No abstract available.
Muscular Dystrophies*

The elbow joint is the most commonly dislocated-joint in the body except for the shoulder, and in children less then 10 years old, it is the most frequently dislocated articulation. The injury and the treatment are well described in most standard textbooks, but the characteristic findings and follow-up evaluations are not generally recognized. Authors have clinically analyzed 45 cases of traumatic fracture and dislocation of the elbow joint which are treated between January, 1975 and June, 1985 at the Department of Orthopedic Surgery, Wonju Medical College of Yonsei University. The results were as follows; 1. The age incidences were in even distribution except in the old ages where the incidence was low and the male to female ratio was 7: 3. 2. The major cause of the injury of the elbow was fall down (60%). 3. Posterior and posterolateral dislocations were about 60% of all cases. 4. Associated fractures were 35.6% of all the elbow dislocations, of which medial epicondyle fracture had the highest incidence. 5. Complications including ulnar nerve injury (3 cases), median nerve injury(1 case), radial nerve mjury(1 case), rupture of brachial artery(2 cases), recurrent dislocation(1 case) and calcification of ligament(2 cases) were observed. 6. Pure elbow dislocation occurred in 13 cases (28.9%). 7. The average immobilization period for patient with non-operative treatment (45%) and operative treatment(55%) were 7 days and 3 weeks, respectively, and much better results were seen in patients with non-operative treatment than in operative treatment and in shortened immobilization period.
Child ; Clinical Study ; Dislocations ; Elbow Joint ; Elbow ; Female ; Follow-Up Studies ; Gangwon-do ; Humans ; Immobilization ; Incidence ; Male ; Median Nerve ; Orthopedics ; Radial Nerve ; Rupture ; Shoulder ; Ulnar Nerve

Shortening and angular deformities in children are one of important orthopedic management problem. Conceptually, lengthening of the short side in treatment of limb length inequality is, in most instance, the most attractive approach to this problem. Throughout the evolution of lengthening procedures, the method that has remained most consistently acceptable is osteotomy followed by gradual distraction. However, the idea of increasing the length of or modifying the axis of s bone during growth by means of distraction of the grwoth plate is relatively new. Recently, Monticelli and Spinelli have had experience with a new and novel method of lower limb lengthening by physeal distraction. We have studied the results of effect of distraction epiphysiolysis and the use of nonsteroidal anti-inflammatory agents to impede bone bridge as well as premature epiphyseal closure. There are some reports in which indomethacin could prevent reformation of a bone bridge between the epiphysis and metaphysis without inhibiting normal growth and bone remodeling. For this study, a total of 30 rabbits with an initial weight of about 600 gram was used. At operation two K-wires(l.lmm in diameter) were drilled percutaneously on parallel trscks through the epipaysis and diaphysis of proximal tibia. Epiphyseal distraction of Turnbuckle type designed at our school was applied on each side of K-wire insertion at the tibia. The correct position of pin was confirmed by radiography and the rate of distraction is 0.5–1mm per day. Distrsction was continued for 3–6 weeks and radiographs was taken every 2 weeks. Some rabbits was sacrified sfter removal of distractor. Through these examination, following results were obtained. 1. Seperation of the epiphysis from the metaphysis occurred after average 3 days, and it always occurred in the zone of provisional calcification. 2. Short term results of growth plate distraction looked promising and longer limbs were seen, but long term results were unsstisfactory with premature epiphyseal closure and bone bridge formation occuring in many cases. 3. The role of indomethacine to impede bone bridge formation across the seperated growth plate could be observed, and was found that shortening could be possibly decreased. 4. Distraction epiphysiolysis would be one of valuable leg lengthening procedure at an age when the subjects bone growth is nearly complete, and also the administration of indomethacin with growth plate distraction might be effective to diminish the significant Change of shortening or angulation in high-risk juvenile fractures.
Anti-Inflammatory Agents, Non-Steroidal ; Bone Development ; Bone Remodeling ; Child ; Congenital Abnormalities ; Diaphyses ; Epiphyses ; Epiphyses, Slipped ; Extremities ; Growth Plate ; Humans ; Indomethacin ; Leg ; Lower Extremity ; Methods ; Orthopedics ; Osteotomy ; Rabbits ; Radiography ; Socioeconomic Factors ; Tibia

