No abstract available.
Broad Ligament* ; Female ; Hemorrhage* ; Pregnancy*

Open fractures of the tibial shaft have a high incidence of complication and often result in poor outcomes. The most common method of stabilization is the external fixation by way of the Ilizarov method but the small diameter interlocking intramedullary nailing has also been introduced. The purpose of this study is to analyze the result of Ilizarov method and to compare its results with those of delayed intramedullary nailing used in the treatment of open tibial shaft fractures. We analyzed 81 patients with open tibial shaft fractures, treated using Ilizarov external fixator, or by delayed locked intramedullary nailing between January 1987 and December 1994. The follow-up period was an average 14.5 months. Out of the 81 patients, 58 patients were treated by nails and 23 patients by Ilizarov external fixators. Both groups were given the same initial management but the operation of the nailing group was delayed until proper soft tissue coverage and healing of the wound were evident. In the Ilizarov method group, 58 fractures obtained union within 26 to 53 weeks (average of 32.8 weeks) and in the nailing group, 23 fractures showed union within 14 to 51 weeks (average of 21.2 weeks). There was a significant difference between the two groups (P<0.05). Complications in the Ilizarov group included 4 nonunions, 12 delayed unions, 3 malalignments, 14 wound infections and 13 stiff ankles. There were no nonunion, 10 delayed unions, 8 malalignments, 6 wound infections and 11 stiff ankles in the nailing group. In this study, the Ilizarov group had more delayed unions and nonunions took a longer period of time to obtain the union, and had a more limited range of motion in the ankle, than the nailing group. The nailing group was easier to manage, especially in the soft tis-sue procedure, and it did not require a high level of compliance while having a relatively low risk of malunion.
Ankle ; Compliance ; External Fixators* ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Open ; Humans ; Ilizarov Technique ; Incidence ; Range of Motion, Articular ; Wound Infection ; Wounds and Injuries

BACKGROUND: This study was conducted to evaluate the surgical outcomes of plate fixation using autologous iliac bone graft shaped in the form of a matchstick in clavicle nonunion resulting from prior surgical or non-surgical management. METHODS: From May 2005 to February 2013, 17 patients underwent surgery for clavicle nonunion. The mean age at the time of surgery was 48.8 years. The iliac bone was harvested and shaped into slivers approximately 3 cm long, which resembled matchsticks. After opening of the medullary canal, the plate and screws were applied and cancellous bone was placed at the nonunion site. Matchstick bone grafts which were longitudinally placed and encircled on the nonunion site were tied with periosteum using 3–4 stitches. Union was determined via postoperative plane X-ray. Clinical status was evaluated using the visual analogue scale score for pain, and Constant and American Shoulder Elbow Surgeon score. RESULTS: All patients had a stable radiological union at the follow-up. The mean duration from index operation to nonunion operation was 13.2 months (7–32 months). The mean follow-up period was 20.1 months (8–56 months), and the mean duration until union was 11.2 weeks (8–16 weeks). All clinical scores were improved at the final follow-up (p<0.001). The mean segmental defect was 3.3 ± 2.6 mm (1–18 mm); and the difference in clavicular length between operative and non-operative site was 5.9 ± 6.9 mm. CONCLUSIONS: Matchstick shaped autologous iliac bone grafting technique in clavicle nonunion is acceptable with a high union rate.
Bone Transplantation ; Clavicle* ; Elbow ; Follow-Up Studies ; Humans ; Periosteum ; Shoulder ; Transplants

