A 12 years old Korean girl was seen on 10 Oct. 1969 with chief complaint of a large fleshy mass extruded out of the orbit associated with ocular pain of mild degree for several months. Her parents were first noticed that the girl's right eye had a peculiar reflex from the pupillary zone in 2 years of her age. She was advised by a local clinician to correct surgicaIly someday later in her childhood. At the age of four, the pupillary margin of the affected eye had become distorted and they became aware of the eyeball was a little protruded and the grade of protrusion had slowly advanced as she had grown up. About a year ago the patient suffered from sudden attack of severe ocular pain associated with vomiting. Having experienced the recurrences of similar attack several times, she at last in Sept. 1969 met a spontaneous outburst of the extruded mass from which the purulent and bloody contents flowed out. It was to be regretted that the history could not reveal when and how the globe had been disorganized as completely as such that no trace of configuration of the anterior segment could be recognized. Familial and past history were not contributory except measle with good recovery at 2 years of age. On examination, the left eye had good vision and no structural changes, wherease the right side showed a marked extrurusion of fleshy mass out of the lid aperture. The mass had a relatively smooth and congested coverage of the conjunctiva except it had the fistulae through which a small amount of the purulent and bloody discharge flowed out under the digital pressure. It was felt somewhat elastic and movable with a broad base into the orbit. On its surface no trace of the cornea or the other global structures could be found. Physical examinations of the whole body including regional lymphnodes revealed normal X-ray Was of chest, skuIl and optic foramina were normal. On 14 Oct. 1969 under general anesthesia an orbital exentration was undertaken because of either probability of a malignant tumor or a long standing intraocular inflammation. In the way of procedure necrotic contents bursted out by mechanical pressure through the weak point, i.e. the fistulae, and correspondingly the tumorous mass became softened. Confirming no hard mass palpable into the orbit, the operating procedure shifted to do partial exentration. The extirpated mass was subjected to the histological study. Grossly, the dissected area revealed that it contained a well preserved structure of sclera on the one side and completly necrotised material on the other, but it did not contain any remnants of the ordinary global structures such as cornea, iris, lens, vitreous and choroid. The hollowed space partially surrounded by scleral structure was filled with the dark and gelatinous materia. The mass was as a whole rather soft Histological examination showed numerous gland like proliferations composed of poorly differentiated and unpigment columner cells having relatively large nuclei, some of which showed a mitotic figure. These were conceivable to be of an embryonic retina. The lumina of the gland like structures with the various sizes and shapes were filled with a pink staining coagulum and an extremly delicate and regularly arranged fibrillar structure. In some parts the tumor consisted of solid cellular conglomeration with rosett like arrangement and in the other necrotic masses containing tumor cells in all stages of degeneration. For the most part and the surrounding structure of the tumor cells, the picture showed likely to be a diffuse inflammation with an infiltration of polymorphonuclear cells, partly vessels being mostly of capillaries and recent hemorrhages, but the cartilage was not found.
Anesthesia, General ; Capillaries ; Cartilage ; Child ; Choroid ; Conjunctiva ; Cornea ; Estrogens, Conjugated (USP) ; Female ; Fistula ; Gelatin ; Hemorrhage ; Humans ; Inflammation ; Iris ; Orbit ; Parents ; Physical Examination ; Recurrence ; Reflex ; Retina ; Sclera ; Thorax ; Vomiting

Differential diagnosis of vertebral lesion by simple radiography is not so easy whether the lesion is benign or malignant. The purpose of this study is to evaluate that the magnetic resonance imaging characteristics can differentiate benign or malignant vertebral lesions. In this study, thirty-nine cases of signal change within the vertebral body by MRI was reviewed retrospectively and the followings are the summary of the results. It is difficult to differenciate benign or malignant lesions, only based on MRI signal changes or vertebral lesion patterns. But those cases of pedicle involvement, complete replacement of bone marrow in T1image and associated soft tissue mass or cord compression are strongly suggest the possibility of malignancy and need further study.
Bone Marrow ; Diagnosis, Differential* ; Magnetic Resonance Imaging* ; Radiography ; Retrospective Studies ; Spine

The fractures of tibial shaft are common and open injury are also frequenly accompanied. Since the AO unreamed interlocking nail is solid type compared to present tubular type nail, it has no dead space, and without reaming the intramedullary blood supply can be preserved and the soft tissue trauma can be minimized. Therefore it can be used with minor risk of infection in the treatment of open tibial shaft fractures without secondary operation such as in the cases using external fixaters. Especially in Orientals, whose tibial medullary canal is narrower than Smm, it can be used ideally. From October 1991, we have experienced 14 cases of tibial shaft fractures treated with AO unreamed interlocking nail. Among 14 cases, the open fractures were 8, 4 cases were type 1 and 4 cases were type 2 by Gustilo classification. Among 6 cases of closed fractures, 4 cases had risk of post operative infection due to accompanying soft tissue injuries, such as abrasion or bulla and 2 cases had narrow intramedullary canal less than 8mm. There was no postoperative infection in all cases including open fractures, and the soft tissue defect could be reconstruted by muscle transfer, etc. The AO unreamed interlocking nail is thought to be recommendable in the treatment of open tibial shaft fracture, closed fracture with risk of postoperative infection, and also the fracture with narrow canal diameter less than 8mm.
Classification ; Fractures, Closed ; Fractures, Open ; Soft Tissue Injuries ; Tibia

