The purpose of this study are to delineate the temporal and spatial changes of bone mineralization at the distraction gap and adjacent parent bone, and to investigate the effect of microaxial dynamization on regenerate bone healing and on development of regional osteopenia at the adjacent parent bone, during callotasis. Sixteen Korean adult mongrel dogs underwent bilateral tibial lengthening by callotasis. To the right hindlimbs, no dynamization was applied and served as control group (group I, and axial elastic dynamization was conffered to the left hindlimbs (group II). Bone mineral density(BMD) was measured by dual X-ray absorptionmetry(DXA) at immediate post-operative day, post-operative 12 day, 22 day, 36 day, 50 day, 65 day, and 85 day. Quantitative computed tomogram(Q-CT) was also taken after sacrifice to analyze temporal changes of mineralization pattern in the distraction gap. The following results were obtained; 1. In both group I and II, the BMD was lowest at the interzone in the distraction gap and increased linearly toward the corticotomy surface. This pattern did not change with time until the consolidation of the distraction gap, but the difference of BMD between the interzone and adjacent parent bone decreased with progress of consolidation. 2. During the distraction period, BMD increased progressively at the distraction gap and adjacent parent bone in both group I and II. During consolidation period, although BMD of the distraction gap still increased progressively, that of the adjacent parent bone decreased progressively in group I; the more distant from the corticotomy surface, the more decreased the relative BMD. in group II, the decrease in BMD of the adjacent parent bone was less than that in group I which was statistically significant in mid-consolidation period. In conclusion, the new bone in the distraction gap during callotasis appeared to form in bilateral direction with linear gradient from interzone toward corticotomy surface. Dynamization during callotasis not only stimulated regenerate bone healing in the distraction gap, but also prevented the occurrence of transient regional osteopenia at the distant part of the adjacent bone during midconsolidation period.
Adult ; Animals ; Bone Density ; Bone Diseases, Metabolic ; Calcification, Physiologic ; Dogs ; Hindlimb ; Humans ; Miners ; Osteogenesis, Distraction ; Parents ; Tibia

Hepatolithiasis is said to exist when stones are present in the right or the left hepatic ducts or their tributaries. Although it is a pathophysiologically benign disease, it causes frequently serious problems-recurrent cholangitis, liver abscess, obstructive jaundice, liver cirrhosis, and sepsis - and has challenged surgeons. Until recently, its fundamental pathogenetic mechanisms have not been elucidated, but bile duct stenosis, bile stasis, and secondary infection are considered as important pathogenetic factors. Therefore, the ultimate goal of the treatment is directed to the correction of these factors. We were retrospectively reviewed 119 cases of patients with hepatolithiasis treated by various surgical methods from Jul. 1989 to Dec. 1996 at the Department of Surgery of Maryknoll Hospital, Pusan. There were 72 women and 47 men, and the mean age was 45.5 years. Thirty-nine patients (32.8%) had previous histories of operations related to biliary stone diseases - cholecystectomy (n=13), T-tube choledocholithotomy (n=21), choledochoduodenostomy (n=9), Roux-en-Y choledochojejunostomy (n=6), and transduodenal sphincteroplasty (n=1). Operative procedures were 24 (20.2%) lithotomy, 60 (50.4%) drainages, and 35 (29.4%) hepatectomies and determined by the location of the stones, the general condition of the patient, and the anatomical change (stenosis or cystic dilatation) in intrahepatic duct. Postoperative complications occurred in 33 (27.7%) patients : wound infection (n=23), atelectasis (n=5), intra-abdominal bile collection (n=3), choledochocutaneous fistula (n=2), hemobilia (n=1), and adhesive ileus (n=1). Residual stones were detected in 39 (32.7%) patients by T-tube cholangiography, ultrasonography, computed tomography. The instances of residual stones was the lowest (17.1%) for hepatectomy compared to 45.8% for a lithotomy and 39.3% for a drainage. The follow-up study showed symptom improvement in 91.5% of the patients with a hepatectomy compared to 58.3% for a lithotomy and 71.7% for a drainage which was statistically significant(P<0.05). Since incomplete stone removal in hepatolithiasis and presence of stenosis in intrahepatic duct frequently require a repeat operation or other invasive management, the authors conclude that a hepatectomy, as an initial treatment for hepatolithiasis, is a safe, satisfactory treatment where possible.
Adhesives ; Bile ; Bile Ducts ; Busan ; Cholangiography ; Cholangitis ; Cholecystectomy ; Choledochostomy ; Coinfection ; Constriction, Pathologic ; Drainage ; Female ; Fistula ; Follow-Up Studies ; Hemobilia ; Hepatectomy ; Hepatic Duct, Common ; Humans ; Ileus ; Jaundice, Obstructive ; Liver Abscess ; Liver Cirrhosis ; Male ; Postoperative Complications ; Pulmonary Atelectasis ; Retrospective Studies ; Sepsis ; Sphincterotomy, Transhepatic ; Surgical Procedures, Operative ; Ultrasonography ; Wound Infection

Chordoma arising from the notochordal remnants is a rare primary bone tumor in the cervicosacral region and is even more unusual in the thoracic region. The authors experienced a case of thoracic chordoma and report its CT and MR findings.
Chordoma* ; Notochord

Chordoma arising from the notochordal remnants is a rare primary bone tumor in the cervicosacral region and is even more unusual in the thoracic region. The authors experienced a case of thoracic chordoma and report its CT and MR findings.
Chordoma* ; Notochord

