No abstract available.
Colorectal Neoplasms*

The treatment of supracondylar fracture of the femur remains a difficult problem because of the wide range of portential complications. In the past, authors thought conservative treatment was superior to operative treatment of supracondylar fracture of the femur. In addition, the advent of the Cast-Brace introduced the change in concept of the conservative treatment. Recently, however, the advances in the techniques and in the devices used in intemal fixation have encouraged the operative treatment. Tibiofemoral angle, gap or stepping of the articular surface of the distal femur, range of motion of the knee, and pains in the knee were used to evaluate the following results investigated by statistical study(T-test). These clinical results were shown by analyzing 49 cases of supracondylar fracture of the femur trea ted in the Department of Orthopedic Surgery, Hallym College of Medicine, from Jan. 1980 to Dec. 1983 1. We end result of each patient was evaluated by scaled score value calculated from above mentioned criteria. 2. The mean value of the operative treatment(35 cases) was 31.03±5.52, while that of the conservative treatment(14 cases) was 27.71±4.56. 3. The mean value of the group which began the exercise of the knee joint within 2 weeks (33 cases) was 32.24±4.43. The mean value of the other group which began the exercise of the knee joint after 2 weeks(16 cases) was 25.78±4.56. This difference of means between two groups was statistically significant. Beginning the knee joint exercise within 2 weeks has large effect on the result of the treatment. 4.The results of treatment in patient over age of 50 were graded as fair irrespective of methods of treatment. 5. Various devices were used in intemal fixation but there was no difference in the results. 6. We mean value of the Tibiofemoral angle(difference from normal angle) in the operative treatment was 2.37±6.25 and that of the conservative treatment was 8.04±4.62. Both of the above method of treatment showed a varus trend, especially in the conservative treatment. In statistical study, through, there was no significance in two methods.
Adult ; Femur ; Humans ; Knee ; Knee Joint ; Methods ; Orthopedics ; Range of Motion, Articular ; Statistics as Topic

No abstract available.
Biofeedback, Psychology* ; Humans ; Meningomyelocele*

Traumatic atlanto-occipital dislocation is usually fatal. To date, few cases have been reported in the literature because survival after traumatic atlanto-occipital dislocation is extremely rare. We present the case of a 47-year-old man with traumatic atlanto-occipital rotatory posterior dislocation combined with atlanto-axial rotatory subluxation and treated by occipito-cervical fusion using Bohlman's triple wiring technique.
Dislocations* ; Humans ; Middle Aged

No abstract available.
Colorectal Neoplasms* ; Electrophoresis* ; Genes, ras* ; Humans* ; Point Mutation* ; Polymerase Chain Reaction*

PURPOSE: We performed this study to assess the value of CT in the differential diagnosis of palpable neck masses in children. MATERIALS AND METHODS: We retrospectively reviewed the CT scans of the palpable neck masses in 30 children. The masses were proved histopathologically and classified into cystic, solid, and inflammatory mass and their CT findings were analyzed. RESULTS: Twelve cases were cystic masses, 4 were solid masses, and 14 were inflammatory lesions. Cystic masses included cystic lymphangiomas (n=6), branchial cleft cysts (n=3), thyroglossal duct cysts (n=2), and ranula (n=l). Cystic lymphangiomas showed insinuating appearances into adjacent structures and 4 cases occurred in the posterior cervical space. All branchial cleft cysts were round cystic masses with smooth wall and displaced the submandibular gland anteriorly and the sternocleidomastoid muscle posteriorly. Two thyroglossal duct cysts occurred centrally adjacent to the hyoid bone and 1 ranula in the submental area. Solid masses were juvenile hemangioma, pleomorphic adenoma in submandibular gland, neurilemmoma, and fibromatosis colli. Juvenile hemangioma showed well-enhancing mass with indistinct margin and the other solid masses had well-defined margin with their characteristic location. Inflammatory lesions were abscess (n=4), deep neck infections with lymphadenopathy (n=4), submandibular gland inflammation (n=3), and tuberculous lymphadenitis (n=3) and they showed strand-like enhancement in adjacent subcutaneous tissues. Tuberculous lymphadenitis had multiple lymph node enlargement with internal low attenuation areas and showed less surrounding strand-like enhancement than suppurative lymphadenopathies. CONCLUSION: Most neck masses in infants and children were of congenital or inflammatory origin. CT is useful for the evaluation of the child presenting with a neck mass, because it can differentiate various forms of neck masses and is able to reveal the relationship of the masses to the adjacent structures with their characteristic location.
Abscess ; Adenoma, Pleomorphic ; Branchioma ; Child* ; Diagnosis, Differential ; Fibroma ; Hemangioma ; Humans ; Hyoid Bone ; Infant ; Inflammation ; Lymph Nodes ; Lymphangioma, Cystic ; Lymphatic Diseases ; Neck* ; Neurilemmoma ; Ranula ; Retrospective Studies ; Subcutaneous Tissue ; Submandibular Gland ; Thyroglossal Cyst ; Tomography, X-Ray Computed ; Tuberculosis, Lymph Node

No abstract available.
Colorectal Neoplasms* ; Humans* ; Oncogenes* ; Point Mutation* ; Polymerase Chain Reaction*

