We have made a statistical survey on 2441 amputated limbs of 2150 patients who were treated at the Depart- ment of Orthopedic Surgery and who were prescribed the prosthetics at the Prosthetic Center of Veterans Hospital from Mar. 1972 to Feb. 1982. 1. The peak incidence was in the age group from 21 to 30 years with 1546 cases (63.3%). Of 2150 patients only 9 patients were female. 2. The main causes of amputation were trauma with 1901 cases (77.9%), vascular insufficiency with 326 cases (13.4%) and chronic osteomyelitis with 157 cases (6.4%). And the most fre#quent cause of traumatic amputation was explosive injury with 1080 cases (56.8%). 3. Of the 2441 amputated limbs, 1756 cases (71.91°) were at the lower extremity and the most frequent site was below the knee with 1000 cases (57%). 4. Minor limb amputation was performed on 326 cases (13.4%). 5. Multiple limb amputation was performed on 255 patients (11.9%) and of these 12 patients were amputated on 4 extremities. 6. Reoperation was performed on 420 cases (17.2%). It was most prevalent in the lower extremity with 365 cases (86.9%) and their main cause was neuroma with 171 cases (40.7%). The most frequent site was below the knee with 240 cases (57.2%).
Amputation ; Amputation, Traumatic ; Amputees ; Extremities ; Female ; Hospitals, Veterans ; Humans ; Incidence ; Knee ; Lower Extremity ; Neuroma ; Orthopedics ; Osteomyelitis ; Reoperation

PURPOSE: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. MATERIALS AND METHODS: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. RESULTS: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. CONCLUSION: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.
Age of Onset ; Biopsy ; Bone Transplantation ; Child ; Curettage ; Diagnosis ; Eosinophilic Granuloma ; Follow-Up Studies ; Fractures, Spontaneous ; Histiocytosis, Langerhans-Cell ; Humans ; Medical Records ; Osteolysis ; Radiography ; Retrospective Studies ; Shoulder ; Torticollis ; Treatment Outcome*

The size and configuration of the lumbar spinal canal constitute one of the important factors in the production of symptoms referable to cauda equina and nerve roots of the lumbar spine and the narrowness of the spinal canal. Numerous attempts have been made to measure the size of the lumbar spinal canal, but most of those are not sufficient to measure the oblique diameter of the lumbar spinal canal. Also, echographic diagnosis is much simple, safe, less expensive and non-invasive and furthermore demonstrates much more accuracy than other alternative and radiographic procedures. The purpose of this study is to establish the range of normal values of the oblique diameter of the lumbar spinal canal in Korean Army-aged group by echographic method in the interest of facilitating clinical evaluation of the lumbar spinal canal stenosis. The author measured oblique diamenter of the lumbar spinal canal in thirty healthy persons of both sexes of ages between nineteen and twenty-five years by ultrasound using sonolayergraphy model SSL-21A. Distance from the ligamentum flavum to the posterior longitudinal ligament was measured in millimeters with dial vernier caliper. Actual distance of oblique diameter of the lumbar spinal canal is obtained by multiplication of the distance of echogram by calibration factor 2.22. The results were as follows; 1. The mean values of the oblique diameter of the lumbar spinal canal in male and female between nineteen and twenty-five years of age were 14.77±0.85mm and 14.87±0.82mm in Ll, 13.99±0.87mm and 14.13±0.96mm in L2, 13.40±0.69mm and 13.71±0.75mm in L3, 12.88±0.69mm and 12.93±0.68mm in L4, 14.58±0.79mm and 14.42±0.84mm in L5 respectively. 2. The oblique diameter of the lumbar spinal canal was the widest at the first lumbar vertebra, the next at the fifth lumbar vertebra and the narrowest at the fourth lumbar vertebra. 3. There was no difference of diameter of the lumbar spinal canal between both sexes.
Calibration ; Cauda Equina ; Constriction, Pathologic ; Diagnosis ; Female ; Humans ; Ligamentum Flavum ; Longitudinal Ligaments ; Male ; Methods ; Reference Values ; Spinal Canal ; Spine ; Ultrasonography

