Sixty six Colles' fracture were treated with radial slab or U-cast (sugar tong splint), from January 1982 through May 1984 at the Department of Orthopaedic Surgery of St. Mary Hospital. A prospective study was made and was evaluated under the subjective criteria of Gartland and Werley, and the objective criteria of Scheck. The results of this study were as follows: 1. All of 66 cases was closed fracture and the incidence was high in females who aged over 6thdecades. 2. In 43 cases of stable fracture, 18 (94.7 %) out of 19 cases treated with radial slab and 21 (87.5%) out of 24 cases treated with U-cast showed satisfactory result. 3. In 23 cases of unstable fracture, 6 (54.6%) out of 11 cases treated with radial slab and 9 (75%) out of 12 cases treated with U-cast showed satisfatory result. 4. As a result, we found that the result of the treatment with radial slab was superior to the U-cast for the stable Colles fracture, however, all of two methods were not staisfatory for the unstable Colles fracture although the U-cast group showed better result.
Colles' Fracture ; Female ; Fractures, Closed ; Humans ; Incidence ; Prospective Studies

PURPOSE: To analyze the imaging features of brain abscess. MATERIALS AND METHODS: MR studies of nine patients with surgically verified brain abscess were retrospectively reviewed. RESULTS: The shape of abscesses were round(n=6), multilobulated(n=2) or triangular(n=1). All lesions were located in corticomedullary junction and extended into white matter. On gadolinium-DTPA enhanced images, smooth rim-like(n=6) or irregular thick enhancement(n=3) of abscess wall was noted. Budlike projection from the abscess capsule was found in 4 cases. The signal intensity of abscess capsule was either hyperintense (n=5) or isointense(n=4) relative to white matter on Tl-weighted images, and hypointense(n=6), isointense (n=2) or mixed hypo and isointense(n=l) on T2-weighted images. Satellite nodules were found in 2 cases. PNS inflammation(n=2), meningitis(n=1), ventriculitis(=2) and subdural empyema(n=1) were associated CONCLUSION: The MR features of brain abscess included characteristic intensity of abscess capsule, budlike projection from the abscess wall, moderate amount of peripheral edema, satellite nodules, and associated meningitis, ventriculitis or PNS infection. The morphology of abscess wall was not specific for the diagnosis of brain abscess.
Abscess ; Brain Abscess* ; Brain* ; Diagnosis ; Edema ; Humans ; Meningitis ; Retrospective Studies

Pleomorphic (undifferentated) carcinoma is a rare histologic type of carcinomas of the gallbladder and an atypical carcinoid is thought to be an intermediated type between carcinoid tumor and small cell carcinoma. Dense core "neurosecretory" granules can be found in the above mentioned tumors. We experienced a case of a double tumor of the gallbladder in a 51-year old male patient. Grossly, a large solid mass, about 5.0 cm in diameter, was found in the fundic portion and the neck portion also had a small 1.5 cm-sized polypoid mass. Microscopically, these lesions had features of pleomorphic carcinoma and atypical carcinoid, respectively. Immunohistochemically, they manifested reactivity for neuron specific enolase. Ultrastructural study revealed neurosecretory granules in the cytoplasms of tumor cells of the fundic and neck masses. Although light microscopic features of these tumor masses are quite different, we consider that these tumors represent a spectrum of neuroendocrine differentiation.
Male ; Humans

Adenocarcinoma of the urinary bladder, including urachal carcinoma, is a rare tumor with incidence in the range between 0.5% and 2.2% of all epithelial bladder neoplasms. Ten cases of adenocarcinoma of the urinary bladder(eight cases of primary adenocarcinoma and two cases of urachal carcinoma)are presented. We described the computed tomography(CT)appearances of adenocarcinoma of the urinary bladder and tried to find out the characteristic CT findings of urachal carcinoma. CT scan were evaluated for the location of the tumors, presence of calcification in the tumor, and the tumor extension. Seven tumors were located at the dome of the bladder(70%0, two were at lateral walls, and one was at anterior wall. Seven were single mass and three were multicentric masses in the bladder. Fine punctate calcifications scattered within the tumors were detected in four cases(40%); three of the eight, primary adenocarcinoma, and one of the two, urachal carcinoma. Two urachal carcinomas were characterized by midline position and predominantly extravesical growth along the urachus. Gross extravesical extension with distant metastasis were presented in seven cases(70%) at the time of initial diagnosis. CT may be useful in evaluating the adenocarcinoma of the urinary bladder and differentiating urachal carcinoma from bladder cancer.
Adenocarcinoma* ; Diagnosis ; Incidence ; Neoplasm Metastasis ; Tomography, X-Ray Computed ; Urachus ; Urinary Bladder Neoplasms ; Urinary Bladder*