BACKGROUND: We investigated the demographic features and characteristics of headache (HA) in patients visiting a primary care clinic (PCC). METHODS: We prospectively collected the demographic and clinical data of 261 consecutive HA patients in a PCC located in Taejon from Oct. 1996 to Jul. 1998. All patients were interviewed and examined by a single neurologist. The types of HA were classified as migraine, tension-type, mixed, and others. RESULTS: The mean age at the initial visit was 37.2 +/-13.4 years. Women were 3 times more common than men (193 patients vs. 68 patients). More than half of the female patients were housewives (47.5%). Migraine was the most common type of headache (114 patients, 43.7%), followed by mixed type (72 patients, 27.6%) and tension-type headaches (57 patients, 21.8%). 85.7% of patients with HA for more than 1 month had taken medication before their initial visit. Among the 168 patients who reported their attitude toward HA, 55 patients continuously worried about their HA even in the HA-free period. CONCLUSIONS: In a PCC, migraine was the prevailing type of HA. The majority of HA sufferers were housewives.
Daejeon ; Female ; Headache* ; Humans ; Male ; Migraine Disorders ; Neurology* ; Primary Health Care* ; Prospective Studies ; Tension-Type Headache

PURPOSE: It is not easy to determine the cause of pulmonary consolidative lesion. Even without any definite mass, malignancy cannot be ruled out. And sometimes, it is difficult to differentiate tuberculosis from pneumonia. To differentiate malignant consolidative lesion from benign one, we studied patterns of air bronchogram, mucoid impaction, and computed tomographic anglogram etc. MATERIALS AND METHODS: Fifty seven cases of pulmonary consolidative lesions(23 cases of malignancy,34 cases of benign lesion) were retrospectively reviewed by three radiologists. RESULTS: Among the 28 cases which showed a little air bronchogram(less than 1/3 of the whole lesion in volumetric measure with the eye) 19 cases were malignancy and nine cases were benign lesions. All of the 12 cases which showed profound air bronchogram over 2/3 of the whole lesion were benign lesions. Bronchiectasis was detected in 31 cases(four of malignancy and 27 of benign lesions). Among the 20 cases which didn't show the mucoid impaction five cases were malignancy and 15 cases were benign lesions. Out of eight cases with mucoid impaction filling the long segments(branching tree shape), seven cases were malignancy and one case was benign lesion. So called CT anglogram was detected in nine cases of malignancy and two cases of benign lesions. All of nine cases of malignancy showed CT anglogram which was like arborizing tree. CONCLUSION: Scanty air bronchogram, profound arborizing mucoid impaction and/or CT angoigram within consolidative lesion could suggest malignancy.
Bronchiectasis ; Pneumonia ; Retrospective Studies ; Thorax* ; Tomography, X-Ray Computed* ; Tuberculosis

No abstract available.
Drainage*

It is well known that anatomic variations affecting the ostiomeatal unit (OMU) become one of the causes of mucosal abnormalities of paranasal sinuses (PNS). Findings of coronal plane CT scans of PNS were analyzed in 95 patients with sinusitis or sinusitis-like complaints. Anatomical variations were seen in 88 cases of 60 patients. Mucosal abnormalities were seen in 27 of 47 cases with concha bullosa, 23 of 37 cases with enlarged ethmoid bulla, 8 of 33 cases with Agger nasi, 20 of 26 cases with nasoseptal deviation, 7 of 8 cases with Haller cell, 3 of 6 cases with duoble middle turbinate, 4 of 6 cases with medially bent uncinate process, 1 cases with laterally bent uncinate process, and 33 of 40 cases with mixed variations. Mucosal abnormalities in cases with antomical variations were detected in 61 cases, including maxillary sinus(51 cases), anterior ethmoid sinus (26 cases), frontal sinus (4 cases), and mixed (32 cases). Mucosal abnormalities without anatomical variations were detected in 13 cases involving maxillary sinuses (7 cases), anterior ethmoid sinuses (5 cases), and frontal sinus(1 cases). In conclusion, as coronal plane CT scan has the capability of dolineating anatomical variations and mucosal abnormalities of PNS, it is considered useful in evaluating the treatment and prognosis of chronic or recurrent sinusitis.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Meperidine ; Paranasal Sinuses ; Prognosis ; Sinusitis ; Tomography, X-Ray Computed ; Turbinates

