Desmoid tumor is a type of fibromatosis usually arise in deep musculo-aponeurotic structures, primarily of the trunk and extremities. It is characterized by proliferation of fibroblastic tissue and does not metastasize but may be locally aggressive. Eventhough the surgical margin reveals clean, recurrence often occurs. To analyze the extent of the tumor and homodynamic characteristics exactly, we performed IV bolus CT. Desmoid tumors show peripheral rim enhancement on early phase scan and more strong, central enhancement on late phase IV bolus CT, which reflects abundant fibroblastic components of the tumor. We report two cases of pathologically confirmed desmoid tumor performed IV bolus CT.
Abdominal Wall ; Extremities ; Fibroblasts ; Fibroma ; Fibromatosis, Aggressive* ; Recurrence

Fourty one cases of open fractures of tibial shaft complicated with varying degrees of soft tissue injuries were trested by one-plane unilateral external fixation with AO fixator. In seventeen csses among them, interfragmental lag screw fixation was applied in addition, for more rigidity and stability of the fixation. All of thern were followed up at least for one year and we obtained the following results. 1. Rigid stable external fixation provided by additional minimum internal fixation may not increase the rate of infection but rather enhance prompt primary bone healing. 2. One-plane unilatersl external fixation may facilitate good access to the wound for subsepuent reconstructive procedures, and enhance pain-free early full range of joint motion, thus promote early bone union. 3. Comparing with bilsteral fixation, there wss almost no difference in the union time of the fracture even with one-plsne unilatersl fixation.
Clinical Study ; External Fixators ; Fractures, Open ; Joints ; Soft Tissue Injuries ; Tibia ; Wounds and Injuries

39 patients with tibial shaft fracture had treated by open reduction and internal fixation with AO DCP and screws applying on the medial surface of the tibia, at the Department of Orthopedic Surgery, Ulsan Dongkang Hospital, from January, 1983 to December, 1985. A clinical study was done on all the 39 cases with the follow-up check over 1 year. In general, because the lateral surface of the tibia is well covered by rich soft tissue, it is popularized to apply the plate on the lateral aspect of the tibia. In our department, we applied the plate on the medial aspect of the tibia, which resulted in mimi-zing soft tissue injuries and, by inserting the screws perpendicular to the surface of the bone, increased stability of the fixation; and therefore resulted in relatively short operation time, relatively low incidences of infection and non-union; but there had been some drawbacks such as focal skin necrosis, hematoma, adhesion after fixatives removal, and cosmetic disfiguring. But there were no problems during the follow up periods. So, this is a recommandable procedure of internal fixation with the plate for the tibial shaft fractures.
Clinical Study ; Fixatives ; Follow-Up Studies ; Hematoma ; Humans ; Incidence ; Necrosis ; Orthopedics ; Skin ; Soft Tissue Injuries ; Tibia ; Ulsan

The AO internal fixation system(the Fixateur Interne) is effective in reducing and stablizing a variety of unstable thoracolumbar fracture patterns. It is relatively effective in decompressing the canal of retropulsed bony fragments associated with burst fracture. Sixty-Two patients with unstable thoracolumbar spine fractures were treated with the AO internal fixator. They were followed for an average of 21 months(range 15-29 months). A compartive radiographic analysis of kyphosis and vertebral height was made using pre-operative, post-operative and follow-up radiogram. Changes in neural canal compromise were measured in 18 cases of burst fractures. Failure of instrumentation occured in 9 cases which were carefully analyzed. Recently, we've constructed the system of which the Schanz screws would be directed divergently in sagittal plane in the hope that the load to the screws might be reduced, thus the failure rate.
Follow-Up Studies ; Hope ; Humans ; Internal Fixators ; Kyphosis ; Neural Tube ; Spine

