No abstract available.
Hemorrhage* ; Hemorrhoids* ; Ligation* ; Rubber*

No abstract available.
Genu Varum*

PURPOSE: To cmpare the clinical results of complex tibial plateau fractures treated by hybrid external fixation and dual plate fixation. MATERIALS AND METHODS: We studied forty patients with Schatzker type V and VI fractures respectively and selected twenty seven patients who were followed at least one year between January 2000 and December 2005. We evaluated the clinical results in which fourteen fractures with hybrid external fixation were compared with thirteen fractures with dual plate fixation. The clinical results were evaluated according to Knee Society Clinical Rating System and the statistical analysis was performed by Student t-test. RESULTS: There were no significant differences in terms of bone union time (average union time: dual plate fixation 13.8 weeks, hybrid external fixation 14.2 weeks). The quality of osseous reduction was superior in the fractures with dual plate fixation than those with hybrid external fixation. There were significant differences in functional score (average functional score: dual plate fixation 73, hybrid external fixation 62), but not in average knee score. CONCLUSION: The hybrid external fixation can be a useful modality for treatment of complex proximal tibial plateau fractures. But the good quality of the fracture reduction by dual plate fixation may be a indicator for favorable prognosis for satisfactory knee function.
Chimera ; External Fixators ; Humans ; Knee ; Prognosis

Bartter's syndrome is a rare tubular disorder characterized by hypokalemic, hypochloremic metabolic alkalosis, hyperreninemic, hyperaldosteronism, hyporesponsiveness to pressor agents and juxtaglomerular apparatus heperplasia. We report a case of Bartter's syndrome of a 5 month-old male infant with subdural hematoma who was confirmed by characteristic clinical, laboratory findings and kidney biopsy.
Alkalosis ; Bartter Syndrome* ; Biopsy ; Epilepsy* ; Hematoma, Subdural* ; Humans ; Hyperaldosteronism ; Infant ; Juxtaglomerular Apparatus ; Kidney ; Male ; Seizures*

The ankle is a complex, weight-bearing joint and has an important role in walking. The injuries to the ankle joint complex include not only injuries that cause disruption of the bony architecture of the ankle joint but often significant ligamentous and soft tissue components. The literature on ankle fractures have divergence of opinion on treatment. However, the method used to obtain a good end result of treatment is a matter of differing opinion. One hundred and seventy six patients with one hundred and eighty cases of ankle fractures treated at Severance Hospital, Yonsei University College of Medicine from Jan. 1971 to Dec. 1980 were analized in clinical and radiological aspect. The results obtained from this study were as followings: 1. Among the 176 patients, male was 126 patients and female 50 patients (M:F=2.5:1). The average age was 29. 2. Of the 180 cases, the main cause of fractures was traffic accident, 74 cases (41.1%) and the other causes were falling from a height (16.1%), slipping down (15.0%) and sports injuries (12.8%) in order. 3. The fractures were almost closed fractures (84.4%). 4. According to the classification of Lague-Mansen, the pronation-external rotation type (40.6%) was the commonest type. 5. One hundred and twelve cases (62.2%) were treated by open reduction and 68 cases (37.8%) by closed reduction. 6. The average period of the cast immoblization after the open reduction was 8 weeks but the closed reduction was 10 weeks. 7. According to clinical and radioiogical assessment of the result of the treatment, the open reduction was better than closed reduction. 8. The fibular fracture involving lateral malleolus and the diastasis of the distal tibiofibular syndesmosis were very important in ankle stability and were treated by internal fixation for accurate anatomical reduction.
Accidental Falls ; Accidents, Traffic ; Ankle Fractures ; Ankle Joint ; Ankle ; Athletic Injuries ; Classification ; Clinical Study ; Female ; Fractures, Closed ; Humans ; Joints ; Ligaments ; Male ; Methods ; Walking ; Weight-Bearing

A purpose of present study is to provide basic information evaluating the utility of Magnetic Resonance imaging as a biological marker estimating manganese effects to central nervous system among welders, which is conducted by comparing urinary and blood manganese concentrations and signal intensities of brain MR images between exposed group and non-exposed group, evaluating the objectivity of subjective grading estimated by correlations between Pallidal signal intensity index (P. I) and subjective grades among exposed group, and comparing the difference of signal intensities according to presence of neurologic symptoms, signs and exposure variables among the exposed group. The exposed group is composed of 11 welders complaining severe symptoms or showing neurological signs, and the non-exposed group is composed of 5 patients who admitted a hospital. Urinary manganese concentrations and signal intensities in T1-weighted MR images among exposed group were higher than those of the non-exposed group significantly, which exhibits that increased signal intensities in T1-weighted MR image represent the effect of manganese exposure. P. Is among the exposed group revealed relatively high correlations with subjective grades ( gamma =0.63, p=0.037) , which suggests the objectivity of subjective grade. Signal intensity in globus pallidus was a suitable single variable representing the effect of manganese accumulation in C.N.S system appropriately, which was verified as follows ; Increased signal intensities among the exposed group had the highest frequency and intensity in the globus pallidus, and the P.I. had a relatively high correlation coefficient ( gamma 0.62, p=0.044) with total score of subjective grades. Signal intensity with subjective grading in globus pallidus represented very high correlation gamma =0.97, p=0.00) with total score of subjective grades, and had a similar correlation coefficient with many variables. It is hard to argue that signal intensities are markers representing pathologic change in C.N.S system or can be used as a diagnostic tool for manganese intoxication, because signal intensities had no difference between the exposed group and the non-exposed group according to presence of neurological signs.
Biological Markers ; Brain ; Central Nervous System ; Globus Pallidus ; Humans ; Magnetic Resonance Imaging* ; Male* ; Manganese ; Neurologic Manifestations