PURPOSE: The authors conducted a retrospective analysis of patients with the carcinoma of uterine cervix treated with curative radiation therapy to evaluated the prognostic factors that would affect the results of the therapy and to get the critical ideas in determining more aggressive treatment schedule. METHODS AND MATERIALS: From January 1987 to December 1988, Four hundreds and sixty patients with uterine cervical carcinomas treated with radiotherapy at KCCH were registered to this retrospective study. One hundred and three patients were treated with external radiation therapy alone, and 357 patients were treated with external radiation followed by low dose rate intracavitary radiation therapy. He follow-up rate was 88% and median follow-up duration was 48 months. RESULTS: The overall 5 year survival rate of the patients was 67.7%, and when classified by FIGO stages, 5 year survival rates were 81.2%, 76.3%, 73.1%, 50%, 52.3%, 11.5% for stages Ib, IIa, IIb, IIIa, IIIb, IVa respectively. Tumor size(p=0.0002), endocervical growth pattern(p=0.003), lymph node invasion(p=0.0001), mean hemoglobin level(p=0.0001), and pathologic cell type(p=0.0001) were significant prognostic factors and decrease in survival for young age patient group was marginally important(p=0.03). CONCLUSION: Significant prognostic factors I the radiation therapy of the uterine cervical carcinoma were tumor size, growth pattern of tumor, lymph node invasion, pathologic cell type, hemoglobin level of patients during treatment and lower survival rate in young age group was obvious, too. Patients with large size tumor(> or =4cm), especially combined with endocervical growth patterns or advanced stages(III or more) need more aggressive treatment to improve the outcome of treatment. And positive feature of lymph node invasion affected the result of therapy, so improvement in the diagnostic and therapeutic trial is essential.
Appointments and Schedules ; Cervix Uteri* ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; Radiotherapy ; Retrospective Studies ; Survival Rate

Eighty five patients of oral cavity cancer, treated with radiation at the Department of Therapeutic Radiology, Korea Cancer Center Hospital, during the period from March 1985 to September 1990 were analyzed retrospectively. Among 85 patients, 37 patients were treated with radiation only and 48 patients were treated with radiation following surgery And 70 patients received external irradiation only by 60Co with or without electron, the others were 7 patients for external irradiation plus interstitial implantation and 8 patients for external irradiation plus oral cone electron therapy. Primary sites were mobile tongue for 40 patients, mouth floor for 17 patients, palate for 12 patients, gingiva including retromolar trigone for 10 patients, buccal mucosa for 5 patients, and lip for 1 patient. According to pathologic classification, squamous cell carcinoma was the most common (77 patients). According to AJC TNM stage, stage I + II were 28 patients and stage III+IV were 57 patients. Acturial overall survival rate at 3 years was 43.9%, 3 year survival rates were 60.9% for stage I + II, and 23.l% for stage III+IV, respectively. As a prognostic factor, primary T stage was a significant factor (p<0.01). The others, age, location, lymph node metastasis, surgery, radiation dose, and cell differentiation were not statistically significant. Among those factors, radiation plus surgery was more effective than radiation only in T3+T4 or in any N stage although it was not statistically sufficient(p<0.1). From those results, it was conclusive that definitive radiotherapy was more effective than surgery especially in the view of pertainig of anatomical integrity and function in early stage, and radiation plus surgery was considered to be better therapeutic tool in advanced stage.
Carcinoma, Squamous Cell ; Cell Differentiation ; Classification ; Gingiva ; Humans ; Korea ; Lip ; Lymph Nodes ; Mouth Floor ; Mouth Mucosa ; Mouth* ; Neoplasm Metastasis ; Palate ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Tongue

The clinical and pathological features of an apparently unique case of an adenomyoitc cyst of the uterus are reported. The cyst was located within the myometrium of a 30-year-old woman suffering from vaginal bleeding for 6 months. Saline infusion sonohysterography revealed uterine cyst. After excision of the cyst, patient's symptoms improved. On histological examination, the cyst most closely resembled an adenomyotic cyst.
Adenomyoma* ; Adult ; Animals ; Female ; Humans ; Mice ; Myometrium ; Uterine Hemorrhage ; Uterus

Lemierre syndrome is caused by an acute oropharyngeal infection with secondary septic thrombophlebitis of the internal jugular vein and frequent metastatic infections. The usual etiologic agent is Fusobacterium necrophorum. Lemierre syndrome was a common disease with a high mortality rate in the pre-antibiotic era. Since the advent of antibiotics and their widespread use for the treatment of pharyngeal infections, there has been a substantial decrease in the incidence of this malady and it has become a "forgotten disease". Prompt diagnosis and antibiotic therapy for Lemierre syndrome is essential to avoid morbidity and mortality. We describe here a case of Lemierre syndrome with multiple septic pulmonary emboli.
Anti-Bacterial Agents ; Diagnosis ; Fusobacterium necrophorum ; Incidence ; Jugular Veins ; Lemierre Syndrome* ; Mortality ; Pharynx ; Pulmonary Embolism* ; Thrombophlebitis