The purpose of this study is to describe the magnetic resonance imaging (MR) findings of metastatic brain tumors with emphasis on the signal intensities of the lesion on MR. Thirty four patients with intracranial metastases were studies with MR imaging. The diagnosis was established on the basis of either brain biopsy or combination of brain MR findings and the presence of primary tumors. The primary tumors include lung cancer (n=18), breast cancer (n=3), stomach cancer (n=3), rectal cancer (n=1), renal cell carcinoma (n=1), hepatocellular carcinoma(n=1), ovarian cancer (n=1), thyroid cancer (n=1), melanoma (n=1) and unknown primary sites (n=4). The parenchymal lesions were solitary in 35% (12/34) and multiple in 65% (22/34). The size of the lesions was variable, ranging from several millimeters to 5cm in diameter. The corticomedullar junction of the cerebral heispheres was the most common location of the lesions (68%). The signal intensity of solid portion of the lesions was usually either isointense (44%) or hypointense (29%) on T1-weighted images, whereas it appeared in isointense (47%), hypointense (8%) or hyperintense (11%) on proton density-weighted or T2-weighted images. The remaining cases showed mixed signal intensities. The enhancement patterns were variable including nodular (<1cm) (6%), homogenous (19%), heterogeneous (10%), ring-like enhancement (22%) or mixed pattern(43%). The size of surrounding edema was larger than the tumor diameter in 76%. In conclusion, although there are no specific MR findings of intracranial metastasis except multiplicity, intracranial metastasis should be included in differential diagnosis with high priority, when a solitary mass showing isointensity on boty T1-and T2-weighted images with massive surrounding edema, especially in the corticomedullary junction of the cerebral hemispheres is encountered.
Biopsy ; Brain Neoplasms* ; Brain* ; Breast Neoplasms ; Carcinoma, Renal Cell ; Cerebrum ; Diagnosis ; Diagnosis, Differential ; Edema ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging ; Melanoma ; Neoplasm Metastasis ; Ovarian Neoplasms ; Protons ; Rectal Neoplasms ; Stomach Neoplasms ; Thyroid Neoplasms

It is well known that anatomic variations affecting the ostiomeatal unit (OMU) become one of the causes of mucosal abnormalities of paranasal sinuses (PNS). Findings of coronal plane CT scans of PNS were analyzed in 95 patients with sinusitis or sinusitis-like complaints. Anatomical variations were seen in 88 cases of 60 patients. Mucosal abnormalities were seen in 27 of 47 cases with concha bullosa, 23 of 37 cases with enlarged ethmoid bulla, 8 of 33 cases with Agger nasi, 20 of 26 cases with nasoseptal deviation, 7 of 8 cases with Haller cell, 3 of 6 cases with duoble middle turbinate, 4 of 6 cases with medially bent uncinate process, 1 cases with laterally bent uncinate process, and 33 of 40 cases with mixed variations. Mucosal abnormalities in cases with antomical variations were detected in 61 cases, including maxillary sinus(51 cases), anterior ethmoid sinus (26 cases), frontal sinus (4 cases), and mixed (32 cases). Mucosal abnormalities without anatomical variations were detected in 13 cases involving maxillary sinuses (7 cases), anterior ethmoid sinuses (5 cases), and frontal sinus(1 cases). In conclusion, as coronal plane CT scan has the capability of dolineating anatomical variations and mucosal abnormalities of PNS, it is considered useful in evaluating the treatment and prognosis of chronic or recurrent sinusitis.
Ethmoid Sinus ; Frontal Sinus ; Humans ; Maxillary Sinus ; Meperidine ; Paranasal Sinuses ; Prognosis ; Sinusitis ; Tomography, X-Ray Computed ; Turbinates

The purpose of this study is to describe the magnetic resonance imaging (MR) findings of metastatic brain tumors with emphasis on the signal intensities of the lesion on MR. Thirty four patients with intracranial metastases were studies with MR imaging. The diagnosis was established on the basis of either brain biopsy or combination of brain MR findings and the presence of primary tumors. The primary tumors include lung cancer (n=18), breast cancer (n=3), stomach cancer (n=3), rectal cancer (n=1), renal cell carcinoma (n=1), hepatocellular carcinoma(n=1), ovarian cancer (n=1), thyroid cancer (n=1), melanoma (n=1) and unknown primary sites (n=4). The parenchymal lesions were solitary in 35% (12/34) and multiple in 65% (22/34). The size of the lesions was variable, ranging from several millimeters to 5cm in diameter. The corticomedullar junction of the cerebral heispheres was the most common location of the lesions (68%). The signal intensity of solid portion of the lesions was usually either isointense (44%) or hypointense (29%) on T1-weighted images, whereas it appeared in isointense (47%), hypointense (8%) or hyperintense (11%) on proton density-weighted or T2-weighted images. The remaining cases showed mixed signal intensities. The enhancement patterns were variable including nodular (<1cm) (6%), homogenous (19%), heterogeneous (10%), ring-like enhancement (22%) or mixed pattern(43%). The size of surrounding edema was larger than the tumor diameter in 76%. In conclusion, although there are no specific MR findings of intracranial metastasis except multiplicity, intracranial metastasis should be included in differential diagnosis with high priority, when a solitary mass showing isointensity on boty T1-and T2-weighted images with massive surrounding edema, especially in the corticomedullary junction of the cerebral hemispheres is encountered.
Biopsy ; Brain Neoplasms* ; Brain* ; Breast Neoplasms ; Carcinoma, Renal Cell ; Cerebrum ; Diagnosis ; Diagnosis, Differential ; Edema ; Humans ; Lung Neoplasms ; Magnetic Resonance Imaging ; Melanoma ; Neoplasm Metastasis ; Ovarian Neoplasms ; Protons ; Rectal Neoplasms ; Stomach Neoplasms ; Thyroid Neoplasms