Gastric Xanthoma / 대한소화기내시경학회지

Authors analysed 42 cases of gastric xanthoma, confirmed by gatroscopic biopsy, at Kangnam Sacred Heart Hospital, College of Medicine, Hallym University from March 1986 to December 1988 The results were as follows; 1) The prevalence of gastric xanthome was 0.9% in 7699 consecutive gastroacopies. 2) The prevalence of gastric xanthoma increased with age. 3) The frequent locations of gastric xanthoma were the antrum (56%) and the lower bady (29%). 4) The most frequent gastroduodenal lesion associated with gastric xanthoma was chronic superficial gastritis (77%). 5) The average level of cholosterol was 169.9 mg/dl, triglyceride was 102.6 mg/dl, and no conelation existed between the serum cholesterol or triglyceride level and the presence of gastric xanthoma.

A Case of Multiple Gastric Diverticula / 대한소화기내시경학회지

Gastric diverticula have been considered to be rave when compored with diverticula in other sites of the gastrointestinal tract. It's prevalence is 0.043% of routine gastrointestinal radiologic examination by Palmer's extensive review. Gastric diverticula almost always occur as a single lesion and approximately 75% of gastric diverticula occur in the juxtacardiac region, high on the posterior wall of the stomach, about 2 cm below the esophagogastric junction and 3 cm from the lesser curvature. We report a case of 75-year-old male patient with multiple gastric diverlicula which was first encountered by endoscopy and confirmed by upper gastrointestinal radiologic examination.

A Case of Leiomyosarcoma of the Duodenum / 대한소화기내시경학회지

Malignant growth of the small bowel accounts for approximately 1 to 3 percent of malignant tumors of the gastrointestinal tract. Leiomyosarcomas are the second most common primary tumor of the small bowel, their frequency being one-third to one-half of adenocarcinoma. The common clinical symptoms of leiomyosarcoma of the small intestine are hemorrhage and abdominal pain. Accurate diagnosis cannot be based on solely on the roentgenographic finding, although in certain situations the dignosis of leiomyosarcoma may be suggested strongly. We report a case of bleeding leiomyosarcoma located in the second portion of the duodenum which was first recognized by endoscopic examination and confirmed by explolaparotomy.

A Clinical Study of 15 Cases: Muscle Ruptures / 대한정형외과학회잡지

Rupture of muscle, either complete or incomplete, is a fairly frequent occurence. It may be caused by direct or indirect violence, and occurs either in normal or diseased muscle. Undoubtedly if any of the aching and painful muscles resulting from trauma is examined, a considerable number of partial ruptures would be found which is often overlooked or wrongly diagnosed as a strain, hematoma, myositis and neuralgia etc. We had the opportunity to examine the 15 patients with ruptured muscles. Our survey is presented in this paper.

The Clinical Study of the Fractures of the Carpal Navicular / 대한정형외과학회잡지

Fractures of the carpal navicular is a serious injury, particulary in a manual worker, because non union and the resultant disability may limit the usefulness of the extremity. There is almost unanimous agreement that fresh fractures of the carpal navicular should be treated by immobilization in a plaster cast and how immobilization should be maintained. As a result of this study we have arrived at several conclusion regarding to the conservative treatment of fresh navicular fracture.

The diagnostic value of computed tomography in obstructive jaundice

Computed tomographic (CT) scans of 46 jaundiced patients were studied to determine the value of CT in the diagnosis of biliary pathology. AII ofthe 12 cases of medical jaundice had positive CT correlation. Of the 34 cases of proven surgical jaundice, 97 .8% were correctly identified by CT. In detecting the level of obstruction, the cases were divided into four groups by anatomica l segments, according to the number of visualized low density ringlike structures produced by dilated bile duct. All of the correctly diagnosed surgical jaundice was 91.2%. The presence of stones or mass, the level of obstruction and the relative size and shape of visualized distal ring had proved to be the most important variables in etiological diagnosis of surgical jaundice. The results indicate that CT is useful and highly accurate in differenting between surgical (obstructive) jaundice and medical (non-obstructive) ajundice, and determining the level of obstruction and the etiology of surgical jaundice.

Clinical Study on the Femoral Fractures / 대한정형외과학회잡지

Fractures of the femur are one of the most frequent injuris which Orthopedic Surgeons are called upon to treat. The incidence of femoral fractures has risen by the results of rapid increase in traffic accident, industrial accident, and prolongation of life expectancy in adults. Two hundred and ninty eight consecutive femur fractures were treated at the Department of Orthopedic Surgery, Hanyang University, during the period of May 1972 to September 1977 were reviewed. The results were as follows; 1. The fractures occured commonly in the 6 to 10 years age group (46.1%) in children and in the 21 to 40 years age group (48.2%) in adults. Males comprised 217 cases (71.1%). 2. Fractures were caused by traffic accident (72.2%) mainly and especially in old aged fractures of the femoral neck and intertrochanter were caused by fell down from a height. 3. Closed fractures were 258 cases (84.7%) and transversefractures were the most common type in, children, and comminuted fractures were the most common type in adults. 4. The freguent fracture site was transcervical fracture of femoral neck, type 3.4 (by Tronzo) of the. intertrochanteric fracture and middle third of femoral shaft. There were no differences between medial and lateral femoral condyle fractures. 5. Associated injuries were common in young adults in 165 cases and in order of frequency, these were fractures of the tibia and fibula, pubics, skulls, patella and ribs etc. 6. Better results were obtained with conservative treatment in children and operative treatment in adults. 7. The period of bony union in children was 7.6 weeks with Bryants traction 9.3 weeks with Russel traction, 8.6 weeks with cast immobilization, 10 weeks with 90-90 skeletal traction and 10.8 weeks with Bohler-braun skeletal traction. 8. The period of bony union in adults was 17 weeks with Kuntscher nail, 13.6 weeks with compression plate and screw fixation, 18 weeks with Bohler-braun skeletal traction and 19weeks with cast brace in femoral shaft fracture. 9. Complications were much more frequent in adults than in children and it were treated well Postoperative infection was occured in 5 cases (1.7%) and they cured well with sequestrectomy, curettage and continuous antibiotics administration. 10. The Bryants traction under 2 years of age, 90-90 skeletal traction over 5 years of age in children and compression plate and screw fixation in adults were further recommended.

Femoral Lengthening: A case report / 대한정형외과학회잡지

A case of femoral lengthening was performed at the Hanyang University Hospital for a 29 year old male patient who hed a 3.0 cm shortening of the left lower extremity. This patient incurred a comminuted segmental fracture of the left femur in a car accident in 1969 when he was 21 years old. At that time, open reduction and internal fixation with Kuntscher nail was done at a private clinic. The fracture was united firmly, but shortening of the left lower extremity developed progressively. At the time of admission to our hospital in 1976, he had a 3.0 cm shortening of the left femur on scanogram and complained of limping. Femoral lengthening was employed by step cut Z ostectomy on the left femur and 3.0 cm lengthening was achieved during the operation by traction with 2 Steinmann pins, one of which was inserted vertically in the greater trochanter, and the other was inserted horizontally in the distal femur. A special plate and screws were modified at our hospital and were attached and fixed to the osteotomy site. Bone gaps which developed after lengthening of the femur were filled with an autogenous iliac bone graft. The patient was followed up for 9 months after the operation, and the last X-ray showed a firm bony union without any specific complications. On pbysical examination at the present time, there is no longer a shortening of the left lower extremity clinically and gait is normal without limping.