Electrical burn is thought to be similar to crushing injury in that it usually involves skin, muscle and neurovascular structure simultaneously. Especially in extremity, there are many occasions that amputations are inevitable. Since the demarcation between viable and non-viable tissue tends to be obscure, electrical burn greatly differs from other types of injury in detailed methods of treatment, such as the level, the timing and the technique of amputation. During the past 10 years from January, 1978 to December, 1987, authors experienced 285 amputations in 181 cases of electrical burn at Orthopedic Department of Hanil Hospital. The clinical data of our experience were reviewed and analysed. The results were as follows ;l. Amputation rate in electrical burn was 22.4%. 2. Out of total 285 amputations, the number of upper extremity was 187 (65.6%) and it was 1.9 times more than that of lower extremity. Right forearm was 1.8 times more than left forearm. 3. Multiple limbs amputation were performed in 83 cases (45.9%). 4. Among 285 stumps, more than one operation were done in 74 stumps because of infection (50%), necrosis of stump end (35.1%), bony overgrowth at stump end (8.1%) and neuroma(6.8%).
Amputation ; Amputees ; Burns ; Extremities ; Forearm ; Humans ; Lower Extremity ; Necrosis ; Orthopedics ; Skin ; Upper Extremity

The authors retrospectively reviewed the high resolution computed tomographic scans of 19 patients who had hematogenous or lymphangitic metastatic lung lesions. In all patients, the histologic diagnosis for primary cancers and the radiographic manifestations of pulmonary metastasis were established. Certain characteristic findings of metastatic lung tumors on HRCT scans were evident: uneven thickening of bronchovascular bundles, multiple small nodules, thickening of interlobular septum, and the presence of polygonal lines. The nodules are more predominent in hematogenous metastasis. The prevalent site of nodules is cortical portion of lung.
Diagnosis ; Humans ; Lung ; Neoplasm Metastasis* ; Retrospective Studies

Rhabdomyosarcoma are reportedly the most common soft tissue sarcoma occuring in childhood, but the biliary tree is a rare site of origin for this tumor. Recently we experienced a case of embryonal rhabdomyosarcoma of the biliary tree in a 30-month-old child. UItrasonography showed hypoechoic mass filling the dilated left. intrahepatic & extrahepatic bile ducts, and CT showed hypodense mass with heterogeneous enhancement after contrast infusion. Intraoperative cholangiography showed filling defects within the dilated left. intrahepatic & extrahepatic bile ducts. Postoperative MRI showed residual mass within the left. intrahepatic duct which was hypointense on T1WI and hyperintense on T2WI.
Bile Ducts, Extrahepatic ; Biliary Tract* ; Child ; Child, Preschool ; Cholangiography ; Humans ; Magnetic Resonance Imaging ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal* ; Sarcoma

Rhabdomyosarcoma are reportedly the most common soft tissue sarcoma occuring in childhood, but the biliary tree is a rare site of origin for this tumor. Recently we experienced a case of embryonal rhabdomyosarcoma of the biliary tree in a 30-month-old child. UItrasonography showed hypoechoic mass filling the dilated left. intrahepatic & extrahepatic bile ducts, and CT showed hypodense mass with heterogeneous enhancement after contrast infusion. Intraoperative cholangiography showed filling defects within the dilated left. intrahepatic & extrahepatic bile ducts. Postoperative MRI showed residual mass within the left. intrahepatic duct which was hypointense on T1WI and hyperintense on T2WI.
Bile Ducts, Extrahepatic ; Biliary Tract* ; Child ; Child, Preschool ; Cholangiography ; Humans ; Magnetic Resonance Imaging ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal* ; Sarcoma

Trigeminal neuropathy os characterized by unremitting facial pain, no evident trigger point and facial sensory change. According to Jannetta, in trigeminal neuropathy, the offending artery is not necessarily in contact with the root entry zone(REZ) but any site of the nerve. We have recently experienced a 48-year-old woman with symptoms and signs compatible with trigeminal neuropathy and explored the CP angle. SCA was crossing just anterior to the trigeminal root and one small arterial loop was lying on the pons close to the root entry zone(REZ) but neither of them was in diirect contact with the nerve. Teflon felt was inserted between the arteries and nerve and secured with silk and beriplast for fear that they should contact by changing position. Immediately after the operation the facial pain and pre-existing facial sensory change were completely gone.
Arteries ; Deception ; Facial Pain ; Female ; Fibrin Tissue Adhesive ; Humans ; Microvascular Decompression Surgery* ; Middle Aged ; Polytetrafluoroethylene ; Pons ; Silk ; Trigeminal Nerve Diseases* ; Trigeminal Neuralgia ; Trigger Points

