Computed tomography is helpful in delineating the extent and configuration of pelvic fracture. These injuries are frequently complex, and the precise pathologic anatomy is not easily demonstrated by conventional radiographs. In some case CT will reveal a fracture which may not be seen on the radiograph. In addition, the extent of soft tissue damage and joint involvement is precisely demonstrated with CT. The twenty-three patients admitted to our Inchon Christian Hospital with pelvic fracture with or without hip dislocation from October 1981 to October 1984. We could assess the applicability of C-T scan in pelvic fracture and the following conclusions were obtained. 1. The axial plane of CT was shown to be the most suitable for evaluation of pelvic fracture. 2. C-T could detect the pattern of hip fracture including degree of fracture fragment displacement, and rotation, hip joint stability, intra-articular osseous fragment and interposed soft tissues in hip joint. 2. C-T permitted better evaluation of associated injuries in soft tissue and viscera on the pelvic and retroperitoneal cavity, and also gave information about other associate fractures. 4. C-T was more sensitive than plain radiography in detecting fracture involving the sacrum, quadrilateral surface, acetabular roof, and posterior acetabular hip.
Acetabulum ; Diagnosis ; Hip ; Hip Dislocation ; Hip Joint ; Humans ; Incheon ; Joints ; Pelvis ; Radiography ; Sacrum ; Viscera

The purpose of this study was to evaluate the results and complications in difficult periarticular fractures of the knee treated with a circular(Ilizarov) external fixator. The mean follow-up period was 34 months(range: 12-55 months). Of the 27 cases, 12 cases involved fractures of distal femur (two M ller type A3, four type C2, six type C3) and 15 cases involved fractures of the proximal tibia (one Schatzker type V, eight type VI, two segmental, four metaphyseal comminuted fractures). Twenty-two cases(81%) were open fractures and most of the cases were open intra-articular comminuted fractures. The average duration of external fixation was 7.7 months (9.8 months for the distal femur cases, 6.5 months for the proximal tibia cases and 11.5 months for the cases which required lengthening, and 6 months in the non-lengthening group). In 8 cases, in which bone lenthening was done, no leg length discrepancy occurred after lengthening. The mean length gained was 5.9 cm and the mean healing index was 1.8 months/cm (1.8months/cm in distal femur cases and 1.9 months/cm in proximal tibia cases). According to Neers criteria, the treatment results for cases involving distal femur fracture were as follows: six satisfactory, three unsatisfactory, three failures; cases with proximal tibia fractures had these results: nine excellent, three satisfactory, three unsatisfactory. Average range of motion was 67 degrees in distal femur fracture cases and 114 degrees in proximal tibia fracture cases. According to Paleys complication grading system, six problems, six obstacles, and eight com- plications occurred. In conclusion, the Ilizarov external fixator can be a useful treatment method in periarticular fractures of the knee with severe intra-articular or metaphyseal comminution, bone loss, severe soft tissue injury, or multiple associated injury. Its use can reduce the associated complications such as leg length discrepancy, infection, and nonunion.
External Fixators* ; Femur ; Follow-Up Studies ; Fractures, Comminuted ; Fractures, Open ; Knee* ; Leg ; Range of Motion, Articular ; Soft Tissue Injuries ; Tibia

Six cases of a rare variant of endocervieal adenocarcinoma (Adenoma maligum, AM) were collected for clinicopethologic analysis. The everage age of six patients was 49.3 years, and their chief com plaints were persis(ent mucid or watery discharge and intermittent vaginal spotting, The clinical im presaion was carcioma of The uterine cervix in faur out, of six cases. All except one were pathologically confirmed by initia1 biupey. two cases by colposcopic biopsies, two by cone biopsies, one by cone biopsy after suggested AM in calposcopic hiopsy. One case was incidentally found from hysterectnmised speeimen, which waas suspected as adennmyosis. On gross examination, the cervix usualty appeared either firm or indurated with thickening af the wall excepl one which was presented es a fungnting mass. The characteristic histologic feetures were ext,ensive arborizing endeervical glands with marked variation in size and shape, and the glands lined by mucin conyaining columnar epithelial cells with basal bland looking nuclei but with occasional cytologic atypia and rare mitose. The nenplasi.ic glands were characterized by deep stronml invasion be yond normal enddcervical glands, assosiated with loose edematous periglandular desmaplastic stromal reaction in moat cases. Immunohistochemical stainnings for carcinoembryonie antigen (CEA) revealed ey- toplasmic positivity in five cases. The clinical stage for all exeept one incidental case were : four Ib and one II b. In three cases, the radical hysterectomy with unilateral salpingooophorectomy plus dissection of bilateral pelvic and paraaortic lymph nodes was performed, and in one case radiotherapy was done prior to radical hysterectomy with bilateral salpingoophorectomy plus the dissection of left pelvic lymph nodes followed by chemotherapy. Total abdominal hysterectomy with bilateral salpingooophorectomy plus Burch's operation followed by radiation therapy was performed in on case. The remaining one case was treated with radiation therapy. Metastasis to the left obturator lymph node was discovered in one case with state IIb, and the patient expired 29 months after the radiotherapy. The remaining five cases are being carefully followed up. From our experience, we conclude that the early diagnosis of AM can be made based on comprehensive analysis concerning the clinical features, histopathological and immunohistochemical findings. The early diagnosis and proper therapy can lead to the better prognosis.
Adenocarcinoma ; Adenoma* ; Biopsy ; Cervix Uteri* ; Drug Therapy ; Early Diagnosis ; Epithelial Cells ; Female ; Humans ; Hysterectomy ; Lymph Nodes ; Metrorrhagia ; Mucins ; Neoplasm Metastasis ; Prognosis ; Radiotherapy

