The Allis maneuver is the most commonly used method for reducing posterior hip dislocation. The authors experienced an iatrogenic proximal tibiofibular fracture in a 91-year-old male who underwent total hip arthroplasty while reducing posterior hip dislocation with the Allis maneuver. The hip was safely reduced under spinal anesthesia with a fracture table. Open reduction and internal fixation with a locking plate were done for the proximal tibia fracture.

The Allis maneuver is the most commonly used method for reducing posterior hip dislocation. The authors experienced an iatrogenic proximal tibiofibular fracture in a 91-year-old male who underwent total hip arthroplasty while reducing posterior hip dislocation with the Allis maneuver. The hip was safely reduced under spinal anesthesia with a fracture table. Open reduction and internal fixation with a locking plate were done for the proximal tibia fracture.

The Allis maneuver is the most commonly used method for reducing posterior hip dislocation. The authors experienced an iatrogenic proximal tibiofibular fracture in a 91-year-old male who underwent total hip arthroplasty while reducing posterior hip dislocation with the Allis maneuver. The hip was safely reduced under spinal anesthesia with a fracture table. Open reduction and internal fixation with a locking plate were done for the proximal tibia fracture.

The present study was performed to evaluate the effect of tetracycline-HCL on the change of implant surface microstructure according to application time. Implant with pure titanium machined surface, double coated FBR(R) surface and oxidized CellNest surface were utilized. Implant surface was rubbed with 50mg/ml tetracycline-HCL solution for 1/2, 1, 1 1/2, 2 and 2 1/2min. respectively in the test group. Then, specimens were processed for scanning electron microscopic observation. The results of this study were as follows. 1. Both test and control group showed a few shallow grooves and ridges in pure titanium machined surface implants. There were not significant differences between two groups. 2. The double coated FBR(R) surfaces showed fine crystalline structures. The roughness of surfaces conditioned with tetracycline-HCL was lessened relative to the application time. 3. The oxidized CellNest surfaces showed the porous structures. The surface conditioning with tetracycline-HCl influenced on its micro-morphology. In conclusion, the detoxification of the affected implant surface with 50mg/ml tetracycline-HCL should be applied respectively with different time according to various implant surfaces.
Crystallins ; Titanium

OBJECTIVE: The objective of this study is to evaluate the clinical and angiographic outcomes after primary balloon angioplasty in patients with symptomatic middle cerebral artery (MCA, M1 segment) stenosis refractory to medical therapy. MATERIALS AND METHODS: Eleven patients with intracranial stenosis were treated with primary balloon angioplasty. All patients had MCA stenosis with recurrent transient ischemic attack (TIA). The indication for balloon angioplasty was patients with significant MCA stenosis: 1) age older than 18 years with recurrent or progressive TIA or infarction despite optimal medical therapy, including anti-coagulation, dual anti-platelet, and anti-lipid medication; 2) previous ischemic events or asymptomatic severe stenosis (more than 50%) with poor collateral cerebral circulation, or diminished cerebral perfusion on single photon emission computed tomography before and after administration of the intravenous dosage of acetazolamide. RESULTS: The median age of patients was 53 years (range 44-79). The technical success rate was 100%. Mean pretreatment stenosis degree was 83.63 +/- 9.53% and 29.1 +/- 15.4% before and after angioplasty, respectively. Procedural-related complications occurred in four of 11 patients (36%), but none of the patients had permanent neurological deficit. All patients were available for an average follow-up period of 19.4 +/- 5.1 months. One patient had a stroke in the territory of angioplasty at two months after angioplasty. The stroke free survival rate at 30 days and 12 months was 100% and 91%, respectively. Restenosis over 50% was observed in three of 11 patients (27%); all were asymptomatic. CONCLUSION: Intracranial angioplasty for symptomatic MCA stenosis refractory to medical therapy can be a treatment option to reduce the risk of further TIA or stroke.
Acetazolamide ; Angioplasty* ; Angioplasty, Balloon ; Atherosclerosis ; Constriction, Pathologic* ; Follow-Up Studies ; Humans ; Infarction ; Ischemic Attack, Transient ; Middle Cerebral Artery* ; Perfusion ; Stroke ; Survival Rate ; Tomography, Emission-Computed, Single-Photon

The abdominal tumors in children are different from those of adult. These tumors are the third most common one, preceded by leukemia and brain tumors, in children under 15 years. X-ray examination is the most important method among diagnostic approaches. The role of diagnostic imaging is to identify the precise anatomic location and extent of pathologic process with the minimal number of imaging procedures. 23 cases of abdominal tumors were reviewed in respect of age incidence, site of origin, radiologic findings. The results are briefly summarized as follows: 1. Neuroblastoma was the most common (6 cases) and wilm's tumor (5 cases), choledocal cyst (4 cases), ovarian mass (3 cases), hydronephrosis (2 cases), were descending order in frequency. 2. The most common site was retroperitoneum (60%) Kidney was the single most common site of origin. 3. Radiologic findings. The most common findings of plain radiography was ill defined soft tissue mass and this method was helpful in the presence of calcification especially in neuroblastoma. Ultrasonographic pattern was anechoic (cystic), echoic or mixed pattern, but this method provide less precise anatomical details, nevertheless Ultrasonography was particularly useful imaging modality for the pediatric abdominal tumors. IVP findings were renal displacement, caliceopelvic system distortion or nonvisualization of kidney, these information was helpful in determining the location of tumors. CT scan showed homogenous or inhomogeneous, cystic or solid, mass with their anatomic location. 4. Ultrasonography was the most widely used specific diagnostic method, but had limited value in detecting the anatomic location of tumors. CT scan was superior to ultrasound for determining the extent of tumors.
Adult ; Brain Neoplasms ; Child ; Diagnostic Imaging ; Humans ; Hydronephrosis ; Incidence ; Kidney ; Leukemia ; Methods ; Neuroblastoma ; Radiography ; Tomography, X-Ray Computed ; Ultrasonography ; Wilms Tumor

