For the evaluation of the clinical and radiologicaI result in the surgical reduction and internal stabilization of the fracture-dislocations in the thoracic and lumbar area, the authors analysed the 39 patients who were treated with Harrington instrumentation supplemented by segmental sublaminar wiring and were follow up 24 months in average. l. Indications for the operation were: compression type with more than 50% of body wedging, bursting type with less than 30% of canal involvement without cord injury, fracture-dislocation type with instability and any type with complete cord injury. 2. Amount of fusion were 6 segments in 25 cases, 7 segments in 11 cases, 5, 8 and 10 segments in 1 case each. 3. Among 31 cases whose lumbar segment were involved in fusion, numbers of movable lumbar motion segments were three or less in 26 and two or less in 8. 4. Angular deformity were changed from 27 preoperatively to 8 postoperatively and to 12 at the end of follow up. Wedging amount of anterior vertebral height were 53% preoperatively, 23% postoperatively and 27% at the end of follow up. 5. External support were applied for 4 months in 35 cases; Taylor brace in 22, TLSO in 10 and body cast in 3. Ambulation was started within a week according to the general status. 6. Solid bony union were observed in 38 cases within 4 months period. Dislodgement of instrumentation and deep infection in one each patient were observed as operative complications. 7. Among 21 cases with cord injury symptoms, 18 cases with complete type showed no neurological recovery, but 3 cases with incomplete type showed complete recovery. It is concluded that the Harrington instrumentation with sublaminar wiring is an effective method of reduction and stabilization for the fracture and dislocations of the thoracic and lumbar spine. On the other hand, the operation is an extensive procedure with significant involvement of lumbar motion segments.
Braces ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Hand ; Humans ; Methods ; Spine ; Walking

No abstract available.
Bile Ducts, Extrahepatic* ; Carcinoma, Hepatocellular*

Metastatic carcinomas are the largest group of malignant tumors of the liver. But parenchymal liver metastasis from cystic ovarian adenocarcinoma is very rare. We report a case in which the resection of metastatic liver neoplasm from ovarian serous cystadenocarcinoma was done 7 yr after initial treatment. A 48-yr-old oriental housewife complained of easy fatigability and right lower quadrant discomfort. The hepatic mass was detected by ultrasonographic examination. Serum albumin, bilirubin, and aspartate aminotransferase/alanine aminotransferase were normal. Alkaline phosphatase level was slightly increased at 146 IU/L. A tumor marker study showed alpha-fetoprotein 0.97 IU/mL, carcinoembryonic antigen 0.965 ng/mL, cancer antigen 125 1,267 ng/mL and CA 19-9 106.1 ng/mL. The operation involved cholecystectomy and segmentectomy VI and VII of the liver. The patient recovered from the surgery without any complication. On the 10th postoperative day, the patient received a single-regimen chemotherapy with paclitaxel (Taxol, 155 mg/m2 BSA) and was discharged. She has been carefully followed-up without any evidence of recurrence after completion of the remaining 5 cycles of chemo-therapy, at intervals of three weeks.
Cystadenocarcinoma, Serous/*secondary/*surgery ; Female ; Hepatectomy ; Humans ; Liver Neoplasms/*secondary/*surgery ; Middle Aged ; Ovarian Neoplasms/*pathology ; Tomography, X-Ray Computed

No abstract available.
Brain* ; Tomography, Emission-Computed, Single-Photon*

The purpose of this study provides measurements of radiation dose from MDCT of head, chest, abdomen and pelvic examinations. A series of dose quantities that are measured of patient weight to compare the dose received during MDCT examinations. Data collected included: weight together with CT dose descriptors, volume CT dose index (CTDIvol) and dose length product (DLP). The effective dose was also estimated and served as collective dose estimation data. Data from 1,774 adult patients attending for a CT examination of the head (n=520) or chest (n=531) or abdomen (n=724) was obtained from spiral CT units using a same CT protocol. Mean values of CTDIvol was a range of 48.6 mGy for head and 6.9, 10.5 mGy for chest, abdomen examinations, respectively. And mean values of DLP was range of 1,604 mGy.cm for head, 250 mGy.cm for chest, 575 mGy.cm for abdomen examinations, respectively. Mean effective dose values for head, chest, abdominal CT were 3.6, 4.2, and 8.6 mSv, respectively. The degree of CTDIvol and DLP was a positive correlation with weight. And there was a positive correlation for weight versus CTDIvol (r2=0.62), DLP (r2=0.694) in chest. And head was also positive correlation with weight versus CTDIvol (r2=0.691), DLP (r2=0.741). We conclude that CTDIvol and DLP is an important determinant of weight within the CT examinations. The results for this study suggest that CT protocol should be tailored according to patient weight.
Abdomen ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; Cone-Beam Computed Tomography ; Cytarabine ; Gynecological Examination ; Head ; Humans ; Subject Headings ; Thioguanine ; Thorax ; Tomography, Spiral Computed

