS: Patients who met the inclusion criteria of BPS/IC through basic tests including the O'Leary-Sant symptom index, overactive bladder symptom score (OABSS), and visual analog scale (VAS) were identified. Treatment-based changes in OAB symptoms were identified using the IC Symptom Index and IC Problem Index (ICSI/ICPI), OABSS, and VAS before, and 4 and 12 weeks after low-dose triple therapy. RESULTS: The patients consisted of 3 men and 20 women, and their mean age was 61.9 years (41.0-83.2 years). Comparing values before treatment, and 4 and 12 weeks after treatment (baseline vs. 4 weeks to baseline vs. 12 weeks), the rates of improvement were as follows: ICSI, 44.2% to 63.7%; ICPI, 46.9% to 59.4%; OABSS, 34.3% to 58.2%; and VAS, 53.6% to 75.0%, which showed statistically significant differences (P<0.05). However, comparing values at 4 and 12 weeks after treatment (4 weeks vs. 12 weeks), the ICSI and VAS showed a statistically significant decrease (P<0.05). The ICPI and OABSS showed slight improvement, but no statistically significant differences (P>0.05). CONCLUSIONS: Low-dose triple therapy in BPS/IC results in a clear decrease in OAB symptoms in the first 4 weeks after treatment, and additional treatment for 8 weeks had a partial effect with varied statistical significances depending on the questionnaires.
Amines ; Amitriptyline ; Cyclohexanecarboxylic Acids ; Cystitis ; Cystitis, Interstitial ; Female ; gamma-Aminobutyric Acid ; Humans ; Male ; Prevalence ; Quality of Life ; Sperm Injections, Intracytoplasmic ; Urinary Bladder ; Urinary Bladder, Overactive

Animal experiment was carried out to measure the physiologic changes of thoracic or thoracolumbar spine that occurred as a result of electrical stimulation, and to evaluate the usefulness of electrical stimulation as a possible treatment for scoliosis. Unilateral electrical stimulations were applied to the back muscle of immature rabbits.They were subgrouped into medial, intermediate, and lateral muscle stimulated groups in order to observe the effects of various electrode placements. The radiograms were taken every other week to observe the changes of the spinal curvatures for the period of 12 weeks. The histological studies of the muscles, which were obtained from the stimulated(right) and the nonstimulated(left) sides at the same level, also were carried out to determine the response of the muscles to the electrical stimulation. The results were as follows. l. A significant scoliotic curvature was observed two weeks after electrical stimulation, and those curvatures did not change more for the next six weeks in spite of prolonged stimulation. 2. Scoliotic curvature induced by electrical stimulation for eight weeks remained unchanged for another four weeks after stopping stimulation. 3. There were no statistical differences in the induced scoliotic curvature among the three groups stimulated at different sites of the medial, intermediate, and lateral regions respectively. 4. A prolonged unilateral electrical stimulation could induce the scoliosis, and may be used as a method for treatment of scoliosis.
Animal Experimentation ; Back Muscles ; Electric Stimulation ; Electrodes ; Methods ; Muscles ; Scoliosis ; Spinal Curvatures ; Spine

Fracture dislocation or dislocation of the knee can produce a popliteal artery injury that may be difficult to evaluate clinically. Diagnosis of disruption or thrombosis of the popliteal artery is frequently delayed until the opportunity to salvage the extremity is lost. 22 cases of popliteal artery injury were reviewed from July 1978 to December 1983, associated with severe knee trauma at the Orthopaedic department of Kyung Hee University Hospital, of whom average follow-up for about 52 months. The results obtained were as follows; 1. In all 22 cases, 14 cases (63. 6%) were amputated. The amputation rate was correlated with ischemic time after injury. 2. Resection of all injuried vessels with reconstitution of continuity by the use of an interposed saphenous vein graft is often warrented to avoid tension. 3. All 8 patients, which was managed conservatively, were amputated in all cases(100%). In cases of suspicious popliteal artery injury, early aggressive exploration and obvious microvascular reconstruction should be mandatory. 4. Subperiosteal fibulectomy-fasciotomy should be done routinely immediately after vascular injury. 5. Diagnosis of popliteal artery injury was based on the clinical findings but the capillary filling was not contributary. 6. The use of Doppler flowmeter and emergency arteriography was recognizedtobeanexcellent methods in determination of arterial injury.
Amputation ; Angiography ; Capillaries ; Diagnosis ; Dislocations ; Emergencies ; Extremities ; Flowmeters ; Follow-Up Studies ; Humans ; Knee ; Popliteal Artery ; Saphenous Vein ; Thrombosis ; Transplants ; Vascular System Injuries

