No abstract available.

No abstract available.

Author report a case of neurocysticercosis that involved the right cerebral hemisphere subcortically. The subject was 38-year-old Korean male. The headache, epileptiform seizures and left sided motor weakness were the symptoms. Simple skull X-rays showed no significant pathological findings. Right carotid angiogram disclosed the signs of a large mass in the centrosylvian region. CT scan also demonstrated large, multiple and round cystic lesions within the substance of the brain itself in the right frontoparietal region. At operation cyst wall and cysticercus in the fluid content of a mass were obtained. Postoperatively with the aids of occurrence of cysticercrus in the skin and positive serologic test, the diagnosis again confirmed.
Adult ; Brain ; Cerebrum ; Cysticercosis* ; Cysticercus ; Diagnosis ; Headache ; Humans ; Male ; Neurocysticercosis ; Seizures ; Serologic Tests ; Skin ; Skull ; Tomography, X-Ray Computed

Bicoronal approach is adopted as an universal method for reduction and internal fixation of the fractured zygomatic arch in the treatment of complex zygomatic fracture. However bicoronal approach leaves many disadvantages, such as long incision, alopecia, prolonged edema, and paresthesia. Nowadays endoscopically assisted minimal invasive technique has been widespread not only for the aesthetic surgery, but also for the reconstructive surgical fields because of the benefits. We have been recently trying to apply endoscopic surgery to facial bone fracture surgery. Endoscopically assisted minimal invasive technique has been applied to 14 patients who admitted to Chosun university hospital from March 1996 to July 1997. We used 4 mm, 30' endoscope and two 1.5-2 cm temple incisions and a subciliary incision for approaching to the zygomatic arch. Protected drill bit and driver had access to fractured zygomatic arch though tiny(5 mm) stab incision over the zygomatic arch. We have been able to successfully reduce and make fixation of the fracture of zygomatic arch by using endoscopically assisted minimal invasive technique. Follow up for 3 months revealed good maintenance of the reduction. We think that application of the endoscopic technology to midfacial bone fracture will result in significant reduction in morbidity and improve postoperative results.
Alopecia ; Edema ; Endoscopes ; Facial Bones ; Follow-Up Studies ; Fractures, Bone ; Humans ; Paresthesia ; Zygoma* ; Zygomatic Fractures

PURPOSE: The pvrpose of this study was to evaluate the accuracy of radioactivity quantitation in Tc-99m SPECT by using combined scatter and attenuation correction. MATERIALS AND METHODS: A cylindrical phantom which simulates tumors (T) and normal tissue (B) was filled with varying activity ratios of Tc-99m. We acquired emission scans of the phantom using a three-headed SPECT system (Trionix, Inc.) witb two energy windows (photopeak window: 126 154 keV and scatter window: 101 123 keV). We performed the scatter correction with dual-energy window subtraction method (k=0.4) and Chang attenuation correction. Three sets of SPECT images were reconstructed using combined scatter and attenuation correction (SC+AC', attenuation correction (AC) and without any correction (NONE). We compared T/B ratio, irnage contrast [(T-B)/(T+B)) and absolute radioactivity with true values. RESULTS: SC+AC images had the highest mean values of T/B ratios. Image contrast was 0.92 in SC+AC, which was close to the true value of 1, and higher than AC (0.77) or NONE (0.80). Errors of true activity by SPECT images ranged from 1 to 11% for SC+AC, 22-47% for AC, and 2 16% for NONE in a phantom which was located 2.4cm from the phantom surface. In a phantom located 10,0cm from the surface, SC+AC underestimated by ?4%, NON.E 40%. However, AC overestimated by 10%. CONCLUSION: We conclude that accurate SPECT activity quantitation of Tc-99m distribution can be achieved by dual window scatter correc.tion combined with attenuation correction.
Radioactivity ; Tomography, Emission-Computed, Single-Photon*

Recently, demand for minimally invasive surgery has increased greatly. As a result, robot-assisted techniques have gained in popularity, because they overcome several of the shortcomings of conventional laparoscopic techniques. However, robotic surgery may require innovations with regard to patient positioning and the overall arrangement of operative equipment and personnel, which may go against the conservative nature of anesthesia care. Anesthesiologists should become familiar with these changes by learning the basic features of robotic surgical systems to offer better anesthetic care and promote patient safety.
Anesthesia ; Anesthesia, General ; Learning ; Patient Positioning ; Patient Safety ; Surgical Procedures, Minimally Invasive

