Postoperative CT scans for accuracy of pedicular screw placement were assessed in 20 patients (82 pedicular screws) treated with several kinds of pedicular screws. When putting screws, the position of the guide pin was confirmed by the image intensifier. The measurement of canal encroachment from the medial border of the pedicle and the angle of insertion through the body of each vertebra were assessed; 1. Fifty-five(69.1%) were placed within the pedicle. 2. Ten(12.2%) were placed within 2mm of the medial border of the pedicle. 3. Three(3.6%) had 2mm to 6mm canal encroachment with the patient developing neurologic complication that was improved 8 months after the operation. 4.Fourteen(17.1%) perforated the lateral border of the pedicle, but they were not associated with neurologic complication. 5. The screws placed within 2mm of the medial border of the pedicle had higher angle of insertion than the screws exactly within the pedicle. Even with the use of image intensifier, there was a high rate of pedicle disruption. We have to insert the screws more exactly according to true anatomic angle of the pedicle on each level of every vertebra from the entry point avoiding high angle of insertion to prevent any disruption of the medial border of the pedicle which may result in neurologic complication.
Humans ; Spine ; Tomography, X-Ray Computed

Aberrant left-sided pulmonary artery(pulmonary artery sling) is an uncommon anomaly, which may cause significant respiratory abnormality. We report a case of pulmonary artery sling which is combined with persistent left superior vena cava and dextrocardia. This case was identified by esophagogram and CT and confirmed by MRI and angiography. We consider that MRI is a valuable new method for the diagnosis of aberrant left-sided pulmonary artery.
Angiography ; Arteries ; Dextrocardia ; Diagnosis ; Magnetic Resonance Imaging ; Methods ; Pulmonary Artery* ; Vena Cava, Superior

Achilles tendon is the most powerful tendon of the body and increases efficiency in weight bearing and walking capability. Since pares' report about the rupture of the Achilles tendon many authors have reported various causes, diagnostic and therapeutic methods. Most of the authors emphasized the early diagnosis and treatment resulted in good prognosis. There are many methods for the diagnosis of the Achilles tendon, roentgeography, angiography, electromyography, histologic examination and Thompsons test. The causes of the rupture of the Achilles tendon are direct and indirect injury. The two methods of treatment are conservative management and surgical treatment. Whether the cause of the injury is direct or indirect, restoration of function after treatment must be emphasized and the proper method of treatment must be determined by the degree of injury. Clinical analysis was done on 15 cases of Achilles tendon rupture treated at Orthopedic Department of Capital Armed Forces General Hospital from Oct. 1973 to Oct. 1978 with the following results. 1. In sex distribution, there were 13 male cases and 2 female cases and the age range of 20 to 30 years old was the most frequent (67%). 2. There was no difference In frequency between the right and the left side. 3. Achilles tendon rupture was two times more frequent in indirect cause than direct cause, especially after falling from heights and exercises. 4. The most frequent site of rupture was 2–5 Cm. above the insertion of the tendon (80%). 5. By means of a cost immobilization, good result was obtained in fresh partial rupture of the tendon. 6. Good results were obtained by end-to-end suture in fresh cases and reconstructive surgery in old cases. 7. Most of the patients returned to their jobs about 6 months after the operation.
Accidental Falls ; Achilles Tendon ; Angiography ; Arm ; Clinical Study ; Diagnosis ; Early Diagnosis ; Electromyography ; Exercise ; Female ; Hospitals, General ; Humans ; Immobilization ; Male ; Methods ; Orthopedics ; Prognosis ; Rupture ; Sex Distribution ; Sutures ; Tendons ; Walking ; Weight-Bearing

No abstract available.
Biopsy, Fine-Needle* ; Melanoma*

BACKGROUND: Early detection and treatment of cytomegalovirus (CMV) infection is very important because CMN infection is a major cause of morbidity and mortality after organ transplantation. CMV antigenemia assay has been reported to be very sensitive and specific for detection of CMV infection among many laboratory methods. However, there is no single method correlated well with the infection state up to now. We compared the results of SHARP Signal System Assay (Digene, USA) using PCR and hybridization with those of CMV antigenemia assay (Clonab CMV-kit; Biotest AG, Germany) to evaluate their clinical usefulness. METHODS: We performed SHARP Signal Assay on whole blood samples of 125 from 56 transplanted patients submitted for CMV antigenemia at Samsung Medical Center. We compared the results with those of CMV antigenemia and evaluated the correlation with CMV disease state. RESULTS: Fifty six patients were classified as three groups; 43 patients with no evidence of CMV infection, four patients with CMV infection and 9 patients with CMV disease. Twenty four cases (19.2%) showed discrepant results between the two methods. Of the 22 cases showing positive only by SHARP Signal Assay, two cases were proved to be CMV disease, 12 cases were on antiviral treatment and remaining cases had no evidence of infection. Two cases showing positive only by CMV antigenemia were confirmed to be CMV disease. For CMV disease, the sensitivity of SHARP Signal Assay and CMV antigenemia were 85.7% and 90.5%, respectively and the specificity of them were 73.1% and 93.3%, respectively. CONCLUSIONS: CMV antigenemia is thought to be useful for early diagnosis and follow-up of antiviral treatment as a quantitative and highly specific method, and SHARP Signal Assay can be used as a complementary method because it correlates well with disease state.
Cytomegalovirus Infections* ; Cytomegalovirus* ; Diagnosis* ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortality ; Organ Transplantation ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Transplants

