No abstract available.
Carcinoma, Hepatocellular* ; Classification*

The CT digital radiography is a new accurate technique for measuring the long bone length. Authors performed acomparative study on accuracy, time and film consumption and radiation dose between conventional spot scanogramand CT scanogram. We used two femur and two tibia specimen for materials, the Somatom II(Siemens) for CTscanogram, and Rad Check(Voctoreen) for radiation dosimetery. There was no significant difference in accuracybetween direct measurement, conventional scanogram and CT scanogram(lesser than 1% difference). The examinationtime of conventional scanogram was about 35 minutes, CT was 15 minutes, and the film consumption of spot scanogramwas 3 of 14x17'' size, but the CT scanogram need only one 8x10'' film for completion of study. The radiation doseof hip, knee and ankle joint were 220 mRad, 365 mRad, respectively, in spot scanogram, but it was lesser than 5mRad in all joints in CT scanogram. The advantages of the CT scanogram are simple, rapid and reduced radiation.
Ankle Joint ; Femur ; Hip ; Joints ; Knee ; Radiographic Image Enhancement ; Tibia

PURPOSE: To evaluate the clinical and radiologic results of minimally invasive plate osteosynthesis, We analyzed the cases of distal femoral fracture treated with this newly developed surgical technique. MATERIALS AND METHODS: We reviewed 12 cases of distal femoral fracture which had been treated with minimally invasive plate osteosynthesis and each patients had been followed up for a minimum twelve months. Post-operative function was evaluated with checking the range of motion of knee joint and Knee Society Score. Union period and post-operative alignment was measured on radiograph. RESULTS: In all cases, bony union was obtained in average fifteen weeks after operation without bone graft. The arc of motion of knee joint which was checked at the last follow up was 123.75 degrees on average. According to Knee Society Score, there were 9 excellent, 1 fair and 1 poor results. The post-operative complications were malunion in 1 case, soft tissue infection in 1 case and joint stiffness in 1 case. CONCLUSION: The treatment of distal femoral fracture with minimally invasive plate osteosynthesis is one of the good surgical options for clinically preferable results with high union rate without bone graft and early joint motion.
Femoral Fractures* ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Range of Motion, Articular ; Soft Tissue Infections ; Transplants

BACKGROUND: Renin-ngiotensin system (RAS) blockers have been used to delay the progression of various renal diseases, but these medications cause hyperkalemia and the elevation of serum creatinine which impede the continuation of the medications. So far, there have been no data on the changes of serum creatinine or serum potassium after withdrawal of the RAS blockers. METHODS: We reviewed medical records of 60 patients who stopped the RAS blockers due to the elevation of serum creatinine or hyperkalemia between March 1995 and May 2005. They were assigned to either the elevated creatinine group or the hyperkalemia group according to the cause of the withdrawal. RESULTS: In the elevated creatinine group (n=37), the serum creatinine and GFR values at the point of withdrawal were 4.0+/-1.8 mg/dL and 18.2+/-10.4 mL/min/1.73m2, respectively. After discontinuation of the medications, a decrease in serum creatinine and an increase in GFR were noted at one month. After one month, however, serum creatinine increased continuously up to 6 months. Serum potassium levels decreased significantly after the drug withdrawal until the end of the study period. In the hyperkalemia group (n=23), the serum creatinine and serum potassium values at the point of withdrawal were 3.0+/-1.0 mg/dL and 6.4+/-0.4 mEq/L, respectively. A significant decrease in serum potassium was also noted after the withdrawal and this decrease lasted up to 6 months. But the transient decrease of serum creatinine, observed in the creatinine group, was not seen in this group. CONCLUSION: It was found that there was a beneficial effect on serum creatinine and GFR immediately after the withdrawal of RAS blockers only when they were stopped due to elevation of the serum creatinine concentration. The serum potassium levels were consistently decreased after the withdrawal of RAS blockers in both elevated creatinine and hyperkalemia groups.
Angiotensin II* ; Angiotensin Receptor Antagonists ; Angiotensins* ; Creatinine* ; Humans ; Hyperkalemia ; Medical Records ; Potassium* ; Renal Insufficiency, Chronic*

PURPOSE: The purpose of this study is to evaluate the effect of polylactide resorbable film in preventing epidural fibrosis after lumbar laminotomy. MATERIALS AND METHODS: Thirty-six New Zealand male rabbits about fifteen month old, weighing 3.5 kg in average, were used. Uniform laminotomy windows measuring 7x7 mm were made on the left side of the spine at three lumber locations (L2, L3 and L4). The laminotomy window at second lumbar spine was left untreated and used as control group (Group 1). The lanimotomy window of 3rd lumbar spine was covered with free fat tissue (Group 2), and polylactide ( Surgi-Wrap(R)) resorbable film was inserted on the laminotomy window of 4th lumbar spine (Group 3). Twelve rabbits were euthanized at 4, 8 and 12 weeks each after operation for biochemical analysis of hydroxyproline content and histologic examination. RESULTS: 1. There was considerable reduction in the total collagen, ranging from 40~48% in the Group 2 or the Group 3 compared to the Group 1. There was no statistical difference between the Group 2 and the Group 3. 2. The extent of fibrosis and fibroblast density was significantly lower in the Group 2 or the Group 3 than in the Group 1. However, the extent of fibrosis and fibroblast density did not differ statistically between the Group 2 and the Group 3. 3. No significant statistical differences of the collagen content and the histologic findings in each group was demonstrated during experimental period. CONCLUSION: These results suggest that polylactide (Surgi-Wrap(R)) resorbable film may be a useful method for reduction of epidural fibrosis after lumbar laminotomy.
Collagen ; Fibroblasts ; Fibrosis* ; Humans ; Hydroxyproline ; Laminectomy* ; Male ; New Zealand ; Rabbits ; Spine