We present a patient with spinal epidural arteriovenous fistula presented with subdural hematoma and progressive myelopathy. Transarterial embolization using NBCA results in complete obliteration of fistula without complication. The pathophysiology, angioarchitexture of the lesion and strategy for its cure would be discussed.
Arteriovenous Fistula* ; Fistula ; Hematoma, Subdural* ; Humans ; Spinal Cord Diseases ; Spine

PURPOSE: We expected the motion fraction could be checked, with simple radiographic examination, according to the guide-line of fluoroscopic technique, and recovery of the function also could be correlated with the improvement of the motion fraction. MATERIALS AND METHODS: We measured the motion fraction of the glenohumeral and scapulothoracic movement using fluoroscope in 30-degree intervals of arm elevation in the scapular plane. The ratio of glenohumeral to scapulothoracic movement (thetaGH/thetaST) was 1.6 for the full range of motion in scapular plane. During arm elevation, scapular tilting from the coronal plane was decreased from 42 degrees to 20 degrees tilting as well as internal rotation (scapular extension). We also measured the motion fraction (thetaGH/thetaST) and functional recovery of the shoulder in 11 patients after operative treatment of the shoulder instability in 15 patients from December 1996 to August 1997. RESULTS: We could find out a significant correlation between the recovery of motion fraction and shoulder function. These results would be applied in planing rehabilitation program after treatment of the shoulder instability. CONCLUSIONS: The measuring technique of glenohumeral to scapulothoracic movement (thetaGH/thetaST) with fluoroscopy could be applied to the simple radiographic measurement at the out-patient clinic in order to identify the pathology and recovery of shoulder motion after treatment
Arm ; Fluoroscopy ; Humans ; Outpatients ; Pathology ; Range of Motion, Articular ; Rehabilitation ; Shoulder*

PURPOSE: To analize the correlation between dynamic vascular pattern and structural histologic type of HCC. MATERIALS AND METHODS: The materials consisted of 35 cases of HCC, which could be classified by structural histologic type and had available preoperative arterial dominant images. Excluding one case of pseudoglandular type, we compared structural histologic type of the tumors(trabecular group;13 cases, mixed group;10 cases, and nontrabecular group ;11 cases) with dynamic vascular pattern such as degrees of tumor staining, severity of tumor vessels on hepatic angiography, and with enhancing degrees of early phase relative to late phase on two-phase incremental bolus dynamic CT. RESULTS: In hepatic anglogram, trabecular group showed stronger tumor staining and more prominant dilatation and irregularity of tumor vessels than those of nontrabecular group, and In two-phase incremental bolus dynamic CT, and trabecular group showed more prominant tumor enhancement in early phase than those in late phase. CONCLUSION: The trabecular type(typical) and non-ti'abecular type of HCC showed radiologically different vascular patterns and therefore we believe that this maybe the basis with which diagnosis and treatment policy of radiologically atypical HCC could be made.
Angiography ; Diagnosis ; Dilatation

PURPOSE: To classify the ultrasonographic findings of cystic lesions of the breast and correlated them with the pathology, to evaluate the characteristic features of cystic masses in benign and malignant tumors, and to determine the appropriate level of patient management according to the ultrasonographic findings. MATERIALS AND METHODS: From June 2002 through to June 2004, the ultrasonographic findings of 113 pathological proven cystic breast lesions were reviewed retrospectively. The cystic lesions were classified as simple acysts, clustered cysts, cysts with thin septa, complicated cysts, cystic masses with a thick wall/ septa or nodules, and complex solid and cystic masses. The ultrasonographic findings of each type of cystic lesion of the breast were compared with the pathology and evaluated according to whether they were benign or malignant. RESULTS: Of the 113 lesions, there were 17 simple cysts, 10 clustered cysts and 19 cysts with thin septa. Twenty four cases of complicated cysts were found to be benign. Five (31.3%) of the 16 cases of cystic masses with a thick wall / septa or nodules and 17 (63%) of the 27 cases of complex solid and cystic masses were found to be malignant. The shape and margin of the 43 cases of cystic masses with a solid component were analyzed. Seventeen out of 36 sonographical round or oval shaped masses and 10 out of 27 sonographical circumscribed margins were found to be malignant. CONCLUSION: The simple cysts, clustered cysts, cyst with thin septa and non-symptomatic complicated cysts detected by sonography were all benign. Symptomatic complicated cysts should be aspirated and treated appropriately. Cystic masses with a solid component should be examined by a biopsy with a pathological confirmation.
Biopsy ; Breast* ; Humans ; Pathology ; Retrospective Studies ; Ultrasonography*