Fracture and Dislocation of Cervical Spine / 대한정형외과학회잡지

There was increasing tendency to stabilize unstable cervical spine injuries surgically with the benefit of good stability of the spine, easy nursing care, early mobilization and therefore early rehabilitation. A clinical study was performed on 47 patients with fractures and dislocations of the cervical spine treated at the department of orthopedic surgery, Inje Medical College, Paik Hospital from Jan. 1975 to Dec. 1981. Following is the summery of the our findings. 1. The prevalent age distribution was between 3rd and 6th decade and the ratio between males and females was 10:1. The most common cause of injuries was automobile accident (70%). 2. The most common site of the injuries was C5-6 (34%) and the most frequent mechanism of injury was flexion-rotation type (47%). 3. In overall patients, neurologic damage was found at first examination in 73% and among these, complete paralysis below the injured level in 26%, incomplete paralysis in 11% and nerve root injury in 35%. 4. Among 47 patients, conervative treatment was performed on 9 patients, anterior spinal fusion on 8 patients, anterior spinal fusion with Halo application on 4 patients, posterior wiring with posterior spinal fusion on 16 patients and posterior wiring with anterior spinal fusion on 8 patients. 5. In the several methods of treatment, the posterior wiring with anterior spinal fusion revealed the best results, the correction rate of displacement was 92%, the correction rate of angular deformity 98% and neural recovery rate 72%. 6. The posterior wiring with posterior spinal fusion revealed good results in correction of displacement and angular deformity but required rigid external support for a long time. The anterior spinal fusion revealed poor results in correction of displacement(67%) and angular deformity(38%) and required rigid external support for a long time and had increasing tendency of kyphotic angle after operation. 7. In the treatment of unstable cervical spine injury, we thoughy that early posterior reduction with posterior wiring and followed anterior spinal fusion was ideal for accurate reduction, rigid stability and early mobilization with simple external support.

A Clinical Study of the Surgical Treatment of the Thoraco-Lumbar Spinal Injuries / 대한정형외과학회잡지

Among 334 thoracolumbar spinal injury patients who were admitted to this hospital from June 1972 to June, 1982, 66 patients with fracture and fracture dislocation of thoraco-lumbar spine which were defined as unstable clinically and radiologically were treated with surgical measures. The ratio between male and female was 7.3:1, the majority was found in third and fourth decade (46 cases, 69%), and the most common cause of injury was falling from a height (38 cases, 58%). The most common site of the injury was lumbar spine (29 cases, 44%) and the most common mechanism of injury was flexion-rotation (29 cases, 44%). Our surgical measures were Harrington rod instrumentation with either anterior or posterior fusion (25 cases, 38%), posterior wiring and fusion (14 cases, 21%), anterior decompression and anterior fusion (14 cases, 21%), posterior fusion (4 cases, 6%), anterior fusion and posterior fusion (3 cases, 5%) and etc. The average correction of displacement was 65% and the average correction of kyphotic deformity was 50%. The most remarkable correction was found at the cases of Harrington rod instrumentation (71%, 74%). Neurological deficit had already developed in 43 cases(65%) prior to operation, and the recovery was observed in 18 cases(42%). Most excellent recovery of neural deficit was found also at the cases of Harrington rod instrumentation (11 cases, 52%). We have analysed the results of these treatment and obtained following conclusions. 1. For the unstable fracture and fracture-dislocation of thoraco-lumbar spine with or without neural involvement, immediate surgical treatments were valuable to expect restoration of anatomical reduction and promotion of every possible recovery of neural function with spinal stability and fewest complication. 2. Fixation with Harrington rod instrumentation appears to provide better reduction and stability with neural improvement than other methods, and therefore early undertaking of rehabilitation activities is possible. 3. For the patients who are seriously compromised or require anterior decompression, immediate posterior reduction and fixation with Harrington rod instrumentation followed anterior decompression and anterior fusion of the involved segments at the eariest feasible time, we feel, is the treatment of choice.