The prognosis of esophageal cancer is poor and strategies for treatment depend on the tumor stage at the time of diagnosis. Surgery is the main therapeutic modality in esophageal cancer and known as the only treatment for cure. Preoperatively it is most important to assess whether the primary tumor is completely resectable or not. Previous staging modality such as CT can not clearly define the depth of invasion and lymph node metastasis of esophageal cancer which is the most important factor in assessing the possibility of curative resection. Endoscopic ultrasonography is now considered as an useful method in evaluating staging and resectability of esophageal cancer. We compared the findings of endoscopic ultrasonography with pathology result to evaluate the accuracy of this new technique in staging of esophageal cancer in 4 esophageal cancer patients who received surgery among the 23 patients assessed by endoscopic ultrasonography due to esophageal cancer, The depth of invasion, lymph node metastasis, and staging was correct in 3 among 4 patients. We consider endoscopic ultrasonography is an useful technique in staging of esophageal cancer.
Diagnosis ; Endosonography* ; Esophageal Neoplasms* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Pathology ; Prognosis

OBJECTIVE: The study was performed to evaluate whether thallium reinjection (RI) distinguishes viable from nonviable myocardium among myocardial segments which showed persistent perfusion defect (PD) in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: We studied 22 patients underwent PTCA after AMI. SPECT was performed in all patients using dipyridamole stress- 4 hour redistribution (RD) followed by 24 hour RI protocols. Dysfunctional segs were classified into 5 groups: 1) normal, 2) reversible, 3) mild to moderate PD, 4) severe PD and 5) reverse redistribution (RR). All patients underwent follow up echocardiography after 4 months to assess regional wall motion (WM) improvement such as a criteria of viable myocardium. RESULTS: A total of 127 segs with abnormal WM was analyzed. Of 74 segs with PD, 17 (23%) showed enhanced uptake after 24 hour RI. Five of 17 segs (29%) with PD that responded to RI with enhanced thallium uptake showed WM improvement. WM improvement were seen in the 24 of 57 segs (42%) not responding to RI. All four segs (100%) with RR that responded to RI showed improvement. WM improvement were not seen in the 5 of 8 segs (71%) with RR not responding to thallium RI. Eleven (73%) of 15 segs with mild-moderate PD after RI showed improvement, but 33% of segs with severe PD after RI did not showed improvement. Segs with mild-moderate PD after RI and fill in after RI showed improvement in comparison to segs with severe PD after RI(p<0.05). CONCLUSIONS: These data indicate that because only small proportion of PD showed further perfusion improvement after RI and predictive value by the uptake after RI was low, there was limited role of RI after myocardial infarction. Usefulness of RI could be found in segs showing RR responding to RI in AMI reflects viable myocardium.
Dipyridamole ; Echocardiography ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Myocardium ; Perfusion ; Thallium ; Tomography, Emission-Computed, Single-Photon

We herein describe a case of a 55-year-old healthy woman with localized primary thymic amyloidosis presented as a mediastinal mass, found incidentally by chest radiography. Computed tomography revealed a 4.1 cm soft tissue lesion with nodular calcification in the left anterior mediastinum. The resected specimen was a well-defined lobulating mass with calcification. Microscopically, the mass was consisted of amorphous eosinophilc hyalinized substances involving the thymus and intrathymic lymph nodes. These eosinophilic substances showed apple-green bi-refringence under polarized light after staining with Congo red. In immunohistochemical study, they were positive for kappa and lambda light chains and negative for amyloid A. There was no evidence of systemic amyloidosis in clinical investigations. A final diagnosis of localized primary thymic amyloidosis was made.
Amyloid ; Amyloidosis ; Congo Red ; Eosinophils ; Female ; Humans ; Hyalin ; Light ; Lymph Nodes ; Mediastinum ; Middle Aged ; Thorax ; Thymoma ; Thymus Gland

No abstract available.
Rickettsia typhi* ; Rickettsia*