Focal segmental glomerulosclerosis is the renal histopathologic lesion observed in 10% of children with idiopathic nephrotic syndrome. Complications include infection, thrombosis, hypocalcemia and adverse effect of steroid use. The incidence of thrombosis reported ranges from 10~40%. The pathogenesis are changes in coagulation system, decrease of Antithrombin III, increase platelet aggregability and steroid or diuretics use. These changes take place passively as a result of increased protein synthesis and urinary loss of low molecular weight protein. We experienced a case of cerebral infarction due to thrombosis associated with focal segmental glomerulosclerosis and steroid resistant nephrotic syndrome in a 11 year old male patient who had been hospitalized because of convulsion and semicoma. MRI showed an evolving infarct in the occipital lobe, decreased antithrombin III and increased factor VIII on coagulation factor assay. We hereby report a case of cerebral infarction due to thrombosis associated with focal segmental glomerulosclerosis and steroid resistant nephrotic syndrome with a brief review of related literature.
Antithrombin III ; Blood Coagulation Factors ; Blood Platelets ; Cerebral Infarction* ; Child ; Diuretics ; Factor VIII ; Glomerulosclerosis, Focal Segmental* ; Humans ; Hypocalcemia ; Incidence ; Magnetic Resonance Imaging ; Male ; Molecular Weight ; Nephrotic Syndrome* ; Occipital Lobe ; Seizures ; Thrombosis*

An endodermal sinus tumor is a malignant germ cell tumor that usually arises in the gonads, but on rare occasion occurs in extragonadal locations. Our case was that of a 3 year old girl who complained of a rapid growing orbital mass. On histologic examination it revealed the typical picture of an endodermal sinus tumor and it also disclosed a positive reaction for alphafetoprotein using an immunoperoxidase technique. An orbital exenteration was performed followed by chemotheraphy, but the patient died 5 months after the onset of the disease.

PURPOSE: To evaluate the usefulness of percutaneous catheter drainage (PCD) in patients who have abdominal abscesses or fluid collections. MATERIALS AND METHODS: We performed PCD for 165 abscesses and fluid collections in 148 patients. The follow-up periods in these patients ranged from 15 days to 42 months (mean, 274 days). The lesion sites were subphrenic space in 46 cases, liver in 33, perihepatic space in 20, pancreas or peirpancreatic space in 14, pelvic cavity in 13, and retroperitoneum in 13. We evaluated the success, failure, and recurrence rates, the causes of failure or recurrence, the mean duration of drainage, and the complications of PCD. RESULTS: Of the 165 cases, one hundred-fifty nine(96.5%) were successfully cured, Although a partial success could be achieved, 2(1.2%) cases were failed and 4(2.4%) were recurred. Multiloculation or fistula formation were the main causes of the unsullessful cases. The duration of drainage rainged from 2 to 605 days (mean, 1 days). Complications occured in 12 cases(7%) during or after procedures, which included fever and chill in 7, transgression of pleura in 2, bowel perforation in 2, and bleeding through catheter in 1. CONCLUSION: PCD is an effective and safe method for various abdominal abscesses or fluid collections.
Abdominal Abscess* ; Abscess ; Catheters* ; Drainage* ; Fever ; Fistula ; Follow-Up Studies ; Hemorrhage ; Humans ; Liver ; Pancreas ; Pleura ; Recurrence