No abstract available.
Child* ; Humans ; Radioisotope Renography*

The results of rotation chair test were known to variable by many parameters such as eye opening and alertness, etc. The situational change in rotation chair test must be considered to interpretation of its result. But in Korea, there were no reports or articles about parameters which influence the result of rotation chair test. So, we assumed that eye opening and alertness were main parameters and took rotation chair test in neurotologically normal subjects. For evaluation of the effect of eye-open or eye-closure and alertness on the rotational vestibular stimulation, we have taken sinusoidal harmonic acceleration test in 30 otoneurologically normal subjects. The maximal slow phase eye velocity, gain and asymmetry were obtained and compared with each other in four different conditions with properly fixed conditions such as in darkness and 0.05Hz frequency. At least five minutes interval was given between the tests and recalibrations were done before each tests. The results of this test were as follows. 1) Vestibular-ocular reflex(VOR) changes according to eye open or closure. In cases of examinees which were given alerting tasks, larger gain was obtained with eyes opened than with eyes closed, and that was statistically significant(p<0.05). In cases of examinees which were not given alerting tasks, larger gain was obtained with eyes opened than with eyes closed, but that was not statistically significant(p>0.05). 2) VOR changes according to alertness. In cases of examinees which opened their eyes, larger gain was obtained with alerting tasks than without alerting tasks, and that was statistically significant(p<0.05). In cases of examinees which closed their eyes, larger gain was obtained with alerting tasks than without alerting tasks, and that was statistically significant(p<0.05). 3) There was no significant changes of asymmetry according to the conditions. Therefore, from above results, we recommend the condition in which examinees open their eyes and be given alerting tasks as one of the optimal condition in sinusoidal harmonic acceleration test.
Acceleration* ; Darkness ; Korea ; Plastics* ; Reflex, Vestibulo-Ocular*

PURPOSE: To present the findings of intestinal obstruction and evaluate the value of CT in the diagnosis of intestinal obstruction. MATERIALS AND METHODS: We prospectively analyzed CT scans of twenty-two patients who were suspected to have intestinal obstruction. All 22 patients were confirmed with surgery:10 patients with adhesion, four with primary intestinal tumor, one with metastatic intestinal tumor, two with inflammatory bowel disease, two with intussusception, two with extrinsic compression by ovarian tumor, and one with inguinal hernia. The CT scans were evaluated with special attention to their causes, locations, and CT findings of intestinal obstruction. CT diagnosis and findings were compared with surgical results. RESULTS: Their causes were diagnosed correctly on CT scans in seventeen of 22 cases(77.3%). Locations of the intestinal obstruction were diagnosed correctly in 16 cases(72.7% ). The CT findings of intestinal obstruction were categorized into dilated proximal bowel loops with normal distal loops, thickening of the affected bowel wall, presence of the transitional zone, and no detectable abnormalities. The associated extraluminal findings were fat infiltration around the dilated bowel loops, ascites, and mesenteric lymphnodes enlargement. There were two limitations of CT in our study:first, no detectable differences between jejunum and ileum on CT scans, and second, difficulty in differential diagnosis between thickened bowel wall mimicking normal non-dilated segment and mechanical obstruction from tumors or inflammatory bowel diseases. CONCLUSION: We conclude that CT is useful method in the evaluation of causes and locations of intestinal obstruction and the demonstration of the associated extraluminal abnormalities.
Ascites ; Diagnosis* ; Diagnosis, Differential ; Hernia, Inguinal ; Humans ; Ileum ; Inflammatory Bowel Diseases ; Intestinal Obstruction* ; Intussusception ; Jejunum ; Prospective Studies ; Tomography, X-Ray Computed

PURPOSE: Tetanus is still one kind of major health problem in many countries, so tetanus prophylaxis is very important. However medical interview and wound description are not always enough to determine the tetanus prophylaxis. Thus, we assessed the utility of Tetanos Quick Stick(R) test for selective tetanus prophylaxis in the emergency department. METHODS: From September 17, 2003 to October 4, 2003, 180 patients were studied for 14 days. Tetanos Quick Stick (R) and ELISA (enzyme-linked immunosorbent assay) were performed with 180 samples from 180 patients. RESULTS: The Tetanos Quick Stick(R) had a sensitivity of 79.6%, a specificity of 99.2%, a positive predictive value of 97.7 %, a negative predictive value of 91.9%, and an accuracy of 93.3%. CONCILUSION: The results of our study revealed that the Tetanos Quick Stick(R) test is useful for selective tetanus prophylaxis in the emergency department.
Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Humans ; Sensitivity and Specificity ; Tetanus* ; Wounds and Injuries

BACKGROUND/AIMS: Screening for hepatocellular carcinoma (HCC) is a common practice in the endemic countries but its exact role has not been fully investigated. The purpose of this study was to determine whether screening can achieve early diagnosis and survival benefits. METHODS: All HCC patients diagnosed at our hospital (September 1994~April 2000) were enrolled; They were divided into two groups; a surveilled group screened with alpha-fetoprotein (AFP) and ultrasound (US) for longer than 6 months before diagnosis and a non-surveilled group. We compared the tumor size, portal vein thrombosis, and stage at initial diagnosis and survival rate between the two groups. RESULTS: A total of 247 patients were enrolled. 64 were in the surveilled group and 183 were in the non-surveilled group. The tumor size at initial diagnosis in the surveilled group was smaller than in the non-surveilled group (2.6+/-2.0 cm vs. 5.7+/-4.1 cm, p<0.05). The percentages of patients with stage I, II, III, and IV were 42.2%, 20.3%, 14.1%, 23.4% in the surveilled group and 8.7%, 19.7%, 36.6%, 35.0% in the non-surveilled group. A significantly higher proportion in the surveilled group had earlier stage compared with the non-surveilled group (p<0.05). Portal vein thrombosis in the surveilled group was noticed as significantly less than in the non-surveilled group (9.4% vs. 26.8%, p<0.05). Among Child-Pugh A patients, the cumulative survival rate in the surveilled group was significantly higher than in the non-surveilled group (1 year; 91.4% vs. 70.7%, 2 year; 71.5% vs. 59.9%, p<0.05). CONCLUSIONS: Screening with AFP and US is a useful tool for early diagnosis of HCC, especially with improved survival in Child-Pugh A patients.
Adult ; Aged ; Carcinoma, Hepatocellular/*diagnosis/mortality/therapy ; Female ; Humans ; Liver Neoplasms/*diagnosis/mortality/therapy ; Male ; Middle Aged ; Survival Rate ; alpha-Fetoproteins/analysis