After an accidental experience of epidural anesthesia by Corning in 1885, the development of Tuohy needle, the discovery of a better local anesthetic, epidural anesthesia came into common usage in clinical anesthesia. Epidural anesthesia is more modern as a regional anesthesia than spinal anesthesia because of the low incidence of hypotension, controllability of the duration of anesthesia time, and the absence of postspinal headache. A total of 1,168 epidural anesthesia cases encountered in Severance hospital during the period of January 1, 1978 to December 31, 1982 were subjected to this clinical evaluation. The results are as follows: 1) The percentage of epidural anesthesia comprised 2.8% of total anesthesia cases. 2) The most common age groups listed in order of decreasing grequency were those in the seventh decade, third decade, and sixth decase. 3) The most common ASA physical status listed in order of decreasing frequency were those in the Class ll, Class l, Class lll. 4) The common agents of local anesthetics used were 1.5 or 2% lidocaine and sometimes bupivacaine. Additive agents such as morphine sulfate for postoperative pain control and epinephrine for prolongation of anesthesia time were used commonly. 5) The most common site of anesthesia was the sixth thoracic vertebral sensory segmental level, but a higher site for sensory anesthesia than required for the operation performed was frequently encountered. 6) The most common complications of epidural anesthesia were hypotension(21.1%) with infrequently dural puncture, traumatic tapping, bradycardia, convulsion, and catheter sequestration. In conclusion, epidural anesthesia is considered to be a safe regional anesthesia that will reduce the incidence of hypotention provided that careful control of the sensory level to be anesthetized is taekn under consideration along with the age, physical status, and operation site of the patient.
Anesthesia ; Anesthesia, Conduction ; Anesthesia, Epidural ; Anesthesia, Spinal ; Anesthetics, Local ; Bradycardia ; Bupivacaine ; Catheters ; Epinephrine ; Headache ; Humans ; Hypotension ; Incidence ; Lidocaine ; Morphine ; Needles ; Pain, Postoperative ; Punctures ; Seizures ; Zea mays

OBJECTIVE: The purpose of this study was to determine differential findings between Type I degenerative endplate changes and diskitis on MR images. MATERIALS AND METHODS: MR images(T1, T2 weighted or Gradient echo) of L-spine in twelve patients with a Type I degenerative endplate change and nine patients with diskitis were reviewed for the morphologic and signal intensity changes of intervertebral disc, vertebral endplate and vertebral body. RESULTS: involvement of the marrow of one side of intervertebral disk was noted in 33%(4/12) of Type I endplate changes, and 11%(1/9) of diskitis. Decreased signal intensity of intervertebral disc was seen in 92% (11/12) of Type I endplate changes, and 11%(1/9) of diskitis on T2 weighted or Gradient echo image. Loss of intranuclear cleft signal was noted in 17%(2/12) of Type I endplate changes, and 78%(7/9) of diskitis. Even disc space narrowing was seen in all cases of Type I endplate changes, but uneven narrowing was seen in 44%(4/9) of diskitis. Only partial cortical disruption was noted in 42%(5/12) of Type I endplate changes, while partial or total cortical disruption was noted in 89%(8/9) of diskitis. The extent of marrow involvement more than 2/3 was noted in 8%(1/12) of Type I endplate changes, but 56%(5/9) of diskitis. The margin of signal intensity change was well defined in 33%(4/12) of Type I endplate changes, but that of diskitis was ill defined in all cases(9/9). Gadolinium enhancement was homogeneous in all cases(5/5) of Type I endplate changes, and 63%(5/8) of diskiris. CONCLUSION: We conclude that involvement of one side of endplate, decreased signal intensity of intervertebral disc on T2 weighted or gradient echo image, even narrowing of disc space, lesser extent of marrow involvement, well defined margin and homogeneous enhancement pattern are the findings of Type I degenerative endplate changes on MR images.
Bone Marrow ; Diagnosis, Differential* ; Discitis* ; Gadolinium ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging*