PURPOSE: Palatal myoclonus(PM) is an involuntary cyclic movement of the soft palate and is known to be caused by the hypertrophic degeneration of the inferior oilvary nucleus of the medulla, secondary to the dentato-rubro-tegmental tract lesions. Our purpose is to describe the brain magnetic resonance(MR) imaging findings in palatal myoclonus. MATERIALS AND METHODS: We retrospectively analyzed the locations and causes of primary lesions in the dentato-rubro-tegmental tract and correlated them with changes in MR signal intensity and size of the inferior olive on T2-weighted MR images in 10 patients with palatal myoclonus. RESULTS: All cases showed hyperintensity in one or both inferior olive and six cases showed accompaning enlargement. The locations of the primary lesions were dorsal aspect of pons(central tegmental tract) in eight patients and the dentate nucleus in one, and no lesion was found in the dentato-rubro-tegmental tract in one. Among eight patients who had lesions in the ports, the ipsilateral inferior olivary nuclei showed changes in five and bilateral olive were involved in three. In the case with a lesion in the dentate nucleus, the contralateral inferior olivary nucleus was involved. The causes of primary lesions were hemorrhage in eight cases and traumatic brain stem injury in one. CONCLUSION: MR specifically showed enlargement and hyperintensity of the inferior olivary nucleus on T2-weighted images and matching lesions in the ports or the dentate nucleus in patients with palatal myoclonus.
Brain ; Brain Stem ; Cerebellar Nuclei ; Hemorrhage ; Humans ; Myoclonus ; Olea ; Olivary Nucleus ; Palate, Soft ; Retrospective Studies

Turner's syndrome results from complete or partial monosomy of the X chromosome and is characterized by hypogonadism or related other congenital anomalies in phenotypic females. In these patients, there are failure to develop normal secondary sex characteristics, amenorrhea, or short stature at puberty and the ovaries are reduced to atrophic fibrous strands devoid of ova and follicles(streak gonads). Individuals with this condition are particularly prone to the development of gonadoblastoma. For this reason, the gonads should be early removed and supplemental estrogen therapy given. We experienced a case of Turner's syndrome, 45, XO/46, XY karyotype in a 20-year-old phenotypic female complained an amenorrhea. On the exploratory laparotomy, the right gonadal mass is sevearly adhered to the adjacent organs and measures 8 x 5 x 5 cm in dimension and 75gm in weight and shows multiple foci of hemorrhage with necrosis. The left streak gonad measures 3.5 x 2 x 1.5 cm in dimension and shows multiple foci of calcification. Microscopically, the right gonadal mass reveals malignant mixed germ cell tumor, composed of endodermal sinus tumor, composed of endodermal sinus tumor with dysgerminoma and gonadoblastoma. The left streak gonad consists of mainly dense fibrous connective tissue and shows some foci of calcification associated with gonadoblastoma. On immunohistochemical and special stainings, the cytoplasm and hyalin droplets of the endodermal sinus tumor component reveal strong positivity to the a-fetoprotein and PAS. After removal of both gonads, the serum level of the a-fetoprotein is markedly down from 1742ng/ml to 2.6 ng/ml.
Female ; Humans

Congenital mesoblastic nephroma(CMN) is an important differential diagnosis of a renal mass occurring in the newborn or in early childhood. It was first described by Bolande as a separate disease entity distinct form Wilms' tumor. In 1974, Beckwith has predicted that this tumor has a pathologic spectrum with classic congenital mesoblastic nephroma at one extreme, unequivocally mallignant spindle cell sarcomas at the other, and intermediate "gray zone" lesions of indeterminate biologic significanse. In 1986, Joshi has described "atypical mesoblastic nephroma" as a potentially aggressive variant of CMN, which shows atypical gross and microscopic features such as hemorrhage, necrosis, high cellularity, and mitotic index. We report of a case of atypical mesoblastic nephroma presenting in a 38 days-old male infant. Grossly, the tumor involved the upper and midportion of the left kidney. On section, the cut surface was fleshy, grayish-white, and homogeneous. Microscopically, the tumorshowed high degree of cellularity and arrangement of fusiform cells in sheets and vague interlacing bundles. The individual tumor cells showed fusiform to oval nuclei, indistinct scanty pale-eosinophilic cytoplasm and many mitotic figures.
Infant ; Child ; Male ; Female ; Infant, Newborn ; Humans ; Diagnosis, Differential