PURPOSE: The purposes of this study were to analyze the MR findings of medulloblastoma, and to evaluate the subarachnoid dissemination and the significance of contrast enhanced MR of brain and spine for tumor.. MATERIALS AND METHODS: The preoperative brain MR studies of 18 patients (9 males, 9 females;mean age, 9.4 years) with surgically proved medulloblastomas were retrospectively reviewed to characterize these neoplasms with regard to their location, size, MR signal intensity, appearance after contrast enhancement, presence of cyst and necrosis, subarachnoid dissemination, and other associated findings. In 14 patients postoperative spine MR studies were evaluated for staging and therapeutic planning. RESULTS: The most frequent location of medulloblastoma was the inferior vermis and the mean tumor size was 4.1 x 3.6 x 3.9 cm. On Tl-weighted image, medulloblastomas generally had low to intermediate signal, predominantly hypointense relative to white matter. On T2-weighted image, medulloblastomas showed modetately high signal, hyperintense relative to white matter. Inhomogeneous contrast enhancement was demonstrated in 13 patients(72.2%) after injection of gadopentetate dimeglumine(Gadolinium). Cyst and necrosis within the tumor were visualized in 15 patients(83.3%). Subarachnoid disseminations of medulloblastomas were noted in 11 patients(61.1%), of which 6 demonstrated intracranial and 2 intraspinal dissemination. Three had both intracranial and intraspinal dissemination. In nine cases with intracranial lesions, there were intraparenchymal mass formation(7), subarachnoid nodules(5), infundibular lesions(2) and diffuse gyral enhancement(I). In five cases with intraspinal lesions, there were extramedullary intradural small nodules(3), central canal nodules(2), intradural masses(I)and fine nodular and sheet-like leptomeningeal enhancement(1). Other associated findings included intratumoral hemorrhage(11.1%), per/tumoral edema(44.4%), tonsillar herniation(44.4%), hydrocephalus(88.9%) and calcification(44.4%). CONCLUSION: Medulloblastomas revealed low to intermediate signal intensity on Tl-weighted image and intermediate to moderately high signal intensity on T2-weighted image, relative to cerebellar white matter. Medulloblastomas were solid tumors with cystic necrosis, which showed inhomogeneous enhancement and subarachnoid disseminations to the intracranial and intraspinal spaces after Gd-DTPA enhancement. Gd-enhanced MR of brain and spine was an useful diagnostic modality in preoperative diagnosis and in staging of postoperative cases of medulloblastomas, which was superior to postcontrast CT or precontrast MR.
Brain* ; Diagnosis ; Gadolinium DTPA ; Humans ; Male ; Medulloblastoma ; Necrosis ; Retrospective Studies ; Spine*

The advent of computerized cranial tomography made a greater advance in the diagnosis of very wide variety of intracranial lesions. Authors analyzed 58 pathologically proven sellar and parasellar tumors examined at Kyung Hee Un-iversity Hospital from Oct. 1977 to Jun. 1981 and the results were as follows; 1. The distribution of the tumors is 28 pituitary adenomas, 18 craniopharyngiomas, 5 meningiomas, 4 germinomas, 2 astrocytomas, and 1 sphenoid mucocele. 2. In pituitary adenoma, the precontrast CT scan of tumors appeared as isodensity in 11 cases, mixed density in 8 cases, high density in 6 cases, and low density in 3 cases, and associated with destruction of sellar turcica in 15 cases, calcification in 3 cases, and hydrocephalus in 2 cases. The postcontrast CT scan study revealed 24 cases of contrast enhancement, including 17 cases of homogenous and 7 cases of ring or rim enhancement. 3. In craniopharyngioma, the precontrast CT scan of tumors appeared as low density in 12 cases, isodensity in 4 cases and high density in 2 cases and associated with calcification in 16 cases, hydrocephalus in 15 cases and destruction of sellar turcica in 2 cases. The postcontrast CT scan study revealed no enhancement in 10 cases and contrast enhancement in 8 cases including 6 of ring enhancement and 2 heterogenous enhancement.
Astrocytoma ; Craniopharyngioma ; Diagnosis ; Germinoma ; Hydrocephalus ; Meningioma ; Mucocele ; Pituitary Neoplasms ; Tomography, X-Ray Computed

Dental restorative materials must have the physical properties to withstand wear and corrosion. Base metal alloys possess better mechanical properties and lower price than the gold alloys. For these reason such alloys have largely replaced the precious metal alloys. One aspect to consider is the release of metal substances to oral environment. The release of elements from dental alloys is a continuing concern because the elements may have the potentially harmful biological effects on local tissue. The purpose of this study was to minimize metal release on the nonprecious metal surfaces by ion bea assisted deposition(IBAD) of titanium nitride (TiN). Ni-Cr-Be alloys with and without TiN coatings were secured in an wear test machine opposing ruby ball to determine their relative resistance to wear with 100m, 200m, 300m and 400m sliding distance. And the corrosion behavior of the Ni-Cr-Be alloys with and without TiN coating and 3 dental noble alloys have been studied. Potentiodynamic curves were used to analyse the corrosion characteristics of the alloys. The measurement of the released Ni and Ci ions was conducted by analysis of the electrolyte solution with atomic absorption spectroscopy. The results were as follows : 1. The critical sliding distance that wore down TiN coating of 2.5micrometer thickness in this study condition was 300m. 2. Ion beam assisted deposition of TiN showed a good surface modification with respect to the properties of wear and corrosion resistance. 3. X-ray diffraction showed that the strongest peak of TiN(111) in the coatings. 4. The release of Ni and Cr ions from alloys measured by means of atomic absorption spectroscopy was reduced by ion beam assisted deposition of TiN.
Absorption ; Alloys* ; Corrosion ; Dental Alloys ; Gold Alloys ; Ions ; Spectrum Analysis ; Tin* ; Titanium ; X-Ray Diffraction