PURPOSE: To evaluate the indication for intracavitary Urokinase(UK) in the treatment of Ioculated pleural effusion. MATERIALS AND METHODS: We analyzed CT and US in 31 patients who were treated with intracavitary UK in Ioculated pleural effusion. In each patient, a single chest catheter (10-12F) was insected under imaging guidance. When the amount of drainage was less than 100ml/day, UK was instilled through the catheter until less than 50ml/day was drained. On follow-up chest radiographs of more than 1 month, we classified the results of treatment into 3 groups:(1) completely effective (lung expansion, over 80%);(2) partially effective (20-80%); (3) ineffective (below 20%) group. Sonographic pattern of pleural fluid was classified into anechoic, septated, and honeycomb appearances and the thickness of parietal pleura was measured on CT. RESULTS: Sixteen patients were completely effective, nine were partially effective, and six were ineffective. patients with completely or partially effective outcome had anechoic and linear septated appearance on had less than 4mm of parietal pleural thickness on CT. Of six ineffective patients, US showed linear septated in one patient and honeycomb appearance in five patients and the thickness of parietal pleura on CT was 3 mm in one patient, 4ram in two patients, 5mm in one patient, and 6mm in two patients. CONCLUSION: UK instillation through percutaneous catheter was an effective method in the treatment of Ioculated pleural effusion. However, we found near complete reaccumulation of pleural fluid when honeycomb appearance of pleural fluid on US or more than 5mm parietal pleural thickness on CT was observed, which might suggest that we should consider the other kinds of treatment method in those patients.
Catheters ; Drainage ; Follow-Up Studies ; Humans ; Insects ; Pleura ; Pleural Effusion* ; Rabeprazole ; Radiography, Thoracic ; Thorax ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

PURPOSE: To determine the value of thin-section CT in the diagnosis of nasal bone fractures. MATERIALS AND METHODS: We evaluated the thin-section CT scans of 40 patients with nasal bone fracture. CT scans were obtained with both axial and coronal planes, 1.5mm collimation with 2mm interval, and 9.6cm field-of-view. The axial scan plane was kept parallel to the orbitomeatal line from the nasion to the lower limit of the nose and the coronal plane was kept perpendicular to the axial plane. The data were reconstructed with bone algorithm. Nasal bone fracture was classified into 1 of 3 types on thin section CT:(I) simple fracture;(ll) simple fracture with displacement;(III) comminuted fracture. Associated facial bone injuries were also evaluated Simple radiographs of nasal bone were reviewed for comparison. RESULTS: Six patients had simple fracture, 10 patients had simple fracture with displacement, and 24 patients had comminuted fracture. Twenty-six patients had associated facial bone injuries which included fracture of nasal septum (n=15), fracture of frontal process of maxilla (n=9), fracture of ethmoid (n=6), widening of nasofrontal suture (n=5), and fracture of nasolacrimal duct (n=2). In 15 of 40 patients, CT could identify nasal bone fractures not detected on simple radiographs. CONCLUSION: Thin-section CT is a valuable aid in the evaluation of nasal bone fracture for accurate identification, nature, and combined facial injury.
Diagnosis ; Facial Bones ; Facial Injuries ; Fractures, Comminuted ; Humans ; Maxilla ; Nasal Bone* ; Nasal Septum ; Nasolacrimal Duct ; Nose ; Sutures ; Tomography, X-Ray Computed

The objectives of this study sere to investigate how the local irradiation affect the survival of random pattern skin flap, and whether or not hyperbaric oxygen and allopurional can improve the survival of the irradiated rat skin flap. There have been many reports about the effects of hyperbaric oxygen and allpurinol on skin flaps. However, very few reports have been presented on the effects of hyperbaric oxygen and allpurinol in treating irradiated skin flaps. The author examined the local irradiation effect on rat skin flap survival after irradiation of 20 Gy, 3 days postoperatively, on cranially based random pattern dorsal skin flap, which was 3 x 9cm in size. The flap survival length was measured in experimental groups treated with hyperbaric oxygen (2.5 atm absolute, 100% oxygen, once a day for 7days) after irradiation and with hyperbaric oxygen combined with allopurinol (100mg/kg, once a day for 7 days), in comparison with a radiation-only group. On reviewing the flap survival length 10 days postoperati-vely, the average flap survival length in the radiation-only group was 2.2+/-0.5cm, while in the non-radiation group it was 5.5+/-0.3cm. The reduction ratio of flap survival by irradiation was 60%. There was a significant increase in the mean flap survival length in the groups treated with hyperbaric oxygen (4.0+/-1.6cm) and hyperbaric oxygen combined with allopurinol (5.5+/-1.8cm). The increased ratio of flap survival in each group was 85% and 150% when compared to the radiation-only group. The author found that rat skin flap survival decreased, even at an early stage, as a result of high dose local irradiation and that decreased flap survival by irradiation could be restored by hyperbaric oxygen and allopurinol. The group treated with hyperbaric oxygen combined with allopurinol showed increased flap survival over the group treated with hyperbaric oxygen only. The results showed a method which could possibly increase flap survival in cancer patients who require early radiation after flap surgery.
Allopurinol* ; Animals ; Humans ; Oxygen* ; Rats* ; Skin*