Congenital synostosis of the proximal ends of the radius and ulna is a rare malformation which often completely prevents pronation and supination of the forearm. The evidence for a genetic etiology is provided by noting its presence in a Klinefelter's syndrome and its positive familial history. Two cases of congenital radioulnar synostosis occurred in brothers have been experienced and are to be reported with review of references.
Forearm ; Humans ; Klinefelter Syndrome ; Pronation ; Radius ; Siblings ; Supination ; Synostosis ; Ulna

Various kinds of spinal instrumentation have been developed for treatment of spinal disorders which are associated with instability. Recently, newly designed devices using pedicle screw were developed with advantages of short segment fixation and firm internal fixation. This is a retrospective clinical and roentgenographic study to evaluate the effectiveness of Cotrel 1. Of the 27 cases, spinal stenosis were 11, spondylolisthesis were 8, spondylolysis were 4, burst fracture were 2, metastatic bone tumor was 1, and failed back syndrome was 1 case. 2. Result of clinical evaluation by Hanley's criteria at last follow up were excellent in 7(27%), Good in 15(58% ), fair in 4(15%). (1 case of metastatic bone tumor was excluded). 3. In the cases of spondylolisthesis, we tried to reduce the displacement in 2 cases of Meyerding Grade II, and 1 case was reduced and 1 case was not reduced. In the cases of of Meyerding Grade I, no further displacement was developed. 4. The complications were observed in 10(37%)cases. A) Generalized complications were 2 cases of hematoma, 3 cases of superficial infection of wound, and 1 case of nerve root irritation. B) Failure in instrmentation were 1 case of screw breakage, 1 case of complete loss of fixation between screw and rod, and 2 cases of partial loss of fixation. 5. To prevent above mentioned complications in fixation of the instrument, the following factors are recommended: 1) Selection of the adequate length of rod. 2) Fixation of the additional implant such as security bolt when instability between screw and rod is predictable. 3) Selection of the closed head screw in the fixation of proximally sided screw if possible. 6. Cotrel-Dubousset instrument has many advantages such as rigid internal fixation, anatomical reduction, and good maintenance and also effective in reduction and maintenance of spondylolisthesis and in wide posterior decompression of spinal stenosis, but for prevention of some complications, precise use of instrument and good application of surgical technique will be needed.
Decompression ; Follow-Up Studies ; Head ; Hematoma ; Internal Fixators ; Pedicle Screws ; Retrospective Studies ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Spondylolysis ; Wounds and Injuries

BACKGROUND: The potential adverse effects of ketamine in neurosurgical anesthesia have been well established. However, the effects of ketamine on intracranial pressure (ICP) and hemodynamics during general anesthesia remain unclear. The purpose of this study was to assess the effects of ketamine on hemodynamics and ICP in anesthetized, ventilated rabbits. METHODS: Thirty rabbits were divided into three groups: Group 1 (n=10) received 1 ml/kg normal saline iv; Group 2 (n=10) received 0.5 mg/kg ketamine iv; Group 3 (n=10) received 1.0 mg/kg ketamine iv. After induction with thiopental, anesthesia was maintained with isoflurane and nitrous oxide in oxygen. During controlled ventilation, ICP, mean arterial pressure (MAP), cerebral perfusion pressure (CPP) and heart rate (HR) were measured. The ICP was measured using Ladd ICP monitoring system. All variables were evaluated at baseline and for 30 min following ketamine. RESULTS: In group 1, ICP, MAP, CPP and HR were unchanged over the course of the study. In group 2, ICP, MAP and CPP were unchanged. HR increased at 1, 3 and 5 min (p<0.01), 10 and 20 min (p<0.05) after injection. In group 3, ICP, MAP and CPP increased at 1 and 3 min (p<0.01) after injection. HR increased at 1, 3 and 10 min (p<0.01), 5 min (p<0.05) after injection. CONCLUSIONS: These results suggest that 0.5 and 1.0 mg/kg of ketamine don't significantly affect the hemodynamics and ICP in anesthetized, mechanically ventilated rabbits.
Anesthesia* ; Anesthesia, General ; Arterial Pressure ; Heart Rate ; Hemodynamics* ; Intracranial Pressure* ; Isoflurane ; Ketamine* ; Nitrous Oxide ; Oxygen ; Perfusion ; Rabbits* ; Thiopental ; Ventilation

Recently, there is seen frequently the tibial shaft fracture due to the increased traffic accident & the high industry, and this fracture has many problems in a treatment because of nonunion, malunion, and infection. And so the methods of treatment is variable according to physicion. Intramedullary nailings are prefered for treatment of tibial shaft fracture. Between June, 1990 and December, 1993, we treated fifty four fractures of the tibial shaft with Ender nails(33 cases) and Delta nails(21 cases). The authors analyzed the effects of these two methods, and we obtained the following resutls. 1) Average operating time was 107 minutes in Ender nail and 109 minutes in Delta nail. In the average full weight-bearing time, postoperatively, was 8.7 weeks in ender nail and 8.5 weeks in Delta nails. The mean bone union time was 16.5 weeks in Ender nail and 16.8 weeks in Delta nail, and so there was no significant difference in bone union time between two devices. 2) The complications are four cases of delayed union(12.1%), three cases of superficial infection(9.1%), two cases of angular deformity(6.1%), and one case of checkrein deformity(3.0%) in the 33 cases of Ender nail, and two cases of delayed union(9.5%), one case of angular deformity(4.8%), and one case of superficial infection(4.8%) in the 21 cases of Delta nail. 3) In the 30 cases of Ender nails(90.9%), the functional results were exellent or good, and 19 cases of Delta nails(90.5%) were excellent or good.
Accidents, Traffic ; Fracture Fixation, Intramedullary ; Tibia ; Weight-Bearing

