We have reviewed seven cases of fracture-separation of the distal humeral epiphysis, one of which was initially misdiagnosed as a fracture of the lateral condyle. There were difficulties in making the diagnosis. The injury must be distinguished from an elbow dislocation and a fracture of the lateral humeral condyle. All seven patients revealed posteromedial displacement of the distal humeral epiphysis on initial x-rays. Three patients were treated by closed reduction and cast immobilization, and four patients by open reduction and internal fixation. All three patients with conservative treatment had slight cubitus varus (under 5 degrees). Two patients with operative treatment had significant deformities of the elbow, one 25 degrees of valgus and one 20 degrees of varus. In treatment of these injuries, accurate evaluation of the state of reduction is most important. We got acceptable results with a conservative treatment.
Child* ; Congenital Abnormalities ; Diagnosis ; Dislocations ; Elbow ; Epiphyses* ; Humans ; Immobilization

No abstract available.
Antibody Formation* ; Heat-Shock Proteins* ; Hot Temperature* ; Mucocutaneous Lymph Node Syndrome*

A total 48 cases of myelography using Metrizamide were performed between August 1981 and July 1983 at the department of Orthopedic Surgery, Kwangju Christian Hospital. Of these cases, H.N.P was 26, tuberculous spondylitis 16, spondylolisthesis 4, and multiple sclero-sis 2 cases. The advantages of this study were as folows: 1. Complications were minimal in most of the cases except a slight headache. 2. Large amount of infusion was possible. 3. Rootlet was clearly seen. 4. Removal of dye was not necessary. 5. It gave a good contrast for the radiologic study.
Gwangju ; Headache ; Metrizamide ; Myelography ; Orthopedics ; Spondylitis ; Spondylolisthesis ; Water

PURPOSE: We applied lateral lithotomy position to the severe ureteral stricture cases supposed to fail with only retrograde approach. MATERIAL AND METHODS: From October 1997 to April 1999, 13 patients with severe ureteral stricture (lenghth>2cm or complete obstruction) supposed to fail with only retrograde approach and one patient with study. The causes of ureteral strictures were pelvic malignancy in 5, tuberculosis in 4, trauma in 2 and others in 2. The patient's ipsilateral shoulder was rotated and fixed like lateral position. And ipsilateral pelvis was elevated with sandbag or pad and rotated about 45 degrees, too. The retrograde approach was tried at first, if fail, antegrade approach was combined. RESULTS: We could insert ureteral stent via retrograde approach only in 3 patients and we needed aid of antegrade approach for passage through ureteral stricture in the other 11 patients (79%). Percutaneous antegrade approaches were combined in those 11 patients and we could pass the guide wire and indwell the stent in 10 of 11 patients (91%) using this position. CONCLUSIONS: The lateral lithotomy position was very helpful to the simultaneous retrograde and antegrade approach in severe fibrotic or malignant ureteral strictures.
Constriction, Pathologic ; Humans ; Pelvis ; Shoulder ; Stents ; Tuberculosis ; Ureter*

Various susceptibility tests have been used to determine minimal inhibition concentration (MIC) of dermatophytes. They have limitations to apply practically because they need long time to determine MiC. Authors examined MIC of T. rubrum to ketoconazole and itraconazole using 96- well microplate and 24-well macroplate by method of Granade and Artis and tried to check the possibility of this method on clinical application. Nine strains of T. rubrum from patients with dermatophytosis were used. Evaluations of the factors affecting MIC were also tried. The results as follows. 1. Effect of inoculation density on determination time and MIC: Determination of MIC were possible in 4th days after inoculation at higher inoculation density (aborbance 2.0, 1.0) compared to 6th days at lower inoculation density (absorbance 0.5, 0.25). 2. Effect of incubation temperature on MIC: When incubating at 37℃, MIC were below 0.006-0.04µg/ml to ketoconazole and below 0.006-0.04µg/ml to itraconazole while at 25℃ 0.08-5.68µ8/ml to ketoconazole and 0.006-0.71µg/ml to itraconazole. Significant reduction of MIC was observed at 37℃ compared to 25℃. 3. Effect of container size on determination time and MIC: When incubating in 96–well microplate and 24-well macroplate, determination of MIC was possible in 4th to 6th days after inoculation in broth-containig 96-well microplate compared to 8th to 12th days in broth-containing 24-well macroplate. But no difference in MIC was observed between different container size. 4. Effect of media on MIC: When using broth as media, MIC were below 0.006-5.68µg/ml to ketoconazole, below 0.006-0.36µg/ml to itraconazole in broth-containg 24-well macroplate. When using agar as media, MIC were below 0.006-5.68 µg/ml to ketoconazole, below 0.006-5.68 µg/ ml to itraconazole in agar-containing 24-well macroplate. 5. These findings confirm that determination of MIC of dermatophtes by method of Granade and Artis is fast and simple technique for antifungal susceptibility test.
Agar ; Arthrodermataceae ; Humans ; Itraconazole ; Ketoconazole ; Methods* ; Tinea ; Trichophyton*