The Treatment of Fractures by the External Skeletal Fixation Devices (Hoffmann Apparatus, Pin and Resin Fixation) / 대한정형외과학회잡지

We have employed the external akeletal fixation devices, that is Hoffmann apparatus and Pin and Resin fixation method, for the treatment of 44 cases of long bone fractures from Dec. 1978 to Dec. 1981. The following are our impressins. 1. Hoffmann apparatus and Pin and Resin fixation method proved to be effective and useful measure for the management of fractures of long bones, particulary in cases of the open tibial fractures. 2. Employing the Hoffmann apparatus to the tibial model, the possible limit of correction of the fracture alignment was calculated. It was found that the average angle of correction of deformity can be managed up to 20 degrees in varus and valgus deformity, 70 degrees in anterior angulation, 40 degrees in posterior angulation and 70 degrees in rotation. 3. Pin and Resin fixation method is one of effective means in immobilization of long bones. It is simple to apply, easy to manipulate and inexpensive while offering fair fixation without much complications and therefore we recommend the method as the best alternative to expensive Hoffmann apparatus. 4. The complications of Hoffmann apparatus and Pin and Resin fixation method were pin tract infections and ankle stiffness which were generally minor and prevented by more careful aseptic technique and encouraging early joint motion.

Clinical Study of the Tibia Fracture / 대한정형외과학회잡지

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.

1 Case of Xanthogranulomatous Pyelonephritis / 대한비뇨기과학회지

Xanthogranulomatous pyelonephritis is characterized by multiple yellowish nodules and secondary inflammatory changes as necrotic area or abscess cavity grossly, and by infiltration of macrophage, mononuclear cell, and rarely giant cell microscopically. Also, this disease is a rare condition, which has been misdiagnosed as other renal disease such as renal tuberculosis or renal carcinoma of clear cell type in literatures. A case of xanthogranulomatous pyelonephritis is added to the literature.

Pelvic seminoma in bilateral undescended testes / 대한비뇨기과학회지

The undescended testis is more liable to develop malignant disease than one in its normal anatomical position. This was recognized in 1918 by Gordon-Taylor, who saw two patients with malignant growths in an undescended right testis, regarded by others as having an appendix abscess. The tumor arising from seminiferous epithelium was given the name seminoma by Chevassu of Paris in 1906. He also sponsored the radical operation for malignant tumors of the testis. Subsequent therapeutic experience has shown such tumors to be usually radio-sensitive. Testicular tumors are rare. Figures for the incidence of such tumors are variable. Patton, Seitzman and Hewitt in a review 672 cases of testicular tumors found the incidence to present about 1 per cent of all malignant conditions in the male. It is well recognized that ectopic testis has a malignant potentiality greater than a normally placed testis. In a review of 7.000 recorded cases of testicular tumors by Gilbert and Hamilton (1940), 840 cases were found in undescended testes. They were observed that neoplasms are for more common in ectopic testes than in scrotal testes. Of patients with unilateral cryptorchidism and one testis tumor, 96. 8 per cent, had the tumor in the undescended testis. There is some suggestion of higher incidence of tumor in the testis retained in the inguinal canal than in the abdomen. Seminoma is the most common tumor to occur in abdominal ectopic testes. Intra-abdominal seminoma usually presents with secondary signs and symptoms, due to the anatomical position of the tumor. A case of seminoma in bilateral undescended testes, found in 29 years old Korean male is reported and added to the literature.

The Relation of Urine Specific Gravity to Its Composition and Osmolality in the Normal Korean

A random urine sample was obtained from each of 155 normal Koreans and its specific gravity (S.G.), the total osmolality (Uosm) and the concentration of chloride (UCl) and urea (Uurea) were determined. The Uosm, 2 X UCl and Uurea were then plotted as a function of the S. G., and the following regression equations were obtaind: Uosm (in mOsm/kg) = 34,500 (S.G.-1,000), 2xUCl (in mOsm/kg) = 20,000 (S.G. 1,000), and Uurea (in mOsm/kg) = 10,000 (S.G.-1,000). the analysis of these data indicated that 58.5% of the Uosm could be accounted for by NaCl and 28.8% by urea while 41.0% of the S. G. of urine could be accounted for by NaCl and only 14.5% by urea. A comparison of these data with corresponding figures obtained from occidentals suggests that, in the Korean, the contribution of NaCl to both the Uosm and S.G. of urine is considerably higher, while that of urea is significantly lower than that in the occidental. This peculiarity of the urinary composition in Koreans is attributed to their ingestion of a lowprotein, high-salt diet.

Uretero-ileocystoplasty: A Report of One Case / 대한비뇨기과학회지

No abstract available.