Bacterial meningitis results in significant neurologic dificits despite in spite of much effort in the treatment of the disease. This study was performed to determine the incidence of caustive organisms and to correlate between the organisms and computed tomographic (CT) findings with clinical outcome of bacterial meningitis in newborns and infants. We analyzed the brain CT and clinical records of 15 infants who had been diagnosed as bactrial meningitis by CSF culture. We found that the most common organisms were Group B streptococcus in neonates withou no neurologic complications in all but one and Hemophilus influenza in infants whose clinical outomes were poor in all except one. CT findings related with poor prognosis in this study were cerebral edema, basal cistermal obliteration & enhancement, and cerebral infarction on initial CT and ventriculomegaly on follow-up CT. We concluded that CT diagnosed intracranial complications of bacterial meningitis well and could contributed to better treatment of bacterial meningitis.
Brain ; Brain Edema ; Cerebral Infarction ; Follow-Up Studies ; Haemophilus ; Humans ; Incidence ; Infant* ; Infant, Newborn* ; Influenza, Human ; Meningitis ; Meningitis, Bacterial* ; Prognosis ; Streptococcus

The purpose of this study was to evaluate the results of various types of opponensplasties which have been performed for the last 15 years. For the patients who had median nerve injury with or without ulnar nerve injury, we usually transferred the ECRL or ECRB to restore thumb opposition and Huber s procedure were usually done for thumb hypoplasia. With the criteria outlined by Sundararaj and Mani, postoperative function of 27 hands from 23 patients who underwent the opponensplasty from March 1981 to March 1995 were evaluated. The results from each etiology group were analyzed by the same criteria. Also subjective opinion of the patients about the scar were investigated by our own criteria. The analysis from overall 27 hands yielded 19 excellent (70.4%), 4 good (14.8%), 3 fair (11.1%), and 1 poor (3.7%) results with Sundararaj and Mani s criteria and 1 excellent (3.7%), 14 good (81.5%), 3 fair (11.1%), and 1 poor (3.7%) results about the scar. In 11 patients with nerve injury (median nerve with or without ulnar nerve injury), 7 excellent and 2 fair results were yielded by the ECRL or ECRB transfer, 1 excellent by Phalen-Miller's procedure, and 1 excellent by Burkhalter's procedure. In 8 patients with congenital hypoplastic thumb, 7 excellent results were yielded by Huber's procedure and 1 excellent by the ECRB transfer. In 8 patients with residual poliomyelitis or brachial plexus injury, the ECRB transfer yielded 3 excellent results. However, 2 good and 1 fair results were obtained by Bunnell's procedure; and l good, l poor by Camitz's procedure. In summary, the ECRL or ECRB transfer in the patients who had neuropathy, such as median with or without ulnar nerve injury, brachial plexus injury or residual poliomyelitis; and Huber's procedure in congenital hypoplastic thumb were thought to be one of the useful methods for the restoration of the thumb opposition.
Brachial Plexus ; Cicatrix ; Hand ; Humans ; Median Nerve ; Poliomyelitis ; Thumb* ; Ulnar Nerve

No abstract available.
Adult* ; Humans

It is well-knwon that computed tomography (CT) is useful in detecting accurately the location, extent, erosion and relationshlp of angiofibroma to surrounding structures such as pterygopalatine fossa, It is well-known that computed tomography (CT) is useful in detecting accurately the location, extent, erosion and relatiohship of angiofibroma to surrounding structures such as pterygopalatine fossa, sphenoid slnus, and etc. CT of 20 patients with juvenile angiofibroma, which were examined for 5 years from Feburary, 1979 to May. 1984 at Department of Radiology, Seoul National University Hospital, were retrospectively analized. The results were as follows: 1. AII 20 patients of juvenile angiofibroma had tumors in nasopharynx and posterior nasal cavity showing homogeneously dense.enhancing soft tissue mass on CT. There was extension of the tumor from nasopharyhx and posterior nas.al cavity into Pílranasal sinus (60%, 12/20), pterygopalatine fossa (55%, 11/20), infratemporal fossa (30%, 6/20), posterior orbit (10%, 2/20) and cranial cavity (15%, 3/20). 2. Angiography usually adds Iittle diagnostic information, but is still needed to identify the precise source of blood supply to the tumor, and to perform the pre-operative embolization. The use of CT has deferred angiography until just before surgery, permitting embolization at optimal time. 3. CT is almost always necessary to reveal accurately the full extent of the tumor, especially intracranial space in the axial and coronal planes with contrast enhancement. CT is useful both in diagnosis as a guide to angiography and in planning the adequate thereapy of juvenile angiogibroma.
Angiofibroma ; Angiography ; Diagnosis ; Humans ; Nasal Cavity ; Nasopharynx ; Orbit ; Pterygopalatine Fossa ; Retrospective Studies ; Seoul

No abstract available.

This study was performed to identify the chronological changes of the knee angle or the tibiofemoral angles in normal healthy Korean children. Full-length anteroposterior view standing radiographs of 818 limbs of 452 Korean children were analyzed. The overall patterns of the chronological changes in the knee angle were similar to those described previously in western or Asian children, but the knee angle development was delayed, i.e., genu varum before 1 yr, neutral at 1.5 yr, increasing genu valgum with maximum a value of 7.8 degrees at 4 yr, followed by a gradual decrease to approximately 5-6 degrees of genu valgum of the adult level at 7 to 8 yr of age. These normative data on chronological changes of knee angles should be taken into consideration when evaluating lower limb alignment in children.
Adolescent ; Child ; Child Development ; Child, Preschool ; Female ; Femur/anatomy & histology ; Humans ; Infant ; Knee Joint/anatomy & histology/*growth & development ; Male ; Retrospective Studies ; Tibia/anatomy & histology