Fracture of the tibial shaft is one of the most common fractures of the long bones and frequently followed by malunion, delayed union and nonunion. We experienced the cases of further increase in the angulation after clinical union of the tibial shaft fractures treated by conservative method. So we analyzed 39 cases of tibial shaft fractures which were followed up from 12 weeks to 37 weeks after clinical union in adults. The results were as follows; l. 7 of the 39 cases(18%) showed the increase in the angulation, and all of them were male. 2. Increase in the angulation occurred more frequenlty in the comminuted fractures than simple fractures. 3. The increment of angulation was more marked in group of patients with higher angulation at the time of clinical union. 4. Increase in the angulation occurred more commonly in the cases not associated with fibula fracture than in the cases associated with fibula fracture. 5. Further increase in the angulation was less common in the cases in whom early weight bearing with PTB cast was started.
Adult ; Fibula ; Fractures, Comminuted ; Humans ; Male ; Methods ; Tibia ; Weight-Bearing

The courses of the progression in the fibrous dysplasia are characterized by asymptomatic progression or spontaneous regression in some cases after the growth has ceased and the aims of treatment for a fibrous dysplasia are prevention of the pathologic fractures and correction of the deformities. The osteogenic potentiality of the cambium layer in the periosteum and the beneficial effect on the osteogenesis of the impregnating bone graft with autologous red marrow are well documented. We experienced an extensive fibrous dysplasia with cortical thinning and pathologic fracture and it was managed with subperiosteal combined xenograft of Kiel bone with autologous red marrow for the induction of cortical thickening and prevention of the pathologic fractures because of the inoperability of curettage due to extensive lesion over the entire femur, limitations in obtaining large amount of autogenous cancellous bone for the graft and lack of the facilities of the bone bank. This subperiosteal composite xenograft with autologous red marrow for a fibrous dysplasia gave an excellent result of a remarkable cortical thickening and we think this can be a type of management for a entensive fibrous dysplasia. So we are reporting this case with bibliographic reviews.
Bone Banks ; Bone Marrow ; Cambium ; Congenital Abnormalities ; Curettage ; Femur ; Fractures, Spontaneous ; Heterografts ; Osteogenesis ; Periosteum ; Transplants

Wide resection is an acceptable alternative to amputation for the management of primary sarcomas of the long bones or pelvis. The resected bone can be debrided of gross tumor tissue, autoclaved, and than replaced to reconstruct the limb anatomically. The procedure can be combined with prosthetic reconstruction of adjacent joints with sufficient strength to allow early unprotected weight-bearing. We had an experience of a large segmental defect in the shaft of the humerus after wide resection due to.a low grade malignant chondrosarcoma without extension to the surrounding soft tissues and this case had been managed by reimplantation after autoclaving the locally resected segment and autogenous iliac bone graft with a sound union and the favorable functional outcomes. So we are reporting this case with bibliographic reviews as a possible method of reconstruction for the management of the segmental defect which was produced by a local resection for a low grade malignancy.
Amputation ; Chondrosarcoma ; Extremities ; Humerus ; Joints ; Methods ; Pelvis ; Replantation ; Sarcoma ; Transplants ; Weight-Bearing

Since osseous healing in the fracture of the femoral neck is carried out by endosteal bone formation, the size of contact area of the fracture fragments and impaction are of prime importance. It is not uncommon to be faced with the problem of back out of the internal fixation devices during healing period. It seems unnecessary to emphasize the benefit of sliding to close the gap between the fracture fragments. We report a retrospective study of 25 cases of the femoral neck fractures treated by closed reduction and fixation with multiple Knowles pins, paying particular attention to the amount and duration of sliding back out of the fixation devices and relating these to the final results of fracture union. Our clinical study led us to the following conclusions; 1. The shortoning of the femoral neck over 3mm occurred in 16 cases(64%) out of 25 cases. The average amount of back out of Knowles pin is 6mm. 2. Most of the shortening occurred during the first 8 weeks after surgery and extrusion of the nail is frequent findings in unstable fractures and osteoporoses. 3. Backing out over 12 weeks after surgery was associated frequently with delayed union and non-union. 4. Collapse or shortening is nceessary to promote a bone to bone contact and bone healing.
Clinical Study ; Femoral Neck Fractures ; Femur Neck ; Internal Fixators ; Osteogenesis ; Osteoporosis ; Retrospective Studies