The venous malformation in head and neck is a developmental vascular disease which arises from the arrest in the certain stage of vascular embryogenesis. However, the lesion extends along the fascia and has a tendancy to recur after incomplete therapy. Retrospectively, the authors reviewed radiologic studies of 20 patients diagnosed as venous malformation during the last 5 years. The diagnosis was verified by histopathology (5 patients) and direct puncture angiography (15 patients). The radiologic studies included. CT with intravenous contrast injection (20 patients), RI angiography with 99m Tc-pyrophosphate (6 patients), and direct puncture angiography (15 patients). Multiplicity of venous malformation was noted in 9 patients. On CT scan, the lesions had lobulated irregular shape, with heterogeneous appearance, showed delayed enhancing characteristics, and had the phleboliths(21 lesions). The venous malformations were located at the masticator space (including masseter muscle) (n=12), retrobulbar space(n=6), submandibular space(n=4), paravertebral space(n=3) and so on. In two cases, the lesions were very extensive involving entire neck and parapharynx. On RI angiography using 99mTc-pyrophosphate, all of the lesions showed persistent and delayed uptake. With direct punture angiography the lesions could be classified as acinar pattern (n=17) and mixed pattern (acinar and saccular) (n=2). Venous connections were noted in 10 lesions. In conclusion, if a soft tissue mass on head and neck shows a heterogeneous attenuation density with or without calcified phlebolith on CT scan, RI angiography is recommended as a next diagnostic study. If it shows delayed persistent uptake, venous malformation can be suspected. Finally direct puncture angiography can verify the nature and extent of the lesions.
Angiography ; Diagnosis* ; Embryonic Development ; Fascia ; Female ; Head* ; Humans ; Neck* ; Pregnancy ; Punctures ; Retrospective Studies ; Technetium Tc 99m Pyrophosphate ; Tomography, X-Ray Computed ; Vascular Diseases

No abstract available.
Animals ; Horns* ; Pregnancy*

No abstract available.
Animals ; Horns* ; Pregnancy*

No abstract available.
Case-Control Studies* ; Placenta Previa* ; Placenta* ; Risk Factors*

Invasive aspergilosis or mucormycosis of the paranasal sinuses involving the cranial cavity is termed'rhinocerebral' mycosis, which is often difficult to differentiate from malignancy. Prognosis of rhinocerabralmycosis: is diastrous and usually fatal. The authors herein report 6 cases of rhinocerebral mycosis: two of themwe mucormycosis and four were aspiergillosis histopathologically. Main CT featurs are nodular mucosal thickeningin the multiple sits of the paranasal sinuses that extend to orbital apex or cavernosu sinus through focaldestruction of bony wall. In spite of their invasiveness beyond bony boundary, destruction is not so remarkableand it is always accompained by bony sclerosis. Awareness of these diseases and CT patterns discussed in thisreport should be helpful in leading to early biopsy and treamtent.
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Aspergillosis ; Biopsy ; Mucormycosis ; Orbit ; Paranasal Sinuses ; Prognosis ; Sclerosis

OBJECT: In order to estimate the frequency and risk factors for adenomyosis. METHOD: The clinical records of 1127 women undergoing hysterectomy were retrieved in the Department of Obstetrics and Gynecology, Incheon Christian Hospital, during 7 years, from Jan. 1st 1991 to Dec. 31st 1997. RESULT: The following results were obtained. 1. Adenomyosis was found in 206 of 1127 patients(18.3%). 2. The highest incidence was 41-50 years of age group, an incidence of 55% and mean age group was 46.9 years. 3. Adenomyosis was more frequently observed in parous woman than non-parous woman, such as 8.3% and 91.7%, respectively. 4. Grossly, the size of uterus was enlarged more than 10 weeks gestational size in adenomyosis, an incidence of 62.4%. 5. Pelvic pain, dysmenorrhea and metrorrhagia were common symptom of adenomyosis, an incidence of 26.7%, 25.2% and 19.4%, respectively. 6. Myoma was the most combined disease in adenomyosis, showing the incidence of 53.4%. 7. Combined pelvic endometriosis was not observed in this study. 8. Endometrial findings of adenomyosis showed proliferative phase of normal endometrial cycle in the highest incidence, giving 72.3% of all cases. 9. Preoperative diagnostic accurracy of adenomyosis was 8.2%. CONCLUSION: This results show that deeply understanding of the common symptom and epidemiology of adenomyosis improve the preoperative diagnostic accuracy.
Adenomyosis* ; Dysmenorrhea ; Endometriosis ; Epidemiology ; Female ; Gynecology ; Humans ; Hysterectomy* ; Incheon ; Incidence ; Menstrual Cycle ; Metrorrhagia ; Myoma ; Obstetrics ; Pelvic Pain ; Risk Factors ; Uterus