PURPOSE: This is to examine the neurodevelopmental outcomes of very low birth weight (VLBW) infants by Korean infant developmental screening test. METHODS: 29 VLBW infants and 39 normal term infants, at their corrected age of 1 to 3 years, were included for the study. Risk factors which influence neurodevelopmental outcomes were analyzed. RESULT: The mean levels of developmental quotients for VLBW infants were lower than those of term infants (P<0.001); gross motor 99.3+/-27.28 vs. 121.3+/-19.08, fine motor 95.9+/-27.22 vs. 118.3+/-17.77, social-personality 100.2+/-28.01 vs. 126.3+/-21.31, language 99.5+/-27.34 vs. 120.1+/-18.82, cognitive-adaptive 101.4+/-28.60 vs. 122.7+/-19.59, and total developmental quotient is 99.3+/-27 vs. 121.7+/-19.18. Nevertheless, the mean levels of the individual developmental quotients for VLBW infants were in normal range. There were five VLBW infants (17%) those who scored lower than 80, also showed neurologic sequelae. The infants who had the more risk factors during hospitalization scored the less developmental quotient (R(2)=0.35, P=0.01). CONCLUSION: Although the mean levels of the individual developmental quotient for VLBW infants, assessed by Korean infant developmental screening test, were lower than those of term infants, they are in normal range.
Child ; Child Development* ; Hospitalization ; Humans ; Infant* ; Infant, Very Low Birth Weight* ; Mass Screening* ; Reference Values ; Risk Factors

The term myotubular myopathy (MTM) implies a maturational arrest of fetal muscle during the myotubular stage of development at 8-15 weeks of gestation. Characteristic muscle histopathology consists of small hypotrophic muscle fibers with centrally placed nuclei and a surrounding clear area devoid of myofibrils. X-linked recessive inheritance is the most common trait. Autosomal recessive and autosomal dominant forms are less frequently reported. The clinical diagnostic criterion for X-linked MTM has relied on a positive family history and the demonstration of the presence of characteristic biopsy findings from affected male subjects. Additional features may include perinatal onset, severe hypotonia, respiratory failure, dysphagia, thin ribs, contractures of the hips or knees, puffy eyelids and ophthalmoplegia. The prognosis is often fatal, and most patients die within the first year of life from respiratory failure. The authors report a case of presumed X-linked MTM with severe hypotonia, muscle weakness and respiratory failure at birth.
Biopsy ; Contracture ; Deglutition Disorders ; Eyelids ; Hip ; Humans ; Knee ; Male ; Muscle Hypotonia ; Myofibrils ; Myopathies, Structural, Congenital* ; Ophthalmoplegia ; Parturition ; Pregnancy ; Prognosis ; Respiratory Insufficiency ; Ribs ; Wills

Total of 53 patients of unresectable and recurrent rectal cancer treated with neutron beam during the period from Oct. 1987 to Apr. 1992 were analyzed. Dose fractionation for the neutron only group was 1.5 Gy per fraction, 3 fraction per week, 21 Gy/41/2 wks for 42 patients out of 53(76%). Neutron only but modified fractionation schedule (10% more or less of total dose) was applied for 9 patients, and mixed team (neutron boost) was for 4 patients. Complete tumor response was obtained in 40 patients(76% response rate). Local control rate was 28 out of 53(53%). Statistically significant better prognostic factors for local control were age below 49 years old (15/22, 68%) than above 50 years old (13/31, 42%), male (20/32, 63%) than female(8/21, 38%), tumor size less than 5 cm and non-metastatic(16/24, 67%) than size more than 5 cm or metastatic(12/29, 4l%). Major complication had developed in 7 patients (13%). Two year overall survival rate by Kaplan-Meier method was 30%, but it was rised to, 47% when the tumor was less than 5cm non-metastatic.
Appointments and Schedules ; Dose Fractionation ; Humans ; Male ; Middle Aged ; Neutrons* ; Rectal Neoplasms* ; Survival Rate