Emergency cerclage commonly known as that performed in the setting of advanced cervical dilatation with bulging membranes and associated with significantly increased failure rates. We experienced a successful emergency cerclage for advanced incompetent internal os of cervix ( IIOC ). Pregnancy was prolonged and we delivered viable fetus. Hereby we report this case with the brief review of literature.
Cervix Uteri ; Emergencies* ; Female ; Fetus ; Labor Stage, First ; Membranes ; Pregnancy

No abstract available.
Cleft Palate* ; Muscles* ; Palate, Soft*

Closed loop onstruction represent a surgical emergency, because this lesion leads to small boweel infarction, perforation, and peritonitis if not treated in time. We analyzed the CT and ultrasonographic findings of 4 patients prospectively and 2 patients retrospectively with surgically proven closed loop obstruction of the small boweel to evaluate the characteristic findings, the cause of the closed loop obstruction and predictive criteria for the viablity of the involved bowel loop. The characteristic CT and sonographic features of the closed loop obstruction of the small bowel included; dilated fluid-filled bowel loops, the thickened bowel wall, absence of peristalsis, and ascites. In one case, closed loop obstructio originating from umbilical hernia was documented by CT and sonography. The possible criteria for the gangrenous changes could be the maximal thickness of bowel more than 7mm, and infiltration in the mesentery/omentum.
Ascites ; Emergencies ; Hernia, Umbilical ; Humans ; Infarction ; Peristalsis ; Peritonitis ; Prospective Studies ; Retrospective Studies ; Ultrasonography*

We examined the rates of postoperative neurologic complications, as recorded in the medical record department in Severance Hospital from 1989 through 1991 for patients who had had operations on the spine. There were 538 hospitalizations for procedures on the spine; 327(60.78%) of herniated disc, 120(22.30%) of spondylolisthesis, 64(11.90%) of infection, 27(5.02%) of spinal stenosis were included. Neurologic complications oecurred in 12(2.23%) patients; 3 cases in herniated disc, 4 in spinal stenosis, 4 in spondylolisthesis, and 1 in infection. Regarding techniques of the operation, 8 complications occurred in arthrodesis, among these, 2 were in anterior approach and 6 in posterior approach. Four cases of the complications occurred in laminectomy and discectomy procedure. Complications were more frequent in the patients who had had spinal stenosis when arthrodesis was performed than decompression procedure only. Possible causes of neurologic complication were postoperative hematoma formation, translation of the vertebral column due to instability after anterior debridement and forceful traction of the nerve root during the operation.
Arthrodesis ; Debridement ; Decompression ; Diskectomy ; Hematoma ; Hospitalization ; Humans ; Intervertebral Disc Displacement ; Laminectomy ; Medical Records ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Traction

Trichofolliculoma is a benign tumor of hair follicle and is intermediate in differentiation between a hair nevus and a trichoepithelioma. It is a rare dermatosis first described by Fessler in 1924. Clinically, asymptomatic 4-5 mm sized solitary tumor usually occurs on the scalp, head and neck in the adultnood, This tumor may be clinically suspected if occurs as a small domeshaped nodule with a central umbilication showing small wisps fimmature hairs. Microscopically, the turnor shows one or several keratinfilled cysts in the dermis which are surrounded by spuamous epithelium, and contain horny meterial and birefringent fragments af hair shaft. These are primary hair follicles. And there are small secondary hair follicles which appear to radiation from the pimary hair follicles and have fine hair. The surrounding squarnous epithelium of primary follicles form epithelial strands, and interconnection the secondary hair follicles. We presented here a case of trichofolliculoma with typical clinical and histopthological findings in a 41 year-old male patient.
Adult ; Dermis ; Epithelium ; Hair ; Hair Follicle ; Head ; Humans ; Male ; Neck ; Nevus ; Scalp ; Skin Diseases