Recently posterior stabilization with various instrumentation and fusion has been used for fractures of the thoracolumbar spine involving anterior and middle columns. However, these methods are sometimes inadequate to gain anatomical reduction and complete decompression especially in burst fractures. So anterior decompression and interbody fusion were frequently added as a second operation. Biomechanically a rigid anterior spinal instrument such as kaneda device can provide enough anterior decompression through partial or total corpectomy and adequate correction of kyphosis as an one stage operation. We have experienced 27 cases of Kaneda instrumentation via anterior approach for thoracolumbar fracture, most of them were burst fractures, from Jan. 1989 to June 1990. Of there 27 cases, 12 were followed up at least 1 year and reviewed. The results were as followed: l. Anterior spinal approach using Kaneda instrumentation provided sufficient anterior neural decompression and adequate correction of kyphotic deformity. It eliminates the second posterior procedure in most cases and enhances early solid union. Simultaneously, it allows early mobilization of patient with an application of brace. 2. Post-operative courses were eventful in most cases except a case of pathological fracture. 3. This procedure seemed to be one of the most suitable method for the treatment of burst fractures of the thoracolumber region. 4. Complications by Kaneda device itself were not developed in the early evaluation stage. However, on longer follow-up study over 1 year revealed some complications including 2 cases of screw breakage and one lateral wedging deformity.
Braces ; Congenital Abnormalities ; Decompression ; Early Ambulation ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Kyphosis ; Methods ; Spine

No abstract available.

No abstract available.
Spine*

To evaluate the possibility of the newly developed highly porous glass ceramics as a space-filler in the cavitary bone defect, we made the opening sized 1 × 0.5 cm on the medial aspect of the right proximal tibia of nine rabbits. We impacted the highly porous glass ceramics firmly to the medullary cavity of rabbit tibia through the opening. Each three were sacrificed at 4th, 8th, and 12th week and analyze in vivo reaction of the glass ceramics in rabbit tibia with radiological and histological methods. On radiological examination, radiolucent line was seen around impacted glass ceramics at 4th week, but this radiolucent line was obliterated gradually to 12th week. On histological examination, new bone formation with osteoblast was appeared at 4th week without foreign body reactions. At 8th week, newly formed bone infiltrated into the porous space between glass ceramics particles was noticed, and the surface of glass ceramics was tightly bound by newly formed bone with osteoblastic rim and mature bone, At 12th week, the amount of newly formed mature bone increased, though there was on evidence of resorption of glass ceramics particle. So, we suggest that the highly porous glass ceramics is one of the possible artificial bone graft substitutes, especially as a space-filler.
Ceramics ; Foreign Bodies ; Glass ; Osteoblasts ; Osteogenesis ; Rabbits ; Tibia ; Transplants

Recently, we performed an ezperi nlent to detect residual ethylene oxide(EO) gas and methylmethacrylate(MMA) monomer in the intraocular lenses from eleven different makers using gas-liquid chromatography. The residual EO gas over 25ppm was seen in 2 makers and also the MMA monomer over 2% was present in two makers. As a result, we recommend that the precise product quality-control of the IOLes is necessary especially for the lenses from foreign manufacturers.
Chromatography, Gas ; Ethylene Oxide* ; Lenses, Intraocular

Recently, we performed an ezperi nlent to detect residual ethylene oxide(EO) gas and methylmethacrylate(MMA) monomer in the intraocular lenses from eleven different makers using gas-liquid chromatography. The residual EO gas over 25ppm was seen in 2 makers and also the MMA monomer over 2% was present in two makers. As a result, we recommend that the precise product quality-control of the IOLes is necessary especially for the lenses from foreign manufacturers.
Chromatography, Gas ; Ethylene Oxide* ; Lenses, Intraocular

No abstract available.
Phototherapy*