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

No abstract available.

We reviewed 56 patients who received mandibulotomy at Yonsei medical center between 1989 and 1999. We also analysed the complications associated with mandibulotomy and its contributing factors. The complications occur in 16 patients(28.6%) and are classified into two categories; intraoperative and postperative complications. Nonunion was observed in 5 patients and osteoradionecrosis in 5. The patients who received preoperative radiation therapy were more tend to develop nonunion and osteoradionecrosis. This study suggests the benefits of mandibulotomy as a surgical approach to oral cancer: 1. Paramedian osteotomy was recommended for preservation of neurovascular bundle and ease of surgical access. 2. By using thin saw blade, reapproximation was improved with minimal bone loss. 3. osteotomy on anterior mandible which lies outside the usual portals of radiation therapy decreases the incidence of osteoradionecrosis.
Humans ; Incidence ; Mandible ; Mouth Neoplasms* ; Osteoradionecrosis ; Osteotomy

We report herein a case of lymphomatoid papulosis showing atypical clinical manifestations. A 54- year-old man had had recurrent erythematous necrotic papules and nodues, numbering more than 200 lesions at the most aggravated time, on the trunk, extremities, buttok, and face for the last twenty years. Recently, he complained of tender swelling on the neck, axillae, and inguinal lymph nodes accompanied by mild fever and gerneral weakness. We had performed thorough examinations including biopsy from the skin lesions, lymph node, and bone marrow to detect some evidences of transforming to malignant lymphoma, but found no evidence of malignant lymphoma except aneuploidy on DNA histogram. The patients showed proinpt response to methotrexate 10-30mg par week wit,hout showing distinct side reactions to the accurvulated dose of 780mg for the last 16 months.
Aneuploidy ; Axilla ; Biopsy ; Bone Marrow ; DNA ; Extremities ; Fever ; Humans ; Lymph Nodes ; Lymphoma ; Lymphomatoid Papulosis* ; Methotrexate ; Neck ; Skin

A delayed hemolytic transfusion reaction (DHTR) is the result of delayed anamnestic alloantibody response four to fourteen days after transfusion of apparently compatible blood. Most DHTRs are very mild and may not be recognized clinically. Some are manifested only by anemia. Only a few cases are severe enough to induce a massive hemolytic reaction followed by frank renal failure. Recently, we experienced a case of DHTR with acute renal failure (ARF) due to anti-E. A 21-year-old woman received compatible four units of packed red cells after right artificial total hip replacement arthroplasty due to juvenile rheumatoid arthritis. She had a history of transfusion 4 years ago. Fourteen days after the transfusion, she showed a fall in hematocrit, hemoglobinuria and a positive indirect antiglobulin test, and accompanied by ARF. Anti-E was identified in the patient's serum by antibody screening and identification test at that time. She recovered from ARF after hemodialysis with conservative management. However, eventually, she died due to disseminated intravascular coagulopathy.
Acute Kidney Injury* ; Anemia ; Arthritis, Juvenile ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Blood Group Incompatibility* ; Coombs Test ; Female ; Hematocrit ; Hemoglobinuria ; Humans ; Mass Screening ; Renal Dialysis ; Renal Insufficiency ; Young Adult

No abstract available.

Lasers have used safely to and in the resection of highly vascular tumors or arteriovenous malformation. As far as blood vessel coagulation, arteries up to 2mm in diameter and veins up to 3mm in diameter can be reliably sealed with the Nd-YAG laser, and lesser size of vessels can be coagulated with the CO2 laser. Another advantage of laser is to be a useful tool for small vessel repair or anastomosis without microsuture technique. The aim of this experiment was to investigate intensity and duration of exposure with the CO2 laser for vessel coagulation and repair. 36 rats weighing 200 to 250 gm, were used in this study. For vessel coagulation of extracranial arteries and veins, power density between 10 and 50 watts/cm2(W) was applied with handpiece, and for vessel repair or anastomosis 2 W was applied with micromanipulator. The results obtained were as follows : 1) The artery was perforated immediately over 10 W with 0.5 seconds of exposure of smaller focal beam. 2) The artery was constricted in its diameter in defocused beam with 30-40 W, and perforated with 50 W. 3) The lower limit of venous coagulation was 15 W, 0.5 sec. of exposure and 2 mm of focal beam diameter. 4) The lower limit or arterial coagulation was 10 W, 5 sec. of exposure, 4 mm of focal beam diameter, and exposure time was reduced to 3 sec. at 20 W. 5) The repair or anastomosis of artery was accomplished with 2 W, 0.05 sec. of exposure of 0.2 mm of focused beam by 6 times of delivery, and the delivery times could be successfully reduced to half under the overlying thin blood clot film on the anastomosis site of the artery. 6) In the histological examination, the entire layer of coagulated vessel wall on the laser delivered side disclosed marked constriction and destruction. On the anastomosis site, re-endothelialization began from 3 days, and completed by 2 weeks after operation.
Animals ; Arteries ; Arteriovenous Malformations ; Blood Vessels* ; Constriction ; Lasers, Gas* ; Lasers, Solid-State ; Rats ; Veins

No abstract available.
Hematoma, Epidural, Spinal* ; Meningioma*

PURPOSE: To determine whether the analysis of abnormally high signal intensities in ischemic tissue, as revealed by diffusion-weighted MR imaging (DWI) can be used to evaluate reversible brain lesions in a cat model of acute ischemia. MATERIALS AND METHODS: Ten cats were divided into two groups of five (Group I and Group II), and in all animals the middle cerebral artery was temporarily occluded. Group I underwent T2-DWI 30 minutes after occlusion, and Group II 120 minutes after occlusion. In both groups, DWI was performed one hour and 24 hours after reperfusion (at one hour, non-T2-weighted; at 24 hours, T2-weighted). Both occlusion and reperfusion were monitored by 99m TC-ECD brain perfusion SPECT. All animals were sacrificed 24 hours later and their brain tissue was stained with TTC. Signal intensity ratios (SIR, signifying average signal intensity within the region of interest divided by that in the contralateral, nonischemic, homologous region) of the two groups, as seen on DWI were compared. The percentage of hemispheric lesions occurring in the two groups was also compared. RESULTS: SIR after occlusion of the middle cerebral artery was 1.29 in Group I and 1.59 in Group II. Twenty-four hours after reperfusion, SIR in Group I was higher than in Group II (p<0.01). After occlusion and reperfusion, the percentage of hemispheric lesions in Group I was less than in Group II. For the latter, the percentage of these lesions revealed by TTC staining and T2-weighted imaging was 48% and 59%, respectively, findings distinctly different from those for Group I. In addition, in group I, infarction was revealed by neither TTC staining nor T2-weighted imaging (p<0.01). CONCLUSION: The use of DWI to evaluate signal intensity ratios can help determine whether or not brain injury after temporary cerebral ischemia is reversible.
Animals* ; Brain Infarction* ; Brain Injuries* ; Brain Ischemia ; Brain* ; Cats ; Infarction ; Ischemia ; Magnetic Resonance Imaging* ; Middle Cerebral Artery ; Models, Animal* ; Perfusion ; Reperfusion ; Tomography, Emission-Computed, Single-Photon

Authors report two cases of central neurocytoma with unusual surgical pitfall. The one of these presented with postoperative intraventricular hemorrhage with hydrocephalus. The other case developed motor aphasia and hemiplegia due to brain retration during operation. We describe peripoerative courses of these cases and discuss possible causes of postoperative complications.
Aphasia, Broca ; Brain ; Hemiplegia ; Hemorrhage ; Hydrocephalus ; Neurocytoma ; Postoperative Complications