A Case of Subsequent Papillary Carcinoma of the Thyroid gland and Hashimoto's Thyroiditis / 대한내분비학회지

The association of thyroid carcinoma and Hashimotos thyroiditis in same thyroid gland is controversial. Incidence of carcinoma who has Hashimotos thyroiditis has been reported from 0.5 to 22.5 per cent by Crile and by Hirabayashi et al. The reason that there are such great diffarences in the reported incidences of carcinoma in Hashimotos disease is the result of the way the material is reported. The carcinomas of the thyroid which occur in association with Hashirnotos thyroiditis are predominently papillary tumors of lower grade malignancy. Thyroid carcinoma need not be feared in patimts with Hashimotos thymiditis, if one examines the ghmd catefully. When patients with Hashimotos disease are treated with thyroxine, there is little or no tendency for Hashimotos disease propess to clinieally detectable carcinoma of the thymid, and the microcarcinoma does not appear. In this case, single thyroid nodule was detected in Hashiimotos disease patient who was treated with thyroxine. There was no significant volume change of thyroid nodule despite of TSH suppression therapy during six months. Therefore we perforrned FNABC twice, the results were highly suspicious thyroid malignancy and subtotoal thyroidectomy was performed. The final pathologic result was microscopic papillary carcinoma with background Hashlmotos thyroiditis. In conclusion, we experienced a case of subsequent microscopic papillary carcinoma of the thyroid in patient with Hashimotos thyroiditis who was TSH suppression therapy with thyroxine.

An experimental study for activities of enzymes involved in nucleic acid degradation in patients with osteosarcoma / 대한정형외과학회잡지

No abstract available.

Percutaneous tetracycline injection(PTI) of benign non-cystic thyroid nodules / 대한내분비학회지

No abstract available.

A Clinical Study of Scoliosis / 대한정형외과학회잡지

A clinical study of scoliosis was carried out on 296 cases of structural scoliosis in the department of orthopaedic surgery, Hanyang University Hospital for 26 years and 6 months between Jan. 1963 and June 1989. The results obtained were as follows: l. Idiopathic scoliosis was the most common cause of strctural scoliosis. 2. The ratio between male and female was 1:1.7(110:186). 3. The most common site of scoliosis was the lumbar region for paralytic scoliosis and thoracic region for idiopathic scoliosis. 4. In idiopathic scoliosis, the thoracic curve was convex to the right in 79.1%. The thoracic curve in the combined type with double curvature was convex to the right in the most 80.4% of both idiopathic and paralytic scoliosis. 5. Severe curvatures over 80° was observed in 30.8% of paralytic scoliosis and in 5.6% of idiopathic scoliosis, being more frequent in paralytic than in idiopathic scoliosis. 6. The number of vertebrae involved in the major curve of scoliotic region was between 6 and 9 in most cases of both paralytic and idiopathic scoliosis. 7. Rotation grade was increased with the degree of eurvature in either paralytic or idiopathic scoliosis. Wedging was increased with the degree of curvature in idiopathic scoliosis, but no significant correlation with the degree of curvature was observed in paralytic scoliosis. 8. Of 37 cases of congenital scoliosis, 19 cases(51.4%) of them were caused by hemivertebra and the majorty of this congenital anomaly was located at the lumbar region. 9. The therapeutic effect of correction with Milwaukee brace was better on idiopathic scoliosis (15.8%) than in paralytic scoliosis(9.8%).10. In paralytic scoliosis treated with posterior spinal fusion without instrumentation, the postoperative correction was achieved in 48.7% of the cases studied with the final correction angle of 49.9°and the correction loss was observed in 12.7%. The postoperative correction with combined anterior or posterior spinal fusions with instrumentation was achieved in 51.7% with final correction angle of 53.0° and the correction loss was observed in 7.9%.11. With instrumentation, the postoperative correction rate of the structural curvature was achieved in 49.6% of the cases studied and the correction loss was observed in 5.1%. The best results were obtained in the thoracic curvature with 3.9% of the correction loss. 12. Three cases of postoperative complications was observed in this study: pseudoarthrosis and bending of graft with some loss of correction following the posterior fusions without instrumentation, and displacement of distraction hook on rod with Harrington instrumentation.

