It is well known that metastatic bone tumor is very rare below knee and elbow joint. Recently, we experienced two cases of metastatic tumor from kidney and lung to the tibia at Koryo General Hospital.
Elbow Joint ; Hospitals, General ; Kidney ; Knee ; Lung ; Tibia

No abstract available.
Paralysis* ; Radial Nerve*

The value of the computed tomography(CT) in the diagnosis of the pelvic bone (especially acetabulum) is being explored. Simple radiographic projections, including specially designed views, although very helpful, often can not provide sufficient information to give a true sense of the fractures.CT,converoly displays the anatomy in a axial plane, thereby providing the missing pieces of information and greatly fascilitating accurate classification of these fractures. In addition, the extent of the soft tissue damage and joint involvement is precisely demonstrated. 10 patients with acetabular fracture, were adimitted to Koryo General Hospital and were taken the CT, were reviewed. Comparing simple radiographic findings with those of the CT, we have made the following conclusions: 1. CT was shown to be useful in the evaluation of the acetabular fractures. 2. CT could detect the pattern of acetabular fracture including degree of fracture fragment, displacement and loose body fragment, and stability of the hip joint. 3. Follow-up of the CT was helful in confirming the extent of bony union of the acetabular fracture. 4. CT was more sensitive than simple radiography in detecting fractures involving the anterior column of the acetabulum.
Acetabulum ; Classification ; Diagnosis ; Follow-Up Studies ; Hip Joint ; Hospitals, General ; Humans ; Joints ; Pelvic Bones ; Radiography

BACKGROUND: The use of prednisone in the treatment of myasthenia gravis (MG) has been required circumspection because of its tendency to produce exacerbations of weakness in the early stages of treatment, often requiring critical management. However, factors influencing the exacerbation has not been defined well. The purpose of this study was to evaluate the clinical factors predicting the exacerbation by prednisone in the early stage of treatment in MG. METHODS: Fifty five patients, first-ever prescribed high dose prednsone (40-80 mg) during hospitalization in Samsung Medical Center were included. Prednisone induced exacerbation was defined as significant exacerbation of objective neurologic signs of MG within 4 weeks after prednisone addition by utilizing Myasthnia gravis Severity Scale (MSS). We investigate the differences between the exacerbated and nonexacerbated groups in the clinical, laboratory and electrophysiological features. RESULTS: Twenty three patients (42%) experienced definite exacerbation after prednisone treatment. Old age, presence of bulbar symptom, and severe neurologic finding reflected by MSS score were significant predictors of prednisone induced exacerbation in multivariate logistic regression analysis. Higher prednisone dosage per body weight (Kg) was neither a significant predictor of exacerbation nor related with the early improvement in bivariate correlation. CONCLUSIONS: Prednisone induced exacerbation in MG is a frequent challenging problem to clinician. Clinicans should keep in mind the possibility of exacerbation of MG when prescribing prednisone especially, to old, bulbar dominant, severe and disable myasthenic patients.
Body Weight ; Hospitalization ; Humans ; Logistic Models ; Myasthenia Gravis* ; Neurologic Manifestations ; Prednisone

Familial amyloid polyneuropathy is commonly the result of deposition of variant transthyretin in nerves and other organs. Apart from the Val30Met variant commonly seen in endemic areas of familial amyloid polyneuropathy, many transthyretin mutations have been described in various populations worldwide. We report a Malaysian patient of ethnic Chinese descent with familial amyloid polyneuropathy and a transthyretin mutation, Ala117Ser. This mutation has not been previously reported in Chinese patients. He presented in middle-age with carpal tunnel syndrome followed progressive sensorimotor polyneuropathy. There was evidence of autonomic dysfunction clinically and cardiomyopathy on 2Dechocardiography. Familial amyloid polyneuropathy is uncommon in Asian patients outside Japan, but the diagnosis should be considered in a progressive late onset sensorimotor axonal polyneuropathy.

No abstract available.
Humerus*

In planning treatment of tibial condylar fracture, the patient's age and physical condition, associated ligament injury and accurate fracture diagnosis, such as presence and degree of separatiori of split fragment, type of fracture and the severity of comminution must be considered. For accurate diagnosis, many kinds of methods including simple X-ray, arthroscopy, arthrography and tomography can be used. In spite of these procedures, sometimes we cannot know the accurate fracture morphology. The computed tomography(CT) has many advantages over other diagnostic methods. The application of CT in the evaluation of patients with spinal and pelvic fractures has been established, but rarely has its usefulness been noted in tibial condylar fracture. We thought that in assessing tibial condylar fracture, CT is more useful and accurate than conventional radiography. From March 1985 to August 1986, we took 17 patients(18 cases) of tibial condylar CT and were convinced with that it is a good diagnostic method. The results are as follows: l. In 5 cases, we could find a new fracture on CT film, which was impossible to be detected on simple X-ray. 2. In 7 cases, the fracture classification by plain X-rays was changed after CT check-up. 3. We could make the decision of treatment methods easily through more realistic classification and better recognition of split and comminution. 4. Proper approach could be done by understanding the accurate fracture size and localization.
Arthrography ; Arthroscopy ; Classification ; Diagnosis ; Humans ; Ligaments ; Methods ; Radiography

No abstract available.
Nevus*

BACKGROUND: An ingrown nail is a common condition of inflammation and infection that can occur when nails are clipped too much or pressure is applied by tight shoes. In Korea, a study on the success of tube insertion after nail guttering has been reported, but studies including other treatments are lacking. OBJECTIVE: To evaluate the success rates of three treatments for ingrown nails: 1) nail splinting via a flexible tube; 2) partial nail extraction and electrocautery; or 3) partial nail extraction and phenol cauterization. METHODS: Fifty-one patients who underwent nail splinting via a flexible tube or partial nail extraction followed by either electrocautery or phenol cauterization of the nail matrix over a 6-year period at our hospital were evaluated for treatment outcome. The disease severity was classified using the Heifetz grading scale. We evaluated the success rates of the various treatments according to reduced disease severity. Treatment failure was defined as persistence or re-occurrence of disease symptoms. RESULTS: 1. Out of 51 cases of ingrown nails, 31 (60%) showed no recurrence after treatment. 2. There were conflicting results between the severity grade and success rate. 3. Treatment via partial nail extraction and either electrocautery or phenol cauterization was more effective (success rates of 63% and 60%, respectively) than nail splinting via a flexible tube (56% success rate). However, the results were not statistically significant. CONCLUSION: Selecting the proper therapeutic method is important for successful treatment of an ingrown nail.
Cautery ; Electrocoagulation ; Humans ; Inflammation ; Korea ; Nails, Ingrown* ; Phenol ; Recurrence ; Shoes ; Splints ; Treatment Failure ; Treatment Outcome

No abstract available.
Dermoid Cyst*