Chordomas are maligaant tumors which arise in the remnants of the embryonic notochord, and exhibit a definite predilection for the extremes of the spinal axis, the great majority arising either in the basioccipital or in the sacrococcy geal regions. Particularly, complete surgical removal is almost impossible, therefore, local recurrence after the surgical removal of this tumor is common or rule. This report describes a csse of chordoma arising sacrococcygeal region treated with block resection.
Chordoma ; Notochord ; Recurrence ; Sacrococcygeal Region

The development of a safe method of transfer of the greater toe for thumb reconstruction, using dorsalis pedis artery and the great saphenous vein, suggested the possibility of one stage microvascular transfer of the second toe for reconstruction of surgery. Based upon our part experience with microsurgical experiments, limb transplantation and toe-to-thumb transplantation since 1975, we accomplished the second toe-to-index transplantation done in Korea on October 24, 1979, and succeeded in one stage second toe-to-index transplantation in two cases. Following results were obtained. I. Free second toe-to index transplantation on making a index is the most excellent method of index reconstruction with results in minimum functional and cosmetic impairment. 2. Technically, skin incision, isolation of blood vessels and flexor tendon in preparation for transplantation of second toe is more difficult than that of greater toe. 3. The specialized microsurgical training with skillful technique is essential for success.
Arteries ; Blood Vessels ; Extremities ; Korea ; Methods ; Microsurgery ; Saphenous Vein ; Skin ; Tendons ; Thumb ; Toes

Great strides has been made in the past 20 years in the treatment of scoliosis. Treatment before scoliosis becomes severe eliminates the need for extensive surgery. Early detection of scoliosis by school screening has proven to be valuable for early diagnosis and prevention of severe deformities. Authors screened 5,256 middle and high school students in Seoul, who were chosen arbitrarily, to determine the incidence rates of scoliosis, and following results were obtained. 1. Scoliosis was diagnosed on a combination of at least one positive physical sign and a lateral curvature more than 5 degrees on an antero-posterior standing X-ray. 2. The overall incidence of scoliosis was 4.68% (Male 0.74%, Female 6.43%). 3. Idiopathic scoliosis was found in 238 students, congenital scoliosis in 5, and paralytic scoliosis in 3. 4. The most common pattern of curvature was thoracic curve. 5. In the single curve right to left ratio was 2.1, but 8.4 in the upper curve of double curve. 6. Close observations were required for all the 246 students and treatment was required in 14 students who had more than 20 degrees, 9 students for Milwaukee brace, and 5 students for surgical correction.
Braces ; Congenital Abnormalities ; Early Diagnosis ; Female ; Humans ; Incidence ; Korea ; Mass Screening ; Scoliosis ; Seoul

A clinical study of the Tibial Shaft fracture was made on 128 patients, who had been treated at the Department of Orthopedic Surgery, College of Medicine Kyung Hee Universlty from the October, 1971 to May, 1979. The results were as follows: 1. The rate of fracture union was accelerated under the age of 20 years but it was slow in aged group. 2. The poor prognosis of fracture union was shown in junction between middle and distal 1/3 than others. 3. The better prognosis of the fracture type was shown in oblique and spiral fracture than in the comminuted and segmental. 4. There was prolonged rate of union in case of associated fibula fracture. 5. The frequency of delayed and nonunion were more prevalent in open fracture. 6. Among the open comminuted tibial shaft fracture with skin and soft tissue loss, the good results was obtained by the Hoffmanns external skeletal fixation method.
Classification ; Clinical Study ; Fibula ; Fracture Fixation ; Fractures, Open ; Humans ; Methods ; Orthopedics ; Prognosis ; Skin

Fifty-seven cases of non-union examined and treated at Department of Orthopedic Surgery, Seoul National University Hospital during the period of 1968 to 1979 were observed and analysed. The results were summarized as follows: 1. Of the 57 cases,there were 43 male and 14 female patients. This result showed marked predominence of male over female patients. 2. Non-unions most commonly occured between 21 and 40 of age. 3. The causes of the fractures consisted of 22 traffic accidents, 20 fallings, 7 machinery injuries, 6 direct blows, and 2 chronic osteomyelitis. 4. Of the 57 cases, there were 20 open fractures and 37 closed fractures. 5. The sites of nonunion were lower extremities in 41 cases and upper extremities in 16 cases. The femur, 31 cases, was most commonly involved. 6. The mean duration from fracture to diagnosis of non-union was 14.8 months. 7. Prior to admission to this hospital, one received no treatment at all, 23 were treated conservatively, and the remaining 33 treated operatively. 8. Probable causes of the nonunions were unsatisfactory immobilization in 26 cases, operative complications in-24, infections in 3, interpositions of the soft tissues in 3, and separations of fragments in 1. 9. All patients received surgical operations, which were successful in 87.7%.
Accidents, Traffic ; Diagnosis ; Female ; Femur ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Lower Extremity ; Male ; Orthopedics ; Osteomyelitis ; Seoul ; Upper Extremity

