To our knowledge, rectal cancer arising at the anastomotic site after surgery for Hirschsprung's disease has not been reported. We report a case of mucinous adenocarcinoma arising at the anastomotic site after Soave operation 26 years ago.
Adenocarcinoma, Mucinous* ; Hirschsprung Disease* ; Mucins* ; Rectal Neoplasms

Fracture of distal one third of tibia is prone to develop angular deformity during weight bearing and delayed union by inadequate immobilization. Most surgeons have performed internal fixation with plate and screws or interlocking Kuentscher nail to provide stability to the fractured tibia. When open reduction and internal fixation is carried out, the periosteum and muscular attachments must be stripped off. And in interlocking Kuentschernailing extraoperative time needed to insert distal screw, and the medullary reaming destroys nutrient circulation by which fracture healing is hindered. However, flexible Ender nailing is a simple procedure which does not necessitate reaming, and also does not disrupt or strip off soft tissues at the fracture site. Authors carried out Ender nailing in 16 patients having distal tibial fractures who were treated at the Orthopaedic Department, Kang-Nam St. Mary's Hospital from February, 1985 to December, 1988. The results are as follows: 1. The radiological union was obtained at 13.3 weeks after operation, and primary healing was taken place. 2. Fractures could be securely fixed by intramedullary Ender nailing. 3. Mild angulation developed in 3 cases, but it did not affect the results. Through the results Ender nailing is proven to be an effective, reliable, and safe method in treatment of fracture of the distal one third of tibia with minimum residua and complication, and brings the natural fracture healing.
Congenital Abnormalities ; Fracture Healing ; Humans ; Immobilization ; Methods ; Periosteum ; Surgeons ; Tibia ; Tibial Fractures ; Weight-Bearing

No abstract available.
Knee ; Ligaments* ; Magnetic Resonance Imaging

OBJECTIVE: The purpose of this study was to evaluate the therapeutic efficacy and toxicity of high dose cisplatin-cyclophosphamide combination chemotherapy on patients with primary epithelial ovarian cancer. METHODS: A review of 63 patients previously diagnosed as primary epithelial ovarian cancer after initial operation and histology at Pusan National University Hospital from Jul. 1993 to Jun, 1997 was performed. Patients were received the combination chemotherapy including cisplatin 100mg/m2/day and cyclophosphamide 750mg/m2/day, repeated 6 cycles every 4 weeks. The mean age was 48 years old, and previous surgical procedures were total abdominal hysterectomy and bilateral salpingo-oophorectomy with omentectomy. The patients were classified into FIGO stage and pathologic results. RESULTS: The clinical response rate was 100% in the FIGO stage Ic patients with PC combination chemotherapy, 100% in stage II, 53.5% in stage III, and 25% in stage IV. The overall response rate was 69.8%. The 3-year survival rate according to the treatment groups was 93.3% in stage Ic group, 60% in stage II, 50% in stage III and 0% in stage IV. The mean survival duration was 34.6 months. Hematologic toxicities in cisplatin-cyclophosphamide chemotherapy were neutropenia and anemia. Nausea and vomiting were the most common side effects and occurred in 96.8%. Most of the toxicities were grade 1 and 2. CONCLUSION: The combination chemotherapy with cisplatin-cyclophosphamide is relatively safe and effective method in the treatment of primary epithelial ovarian cancer.
Anemia ; Busan ; Cisplatin* ; Cyclophosphamide* ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Hysterectomy ; Middle Aged ; Nausea ; Neutropenia ; Ovarian Neoplasms* ; Survival Rate ; Vomiting

100% sulfur hexafluoride(SF6) was injected into the vitreous cavity of nonvitrectomized retinal detachment patients. A total of 0.5ml of gas was injected with a single shot in 3 eyes or two 0.25ml in 3 eyes without lowering of intraocular pressure. And in 3 eyes, single shot of 0.5ml of gas was used after lowering of intraocular pressure. The changes of intraocular pressure were monitored at 5 minute intervals for 60 minutes and at one hour intervals for 8 hours after injection. Marked elevation of intraocular pressure was noted in both single shot group, but the elevation of intraocular pressure of double shot group was much smaller. But in all groups, the intraocular pressures were returned to under 30mmHg within 20 minutes and no re-elevation of intraocular pressure was noted in all cases after initial return to normal. In a case with two 0.3ml shots, the highest pressure was 49mmHg and with 0.35ml shots, the highest pressure was 78mmHg. So the effect of SF6 on intraocular pressure seemed to be negligible so long as the injection volume was limited to 0.5ml or less in single shot; and 0.6ml in double shots.
Humans ; Intraocular Pressure* ; Retinal Detachment ; Sulfur

Chronic central serous chorioretinopathy[CSC], which also has been termed diffuse retinal pigment epitheliopathy, is defined as a sensory retinal detachment associated with areas of RPE atrophy and pigment mottling. Fluorescein angiographic finding includes areas of granular hyperfluo-rescence and one or many subtle leaks. In older age group, choroidal neo-vascularization[CNV]may develop as a complication. We investigated the clinical features and performed fluorescein angiography[FAG], indocyanine green[ICG]angiography in 10 patients with CNV among 32 patients with chronic CSC. The location of CNV was extrafoveal[3 eyes]and juxtafoveal[7 eyes]. Associated fundus findings were RPE atrophy[8 eyes], PED[5 eyes], serous RD[4 eyes], subretinal hemorrhage[4eyes]. ICG findings were hypo-fluorescence[8 eyes], choroidal hyperpermeability[7 eyes], choroidal delayed filling[5 eyes]. Choroidal neovascularization was identified only with ICG angiography in 6 out of 10 cases. Laser photocoagulation was performed using ICG angiography in 6 cases. Visual acuity was improved in 4 out of 10 cases, and unchanged in 3 out of 10 cases. Therefore, we suggest that ICG angiography may be used as an important device for the diagnosis and management of CNV in patients with chronic CSC. Visual prognosis of CNV in chronic CSC seems to be relatively good.
Angiography ; Atrophy ; Central Serous Chorioretinopathy* ; Choroid* ; Choroidal Neovascularization ; Diagnosis ; Fluorescein ; Humans ; Light Coagulation ; Prognosis ; Retinal Detachment ; Retinaldehyde ; Visual Acuity

