No abstract available.
Child* ; Humans ; Rhabdomyosarcoma*

Displaced intra-articular fractures of the calcaneus result in serious and prolonged disability. These injuries continue to pose a therapeutic challange and there remains a great deal of controversy regarding treatment, operative versus nonperative. The lateral approach for open reduction, popularized by Palmer, has been used by many authors, with high percentage of excellent results. We treated 21 displaced intra-articular fractures of the calvaneus in 18 patients by open reduction and internal fixation through the lateral approach from July 1990 to May 1992 and the patients have been followed from 12 to 36 months from the time of their injury. The clinical and radiographic analyses were as follows; 1. The most common cause of injury was falls from a height: 19 fractures in 16 patients(88.8%), Spine fracture was most commonly associated injury : 5 patients (27.8%). 2. Fracture was classified according to classification of Paley and Hall. Eight fractures were tongue type(no comminution 4, with comminution 4), 12 joint depression type(no comminution 8, with comminution 4), and a comminuted type. 3. The average bohler tuber-joint angle was
Accidental Falls ; Calcaneus ; Classification ; Congenital Abnormalities ; Depression ; Follow-Up Studies ; Foot ; Fractures, Comminuted ; Heel ; Humans ; Hypesthesia ; Intra-Articular Fractures ; Joints ; Osteomyelitis ; Spine ; Toes ; Tongue ; Transplants

The purpose of this study is to examine the change of enzymeimmuno-assay for prostaglandinE2 in the synovial fluid lavage specimen of patients with mandibular fracture patients without condylar fracture. For this study, fourteen patients (eight males, six females) with mandibular fractures without condylar fracture was investigated to analyse the synovial fluid from upper temporomandibular joint cavities. Synovial fluid was collected from TMJ cavities of mandibular fracture patients before open reduction and after one week of open reduction, and then stored in liquid nitrogen tank after centrifuge. Two synovial fluid lavage samples of TMJs of 2 asymptomatic served as normal controls referred from other data. The concentrations of PGE2 were measured by use of PGE2 EIA system (Amersham). The following results were obtained: 1) In nine patients, the concentrations of PGE2 are lower after open reduction than before. 2) In three patients, the concentrations of PGE2 are higher after open reduction than before. 3) There was no statistical significant between the preoperative group and postoperative 7 days (p>0.05), but there was some difference between the two groups. In conclusion, the results suggest that PGE2 probably does not play as important role in the harm of TMJ.
Dinoprostone* ; Humans ; Male ; Mandibular Fractures* ; Nitrogen ; Synovial Fluid* ; Temporomandibular Joint* ; Therapeutic Irrigation

PURPOSE: The pressure-flow study is only objective study that can determine the presence or absence of bladder outlet obstruction and impaired detrusor contractility. Although many results of pressure-flow study are reported in diseased state such as benign prostatic hyperplasia, but are rarely evaluated in adult male patients without voiding symptoms as control group. The purpose of this study was to evaluate the findings of pressure-flow study in asymptomatic male patients. MATERIALS AND METHODS: Twenty-three male patients without voiding symptom were recruited for this study. Mean age of these patients was 49.8 years(range 21-70). Mean AUA symptom score was 1.1(range 0-4) and mean prostatic volume was 27.3gm(range 20-35) on digital rectal examination. The study was done by using 7 Fr. urethral catheter on sitting or standing position. RESULTS: Mean values were followed; PdetQmax was 48.1cmH2O(range 25-94), Qmax was 15.7ml/sec(range 3-23), and postvoid residual urine was 14.5ml(range 0-80). According to the Abrams-Griffiths nomogram, 8 were unobstructed and 4 were obstructed, the remaining 11 falling in the equivocal zone. In each types, mean group specific urethral resistance factor (URA) was 12.8cmH2O in unobstructive type, 51.5 in obstructive type, and 22.1 in equivocal type. CONCLUSIONS: The results were maybe guessed as following; First, the values of defining obstrucion were set too low. Second, obstruction was less relevance in the development of symptoms than had been suggested previosly by some observers. Therefore, we thought that interpretations of pressure-flow finding were carefully considered to method of test, and/or uncomfortable voiding.
Adult* ; Digital Rectal Examination ; Humans ; Male* ; Nomograms ; Prostatic Hyperplasia ; Urinary Bladder Neck Obstruction ; Urinary Catheters

