No abstract available.
Antibodies, Antinuclear* ; Scleroderma, Systemic*

No abstract available.
Cervix Uteri* ; Female ; Hysterectomy*

The anatomical characteristics of the tibia, which is covered by subcutaneous tissue anteriorly, emphasize the vulnerability of the tibia to trauma and frequently result in open comminuted fracture. Open fractures add to the risk of infection and nonunion and require treatment that prevent infection, provide skin coverage, and maintaine reasonable fixation during the early healing phase. 50 cases of tibia shaft fractures were reviewed from May 1978 to December 1983, managed with the modified Vidal-Adrey frame of Hoffmann extemal fixator, at the Orthopaedic Department of Kyung Hee University Hospital. The results obtained were as follows; 1. In 50 cases of tibia fractures, 46 cases are open injuries and 43 cases (86.0%) among them were Grade II and IU open fractures. 2. 31 operative procedures were performed for the coverage of soft tissue injury; 13 cases of rotation and cross-leg pedicle flaps were effective aids, but futher good results could be expected with the micmvascular free flap. 3. 17 operative procedures for acceleration of bony union and reconstruction of bone defect were performed. In cases of massive bone defect, vascularized fibular transplantation and free vascularized fibular graft should be employed, and additional bone shortening and electric stimulation would contribute to the enhancement of the bony union process. 4. The mean period of extemal immobilization with the frame was 15.4 weeks and that of bone union was 31.7 weeks. The periods of bone union were markedly delayed in cases of Grade II andIII open fracture than those of closed and Grade I open fractures. 5. Nonunion developed in 17 cases (34.0%); 4 cases in Grade II and 13 cases in Grade III injury. 6. 12 cases of wound infection developed. 7. 12 cases of pin tract infection happened. More careful pin tract management could diminish this troublesome complication.
Acceleration ; Electric Stimulation ; Fractures, Comminuted ; Fractures, Open ; Free Tissue Flaps ; Immobilization ; Skin ; Soft Tissue Injuries ; Subcutaneous Tissue ; Surgical Procedures, Operative ; Tibia ; Transplants ; Wound Infection

Intracranial hypoglossal neurinomas are rare and only about fifty cases have been reported worldwidely. They usually present with hypoglossal nerve palsy preoperatively. The authors experienced, however, two cases of intracranial hypoglossal neurinomas without preoperative hypoglossal nerve palsy. One patient was operated using transcondylar retrosigmoid approach with C1 laminectomy and the other using midline suboccipital craniectomy with C1 laminectomy. Postoperatively hypoglossal nerve palsy was developed in both cases. Absence of preoperative hypoglossal palsy seemed to be related to somewhat different growth pattern in these two cases. When the tumor shows typical radiological findings of hypoglossal neurinoma, it must be included in differential diagnosis despite absence of preoperative hypoglossal nerve palsy.
Diagnosis, Differential ; Humans ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Laminectomy ; Neurilemmoma* ; Paralysis

PURPOSE: The authors report a case of optic nerve evulsion with literature review. METHOD: 15-year-old boy, who had optic nerve evulsion by tear of inferior rectus and medial rectus muscles, and hypotony by retinal and choroidal detachment RESULTS: we could preserve the eyeball with normal pressure by pars plana vitrectomy, endolaser photocoagulation and silicone oil injection
Adolescent ; Choroid ; Humans ; Light Coagulation ; Male ; Muscles ; Optic Nerve Injuries ; Optic Nerve* ; Retinaldehyde ; Silicone Oils ; Vitrectomy

OBJECTIVE: This study was undertaken to review the disease course, clinical and laboratory manifestations, prognosis and treatment of adult onset Still s disease (AOSD) in Korea. METHODS: Thirty-two patients with AOSD were enrolled from 1986 to 1997 in Hanyang University Hospital. Diagnosis of AOSD was based on the criteria proposed by Yamaguchi. We classified the disease course into self-limited, inter mittent, or chronic disease course. RESULTS: Twenty-four (75%) patients were female. Skin rash occurred in 28 (88%) patients, lymphadenopathy in 8 (25%), hepatomegaly in 4 (13%), and pericarditis in 2 (6%) out of 32 patients. The most commonly affected joints were knee joints (88%). Elevated LDH was seen in 18 (60%) patients and decreased CK in 17 (61%) patients. Rheumatoid factor was detected in 4 (13%) patients and ANA in 12 (38%) patients. Anemia (Hb < 10 g/dL) was seen in 13 (41%) patients and hypoalbuminemia (<3. 5 g/dL) in 14 (52%) patients. Elevated ferritin (300 ng/mL) level was seen in 23 (79%) patients. Twenty-five (78%) patients had elevated serum transaminase. Bone marrow studies were performed in 16 patients. Nine out of 16 patients showed hyperplasia of the myeloid series and 2 patients displayed the features of a hemophagocytic syndrome. The mean duration of follow up of 32 patients was 32 months (range 3- 108). Eight (27%) patients had a self-limited, 9 (30%) an intermittent, and 13 (43%) a chronic disease course. The hypoalbuminemia was significantly associated with an "intermittent or chronic disease group" (p<0. 05). Thirty-two patients received systemic corticosteroids and 21 patients received single or combination of disease modifying antirheumatic drugs. CONCLUSION: We found that hypoalbuminemia at presentation was significantly associated with an unfavorable outcome, intermittent or chronic disease group. The clinical manifestations and disease course of AOSD in Korea were similar to those previously reported in other countries except significantly lower incidence of lymphadenopathy, hepatomegaly, and pericarditis.
Adrenal Cortex Hormones ; Adult* ; Anemia ; Antirheumatic Agents ; Bone Marrow ; Chronic Disease ; Diagnosis ; Exanthema ; Female ; Ferritins ; Follow-Up Studies ; Hepatomegaly ; Humans ; Hyperplasia ; Hypoalbuminemia ; Incidence ; Joints ; Knee Joint ; Korea* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Pericarditis ; Prognosis ; Rheumatoid Factor ; Still's Disease, Adult-Onset*