Intracerebral hemorrhage is the most serious complication of cerebral arteriovenous malformations (AVM). To identify angiographic characteristics of AVM which correlate with a history of hemorrhage, we retrospectively analyzed angiographic findings of 25 patients with AVM. Nine characteristics were evaluated; these include nidus size, location, arterial aneurysm, intranidal aneurysm, angiomatous change, venous drainage pattern, venous stenosis, delayed drainage and venous ectasia. These characteristics were correlated with hemorrhage, which was seen in 18 (72%) patients of CT or MR images. Venous stenosis (P<.05) and delaved venous drainage (P<.05) well correlated with a history of hemorrhage. Arterial aneurysm and intranidal aneurysm also had a tendency hemorrhage although they did not prove to be statistically significant. Detailed analysis of angiographic finding of AVM is important for recognition of characteristics which are related to hemorrhage and may contribute to establishing a prognosis and treatment planning.
Aneurysm ; Cerebral Hemorrhage ; Constriction, Pathologic ; Dilatation, Pathologic ; Drainage ; Hemorrhage* ; Humans ; Intracranial Arteriovenous Malformations* ; Prognosis ; Retrospective Studies

The trochanteric fracture occurs through the wide metaphyseal area, giving it high potential for healing and results in low incidence of non union. Even in the treatment of unstable trochanteric fracture, the results are relatively good with the advancement of fixation devices and reduction methods. The authors experienced 10 cases of non-union of trochanteric fractures from 1975 to 1984 and followed them up for more than 1 year at Orthopaedic department of National Medical Center. The results are as follows, l. Of reduction methods in primary operation, anatomical reduction was performed in 6 cases, medialization in 2 cases. Of fixation devices, compression hip screw was used in 2 cases, Jewett nail in 3 cases and others in 3 cases. 2. The probable causes of non-union were fixation failure in 6 cases, inadequate immobilization in 2 cases, infection in 2 cases and trauma in 1 case. The other 2 cases were not treated. 3. In secondary operation, anatomical reduction was performed in 3 cases, valgus reduction in 3 cases and valgus with medialization in 2 cases. Of fixation devices, compression hip screw was used in 3 cases, Judet plate in 3 cases and Jewett nail in Z cases. 4. The time interval between the last operation and bony union was 4.2 months clinically and 6.6 months radiologically in average. 5. During follow-up, hip pain was noted in 2 cases. Limited range of motion of hip and knee in 4 cases.
Femur ; Follow-Up Studies ; Hip ; Hip Fractures ; Immobilization ; Incidence ; Knee ; Range of Motion, Articular

We have treated the open tibia shaft fractures, especially Gustilo type II, with unreamed interlocking intramedullary nail. In cases combined with soft tissue damage around fracture site, maintaining rigid internal fixation and preserving endoosteal blood supply is important in union of fracture and soft tissue healing. We have analyzed 18 cases of Gustilo type II open tibial shaft fractures managed with intramedullary nailing without reaming since 1991, the follow-up period was average 22 months. Most of the fractures were the result of moderate to high-energy trauma. In all 18 cases, nails were inserted via closed method. Static interlocking nailing was used in all cases. In 16 cases, union of the fracture was achieved from 16 to 25 weeks(average 23 weeks). In the other 2 cases, union was achieved in 7 months. There was no serious postoperative complication except one skin infection with skin defect managed by skin flap and one failure of the interlocking screw. These results are comparable with those obtained from other forms of fixation, including immobilization with a cast, reamed intramedullary nailing, and external fixation.
Follow-Up Studies ; Fracture Fixation, Intramedullary ; Immobilization ; Methods ; Postoperative Complications ; Skin ; Tibia

The author analyzed the postoperative results in 96 patients who underwent temporary clipping during cerebral aneurysm surgery from July, 1990 to April, 1995. 1) The overall outcome were as follows:excellent(55.2%), good(21.9%), poor(16.7%), dead(6.3%) and its results were relatively similar to those of the patients who did not have the temporary clipping. 2) The patients were divided into 4 groups according to the site of the temporary clip application. The safe durations of temporary clipping were as follows:In the 1) anterior cerebral artery clipping group, 5 minutes for Hunt-Hess grade 1 & 2 patients and 2 minutes and 30 seconds for Hunt-Hess grade 3 & 4 patients, In the 2) middle cerebral artery clipping group, 5 minutes;In the 3) internal carotid artery clipping group, 5 minutes in Hunt-Hess grade 1 & 2 and 2 minutes for Hunt-Hess grade 3 & 4;The only one patient in the 4) basilar artery clipping group showed excellent outcome after 3 minutes of temporary clipping. Therefore, we concluded that the temporary clipping tecnique would be very useful to dissect the aneurysmal neck, to prevent and control the premature rupture without influencing the outcome. Furthermore, use of the cerebral protective agent, intraoperative cerebral blood flow monitoring and avoidance of excessive and prolonged hypotension during cerebral aneurysm surgery might be very helpful for preventing the cerebral ischemia and increasing the safety duration of the temporary clipping.
Aneurysm ; Anterior Cerebral Artery ; Basilar Artery ; Brain Ischemia ; Carotid Artery, Internal ; Humans ; Hypotension ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Neck ; Rupture