PURPOSE: To evaluate the effectiveness of a polylactic acid bioresorbable film in the prevention of tendon adhesion after tendon repair. MATERIALS AND METHODS: Twenty-four adult rabbits (48 cases) were used in this study. In the first (control) group, the flexor tendons of the third toe were cut and a tenorrhaphy was performed. The 2nd group was injected with hyaluronic acid between the tendon and tendon sheath after suturing. The 3rd group underwent an enveloping of the tendon with polylactic acid film, followed by tenorrhaphy. The test animals were euthanized at 1, 2, 3, and 6 weeks after surgery, and the histology and biomechanics were evaluated. RESULTS: Microscopic evaluations revealed fibrosis to be most apparent in group 1, while groups 2 and 3 showed no significant differences. The biomechanical tests, which were carried out using a Universal Testing Machine, revealed that an increase in adhesion strength with time. At 6 weeks after surgery, group 1 exhibited an adhesion strength that was 2.5-3 times greater than that exhibited by groups 2 and 3. Group 2 had a higher adhesion strength than group 3, but this difference was not statistically significant. CONCLUSION: Increases in granulation tissue and fibrosis during the healing of sutured tendons were observed, and the tested polylactide resorbable film was found to be effective in reducing the level of adhesion formation after tendon repair.
Adult ; Animals ; Fibrosis ; Granulation Tissue ; Humans ; Hyaluronic Acid ; Rabbits ; Tendons* ; Toes

Diphenylhydantoin (DPH) is one of the most widely used anticonvulsants for treatment and prevention of seizures. However it is frequently associated with drug-induced leukopenia. Hypersensitivity reactions to phenytoin are well recognized and can be severe. Phenytoin is associated with serious hematologic side effects such as agranulocytosis, thrombocytopenia, red cell aplasia and hemolytic anemia, either through humoral or cell-mediated immunemechanism. We describe a 57-year-old male patient who developed a severe granulocytopenia while taking phenytoin for 66 days in the total amount of 21.6 gram. Bone marrow examination showed isolated depletion of myeloid elements. After 10 days of phenytoin withdrawal and G-CSF treatment, the patient recovered from granulocytic suppression. Using in vitro culture, marrow suppression associated with phenytoin therapy was felt to be non-immune mediated marrow suppression.
Agranulocytosis ; Anemia, Hemolytic ; Anticonvulsants ; Bone Marrow Examination ; Bone Marrow* ; Granulocyte Colony-Stimulating Factor ; Humans ; Hypersensitivity ; Leukopenia ; Male ; Middle Aged ; Phenytoin* ; Seizures ; Thrombocytopenia

No abstract available.
Perfusion*

Occurence of lactic acidosis with adequate tissue oxygenation(type B lactic acidosis) has been described in association with leukemia, lymphoma, small cell carcinoma and breast cancer. However, no such case has been reported in Korea. Therefore, we report a case of type B lactic acidosis in a man with rapidly progressing acute lymphoblastic leukemia which had been transformed from lymphoma.
Acidosis, Lactic* ; Breast Neoplasms ; Korea ; Leukemia ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma ; Precursor Cell Lymphoblastic Leukemia-Lymphoma*

Broncho-esophageal fistula(BEF) is an uncommon clinical entity which can cause severe suppurative lung disease. Acquired fistulas between the esophagus and tracheobronchial tree are relatively uncommon. They are caused by many diseases including malignancy and chronic inflammation such as tuberculosis and have favorable outcome with proper treatment. To our knowledge, there has been no description of patients with BEF due to the bronchiectasis. We report a case of broncho-esophageal fistula in association with bronchiectasis in a 35-year-old male patient with hemoptysis. Bronchoscopy revealed mild bleeding from the superior segment of the right lower lobe without specific endobronchial lesion. Barium esophagogram could not confirm the fistula. The diagnosis of a broncho-esophageal fistula was established by an esophagogastroscopy using fistulogram and subsequent bronchoscopy, in which the communication between the bronchial tree and the esophagus was demonstrated by instilling dye selectively through the fistulous opening using esophagogastroscopy and visualizing the fistula and the bronchial tree. The patient was treated with resection of the right lower lobe, extirpation of the diverticulum and surgical closure of the bronchial defect and fistula, but he suffered from pneumonia thereafter and eventually expired due to sepsis and multiple organ failure.
Adult ; Barium ; Bronchiectasis* ; Bronchoscopy ; Diagnosis ; Diverticulum ; Esophagus ; Fistula* ; Hemoptysis ; Hemorrhage ; Humans ; Inflammation ; Lung Diseases ; Male ; Multiple Organ Failure ; Pneumonia ; Sepsis ; Tuberculosis