The result of interference with the conductibility of the spinal cord is one of the most disabling and distressing complications of splnal tuberculosis. This fact was recognized as early as in 1779, when Pott published. The antituberculous drugs and improved surgical treatment have made possible a more effective treatment than before and improved the prognosis but not solved all problems completely. The following results were shown by analysis of 63 cases of spinal tuberculosls with neurological symptom experienced in the Department of Orthopedic Surgery, Seoul National University in the past 9.5 years from Jan. 1970 to Jun. 1979. 1. Number of cases In child was 15. (29%). 2. Pulmonary and other tuberculous diseases were manifested in 29 cases (46%). 3. Regions of the spine inovolved were most common In thoracic spine (43 cases), especially lower thoracic spine. 4. There were 49 early and 14 late paraplegia 5. There were 24 complete and 39 incomplete paraplegia. 6. Spastic type was more common than flaccid type. 7. Anterior fusion was done in 55 cases and costotransversectomy in 8. 8. There were 36 cases (57%) of complete recovery and 8 of fallure. 9. The prognosis for recovery from paraplegia appeared to depend on age, duration, type and onset of paraplegia.
Child ; Humans ; Muscle Spasticity ; Orthopedics ; Paraplegia ; Prognosis ; Seoul ; Spinal Cord ; Spine ; Tuberculosis ; Tuberculosis, Spinal

As trochanteric fractures frequently occur in the elderly patients and complications such as pneumonia, thrombo-embolic disease, decubitus ulcer, and urinary tract infection are common, early mobilization after open reduction and internal fixation with hip nail are the standard treatment. Since 1931 when Smith-Peterson first introduced a tri-flanged nail, further more, since 1941 when Jewett pioneered the one-piece nail by adding a solid plate to a Smith-Peterson nail, numorous implants including threaded pins, screws, nails, and plates have been modified and desiged for fractured hips till now to achieve early ambulation and to maintain stable reduction. In 1955 Pugh and Ken introduced a sliding nail-plate and Schumpelick described the use of sliding screw-plate, which was modified further by Callender and Holt pioneered the concept of heavy nail in 1963. Recently compression sliding screw-plate is popular. Also many surgeons such as Evans, Dimon and Hughston, Sarmiento, and Boyd and Anderson have attempted to provide stable fixation of fracture by altering the position of fracture fragments to improve the mechanical resistances of bone to disruptive forces of weight-bearing. The surgical procedures of open reduction and internal fixation were carried out and followed for more than 6 months on 45 intertrochanteric fractures at Department of Orthopedic Surgery, Seoul National University Hospital, from Jan. 1968 to June. 1975 and the results were observed as follows. 1. Of 45 cases of inter-trochanteric fractures 28 cases occurred in man, 17 cases in woman and each mean age was 54 years in man, 74 years in woman. 2. Of fixation devices, Smith-Peterson nail-plates were used in 19 cases, Jewett nails in 15 cases, compression sliding screw-plates in 9 cases, Smith-Peterson nail in 1 case, and Ken sliding nail-plate in 1 case. 3. Stable fractures occurred in 10 cases were fixed internaly after anatomical reduction. 4. Dimon-Hughston reductions and Jewett Nailing were achieved in 11 cases of 12 unstabIe fractures and had disadvantages such as some limitation of R.O.M. of the affected hip, shortening, and valgus deformity. 5. Of 9 unstable fractures treated by compression sliding screw-plate 7 cases were reduced as anatomicaly as possible and 2 cases were reduced non-anatomicaly because of impossible anatomical reduction but good results were obtained except one failed nailing. 6. Of 7 failures, 6 cases resuIted from failures of nailing during operation and only 1 failure resulted in varus defermity after Dimen-Hughston reduction with Jewett nail.
Aged ; Congenital Abnormalities ; Early Ambulation ; Female ; Hip ; Hip Fractures ; Humans ; Orthopedics ; Pneumonia ; Pressure Ulcer ; Seoul ; Surgeons ; Urinary Tract Infections ; Weight-Bearing