PURPOSE: To evaluate dynamic CT features and its clinical courses of eosinophilic hepatic abscess. MATERIALS AND METHODS: Two-phase dynamic CT findings and the clinical courses of 13 pathologically proven cases of eosinophilic abscess were reviewed. All patients showed peripheral eosinophilia, and diagnoses were confirmed by ultrasound-guided biopsy(n=9) or operation(n=4). In two of the four patients who underwent segmental hepatectomy, worms of the species Fasciola hepatica were detected. Follow-up CT scans after treatment with antibiotics or praziquantel were available in seven and eight patients, respectively. RESULT: All hepatic lesions were found ina subcapsular location or in contact with Glisson's capsule around the bile duct. Arterial-dominant phase CT(n=11)demonstrated clusters of ill-defined low density masses without rim enhancement. Late-phase CT(n=13) more clearly depicted clustering lesions with enhancing rims and diminution of the low-density area. Follow-up CT scans aftertreatment with antibiotics(n=7) showed no change in the lesions in three patients and slight shrinkage of the mainmass with additional new lesions in four. On CT scans of nine patients performad after praziquantel therapy, hepatic masses were seen in all patients to be very slightly smaller after improvement of peripheral hypereosinophilia. CONCLUSION: Two-phase dynamic CT features appear to be helpful for the diagnosis ofeosinophilic hepatic abscess in patients with peripheral eosinophilia. Parasitic infestation by Fasciola hepaticafor example, is the presumed cause of such abscesses, though further studies are required.
Abscess ; Anti-Bacterial Agents ; Bile Ducts ; Diagnosis ; Eosinophilia ; Eosinophils* ; Fasciola ; Fasciola hepatica ; Follow-Up Studies ; Humans ; Liver Abscess* ; Parasites ; Praziquantel ; Tomography, X-Ray Computed

Forty-two preoperative CT scans with renal cell carcinoma were reviewed and compared with pathologic findings to evaluate the differential points between stage I and II. Regardless of whole body staging, perirenal fat infiltrations were seen in 9 cases and the other 33 cases showed no infiltration onto perirenal fat tissue. We retrospectively reviewed them by comparing tumor size and CT findings, following three view points, lobulating contour of tumor margin, thickening of Gerota's fascia and strands in perirenal fat tissue. The size of them was 2-15 cm, size of the stage I tumors was 2-15 cm and that of stage II was 6-15 cm. In stage I(n=33), 25 cases(76%) showed smooth margin, and the others(n=8) showed lobulating contours. Thickening of Gerota's fascia was observed in 7 cases(21%) and strands in perirenal fat tissue in 14(42%). Of these, only one positive finding was seen in 7 cases(21%), 2 findings in 6(18%), 3 findings in 3(9%) and nothing in 17cases(51%). In stage II(n=9), 3 cases(34%) showed smooth margin, and the others(n=6) showed lobulating contours. Thickening of Gerota's fascia were observed in 5 cases(55%) and strands in perirenal fat tissue in 9(100%). Of these, one finding was seen in 2 cases(22%), 2 findings in 3(33%), 3 findings in 4(44%). In conclusion, it is insufficient to evaluate the perirenal fat infiltration in renal cell carcinoma with only one positive finding of 3 view points; lobulation of tumor margin, thickening of Gerota's fascia, strands in perirenal fat tissue. But if all these findings are shown, it is helpful to determinate perirenal fat infiltration of renal cell carcinoma.

PURPOSE: To analysis the efficacy of MRI in assessing fracture configuration and frequency of associated soft tissue injuries in tibial plateau fractures. MATERIALS AND METHODS: In the plain films and MRI of 47 cases with tibial plateau fractures,every fracture was classified by findings on plain film and MRI respectively according to the Schatzker system and they were compared with each other. The degree of displacement and depression of the fracture fragments were measured on plain film and MRI. RESULTS: MRI was more accurate in determining the classification of the fracture and measuring the displacement and depression of fragments. Fracture classifications were changed in 12 cases. Especially in Schatzker VI cases, articular step off over 2 mm and articular fragments over 2X2 cm were revealed in detail by MRI. Evidence of internal derangement of the knee was found in 38 (80.8%) cases. CONCLUSION: Most of the cases with acute tibial plateau fracture were commonly associated with ligamentous and meniscal injuries. MRI can aid in accurate evaluation of tibial plateau fracture patterns and decision of treatment plan.
Classification ; Depression ; Knee ; Ligaments ; Magnetic Resonance Imaging* ; Soft Tissue Injuries

Mycosis fungoides(MF) is representative of cutaneous lymphoma and over many years progresses to plaques and tumors steadily. The extent and type of skin lesions at initial diagnosis and the presence of extracutaneous involvement are predictive indicators of survival in MF patients. Patients with limited plaque lesions are the least likely to have extracutaneous involvement and thus have the longest survival similar to the control population. We report a case of 45-year-old woman, who developed multiple subcutaneous nodules in normally appearing skin during photochemotherapy (PUVA). She had been treated with PUVA for the limited pre-mycotic skin lesions (T1 stage), which themselves showed good response to the treatment. She experienced the insidious course of early stage, but thereafter rapidly progressed to the tumor stage unusually during treatment.
Diagnosis ; Female ; Humans ; Lymphoma ; Middle Aged ; Mycosis Fungoides* ; Photochemotherapy ; Skin