Two cases of monochorial twins with twin-to-twin transfusion syndrome were presented. In both of two cases, cases, there were marked difference in hemoglobin levels between two identical twins but in one of two cases, the anemic two was more larger than the pletoric one in birth weight unusually. In one of two cases, both anemic infant and plethoric one survived, but in the other case, both succumbed.
Birth Weight ; Female ; Fetofetal Transfusion* ; Humans ; Infant ; Pregnancy ; Twins* ; Twins, Monozygotic

No abstract available.
Polycystic Kidney Diseases* ; Tuberous Sclerosis*

The metal ceramic crown is currently the most popular complete veneer restoration in dentistry, but in many cases, the metal cervical collar at the facial margin is unesthetic and unacceptable. Facial porcelain margin has been used in place of it. But this dose not solve the problems, such as dark gingival discoloration and cervical opaque reflection of porcelain veneer. Recently, metal copings which were designed to terminate its labio-cervical end on the axial walls coronal to the shoulder have been clinically used to solve the esthetic problem of metal ceramic crown. But in this design, porcelain veneer of labio-cervical area which is not supported by metal may not be able to resist the stress during cementation and mastication. The purpose of this study was to evaluate fracture strength and fractured appearance of crowns according to different coping designs. A resin maxillary left central incisor analogue was prepared for a metal ceramic crown, and metal dies were made with duplication mold. Metal copings were made and assigned to one of four groups based on facial framework designs: group 1, coping with 0.5mm metal collar; group 2, metal extended to the shoulder; group 3, metal extended to 1 mm coronal to the shoulder; group 4, metal extended to 2mm coronal to the shoulder. Copings and crowns were adjusted to be same size and thickness, and cemented to metal dies with zinc phosphate cement by finger pressure. Fracture strength was measured with Instron Universal Testing Machine. Metaldies were anchored in Three-way-vice at 3mm below finish line and at 130degree inclined to the lone axis of the crown. Load was directed lingually at 2mm below midincisal edge. Load value at initial crack and at catastrophic fracture was recorded. The results obtained were as follows: 1. Fracture strength values at initial crack were higher in groups 1, 2 than in groups 3, 4 but this difference was not statistically significant(P<0.05). 2. Conventional metal collared crown had greater catastrophic fracture strength than any other collarless crowns. 3. The greater the labial metal coping reduction, the lower the catastrophic fracture strength of crowns but when more than 1mm of labial metal reduction was done, the difference in strengths was not statistically significant(p<0.05). 4. The strongest collarless coping design was group 2.
Axis, Cervical Vertebra ; Cementation ; Ceramics* ; Crowns* ; Dental Porcelain ; Dentistry ; Fingers ; Fungi ; Incisor ; Mastication ; Shoulder ; Zinc Phosphate Cement

CT provides a valuable new perspective in assessing abnormalities of the thorax. In patients with amediastinal mass or widening detected by plain chest radiography, a definite diagnosis is sometimes possible whichwould not obtainable by conventional radiological technique. Clinical staging of bronchogenic carcinoma can beachieved by CT better than any other radiologic method. In fifty patients with histologically or angiographically confirmed disease of the thorax,an analysis of chest radiography and chest CT manifestations was made, and theresults were as follows; 1. 27 patients with mediastinal mass detected by chest radiography, a definite diagnosiswas possible in 10 patients (36%), who were 6 with teratodermoid, 1 with thymic cyst, 3 with aneurysm. In allpatients, the extent and localization of mediastinal mass could be established more precisely than by the chestradiography. 2. In 15 patients wtih bronchogenic carcinoma, 9 patients (60%) showed hilar adenopathy ormediastinal adenopathy which could not be noted on the chest radiography. 3. Main CT findings of braonchogeniccarcinoma were peripheral lung mass, spiculated or lobulated margin, adhesion to pleura or chest wall, andatelectasis or chronic pneumonia. 4. Commonly observed CT findings of teratodermoid were well capsulated mass,calcification, fat density , and multi-loculation. 5. Commonly observed CT findings of thymoma were homogenousmass, round contour, partially preserved mediastinal fat. CT was superior in evaluation of mediastinum and in the detemination of the extent of known bronchogenic carcinoma.
Aneurysm ; Carcinoma, Bronchogenic ; Diagnosis ; Humans ; Lung ; Mediastinal Cyst ; Mediastinum ; Methods ; Pleura ; Pneumonia ; Radiography ; Thoracic Wall ; Thorax ; Thymoma ; Tomography, X-Ray Computed