The authors clinically analysed the causes of metallic failure in 21 cases after treatment of comminuted fracture of femur at Department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital during 5 year period from May 1981 to December 1986. In this series, the nature of metallic property was not studied which may influence the result of failure. 1. Metallic failure occurred in seventeen self-compression plates, one Kuntscher nail, one I-beam nail, one Ender nail, and one Angle blade-plate. 2. Seventeen patients had fractures in the middle or distal one third of femur. 3. Metallic failure occurred from 3 to 19 months following open reduction and internal fixation. The time interval between internal fixation and failure was 9.6 months on an average. 4. Metallic failure of the self-compression plate was observe in the empty hole over the fracture site in 14 out of 17 patients. In the Kiintscher, failure developed at the interlocking hole corresponding with the fracture level. In the Ender nail and Angle blade-plate, failure developed at the fracture site, and in the I-beam nail plating, failure developed at the neck of the fixation screw, and not at the plate. 5. The cause of metallic failure in 17 self-compression plate-treated cases was improper plating such as varus plating in 4, absence of medial buttress due to cortical comminution in 10. Above mentioned two conditions were combined in 4 cases, in which one case of Angle blade-plate was included. Incorrect position of I-beam nail, inadequate postoperative management following Ender nailing and incorrect selection of implant in one case of Kiintscher nailing were the other possible causes of metallic failure.
Femur ; Fractures, Comminuted ; Humans ; Neck

No abstract available.
Malingering*

STUDY DESIGN: We report two cases of symptomatic spinal epidural lipomatosis (SEL) associated with long-term use of steroid medication OBJECTIVES: The purpose of this study was to assess the clinical characteristics, diagnosis and treatment of symptomatic spinal epidural lipomatosis. SUMMARY OF LITERATURE REVIEW: Spinal epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It can present neurologic symptoms including back pain, radiculopathy or cauda equina. Magnetic resonance imaging is the most helpful dignostic means and should be used initially if suspected. Treatment is decompressive laminectomy and debulking of fat. MATERIALS AND METHODS: Two cases of lumbar epidural lipomatosis with neurologic symptoms were discussed and evaluated by physical examination, postmyelography CT and MRI. RESULTS: Two cases were treated with decompressive laminectomy and debulking of fat. Increased accumulation of the fatty tissue was seen predominently in posterior and posterolateral epidural space of the spinal canal, displacing and compressing the lumbar spinal cord anteriorly. Both gross and histologic evaluation revealed overgrowth of unencapsulated normal appearing fat consistent with spinal epidural lipomatosis. One case was demonstrated gradual improvement in symtoms after operation but the other was died due to medical problems. CONCLUSION: The authors reviewed the literature and reported the results of operative treatment of patients with lumbago, radicular pain and intermitent claudication caused by epidural lipomatosis of lumbar spine and degenerative spinal stenosis.
Adipose Tissue ; Back Pain ; Cauda Equina ; Diagnosis ; Epidural Space ; Humans ; Laminectomy ; Lipomatosis* ; Low Back Pain ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Physical Examination ; Radiculopathy ; Spinal Canal ; Spinal Cord ; Spinal Stenosis ; Spine

No abstract available.
Epidermal Cyst ; Pilomatrixoma

No Abstract Available.
Keratitis* ; Keratomileusis, Laser In Situ*

No abstract available.
Humans ; Otitis Media* ; Otitis*

The authors experienced 52 patients with myasthenia gravis who were diagnosed at the Department of Neurology, Yeungnam University Hospital from August 1985 to January 1996. The following results were obtained through diagnostic evaluation and treatment. 1. The ratio of male to female was 1:1.7 and the most prevalent age group was second decade. 2. The most common initial presentation symptom was ocular(71.2%) and the peak incidence group was stage I (69.3%) according to the modified Osserman's classification. 3. In 16 patients(30.8%), it took more than a year to diagnose due to symptoms which were relapsed and remitting. 4. Of 52 patients, 2 cases were associated with thyroid disease(3.8%) and 2 with insulin-dependent diabetes mellitus(3.8%). 5. All of those who received anticholinesterase and corticosteroid therapy were improved with the exception of 5 cases which were improved after thymectomy and/or plasmapheresis.
Classification ; Female ; Humans ; Incidence ; Male ; Myasthenia Gravis* ; Neurology ; Plasmapheresis ; Thymectomy ; Thyroid Gland

For the clinical analysis and evaluation on the patients with gestational trophoblastic disease(GTD), a study was done retrospectively on 114 patients with GTD(60 in Hydatidiform mole, 10 in invasive mole, 44 in choriocarcinoma) treated from Jan. 1, 1985 to Dec. 31, 1994 at the Department of Obstetrics and Gynecology, Kosin Medical College, Pusan, Korea. We obtained the following results ; The incidence of GTD was 1 per 73 deliveries in H. mole, 1 per 437 deliveries in invasive mole, and 1 per 99 deliveries in choriocarcinoma. The most prevalent age was 21-40 groups. Abnormal vaginal bleeding was a main symptom and sign. 30.6% of H. mole was managed by dilatation and curettage. 90.0% of invasive mole and 51.4% of choriocarcinoma were managed by surgical treatment and chemotherapy. The overall remissinon rate of choriocarcinoma was 71.4%(100.0% in stage I, 66.7% in stage II, 54.5% in stage III, 50.0% in stage IV).
Busan ; Choriocarcinoma ; Dilatation and Curettage ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Gynecology ; Humans ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Incidence ; Korea ; Obstetrics ; Pregnancy ; Retrospective Studies ; Trophoblasts ; Uterine Hemorrhage

To evaluate the effectiveness of conization in the diagnosis of cervical cancer, the histopathologic finding of 464 consecutive cases were analized with respect to the cytology, punch biopsy and hysterectomy. Cold knife conization was performed under direct visualization(naked eye conization) from January, 1987 to Octorber 1994 at department of Obstetrics and Gynecology, Kosin Medical Center. The results were summerized as follows : 1. The rate of agreement and underdiagnosis of between pap smear and naked eye conization were 43.7% and 47%. 2. The rate of agreement and underdiagnosis of between punch biopsy and naked eye conization were 64.5% and 21.8% 3. Subsequent hysterectomy was done on the 382 case and their incidence of residual disease rate was 44.2%(169 cases). Their incidence of residual lesion was increased with severity of the carcinomatous change. 4. The rate of complication undergoing conization was 8.4%(39 cases).
Biopsy ; Conization* ; Diagnosis ; Gynecology ; Hysterectomy ; Incidence ; Obstetrics ; Uterine Cervical Neoplasms

Spinal cord infarction as a complication of spine surgery occurs rarely. Herein, a case of spinal cord infarction, which developed in a 69 year old woman following posterior decompression and internal fixation for a T11 bursting fracture, is descirbed. The anesthetic induction and intraoperative course were uneventful, except at the end of the procedure, where her blood pressure suddenly dropped from 130/90 to 90/60 mmHg. The patient was aggressively treated with a transfusion and vasopressor, the blood pressure then returned to its usual value within 10 minutes. However, during a physical examination in the recovery room, the patient was found to have flaccid lower limbs, with impaired sensory function below the T8 level. Her cord diameter had increased, and a high signal lesion was observed within the thoracic spinal cord, from T9 to T12 level on T2-weighted MR images, which was diagnosing as a spinal cord infarction, was and showed no improvement despite the immediate and aggressive treatment.
Aged ; Blood Pressure ; Decompression ; Female ; Humans ; Infarction* ; Lower Extremity ; Physical Examination ; Recovery Room ; Sensation ; Spinal Cord* ; Spine*