PURPOSE: Signet-ring cell carcinoma is rather invasive and infiltrative than other histologic types of gastric cancer. We evaluated the characteristic CT findings of signet-ring cell carcinoma especially in the intensity and pattern of contrast enhancement. MATERIALS AND METHODS: We analyzed the CT findings of 22 cases with histologically proven signet-ring cell carcinoma, and compared them with those of 35 cases with histologically proven tubular adenocarcinoma. RESULTS: The double ring enhancement of the gastric mass was seen in 12 cases of signet-ring cell carcinoma and only one case of tubular adenocarcinoma. The masses of signet-ring cell carcinoma were enhanced more by the CT number of 10.2 than those of tubular adenocarcinoma. Of the masses of signet-ring cell carcinoma, those showed double ring enhancement were more intensely enhanced than those showed diffuse enhancement by the CT number of 22.9. CONCLUSION: We thought that neovascularity and different infiltration of the tumor cells in the gastric wall were responsible for the intense enhancement and double ring sign of signet-ring cell carcinoma. The possiblity of signet-ring cell carcinoma is high if a gastric mass show double ring sign and strong contrast enhancement.
Adenocarcinoma ; Carcinoma, Signet Ring Cell* ; Stomach Neoplasms ; Stomach*

PURPOSE: To evaluate factors related to the recurrence of TCC(transitional cell carcinoma) in the urinarybladder after transurethral resection of bladder tumor(TUR-BT). MATERIALS AND METHODS: We retrospectivelyreviewed 54 patients in whom TCC(transitional cell carcinoma) after TUR-BT had been confirmed. Recurrence wasevaluated by US, CT, cystoscopy and urine smear during the follow-up period of 6 months. The multiplicity, shape,size, and calcification of TCC, as revealed by radiologic studies, were evaluated retrospectively before TUR-BT.After TUR-BT, the histologic grade and pathologic stage of TCC were evaluated. RESULTS: According to themultiplicity of TCC, the recurrence rate was 66.7% in the multiple type and 28.6% in the single type(p=0.039) ;according to shape, this rate was 61.5% in the sessile type and 29.3% in the pedunculated type(p=0.0505), andaccording to mass size, the rate was 41.7% in tumors more than 3cm in diameter and 35.7% in tumors less than3cm(p=0.706). In the presence of calcification, the recurrence rate was 40.0% and in its absence, this rate was36.7%(p=0.885). Pathologically, the higher the grade and stage of TCC, the higher the recurrence rate(respectivelyp=0.010 and 0.041). CONCLUSIONS: Radiologically, multiple and/or sessile type TCC had a higher recurrence ratethan the single and/or pedunculated type. Pathologically, when the grade and stage of bladder tumor were higher,recurrence rates were higher.
Carcinoma, Transitional Cell* ; Cystoscopy ; Follow-Up Studies ; Humans ; Recurrence* ; Retrospective Studies ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: To access the usefulness of transcatheter radiofrequency(RF) electrocautery as a method ofnonsurgical tubal occlusion. MATERIALS AND METHODS: Using the coaxial technique under fluoroscopic guidance,transvaginal fluoroscopic fallopian tube catheterization was performed in thirteen rabbits. In each rabbit,unilateral tubal ablation was performed using RF electrocautery. A 0.018 inch metallic wire protruding from themicrocatheter tip was used as the source of the RF energy ; the length of the noninsulated part of this wire was10mm and the duration of RF supply was 20 seconds. The contralateral normal fallopian tube and uterus were used asa control. All 13 rabbits were randomly sacrified on two days(group I) or 30 days(group II) after the procedure,and tubal patency and histologic change were evaluated. RESULT: In group I(n=5), significant RF ablation-inducedtissue necrosis of the endosalpinx was found in all five rabbits. In group II(n=8), the fallopian tube wascompletely occluded with tubal wall fibrosis, in all eight rabbits, but there was no tissue damage in adjacentperitoneal organs. For contralateral control tubes, the histologic findings were normal. CONCLUSION: Transcatheter RF electrocautery is thought to be a useful method for tubal occlusion. It is simple, safe, and lessexpensive and might have a role in future female tubal steralization.
Animals ; Catheterization ; Catheters ; Electrocoagulation* ; Fallopian Tubes* ; Female ; Fibrosis ; Humans ; Necrosis ; Rabbits ; Sterilization, Tubal ; Uterus