To evaluate the results of anterior decompression and fusion with autogenous bone graft for cervical disc disease, the authors reviewed 18 cases of cervical disc herniation which were treated surgically at Inje Univ. Paik Hosp. from 1990 to 1994 with special interest in the thickness of the bone graft. All cases have been followed for more than 12 months. We try to know the clinical results of anterior decompression and fusion with autogenous bone graft. At this treatment, controversial point is a ideal thickness of graft and the width of distraction. Therefore, we follow up the correlation between thickness of graft on roentgenogram and clinical results. The clinical results were satisfactory as excellent in 11 cases, good in 5 cases according to criteria of Robinson et al. Successful fusion occured in 16 cases within 3 months after their initial procedure, and fusion failure resulted in 2 cases. 3mm distraction from baseline disc height was considered ideal thickness of graft after anterior decompression and all cases healed successfully. We concluded that 3mm distraction from baseline disc height is necessary for successful decompression & fusion.
Decompression ; Follow-Up Studies ; Transplants

There are many advantages in treating long bone fractures with interlocking intramedullary nail and its advantages are well known. Although it is used widely, many major and minor complication can develop in spite of meticulous operation techniques. Frist fifty consecutive interlooking intramedullary nail of two different surgeon, total of 100 cases that were operated in Seoul Paik Hospital from January, 1991 to July, 1994, were reviewed and the complications were analyzed with various factors. 1. Among the 100 cases, a total of 30(30%) major and minor complications had developed. But only 4 major complications which needed reoperation or poor result occurred. 2. Among the complications that had developed, angulation and rotation deformity being 10 cases were the most common, other complications were delayed union in 5 cases, nonunion in 2 cases, problem of screw in 4 cases, metal failure in 2 cases, misentry point in 2 cases and others in 5 cases. 3. There were no remarkable difference between surgeon A and surgeon B. The complications decreased abruptly after 30th case for each surgeon and only a few complications, probably due to complex fracture pattern, occurred. In conclusion, complications after interlocking intramedullary nailing can be reduced by meticulous preoperative planning and learning process of surgeon.
Congenital Abnormalities ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Learning ; Reoperation ; Seoul

The authors analysed 340 cases of the ocular injuries among 7633 out and in-patients who visited to the clinic of P.N.U. hospital during 5 years, from Jan. 1964 to Dec. 1968. Followings were discussed. 1. We found that 4.6% of all cases attending our eyes clinic was victims of ocular injuries. 2. The sex incidence showed that 78.9% of such ocular injuries occured in male and 21.1% in female. 3. The incidence was prevalent in young adult 21-30 years of age, and their large number of cases were injured from blowing and industrial accidents, while in children under 10 years of age sharp-pointed toys were more frequent causes. 4. The subconjunctival hemorrhage was the most frequent disturbance of ocular injuries and then came traumatic cataract and corneal foreign bodies in that order. 5. The prognosis of ocular injuries was generally poor, especially, poor, especially in the perforating and penetrating wound of the whether the foreign body was retained or not.
Accidents, Occupational ; Cataract ; Child ; Female ; Foreign Bodies ; Hemorrhage ; Humans ; Incidence ; Male ; Play and Playthings ; Prognosis ; Wounds, Penetrating ; Young Adult

No abstract available.
Follow-Up Studies* ; Spinal Stenosis*

No abstract available in English.
Child ; Humans ; Osteomyelitis

From Nov. 1986 to May 1988, we experienced 5 patients of bilateral recurrent patellar dislocation and obtained the following results:1. The age at operation raaged from 17 to 25 years. Among 5 patients, four were female and one, male. 2. The age at the onset of symptom ranged from 7 to 16 years. 3. The common presenting symptoms were pain(5 knees), giving way(4), grating(4), swelling (3), and weakness(2). 4. The roentgenographic findings were lateral patella tilt(9 knees), lateral femoral condyle hypoplasia(6), patella alta(2), patella dysplasia(2), and accessory ossification center(2). 5. All knees were treated by Hughston technique:One patient(2 knees) was treated with proximal realignment only, and the others(7 knees) were with proximal and distal realignments. 6. Follow up period ranged from 1 to 2 years. And the excellent to good result was obtained from the patients treated with proximal and distal realignments(excellent in 4 knees, good in 2 knees), the fair result from the patient treated with proximal realignment only(2 knees), and the poor result from the patient slipped down at 6 weeks postoperatively(1 knee).
Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Patella ; Patellar Dislocation

Gold Sodium Thiomalate (Myochrysine) used for rheumatoid arthritis has been known that it can cause the long term remission by its antimicrobial action, cell metabolism, complement activation and by activating the cell related to immunologic response. Accordingly the effect and side effect of gold theraphy has long been an object of concern. Authors clinically analyzed cases of 49 rheumatoid arthritis patients who were treated with gold and the mean duration of follow-up was 2.7 years. 50mg of Gold Sodium Thiomalate was injected intramuscularly in accordance with weekly based check up of symptom improvement & side effect. The interval of injection was prolonged and maintained to 4 weeks or 6 weeks when the total amount of injected gold was reached to 1gm or 1.2gm. The over-all symptom remission was forty (82%) and twenty five (51%) showed symptom remission and its maintenance. In symptom remission group, the change of laboratory findings was the reduction of erythrocyte sedimentation rate (ESR) from 59.7 to 32.3. As for side effects, dermatitis found in 16 cases was the most common and stomatitis found in 8 cases. There were others such as irritation symptom of gastrointestinal system & nephritis and 7 cases where the injection was stopped because of side effects was found out. Considering the above results, Gold Sodium Thiomalate is regarded as one of the effective methods for the treatment of rheumatoid arthritis when it is used electively paying heed to side effect.
Arthritis, Rheumatoid ; Blood Sedimentation ; Complement Activation ; Dermatitis ; Follow-Up Studies ; Gold Sodium Thiomalate ; Humans ; Metabolism ; Nephritis ; Stomatitis