No abstract available.
Breast Neoplasms* ; Breast*

Os subfibulare is a accessory bone arround the lateral maleolus, but it is different from many other accessory bones in foot and ankle in its development related to trauma and frequent symptoms of ankle instability. Accessory bone is a developmental anomaly which fails to unite to main secondary ossification center and usually asymptomatic. But os subfibulare is developed by recurrent ankle sprains in younger age or non-union of avulsion fracture of anterior talofibular ligament and causes instability of ankle. We experienced two cases of symptomatic os subfibulare in adolecents and report them with review of literatures.
Ankle ; Ankle Injuries ; Foot ; Ligaments

No abstract available.
Humans

Because of failure to intubate 2-year-old male patient suffering from respiratory difficulty due to sublingual mass (teratoma), emergent tracheostomy was planned. During induction with 100% oxygen and halothane with face mask, sudden cardiopulmonary arrest was occured. Circulation was resuscitated promptly but airway was not kept due to difficult intubation. So ventilation was proceeded through 16 gauge angiocatheter by cricothyroid membrane puncture and retrograde intubation was carried out with epidural catheter through another cricothyroid membrane puncture after then tracheostomy and removal of teratoma was carried out without event. But the patient has had severe dyspnea frequently in postoperative period. On postoperative 7th day, funnel shaped congenital tracheal stenosis was found with bronchogram. Therefore, we concluded that the post-tracheostomy respiratory problem was due to congenital tracheal stenosis. In conclusion, retrograde intubation is a valuable alternative for the emergent unexpected difficult intubation for adults or children because it has a high success rate, easy to learn, requires little practice and does not require complex apparatus. And the failure of a suitable tube to insert the trachea after it passed through the vocal cords or continuous dyspnea after intubation or tracheostomy be considered as the presence of airway narrowing and, possibly, congenital tracheal stenosis.
Adult ; Catheters ; Child* ; Child, Preschool ; Dyspnea ; Emergencies* ; Halothane ; Heart Arrest ; Humans ; Intubation ; Intubation, Intratracheal* ; Male ; Masks ; Membranes ; Oxygen ; Postoperative Period ; Punctures ; Teratoma* ; Trachea ; Tracheal Stenosis* ; Tracheostomy ; Ventilation ; Vocal Cords

Although metastatic renal cell carcinoma is not uncommon, metastases to the ureteral stump and bladder are very rare. A 69-year-old woman who had undergone radical nephrectomy because of right renal cell carcinoma about 8 years ago, visited our hospital for evaluation of painless gross hematuria. Histologic examination of the removed ureteral stump and bladder specimen demonstrated metastatic renal cell carcinoma. We report a case of renal cell carcinoma with metastases to the ureteral stump 5 years after radical nephrectomy and bladder 8 years after radical nephrectomy.
Aged ; Carcinoma, Renal Cell* ; Female ; Hematuria ; Humans ; Neoplasm Metastasis* ; Nephrectomy ; Ureter* ; Urinary Bladder*

OBJECTIVES: Using two stimuli, this study was designed to evaluate variations of P300 in relations to reaction time of pressing the button for target tones in patients with schizophrenia. METHODS: The auditory oddball paradigm was used for the patients (N=22) and normal controls (N=23). The two stimuli were composed of target (20%, 2000 Hz, 75 dB) tone and standard (80%, 1000 Hz, 75 dB) tone, with 2 sec inter-stimulus interval, 50 msec duration and 10 msec rise or fall time. In each subject, P300s were acquired for both fast reaction time (FRT) and slow reaction time (SRT) to target response. RESULTS: P300 amplitude in patients with schizophrenia was lower than controls across FRT and SRT (p<0.001), but P300 latency was not delayed (p>0.8). In this study, even though the reaction time for the button pressing task might be faster in patients with schizophrenia (p<0.1), the P300 to FRT in patients with schizophrenia was lower than the P300 to SRT in controls (p<0.01). CONCLUSION: These results suggest that the lower P300 in patients with schizophrenia might be due to cognitive dysfunction and the patient's performance in reaction time for pressing buttons, both independently. Thus, P300 as well as reaction time may be used to further explore a variety of domains of cognitive function.
Evoked Potentials* ; Humans ; Reaction Time* ; Schizophrenia*

To examine the cytotoxic effect of chemotherapy on the ovary, 23 cases undergoing oophorectomy with radical hysterect,orny in premenopausal wemen receiving induction chemotherapy with cisplatin and 5-fluomouracil for carcinoma of the cervix between March, 1989 and December, 1992 were studied by light microscopy. Out of 23 cases, 19 (82.6%) showed vascular congestion and 12(52.1%) revealed hemorrhage around folliele and within corpus luteum. The follicular structure was desLroyed in 16 cnses (69.5%) and oocytes of ovums were lost in 17 cases. The mechanism of injury of the ovarian structures after combination chemotherapy with cisplatin and 5-fluorouracil is considered to be caused by secondary cell damage following circulatory disturbance of direct toxicity on fallicular cells of oocytes.
Cervix Uteri ; Cisplatin ; Corpus Luteum ; Drug Therapy* ; Drug Therapy, Combination ; Estrogens, Conjugated (USP) ; Female ; Fluorouracil ; Hemorrhage ; Humans ; Induction Chemotherapy ; Microscopy ; Oocytes ; Ovariectomy ; Ovary* ; Ovum

