No abstract available.
Intra-Articular Fractures* ; Tibia*

Polydactyly is one of the most common congenital anomalies of the limb, however its surgical treatment varies from simple excision to reconstruction. The purpose of this study is to present out classification of polydactyly in which the type of surgery was concerned primarily. Two hundred and thirty five digits(134 fingers and 101 toes) in 188 patients were operated from 1980 to 1992. We divided the polydactyly into two types-the simple type, in which the extradigit arises from only one digit, and the complex type in which the extradigit connects more than two adjacent main digits. The simple type was subdivided into joint type(type I), in that the extradigit has its own joint in its origine; epiphyseal type(type II), the extradigit share common epiphysis with main digit; and hypoplastic type(type III), the extradigit is connected only by soft tissue to the main digit. The epiphyseal type(type II) was further divided into subtype A(type IIA), in that the origin seems to be directly derived from the epiphysis; and subtype B(type IIB), which resemble an osteochondroma. Type III and type IIB can be treated by simple excision, however the type I and type IIB can be treated by arthroplasty with or without osteotomy as well as excision of extradigit. Result of surgical treatment in 1 digit of the simple form, which siginifies the extradigit arising from only one digit, are good in 193 digits(91%), fair 14(6.6%), and poor 5(2.4%) after an average follow-up period of 20 months. Our principles in the surgical treatment of polydactyly was treatment according to the type, and early treatment.
Arthroplasty ; Classification ; Epiphyses ; Extremities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Osteochondroma ; Osteotomy ; Polydactyly

No abstract available.
Muscular Atrophy, Spinal* ; Spinal Muscular Atrophies of Childhood*

No abstract available.
Child* ; Humans ; Meningitis* ; Plasma*

A 68-year-old female had slightly elevated, dusky erythematous nodules on the right infraorbital and the right temple area. Topical, intralesional corticosteroids and oral antihistamines provided temporary but incomplete improvement. Follow up biopsy, four months after the first visit revealed a tiny gold acupuncture needle lodged at the center of the nodule. Subsequent skull series revealed seven more linear radiopaque densities on the corresponding sites to the skin nodules. A patch test and an intradermal test with gold chloride showed strongly positive reactions. Removal of the embedded needles led to disappearance of the cutaneous nodules and itching sensation in seven days.
Acupuncture* ; Adrenal Cortex Hormones ; Aged ; Biopsy ; Female ; Follow-Up Studies ; Histamine Antagonists ; Humans ; Hypersensitivity* ; Intradermal Tests ; Needles* ; Patch Tests ; Pruritus ; Sensation ; Skin ; Skull

No abstract available.
Child* ; Encephalitis* ; Humans

Retinal toxicity secondary to intravitreal injection of gentamicin for the purpose of prophylaxis or treatment of endophthalmitis was reported infrequently and it was thought to be caused by an error in the intravitreal injection technique or by faulty dilution of gentamicin. After vitrecotomy, we experienced two cases of ischemic retinopathy secondary to intravitreal injection of gentamicin for prevention of endopthalmitist.
Endophthalmitis ; Gentamicins* ; Intravitreal Injections ; Retinaldehyde ; Vitrectomy*

We have applied the intraoperative use of Perfluorophenanthrene (C14F24) liquid in 19 eyes of complicated retinal detachment surgery in 19 patients since November 1990 to October 1991. The vast majority of case of retinal detachment was trauma (9 eyes) and uveitis including pars planitis (6 eyes) remainders were juvenile retinoschisis, cataract surgery, myopIa, diabetes one eye each. The grade-D of proliferative change was found in 9 eyes (D1 3 eyes, D2 3 eyes, D3 3 eyes) and 8 eyes belong to over grade-C2 (C2 4 eyes, C3 4 eyes). Multiple anterior retinal tears were found in two. Giant retinal tear was noticed in 5 eyes and the other one was made on therapeutic purpose. Intraoperative reattachment was obtained in all eyes. The follow-up periods were 6 or more (mean 9.1) months. At last follow-up, the retina was attached in 12 eyes (63%), partially attached in 2 (10%) and redetached in 5 (26%). Visual acuity was improved or same in 12 eyes (63%), became worse in 7(37%). Visual acuity of 0.02 or better was obtained in 12(63%) eyes and 3(16%) saw 0.1 or better. Perfluorophenanthrene liquid was thought as non-toxic, heavy biomaterial and effective to treat the complicated retinal detachments.
Cataract ; Follow-Up Studies ; Humans ; Myopia ; Pars Planitis ; Retina ; Retinal Detachment* ; Retinal Perforations ; Retinaldehyde* ; Retinoschisis ; Uveitis ; Visual Acuity ; Vitrectomy

PURPOSE: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. MATERIALS AND METHODS: 118 patients (M: F=66:52, 62.7+/-10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-201/stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods (14.6+/-5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. RESULTS: Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted` out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. CONCLUSION:: We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.
Death ; Electrocardiography ; Heart Failure ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Myocardial Ischemia ; Perfusion ; Perioperative Period ; Retrospective Studies ; Risk Factors ; Tomography, Emission-Computed, Single-Photon*

A patient with extraskeletal cervical epidural Ewing's sarcoma who presented with cervical radiculopathy is reported. A 58-year-old woman presented with right posterolateral neck pain and upper extremity radiculopathy. The computed tomography myelography showed epidural and paravertebral masses on right side, with widening of the ipsilateral neural foramina at the C2-C3 level. On magnetic resonance images, the mass was isointense to soft tissue on T1-weighted images, hyperintense on T2-weighted images, and showed diffuse enhancement on GdTA enhanced T1-weighted images. The staged, combined posterior and anterior approach were done and the tumor mass was subtotally removed. During postoperative adjuvant chemotherapy with Cytoxane, Adriamycin, Vincristine, Prednisolone regimen, the patient died of severe compression of upper cervical cord by recurrent, extended tumor mass in the spinal canal.
Chemotherapy, Adjuvant ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Female ; Humans ; Middle Aged ; Myelography ; Neck Pain ; Prednisolone ; Radiculopathy ; Sarcoma, Ewing* ; Spinal Canal ; Upper Extremity ; Vincristine