Cementless Bipolar Endoprosthesis / 대한정형외과학회잡지

The bipolar endoprosthesis was first reported by Giliberty, as well as Bateman in 1974. There were several reports indicating less acetabular erosion in bipolar endoprosthesis than in unipolar, Even if there was a problem of dislocation and valgus position of cup of initial design, the prosthesis of nowadays is useful in failed total hips with erosion of the acetabulum as well as hip with normal acetabular cartilage. The authors reviewed and analysed 44 cases of cementless bipolar endoprosthesis (Self Centering Universal Hip replacement utilizing the Tri-Lock total hip femoral stem), operated at the department of orthopaedic surgery, Hanyang University Hospital from June 1984 to May 1987. The following results were obtained. 1. There were 18 males and 25 females. 2. 22 cases were idiopathic avascular necrosis with relatively good acetabulum, 21 cases of fracture of femoral neck and 1 case of metastatic adenocarcinoma. 3. Average operation time eas 1 hour and 10 minutes and average amount of transfusion; 650cc. 4. We used 42 Watson-Jones approach and 2 Charnley's. 5. The common size of metal cup was 45–53mm in men and 43–47mm in women. 6. The size of prosthetic femoral head was equal to normal head in 16 cases, larger than normal in 14 cases, smaller than normal in 14 cases. 7. There were 2 case of intraoperative undisplaced fracture of femur and one case of heterotopic ossification. 8. There were motion of outer and inner bearing when the extremity was abducted and adducted on serial roentgenogram during a period between 2 years and 5 years. 9. Average Harris hip rating score was 38.5, preoperatively and 95.2, postoperatively.

Factors of Loss of Correction Kyphotic Angle After Operation in Spinal Tuberculosis / 대한정형외과학회잡지

No abstract available.

Aneurysamal Bone Cyst in Pubic Bone: A Case Report / 대한정형외과학회잡지

The pubic bone is an unusual site for an aneurysmal bone cyst. This case, a 15year old male patient, was diagnosed as an aneurysmal bone cyst in the superior ramus of the right pubic bone. He was treated by complete excision of the superior ramus and on five years follow up no problems were noted in terms of weight bearing as well as hip function or evidence of recurrence.

Paget's Disease of Bone with Pathologic Fracture of the Femur: a Case Report / 대한정형외과학회잡지

Paget's disease is one of the chronic disorders of skeletal system which is frequently accompained with pathologic fractures. This disease is extremely rare in Korea and only three cases have been reported in the Journal of Korean Orthopaedic Associstion. And all these cases were not associated with pathologic fracture. We experienced a case of Paget's disease with pathologic fracture of the femur which is typical in radiologic, laboratory and histopathologic findings.

Thumb Reconstruction with a Osteocutaneous Free Flap Transfer with Partial 1 st Matatarsus (Case Report ) / 대한정형외과학회잡지

Thumb reconstruction with a free neurovasculsr wrap around flap from the great toe by microsurgery had been first reported by O'Brien, Macleod and Morrison in 1980. We have performed one case of thumb reconstruction with psrtial first metstarsus for loss of thumb except pulp and one digital vessel by microsurgery. The results were summerized as followings ; 1. This one stage procedure has the unique advantage to reconstruct a thumb almost identical to the origin. 2. This technique allows preservstion of the toe and the secondary defect results in no significant morbidity.

A Clinical Study of the Fracture Patterns in Children / 대한정형외과학회잡지

There is an increasing interest in the epidemiology of children's fractures particullary to the patterns of children's fractures but there is a few available articles about them. We reviewed 398 children under the 15 years of age who were affected by fractures during 4 years and analysed the patterns of children's fractures concerning with the sex, age, seasons of a year, etiology, fracture sites and the types of fractures. The results were as follows : 1. Boys were affected about 2.5 times than girls. Fractures were predominant in between 5 and 9 years of age group. 2. The three highest monthly incidences of the fractures were showed in July, September and October. 3. The major causes of fractures were fall from a height or slipdown, pedestrian traffic accidents and sports injury in decreasing orders. 4. The traffic accidents were occured frequently in children of five to seven year old, and it is occured predominantly in June, July and August(37.8%). 5. The frequent sites of children's fractures were humerus(33.5%), tibia(21.0%), forearm (17.3%) and femur(13.6%). 6. The sports injuries were affected evenly in all age groups except below 3 years old children and the frequent causes were bicycling, exercising on the horizontal bar, Korean wrestling and during football game in decreasing orders.