STUDY DESIGN: A retrospective study OBJECTIVES: In the operative treatment of lumbar spinal stenosis, the wide decompression and fusion method has many problems, such as a long operation time, large blood loss and the long time required to achieve solid fusion. As a solution to these problems, a minimal decompression method was been performed, which minimizes the resection of laminae and facet joints. SUMMARY OF LITERATURE REVIEW: In the operative therapy for lumbar spinal stenosis, favorable results can be obtained by simple decompression. MATERIALS AND METHODS: 42 cases of degenerative lumbar stenosis, with neither segmental instability nor spondylolisthesis, underwent a minimal decompressive surgery, without instrumentation. The mean operation time and amount of blood loss were analyzed, and the clinical results evaluated according to Kim's criteria and the postoperative segmental instability by the Dupuis method. The average follow-up period was 70 months. RESULTS: Transfusions were not required in all cases. The mean operative times were 1hour 5minutes and 1hour 46minutes in the one and two segment decompressions, respectively. The clinical results, according to Kim's criteria, were excellent in 24 cases and good in 12. There was no dynamic instability in the radiographs at the last follow-up. CONCLUSIONS: With the degenerative lumbar stenosis, without segmental instability or spondylolisthesis, minimal decompression was an effective surgical method.
Constriction, Pathologic* ; Decompression* ; Follow-Up Studies ; Operative Time ; Retrospective Studies ; Spinal Stenosis ; Spondylolisthesis ; Zygapophyseal Joint

PURPOSE: To evaluate the efficacy of combined treatment of surgery and chemoradiotherapy for supratentorial primitive neuroectodermal tumors (SPNET) and obtain the prognostic factors and complications. MATERIAL AND METHODS:The age of 18 patients ranged from 1 to 27 years (median=5 years). There were 12 males and 6 females. The extents of surgery were gross total (n=9), subtotal (n=8), biopsy only (n=1). Craniospinal radiotherapy was delivered to all the patients except 2 patients who were treated only with the whole brain and primary lesion. Radiation dose were 3120-5800cGy (median=5460) to primary mass, 1500-4200cGy (median=3600cGy) to the whole brain and 1320-3600cGy (median= 2400 cGy) to the spinal axis. Chemotherapy was done in 13 patients. Median follow-up period was 45 months ranged from 1 to 89 months. RESULTS: Patterns of failure were as follows; local recurrence (1), multiple intracranial recurrence (2), spinal seeding (3), craniospinal seeding (2) and multiple bone metastasis (1). Two of two patients who did not received craniospinal radiotherapy failed at spinal area. All the relapsed cases died at 1 to 13 months after diagnosis of progression. The 2- and 5-year overall survival rates were 61% and 49%, respectively. The age, sex, tumor location did not influence the survival but aggressive resection with combined chemotherapy showed better outcome. Among 9 survivors, complications were detected as radiation necrosis (n=1), hypopituitarism (n=2), cognitive defect (n=1), memory deficit (n=1), growth retardation (n=1). CONCLUSION: To improve the results of treatment of SPNET, maximal surgical resection followed by radiation therapy and chemotherapy is necessary. The extended radiation field including craniospinal axis may reduce the recurrence in spinal axis.
Axis, Cervical Vertebra ; Biopsy ; Brain ; Chemoradiotherapy ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Hypopituitarism ; Male ; Memory Disorders ; Necrosis ; Neoplasm Metastasis ; Neuroectodermal Tumors, Primitive* ; Radiotherapy* ; Recurrence ; Survival Rate ; Survivors

We report a case of an accidental extravasation of contrast material. A large-volume extravasation occurred in an adult during spiral contrast-enhanced CT. The amount of contrast material extravasated was 47 ml. The patient had a swelling of the dorsum right hand. The extravasation injury site was determined by CT scanning. The extavasation case was examined using five separate display techniques: axial, multi planar reformation (MPR), maximum intensity projection (MIP), volume rendering, and shaded-surfaced display (SSD). This paper introduces extravasation with the CT and the three-dimensional appearance.
Adult ; Contrast Media* ; Extravasation of Diagnostic and Therapeutic Materials* ; Hand ; Humans ; Injections, Subcutaneous* ; Tomography, X-Ray Computed

No abstract available.
Cervix Uteri* ; Female ; Polyarteritis Nodosa*