In order to inquire the most-effective management of increased intracranial pressure(ICP), mannitol, steroid and hyperventilation were used in rabbits after ligation or non-ligation of the carotid artery. Mannitol was more effective than steroid and hyperventilation in the degree of the reduction of ICP. The intracranial pressure was decreased 43~45% for 25~30 minutes after injection of mannitol. Steroid was less effective than mannitol in the degree of the reduction of ICP. But the time of reduction of ICP was longer, that is, the degree of reduction was 24~60 minutes after injection of steroid. Hyperventilation is effective in the initial time only, for 10 minutes after hyperventilation. The degree of ICP reduction was 13.5~16.7 % for 10 minutes after hyperventilation. The combined group, that is three kinds of mangenent were used, is the most effective treatment to reduce ICP of ICP. The degree of the reduction of ICP was 42.1~49.3% for 20 minutes, 47.7~52.5% for 30minnutes. There was no significant difference between and non-ligation group.
Carotid Arteries ; Carotid Artery, Internal* ; Hyperventilation ; Intracranial Pressure* ; Ligation ; Mannitol ; Rabbits*

An Insertion/deletion polymorphism in angiotensin converting enzyme gene has been considered the important regulator of ACE activity in plasma and tissue. The deletion allele of this gene is associated with higher ACE activity, which ultimately increased angiotensin II formation. It is possible that alteration of ACE polymorphism might be contribute to development of end stage renal disease and cardiovascular disease where RAS system is implicated in disease process. This study determined the distribution of ACE genotype in 122 end stage renal disease patients and in a group of 101 healthy controls. Also we evaluated the difference of allele frequency in the hemodialysis patients with or without cardiovascular disease. ACE genotype was determined by polymerase chain reaction technique from the PBMC leukocytes of the patients. The results were as follows; 1)Patients population consisted of 122 hemodialysis patients and male to female ratio was 66:56, mean age was 54.3+/-12.8 years old. Mean duration of dialysis treatment was 52.5+/-37.5 months and the underlying disease of ESRD were diabetic nephropathy in 78 cases, chronic glomerulonephritis in 29 cases, hypertension in 8 cases, other disease in 7 cases. 2)In the contol patients, male to female ratio was 52:49, mean age was 46.1+/-15.1 years old. The age and sex distribution between ESRD and control group was not significantly different. 3)Of the total hemodialysis patients, 26.2% showed the II genotype, 35.2% of ID genotype and 38.6% of DD genotype. In the contol group, the frequency of each genotype was 20.8% of II, 55.4% of ID and 23.8% of DD genotype. The frequency of DD genotype was significantly higher in ESRD group than control group(p<0.05). 4)In the ESRD patients, 72 patients(59%) had the LVH and 23 patients(18%) had the ischemic heart disease. The genotype distribution in ESRD patients according to the presence of LVH or ischemic heart disease did not show any significant difference. The frequency of each genotype in the patients with LVH showed 22.2%(II), 43.1%(ID), 34.7%(DD), and 32.8%(II), 37.5%(ID), 29.7%(DD) in the patients without LV et al.:Angiotensin Converting Enzyme Polymorphism in Patients with End Stage Renal Disease- H. In the aspect of ischemic heart disease, the frequency of ACE genotype was 27.3%(II), 45.5% (ID), 27.3%(DD) in the group of ischemic heart disease, compared with the ditribution of 31.5 %(II), 40%(ID), 32.6%(DD) in the patients without ischemic heart disease. From the above results, it was concluded that insertion/deletion polymorphism in angiotensin converting enzyme gene, especially DD genotype, may be important in the pathogenesis of progression to end stage renal disease. There was no significant difference in I/D polymorphism according to the presence or absence of cardiovascular complications
Alleles ; Angiotensin II ; Angiotensins* ; Cardiovascular Diseases ; Diabetic Nephropathies ; Dialysis ; Female ; Gene Frequency ; Genotype ; Glomerulonephritis ; Humans ; Hypertension ; Kidney Failure, Chronic* ; Leukocytes ; Male ; Myocardial Ischemia ; Peptidyl-Dipeptidase A* ; Plasma ; Polymerase Chain Reaction ; Renal Dialysis ; Sex Distribution