The Clinical Application of Radionuclide Angiography(RNA) / 대한정형외과학회잡지

Angiography has been playing important roles in diagnosis and treatment in the field of orthopaedic surgery. Conventional angiography is the most reliable and widely used method in diagnosis of peripheral arterial disease. But the clinical use of the conventional angiography has been limited by the risk of possible complications and time-consuming procedures. Radionuclide sngiography is rapidly performed, rapidly interpretable and time-saving procedure for the visualization of arterial tree prior to vascular intervention in the critically ill patient. We have analyzed and compared the 22 cases who had taken radionuclide angiography and conventional angiography simultaneously from November, 1986 to August, 1987 in Department of Orthopaedic Surgery, Hanysng University Hospital. The results were as follow 1. Radionuclide angiography is simple, non-invasive, accurste, reproducible method. It eliminstes the discomfort and morbidity of conventional angiography and can be done on an outpatient basis at a much lower cost. It is useful in the patients who may be allergic to the contrast medium. 2. In cases of arterial occlusion, radionuclide angiogrpahy is also useful in the evsluation of obstruction of major artery and can be substituted for conventionsl angiography. 3. For the purpose of evaluation of success in the cases of vascular reconstruction, radionuclide angiogrphy also demonstrate the vasculsr blood flow without any risk. 4. Although rsdionuclide angiography has limitstion in snatomic detsil, it could be psrtially substituted for conventionsl angiography in the diagnosis of vascular anomalies or tumors.

Gluteal Fibrosis in Adult / 대한정형외과학회잡지

Gluteal fibrosis is rare in Kores. We thought the probable primary etiology of gluteal fibrosis might be repeated intramuscular injection into the buttock, Inability to adduct the legs in the sitting position and flex the hips in neutral position had been observed. Four cases(3 persons) of gluteal fibrosis in adult from October 1986 to February 1987 are presented with much improvement of squatting and flexion of hip in neutral position after operation.

The Treatment of Recurrent Anterior Dislocation of the Shoulder by Bristow Operation / 대한정형외과학회잡지

A review of four cases of the Bristow operation for recurrent anterior dislocation of the shoulder from Jan. 1984 to Dec. 1986 was presented and the following results were obtained. 1. The ages at the initial dislocation were ranged 17 years to 28 yesrs with the average of 21.5 years. 2. The average loss of external rotation was 8.8 degree. 3. There were three excellent and one fair results by Rowes grading system.

A Clinical Study of the Flexor Tendon Injures in the Hand / 대한정형외과학회잡지

Many injuries of the hand have been occured in these days because of frequent industrial hazards and frequent handling of tools in modern civilizing life. A voluminous amount of literature has been recently concerned with many problems and questions posed by tendon surgery. Many investigations have been devoted to discussion of suture materials, tendon suturing, grafting, healing, rate of healing, nutrition and related clinical and laboratory endeavors. Because of these efforts, the designation of Zone II as“no man's land” is no longer significant and should be called “skilled man's land”. With regard to to secondary reconstructive surgery, in cases without much scarring and few associated lesions, we routinely select the one-stage graft and use early motion in the postoperative programs. This paper aimed to review our experience with 215 patients with flexor tendon injuries in hand who were treated with primary repair or tendon graft with average follow up of 8.5 months from June, 1973 to May, 1987 and the following results were obtained. 1. The most frequent site of injury was Zone V. 2. The over all end result of primary repair was satisfactory in 86.5% by White and Kleinert criteria. 3. The over all end result of tendon graft in Zone Il was satisfactory in 51.0% by White and Kleinert criteria. 4. In Zone lI, primary repair obtained satisfactory result in 36.4% but the tendon graft obtained satisfactory result in 51.0%. 5. In tendon graft, the preoperative stste was supposed to have close relation to postoperative result and the duration from injury to graft was supposed to have little relation to postoperative results. 6. In primary repair, the cases using Bunnells suture technique obtained satisfactory result in 85.1% and the cases using modified Kesslers suture technique obtained satisfactory result in 91.2%.

Ipsilateral Fractures of the Arm and Forearm / 대한정형외과학회잡지

The simultaneous ipsilateral fractures of the arm and forearm are relatively rare and there is no exact method of treatment for these fractures. Authors has clinically analized 37 cases of these fractures which are treated between September, 1973 and May, 1987 at the Department of Orthopedic Surgery, Hanyang University College of Medicine. The results can be summarized as follows. l. Among 440 patients with humeral fracture, there were associated fractures of the ipsilateral forearm bone in 69 patients (13. 4%). 2. The main cause of these fracture was traffic accident and the next one was fell from a height. 3. The most frequently associated injury was nerve paralysis. 4. The methods of treatment were classified as follows . 1 st method Both arm and forearm were treated by internal fixation (32.1%). 2nd method The arm was treated by internal fixation and the forearm by conservative method (11.8%). 3rd method The arm was treated by conservative method and the forearm by in- ternal fixation (11.8%). 4rdmethod Both arm and forearm were treated by conservative method (44. 3%). 5. By Andersons criteria, excellent and satisfactory results were obtained in 47. 1% of cases which were treated by mainly 1 st method.