PURPOSE: The onlay island flap urethroplasty, a variation of the transverse preputial island flap, was originally introduced as an alternative to the meatal-based flap urethroplasty for anterior hypospadias. Recently, the indications for use of the onlay island flap urethroplasty have been extended to include repair of more proximal hypospadias with/without moderate degrees of chordee. We evaluated application and outcome of onlay island flap hypospadias repair. MATERIALS AND METHODS: We analyzed medical records of 126 patients who underwent primary hapospadias repair at our hospital during recent 10 years with respect to age at surgery, type of hypospadias, surgical technique and outcome. A minimum follow-up of 6 months was necessary for inclusion of the study. RESULTS: Age ranged from 7 months to 32 years(mean 6.7 years). For 59 patients with anterior hypospadias, 14 onlay island flap, 21 MAGPI, 14 pyramid, 8 Mathieu and 2 tubularized incised plate urethroplasties were performed. For 67 patients with mid to posterior hypospadias, 31 onlay island flap, 29 transverse island flap, 3 King, 3 augmented Duckett (Transverse island flap+hiersch-Duplay) and 1 tubularized incised plate urethroplasty were performed. Out of total 129 patients, 45 patients underwent onlay island flap repairs including combined with 7 dorsal penile plications. Out of 31 patients who underwent onlay island flap repairs, 3 patients developed complications. Out of 29 patients who underwent transverse preputial island flap repair, 13 patients developed complications. During the period of first 5 years, we performed 10 onlay island flap and 21 transverse island flap repairs for 37 mid to posterior hypospadias, whereas during the second 5 years, we did 21 onlay island and 8 transverse island flap repairs for 30 mid to posterior hypospadias. CONCLUSIONS: The onlay island flap hypospadias repair with/without dorsal penile plication was even applied to mid and posterior hypospadias as well as anterior hypospadias. The onlay island flap hypospadias repair maintained its technical advantages and lower complication rate compared to transverse island flap. More favorable results were obtained through as possible as preservation of urethral plate in hypospadias repair.
Female ; Follow-Up Studies ; Humans ; Hypospadias* ; Inlays* ; Male ; Medical Records

Hemorrhage or cystic rupture of adrenal gland is uncommonly reported in infants. However, spontaneously ruptured nonfunctioning adrenocortical carcinoma has not been yet reported in Korean literature We describe a 65-year-old woman who developed unilateral spontaneous adrenal rupture in coexisting nonfunctioning adrenocortical carcinoma without trauma or infection. And our preoperative impression was suspicious ruptured renal cell carcinoma.
Adrenal Glands ; Adrenocortical Carcinoma* ; Aged ; Carcinoma, Renal Cell ; Female ; Hemorrhage ; Humans ; Infant ; Rupture ; Rupture, Spontaneous*

Sir James Paget described the first case of Paget's disease of the breast in 1874, and Du-breuilh, in 1901, reported the first case of extramammary Paget's disease of the vulva. Paget's disease of vulva is a rare intraepithelial neoplasm of uncertain histogenesis. Recently we expe-rienced a case of Paget's disease of the vulva that we present a brief review of literature.
Carcinoma in Situ ; Paget Disease, Extramammary ; Paget's Disease, Mammary ; Vulva*

PURPOSE: The management of patients with superficially invasive, stage T1N0M0 bladder cancer remains controversial. While some physicians advocated early cystectomy, others believe that with initial TURB and effective intravesical BCG, local disease control can be achieved in most patients. We evaluated the outcome of stage T1 transitional cell carcinoma of the bladder treated with TURB and intravesical BCG therapy. MATERIALS AND METHODS: We reviwed records of 109 patients with stage T1 bladder tumor who treated with BCG between February 1986 and January 1997 with respect to age, grade, interval of progression and recurrence and current status. Each course of BCG consisted of 6 weekly and subsequent 3 monthly treatments. RSEULTS: Forty five of 109 patients(41.3%) had initial grade I tumors, including 13 patients (28.9%) who had at least one or more local recurrences and 2 patients(4.4%) had disease progression. Fifty seven of 109 patients(52.3%) had grade II tumors, with local recurrence in 23 patients(40.4%) and disease progression in 4 patients(7.0%). Among remaining 7 patients (6.4%) who had grade III tumors had local recurrence in 1 patient(14.3%) and disease progression in 4 patients(57.1%). The median intervals of progression on patients with initial grade I, II and III were 20.5, 15.3 and 16.9 months, respectively. Five of 10 patients who had progressed died because of the metastasis despite salvage therapies. CONCLUSIONS: Intravesical BCG was appropriately treated for patients with initial grade I or II stage T1 tumor because of low risk of disease progression. Patients with initial grade 3 stage T1 tumor had high risk for disease progression and BCG did not seem to decrease this risk. Therefore, grade 3 stage T1 tumor was regarded as high risk of disease progression and should be treated to more aggressive modality like invasive tumor.
Bacillus* ; Carcinoma, Transitional Cell ; Cystectomy ; Disease Progression ; Humans ; Mycobacterium bovis ; Neoplasm Metastasis ; Recurrence* ; Salvage Therapy ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: To evaluate the functional results of the elbow and the complications after internal fixation for distal humeral fractures. MATERIALS AND METHODS: We reviewed 38 distal humeral fractures; 12 type A, 7 type B and 19 type C by AO classification. There were six low columnar fractures in type A and nine in type C. Six type C fractures were open. The fracture healing and complications were assessed and the functional result was evaluated by rating system of Jupiter et al. RESULTS: Type A fractures were healed in an average of 10.6 weeks, type B 7.7 weeks and type C 11.5 weeks. Ulnar neuropathy occurred in six cases, loss of fixation in two cases, nonunion in one case, heterotopic ossification in one case and traumatic arthritis in one case. The functional result showed excellent or good in 34 cases (89%) and fair or poor in 4 cases (11%). Open fractures showed significantly worse result than closed fractures. CONCLUSION: To obtain the satisfactory results, stable fixation followed by early motion is required in most distal humeral fractures. Ulnar neuropathy occurs postoperatively in high incidence and the result of open fractures is worse than that of closed fractures.
Arthritis ; Classification ; Elbow* ; Fracture Healing ; Fractures, Closed ; Fractures, Open ; Humeral Fractures ; Humerus* ; Incidence ; Ossification, Heterotopic ; Ulnar Neuropathies

No abstract available.
Neural Tube Defects* ; Spinal Canal*