The surgical technique for removal of ruptured lumbar intervertebral disc has changed very little since it was introduced by Mixter and Barr in 1934. The technique of the interlaminar operation used by most neurosurgeons was used successfully in early cases to relieve the sciatica, but many patients were unable to return to heavy work because of low back pain. Cloward described a different surgical technique for removal of a ruptured lumbar intervertebral disc. The operation utilizes a transverse skin incision and a wide bilateral stlipping and retraction of fascia and muscles. The ligamentum flavum is not removed but detached and reflected medially in a flap. Only the bone margins of the adjacent facets are removed. A complete laminectomy is never done except for spondylolisthesis when the separate neural arch is disarticulated and removed. Using a "Vertebral Spreader", and interlaminar exposure is developed two to three times larger than that obtained y the "standard" technique. The advantages are obvious: 1. Both operations were done through a single transverse incision. A wider lateral exposure for the skin wound, being made parallel to the lumbar operation was possible and the normal skin lines, heals better with less scar. 2. The entire ligament is preserved, by separating its attachments from the lamina and reflecting in a flap, a larger opening into the spinal canal is obtained and the replaced flap protects the dura and prevents scarring. 3. Cloward recommends the use of a narrow, sharp chisel and hammer, but we used the spinal rongeurs including the Kerrison punch to remove part of the laminal edge. We leave the articular facets of the lumbar disc surgery because the articular facets are considered important major elements in the articulation of the vertebral joints, and as an essential bony surface to be used in posterior spinal fusion operation. 4. The routine use of intrathecal cortisone after lumbar disc operation has not been used in our cases because of increased pressure of the cerebrospinal fluid in modified prone position of the patient.
Cerebrospinal Fluid ; Cicatrix ; Cortisone ; Fascia ; Humans ; Intervertebral Disc ; Joints ; Laminectomy ; Ligaments ; Ligamentum Flavum ; Low Back Pain ; Muscles ; Prone Position ; Sciatica ; Skin ; Spinal Canal ; Spinal Fusion ; Spondylolisthesis ; Wounds and Injuries

PURPOSE: To compare the incidence and the interval between the development of posterior capsular opacification (PCO) and Nd: YAG laser capsulotomy among patients implanted with a 811B, SI40NB, and MA60BM intraocular lens METHODS: One hundred ninty eyes of 157 patients who had undergone implant surgery with 811B, SI40NB, and MA60BM intraocular lens at the Presbyterian Medical Center were studied retrospectively. We compared the postoperative best corrected visual acuity, the incidence and the time interval between the development of PCO and laser capsulotomy, and the total energy used in laser capsulotomy among three intraocular lens groups. RESULTS: The incidence of development of PCO was 26.9% in 811B, 23.8% in SI40NB, and 10% in MA60BM groups, showing that incidence was significantly lower in the MA60BM group as compared to 811B (P=0.0016) or SI40NB (P=0.0056) group. The 811B group induced PCO earlier than SI40NB group. The energy used in Nd: YAG laser capsulotomy was lower in 811B than that in SI40NB or MA60BM. CONCLUSIONS: The incidence of posterior capsular opacification and that of Nd: YAG laser capsulotomy were found to be significantly lower in the MA60BM group than those in 811B or SI40NB group.
Humans ; Incidence ; Lasers, Solid-State* ; Lenses, Intraocular* ; Protestantism ; Retrospective Studies ; Visual Acuity

PURPOSE: To evaluate the efficacy of the Ellman Dento-Surg 90FFP for the isolated trichiasis or distichiasis. METHODS: 61 eyelashes of 23 patients, who were diagnosed as trichiasis or distichiasis and had less than 5 aberrant cilia that were isolated, were treated with the Ellman Dento-Surg 90FFP. At 1 week, 1 month, 2 month and 6 month postoperatively, we examined the success rate and postoperative complication. RESULTS: Fifteen eyelashes of 9 patients were regrown after mean 1.3month follow-up period (75.4% success rate). Among 10 eyelashes of 6 patients, 2 eyelashes of 2 patients were regrown (80% success rate). Thirteen patients experienced mild burning sensation 1-2 days postoperatively. Eyelid notching was observed in 2 patients. CONCLUSIONS: High frequency radio wave electrosurgery with Ellman Dento-Surg 90FFP is a simple and secure procedure with high success rate and negligible complication, and can be effectively used to treat isolated trichiasis or distichiasis.
Burns ; Cilia ; Electrosurgery ; Eyelashes ; Eyelids ; Follow-Up Studies ; Humans ; Postoperative Complications ; Radio Waves ; Sensation ; Trichiasis*

Currently, three different automated objective refractors are available commercially and are being used throughout the world. The most recently developed objective refractor. Dioptron, is an electro-optical instrument for measuring the refractive state of the eyes. The computer in this instrument takes the measurements and calculates automatically his objective refraction in term of sphere, cylinder and axis corrected for 12mm vertex distance. The motivation for this investigation was the need for a quantitative evaluation of Dioptron to determine how it may be utilized most effectively in clinical practice. The results in this study are based on comparisions of differences between Dioptron and streak retinoscopy which were examined the random samples of 800 eyes. In this analysis, authors found that the Dioptron proved to be more accurate in the cylinder and axis and equivalent in sphere findings when compared to streak retinoscopy although Dioptron could not replace physician's judgement.
Axis, Cervical Vertebra ; Evaluation Studies as Topic ; Motivation ; Retinoscopy*

This study was to evaluate the clinical usefulness of 99m Tc-MDP bone scintigraphy for assessing vascular ingrowth into the ocular implants after enucleation and evisceration. Twenty four patients(M:F=7:17, mean age:36), with a coralline hydroxyapatite after uncomplicated enucleation or evisceration surgery were studied. Uptake ratio was also calculated by measuring the implants activity(H)and contralateral orbit activity(N). Grading score and uptake ratio were compared with clinical outcome of vascularization. Additionally, we also analyzed the vascularization status as time lapse between primary surgery and scintigraphic study and surgical methods. The degree of grade and uptake ratio were inversely correlated with vascular ingrowth. Higher than grade 2 or greater than 1.56 in H/N ratio seemed to be an indicator for better prognosis. 99m Tc-MDP bone scintigraphy can be a useful method to evaluate the vascularized status of implants. Adequate time for 99m Tc-MDP bone scintigraphy after enucleation and evisceration was 11~20 weeks.
Durapatite ; Orbit ; Prognosis ; Radionuclide Imaging*