PURPOSE: An osteochondral lesion of the talus in ankle fracture needs appropriate treatment to prevent traumatic arthritis. Despite the high incidence of an osteochondral lesion in cases of ankle fracture, it is difficult to identify the location of the lesion during open fracture reduction due to limitation of the surgical approach. Therefore, we reviewed retrospectively the MRIs of ankle fractures to determine the incidences and locations of osteochondral lesions of the talus according to ankle fracture injury mechanism. MATERIALS AND METHODS: The MRIs of forty patients with ankle fractures were reviewed. Locations of osteochondral lesions were divided into nine areas; i.e., medial, central, lateral and anterior, central, posterior. Injury mechanisms were divided into supination and pronation groups. RESULTS: Twenty eight (70%) out of 40 patients with ankle fractures had an osteochondral lesion of the talus. Thirteen (46%) patients were allocated to the supination group and 15 (54%) to the pronation group. Lesion locations were; 7 cases of lateral, 1 central, 5 medial and 8 posterior, 3 central, and 2 anterior for supination injury. In cases of pronation injury, 13 were lateral, 1 each central and medial, and 9 posterior, 5 central, and 1 anterior. The incidences of osteochondral lesions were significantly different at the lateral and central areas, and also between the posterior and anterior areas in both the supination and pronation groups. CONCLUSION: For osteochondral lesion in cases of ankle fracture, careful observation of the posterior and lateral areas of the talar dome should be performed and additional treatment should be added for the lesion if required.
Ankle Fractures* ; Ankle* ; Arthritis ; Fractures, Open ; Humans ; Incidence* ; Magnetic Resonance Imaging ; Pronation ; Retrospective Studies ; Supination ; Talus*

PURPOSE: We compare the sagittal stability of 6 different osteotomies of the metatarsal shaft : the proximal crescentic, proximal chevron, Mau, Scarf, Ludloff, and biplanar closing wedge osteotomies. MATERIALS AND METHODS: Ten fresh frozen, human cadaveric specimens were used for each osteotomy. All specimens were then dissected out en bloc as the first metatarsal -medial cuneiform complex which was fixed with 3 Kirschner wires and clamped to a MTS Mini Bionix load frame. Cantiliver bending load was applied until bony fracture, pull out of screw, or a displacement of osteotomy greater than 2 mm as measured by the extensometer was observed. The data was compared with Student's t-test. RESULTS: The average bending strength for 6 osteotomies were 199.56 kg/cm2 in proximal crescentic osteotomy, 205.3 kg/cm2 in proximal chevron osteotomy, 372.0 kg/cm2 in Ludloff osteotomy, 428.4 kg/cm2 in Scarf osteotomy, 508.8 kg/cm2 in biplanar closing osteotomy, and 530.0 kg/cm2 in Mau osteotomy. Statistical analysis revealed insignificant difference (P>0.01) between Ludloff and Scarf and biplanar closing wedge and Mau osteotomies. There were statistical differences between Mau or Scarf osteotomy and proximal chevron or crescentic osteotomy. CONCLUSION: Proximal chevron and proximal crescentic osteotomies need longer postoperative immobilization for the prevention of plantar angulation of first metatasus.
Bone Wires ; Cadaver ; Hallux Valgus ; Humans ; Immobilization ; Metatarsal Bones* ; Osteotomy*

A 66 year-old male patient underwent resection of a pheochromocytoma under general anesthesia. The patient was treated with phenoxybenzamine and propranolol for 7 days preoperatively. Follwing an induction of anesthesia with intravenous fentanly 100 ug, thiopental sodium 250 mg, vecuronium 12 mg, and magnesium sulfate 3.0 gm, endotracheal intubation was performed. Aneathesia was maintained with nitrous oxide, oxygen and isoflurane. For the management of blood pressure during surgical manipulation, magnesium sulfate was infused at the rate of 0.75-1.0 mg/kg/min. After the removal of the tumor mass, the blood pressure dropped to 80/40 mmHg. Whole blood and fresh frozen plasma were transfused and norepinephrine 0.5 ug/kg was infused to maintain the blood pressure for 40 min. Postanesthestic recovery course was uneventful.
Aged ; Anesthesia ; Anesthesia, General ; Anesthetics ; Blood Pressure ; Humans ; Intubation, Intratracheal ; Isoflurane ; Magnesium Sulfate* ; Magnesium* ; Male ; Nitrous Oxide ; Norepinephrine ; Oxygen ; Phenoxybenzamine ; Pheochromocytoma* ; Plasma ; Propranolol ; Thiopental ; Vecuronium Bromide