A Clinical Study of the Ankle Fracture / 대한정형외과학회잡지

The ankle is a complex, weight bearing joint consisting of tibia, fibula, talus, and many soft tissue structures, which play an important role biomechanically. The injuries to the ankle joint include not only fractures of bone but significant injuries of ligaments and other soft tissues. It is very important to understand the mechanisms of trauma in order to make definite diagnosis and proper treatment. The author' analysed 127 eases(126 patients) of the ankle fractures which were admitted and treated in Orthopaedic Department,Hanyang University Hospital from January 1978 to December 1985. The results obtained from this study were as follows: 1. Of the 127 cases, male was 90 cases(70.87%), female was 37 cases(29.13%), and average age of the patients was 37.6 years. 2. Open fractures were 12 cases(9.4%) and closed fractures were 115 cases(90.6%). 3. According to the classification of Lauge-Hansen, the most common type of the ankle fracture was supination-external rotation type (35.43%). 4. Of the 127 cases, 63 cases were treated by closed reduction and 64 cases by open reduction. 5. The average period of the cast immobilization after open reduction was 7.8 weeks, where as that of closed reduction was 10.5 weeks. 6. According to clinical and radiological assessment of the result of the treatment, open reduction was better than closed reduction. 7. The best result of the treatment was noticed in supination-adduction type, according to the classification of Lauge-Hansen. 8. Accurate reduction and rigid internal fixation of the fractured lateral malleolus and distal fibuIa was important in treatment of the ankle fracture.

The Proximal Humeral Fractures Treated by the Primary Prosthetic Replacement: A Report of 3 Cases / 대한정형외과학회잡지

Four-part displaced fractures, four-part fracture-dislocations, impression fractures of the articular surface involving greater than 50% of the head, and head-splitting fractures are to be best treated by primary prosthetic replacement. 3 primary prosthetic replacements were performed for the treatment of the proximal humeral fractures(l case of four-part displaced fracture, 2 cases of fracture-dislocation) and all cases were followe( up at least 3 years. Case II had excellent result, case I was satisfactory, and case III failure by Neers numerical ratin method. There were proximal subluxation roentgenologically in case I and III.

A Study about Changes in the Lumbosacral Region and Wrist of the Adolescent Weightilifters / 대한정형외과학회잡지

The weightlifting is a sort of the sport, which has objects to promote the physical condition and to develop the fundamental strength in the adolescent period, but thete been no interests from the view points of sports injuries for weightlifting. So the authors have studied the changes in the lumbosacral region and wrist of the adolescent weightlifters and the results obtained are as follows; 1. The increase in the lumbosacral angle has a statistically significant relationship with the low back pain in the adolescent weightlifters. 2. The ulnar variance shows statistically significant increase than the control group and its increase seems to be a causative factor in developing wrist pain among the adolescent weightlifters.

A Clinical Study of Vascularized Osteocutaneous Fibular Transfer / 대한정형외과학회잡지

Recently, there were many cases which was associated with bone defect in the limb and skin defect. We had performed vascularized osteocutaneous fibular transfer with microsurgical technique and experienced early bone union and simutsneous external wound healing. So we, authers, reviewed 12 cases of vascularized osteocutaneous fibular transfer which were performed to the extensive bone defect of the tibia and associated soft tissue injury. And the following remarkable results were obtained. 1. With the uncontrolled bone infection, the vascularized osteocutaneous fibular transfer was able to be performed and there was no non-union. 2. During the follow up period, the grafted fibula had been hypertrophied. 3. In the cases which the fibula were grafted to the defect after the segmental and partial excision of the tibia, in general, the partial weight bearing was able to be started from 3 months to 5 months after the operation, In the cases with segmental and complete excision of the tibia, the partial weight bearing was able to be started from 5 months to 7 month after the operation. 4. In adult, free fibula can be obtained and grafted as 20cm as long and the fibula was a good donor for extensive long bone defect as a compact bone; the skin flap with fibula can be obtained and grafted as 17 × 9cm as large in our experience. 5. In the vascularized osteocutaneous fibula transfer, the skin flap could be confirmed wheather the vascular anastomosis is patent or not as a monitor.

The Reconstruction of Injured Hands by Microsurgery / 대한정형외과학회잡지

The human hand is a highly sophisticated tool of sensibility and prehension, and the reconstruction of injured hands are essential to not only reconstruct of hand function but also reconstruct of body. Seven cases of tendocutaneous flap, a case of osteocutaneous flap, nine cases of thumb reconstruction with a free neurovascular wrap-around flap from the big toe, two cases of second toe-to-index trander, and a case of left ring finger to right index finger transfer were performed at the Department of Orthopedic Surgery of Hanyang University Hospital, and satisfactory results were obtained both comsmetically and functionally.